453 NE 102 St (5)Z6 dle,0 41
l\NAMI SHORES VILLAGL°1
BUILDING DEPARTMENT 'VS
305- 795 -2204
Building Inspection Request
Date 8170
7
Type Insp'n Pa i
Permit No 3P 05--11 J
Name l�' I Io1 T
Address — 15? tJ 10ZS4
Compan '`e l &L
Phone #
Inspection Date
Approved
Correction
Re- Insp'n Fee
Miami Shores Village
10050 NE 2nd Avenue
Building Permit
Phone: 305- 795 -2204 Permit Number: BP2005 -1131
Printed: 8/2/2005
Applicant: JEFFREY CHARLES
Owner: KELLUM
JOB ADDRESS: 453 NE 102
Parcel # 1132060170810
KELLUM
JEFFREY CHARLES
ST
Contractor COMPLETE HOME PAINTING Contractor's Address: 1476 NE 130 STREET
Local Phone: 305 - 895 -1368
Legal Description: MIAMI SHORES SEC 4 AMD PLAT
Permit Status: APPROVED Permit Expiration: 1/28/2006 Construction Value: $2,450.00
Work: PAINT HOUSE
Page 1 of 1
PB 15 -14 LOT 19
Fees:
FEE2005 -10549
FEE2005 -10550
FEE2005 -10551
FEE2005 -10552
Description
Building Painting Fee
CCF
Training and Education Fee
Technology Fee
Total Fees:
Amount
$60.00
$0.60
$0.20
$1.50
$62.30
Total Fees: $62.30
Total Receipts: $62.30
AUG 1 5 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.
Signed: (Contractor or Builder)
BY:
BLK 92
4.
4 n ate 7
Owner's Name
J
Owner's Address
City /ON'1 / .
Miami Sees Village
Paint Color Approval and Agreement
krik
fir- /0L 51
f State
Job Address (where the work is being done)
City Miami Shores Village
Is Building Historically Designated YES
Walls a) i.
Fascia 4} tt. I-
Drip Cap/drip Edge Iv
Soffit
Roof
/
Flower bins
Shutters £ /
Awnings w
Chimney f" /
Doors and door jams
Garage doors
Railings W AJ ! 4f
Fences
Gt1
Decorative metal
Signature
Gu G._-tt,,
APPLICATION APPROVED BY:
w
Zip
/02 .�`
County Miami -Dade
NO.
Phone # 303 7 S4 ' 3��b
9 3/ 3 c f-
Zip
Contractor's Company Name (if applicable)
********************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** *********** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
All elements on the site must be listed and indicate the color to be painted
Attach Color Samples
With Numbers
All brick (simulated or regular)
Stucco banding
Any other stucco features � LU � �If�
Accessory Buildings W l�[.Q�
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.
Owner or Agent
Date 7 /2 / r
Date
Bonding Company's Name (if applicable)
Bonding Company's Address e—
City State Zip
Mortgage Lender's Nanie (if applicable)
Mortgage Lender's Address
City
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: 1 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.
h s-K/xeut
Owner or Agent Contractor
The foregoing instrument was acknowledged before me this 27 The foregoing instrument was acknowledged before me this
day of 3�� d� , 20 by ,J C5(� 4 e GGk PL! , day of , 20 , by
who is personally to me or who Kasuced who is personally known to me or who has produced
p p
as identification and who did take an oath.
Signature
p Y
As identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
Sign: Sign:
Print: � / G- Print:
WI haej jw as k ewycz My Commission Expires:
i t 20 06
tin
*********************************** * * * * * * ********** * * * * * * * * * * * * * * * ** ************ * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
My Commission Expires:
* * * * * * * * * * * * * * * * * * * **
APPLICATION APPROVED BY:
Chc 05/13/03
At
State
Zip
Plans Examiner
Engineer
r/ / 7 Zoning
4
•••
BUILDING
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
Permit No. 6 - 03 )
PERMIT APPLICATION , . , ,
Master Permit No.
FBC 2001
(
Permit Type (circle): Building ElectrkaJ Plumbing Mechanical Roofing
Owner's Name (Fee Simple Titleholder) 7 - -4-1 /61-4 141
Owner's Address Phone # 3cr— 7 5
Ow 3j--16
( 7 1 5 3 1/1/- la2- /....)
City / /C'144, SAO State Ft_ Zip 733 (3J
Tenant/Lessee Name
Is Building Historically Designated YES
Architect/Engineer's Name (if applicable)
Total Fee Now Due $
(Continued on opposite side)
• v •
Job Address (where the work is being done) A/ /02- SI
City Miami Shores Villa e County Miami-Dade Zip 3 3 /3 cf
"V
NO
frit ti
Phone
Contractor's Company Name Q0 Af /A e fro
Contractor's Address / Wt 0
City 1 At State Ft t Zip 3/6/
Qualifier
Phone #
State Certificate or Registration No. • Certificate of Competency No. C/ /
Phone #
$ Value of Work For this Permit 2 4 Square Footage Of Work:
Type of Work: ['Addition CIAlteration flNew El Repair/Replace [1 Demolition
Describe Work: ,2e!),.)- of d pee Xerva-e
Cie 4:k41,:::7
submittal Fee Permit Fee $ (.0, 0 . CCF $ CO/CC
Notary $ Training/Education Fee $ Technology Fee $
Scanning $ Radon $ Zoning Bond $
Code Enforcement $ Structural Plan Review. $
Miami Shores Village
10050 NE 2nd Avenue
Phone: 305 - 795 -2204
Printed: 8/2/2005
Applicant: JEFFREY CHARLES
Owner: KELLUM
JOB ADDRESS: 453 NE 102
Contractor COMPLETE HOME PAINTING Contractor's Address: 1476 NE 130 STREET
Local Phone: 305 - 895 -1368
Parcel # 1132060170810
Building Permit
Permit Number: BP2005 -1131
KELLUM
JEFFREY CHARLES
ST
Legal Description: MIAMI SHORES SEC 4 AMD PLAT
Fees:
FEE2005 -10549
FEE2005 -10550
FEE2005 -10551
FEE2005 -10552
Description
Building Painting Fee
CCF
Training and Education Fee
Technology Fee
Total Fees:
Amount
$60.00
$0.60
$0.20
$1.50
$62.30
Total Fees: $62.30
Total Receipts: $62.30
Permit Status: APPROVED Permit Expiration: 1/28/2006 Construction Value: $2,450.00
Work: PAINT HOUSE
Page 1 of 1
PB 15 -14 LOT 19
AUG 1 5 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.
Signed: (Contractor or Builder) BY:
BLK 92
New Building
Owner's Name and Address ......
_1
Registered Architect and /or Engineer _.
Name and address of licensed contractor
Location and legal description of lot to be built on:
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMEN
APPLICATION FOR BUILDING PERMIT
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build-
ing or oilier structure herein described. This :application is made in compliance and con +ormity with the Building Ordinance of Miami
Shores Village, Florida, and all provisions of the Laws cf the Statt. of Florida. all md:nances of Mi.,mi Shores Village and all rules and
regulations of the Building Div;:ien of Miami Short Village .h-'1 he complied with, whether herein specified or not. A copy of approved
plans and specifications must be kep at building durinc, progress of the work.
Lot. ._ Block.._ ___. Subdivision__
Street and Number where work is to be done_` ti' � r E
State work to be done and purpose of building (by floors)
To be constructed of. ___ . _ _ .. _.. Kindfoundation.
Date 19t�__
No Street_.
a
R of Covering__ _ . _.
Estimated "- >tal cost of improvements $__ Amount of Permit $_ - ..
6 and for no other purpose.
Remodeling_. ____ _ ._. Addition____ ____ ___ _ ___ _ ___ Repairs. _ . _ . _ No. of Stories
Zone rubage required. __. plan Cubage__- __.._.
Distance to next nearest building._ _Size of Building Lot
Maximum live load to be borne by each floor
hereby submit all the plans and specili :.ations for said building. All notices with reference to the building and its construction may
be sent to. - -- - -- --
The undo *signed applicant for this building permit does hereby certify (hat he understands and accepts his obligations as an employer
of labor under she Florida Workmen's Compensation Act. being S' tion 5960, Cor'-.piled Gen -al Laws of Florida, P,.r,iianeni Snook Went,
and has complied with the rovkions thereof, and will require similar comp lance from all contractors or sub - contractors einplo'. ed by hint
in the wok to be p rf •-met under this permit: and will post or cause to be posted f ^' nspection on the site of the work such public noti e
or i.otites as are requir• d by the Act. The ui thrsign : -d agrees to employ only such . tcontr. to on 'r', to btj p orn, d er this
permit, as are licensed by Miami Shores ‘ illage. z� ���, /��
Remarks_- (Signed � s''
STATE OF .FLORIDA,
COUNTY OF DADE. ss.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths ,..nd take acknowledgments, personally Ap-
peared _
and who, being by me first duly sworn, upon oath deposes and says that he is the
of th abov. de .t.. ibed , istruction. t:, .t h, has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him sta . i1e.
4 '
l
Permit No Date__. ____ .___ __ __._ . Read, Sworn to and Subscribed before me.
Disapproved Date__. .
(Signed)
Chairman
Member
Member
Council Approved
Notary Public State of Florida
Building Inspector My Com:nission Expires
PLANNING BOARD -DATE
Member ...
Member -
Member __ ...._
.Date Disapproved .
to me well known,
Date
NOTE: A charge of $1.00 will be made for making corrections or changes to this application Ater approval h he a obtained from
the Planning Board.
A re-inspection fee of $1.00 will be charged when such re- inspection is m, le necessary by improper notice for insp' t'nr or fa. ity
materials and /or workmanship.