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BP-05-623 Miami Shores Village Building Department 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 W Tel: (305)79542204ax.,,(305) 56.8972 BUILDING ' Permit No. 4 oly PERMIT APPLICATION ` M seer Permit No. FBC 2001Permit Type (circle): Building Electricalmbing Mechanici I Roofing Owner's Name(Fee Simple Titleholder) Phone# l.�.J � � sc-`go Owner's Address 2, City State - ( Zip J Tenant/Lessee Name Phone# Job Address(where the work is being done) City Miami Shores Village___ County Miami-Da Zip Is Building Historically Designated YES NO Contractor's Company Name(X,lJ�i��„C� P, Phone# Contractor's Address City State Zip Qualifier State Certificate or Registration No. pe ency No. Architect/Engineer's Name(if applicable) P e# $Value of Work For this Permitil Square Footage Of Work: Type of Work: ❑Addition ❑alteration w `❑ Repair/Replace ❑Demolition Describe Work: Submittae Permit Fee$ D` CCF$ �'�V CO/CC Notary$? Training/Education Fee$ C Technology Fee$ Z. f o Scanning$ Radon$ Zoning Bond$ Code Enforcement$ Structural Plan Review.$ Total Fee Now Due$ (Continued on opposite side) ` Bonding Company's Name(if applicable) Bonding Company's Address City State Zip y A 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 copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property ' ubject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first in pec 'on whi occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not b appro d and a reinspection fee will be charged. Signature Signature Ow:as /acknowledged gent Q Contractor The foregoing instrument _befom this V-I The foregoing instrument was acknowledged before me this by day of 20 by who is personally known to e or who has produced who is personally known to me or who has produced s identification and who did take an oath. as identification and who did take an oath. NOTARY P L NOTARY PUBLI t�r,�inny .bonell ``SPAY Pu W Sign: o ]Xion#DD323870 =• ° ''=ExMay 26,200 oPoa: pded Thru At tic BBoonding Co.,Inc. My Commission Expire "y Commission Expires: APPLICATION APPROVED BY: 7 Plans Examiner Engineer Zoning chc 05/13/03 Miami Whores Village y • Paint Color Approval and Agreement Date Owner's Name LTJ Y��Z't� GC Phone# Owner's Address City State Zip Job Address(where the work is being done) City Miami Shores Village Countyade Zip Is Building Historically Designated YES NO Contractor's Company Name(if applicable) Phone# yAll elements on the site must be listed and indicate the color to be painted Walls W "t Fascia Drip Cap/drip Edge Soffit Roof Flower bins Attach Color Samples Shutters With Numbers Awnings Chimney ( � Doors and door jams Garage doors Railings Fences Decorative metal All brick(simulated or regular) — Stucco banding Anv other stucco features Accessory Buildings Other OWNER'S AN A T: 1 rtify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws egul ig on traction and zoning. Signature Date Owner or Agent AI'P�I`-P TI`)N APPROVED BY: A-1 Date L- 7, circ 6/18/0" Miami Shores Village Bumilding 10050 NE 2nd Avenue Phone: 305-795-2204 Permit Number: BP2005-6 3 " Printed:4/29/2005 Page 1 of 1 Applicant: TATIANA BROOKE Owner: BROOKE TATIANA JOB ADDRESS: 129 NW 96 ST Contractor Contractor's Address: Local Phone: Parcel # 1131010250100 Legal Description: RESUB OF BLK 3 OF BONMAR PARK PB 42-60 LOT 10 BLK 3 Fees: Description Amount FEE2005-5312 Building Painting Fee $60.00 FEE2005-5313 CCF $0.60 Total Fees: $62.30 FEE2005-5314 Technology Fee $1.50 Total Receipts: $62.30 FEE2005-5315 Training and Education Fee $0.20 Total Fees: $62.30 Permit Status: APPROVED Permit Expiration: 10/26/2005 Construction Value: $200.00 Work: PAINT HOUSE EXTERIOR /* I 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 10050 N.E. 2nd Avenue Miami Shores, FL 33138-0000 Phone: (305)795-2204 Fax: (305)756-8972 Permit Permit Status: APPROVED Issue Date: 4/29/2005 Expires: 03/14/2007 Permit Number: BP2005-623 Owner's Name: TATIANA BROOKE one: 305/915-9018 Permit Type: Imported Permit Parcel#: 1131010250100 Work Classification: <NONE> Block: Lot: Job Address: 129 96 Street NW Section: PB: Miami Shores Village, FL 33138- Contractor(s) Phone Primary Contractor Total Square Feet: 0 Total Valuation: $ 200.00 omments: Re uired Inspections PAINT HOUSE EXTERIOR Additional Information Perm Type: Building Alpha Two:PAINT Alpha Four:PAINT Alpha Five:RESIDENTIAL Alpha Six:SINGLE FAM Pay Date:4/29/2005 Pay Amount:62.3 Pay Comments:CK#7543 Bond Return : 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 responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL, PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work. OWNERS 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. Futhermore, I authorize the above-named contractor to do the work stated. Fees Due Amount Invoice Number Amt Due Amt Paid Renewal/Extension Fee $60.00 imp-3-06-24132 $60.00 $60.00 Total: $60.00 Total: $60.00 Building Department File Copy NOTICE: In addition to the requirements of this permit, there may be additional restrictions applicable to this property that may be found in the public records of this county. AND THERE MAY BE ADDITIONAL PERMITS REQUIRED FROM OTHER GOVERNMENTAL ENTITIES SUCH AS WATER MANAGEMENT DISTRICTS,STATE AGENCIES,OR FEDERAL AGENCIES. Applicant Signature