PAINT PERMITBUILDING
PERMIT APPLICATION
FBC 2001
Miami Shores Village
uilding Department
Permit No. ( C 4503 '
Master Permit No.
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
Permit Type (circle): Building Electrical Plumbing Mechanical Roofing ( �
Owner's Name (Fee Simple Titleholder) /Czt6�icN i Phone # 6E4 3 9 -c 4 (` T
Owner's Address l ! e5 N. e • /&/ s/
City / /q7f/ sH -S' State �� Zip 33/21
Tenant/Lessee Name /() // Phone # // //9 •
Job Address (where the work is being done) /1(5 • /0/
City Miami Shores Village County Miami -Dade Zip 33/3F
Is Building Historically Designated YES NO
Contractor's Company Name /J J � ' Phone #
Contractor's Address
City State Zip
Qualifier
Architect/Engineer's Name (if applicable) - Phone #
Architect/Engineer's Address
City ''. State Zip
� u
$ Value of Work For this Permit t 143 - D
Number of: Bays Stories / Families Bedrooms Baths
Type of Work: ❑Addition t.Alteration . ONew ❑ Repair/Replace ❑ Demolition
Describe Work: /P.-/- /°,4/ 1 E - r 7e40/C___
Square Footage Of Work:
* * * * * * * * * * * * * * * * * * * * * * * * * * ** F ees * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
County Escrow Fee $ , b 0 Permit Fee $ • CCD Notary $ S • CO
Education/Training Fee $ Tech $ Scanning $ Radon $
Code Enforcement $ Bond $ Struct. $
Minus Plans Check Fee $ Total Fee Now Due $ OS tulip (Continued on opposite side)
Bonding Company's Name (if applicable) i0/ /T
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.
Signature Signature
Owner or Agent
The foregoing instrument was acknowledged before me this ?i9
day of Sefrr , 20 03 , by
who is personally known to me or who his produced . .who is personally knovvn to me or who has produced
As identification disktakeiothikartg 194 as identification and who did take an oath.
Bonded Thru
lb
p • t. Ammo. LA/ A
'''' Atlantic Bonding Co., Inc.
M — r
My Commission Expires:
My Commission Expires:
Contractor
The foregoing instrument was acknowledged before me this
reei M • TrunIr , day of , 20 _, by
(Certificate of Competency Holder)
State Certificate or Registration No. Certificate of Competency No.
************** 1 k******************** * * * * * * **** *s. * * * *• *** * *s *sss *s ***** s** • *ss * *.s * * * * * **** * * ** * ** * * *****
APPLICATION APPROVED BY:
chc7/7 /03
3
Plans Examiner
Engineer
Zoning
MIAMI SHORES VILLAGE
Paint Color Approval and Agreement
DATE: . �. —0 o2y
OWNER'S NAME: ! . Ji J7 PHO D '�
ADDRESS: //g5 /6. (0/ , S /m )2/ SSe liqS j
********************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
ADDRESS OF SITE: // $5 NE. /0 / S 144/1 fill S& Te._ 23/3F
CONTRACTOR & LICENSE (if applicable) N/&
COMP ANY NAME: A /A- PHONE:
********************************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** 6�
All Elements on the site must be listed and indicate,the color to bq painted. b
e ? (.r -aw /30 J 0 c�
Walls 0)
Fascia Pa:fA -o /6MJ
Drip Cap/Drip Edge N /r+
2 Soffit 4
\ Roof f.
Co ower Bins /✓,p
Shutters 40'
Awnings NO
Chimney / -Cee9e-/A
Doors and door jams Riteo /37(_Oc J,u
Garage Doors t .)/f/T
Railings /1//4
Fences /Li
Decorative Metal /C( e, ,34
All brick (simulated or regular) ,d /I
Stucco Banding f KozAJ % cL 7AJ
Any other stucco features Pdifi
Accesso Buildings kii � G� m n 2161-40
Other �r }may
o
T
c
o i
BENJ M 2161
COLORPREVIEW'" L V
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. I authorize the above -named contractor, if applicable, to
do the work stated. Furthermore . , the paint colors will be as per the attached
samples./ a . .
Si:" ature of Owner ate Signature of Contractor Date
*********************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
WHEN PAINTING IS FINISHED,
CALL FOR FINAL INSPECTION
Buildin g Official Date r 7 /ee.ye5J 4/23/01
APPROVED:
i
/� /ki E
MIAMI SHORES VILLAGE
Paint Color Approval and Agreement
DATE: /O
OWNER'S NAME: l �7 _� PHONE : v��v
ADDRESS: S l Atir Giii �s�j J
********************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
ADDRESS OF SITE: x/27
CONTRACTOR & LICENSE (if applicable)
COMPANY NAME:
********************************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
All Elements on the site must be listed and indicate the color to be painted.
Walls O
Fascia , d t/ 2
Drip Cap/Drip Edge
Soffit ,etc/ m1i 4' i69c
Roof
Flower Bins ,.04.
Shutters t✓ /,
Awnings ,U /j
Chimney ocii S
Doors and door J jams %
Garage Doors w% 7�
Railings ti /P-
Fences N //�-
Decorative Metal / `,
All brick (simulated or regular) N /A-
Stucco Banding /2 /C/ino".0 63
Any other stucco features ,v /,4 .
Accessory Buildings .
Other /Z Sc)re-Lf )A-d
OWNER'S AFFIDAVIT: I certify that all the foregoin,
and that all work will be done in compliance with all apj
construction and zoning. I authorize the above -named c
do the work stated. rthermore , the paint colors will IN
s pies.
to l
Signature of Owner Date • Signature of Contractor Date
*********************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
APPROVED: WHEN PAINTING IS FINISHED,
CALL FOR FINAL INSPECTION
/470
PHONE:
SZ Pad
a6evJaH
96
n'
3
O
BENJAMIN MOORE®
COLORPREVIEW' HC
Building Officia Date v /69teesi 4/23/01
el
8Z
Miami Shores Village
10050 NE 2nd Avenue
Building Permit
Phone: 305 - 795 -2204 Permit Number: BP2003 -1563
Printed: 10 /6/2003
Applicant: RUBEN FUENTES
Owner: FUENTES RUBEN
JOB ADDRESS: 1185 NE 101 ST
Contractor
Local Phone:
Parcel # 1132050190110
Contractor's Address:
Legal Description: 5 53 42 MIAMI SHORES SEC 8 REV PB 43 - 67 LOT 1 BLK 176 LOT SIZE
Fees: Description Amount
FEE2003 -5809 Building Fee $60.00
FEE2003 -5810 Notary Fee $5.00
FEE2003 -5811 CCF $0.60
Total Fees: $65.60
Total Fees: $65.60
Total Receipts: $65.60
Permit Status: APPROVED Permit Expiration: 3/27/2004 Construction Value: $150.00
Work: PAINT EXTERIOR OF HOUSE
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: (INSPECTOR)
Page 1 of 1
Signed: (Contractor or Builder) BY: