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5 NE 102 St (12)Issue Date: 10/11/2006 Owner's Name: ROBERT SAKZ Permit Type: Paint Work Classification: Addition /Alteration Job Address: 5 102 Street NE Additional Information Miami Shores Village, FL Fees Due Amount CCF $1.20 Education Surcharge $0.40 Notary Fee $5.00 Permit Fee $60.00 Technology Fee $1.50 Total: $68.10 Building Department File Copy Applicant Signature Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Fax: (305)756 -8972 Permit Expires: 04/09/2007 Contractor(s) HOME OWNER Phone Primary Contractor Yes Type of Work: Exterior Additional Info: Color: Classification: Residential 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 responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL, PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work. OWNERS 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. Futhermore, I authorize the above -named contractor to do the work stated. Invoice Number PT - 10 - 06 - 26334 Total: Permit Status: APPROVED Permit Number: PT -10 -06 -2502 Phone: Parcel #: 1132060131640 Block: Lot: Section: PB: Total Square Feet: 0 Total Valuation: $ 1,500.00 Required Inspections Amt Due $68.10 Amt Paid OCT 12P Final NOTICE: In addition to the requirements of this permit, there may be additional restrictions applicable to this property that may be found in the public records of this county. AND THERE MAY BE ADDITIONAL PERMITS REQUIRED FROM OTHER GOVERNMENTAL ENTITIES SUCH AS WATER MANAGEMENT DISTRICTS, STATE AGENCIES, OR FEDERAL AGENCIES. Miami Shores Village BUILDING IVICOIVM Permit No. 1:7 1 - a, PERMIT APPLICATION a oCT 0 5 100 aster Permit No. FBC 2004 BY: -- - -- - - - - -- Permit Type (circle): �! i uildin Electrical umbing Mechanical Roofing Owner's Name (Fee Simple Titleholder) Q e � � hZ Phone # C 7$ 8 — 1 to ci g Owner's A j ddress S /� ( ) 402. s.E Cit 1 sA t 1 (4 ° k ei ' State Tenant/Lessee Name Job Address (where the work is being done) ! Y City Miami Shores Village County Miami -Dade Zip /.3 FOLIO / PARCEL # J, - 3 2 — 0 6 - 0 1 Is Building Historically Designated YES NO i$ Contractor's Company Name Contractor's Address Architect/Engineer's Name (if applicable) Value of Work For this Permit $ // 52 O Type of Work: ❑Addition Describe Work: Building D epartment 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 ration e Zip 33 / 3 g Phone # Phone # City State Zip Qualifier Name Phone # State Certificate or Registration No. Certificate of Competency No. Phone # / Linear Footage Of Work: ilep ie o? /0 S) Ff ❑ Repair/Replace ❑ Demolition ********* * * * * * * * * * * * * * * * * * * * * * * * * * ** * ** F * * * * * * * ** * ** * * * * * * * * * * * * * * * * ** Submittal Fee $ Permit Fee $ 6 V ''%-. ''%-. CCF $ 1%2-0 CO /CC Notary $' Training/Education Fee $ 0 -40 Technology Fee $ 150 Scanning $ Radon $ DPBR $ Zoning $ Bond $ Code Enforcement $ Double Fee $ Structural Review. $ Total Fee Now Due $ 6a. lo See Reverse 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 d a reinspection fee will be charged. Signature Sign: Print: My Com O erorA•- t The foregoing instrument was acknowledged before me e S day of C..', 20Oq by eOb,/, JCS 2Z , who is personally known to me or who has produced As identification and take an oath. T C o0(26 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: NOTARY P * * * * * * * * ** (Revised 02/08/06) ission Expires: APPLICATION APPROVED BY: * * * * * * * * * * * * * * * * * ** *************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** 111 / /)4 & . 0 �I 0 /h,. Sign: Print: My Commission Expires: `0 t c1��o�Ub Plans Examiner Engineer Zoning Miami Shores Village Paint Color Approval and Agreement Date: (2C (v b { - � p /'(2 2.(00 p o Owner's Name: �f C <ZPhone #: 3 oS 7 2 - Lj 0 L Job Address (where the work is being done): S /V C /0 2 Sf City: Miami Shores Village County: Miami -Dade Zip: 3 , 1 3S Is Building Historically Designated ?: YES NO 1" Contractor's Company Name (if applicable): Roof: Flower Bins: Shutters: Awnings: Chimney: Doors and Door Jams: Garage Doors: c Railings: Fences: Decorative Metal: Signature: All elements on the site must be listed and indicate the color to be printed Walls: Sitrwtn/ ` Wi ll (c,r,4( *SI.J X 1,65 Fascia: .� -1 e #) - w ((((t p S -U 9 12 I. Drip Cap /Drip Edge: Soffit: She in) `W, 64 $- Ski a' z All brick (simulated or regular): /1 J2 T 1 FA C T Stucco Banding: ,4/9 Any other Stucco Features: /✓ )/`1 Accessory Buildings: N /f}, Other: OWNER'S AFFIDAVIT: N /4 N/i N/A //D le w(n, Lt) t Jll N JA Shy vw •� SW 2. 2. MsS it) Z �j done in compliance w • wne APPLICATION AP' ' OVED BY: P & Z OFF[CIAL D W C l/ Phone #: 6vctsf )k Tv� GATF ,Z - roA, 6 o GU) 1/1 y,.,r Xr to z _f(.-o,v q fe Q�tIc cpju c(L E C E $7A t w Date: Date: ip SW 2926 Iron Gate that all the foregoing information is accurate and that all work will be able laws regulating construction and zoning. Q f 2 O co csk0 * *MUST BE ATTACHED WITH PURPLE BUILDING APPLICATION ** �'W 8163 Grassland EXTERIOR PAINTING WALLS: GRASS LAND GARAGE DOOR: IRON GATE JAN 09 2007 Passed '6)'- 1 Inspector Comments Failed Correction Needed Re- Inspection Fee ($75) No Additional Inspections can be scheduled re- inspection fee is paid. until Inspection Date: 01/08/2007 Inspector: Grande, Claudio Owner: SAKZ, ROBERT Job Address: 5 102 Street NE Project: <NONE> Miami Shores Village, FL Contractor: HOME OWNER Building Department Comments Friday, January 5, 2007 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Permit Type: Paint Inspection Type: Final Work Classification: Addition /Alteration Block: Phone Number Parcel Number 1132060131640 Lot: Page 1 of 1 Date y-/7-9‘ Job Address PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Legal Description 5 /V• :• /A2 33J3$ Tax Folio // - c3- ° C - 0 / 3 -/6 145 Owner/Lessee / Tenant I/ f L ES Master Permit # Owner's Address S /0,? S � Contracting Co. .roKzfL1_.Be Addre 2333 iiielZKV..4 Rv f#.ZT7 270.3 Qualifier x-a Vc-R SS# - / - ' Phone State # Municipal # Competency # Architect/Engineer Address Bonding Company Address Mortgagor Address Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN , 5 RZ W /5,// t T 'i// - 41s Gam',EF/ ' e r re- irt7" ) o o4- GA-4/1-6- Square Ft. /5V Estimated Cost (value) jyaa G WORK DESCRIPTION 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 ork stated. Si u ature of owner APPROVED: Zoning Mechanical d/or Condo President Date FEES: PERMIT ` C. RADON (01 0 Notary as to Owner and/or Condo President Date My Commission Expires: - p (2V P4/ G�a'dL 0 6 af. vn A C7 `x;511 ?L • ri , oc r 3SIO ill i n 7, �' CqV a°,Ow"ry d •E:" OF 0.0 � i Ve ' i ' l ' ,T Building wM fvo Historically Designated: Yes No • re .f Contr Phone Electrical 3 %5- L/ 857- Rss8 'qAdap q /7-`/° o or •wner- Builde Date No ary as to Contractor or Owner - Builder My Comm4ssitiExpires.. � � pq � !i sAmr g B: ii. • A. • Oz : ) �r; -;, < L --&26z_cJc Date ). / -r 7 r C.C.F. 1 NOTARY r - TOTAL DUE y Plumbing Engineering