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BP-05-999 Miami Shores Village * 4 Building Department 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 Tel: (305)795.2204 Fax: (305)756.8972 BUILDING Permit No, PERMIT APPLICATION ON '-4 �Master Permit No. FBC 2001 Permit Type(circle): Building Electrical lumbing Mechanical Roofing Owner's Name(Fee Simple Titleholder) Phone# Owner's Address C �77 AN ® r City G6 O IZ State Zip Tenant/Lessee Name Phone# yj Job Address(where the work is being done) A 11A I 71" rvw City Miami Shores Village Coun Miami-DadeZip Is Building Historically Designated YES NO Contractor's Company Namene# - Contractor's Address City State Zip Qualifier t State Certificate or Registration No. erd to of Competency No. Architect/Engineer's Name(if applicable) Phone# $Value of Work For this Permi Square Footage Of Work: Type of Work: ❑Addition ❑Alteration ❑New ;. ❑ Repair/Replace ❑.Demolition Describe Work: c Submittal Fee$ Permit Fee$ 600 ! 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 attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which oc s seven (7) days after the building per it is issued. In the absence of such posted notice, the inspection will not e approve a d a reinspec 'on fe it be charged. SignatwSignature Owner or Agent Contracttor The foregoing i rument was acknowledged beforee this The foregoing instrument was acknowledged before me this day of COJJ 20 h1cliby��Q �rn�� 20_,by who i r nally own 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 UB IC: NOTARY PUBLIC: Sign: Sign: Print: QAY Pua n Print: 'ptres:Ju 3, My Commission Expires o ,nd£,A ('hr" My Commission Expires: vrF..FP n � APPLICATION APPROVED BY: Plans Examiner Engineer C i Zoning chc 05/13/03 '.r�✓ / /� , � '�� � �1� Miami Shores village Paint Color Approval and Agreement Date _ Owner's Name Phone# � � c I'1 Owner's_Address �Cl// State Zip City Job Address (where the work is being done) 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 painted Walls Fascia �Y r Drip Cap/drip Ed e W ' Soffit Roof Flower bins `�—' Attach Color Samples 10 Shutters �� With Numbers Awnings Chimney Doors and door jams Garage doors Railings _. Fences Decorative metal I All brick(simulated or regular) Stucco banding l/ Any other stucco features Accessory Buildings Other OWNER'S AFFIDAVIT: I certify th all+the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating co structi d zoning. Signatur / Date TJOwner or Agent 41c' Date APP�I A?IOI�F APP VEE Iii: ��� 1.4, � 1 QI1C4a1 ',r cttc 5/18/Q °R Miami Shores Village Building Permit 10050 NE 2nd Avenue ..;,. '" ' Phone: 305-795-2204 Permit Number: BP2005-999 ' OR Printed: Printed:7/8/2005 Page 1 of 1 Applicant: GEOVANNA MERA Owner: MERA GEOVANNA JOB ADDRESS: 9337 NW 2 PL Contractor Contractor's Address: Local Phone: Parcel # 1131010150210 Legal Description: ODELL MANORS PB 41-57 LOT 13 BLK 2 LOT SIZE 75.000 X 100 Fees: Description Amount FEE2005-9345 Building Fee $60.00 Total Fees: $67.30 FEE2005-9346 CCF $0.60 FEE2005-9347 Notary Fee $5.00 Total Receipts: $0.00 FEE2005-9348 Training and Education Fee $0.20 FEE2005-9349 Technology Fee $1.50 Total Fees: $67.30 C- Permit Status: APPROVED Permit Expiration: 1/1/2006 Construction Value: $60.00 C) Work: Work: EXTERIOR PAINT 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: