166 NE 101 St (9)Type Insp'n
Permit No.
Address
Phone #
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
Buil.ing Inspection Request
Parn
PPou — / 115 .
Name VI
KO r 1 01 &-
Company °w W2 v
Date
Inspection Date
pp rov d .----
Correction
Re- Insp'n Fee
(SY
Permit Type (circle):
Contractor's Company Name
Contractor's Address
Miami Shores Village
ATCE E : ilding Department
s zooOOSi, N.E.2nd Avenue, Miami Shores, Florida 33138
el: (305) 795.2204 Fax: (305) 756.8972
BUILDN
PERMIT APPLICATION
FBC 2001
Owner's Name (Fee Simple Titleholder) /4 LCG X JIZ • • Phone # & `770 — G2q13
Owner's Address /64 / /0/
City/f i4 yy( gtVec State 12
Tenant/Lessee Name _ ' q1i€ F. !f j & Phone #
Job Address (where the work is being done) /t/p 1 ' /1.):, (0(
City Miami Shores Village County
is Building Historically Designated YES NO
Miami -Dade
Permit No.F)T 0 41 )1 1 c
Master Permit No.
Electrical Plumbing Mechanical Roofing
Zip 33 le?
Phone #
Zip 3 /
City State Zip
Qualifier
State Certificate or Registration No. Certificate of Competency No.
Architect/Engineer's Name (if applicable) Phone #
$ Value of Work For this Permit
Total Fee Now Due $ ( j '7 r 3 55" fo
(Continued on opposite side)
Square Footage Of Work:
Type of Work: ❑Addition ['Alteration ❑N Repair/Replace 0 Demolition
- PI
Describe Work: /` /V 7 ?N( Of ^ 1-Ion,
* * * * * * * * * * * * * * * * * * * * * * * * * * ** F ees * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
a b /
Submittal Fee $ . Permit Fee $ So_ — — CCF $ „ a CO /CC
Notary 5-5.. 0 0 Training/Education Fee $ 0 Technology Fee $ 1 ,--5 d
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 o urs seven (7) days after the building permit is issued. In the absence of such posted notice, the
inspection will not be a': 'over a , Fa reinspectio[ee will be charged.
Signatur Signature
Contractor
The e.:. ing instrument was acknowl dged be ore me this The foregoing instrument was acknowledged before me this
day , 20 ay of , 20 , by
who is persona known to me or who has produced vY who is personally known to me or who has produced
As identification and who did take an oath. as identification and who did take an oath.
NO
Sign.
V S r
Print:
t A4: ^ S
My Commission Expires:
***************************************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
*********************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * *�/ *AUG *t* *� * * * * * * * * * * * * * * * * * * * * * **
APPLICATION APPROVED BY:
Chc 05/13/03
Owner or A =e
a 3 /( 7 / 5
NOTARY PUBLIC:
Sign:
Print:
My Commission Expires:
Plans Examiner
Engineer
Zoning
•
Owner's lame
Owner's Address
City //740/ '/L f S State ■
Job Address (where the work is being done)
City Miami Shores Villa=
Is Building Historically Designated YES
Contractor's Company Name (if applicable)
***************************************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
All elements on the site must be listed and indicate the color to be painted
Railings
Fences
All brick (simulated or regular
Stucco banding
Any other stucco features
Accessory Buildings
Other
OWNER'S AFFIDAVIT: I ce
applicable laws regulating co
Signature
APPLICATION APPROVED BY:
Miami Shores Village s- l c _ o 1
Paint Color Approval and Agreement
R4 7. do,oko i ,712 ,
/(o( /oe /t/ Sr
f&
/66 4)t /V .37L
County Miami -Dade Zip 3 / &CS
NO X
Walls_ / 41 DIY/us C
Fascia # 3
Drip Cap /drip Edge
Soffit 4 -
Roof A) /iii"
Flower bins A) //, A�
Shutters /v / (1e /N� I e "i`�o
Awnings
Chimney . o 04) VMtilv�0
Doors and door jams 4, /�
Garage doors �• 3
A) a
Decorative metal ,
J
********************************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
that all the foregoing information is accurate
tion • d zoning.
Owner or Agent
P &ZOffici
Phone* ( os 757 -- {74 a
zip 3 3 /ae?'
Phone #
* ******** * * * * * * * * * *c * * * * * * * * * * * * * * * * * * **
d that all work will be done in compliance with all
Pa o race
Date '94/6 ■0re e
Date Y / 7 /0
o.
chc 6/18/03
Miami Shores Village
10050 NE 2nd Avenue
Printed: 8/18/2004
Applicant: RAUL LOPEZ
Owner: LOPEZ RAUL
JOB ADDRESS: 166 NE 101 ST
Contractor
Local Phone:
Parcel # 1132060131970
Building Permit
Phone: 305- 795 -2204 Permit Number: BP2004 -1115
Contractor's Address:
Page 1 of 1
Legal Description: MIAMI SHORES SEC 1 AMD PB 10 -70 LOTS 6 & E1/2 LOT 7 BLK 15 LOT SIZE
Fees: Description Amount
FEE2004 -8368 Building Painting Fee $60.00
FEE2004 -8374 CCF $0.60
FEE2004 -8375 Notary Fee $5.00
FEE2004 -8376 Training and Education Fee $0.20
FEE2004 -8377 Technology Fee $1.50
Total Fees: $67.30
Total Fees: $67.30
Total Receipts: $67.30
Permit Status: APPROVED Permit Expiration: 2/12/2005 Construction Value: $300.00
Work: EXTERIOR PAINTING
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:
Date I1— (( Job Address 1 ( 0 (0 AZ ((A (1* Tax Folio // gA94 49 /9 ;v 7 1 0 s ilviy
Legal Description
• ,
• PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Owner / Lessee / Tenant -) r th,k,d Tr,L'2if Master Permit # vv _e
Owner's Address 110/Q 71 I G( c ) tPe-(-- Phone - 756, - 4
Contracting Co. t(fk9-V Address
Qualifier SS# - - Phone
State # ' is - ► Competency # Ins.Co.
Architect /Engi _ Address
Bonding Compan 232 — 234 1680 Address
Mortgagor Address
Permit Type(circle one):
WORK DESCRIPTION . ;h - t6'--
Square Ft. A.� F�
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 abov ed contractor to do the work stated.
Sign re of owner and /or Condo President Signature of Contractor or Owner- Builder
Date:
** *
APPROVED:
Zoning
as to Owner an dePrtg4VJgfitOFWmb
Commission Expires % . o•. :tdyCommission hp.ApN30,1
ry.ft.;��° Na CC197545
• ••. ..••
ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
Estimated Cost(value)
Date:
#03.
Notary as to Contractor or Owner- Builder
My Commission Expires:
* * * * * * * ^ * * * * * * **
FEES: PERMIT Y74 RADON C.C.F. 1 NOTARY 546 TOTAL DUE 0 0
Fire Other
Building )) trn, Electrical
Mechanical Plumbing Engineering_