BP-04-944Miami Shores Village
10050 NE 2nd Avenue
Phone: 305 - 795 -2204
Printed: 7/16/2004
Applicant: ANN
Owner: WATERS
JOB ADDRESS: 126
Contractor
Local Phone:
Parcel # 1131010260070
NW 98
Signed: (INSPECTOR)
Building Permit
Permit Number: BP2004 -944
WATERS
ANN
ST
Contractor's Address:
Legal Description: RESUB OF BLK 2 OF BONMAR PARK
Page 1 of 1
Fees: Description Amount
FEE2004 -6963 Building Painting Fee $60.00
FEE2004 -6964 Notary Fee $5.00
FEE2004 -6965 CCF $0.60
FEE2004 -6966 Technology Fee $1.50
FEE2004 -6967 Training and Education Fee $0.20
Total Fees: $67.30
Total Fees: $67.30
Total Receipts: $67.30
Permit Status: APPROVED Permit Expiration: 1/9/2005 Construction Value: $300.00
Work: PAINT
PB 42 -59 LOT 7 BLK 2
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:
Contractor's Company Name
Contractors Address ®
City iith4 1
Qualifier
Owner's Address
City
Tenant/Lessee Name
BUILDING
PERMIT APPLICATION
FBC 2001
Permit Type (circle):
^
Owner's Name (Fee Simple Titleho ld er ) fri%J #4 U)I4Js Phone #
Zip 55/50
Job Address (where the work is being done)
City Miami Shores Village
Is Building Historically Designated YES
$ Value of Work For this Permit 3W
FA A-
Total Fee Now Due $ ( l' ' ! - 3 0
(Continued on opposite side)
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
Electrical
ouzitio7e.
Master Permit No.
Plumbing Mechanical
Phone #
1i4 NW 9P 5 T-
-§ECEOVED
1 3 "nrt
Submittal Fee P $ Permit Fee $ 00-00 CCF $ (00 CO /CC
Notary $ s Training/Education Fee $ • 2.0 Technology Fee $ ` - S 0
od Qo A • �
Permit No. SP0L1 got)
Roofmg
County Miamipade Zip
NO
i algg-- 2-466
State Certificate or Registration No. Certificate of Competency No.
Architect/Engineer's Name (if applicable) Phone #
Square Footage Of Work:
Type of Work: ['Addition
'Dire ❑New [1 Repair/Replace ['Demolition Describe Work:
Scanning $ Radon $ Zoning Bond $
Code Enforcement $ Structural Plan. Review. $
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 FT,F.CTRICAL WORK, PLUMBING, SIGNS,
WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDMONERS, 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 a reinspection fee will be charged.
Signature
Contractor
r Q �,� , 1 4 The foregoing instrument was acknowledged before me this
day of \U) 20 Oil by Ann &( day of ,20 ,by
wh is p-rsonal L ly known to me or who has produced T . who is personally known to me or who has produced
Ug All As an oath. as identification and who did take an oath.
2• - � Commission #DD231984
NOTARY P" : IC: °- Ex i ires: Jul 13, 2007 NOTARY PUBLIC:
Sign: / :.d2 -. l�,. :�.n . R � Sign:
Print: ��,. c.�i�►�i► - Print:
My Commission Expires:
Owner or Agent
The foregoing instrument was acknowledged before me this i 3
APPLICATION APPROVED BY:
Cho 05/13/03
My Commission Expires:
********************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** ********************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
71)W
JUL 14 2004
Plans Examiner
Engineer
Zoning
Date
tom
Owner's Address p I (, /1 U `z er sr
City • 510^ state
Owner's Name
Job Address (where the work is being done) aeo Al GV 9 E
City Miami Shores Village County Miami -Dade Zip
Is Building Historically Designated YES NO
Contractor's Company Name (if applicable) Phone #
************ * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** ********************************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *.
All elements on the site must be listed and indicate the color to be painted
Walls
Fascia Gfhto
Miami Shores Village
Paint Color Approval and Agreement
Drip Cap /drip Edge
Soffit
Roof
Flower bins
Shutters
Awnings
Chimney
Doors and door jams
Garage doors
Railings myskiA.,
Fences
Decorative metal
All brick (simulated or regular) L� f -4.A0
Signature (.;:jyz.,ic.)
Stucco banding
Any other stucco features /Gv
Accessory Buildings
Other
************************************************************************************************************
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.
APPLICATION APPROVED BY:
Owner or Agent
Phone # Oi06
Zip 3 j
Date
Date 7 7
chc 6/18/03