53 NE 101 St (8)MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
Building Inspection Request
Date7-1Z Time
Type Insp' n ' AM n
Permit No. 0 Zeo3 - (o 1 IV
Name OG O-Q m
Address S3 Iv , o t S4-
Company
Phone # U 1(J — 4-D3 r
For Inspect`�or 9 13 Name & Date
Approved
)1C
Correction ❑
Re- Insp'n Fee ❑
call nom ond ne (1
.\ asap .
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT 4
305- 795 -2204
Building Inspection Request v��
Date 7\ "A e9C! '
Type Insp'n Pi-viL l0 ‘ 04A- 1
Permit No. Si 63" a L 6
Name CC( C s&'vi
Address
Company
Phone #
Inspection Date 7N lq OC"
Approve• ,
Correction
Re- Insp'n Fee ❑
BUILDING
PERMIT APPLICATION
FBC 2001
Permit Type (circle)-
Contractor's Company Name
Contractor's Address
• Miami Shores Village rEo
Building Department MAY 2 4 2004
10050 N.E.2nd Avenue, Miami Shores, Florida 33138 i
Building
Tel: (305) 795.2204 Fax: (305) 756.8972
Electrical Plumbing Mechanical Roofing
`r'. • _ y � ip
Owner's Name (Fee Simple Titleholder) (H:e.1 509/7 r O 5 Phone # (.9 0 5'2 2/5 •7 53 9
Owner's Address
City ) /� S c2/f e*e / L •
Tenant/Lessee Name
Job Address (where the work is being done) 230 / E - /04
City Miami Shores Village County Miami -Dade Zip 33/31?
Is Building Historically Designated YES NO
Total Fee Now Due $
(Continued on opposite side) v
Structural Plan Review. $
3
Permit No. Sr OL r 69G
Master Permit No.
Zip X1
Phone #
Phone #
City State Zip
Qualifier
Architect/Engineer's Name (if applicable) Phone #
$ Value of Work For this Permit 6:C
Square Footage Of Work:
Type of Work: ❑Addition \t-kA ENew ❑ Repair/Replace ❑ Demolition
`
Describe Work: i 1iT -P tC'1�► A(7V ' k SQ
* * * * * * * * * * * * * * * * * * * * * * * * * * ** F ees * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
c .3v /
Submittal Fee $ C l' IO' C sk Permit Fee $ (pa' CCF $ • la O coicc
Notary $5' W Training/Education Fee $ , "l U Technology Fee $ 1 , S ()
Scanning $ Radon $ Zoning Bond $
Code Enforcement $
Bonding Company's Name (if applicable)
Bonding Company's Address
City State Zip 4 : -
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 df such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
Signature
553: -000-
NOTAR
Sign:
The foregoing instrument was
Owner or Agent
wledged be
da 2
who is
who is personall known to me or who has produced
^As identification
v Angel; M Becher
Print: w c� n�
i \/ ; Vi
My Commission Expire o o �xpirasNovernbar5 , 2008
me this
d take an oath.
***************************************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
(Certificate of Competency Holder)
State Certificate or Registration No. Certificate of Competency No.
************************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** ' ***************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
MAY 252004
APPLICATION APPROVED BY:
Chc 12/15/03
Signature
Contractor
The foregoing instrument was acknowledged before me this
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:
My Commission Expires:
Plans Examiner
Engineer
Zoning
. • Miami Shores Village
Paint Color Approval and Agreement
Date o7 o
Owner's Name / cr.:( _
�'e � h /0) Phone # (3051 2 /C —/ 5 - 3
�
Owner's Address q c Ar` E ' '74/ 37 •
City . 5A Q A_ .0/ • State f £ Zip S 3 / 3 P
Job Address (where the work is being done) 23 0 / e r /0 S/ . n
City Miami Shores Village County Miami -Dade Zip 33/ 3 d
Is Building Historically Designated YES NO
Contractor's Company Name (if applicable)
Phone #
***************************************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
All elements on the site must be listed and indicate the color to be painted
a ll
Walls 3 ' • t'( / 6 709 pill 7;9 '
Fascia Sr• • Cs 11 /3 i, e i / T
Drip Cap /drip Edge i�/
Soffit li(//
Roof it/7/
Flower bins ,/ /I4
Shutters ,e
Awnings f
Chimney f '/A
Doors and door jams 0,4 ;7—e y�
Garage doors 5•14). 6 2— (7 / 5 P v;
Railin Ai/ / A
Fences Wig
Decorative metal N /'y
All brick (simulated or regular) 0 // i S e e∎ T
Stucco banding 0
Any other stucco features /F . A
q
Signature
APPLICATION APPROVED BY:
Owner or Agent
ti
Date
17
SW 6112
Biscuit
SW 6115
Totally Tan
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.
Zi
Date --)
e-7/
chc 6/18/03
Miami Shores Village
10050 NE 2nd Avenue
Phone: 305 - 795 -2204
Printed: 5/27/2004
Applicant: AIMEE
Owner: SANTOS
JOB ADDRESS: 230 NE 104 ST
Contractor
Local Phone:
Parcel # 1121360130350
Building Permit
Permit Number: BP2004 -696
SANTOS
AIMEE
Contractor's Address:
Permit Status: APPROVED Permit Expiration: 11/20/2004 Construction Value: $500.00
Work: PAINT EXTERIOR HOUSE
Signed: (Contractor or Builder) BY:
Page 1 of 1
oR
Legal Description: MIAMI SHORES SEC 5 PB 10-47 LOT 9 & W1/2 LOT 8 BLK 119 LOT SIZE
Fees: Description Amount
FEE2004 -5349 Building Painting Fee $60.00
FEE2004 -5350 CCF $0.60
FEE2004 -5351 Notary Fee $5.00
FEE2004 -5352 Training and Education Fee $0.20
FEE2004 -5353 Technology Fee $1.50
Total Fees: $67.30
Total Fees: $1
Total Receipts: 0:00
a ,3�
MAY 2 7 PAID
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.
Rtia 1.01(U4 1412 15LNUA L7644 CASH
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
10050 N..ad•Avenue • Miami Shores, Florida 33138 • Phone: 305- 795 -2204 • Fax: 305- 756 -8972
• P
Date Job Addres S3 /D / 1 Tax Folio
Legal Description Historically Designated: Yes No
Owner /Lessee/Tenet r `- if Master Permit #
/Owner's Address S,3 ^) c to / S 1 Phone 78'4, - `l�G� ' S7
/'� Contracting Co. Address
Qualifier SS# Phone
State # Municipal # Competency # Ins. Co.
IF THERE IS NO PERMIT PACKAGE ACCESSIBLE ON THE JOB SITE FOR INSPECTORS TO VERIFY,
THERE WILL BE NO 'I • CTION. RE- INSPECTION FEE IS 850.00 AND MUST BE PAID IN ADVANCE
BE 1 RE CALLING FOR ANOTHER INSPECTION.
Permit Type (circle one):
ORK DESCRIPTION:
FEES: PERMIT
APPROVED:
ELECTRICAL PLUMBING MECHANICAL ROOFING
Square Ft. Cost (value) / b
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). 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 all disciplines.
OWNERS AFFIDAV : 1 certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws
regulating constructs ;� and zoning. Furthermore, I authorize the above named contractor to do the work stated.
wner and/or Condo President Date Signature of Contractor or Owner Builder Date
o- 6t -221
otary as to • wner an or C e a • r si nt
owl My Commission Exff, .
• My Commission DD150048
a , Expires November 15, 2006
RADON
Notary as to Contractor or Owner Builder N Date
My Commission Expires I
f r I ‘ 4*
C.C.F . C e NOTARY ----' a zo BOND 4-
TOTAL DUE 6._...c. V �
Zoning t. 005 Building Electrical
Mechanical Plumbing Structural Engineer
MIAMI SHORES VILLAGE
Paint Color Approval and Agreement
DATE: 41 4 1 / °)
OWNER'S NAME: PHONE: 7n - 4/43 - 5 7 7
ADDRESS: 53 r/ /o s T 04 ,4 4 ' S i1 ,)
********************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
ADDRESS OF SITE: S 4 E i 5 T vet S (4-cru2
CONTRACTOR & LICENSE (if applicable)
\ COMPANY NAME: PHONE:
********************************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
All Elements on the site must be listed and indicate the color to be painted.
Walls ✓ 6)
Fascia
Drip Cap/Drip Edge
Soffit
Roof
Flower Bins ,✓ cV
Shutters
Awnings
Chimney ✓ 0
Doors and door jams ,✓
Garage Doors
Railings ;✓ 9
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 . d zoning. I authorize the above -named contractor, if applicable, to
do the wor ated. Furthermore , the paint colors will be as per the attached
sam
gnatur: of Owner ate Signature of Contractor Date
*********************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
APPROVED: WHEN PAINTING IS FINISHED,
CALL FOR FINAL INSPECTION
,a ,/.7. 3
Building Offrcial Date
4/23/01
Operation of a motor vehicle constitutes caveat to any sobriety test required by law.
ISSUED EXPIRES
12-22439 03,09-04
The Sunshine State
UCENSE MASER
C252-750-69-289-0
RICHARD J CACCAMISE JR
3402 NE 171TH STREET
N MIAMI BEACH, FL 33160.0000
NM DATE SEX Fiat REST
08-0949 M 5-10 A
ENDORSE.
DUPLICATE
0218.02:
Miami Shores Village
10050 NE 2nd Avenue
Printed: 4/30/2003
Applicant: RICHARD
Owner: CACCAMISE
JOB ADDRESS: 53
Contractor
Local Phone:
Parcel # 1132060131530
Signed:
NE 101
(INSPECTOR)
Building Permit
Phone: 305 -795 -2204 Permit Number: BP2003 -696
CACCAMISE
RICHARD
ST
Contractor's Address:
Fees: Description Amount
FEE2003 -2573 Building Permit Application Fee $60.00
FEE2003 -2574 CCF $0.60
FEE2003 -2575 Notary Fee $5.00
$65.60
Total Fees:
Total Fees: $65.60
Total Receipts: $0.00
Permit Status: Permit Expiration: 10/27/2003 Construction Value:
Work: EXTERIOR PAINTING AS EPR AGREEMENT
Page 1 of 1
Legal Description: MIAMI SHORES SEC 1 AMD PB 10 -70 LOT 18 & E1/2 LOT 17 BLK 11 LOT SIZE
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
10050 NE 2nd Avenue
Phone: 305 - 795 -2204 Permit Number: BP2003 -696
Printed: 4/30/2003
Applicant: RICHARD
Owner: CACCAMISE
JOB ADDRESS: 53
Contractor
Local Phone:
Parcel # 1132060131530
Permit Status:
Work: EXTERIOR PAINTING AS EPR AGREEMENT
Signed:
NE 101
Building Permit
CACCAMISE
RICHARD
ST
Contractor's Address:
Page 1 of 1
Legal Description: MIAMI SHORES SEC 1 AMD PB 10 -70 LOT 18 & E1/2 LOT 17 BLK 11 LOT SIZE
Fees: Description Amount
FEE2003 -2573 Building Permit Application Fee $60.00
FEE2003 -2574 CCF $0.60
FEE2003 -2575 Notary Fee $5.00
Total Fees: $65.60
Total Fees: $65.60
Total Receipts: $0.00
Permit Expiration: 10/27/2003 Construction Value:
(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:
Miami Shores Village
10050 NE 2nd Avenue
Phone: 305 - 795 -2204
Printed: 4/30/2003
Applicant: RICHARD
Owner: CACCAMISE
JOB ADDRESS: 53
Contractor
Local Phone:
Parcel # 1132060131530
NE 101
Building Permit
Permit Number: BP2003 -696
CACCAMISE
RICHARD
ST
Contractor's Address:
Fees: Description Amount
FEE2003 -2573 Building Permit Application Fee $60.00
FEE2003 -2574 CCF $0.60
FEE2003 -2575 Notary Fee $5.00
$65.60
Total Fees:
Total Fees: $65.60
Total Receipts: $0.00
Permit Status: Permit Expiration: 10/27/2003 Construction Value:
Work: EXTERIOR PAINTING AS EPR AGREEMENT
Signed:
Page 1 of 1
Legal Description: MIAMI SHORES SEC 1 AMD PB 10 -70 LOT 18 & E1/2 LOT 17 BLK 11 LOT SIZE
(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:
BUILDING DEPARTMENT
10050 N.E. SECOND AVENUE
MIAMI SHORES, FLORIDA 33138 - 2382
TELEPHONE: (305) 795 -2204
FAX: (305) 756 -8972
GENERAL INFORMATION
• HAVE PERMIT CARD & APPROVED PLANS ON
SIZE
• PLEASE CALL FOR ALL INSPECTIONS AT
(305)795 -2204 Leave a message in our voice
ALL PERMITS REQUIRE INSPECTIONS
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date , % fiD b Address 3 X C p / $T . Tax Folio
Legal Description Historically Designated: Yes No
Owners Address /� Phone ( c G - D 0 4
Contracting Co. / ( Address
Qualifier SS#
State # Municipal # Competency #
Architect/Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANIC . • E SIGN
WORK DESCRIPTION
/Tenant g /l O G% /C(
Square Ft. Estimated Cost (value) 74e ag. yP
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.
ignature of owner t► o • Condo President Date e
Rotary as to Owner and/or Condo President Date
, PV OFFICIAL NOTARY SEAL
0
<- SANDRA M MONTIEL
u .4.46 ' 11 . COMMISSION NUMDEFI
4 i ` '0" �� MY COMMISSION .EXP.
Ur F‘ all in 17 1nIt
FEES: PERMIT f / ° RADON
APPROVED:
Zoning
cchanical
/39 A
Building
C.C.F.
i
Signature
Master Permit #
AO
Notary as to Contractor or Owner - Builder Date
My Commission Expires:
A
- yi , Ic• MY COMMISSION .frttP:
aF F .° L U i. 1? `i flfAi
NOTARY
Poe OFFICIAL NOTARY SEAL
ei SANDRA M L1ORITIEL
* COMMISSION WIDER
Q CCQ01261
Electrical
TOTAL DUE
�8 §
or Owner- Builder Date
is -5
9i0
Plumbing Engineering
•