Loading...
PT-07-363Miami Shores Village Building Department 10050 N.E.2 lorida 33138 Tel: (3 i x rig .8972 BUILDING PERMIT APPLICATION FBC 2004 FEB BY_ ctiA0 Llokot e6'.k Tr Mis y C TiAti '4'S V O t Permit No. PT - -- --Master Permit No. Permit Type (circle): Building Electrical Plumbing Mechanical Roofing Owner's Name (Fee Simple Titleholder Owner's Address 44*t. City 0,, Tenant/Lessee Name State Phone # ®P Zip Phone # Job Address (where the work is being done) City . {iami Shores Village e„i""' County Miami -Dade � Zip FOLIO / PARCEL # Is Building Historically Designated Phone #3,05_750-1057 Contractor's Company Name Contractor's Address 23V� City /.L ""ems Qualifier Name State Certificate or Registration No. Certificate of Competency No. eOo /32 Architect/Engineer's Name (if applicable) Phone # Value of Work For this Permit $ [�!c Type of Work: ['Addition ['Alteration Describe Work: ,r,_ - aide. Square / Linear Footage Of Work: ew ❑ Repair/Replac . ❑ Demolition * * * * * * * * * * * * * * * * * * ** Submittal Fee $ Permit Fee $ Notary $ 06D * * * * * * * * * * ** * ** Fees ** * * *** * * * * * * ** * * * * * * * ** * ** ** ** * * * * * * ** •CO • CCF $ 2 • coicc Training/Education Fee $ 0 Scanning $ Radon $ DPBR $ Bond $ Code Enforcement $ Technology Fee $ Double Fee $ Zoning $ Structural Review. $ Total Fee Now Due $ OCT 770 See Reverse si {l 0 5 Km CASH 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 UR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Notice to Applicant: As a emit he issuance of a building permit with an estimated value exceeding $2500, the applicant must promise in good faith that a copy /of 'otice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attach t. o, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs s; n(7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a remsp- jon fee will be charged. Owner or Agent The foregoin ' •. trument was acknowledged before, day of O'%,' by who is personally this O.Jf6r$1 The foregoin instrument was acknowledged before me /this day of Fit , 2001 by £O e�'ddv 7 y /t! , own to me or who has produced who is personally known to me or who has produced IX wee Signature NOTARY PUBLI As identification and who did take an oath. tl Sign: Print: My Commission Expires: * * * * * * * * * * * * * * * * * * * ** APPLICATION APPROVE (Revised 02/08/06) eA' /o 4/z/ Offit�t>tl Seal Notary Pubic State of Florida My Comm. expires Feb 8, 200P BY: No. 79156 Zit m as identification and who did take an oath. NOTARY PUBLIC: Sign: Print: My Commission Ex * * * * * * * * * * * * * * * * * * * * * * * ** 4 * * * * * * * * * * * * * * * * * * * * ** C__ Plans Examiner Engineer Zoning Miami Shores Village Paint Color Approval and Agreement Date: Owner's Name: Phone #: Job Address (where the work is being done): 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 pwinted Walls: C& C� 4V-A-2" ° Fascia: Drip Cap/Drip Edge:``,, ,�A (_ Soffit: , 4) (Ytw Roof: li1YWtOk, V\li \TVA, (hi Flower Bins: (, V t LO CVO* CO6 4 W Shutters: Awnings: Chimney: (4-14it0 OXIM, Doors and Door Jams: Garage Doors: Railings: A,A Fences: AAA Decorative Metal: A1 /4 All brick (simulated or regular): A/id Stucco Banding: A/ 14 Any other Stucco Features: Al Accessory Buildings: Other: Attach color Samples with numbers Cameo Cream Crema Camafeo Camee Creme 4W9 -2 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: Owner or Agent APPLICATION APPROVED BY: P &ZOFFIC °L Date: Date: 1 )1(� * *MUST BE ATTACHED WITH PURPLE BUILDING APPLICATION ** Miami Shores Village � GOrer6 �- Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 BUILDING MOME7M1111 Permit No. PT 1"7-2 -4 PERMIT APPLICATIO FEB 0 8 2007 so Master Permit No. F$C 2004 BY: Permit Type (circle): : uilding Electrical Plumbing tia DonnlftgDea Owner' Address H t. t gq City I NRI Yr)rtiSState pi Zip t 50 Phone # Owner's Name (Fee Simple i eholder) Mechanical Roofing Phone #(.3D5-) Tenant/Lessee Name Job Address (where the work is being done) H ,. � Lit' red— City Miami Shores Village Ls Building Historically Designated YES Contractor's Company Name nee dila Contractor's Address City State Phone # Zip Qualifier Name Phone # State Certificate or Registration No Certificate of Competency No Architect/Engineer's Name (if applicable) Phone # Value of Work For this Permit 400 ,DO Square /Linear Footage Of Work: Type of Work: (Addition ['Alteration Describe Work: e. N411_9 -100 -e ❑ Repair/Replace ❑ Demolition den **** ** ***** * * * * ** ** *** * ***** * *���, car***** ees************* *** ** ***** * ** * * * * * * ** * * * * ** ** ** Submittal Fee $ Permit Fee $ C (L ©✓ CCF $ Q( 2 CO /CC 1.50 Notary $ )' Training/Education Fee $- Technology Fee $ Scanning $ Radon $ DPBR $ Zoning $ Bond $ Code Enforcement $ Double Fee $ Structural Review. $ Total Fee Now Due $ 6709 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 ,&ENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Notice to Applicant: As a condition She issuance of a building permit with an estimated value exceeding $2500, the applicant must promise in good faith that a copyrofjbel notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attaclirminy Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occu s even (7) days after the building permit is issued In the absence of such posted notice, the inspection will not be approved and 4 fir ectzon fee will be charged Signatures'! er or Agent Signature Contractor The foregoing instrument was acknowled ore me this 1 The foregoing instrument was acknowledged before me this day of Raj , 20 61 by h4;;Th Ul a, , day of , 20 , by who is personally known to me or who has ced ft, DI5906. who is personally known to me or who has produced as identification and who did take an oath. As identification and who did take an oath. NOTARY PUBLIC: Sign: Print: My Commission Expires: * * * * * * * * * * * * * * * * * * * * * * * * * * * ** APPLICATION APPROVED BY: (Revised 02/08/06) NOTARY PUBLIC: Sign: Print: My Commission Expires: Plans Examiner Engineer Zoning Miami Shores Village Paint Color Approval and .Agreement Date: Owner's Name: io kcLIf1t a —e2 Phone Job Address (where the work is being done): 1 41 N, r, s q City: Miami Shores Village County: Miami -Dade Zip: en3 i Is Building Historically Designated ?: YES NO Contractor's Company Name (if applicable): Phone #: %alls: Fascia:. All elements on the site must be listed and indicate the color to be painted Drip Cap/Drip Edge: Soffit: tj C lore EC,C,- co (AIN it vIt oof: Flower Bins: IJ1A Shutters: Awnings: Chimney: 01-)In P r11- uotta 13)tyy Aral- fcC - ";� _ R2.0 Nit Doors and Door Jams: k lt��yh � � � ?f�1,# Garage Doors: lAJPI17e, Railings: !" Fences: ./j Decorative Metal: All brick (simulated or regular): Pk Stucco Banding: /t /if Any other Stucco Features: Accessory Buildings: Other: /1-/�d Attach color Samples with numbers OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance wt all applicable lawstregulating construction and zoning. Signature= te: • caner or Agent _ _, APPLICATION APPROVED BY ' Date: 2- P & O" C. * *MUST BE ATTACHED WITH PURPLE BUILDING APPLICATION **