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PT-07-1971Miami Shores Village Building Department 10050 N.t.2nd Avenue_ Miami Shores, Florida 33138 Tel: BUILDING PERMIT. APPLICATION FBC 2004 (305) 795.2204 Fax: (305) 756.8972 Permit No.' r CT"— / MCS Master Permit No. 241(r-= itfl Ts.) Permit Type: PAINT PERMIT /I 1 0 Owner's Name (Fee/k Simple Titleholder) �,I J� Owner's Address 10 /Os -s1 CityhareJ State I Tenant/Lessee Name SEP 1 9 2007 s G.. Phone # 36_-lo3-`/qc Zip ,7,/./a Phone # E-MAIL: %) )oif/(' JJ1 /tje Job Address (where the work is being done) City Miami Shores Village FOLIO / PARCEL # Is Building Historically Designated YES Contractor's Company Name Contractor's Address State V Name 1te or Registration No.0441;N 61 qa_ 105s-1- . County Miami -Dade Zip NO tai %lair City Qualifier Natn State Certificate OWNER BUILDER: Phone # Zip Phone # Certificate of Competency No. Value of Work For this Permit $ Describe Work: Typ ofWo, rlc: Addition / ❑ Alteration / NNew / ❑ Repair/Replace e, Application is hereby made to oltain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance ()la 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 he secured for [1.IfCTRIC'AI. WORK. PLUM131N(, SIGNS. WELLS. POOLS, FURNACES, BOILERS, HEATERS. TANKS and AIR CONDITIONERS, ETC "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FO IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFOR RECORDING YOUR NOTICE OF COMMENCEMENT." Notice to Applicant: pplicant: A.s a condition to the issuance ofa building peril with an estimated value exceeding $2500. the applicant must promise in good faith flint a copy of Me nonce of commencement and construction lien km: brochure will he delivered to the person whose properly is subject to attachment. Also. a certified copy oldie recorded notice of commencement must he posted al the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted nonce. the inspection will not he approved and a reinspection fee will he charged. r ******* * ,***************************Feeessww* xxxx**.*****..**wwwwww,: .,wwww**.w.wxxx** Permit Fee $ CO© CCF $ F - D Technology Fee: ( , 50 Training/Education Fee $ r 4-0 Notary $ b • ©© Code Enforcement $ Double Fee $ Zoning $ Total Fee Now Due $ b8.10 See Reverse side - PAINT COLOR APPROVAL AND AGREEMENT All elements on the site must be listed and indicate the color to be painted Directions: Please circle corresponding number to appropriate color sample. Walls: Fascia: I IVA2 4 Drip Cap/Drip Edge: 4 Sofia: 1 3 4 Roof: I teACA CAc1rA 4 Flower Bins: I 12 3 4 Shutters: 1 3 4 ,Awnings: 1 1 2 3 4 Chimney: v Doors and Door Jams: 01te, 3 4 Garage Doors: Railin<gs: 4 I 12 3 4 0)111 '-1.''0v4M 4 Fences: I LOO1) 2 4 All .brick (simulated or regular): 11N',6\ 2 Stucco Banding: Any other Stucco Features: Accessory Buildings Other: Attach color samples with name and number. Natural Choice • SW 7011 A* e OWNER'S AFFIDAVIT: 1 cert' y that all the foregoing informatib is accurate and that all work will be done in complianc with all applic‘ bljws regulating construction and zoning. Signatur Owner or Agenl The foregoing instrument was ackno‘y+edged before mr this day of . 20(7.1. by YtA wilt pl t is pe s molly known to me or who has uduccd ��Yl�il'sLK 01,109 fZO O -As NOTARY I'll Sign: Print: ification and who did take an oat Signature Contractor The foregoing instrument • . acknowledged before me this day of . 20 • who is personally known to me or who ' s produced as identification and who id take an oath. My Commission Expires: ************************ NOTARY PUBLIC: Sign: Print: My Commission Expires: ************.***********************************xx**x*** 1/;-)—/n APPLICATION APPROVED BY: Plans Examiner Preservation Board Code Einlbrcement XXY.X%Y.Y. (Revised 04/24/0