BP-05-574Miami Shores Village
10050 NE 2nd Avenue
Phone: 305 - 795 -2204
Printed: 5/11/2005
Applicant: HENRY
Owner: PETRASEK
JOB ADDRESS: 1438 NE 104
Building Permit
Parcel # 1122320320290
Permit Number: BP2005 -574
PETRASEK
HENRY
ST
Contractor COMPLETE HOME PAINTING Contractor's Address: 1476 NE 130 STREET
Local Phone: 305 - 895 -1368
Legal Description: RIVER BAY PARK ADDN PB 40 - 72 LOT 8 BLK 4 LOT SIZE 75.000 X 118
Fees: Description Amount
FEE2005 -5863 Building Painting Fee $60.00
FEE2005 -5864 CCF $1.80
FEE2005 -5865 Notary Fee $5.00
FEE2005 -5867 Technology Fee $1.50
FEE2005 -5868 Training and Education Fee $0.60
Total Fees: $68.90
Total Fees: $68.90
Total Receipts: $68.90
Permit Status: APPROVED Permit Expiration: 10/18/2005 Construction Value: $2,450.00
Work: PAINT
Page 1 of 1
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.
Signed: (Contractor or Builder) BY:
Date
Type Insp' n
Permit No. 'arC--)n :S74
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305-795-2204
Building Inspection Request
Name
- f 2 .34 1 .
Address
Correction
Company ....,-.1 "ki( '04'.77 A I Ni
Phone #
Inspection Date L
Re-Insp'n Fee
BUILDING
PERMIT APPLICATION
FBC 2001
Permit Type (circle):
$ Value of Work For this Permit 2 -1(s -0
Type of Work:
Describe Work:
Building
Miami Shores Village
Building Department
10050 N.E.2nd Avenue', Miami Shores, Florida 33138
Tel: (305) 795 2204''Fax 4305) 756.8972
['Addition ❑Alterat' n ['New
t a C L eh -ei V- 1 04i&57 ,
,(%2 a
Total Fee Now Due $ COE3 a q 0 �/ 4S-1
(Continued on opposite side)
ermit No.
VIaSter Permit No.
ti
Electrical Plumbing Mechanical Roofmg
Owner's Name (Fee Simple . er) /f 6Nfl- y %ogre1y' . Phone # f) 7T / 7a 9er
Owner's Address 1 / V3 t N O / ( ,r7
City /1' Pw , SAm c.) State PC •
Tenant/Lessee Name
Zip 33 /3tt
Phone #
Job Address (where the work is being done) /e/ /i1-- /D( s
City Miami Shores Villas e County Miami -Dade Zip 3) / 1
Is Building Historically Designated YES NO
Contractor's Company Name 60190/4 /17,4 .tet � y L
C/1 hone i .300 � 1 /3 eS
Contractor's Address / 4 ( 7 6 alt o
City / 111 f State 1 -1- r Zip 3
Qualifier 2-4-7, ma here 7
State Certificate or Registration No. Certificate of Competency No. D 1 ' C.f 3/
Architect/Engineer's Name (if applicable) Phone #
Square Footage Of Work:
Repair/Replace ❑ Demolition
* * * * * * * * * * * * * * * * * * * * * * * * * * ** F *** * *, ** *4;* * ** * * * ** *** * * * ** * **
Submittal Fee $ Permit Fee $ 6 0. co CCF $ 1 a�v CO /CC
Notary $ Cj .0 Training/Education Fee $ . 4 C) Technology Fee $; 1 -
Scanning $ Radon $ Zoning Bond $
Code Enforcement $ Structural Plan Review. $
Bonding Company's Name (if applicable) A ,�
Bonding Company's Address /v
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 not be approved and a reinspection fee will be charged
'<nature � ?CI
/ e�
p .
Signature � �f • / e4 a--
Contractor
The foregoing instrument was acknowledged before me this / ' . The foreg• ng ins A / ent was ackn wledg�ed before �me this 2
day of 2/ , 20DJ"byCi ey f -A-Kt� day of 11 � 20 y (Li (,� -7�a � arA
who is personally known to me or who J has produced who is personally known to me or who has produced
did take an oath.
Owner or
NOTARY P
Sign
Prin
My Commission Expires:
APPLICATION APPROVED BY:
Chc 05/13/03
NOTARY PUBLIC:
Sign:
Print:
My Comm'
********************* * * * ** * * * * *** * * * * ** * * *** **.�i�Ii *************************** * * * * * * * * * * * * * * * * * * * * * * * * * ** * * **
sat In WY
Oft
T rIC:tr:titIC:steetatiRft'' djel:41 thr1:1*
ntification and who did take an oath.
ion Expires:
Plans Examiner
Engineer
Zoning
Miami Shores Village
Paint Color Approval and Agreement
Date
fF •' �F- T1Zpf.gA.K Phone # l os-) 731-.72
Owner's Name
Owner's Address / y3ep 4/.5 /a 9
City /17i yew/ SY WO State
Job Address (where the work is being done) /931 /tie /0 ' 17e-
City Miami Shores Village County Miami -Dade Zip 33/ Of
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
�G
81 ,, E _
Walls
Drip Cap /drip Edge gm-He,-
Soffit 1J' -He - te'Y
Roof 0t'/ ki
Flower bins /" / h"
Shutters A, / 1
Awnings i /
Chimney — ` 4 -
Doors and door jams �it1 /� �/ v
Fascia
Garage doors # e_
Railings y#4
Fences OG/
Decorative metal 1 hr
All brick (simulated or regular) � i0 4
zip s3/3,f-
Stucco banding
Any other stucco features Gt' 1 frt
Accessory Buildings Fu l
Other A /
***************************************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
.
• information _ .. work _.�tt L_ done ......m.�lionro with all
OWNER'S AFFIDAVIT: I certify that all the foregoing
applicable laws regulating construction and zoning.
Signature Cr/v thm, 1(
J Owner ofAgent
APPLICATION APPROVED BY:
P& Z 'a`
Date % /zo/f
Date g/r��1 L;
chc 6/18/0"
Miami Shores Village
10050 NE 2nd Avenue
Phone: 305- 795 -2204
Printed: 5/11/2005
Applicant: HENRY PETRASEK
Owner: PETRASEK HENRY
JOB ADDRESS: 1438 NE 104 ST
Parcel # 1122320320290
Signed: (INSPECTOR)
Building Permit
Permit Number: BP2005 -574
Contractor COMPLETE HOME PAINTING Contractor's Address: 1476 NE 130 STREET
Local Phone: 305 - 895 -1368
Page 1 of 1
Legal Description: RIVER BAY PARK ADDN PB 40 -72 LOT 8 BLK 4 LOT SIZE 75.000 X 118
Fees: Description Amount
FEE2005 -5863 Building Painting Fee $60.00
FEE2005 -5864 CCF $1.80
FEE2005 -5865 Notary Fee $5.00
FEE2005 -5867 Technology Fee $1.50
FEE2005 -5868 Training and Education Fee $0.60
Total Fees: $68.90
Total Fees: $68.90
Total Receipts: $68.90
Permit Status: APPROVED Permit Expiration: 10/18/2005 Construction Value: $2,450.00
Work: PAINT
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: