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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: