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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.