BP-04-455 --° Miami Shores Village
Building Department RECEIVED
tY � � p
10050 N.E.2nd Avenue,Miami Shores,Florida 33138 i 0 5 2004
Tel:(305)795.2204 Fax: (305)756.8972
]BUILDING Permit No.
PERMIT APPLICATION Master Permit No.
FBC 2001
Permit Type(circle) Buildin Electrical Plumbing Mechanical Roofing
Owner's Name(Fee Simple Titleholder) Ol dirt sfina- Via-&- Phone# 81Y 7 w�>
Owner's Address
City M P Ornu S key--S State rZ— Zip 1
Tenant/Lessee Name Phone#
Job Address(where the work is being done) � /®S I "
City Nfiami Shores Village County Mtiamii--Dade Zip
Is Building Historically Designated YES NO �✓
Contractor's Company Name 6M e-,,t C, S F2 low �{�'�'' �Q Phone# 5'° S;4-4
Contractor's Address Cx::>2-&
City112a� State F::c, Zip 3 3[)(Sr
Qualifier
Architect(Eagmeer's Name(if applicable) ne#
$Value of Work For this Permit goo-� Square Footage Of Work:
Type of Work: ❑Addition ❑Alteration ❑New ] Repair/Replace ❑Demolition
Describe Work: P J� - - k
Submittal F $ Permit Fee$(0 � CCF$ � CO/CC
Notary$ Training/Education Fee S -(00 Technology Fee$ [ - ,so
Scanning$ Radon$ Zoning_ Bond$
Code Enforcement$ Structural Plan Review.$
Total Fee Now Due$ 1, 0
.(Continued on opposite side) pala
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$2500, the applicant must
promise.in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is is ed n the absence of such posted notice, the
inspection will not be approved and a reinspection fee will be charged
Signature �
Owner or Agent ' ' Contractor
The foregoing instrument was acknowledged before me thi *\ \ The foregoing instrument was acknowledged before me this
day of Aa r 20 Eby (2 hrtr W�b4 day of kap;Jn 20 C4 by `° lrre°9s$i cx� Cc$ 11?r'®
who is rsonally known to a or who has produced who i. ersonally known toor who has produced
As identification and who did take an oath as.identification and who did take an oath.
NOTARY PUBLIC: yyW,0,NOTARY PUBLIC: Ec►wxb
Sign: •wycmrwonDO Sign:
Print: Print: eDUA V-Do 1�i4 C E��i
My Commission Expires: AprtL 3® 2®D-? My Commission Expires: Apr-JL 3o ,�,
(Certificate of Competency Holder)
State Certificate or Registration No. Certificate of Competency No.
APPLICATION APPROVED BY: o 7 200V Plans Examiner
Engineer
Zoning
Chc 12/15/03
Miami Shores Village
' Paint Color Approval and Agreement
Date
Owner's Name
OAas h,na_ C�a� l- Phone#
Owner's Address /®S`j Me /C)S Sys e e
City ff7i 47 n t S State - Zip 331 a
Job Address(where the work is being done) /CS A�12-�7 /TE
City Miami Shores Village County Miami-Dade Zip -3 3 t g
Is Building Historically Designated YES NO_LZ
Contractor's Company Name(if applicable)AM PVT Cc,-. 7=t lr- a-e Phone#
All elements on the site must be listed and indicate the color to be uainted
Walls Ie-&LP (OR-7-3)
Fascia
Drip Cap/drip Edge
4---
Soffit t ~
Roof
Flower bins //-T
Shutters
Awnings N f A'
Chimney
Doors and door jams N �"
Garage doors W h t
Railings 4_11A-
Fences Nl A r
Decorative metal
All brick(simulated or regular)
Stucco banding N I A
Any other stucco features NIA-
Accessory Buildings
Other lYY-mil f 6r0
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 Date
Owner or Agent
APPLICATION APPROVED BY:
Date
P&Z cw chc 6/18/03
Miami Shores Village i l d i n Permit
Bu g
10050 NE 2nd Avenue
Phone: 305-795-2204 Permit Number: BP2004-455 ``
Printed:4/8/2004 Page 1 of 1
Applicant: CHRISTINA CABALLERO
Owner: CABALLERO CHRISTINA
JOB ADDRESS: 1055 NE 105 ST
Contractor Contractor's Address:
Local Phone:
Parcel# 1122320280810 Legal Description: MIAMI SHORES ESTATES PB 47-58 LOT 10 BLK 5 LOT SIZE IRREGULAR
Fees: Description Amount
FEE2004-3696 Building Painting Fee $60.00 Total Fees: $63.90
FEE2004-3697 CCF $1.80 Total Receipts' $63.90
FEE2004-3698 Training and Education Fee $0.60
FEE2004-3699 Technology Fee $1.50
Total Fees: $63.90
Permit Status: APPROVED Permit Expiration: 10/2/2004 Construction Value: $2,400.00
Work: PAINT EXTERIOR OF HOUSE AS AGREED
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:
Miami Shores Village Building Permit
10050 NE 2nd
Avenue '� •..
Phone: 305-795-2204 Permit Number: BP2004-455
Printed:4/8/2004 Page 1 of 1
Applicant: CHRISTINA CABALLERO
Owner: CABALLERO CHRISTINA
JOB ADDRESS: 1055 NE 105 ST
Contractor Contractor's Address:
Local Phone:
Parcel # 1122320280810 Legal Description: MIAMI SHORES ESTATES PB 47-58 LOT 10 BLK 5 LOT SIZE IRREGULAR
Fees: Description Amount
FEE2004-3696 Building Painting Fee $60.00 Total Fees: $63.90
FEE2004-3697 CCF $1.80 Total Receipts' $63.90
FEE2004-3698 Training and Education Fee $0.60
FEE2004-3699 Technology Fee $1.50
Total Fees: $63.90
Permit Status: APPROVED Permit Expiration. 10/2/2004 Construction Value: $2,400.00
Work: PAINT EXTERIOR OF HOUSE AS AGREED
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: