810 NE 100 St (9)G ` j
BUILDING
PERMIT APPLICATION
FBC 2001
Total Fee Now Due $
(Continued on opposite side)
$ Value of Work For this Permit 24o o. 00
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
Permit Type (circle . Buildin Electrical Plumbing Mechanical Roofing
Owner's Name (Fee Simple Titleholder))*/V� AA Phone # 3cS l5 ( 32-1
Owner's Address Zfkt /t (00
Cit A44,G S40 5 State '�( Zip 3313'
Tenant/Lessee Name Phone #
Job Address (where the work is being done) gf0 N • E /00
City Miami Shores Village County Miami -Dade Zip 313g'
Is Building Historically Designated YES NO ✓
Contractor's Company Name N(k Lovr1T
Contractor's Address (04-o (u
City a, 4,; t Sys State
Qualifier (n(2>
Permit No. P) P afro - 9 OS
Master Permit No.
Phone # 'o5 1 - ??
Zip 3313 t
Architect/Engineer's Name (if applicable) Phone #
Square Footage Of Work:
Type of Work: ['Addition ❑Alteration ['New ❑ Repair/Replace ❑ Demolition
Describe Work: ?ect
* * * * * * * * * * * * * * * * * * * * * * * * * * ** Fees * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
0
Submittal Fee $ Permit Fee $ D , CCF $ /1 d v CO /CC
Notary $ .S, 0 Training/Education Fee $ • 6 6 Technology Fee $ /4...c
Scanning $ Radon $ Zoning Bond $
Code Enforcement $ Structural Plan Review. $
Bonding Company's Name (if applicable)
Bonding Company's Address
4 it 4
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 y. be approved and a reinspecti y ee will be charged.
who is
Chc 12/15/03
Owner or Agent
The foregoing instrument was acknowledged before me this 3O
day of S1,,,t1e_ , 20 b 'k, by Q &r t L1 F.9 gem)
APPLICATION APPROVED BY:
r who has produced
NOTAR PUBLIC: _
Sign: P. . e 3tlJ t
Print: OS1,a.I1 �1Ota■
My Commission Expires: 6 -76-
As identification and who did take an oath. r
Signatur
Contractor
The foregoing instrument was acknowledged before me this
day of , 2V f , by R pberT 1/i50 T •
who is persona y known to me or who has produced
,.��g LatSho I'. I5 aC� UBLI :
'4 Commission #11D31848#1:
_.t;. ':. ** Expires• Jun 20, 2008
S'"ai0As Bo Thu Print:
Atlantic Bonding Co., Inc.
My Commission Expires:
(Certificate of Competency Holder)
State Certificate or Registration No. Certificate of Competency No.
******************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * *j. *********** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
dy
-IUL - e 2004
entification and who did e an oath.
Plans Examiner
Engineer
Zoning
MIAMI SHORES VILLAGE
Paint Color Approval and Agreement
DATE: j• vb . vL
OWNER'S NAME: xitt4 Algs Qc6/rt PHONE:3 32-19
ADDRESS: o 100 s-c—
********************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
ADDRESS OF SITE: gto E. kook
CONTRACTOR & LICENSE (if applicable) RiO2..4.
COMPANY NAME: scot, �1 �c,�J -r.J� PHONE: r-6 ?r
********************************* * * * * * * * * * * * * * * * ** * * * * * * * * * * * * **
All Elements on thy site must be listed and indicate the color to be painted.
Walls ELLOvJ
Y
Fascia
7yA-
Drip Cap/DrEdge °
Soffit yvf
Roof t�k b a,
Flower Bins
Shutters -
Awnings , ar
Chimney
Doors and do r jams vJ}!-rrE ,.{o FRO a � 4wj1.stk-
Garage Doors
Railings \ ' E
Fences
Decorative Metal
All brick (simulated or regular) 1 i
Stucco Banding v,i fit;
Any other stucco features
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. I authorize the above -named contractor, if applicable, to
do the work stated. Furthermore , the paint colors will be as per the attached
sa
Signature o
Owner
* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *
APPROVED:
Building Official Date
z:.
• c
Date �• 22. 0
? Si nature of Co tractor Date
g
WHEN PAINTING IS FINISHED,
CALL FOR FINAL INSPECTION
/ ay
4/23/01
Miami Shores Village
10050 NE 2nd Avenue
Phone: 305- 795 -2204 Permit Number: BP2004 -905
Printed: 7/7/2004
Applicant: DANIEL ROBBIN
Owner: ROBBIN DANIEL
JOB ADDRESS: 810 NE 100 ST
Contractor
Local Phone: 305 - 751 -7164
Parcel # 1132060340060
VISCOUNT PAINTING & DECORATING Contractor's Address: 640 GRAND CONCOURSE
Fees: Description Amount
FEE2004 -6772 Building Painting Fee $60.00
FEE2004 -6773 CCF $1.80
FEE2004 -6774 Notary Fee $5.00
FEE2004 -6775 Training and Education Fee $0.60
FEE2004 -6776 Technology Fee $1.50
Total Fees: $68.90
Total Fees: .98
Total Receipts.
F
) 6 o
Permit Status: APPROVED Permit Expiration: 12/28/2004 Construction Value: $2,400.00
Work: PAINT EXTERIOR HOUSE
Signed: (INSPECTOR)
Building Permit
Page 1 of 1
Legal Description: 5 6 53 42 MIAMI SHORES SEC 8 PB 14 -33 LOT 9 & E1/2 OF LOT 10 BLK 169 LOT
a 1 2pain
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:
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
10050 N.E. 2nd Avenue • Miami Shores, Florida 3313 • Phone: 305- 795 -2204 • Fax: 305- 756 -8972
`f
Date 171)/03 /03 ' Job Address lJ / f � N� I o
s o O 8 ent
ommission i e9Ay Commission DD150048
:. 'o = •. ,0* Expires November 15, 2006
FEES: PERMIT
6o
RADON
APPROVED:
Zoning Building
D. to
C.C.F
Legal Description /, ikO Historically Designated: Yes
essee/Tenet PO\ b) ( h Master Permit #
Owner's Address
‘ 8 /0!"E)Oo
i , W ) � � N
Contracting Co. ( eg t�i 115
Qualifier
State # Municipal #
Square Ft. Estimated Cost (value
LDP q0
ax Folio
3a5
� / _ (104115+ ..b
Add Phone ress V 5 i E
(J� 1 4 U i ( - e`< SS# { Phone 3 O/ 1/
Competency # Ins. Co.
IF THERE IS NO PERMIT PACKAGE ACCESSIBLE ON THE JOB SITE FOR INSPECTORS TO VERIFY,
THERE WILL BE NO INSPECTION. RE- INSPECTION FEE IS $50.00 AND MUST BE PAID IN ADVANCE
BEFORE CALLING FOR ANOTHER INSPECTION.
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING
WORK DESCRIPTION: Pre56 U`re c ekr\ a 'Ad- /al A+ +1 I e- roo
B oO
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 ANY 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). l 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 all disciplines.
OWNERS 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.
6 /z)0
atu
Signre of owner and/ ondo President Dat Sig at of Contractor or O r uilder a
is 0 - L1 3 - 91 . 2 Z'T D
er
My Commission DD150048
?ogncf Expires November 15, 2006
13
NOTARY NOTARY S - 0 b
R E C r lW
JUN -22!03
4u) 4IA/Q_:?
o Owner Builder Date
BOND
TOTAL DUE
Electrical
Mechanical Plumbing Structural Engineer
MIAMI SHORES VILLAGE
Paint Color Approval and Agreement
DATE: 7 , a
LOWNER' N PHONE:
LA'6DRESS: l o . F'. )be' OT
* * * * * * * * * * * * * * * ** **************** * * * * * * * * * * * * * * * * * * * * * * * * * * * **
ADDRESS OF SITE: 1 0 - (. 100
CONTRACTOR & LICENSE (if applicable)
COMPANY NAME: PHONE:
********************************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
All Eleme s on the site must be listed and indicate the color to be painted.
Walls
Fascia
Drip Cap/Drip Edge
Soffit
—Roof
Flower Bins
Shutters
Awnings
Chimney
Doors and door jam
Garage Doors
Railings
f)\
Fences
Decorative Metal
All brick (simulated or regular)
Stucco Banding
Any other stucco features
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. I authorize the above -named contractor, if applicable, to
do the-work stated. Furthermo e , the paint colors will be as per the attached
s • Pl //
ignature of Owner Date Signature of Contractor Date
*********************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
APPROVED: WHEN PAINTING IS FINISHED,
CALL FOR FINAL INSPECTION
2&% 6 730 - 9
\Building Official Date
4/23/01
r'
Miami Shores Village
10050 NE 2nd Avenue
Phone: 305 - 795 -2204
Printed: 6/6/2003
Applicant: DANIEL
Owner: ROBBIN
JOB ADDRESS: 810
Parcel # 1132060340060
Fees:
FEE2003 -3453
FEE2003 -3454
FEE2003 -3455
PAUL R. KAWALEK ROOFING & PAINTING
485 N.E. 92ND STREET PH. 305- 754 -0191
MIAMI SHORES, FL 33138 -2566
NE 100
Date
order of Mcuv . la qe
Pay Pay to the
b rku' dreL ine t
B eo k,ovi t i ve940,54,
AcL,60,13,0A
D I `i g1ooC t,J.
1:063 L00 2 ? ?I: 0036606 10 33 2?
Building Permit
Permit Number: BP2003 -928
1 os
ROBBIN
DANIEL
ST
Contractor Contractor's Address: 485 N. E. 90
Local Phone: 786- 277 -9540
Legal Description: 5 6 53 42 MIAMI SHORES SEC 8 PB 14 - 33 LOT 9 & E1/2 OF LOT 10 BLK 169 LOT
Description Amount
Building Permit Application Fee $60.00
CCF $1.20
Notary Fee $5.00
Total Fees: $66.20
Permit Status: APPROVED Permit Expiration: 12/3/2003 Construction Value: $1,800.00
Work: PAINT ROOF WHITE
3327
63- 27/631 FL 4
810
Page 1 of 1
Total Fees: $66.20
Total Receipts: $0.00
1 compliance with all ordinances and regulations pertaining thereto and in strict
Aiami Shores Village. In accepting this permit I assume responisibility for all work
"° .i BY:
Date 2 i f - Job Address
FEES: PERMIT l ° 1 4 . 5 RADON
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Signature of owner and/or Condo President Date
910 Mt- /00 sr, Tax Folio
Legal Description rr Historically Designated: Yes N / / -
Owner/Lessee / Tenant 1) a rt. A o E Y) (' 1(� Master Permit # 3 / / (PAS
Owner's Address el() IQ loo S Phone
Contracting Co. Air% 1 1 kt C! 3q (, -4 t h J q L (
Address 2 et 0 6 Z.o S t
Qualifier L V t$ At ( t d SS# Phone S 7/ 9‘
State # + /et Municipal # f 1 — 46 9 i cr .:?Competency # Pt L) ,, Ins. Co. A r t e S 5,
Architect/Engineer Address
Bonding Company Address
Mortgagor Address
C.C.F. 1 J NOTARY
ctor or Owner- Builder
Notary as to Owner and/or Condo President Date Notary as to Contractor or Owner- Builder
My Commission Expires: My Commission Expires:
Date
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION T r S so r G` e Q s' J pc c () 4 P L pc? '1 1t G 2cJ //2
54 < h t o /A /' 1 Q40 r wN zr 7`o W/12
Square Ft. 3 Q t7 ?t. Gta 'se) Estimated Cost (value) 2. J
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 above -named contractor to do the work stated.
•
Date
TOTAL DUE t d/
APPROVED:
w G�
Zoning Building I� Electrical
Plumbing Engineering
STATE OF FLORIDA
COUNTY OF DADE.
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.
Owner's Name and Address
Registered Architect andior Engineer
Name and address of licensed contractor 0 O. n Q +'
Location and legal description of lot to be built on:
LotgS' 2 1 Block /b 9
(/Street and Number where work is to be done g D
//gtate work to be done and purpose of building (by floors). state exterior colors (submit samples)
and for no other purpose.
New Building Remodeling Addition Repairs No. of Stories
To be constructed of Kind of foundation Roof overing
(/Estimated Total cost of improvements S V Amount of Permit $ -3 7-S7 2
Zone cubage required Plan Cubage
Distance to next nearest building Size of Building Lot
Maximum live load to be borne
I hereby submit all plans a
The undersigned applicant for . that he understands and accepts his obligatons as an employer of Labor under the Florida Workmen's
Compensation Act, being Secti( 2/C ida. Permanent Supplement. and has complied with the provisions thereof, and will require similar
compliance from all contractor. 072 a 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 n(7 t ci or notice- -_ _ y the Act. The undersigned agrees to employ only such subcpntractors. on work to be performed
under this permit, as are licensed by Miami Shores Village. ,f
Remarks (Signed)'` "`^--,
}SS.
Before me, the undersigned authority. a notary public. duly authorized to administer oaths and take acknowledgments, personally appeared
Disapproved Date
(Signed) / -2'9 /
APPLICATION FOR BUILDING PERMIT
Subdivision 7n 4 /Pill O
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
&O OoJ
N - r
Notary Public, State of Florida
,AN a 19
No $/ 0 Street N e / 0 O Sr-
,4.f
X-rts ,c O C. }-Ev tit sc..
notices with reference to the building and its construction may be sent to
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.
Permit No. 9 d/ Date / W Read. Sworn to and Subscribed before me.
My Commission Expires
PLANNING BOARD DATE
Chairman Member
Member Member
Member Member
Council Approved Date 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 anchor workmanship.