437 NE 102 St (6)MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
Building Inspection Request
Dat
Type Insp'n n
Permit No. -- OP d` )V 3 116S .
Name La { be r
Address 1 �' / L
Company
Phone #
Inspection Date
Approved
Correction
Re- Insp'n Fee
r
BUILDING
PERMIT APPLICATION
FBC 2001
Permit Type (circle):
Miami Shores Village
c F N®uilding Department
Owner's Name (Fee Simple Titleholder) ALjkf •P g-&. Phone #
Owner's Address L '+ -- 'y 1 Q2 5 -
City M ( 1 6 MA l 5 VcoR `t5 State - Et— Zip -3(38
Tenant/Lessee Name
Master Permit No.
Phone #
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
Permit No. j p Z1 3_! %3
Electrical Plumbing Mechanical Roofmg
39 s31 8Z
Job Address (where the work is being done)
City Miami Shores Villaee County Miami -Dade Zip g 3 ( 3 g
Is Building Historically Designated YES NO
Contractor's Company Name a O Y . Phone #
Contractor's Address
City State Zip
Qualifier
Architect/Engineer's Name (if applicable) • Phone #
Architect/Engineer's Address
City ". State Zip
$ Value of Work For this Permit (81 . e
Square Footage Of Work:
Number of: Bays Stories Families Bedrooms Baths
Type of Work: ['Addition ['Alteration ['New ❑ Repair/Replace ❑ Demolition
Describe Work: P' I NsT € KT-cr R(0IZ-
* * * * * * * * * * * * * * * * * * * * * * * * * * ** F ff *** * * * * * * * * * * * * * * ** * * * * ** * **
County Escrow Fee $ . Permit Fee $ `E�-) • v V Notary $ S •vC)
Education/Training Fee $ Tech $ Scanning $ Radon $
Code Enforcement $
Minus Plans Check Fee $
Bond $ Struct. $
Total Fee Now Due $ (Continued 011 opposite side)
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 not be approved a reinspection fee will be charged.
Signature
APPLICATION APPROVED BY:
chc7rno3
Owner or Agent Contractor
The foregoing instrument was acknowledge beforeAne this '7 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.
who is pe ona y known to me or wh produced
As iden a .. n and who did take an oath.
NOT
Sign: Sign:
Print:
Print:
My Commission Expir:� My Commission Expires:
* * * * * * ** * * ** * * * * * * ** , t, k*, tfi**, t**, tt tt ,t,Mt *,t,t *,t * *,r,t *,hr * *** * *, tit, t*, t*, t* tr*********** tr***** ,t,t *,r *,t * * * *,t,t,t * *s *,trr
(Certificate of Competency Holder)
State Certificate or Registration No. Certificate of Competency No.
**************'************************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
\' ei Vargas NOTARY PUBLIC:
D231984
mg o.,
Signature
NOV - 7 2003
Plans Examiner
Engineer
Zoning
• MIAMI SHORES VILLAGE
Paint Color Approval and Agreement
DATE: ii7 / o3
OWNER'S NAME: A- 02r) PHONE: 305 7-511 S 8 Z
ADDRESS: L( Nse 107- . Sr - " c.) v 5 i FL--
33138
********************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
ADDRESS OF SITE: 5
CONTRACTOR & LICENSE (if applicable)
COMPANY NAME: PHONE:
********************************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
All Elements on the si must be listed and indicate the color to be painted.
Walls 'Ff( �^
Fascia VV
Drip Cap/Drip Edge W
Soffit w 7E-
Roof
Flower Bins
Shutters w ttrif,
sam
APPROVED:
Building Official Date
Awnings
Chimney
Doors and door jams
Garage Doors
Railings
- Fences
Decorative Metal
All brick (simulated or regular) -
Stucco Banding
Any other stucco features
Accessory Buildings
Other f o laC N ) f 1 Te. C)
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 w st d. Furthermore , the paint colors will be as per the attached
H
sign- re o Owner ** D * * * * * * * ** Signature ** ** * * * * ** Contractor
* * * * * * * ** * * * * * * * **
G * * * * * * * * * * * * * * * * * **
WHEN PAINTING IS FINISHED,
CALL FOR FINAL INSPECTION
4/23/01
1
Miami Shores Village
10050 NE 2nd Avenue
Phone: 305 - 795 -2204 Permit Number: BP2003 -1763
Printed: 11/10/2003
Applicant: PAUL LARKIN
Owner: LARKIN PAUL
JOB ADDRESS: 437 NE 102 ST
Contractor
Local Phone:
Parcel # 1132060170800
Signed: (INSPECTOR)
Building Permit
Contractor's Address:
Legal Description: MIAMI SHORES SEC 4 AMD PLAT
Page 1 of 1
Permit Status: APPROVED Permit Expiration: 5/5/2004 Construction Value: $1,000.00
Work: Paint exterior
PB 15 -14 LOTS 17 & 18 BLK 92
Fees: Description Amount
FEE2003 -7013 Building Fee $60.00
FEE2003 -7014 CCF $0.60
FEE2003 -7015 Notary Fee $5.00
Total Fees: $65.60
Total Fees: $65.60
Total Receipts: $65.60
NOV 1 3 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: