BP-05-575Miami Shores Village
10050 NE 2nd Avenue
Phone: 305- 795 -2204 Permit Number: BP2005 -575
Printed: 5/5/2005
Applicant: MARIE
Owner: DEE
JOB ADDRESS: 350
Contractor
Local Phone:
Parcel # 1121360010230
NW 112
Signed: (INSPECTOR)
Building Permit
DEE
MARIE
TERR
Contractor's Address:
Legal Description: NEW MIAMI SHORES ESTS PB 51 -80 LOT 7 BLK 2 LOT SIZE 75.000 X
Permit Status: APPROVED Permit Expiration: 10/18/2005 Construction Value: $700.00
Work: PAINT
Page 1 of 1
Fees: Description Amount
FEE2005 -5489 Building Painting Fee $60.00
FEE2005 -5490 CCF $0.60
FEE2005 - 5491 Notary Fee $5.00
FEE2005 - 5492 Training and Education Fee $0.20
FEE2005 -5493 Technology Fee $1.50
Total Fees: $67.30
Total Fees: $67.30
Total Receipts: $67.30
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 responisibiliity for all work
done by either myself, my agent, servants or employes.
Signed: (Contractor or Builder) BY:
BUILDING
PERMIT APPLICATION
FBC 2001
Permit Type (circle):
Owner's Name (Fee Simile
Owner's Address
City
Tenant/Lessee Name
Job Address (where the work is being done)
City Miami Shores Village
Is Building Historically Designated YES
Contractor's Company Name
Contractor's Address
Total Fee Now Due $
(Continued on opposite side)
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
Electrical - Plumbing Mechanical Roofmg
County Miami -Dade
NO
,915q.
Phone #
Phone #
IT 1 f �°�
a r� 9
1A 6_ -
Permit No. I FO S -5-
Master Permit No.
Phone # 605 . ?0° , 7960
Ce
Zip ✓ 3 ka
City State Zip
Qualifier
State Certificate or Registration No. Certificate of Competency No.
Architect/Engineer's Name (if applicable) Phone #
$ Value of Work For this Permit 100 CJ Square Footage Of Work:
Type of Work: Addition ElAlteration ['New ❑ Repair/Replace ❑ Demolition
Describe Work: plan:6‘ ot,c& 0-P /x� ,/ 1 S
�t–l� �' CCe� X15 L
* ************************F
** ***** *** * **** ** ** F ees * ** * * * * * * * **** **** * * ** * * * ** * **
Submittal Fee $..,,,� \\ Permit Fee $ � j 0 r o6 CCF $ 1 / ® CO/CC
W
Notary $ C5 • Training/Education Fee $ l an • Technology Fee $ ,
Scanning $ Radon $ Zoning Bond $
Code Enforcement $ Structural Plan Review. $
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 RECORIDING 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 a achment. Also, a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspectio c occur sever ays after the building permit is issued. In the absence of such posted notice, the
inspection will no ' e approv rei ' fee wil e charged
if
Owner or Agent n
(
The fore • ing ins ment was cknowledged before m this 9
day of i 1 20 by , 1� G G C t_
who is perst nil . own to me or wh • . s produced '
As identification and who did take an oath.
eteeea �, , ' . .
NOTARY P C: ; °.K l � l rVBS NOTARY PUBLIC:
�1 ? Con sion J�s1984
Sign: j�� _ hx• u t : Jt Sign:
111111111111b11. +, aP�i�P� inded g.:
eV ,anti .1, , , . , .1 Print: IP
0 * * * * * **
My Commission Expir
Chc 05/13/03
* * * * * * * * * * * * * * * * ** *******************,***************************** * * * * * * * * * * * * * *** * * * * * * * * * * * * **
******************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
APPLICATION APPROVED BY:
* * * * * * * * * * *****************************************
• R 2 7 2g35 Plans Examiner
® Engineer
e( 2 /J , C IA 1 e 5 Zoning
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.
My Commission Expires:
Date
Owner's Name
Owne Ad', -. = :%� W*
City `I..� .L . ,,,, S State Zip
Job Address (where the work is being done)
City Miami Shores Village
County Miami Dade Zip 5,3 0
Is Building Historically Designated YES NO . )(
Contractor's Company Nance (if applicable)
Phone #
**************************************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
All elements on the site mu be listed and indicate the color to be painted
Walls JJ1 l S y tr f I1its
Fascia U.) 11 1
Drip Cap /drip Edge Win UL
Soffit CI t ` •
Roof
Flower bins
Shutters
Awnings
Chimney
Doors and door jams
Garage doors
Railings
Fences P1)l.L L �
Decorative metal
All brick (simulated or regular) t�
Stucco banding
Any other stucco features
Accessory Buildings
Other
OWNER'S
applicable la
AL Ar
* ** * * * ** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
APPLICATION APPROVED BY:
Miami Shores Village
Paint Color Approval and Agreement
/l. e/Let—Phone # S 8 1 / 0 kO
3co NW Il�� ��r c�
************************************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
rmation is accurate and that all work will be done in compliance with all
P� Z cial
Date /* e9/0 F
Date
chc 6/18/03
Date
b
Miami Shores Village
Paint Color Approval and Agreement
Owner's Name
Owner's Address
City State Zip
Job Address W
ess where the work is being done) SSO Ni 1 1 le f/
City Miami Shores Village County Miami -Dade Zip
Is Building Historically Designated YES NO
Contractor's Company Name (if applicable)
Phone #
***************************************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
All elements on the site must be Listed and indicate the color to be painted
Walls b(T Sh 01/41 . ` -/In L.X
II
Fascia A..� l
in
Drip Cap /drip Edge -
Lk) nl
Soffit
Roof
Flower bins
Shutters
Awnings
Chimney
Doors and door jams
t ( X-- )
Garage doors
Railings
Fences
Decorative metal h AU brick (simulated or regular) _ h al}
Stucco banding
Any other stucco features
Accessory Buildings
Other
******** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
OWNER'S AFFID
applicable laws
Signature
APP:.ICATION APPROVED BY:
or
Owner or Agent
P& Z cia
Phone #
*********************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
ing information is accurate and that all work will be done in compliance with all
•
Date
Date
chc 6/18/03