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BP-05-284BUILDING ( Fp '!E PERMIT APPLICATION FBC 2001 Permit Type (cir k Building ! Electrical '; mbing Mechanical Roofing Owner's Name (Fee S e Title ®i(/ 2C✓ L. L- Owner's Address 76)J t) // / 6 City State Tenant/Lessee Name Z2 i).E Phone # Job Address (where the work is being done) ,4S 2i/i BLS` / Ai 'C'4 City Miami Shores Village County Miami -Dade Zip Is Building Historically Designated YES NO X Contractor's Company Name NA e' JIJ/Vt Contractor's Address City Qualifier State Certificate or Registration No. /1,41,12 j® 47'3 Architect/Engineer's Name (if applicable) $ Value of Work For this Permit �l�® m Type of Work: ['Addition ❑Alteration ONew El Repair/Replace ❑ Demolition 4.� E. Describe Work: .'L0.2 ; iQL (- Z 'i' — f G ®, P, v/(/r`al' **************,*************F Submittal Fee $ Permit Fee $ ° ✓ CCF $ Notary $ � Training/Education Fee $ ®. Technology Fee $ Scanning $ Radon $ Zoning Bond $ Code Enforcement $ Structural Plan Review. $ Total Fee Now Due $ (Continued on opposite side) 67 SD Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 State Permit No, Plaster Permit No Phone # 305 - 75; °.%55Z/ Zip Z Phone # Zip Certificate of Competency No. 5 /- Phone # qju r e� ag e W 3 2/ 6 ,j` — CO /CC S 7) R61 J 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 JMPROVEMENTS. 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 approve , ii d a reinspection fee will be charged. Owner or Agent The f g instrument was . .• owledged betr day of e , 200r, by who is personally known to R /W — /P ; APPLICATION APPROVED BY: Cho 05/13/03 who did take an oath. as identification and who did take an oath. NOTARY PUBLIC: o < rR .,^ �JXYAZ�Y oneii • ∎ � i : - _�� = � mmission v 1 33870 " % k ' Atlantic Bo mission Expires: ********* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** &,/ Contractor The foregoing instrument was acknowledged before me this day of ,20 ,by who is personally known to me or who has produced 2 /OS -2 ********* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * Plans Examiner Engineer Zoning , � Miami Shores Village Paint Color Approval and Agreement Date g / ,zf //y 5 Owner's Name ex/ #30ffLZ Owner's Address 26 �e V /1 / 67 City yam/ 3©e. State cz Job Address (where the work is being done) P'2 City Miami Shores Village County Miami Dade Zip ,.31'&8 °132 Is Building Historically Designated YES NO ,,.>< Contractor's Company Name (if applicable) Phone # ***************************************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** All elements on t le must be listed and indicate the color to be painted e/® Wails _ _ iv ire.2 3 /P (1A/ Fascia 6 .LwDEiV 0L gg5® GailP 7" LR Drip Cap /drip Edge " Soffit jf f Roof —5 G ��e�! <9�' Flower bins ,,;VA Shutters Ah4 Awnings AM Chimney c ) - 1 %,',444-y -Y VfT/2 L /9,' 4. t a/ 3 .0;0 boars and door jams D ® ®eW $ Ah4 1-117E Garage doors 4ZID,47.5// �Iyi rA Railings Ad Fences A✓ A Decorative metal 1✓ifq All brick (simulated or regular) A h Stucco banding AP Any other stucco features ,/I/ Accessory Buildings Other ,r`/® ************************************************************************ * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** 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. Signature APPLICATION APPROVED BY: "I:9 /i,eete_Zg Owner or Agent Phone # r3';• 7,.5a9-e:752/ Zip 3,5/6c5 `I g2Z Date Xi2 0/ Date chc 6/18/03 682 "PREMIUM" "STAY- WHITE" ACRYLIC LATER ROl'' - SEMI -GLOSS An unusually high quality semi -gloss enamel roof paint especially formulated for. -roof surfaces in tropical climates. Use on all roofs, such as concrete tiles, barrel tiles, poured concrete, wood shingles, corrugated galvanized steel, mobile home roofs, etc. Contains the maximum amount of mildewcide allowed by law. Because of its harder, glossy enamel finish, this roof paint sheds dirt better and remains cleaner looking longer with normal rinsing by tropical rainstorms. ft