PAINTMiami Shores Village
BUILDING
PERMIT APPLICATION
FBC 2001
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
Permit Type (circle): Building Electrical Plumbing Mechanical
Owner's Name (Fee Simple Titleholder)
Owner's Address q d et . ?r
Cit X t auti L Sga/W State / L
Tenant/Lessee Name
Job Address (where the work is being done)
City Miami Shores Village County Miami -Dade
Is Building Historically Designated YES NO X
Permit No.
Master Permit No.
Zip 3 &3F
Phone #
8paoa y zy
Roofing
Phone # 3 5 7S 71 65
Zip
Contractor's Company Name Phone #
Contractor's Address
City State Zip
Qualifier
Architect/Engineer's Name (if applicable) Phone #
$ Value of Work For this Permit
Type of Work:
Describe Work:
• C.C.
Submittal Fee $ ,�Q Permit Fee $
5,r
Scanning $ ' Radon $
Code Enforcement $ Structural Plan Review. $
Total Fee Now Due $41 1 3
(Continued on opposite side)
❑ Demolition
Square Footage Of Work: 2v o a
❑ Ad tion ❑Alteration ❑New ❑ Repair/Replace
Pg A'T o
* * * * * * * * * * * * * * * * * * * * * * * * * * ** F ees * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
0 CCF $ ' a CO /CC
Technology Fee $
Zoning Bond $
Training/Education Fee $ 4 .
Bonding Company's Name (if applicable)
Bonding Company's Address
City State Zip
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
City State Zip
Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has
commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating
construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS,
WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC.....
OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all
applicable laws regulating construction and zoning.
"WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR
PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING,
CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
COMMENCEMENT."
Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the
inspection will not be approved and c, rei section fee will be charged.
I/
1�
Signature
Owner (il Agent
The foregoing instrument was acknowledged before me this
day of
who is personally known to me or who has produced
�1 Pyoo y6Sf3 3111•D As identification and who did take an oath.
20 ey , by , day of , 20 by
who is personally known to me or who has produced
as identification and who did take an oath.
NOTARY P I : IC: NOTARY PUBLIC:
Sign: �/� Sign:
Print: Print:
My Conunission Expires: ��:• Vii`, `)
(Certificate of Competency Holder)
State Certificate or Registration No. Certificate of Competency No.
*********. k***************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** '************** * * * * * * * * * * * * * * * * * * * * * * ** * * * * * **
IAN 14 2004
APPLICATION APPROVED BY:
Chc 12/15/03
Signature
Contractor
The foregoing instrument was acknowledged before me this
My Conunission Expires:
/7/ (07
Plans Examiner
Engineer
Zoning
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
BUILDING Permit No. BP2W y-z f
PERMIT APPLICATION - :` Master Permit No
FBC 2001
Permit Type (circle):
Owner's Name (Fee Simple Titleholder)
Owner's Address q0 " t /U £
City U` taloit L S /ja State
Tenant/Lessee Name
Job Address (where the work is being done)
City Mfiami Shores Village
Is Building Historically Designated YES
Qualifier
$ Value of Work For this Permit
Type of Work: ❑Ad Won ti i
Describe Work: � ikNT
Total Fee Now Due $
(Continued on opposite side)
Miami Shores Village
Building Department
Building Electrical
2n Co
3 6,5 G.
QY f -
cW L44,
NO
Plumbing
c..
Zip
Phone #
3 313d'
Phone #
❑ Alteration ❑New ❑ Repair/Replace
Es s itof t rd Go/Z
REC.. C OVIED
jr A 20
Mechanical Roofing
3o,5 75-1 65F
County Miami -Dade Zip
Contractor's Company Name Phone #
Contractor's Address
City
State Zip
Architect/Engineer's Name (if applicable) Phone #
Square Footage Of Work: 2C '
'Demolition
•
CC. CCF $ CO /CC
Submittal Fee S a Permit Fee $
Notary $5" Training/Education Fee S Technology Fee $
Scanning 5 ` Radon $ Zoning Bond $
Code Enforcement $ Structural Plan Review. $
Miami Shores Village
10050 NE 2nd Avenue
Printed: 1/15/2004
Applicant: CARMEN DOLL
Owner: DOLL CARMEN
JOB ADDRESS: 909 NE 99 ST
Contractor
Local Phone:
Parcel # 1132060340230
Permit Status:
Work: CLEAN AND PAINT ROOF WHITE
Signed: (INSPECTOR)
Building Permit
Phone: 305-795-2204 Permit Number: BP2004 -24
Contractor's Address:
Legal Description: MIAMI SHORES SEC 8 PB 14 - 33 LOTS 13 & 14 BLK 170 LOT SIZE 106.600 X
Fees: Description Amount
FEE2004 -469 Building Painting Fee $60.00
FEE2004 -470 CCF $0.60
FEE2004 -471 Notary Fee $5.00
FEE2004 -472 Training and Education Fee $0.20
FEE2004 -474 Technology Fee $1.50
Total Fees: $67.30
Total Fees: $
Total Receipt
cJ V? . 3 a
7 sPa
too
Permit Expiration: 7/7/2004 Construction Value: $200.00
Page 1 of 1
In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict
conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responisibility for all work
done by either myself, my agent, servants or employes.
Signed: (Contractor or Builder) BY:
Miami Shores Village
BUILDING
PERMIT APPLICATION
FBC 2001
Job Address (where the work is being done) �
City Miami Shores Village County Miami -Dade
Is Building Historically Designated YES NO X
$ Value of Work For this Permit 2"
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
Permit No.
Master Permit No.
Owner's Address go 0 1 4J E- Y
City 41 0/44 L State �t- Zip
Tenant/Lessee Name Phone #
Architect/Engineer's Name (if applicable) Phone #
Scanning $ Radon $ Zoning Bond $
Code Enforcement $ Structural Plan Review. $
Total Fee Now Due $ I } 3 v
(Continued on opposite side)
Square Footage Of Work: 2
81'.2oa9 zy
Permit Type (circle) :. Building 1 Electrical ( Plumbing Mechanical Roofing
J
Owner's Name (Fee Simple Titleholder) t le " v d L Phone # l ¶ 7S1 65 5
Zip
Contractor's Company Name Phone #
Contractor's Address
City State Zip
Qualifier
Type of Work: ❑Ad ition ❑Alteration ENew ❑ Repair/Replace ❑ Demolition
Describe Work: v / (NT eo 0 (- S jvW „It -- 1,v kt,71
* * * * * * * * * * * * * * * * * * * * * * * * * * ** F ees * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
C.C. /
Submittal Fee $ , 54 Permit Fee $ , 0 CCF $ p a CO /CC
Notary $,S Training/Education Fee $ o 'D Technology Fee $ j . S_(7)%
Bonding Company's Name (if applicable)
Bonding Company's Address
City State Zip
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
City State Zip
Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has
commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating
construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS,
WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC
OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all
applicable laws regulating construction and zoning.
"WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR
PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING,
CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
COMMENCEMENT."
/Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the
inspection will not be approved and c re i .ection fee will be charged.
Signature
Owner Agent Contractor
The foregoing instrument was acknowledged before me this The foregoing instnunent was acknowledged before me this
Signature
day of
20 0'j, by day of , 20 _, by
who is personally known to me or who has produced who is personally known to me or who has produced
fl 1. Dooy6SJ"33z /.f As identification and who did take an oath. as identification and who did take an oath.
NOTARY P d : 1C: NOTARY PUBLIC:
Sign: Sign:
Print:
My Commission Expires: A;-"dic.
F. L`
(Certificate of Competency Holder)
State Certificate or Registration No. Certificate of Competency No.
APPLICATION APPROVED BY:
Chc 12/15/03
Print:
My Conunission Expires:
*************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** ************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
///
JAN 14 2MQit
Plans Examiner
Engineer
Zoning
Miami Shores Village
in De artment I RCEOVED
Building p
10050 N.E.2nd Avenue, Miami Shores, Florida 33138 } JAM 0 9 201
Tel: (305) 795.2204 Fax: (305) 756.8972
BUILDING Permit No. ,$ADD f -z'f
PERMIT APPLICATION Master Permit No
FBC 2001
Permit Type (circle): Building Electrical Plumbing Mechanical Roofing
J'tI " 66 G L. 3 5 7Pt 3 65
Owner's Name (Fee Simple Titleholder) Phone #
Owner's Address q0"1_ 4) C. ? `( ¢/
City 1M 114 L I/A4S State r L Zip 3 313d"
Tenant/Lessee Name Phone #
Job Address (where the work is being done) 5 4 `
City Miami Shores Village County Miami Dade Zip
Is Building Historically Designated YES NO
Contractor's Company Name Phone #
Contractor's Address
City State
Qualifier
Zip
Architect/Engineer's Name (if applicable) Phone #
$ Value of Work For this Permit 2" a
(Continued on opposite side)
Square Footage Of Work:
°
Type of Work: ❑AdOition ❑Alterati ['New ❑ Repair/Replace II Demolition
Describe Work: . v PJQWT �o Sed�4 6 (d 1.1 ^ W LIT.-
* * * * * * * * * * * * * * * * * * * * * * * * * * ** F * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
C.C. CCF $ CO /CC
Submittal Fee $ ,52 Permit Fee $
Notary SS"' Training/Education Fee $ Technology Fee $
Scanning $ ' Radon $ Zoning. Bond $
Code Enforcement $ Structural Plan Review. $
Total Fee Now Due $
Miami Shores Village
10050 NE 2nd Avenue
Building Permit
Phone: 305-795-2204 Permit Number: BP2004 -24
Printed: 1/15/2004
Applicant: CARMEN DOLL
Owner: DOLL CARMEN
JOB ADDRESS: 909 NE 99 ST
Contractor
Local Phone:
Parcel # 1132060340230
Permit Status:
Work: CLEAN AND PAINT ROOF WHITE
Signed:
Permit Expiration: 7/7/2004 Construction Value: $200.00
(INSPECTOR)
Contractor's Address:
Page 1 of 1
Legal Description: MIAMI SHORES SEC 8 PB 14 -33 LOTS 13 & 14 BLK 170 LOT SIZE 106.600 X
Fees: Description Amount
FEE2004 -469 Building Painting Fee $60.00
FEE2004 -470 CCF $0.60
FEE2004 -471 Notary Fee $5.00
FEE2004 -472 Training and Education Fee $0.20
FEE2004 -474 Technology Fee $1.50
Total Fees: $67.30
Total Fees: $
Total Receipt
c2 V) ,3 a
7 a
o.00
In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict
conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responisibility for all work
done by either myself, my agent, servants or employes.
Signed: (Contractor or Builder) BY:
•
l
!' Z
l
BUILDING
ELECTRICAL
PLUMBING
ROOFING
Owner of
Building `
MIAMI SHORES VILLAGE. FLORIDA 3
❑
PERMIT N? DATE
❑ 6'7 �1R �' Con rs
t
, e ..
t 44,E e
❑ Work to be performed under this Permit ` ,
Architect
Contractor
or Builder ' r ` t , -` N r
Legal Lot 1 I Subdi-
Description — I Bl vision
r
Address of "`
`� y Value of,
Building ' Project $ �
i
This permit is granted to the contractor or builder named above to construct the building or to install the equipiment or device described in the application
herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will bp performed in compliance with any plans
drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any
time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is
granted is the understanding that the contractor or builder named above assumes the respons' ility for a thorough khowiedge of the ordinances and regulations
pertaining to the work covered hereby whether shown on the plans or drawings or in the s tements or specifi tions and that he assumes responsibility for work
done by his agents, servants or employees. f
Signed t ` .* BY+.
INSPECTOR
Amount of —
Permit $
L
195
In consideration of the issuance to me of this permit I agree to perform the work covere hereunder in compliance with all ordinances and regulations
pertaining thereto and in strict conformity with the plans, drawings, statements or specifications bmitted to the proper authorities of Miami Shores Village. In ac-
cepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee.
_,..
• _ . ,.. L ,
CONTRACTOR OR BUILDER BY AUTHORITY
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date i 20 Job Address 70? N£ 7 7 f r Tax Folio
Legal Description Historically Designated: Yes No
Owner/Lessee / Tenant 0 4// t/ D O G L a R V ('✓ L L Master Permit #
Owners Address 1 l 2 v £ G rr Phone 7 5 `l 965
Contracting Co. U., g Address
Qualifier SS# Phone
State # Municipal # Competency # Ins. Co.
Architect/Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
A/yr Ho(/St — lt/ 4cTL l(/4-1%l
WORK DESCRIPTION �I
12 0 a u/k 111 6 4J4 i/ L
Square Ft. Estimated Cost (value)
WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY
RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTEND TO OBTAIN FINANCING,
CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.)
Application is hereby made to obtain a permit to do work and installation as indicated above, and on the attached addendum (if applicable). I
certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate
permits are required for ELECTRICAL, PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK.
OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable
laws regulating construction and zoning. Furthermore, I authorize the above -named contract r to do the wok stated.
Signature of owner and/or Condo President Date
FEES: PERMIT RADON
Signature '' Contractor or Owner- Builder
Notary as to Owner and/or Condo President Date Notary as to Contractor or Owner - Builder
My Commission Expires: My Commission Expires:
�,11Y 1 11, E
sz'm Carmen Doll
s*: ';* MY COMMISSION N CC582528 EXPIRES
.°1 September 5, 2000
BONDED THRU TROY FAIN INSURANCE, INC.
C.C.F. r / NOTARY BOND
// c
Date
/ht
Date
APPROVED:
Zoning Building 1141/114 Electrical
Mechanical Plumbing Engineering