BP-04-539Miami Shores Village
10050 NE 2nd Avenue
Building Permit
Phone: 305 - 795 -2204 Permit Number: BP2004 -539
Printed: 5/21/2004
Applicant: SHARON
Owner: KELLY
JOB ADDRESS: 55
Contractor
Local Phone:
Parcel # 1131010180390
Signed:
NW 100
(INSPECTOR)
KELLY
SHARON
ST
Contractor's Address:
Page 1 of 1
Legal Description: 1 53 41 NAVARRO SUB PB 12 - 59 LOT 13 & LOT 14 LESS E10FT BLK 4 LOT
Fees: Description Amount
FEE2004 -5195 Building Painting Fee $60.00
FEE2004 -5196 CCF $1.80
FEE2004 -5197 Notary Fee $5.00
FEE2004 -5198 Training and Education Fee $0.60
FEE2004 -5199 Technology Fee $1.50
Total Fees: $68.90
Total Fees: $68.90
Total Receipts: $68.90
Permit Status: APPROVED Permit Expiration: 10/19/2004 Construction Value: $3,000.00
Work: PAINT EXTERIOR OF HOUSE AS AGREED
In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict
conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responisibility for all work
done by either myself, my agent, servants or employes.
Signed: (Contractor or Builder) BY:
BUILDING
PERMIT APPLICATION
FBC 2001
Permit Type (circle):
Owner's Name (Fee Simple Titleholder
Owner's Address
City r fQ6' /." ® State Z Zip _33/ ,--e)
Tenant/Lessee Name 17.0 j' 4'4 AIM Phone # ,3 6S 7s s
Job Address (where the work is being done) 55 G"6 4 T
City Miami Shores Village County Miami -Dade Zip ,/ .$Q
Is Building Historically Designated YES NO .
Contractor's Company Name
r� r' �',,,
Contractor's A 1 . - s a 3 ! .1 / -
,,
City - J (' i L tate �l• Zip 3
Qualifier CG d a 13 S QQ °/
Architect/Engineer's Name (if applicable) 4 4
$ Value of Work For this Permit t m f &
Type of Work: ❑Addi 'on ['Alteration I ON w ❑ Repair/Replace ❑ Demolition
Describe Work: • r -f/U` - a/fJ �
****************************F
Submittal Fee S_QajCii j2E0 grmit Fee $ (' ® , 00 CCF $ - s 0 CO /CC
Notary $ 5.00 Training/Education Fee $ Technology Fee $
Scanning $ Radon $ ^ C I Zoning Bond $\ m .5) 0
Code Enforcement $ Structural Plan Review. $
Total Fee Now Due $
(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
Building
(06 PO 0)L 52
Phone #
Square Footage Of Work:
RECENED
op 42 2004
Permit No. ,91004
Master Permit No.
Electrical Plumbing Mechanical Roofing
Phone #, 'rte 7 .59
Al
.
Phon= # lD 0
rq�
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 inspectio which occurs seven (7) days after the building permit is issued In the absence of such posted notice, the
inspection will not bpproved and a reinss'ection fee will be charged
Si
The foreg
day of
Owner or Agent 11
g instrument acknowledged before me this (-1 200`1 , by
who is personally known to me or who has produced
NOTARY P
Sign:
Print:
My Commission Expires:
APPLICATION APPROVED BY:
Chc 12/15/03
As identification and who did take an oath.
oogw,,, Mabel Vargas
Commis NOTARY PUBLIC:
? `':', :
Signature ' �J
Contractor
The foregoing instrument was acknowledged before me this 6
day of 20
who is perso known to me or who has produced
as identification and who did take an oath.
Sign.
Print:
My Commission Exp
cOye
MAY 1 8 EN
Plans Examiner
Engineer
Zoning
*de*** ****** ire? ******icw*ik**de * ** Ya**at***9eaR+ t** ResY*9e *** *** **aY*9z*9e********
(Certificate of Competency Holder)
State Certificate or Registration No. Certificate of Competency No.
**************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** * ******* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
//41
Date
Miami Shores Village
Approval and Agree t en t9 Paint Color Appr g � � � �oo�
Owner's Name
Owner's
City HP (
State S Zip
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 el ments on the site must be listed and indicate the color to be painted
Walls - 4 l !( � UC ®.
Fascia wit
Drip Cap /drip Edge (,it /
Soffit Jil �II nn
Roof Ladd i I'�
Flower bins
Shutters
Awnings
Chimney
Doors and door jams ^11 hP•riilb •
n .1!n IA
Garage doors
Railings
Fences •
Decorative metal
Stucco banding
Accessory Buildings
APPLICATION APPROVED BY:
f1/4-1
55 t� f6 c L
County Miami -Dade
NO K,
7 6L--yyvy @_O - .
P& Z4Tiffitial
Phone # 3631:1
33 /SO
Zip •331$b
e
0
0
o .
0
moonlight
All brick (simulated or regular)
r 1 f
Any other stucco features fLifl
``
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 r ' g constructio and zoning.
Signature J ,,i)
Lip Date
/ Owner or Agent
Date 5 -/7
chc 6/18/03