1120 NE 100 St (10)MIAMI SHORES VILLAGE
BUILDING DEPARTMENT 0
305- 795 -2204
ding Inspection Request \,
Bui
Date A
l
Type Insp' n 11 ' J qtytiek\
Approved
Correction
Re- Insp'n Fee
b
Permit No. FAA -5c-)CD
Name { I `v k E 1 Vv V
Address
Company
Phone #
Inspection Date 4-
Miami Shores Village
10050 NE 2nd Avenue
Phone: 305 - 795 -2204
Printed: 5/3/2004
Applicant: DAYNA
Owner: DAVITZ
JOB ADDRESS: 1120 NE 100 ST
Parcel # 1132050190450
Building Permit
Permit Number: BP2004 -566
DAVITZ
DAYNA
Contractor COMPLETE HOME PAINTING Contractor's Address: 1476 NE 130 STREET
Local Phone: 305 - 895 -1368
Page 1 of 1
Legal Description: 5 53 42 MIAMI SHORES SEC 8 REV PB 43 -67 LOT 9 BLK 178 LOT SIZE
Fees: Description Amount
FEE2004 -4453 Building Painting Fee $60.00
FEE2004 -4454 CCF $1.80
FEE2004 -4455 Notary Fee $5.00
FEE2004 -4456 Training and Education Fee $0.60
FEE2004 -4457 Technology Fee $1.50
Total Fees: $68.90
Total Fees: $68.90
Total Receipts: $68.90
Permit Status: APPROVED Permit Expiration: 10/24/2004 Construction Value: $2,365.00
Work: PAINT EXTERIOR OF HOUSE AS AGREED
Signed: (INSPECTOR)
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:
BUILDING
PERMIT APPLICATION
FBC 2001
Permit Type (circle): Electrical Plumbing Mechanical Roofing
' Owner's Name (Fee Simple Titleholder) DAV hl `` A- D AV 1 T Z- Phone # 306 = 151 - j g6
Owner's Address l a 0 E 100 SL
City M I c ■r t St1 r es State F
Tenant/Lessee Name
Qualifier
$ Value of Work For this Permit Z 3 6 3
Total Fee Now Due $ U % Q 1, V. 41 g LI
(Continued on opposite side)
Miami Shores Village i RECEIVED
Building Department 2 7 2fl04
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756,8972
Master Permit No.
Zip 3313
Phone #
Permit No. 0 P2,00 5
)Krob Address (where the work is being done) 1 2 0 me ) 0 0 St
City Miami Shores Village
Is Building Historically Designated YES NO
Contractor's Company Name Ct,s1,/ 7e, / i ione# 003) f f,� - /3kr
Contractor's Address / ' AE /30
City `/I /'j! .-r U, _ State ' Zip f3/3e
County Miami -Dade Zip 33 SS
Architect/Engineer's Name (if applicable) Phone #
Square Footage Of Work:
Type of Work: ❑Addition ❑Alteration ❑New ❑ Repair/Replace ❑ Demolition
Describe Work: „ n
* * * * * * * * * * * * * * * * * * * * * * * * * * ** F ees * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
Submittal Fee $ Permit Fee $ GO.00 CCF $ `- ISO CO /CC
Notary $ 5 .0 () Training/Education Fee $ o Co 0 Technology Fee $ 1 . S 0
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 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 a reinspection fee will be charged.
The foregoing instrument was acknowledged before me this Zr A2 yN
day of i� , 20 , by ai OP U '
who is personally knowfi m r wh has produced
.�t.1.: 1111.11.∎ •11) 1) I_.... 1
NOTARY PUBLIC.'
Sign: ,1�I 1
Print: ( // C • L_ .W ir,N/ y GE---
My Commission Expires:
****************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
APPLICATION APPROVED BY:
Chc 12/15/03
take an oath.
My Commission Expires:
(Certificate of Competency Holder)
State Certificate or Registration No. Certificate of Competency No.
A y .
The foregoing instrument was acknowledged before me this
day of , 20_, by
who is personally known to me or who has produced
as identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
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************************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
pPR 2 7 2004
Plans Examiner
Engineer
Zoning
Date
Drip Cap /drip Edge /'T e — /2- /
Soffit 17-
Roof /
Flower bins W/ "
Shutters NC " /2r
Awnings /(//it
Chimney A' / fr,
Doors and door jams / - / y
FP'
Garage doors /P'
Railings A0/
Fences w/e
Miami Shores Village
-Paint Color Approval and Agreement
V Owner's DoNy D U v 1 6 Phone # 3 -16
> \ 1 a 0 N-G 10 ,S(.
Owner's Ad Zip 3313`
cit IA a yy. ► S P - State
o b Address (where the work is being done) 1\2-0 1I t✓ i o o S-6
City Miami Shores Village at e County Miami-Dade Zip 3313
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 //C — V g ~
Fascia /Sd
Decorative metal A. /
All brick (simulated or regular) // /f
Stucco banding „ co (o r a
Any other stucco features if// i f
Accessory Buildings ca�2 4 C
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:
P& Z Official
Date
vvan ivumners
Li-1.231o+
Date ?ill �' -/
chc 6/18/03
* **