PT-10-354In
p`
at
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P oct Address
er Information
71Ctc' (s)
E OV•.'NER
T} f Work: Exterior
c esidential
Cu _ANp:.,ved
Coi _Approved_
Fe Duc
CC'
Ed an Surcharge
ch 1r :'110
Miami Shores Village
10050 N.E. 2nd Avenue
Miami Shores, FL 33138 -0000
Phone: (305)795 -2204
Expiration: 09/13/2010
Parcel Number
Applicant
L - ' '7 100 Street 1131010220350
r imi Shores, FL 33138- Block: Lot:
c
ONSWAMMORMADASIMM
r , RRIS & MAXINE FILL
Amount
$0.60
$0.20
$80.00
$0.80
$61.60
Address
126 100 Street
MIAMI SHORES FL 33150-
Phone CeII Phone
Code Comments:
Color: _Denied
A cd Signature: Owner / Applicant / Contractor / Agent
Department Copy
Phone
(305)754 -2134
Pay Date Pay Type Amt Paid Amt Due
Invoice # PT -3 -10 -37220
03/15/2010 Check #: 1220 $ 61.60 $ 0.00
NORRIS & MAXINE FILL
Date
Cell
Available Inspections:
Inspection Type:
Final
of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations
and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In
)ermit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are
,;TRICAL, PLUMBING, MECHANICAL WINDOWS, DOORS, ROOFING and SWIMMING POOL work.
0 )AVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
cr is o r ,:f zoning. Futhermore, I authorize the above -named contractor to do the work stated.
March 15, 2010
1
BUILDING
PERMIT APPLICATION
FBC 2004
Owner's Address I Z(p eu 40) 100
CityA jomt ,S110rC.s State
Tenant/Lessee Name
E -MAIL: ij(_i mt_ 1 ____, (ppli
Job Address (where the work is being done)
City Miami Shores Village
Is Building Historically Designated YES
'Contractor's Company Name •
Contractor's Address
City
Qualifier Name
State Certificate or Registration No.
OWNER BUILDER:
Value of Work For this Permit $
Describe Work:
Permit Fee $
Training /Education Fee $
Double Fee $ Zoning
Miami Shores Village
Bu Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
Permit Type: PAINT PERMf r
Owner's Name (Fee Simple Titleholder) Ke.Nt1 IJ i; 11 Phone # 335 4944 Sl7 /
State
2 (o Ai to.) 100 SI
CCF $
County
FOLIO /PARCEL# 11 °3101 °O -2.— O3SO
NO X
Miami -Dade
Master Permit No.
Zip 33) 56
Phone #
Phone #
Permit No.
Zip 3
Li Nrl.K 0 v tiJ il,;' PS
BY:
Zip
Phone #
Certificate of Competency No.
Type of Work: ❑ Addition / ❑ Alteration / ['New / ❑ Repair /Replace
Technology Fee:
Notary $ Code Enforcement $
Total Fee Now Due $ (Q1
Application is hereby made to obtain a permit to do the w r and installations as indicated. 1 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 fail laws regulating construction in this jurisdiction. I understand that a separate permit trust be secured fin
ELEC'TRICAI. WORK. PLUMBING, SIGNS, WELTS. P )LS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC.....
"WARNING TO OWNER: YOUR FAILURE O RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAVING TWICE FOR
IMPROVEMENTS TO YOUR PROPERTY. IF Y U INTEND 10 OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE
RECORDING YOUR NOTICE OF COMMENCEME T."
Notice to Applicant: .1s a condition to the issuance of a h Wing permit with an estimated value exceeding $2500. the applicant trust promise in good faith that a copy oldie
notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also. a certified copy oldie recorded notice
of conzrnencemenl.must he posted at the job site for the ,f r.4t inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice. the
inspection will not be approved and a reinspeclionfee will be charged.
* * *** * * * * * * * * * ** * * * * ** * fie * * *m * * * * * * * * * ** F * * * * ** ** ** * **** ** * * * * * * * * * * **
See Reverse side a
Directions: Please circle corresponding number to appropriate color sample.
Chimney:
Doors and Door Jams:
Garage Doors: 1
Railings:
Fences:
Walls:
Fascia:
Drip Cap /Drip Edge: 1
2
Soffit: I
Roof: 1 2 , 4
Flower Bins: 1 3 4
Shutters: 1 2 3 4
Awnings: 1 2 3 4
2
All brick (simulated or regular):
3
Stucco Banding: 1
Any other Stucco Features:
Accessory Buildings • • Other:
who "~ persowdly known to me or who has piuduccd
My Commission
PAINT COLOR APPROVAL AND AGREEMENT
All elements on the site must be listed and indicate the color to be painted
4
4
4
4
Attach color samples with name and
number..
Signature
Owner or Agent Contractor
The foregoing instrument was acknowledged beffore me this _ O The foregoing instrument was acknowledged before me this
day of TA&- Q�c.t� . 20 0 . by • p i i1 /V ( 1 day of . 20 , by
who is personally known to me or who has produced
e �
As ' • o i'. ke an oath. as identification and who did take an oath.
NOTARY PUBL Adlik. 4 NOTARY PUBLIC:
Sign: I r � Sign:
mvi ,zri i:,cs:a:, .
r I [sv � �j EIRE$ , I
Print: + .. Print:
eigaiikitiaiiiiiiiiiiiiai
My Commission Expires:
APPLICATION APPROVED BY: Plans Examiner
Preservation Board
Code Enlorcement
Ca. P \4 ' 1
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.
******** Be4e4r***** oY***** aYx aY*aFat**** ke4*** *k****x+fete***ic*****xcketa4. tit ********dea4***v4dr** **** ** rdruar********+Yirx*****
(Revised 04/241/0-/
Prepared by and return to:
Steven K. Baird, Esq.
Attorney at Law
Steven K Baird, P.A.
5981 N.E. Sixth Avenue
Miami, FL 33137
305 - 754 -8170
File Number: 06 RE
Will Call No.:
[Space Above This Line For Recording Data]
Quit Claim Deed
This Quit Claim Deed made this' day of June, 2006 between Norris John Fill and Maxine Bisset Fill, his wife
whose post office address is 81 NE 163 Street, North Miami Beach, FL 33162, grantor, and Kenneth Norris Fill and
Laura Broderick Fill, his wife whose post office address is 126 NW 100 Street, Miami Shores, FL 33150, grantee:
(Whenever used herein the terms "grantor" and "grantee" include all the parties to this instrument and the heirs, legal representatives, and assigns of
individuals, and the successors and assigns of corporations, trusts and trustees)
Witnesseth, that said grantor, for and in consideration of the sum TEN AND NO /100 DOLLARS ($10.00) and other good
and valuable consideration to said grantor in hand paid by said grantee, the receipt whereof is hereby acknowledged, does
hereby remise, release, and quitclaim to the said grantee, and grantee's heirs and assigns forever, all the right, title, interest,
claim and demand which grantor has in and to the following described land, situate, lying and being in Miami - Dade County,
Florida to -wit:
Lot 3 and the East 1/2 of Lot 2, Block 5, GOLD CREST, according to the Plat thereof, as recorded in
Plat Book 21, Page 56, of the Public Records of Miami -Dade County, Florida.
Parcel Identification Number: 11- 3101- 022 -0350
1111111 11111( 1111111111111111111111111111 1111
: 1 200 6RC 7 9 2O 2 . o
OR r.k 2e747 Ps 0530 531; i2pyc;t
RECORDED 07/24/2006 i0 :35:52
DEED C'OC fAX 0.60
HARVEY CLERK a COURT
,'•.1. !- I!!!. "'t.fil. t:. •a ?_NiYP L._ }RiCH
Subject to taxes for 2006 and subsequent years; covenants, conditions, restrictions, easements,
reservations and limitations of record, if any.
This Quit Claim Deed is being given for estate planning purposes. There is no monetary
consideration being paid on this transfer.
To Have and to Hold, the same together with all and singular the appurtenances thereto belonging or in anywise
appertaining, and all the estate, right, title, interest, lien, equity and claim whatsoever of grantors, either in law or equity, for
the use, benefit and profit of the said grantee forever.
In Witness Whereof, grantor has hereunto set grantor's hand and seal the day and year first above written.
DoubleTime®
Signed, sealed and delivered in our presence:
pit c,2-4, J . `E"--)
Wi ss Name: _afte (s (tal. re0
Witness
State of Florida
County of Miami -Dade
The foregoing instrument was acknowledged before me this .C6 day of June, 2006 by Norris John Fill and Maxine Bisset
Fill, who [J are personally known or [X] have produced a driver's license as identification.
LAC Fide .1-412 4 f9 41 - o
Pc 'C' ilea 6 30 ¢F
[Notary Seal]
4 MICHAEL J. CONWAY
o` -4 .. Commission # DD0205488
Expires 8/18/2007
''�' N CR , Bonded through
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(800- 432 -4254) Florida Notary Assn., Inc.
s
, 4/ 02 2,:i4 v -43-7
Norris John Fill
Maxine Bisse Fill
Notary Public
Printed Name:
My Commission Expires:
OR BK 247'47 PG 05:31
LAST 1= A GE.
eal)
Quit Claim Deed - Page 2 DoubleTime®
Inspection Number: INSP - 137341
Scheduled Inspection Date: April 20, 2010
Inspector: Bruhn, Norman
Owner: FILL, NORRIS & MAXINE
Job Address: 126 NW 100 Street
Project: <NONE>
Miami Shores, FL 33138-
Contractor: HOME OWNER
Building Department Comments
April 19, 2010
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
For Inspections please call: (305)762 -4949
Permit Number: PT -3 -10 -354
Permit Type: Paint
Inspection Type: Final
Work Classification: New
Phone Number (305)754 -2134
Parcel Number 1131010220350
PAINT EXTERIOR OF THE HOUSE
Passed
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Inspector Comments
Page 8 of 28