94 NE 100 St (15)Type Insp'n
Permit No.
Name
MIAMI SHORES VILLAGE O O\
BUILDING DEPARTMENT �
305- 795 -2204
Building Inspection Request
9 L I (()
Company
Address
Approved
Correction
Re- Insp'n Fee
Phone #
Inspection Date ( I _
FED
L v
BUILDING
PERMIT APPLIC
FBC 2001
-.J
TION
Permit Type (circl Building Electrical Plumbing
Owner's Name (Fee Simple Titleholder) �4 kJ �(. b T"►41, _ f2.4$hone #
Owner's Address q " l /4J de ( c
City AA ` ‘(■4"..0- ��� State PI Zip
Job Address (where the work is being done)
City Miami Shores Village
Is Building Historically Designated YES
Architect/Engineer's Name (if applicable) 1
t „)
7
$ Value of Work For this P e r m i t 2. L $ )
Type of Work: ['Addition ❑Alterati n
4 U1� !A
Describe Work:
0.6
Submittal Fee $5D. —. Permit Fee $
Notary $
Scanning $
Code Enforcement $
Total Fee Now Due $ I - l
(Continued on opposite side)
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
County Miami -Dade
NO
Training/Education Fee $ 0
Structural Plan Review. $
Permit No.
Master Permit No.
Phone #
Radon $ s Zoning
Mechanical
Tenant/Lessee Name Phone # ,3 t( 1 1-
Contractor's Company Name � t h $ ( � Phone #
�p
Contractor's Address -- a � , (it t r
City ( k 4' State 'P( Zip 3.30,
Qualifier
Square Footage Of Work: /41/t("59‘.
❑ Repair/Replace
se—
* * * * * * * * * * * * * * * * * * * * * * * * * * ** F ees * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
CCF $ , ( a CO /CC
Technology Fee $ l t (7
Bond $
Roofing
Zip
❑ Demolition
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 . of b ' :.proved an a reins ee will be charged
,..11 Lam►
Signa
Chc 12/15/03
Owner or Agen
The foregoing instrument was acknowledged before me this
day of L b , 20 Q, by
who is personally known to me or who has produced
NOTARY IC:
Sign : 1
Print:
My Commission Expires:
State Certificate or Registration No.
APPLICATION APPROVED BY:
As identification and who did take an oath.
WE�: abel Var_
`�` `ojmission as
1 D231984
`xpires: Jul 13, 2007
****************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
a / /a - /r3y •
Signature
My Commission Expires:
Certificate of Competency No.
FEB 1 a 2004
Contractor
The foregoing instrument was acknowledged before me this
G 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:
************** * * * * * * * * * * * * * * ***A * * B ogi g ttiCo* I n c. ************************ * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
(Certificate of Competency Holder)
************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
Plans Examiner
Engineer
Zoning
MIAlVII SHORES VILLAGE
Paint Color Approval and Agreement
DATE. E VU .. ( 2:6.) 3-
OWNE''S N • � : - 0 (-`b SQL -- 60 0_6 PHONE - 7�y - q?`1
ADDRES qy /
* ** * ***4,* * * * * * * * * ** * ** k*********** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** •
ADDRESS OF SITE: > -4 (t%
CONTRACTOR & LICENSE (if applicable)
COMPANY NAME: L k u 00, (11-1-(h PHONE:30 90's (7) 2 --
*********************** * * * * * * * * * * * * * * *4 * * * * * * * * * * * * * ** * * * * * * * **
All ElemeiAs on the i site must 'sted and indicate the color to be painted.
Walls
Jc& b L
M(12_
Fascia () t- o
Drip Cap/Drip Edge w,, 0 ti
w
Soffit
Roof V
Flower Bins lip ( {4
Shutters C-J
Awnings p .��
Chimney
Doors and door jams \•N
Garage Doors c
Railings
Fences (A
Decorative Metal (,.J1' ‘ de--
All brick (simulated o regular)
Stucco Banding LA V , --
Any other stucco featur - s , •
Accessory Buildings 1j
Other 1J`
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
doq
Signature of 0 Date • Signature of Contractor Date
*********************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
WHEN PAINTING IS FINISHED,
CALL FOR FINAL INSPECTION
APPROVED:
d/ ' 11/
Building O011 cial Date
18
SW 6119
Antique White
SW 6120
Believable Buff
4/23/01
Miami Shores Village
10050 NE 2nd Avenue
Building Permit
Phone: 305 - 795 -2204 Permit Number: BP2004 -182
Printed: 2/13/2004
Applicant: DONALD
Owner: SALTZBURG
JOB ADDRESS: 94
Contractor
Local Phone:
Parcel # 1132060131190
Signed:
NE 100
(INSPECTOR)
SALTZBURG
DONALD
ST
Contractor's Address:
Permit Status: APPROVED Permit Expiration: 8/9/2004 Construction Value: $2,200.00
Work: EXTERIOR PAINTING
Page 1 of 1
Legal Description: MIAMI SHORES SEC 1 AMD PB 10 -70 LOTS 1 2 3 LESS W35FT BLK 9 LOT SIZE
Fees: Description Amount
FEE2004 -1553 Building Painting Fee $60.00
FEE2004 -1554 CCF $1.80
FEE2004 -1555 Notary Fee $5.00
FEE2004 -1556 Training and Education Fee $0.60
FEE2004 -1557 Technology Fee $1.50
Total Fees: $68.90
Total Fees: gteb90 0
Total Receipts: $0.60 I
J,G4 1
FEB 13 PAID
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
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build-
ing 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 � ° L'� , 19
Owner's Name and Address ' "� No Street
Registered Registered Architect and /or Engineer 11
Name and address of licensed contractor \I • !!i,¢ • ��
Location and legal description of lot to be built on:
Lot Block Subdivis'Qn
Street and Number where work is to be done
State work to be done and purpose of building (by floors)
New Building Remodeling Addition Repairs No. of Stories
To be constructed of Kind of foundation Ro f Covering
U
Estimated Total cost of improvements $ G i e ® - - Amount of Permit $
Zone cubage required _Plan Cubage
Distance to next nearest building Size of Building Lot
and for no other purpose.
Maximum live load to be borne by each floor
I hereby submit all the 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 obligations 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 to employ only such subcontractors, on work to be performed under this
permit, as are licensed by Miami Shores Village.
Remarks ( Signed)
STATE OF FLORIDA,
COUNTY OF DADE. j ss.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap-
peared
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 reach the foregoing application, and that he did sign the same, and that all facts
therein by him st ed are trrue. „ J
Permit No 1 q b Date it- (3 - Read, Sworn to and Subscribed before me.
Disapproved Date
(Signed)°
Building Inspector My Commission Expires
Notary Public, State of Florida
PLANNING BOARD DATE
Chairman Member
Member Member
Member Member
Council Approved Date Disapproved Date
NOTE: A charge of $1.00 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 $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty
materials and /or workmanship.
BUILDING vim" DATE / r
ELECTRICAL PERMIT iN? 13906
PLUMBING Fl
ROOFING fl Work to be performed under this Permit
Owner of
Building Vt., -)
Architect
Contractor
or Builder
Legal
Description
Address of
Building
Lot
II
I 41- I) !roc)
CONTRACTORr..o* BUIL
MIAMI SHORES VILLAGE, FLORIDA
Bl.
Subdi-
vision
Signe ''r'�'�""`
Value of Y .7r V
Project $
195
Contractor's
License No
.....
Amt. of
Permit $ ...,.
This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the application
herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans,
drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any
time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is
granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations
pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes responsibility for work
done by his agents, servants or employees.
BY
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 assuyne responsibility for all work done by either, myself, my agent, servant or employee.
BY AUTHORITY
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build-
ing 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._ .I.2 ' Z Z m et/97 h No q T Street
Registered Architect and /or Engineer _.
P
Name and address of licensed contractor
Location and legal description of lot to be built on:
Lot Lai / 4 E /.i•'cf 3 Biock p:L__.. Subdivision
Street and Number where work is to be done q
Estimated Total cost of improvements $__ ._.��� '-
STATE OF FLORIDA,
COUNTY OF DADE.
Permit No
Disapproved
(Signed) _____
APPLICATION FOR BUILDING PERMIT
ss.
Date
D
Building n .ector
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
% / / S4 t- Se'
State wo k o be done and ur o of` buildin by floors)...
�o tt &L !/l._ _. � Ve 112. r
w Building /l Remodeling. Addition Repairs
To be constructed of Kind of foundajigp
Amount of Permit $
Zone cubage required plan Cubage
Distance to next nearest building Size of Building Lot
oCe c to Doar _ Di/1/27
w :/fn
"Ind' for no other
No. of Stories /
vering
purpose.
Maximum live load to be borne by each floor
I hereby submit all the 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 obligations 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 to employ only such subcontractors, on work to be performed under this
permit, as are licensed by Miami Shores Village.
Remarks (Signed) t' "
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap-
peared
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 state�
to me well known,
Read, Sworn to and Subscribed before me.
Notary Public, State of Florida
My Commission Expires
PLANNING BOARD DATE
Chairman Member
Member Member
Member Member
Council Approved Date Disapproved Date
NOTE: A charge of $1.00 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 $1.00 will be charged when such re- inspection is made necessary by improper 'notice for inspection or faulty
materials and /or workmanship.