BP-05-914 Miami Shores Village
Building Department
10050 N.E.2nd Avenue,Miami Shores,Florida 33138
Tel: (305)795.2204 Fax: (305)756.8972
BUILDING Permit No.`6M5 ' q ! 4
F' r� :j
PERMIT APPLICATION' Master Permit No.
FBC 2001 '� 7 Iq�
Permit Type(circl : Building ,Pl mbing Mechanical Roofing
Owner's Name(Fee Simple Titleholder) �L� ctS C �ce `��— �`�
Owner's Address
City U(4U � l`"" State Zip 1r0/
Tenant/Lessee Name Phone#
Job Address(where the work is being done) a w e..,
City Miami Shores Village County Miami-Dade Zip
Is Building Historically Designated YES NO
Contractor's Company Name r9done
Contractor's Address
City State �� ip
Qualifier
t
State Certificate or Registration No. Certificate of Competency No.
Architect/Engineer's Name(if applicable) Phone#
$Value of Work For this Permit - , U Square Footage Of Work:
Type of Work: ❑Addition ❑Alteration ❑New ❑ Repair/Replace ❑Demolition
Describe Work: t
V V //(4VVL TUP ' 0
Submittal Fee$ Permit Fee$ CQ 0. CCF$ 0,SoO CO/CC
Notary$ 5-00 Training/Education Fee$ 0 C)o Technology Fee$ (•
Scanning$ Radon$ Zoning Bond$
Code Enforcement$ Structural Plan Review.$
Total Fee Now Due$ G:T•
(Continued on opposite side)
Bonding Company's Name(if applicable) -�
Bonding Company's Address r
Cit State
y 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$2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
Signature Signature
Owner or Agent Contracttor
The foregoing instrument wa knowle ged be re me .s ! The foregoing instrument was acknowledged before me this
day oJJ �f 20 by a df , 20_ by
3
who rsonally n to me or who has produced ho is personally known to me or who has produced
As identification and who did take an oath. as identification and who did take an oath.
NOTARY PU LIC: NOTARY PUBLIC:
Sign: Sign:
4n c
Print: as
� �' 'Sion ,? Print:
Tres:
M Commis ion Expires::.` + + ❑ 3�21)0 7
Yonded ihr„ My Commission Expires:
_ .ntic$on
APPLICATION APPROVED BY: Plans Examiner
Engineer
d J Zoning
the 05/13/03
• Miami Shores Village
Pint Color Approval and Agreement
gate fty�� � /�-d� -- ��-��c-��1�?n �.-�s�-
Owner's Name ���' � P ` "" ' � 2�
x r
Owner's Address /\`
City t0 AU-1 166/Z—f�itate �-` Zip
Job Address(where the work is being done) G �{
City Miami Shores Village County Miami-Dade Zip
Is Building Historically Designated YES NO
Contractor's Company Name(if applicable)
"e V Phone#
All elements on the site must be listed and indicate the color to be Painted
Walls Cu
Fascia
V>— A
Drip Cap/drip Edge
Soffit
Roof
� Attach Color Samples
Flower bins_N
Shutters_____U " ' With Numbers
Awnings 4A,dT. 1
Chimney
Doors and door jams ,�� pp� �p
Garage doors rl �.(Il A
Railings
Fences °
Decorative metal r® lAL%t-dam
All brick(simulated or regular)
Stucco banding
Any other stucco features
Accessory Buildings
Other
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. °
✓ Date
Signature
Owner
r
Date
tvr'pIA i IOh AP° QVi✓f BY: 'Z C'
COficia- clic 6118/02
■ ' ` '
Miami Shores Village Building Permit
# Jill
10050 NE 2nd Avenue „`,:,. '
Phone: 305-795-2204 Permit Number: BP2005-914 OR `
Printed:6/21/2005 Page 1 of 1
Applicant: FELICITAS CALILUNG
Owner: CALILUNG FELICITAS
JOB ADDRESS: 173 NE 108 ST
Contractor Contractor's Address:
Local Phone:
Parcel # 1121360090230 Legal Description: DUNNINGS MIAMI SHORES EXT NO 5 PB 48-21 LOT 15 BLK 216 LOT SIZE 75.000 X
Fees: Description Amount
FEE2005-8505 Building Fee $60.00 Total Fees: $67.30
FEE2005-8506 CCF $0.60
FEE2005-8507 Notary Fee $5.00 Total Receipts: $0.00
FEE2005-8508 Technology Fee $1.50
FEE2005-8509 Training and Education Fee $0.20
Total Fees: $67.30
Permit Status: APPROVED Permit Expiration: 12/14/2005 Construction Value: $300.00
Work: EXTERIOR PAINTING
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: