BP-05-947 Miami Shores Village
Building Department2 7 y
10050 N.E.2nd Avenue,Miami Shores,Florida 33138
Tel: (305)795.2204 Fax: (305)756.8972
BUILDING Permit No. f5RDS—
PERMIT APPLICATION Master Permit No.
FBC 2001
Permit Type(circle • Building Electrical Plumbing Mechanical Roofing
Owner's Name(Fee Simple Titleholder) a-*� /u • P�l.,�-�.C,,R.a Phone# -2>CL-)S`—7 5 t
Owner's Address / Lf �j �,tq
Ci , &VM � .d`69a► State w Zip )31 21
Te ant/Lessee Name Phone#
Job Address(where the work is being done) IJ —1 44--,�
City Miami Shores Village County Miami-Dade Zip i
Is Building Historically Designated YES NO
Contractor's Company Name
Contractor's Address
City State Zip
Qualifier Vj cow
t
State Certificate or Registration No. Certificate of Competency No.
Architect/Engineer's Name(if applicable) Phone#
$Value of Work For this Permit ,,�(D (7. C) Square Footage Of Work:
Type of Work: ❑Addition ❑Alteration ❑New ❑ Repair/Replace ❑ Demolition
Describe Work:
n�'s**************��***,�***�,��****
Submittal Fee$ Permit Fee$ w-00 CCF$ 160 . CO/CC
Notary$S=0 Training/Education Fee$ / 0L-0 Technology Fee$ '56
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 r
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 issued. In the absence of such posted notice, the
inspection i of be approved and a reinspection fee will be charged.
Signature Signature
Owner or Agent Contractor
The foregoing instrument was acknowledged�befmet is The foregoing instrument was acknowledged before me this
day of 20� by Y(, Irk) day of ,20,,by
who 1 ersonall wn to me or who has producedolMp 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 UBLIC- _ NOTARY PUBLIC:
Sign: Sign:
4 a:�p1{`!P!j
dS
Print: a. Print:
My Com iss ion Expires., qW Expires:JU ,2007 My Commission Expires:
Flo ondedTh
APPLICATION APPROVED BY: Za D Plans Examiner
Engineer
Zoning
Chc 05/13/03
i
Miami Shores Village
~� ,Paint Color Approval and Agreement
Date' I
aN1 'P Phone# 3�Owners a0�{ ��c �- 1
Owner's Address qy ��-J
City/"U�—
State 1. Zip
(where the work is being done) Aye
Job Address
City
Miami Shores Village County Miami-Dade Zip
Is Building Historically Designated YES NO
Contractor's Company Name(if applicable) 9Q-JP'�J Phone#
All elements on the site must be listed and indicate the color to be painted
Walls C r
Fascia
Drip Cap/drip Edge
Soffit
Roof_ 1J
Flower bins --�-�-�v Attach Color Samples
Shutters 1� With Numbers
Awnings 1J
Chimney t
Doors and door jams _
Garage doors
Railings
Fences
Decorative metal
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 regul . g construction and zoning.
r'
Date
Signature
Owner or Agent
APPLICATION APPROVED BY: ! %7 Date
PSG Z Official chc 6/18/03
OR
Miami Shores Village Building Permit
10050 NE 2nd Avenue .....
Phone: 305-795-2204 Permit Number: BP2005-947OR
4k
Printed:6/29/2005 Page 1 of 1
Applicant: ANA PARDINO
Owner: PARDINO ANA
JOB ADDRESS: 94 NE 99 ST
Contractor Contractor's Address:
Local Phone:
Parcel # 1132060131040 Legal Description: MIAMI SHORES SEC 1 AMD PB 10-70 LOTS 1 &2 BLK 8 LOT SIZE
Fees: Description Amount
FEE2005-8923 Building Fee $60.00 Total Fees: $67.30
FEE2005-8924 CCF $0.60
FEE2005-8925 Notary Fee $5.00 Total Receipts: $0.00
FEE2005-8926 Training and Education Fee $0.20
FEE2005-8927 Technology Fee $1.50
Total Fees: $67.30
Permit Status: APPROVED Permit Expiration: 12/24/2005 Construction Value: $500.00
Work: PAINT
C4
L-bq-,
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: