BP-05-961 Miamihores Village
Building Department
10050 N.E.2nd Avenue,Miami Shores,Florida 33138
Tel: (3p5)795�2Z04 Fax.(3051756.8972
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BUILDING f w;r° p t Permit No.
PERMIT APPLICATION t •14aster Permit No.
FBC 2001 ,
Permit Type(circle): Building Electrical Plumbs Mechanical Roofing
Owner's Name F�Mt�4e�
itleholder P /� > Phone# /�� "7S—L,/
( ) � C J r�
Owner's Address.
City-Y,:)n_j-, StateL-. Zip
Tenant/Lessee Name Phone#
Job Address(where the work is being done) f` � ^– r
City Miami Shores Village County Miami-Dade Zip .
Is Building Historically Designated YES NO
Contractor's Company Name _ l/y��� Pho #
Contractor's Address
City tat Zi
Qualifier
State Certificate or Registration F.— Certificate of Competency No.
Architect/Engineer's Name(if applicable) Phone#
$Value of Work For this Permit_ l(� '1 Square Footage Of Work:
Type of Work: ❑Addition ❑Alteration ❑New ❑ Repair/Replace
❑Demolition
_
Describe Work: "�. ., -
J
h
Submittal Fee$ Permit Fee$ CCF$ CO/CC
Notary$ Training/Education Fee$ Technology Fee$
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
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 attaq.hment. 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 n be approved and a reinspection fee will be charged
il.-S ignat Signature
Owner or Agent Contractor
4� s
The foregoing instrument w�s.aeknowla ged'before me this The foregoing instrument was acknowledged before me this
day of C ,20 by l�c of ,20_,by
who is rsonally known to me or who has produced 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 P BL j" NOTARY PUBLIC:
Sign: Sign:
IOn �<<
Print: Print:
My Commi on Expires: yrs®e��.° "��nd��+ !'hru
p My Commission Expires:
APPLICATION APPROVED BY: Plans Examiner
Engineer
Zoning
chc 05/13/03
Miami Shores Village
Paint Color Approval and Agreement
Date
Owner's Name Q�l✓P � "
Phone# L) �S 3
owner's Address
y- (� ltd �i_ �{s`.: �i`----
City =nn- 4_1! State =� Zip 3 (%
Job Address (where the work is being done) - , ,` /A'
City Miami Shores Village County Miami-Dade Zip
Is Building Historically Designated YES NO
Contractor's Company Name(if applicable)
Phone#
All elements on the site must be listed and indicate the color to be gaigted
Walls v� t ),� tY,r / ��� b�+ nl. e C
Fascia
Drip Cap/drip Edge 441 Lfoe,P, In
Soffit
Roof
Flower bins Attach Color Samples
With Numbers
Shutters
Awnings
Chimney
-
Doors and door jams
Garage doors , r ,
Railings /
Fences
Decorative metal 1 ^�
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 re ating construction and.zoning.
Date aJ of
Signature
Owner or Agent
A ?,_p'tM0',�T APPROVED BY'
Date
Okla'; oiic 6118/Q3
* 0 Z?
Miami Shores Building VillagePermit
WINs �
10050 NE 2nd Avenue
Phone: 305-795-2204 Permit Number: BP2005-961 ,
Printed:6/30/2005 Page 1 of 1
Applicant: ELENCIR MITCHELL
Owner: MITCHELL ELENCIR
JOB ADDRESS: 455 NE 91 ST
Contractor Contractor's Address:
Local Phone:
Parcel # 1132060140140 Legal Description: MIAMI SHORES SEC 2 PB 10-37 LOT 20 BLK 49 LOT SIZE 50.000 X
Fees: Description Amount
FEE2005-9008 Building Fee $60.00 Total Fees: $67.30
FEE2005-9009 CCF $0.60 Total Receipts: $0.00
FEE2005-9010 Notary Fee $5.00
FEE2005-9011 Training and Education Fee $0.20
FEE2005-9012 Technology Fee $1.50
Total Fees: $67.30
Permit Status: APPROVED Permit Expiration: 12/25/2005 Construction Value: $100.00
Work: PAINTING EXTERIOR OF HOUSE
JUN 3 0 PAID
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: