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1254 NE 100 St (6)MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request m Date Th4 Type Insp'n k?f Permit No. (0 �• Name M12 2 55 1CL Address j 23L1 5\S t Ov Company Phone # Inspection Date Approved Correction ❑ Re- Insp'n Fee ❑ Contractor's Company Name C � /e—/c � � Contractor's Address / 5 /1/, '4 City� 11"1/ State l Qualifier 2/4( e�G $ Value of Work For this Permit Submittal Fee$ Notary $ Training/Education Fee $ Scanning $ � Radon $ Code Enforcement $ Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (3 95.2204 Fax: (305) 756.8972 BUILDING VIE C PERMIT APPLICATION ~ d R 0114 FBC 2001 / Permit Type (circle): Building Electrical U Plumbing Mechanical Owner's Name (Fee Simple Titleholder) ,./ Ott Ceas/ Phone # (30S3 759' 931' Owner's Address / 2 5 7 /1/ /0 a Of City 14/ W4// 14/ 109,1 State / • Zip .;3 /9 cf Tenant/Lessee Name Job Address (where the work is being done) C Q'.f S / City Miami Shores Village e Is Building Historically Designated YES NO ✓ Permit No. /30000.0g--A aster Permit No. Phone # Zip 3/.3 [1 #(6 — ora 4P Phone #( or Zip 33 /t(/ State Certificate or Registration No. Certificate of Competency No. Architect/Engineer's Name (if applicable) Phone # Type of Work: EAddition ❑Alteration New Describe Work: /1 Structural Plan Review. $ Total Fee Now Due $ &e. C . 44 ?)GS (Continued on opposite side) Square Footage Of Work: P te J ea Le /0 6 l , * * * * * * * * * * * * * * * * * * * ** * * ** Feed * * * * * * ** * * * * * * * * * * * * * * * * * * * ** ' Permit Fee $ 0 Q � � " CCF $ ❑ Repair/Replace ❑ Demolition Technology Fee $ /, 6 Z ° Zoning Bond $ CO /CC Roofing Bonding Company's Name (if applicable) Bonding Company's Address tea . City State Zip Mortgage Lender's Name (if applicable) Mortgage Lender's Address W City State Zip Application is hereby made to obtain a pennit 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 Hurst 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 sire 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. Owner or Agent The foregoing instrument was acknowledged before me this 7 The fore ing instrument was acknowledged before me tlus( day of A r= 200____y, , by .J c oJJ l , day of ) ( , 2161 , by who is personally to me or wiio has produced who is personally k oivn to me or who has produced at; identification and who did take an oath. Signature P Y P As identification and who did take an oath. NOTARY PUBLIC: Sign: �t _�/ Print: /�i e 4 9' . My Commission Expires: * * * * * * * * * * * * * * * * * * * * ** APPLICATION APPROVED BY: * ************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Chc 05 /13/03 Signature * * * * * * ** NOTARY PUBLIC: Sign: Print: 11 10, 2006 Bonded Thin My Commission Expires: Contractor t , * * * * * * * * * ** ************ * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Plans Examiner Engineer Zoning Date Miami Shores Village • " Paint Color Approval and Agreement Owner's Name \_..) Owner's Address City MI 4// f 1,40 Walls Signature Job Address (where the work is being done) City Miami Shores Village Is Building Historically Designated YES Contractor's Company Name (if applicable) Phone # ***************************************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** All elements on the site must be listed and indicate the color to be painted g ' # 2, B � — 9e l Fascia /2/0 /�'O f�F % 7 'e �c-. J Drip Cap /drip Edge ir� l Soffit en/ ^ 9 Q Roof Flower bins /t Shutters `" / if Awnings Ao Chimney ti Doors and door jams !'7 ) htC. 4 Garage doors S-22_ Railings Fences Decorative metal Stucco banding Any other stucco features Accessory Buildings NE /eV ft State fe • ` 4 *7 6.t APPLICATION APPROVED BY: All brick (simulated or regular) 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. Owner or Agent County Miami-Dade Zip 33/ 3 c NO Zip Phone 3 D T) %3 9 v 3 33I3( .. __........,ucr Date / 2/7/4 [� Date / 2 4 chc 6/18/03 Miami Shores Village 10050 NE 2nd Avenue Printed: 12/13 /2004 Applicant: BARBARA MESSICK Owner: MESSICK BARBARA JOB ADDRESS: 1254 NE 100 ST Parcel # 1132050090040 Building Permit Phone: 305- 795 -2204 Permit Number: BP2004 -1606 Contractor COMPLETE HOME PAINTING Contractor's Address: 1476 NE 130 STREET Local Phone: 305 - 895 -1368 Legal Description: EARLETON SHORES PB 43 -80 LOT 4 Page 1 of 1 BLK 1 LOT SIZE 75.000 X 109 Fees: Description Amount FEE2004 -12274 Building Painting Fee $60.00 FEE2004 -12470 CCF $1.80 FEE2004 -12471 Notary Fee $5.00 FEE2004 -12472 Training and Education Fee $0.60 FEE2004 -12473 Technology Fee $1.50 Total Fees: $68.90 Total Fees: $68.90 Total Receipts: $68.90 Permit Status: APPROVED Permit Expiration: 6/6/2005 Construction Value: $2,400.00 Work: PAINT HOUSE EXTERIOR 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: Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Printed: 12/13/2004 Applicant: BARBARA Owner: MESSICK JOB ADDRESS: 1254 Contractor COMPLETE HOME PAINTING Local Phone: 305 - 895 - 1368 Parcel # 1132050090040 NE 100 Signed: (INSPECTOR) Signed: (Contractor or Builder) Building Permit Permit Number: BP2004 -1606 MESSICK BARBARA ST Contractor's Address: 1476 NE 130 STREET Legal Description: EARLETON SHORES PB 43 -80 LOT 4 Fees: FEE2004 -12274 FEE2004 -12470 FEE2004 -12471 FEE2004 -12472 FEE2004 -12473 Description Building Painting Fee CCF Notary Fee Training and Education Fee Technology Fee Total Fees: Amount $60.00 $1.80 $5.00 $0.60 $1.50 $68.90 Total Fees: $68.90 Total Receipts: $68.90 Permit Status: APPROVED Permit Expiration: 6/6/2005 Construction Value: $2,400.00 Work: PAINT HOUSE EXTERIOR BY: Page 1 of 1 BLK 1 LOT SIZE 75.000 X 109 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. Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Printed: 12/13/2004 Applicant: BARBARA Owner: MESSICK JOB ADDRESS: 1254 Contractor COMPLETE HOME PAINTING Local Phone: 305 - 895 - 1368 Parcel # 1132050090040 NE 100 Signed: (INSPECTOR) Signed: Building Permit Permit Number: BP2004 -1606 MESSICK BARBARA ST Contractor's Address: 1476 NE 130 STREET Legal Description: EARLETON SHORES PB 43 -80 LOT 4 Fees: FEE2004 -12274 FEE2004 -12470 FEE2004 -12471 FEE2004 -12472 FEE2004 -12473 Description Building Painting Fee CCF Notary Fee Training and Education Fee Technology Fee Total Fees: Amount $60.00 $1.80 $5.00 $0.60 $1.50 $68.90 Total Fees: $68.90 Total Receipts: $68.90 Permit Status: APPROVED Permit Expiration: 6/6/2005 Construction Value: $2,400.00 Work: PAINT HOUSE EXTERIOR Page 1 of 1 BLK 1 LOT SIZE 75.000 X 109 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. (Contractor or Builder) BY: PERMIT APPLICATION FOR MIAMI SHORES VILLAGE / /I/ Job Address /6 ` Tax Folio Date Legal Description Owner/Lescee / Ten // an Owner's Address / Contracting Co /rI. i 1�,'/.r"I Address ff97 A . Qualifier 1 ' ter/ ' / State # Municipal "z465 Competency # ae.) Ins. Co. Architect/Engineer Address Bonding Company Address Mortgagor Address Permit Type (circle one): BUILDING PLUMBING l ELECTRICAL / MBING MECHANICAL ROOFING OFING PAVING FENCE SIGN WORK DESCRIPTION �,� Gc�,n�Or..� � l�f7i �`G� , Jif`CSS c.� � � C ,��A. -) f f Square Ft. Estimated Cost (value) Zxr) 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 pennit 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 contractor to do the work stated. FEES: PERMIT tary as to Owner and/or Condo President tt"it Commission Expires: RADON SUSAN COLON My Ct —.im Exp. 10/21/2002 No. CC 784974 f 1 Kerssn:ty Kra. -�+ f 1 other I.D. APPROVED: Zoning Mechanical Plumbing Structural Engineer O Building ' Historically Designated: Yes No Master Permit # Phone SS# , (A'jj otary as to Contractor or Owner- Builder My Commission Expires: SUSAN COLON My Cc.,tm Fxp. 10/21/2002 No. CC 784974 f 1 °aw,:ty Mown f 1 Other 1.0. C.C.F. NOTARY •— BOND Electrical TOTAL DUE Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of the work. Date ��/ Owner's Name and Address Q /� / o R e L`' ` /74 ./.2••• )o2 ' �� `� Street Registered Architect and /or Engineer Name and address of licensed contractor STATE OF FLORIDA COUNTY OF DADE. J SS. MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Location and le al description of lot to be built on: n q Lot Block / Subdivision �� "- P� /I . q� Z€ ,/ e 7 .6 '� -7--- Street and Number where work is to be done f Q`4 / " A14 1 a , s J J }- Sta k to be done an� d se of building Iby floors), state exterior colors (submit samples) � CK e P 1,0 A / T / AI xi New Building Remodeling Addition To be constructed of / Kind of foundation Estimated Total cost of improvements $ / 0 7 0 . 0 0 Amount of 1 Zone cubage required r Plan Cubag Distance to next nearest building Size of Bui 1 /A Maximum live load to be borne by each floor I hereby submit all plans and specifications for said building. All notices with reference to the building and its construction may be sent to The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligatons as an employer of Labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Supplement, and has complied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees employ only such subcontractors. on work to be performed under this permit, as are licensed by Miami Shores Village. /- Before Remarks (Signed) ` me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known. and who. being by me first duly sworn. upon oath deposes and says that he is the of the above described construction. that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. ti Permit No. " 1 1 Date 4 Read, Sworn to and Subscribed before me. Disapproved (Signed) Building Inspector Date 624 Nn. of Stories Notary Public. State of Florida 19 and for no other purpose. My Commission Expires PLANNING BOARD DATE Chairman Member Member Member Member Member Council Approved 1 ate Disapproved Date NOTE: A charge of $25.00 will be made for making corrections or changes to this application after approval has been obtained from the Planning Board. A re- inspection fee of $25.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and /or workmanship. `,,