PT-14-565Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
INSPECTION'S PHONE NUMBER: (305) 762.4949
BUILDING •
PERMI(T APPLICATION
FBC 20 IU
PT 4Sc pS
Permit No.
Master Permit No.
Permit Type: PAINT
OWNER: Name (Fee Simple Titleholder):
0'n, Phone#: 3oS 3 - 3
Address: cTD OJ E `3 k1%g
City: /`6 !-O't't S '(-S State: Zip: 33)-3$
Tenant/Lessee Name: ' 1-y& Phone#:
(-Alb a n `1- i N 11-oL . C
Email:
JOB ADDRESS: q ODIC l `t k- P -v
City: Miami Shores County: Miami Dade
Zip: 33) 3$
Folio/Parcel#:
Is the Building Historically Designated: Yes
NO l/ Flood Zone: V-513
CONTRACTOR: Company Name: klitE"ED Phone#:
Address:
City: State: Zip:
Qualifier Name: Phone#:
State Certification or Registration #: Certificate of Competency #:
Contact Phone#:. Email Address:
Value of Work for this Permit: $ Square/Linear Footage of Work: aZ00 SQs Aa -=4 - 63)6
Description of Work:', �' tki e,
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
"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 an inspection fee will be charged.
***************************************Fees********************************************
Permit Fee $ CCF $ Notary $ Training/Education Fee $
Technology Fee $ Double Fee $ TOTAL FEE NOW DUE $
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: 1 2 3 4
Fascia: 1 2 3 4
Drip edge: 1 2 3 4
Soffit: 1 2 3 4
Roof: 1 2 3 4
Flower Bins: 1 2 3 4
Shutters: 1 2 3 4
Awnings: 1 2 3 4
Chimney: 1 2 3 4
Doors & Jambs: 1
Garage Doors: 1
Railings: 1
Fences: 1
All Brick: 1
Stucco Bands: 1
2
3 4
2
3 4
2
3 4
2
3 4
2
3 4
2
3 4
Other Stucco
Feature: 1
2
3 4
Accessory Bldg: 1 2 3 < 4 . .
OWNER'S AFFIDAVIT: I certify that all the foregoing information is accuritsand that all work will be done in compliance with all
applicable laws regulating construction and zoning.
•
Attach color sample with name and number
3.
4.
Costa Mesa 45YY
Del Mar Shores 6
Signature:
Owner or Agent -
S4
The foregoing instrument was acknowledged before me this Z�
day of K\QC , 20 04- , by Srar �Ir1Y1\L
who is personally known to me o who has produced
As iden fica o an
NOTARY
rn:
nnt:
PUBLIC:
1 Ill'
at,
1 J • s 1.,-.,s
MARIA JULIANA LONDON°
MY COMMISSION # FF 083331
EXPIRES: January 14, 2018
o '. Bonded Thru Notary Public Underwriters
a
to (1\ h
My Commission Expires:
Signature:
Contractor
The foregoing instrument was acknowledged before me this
day of , 20 , by
who is personally known to me or who has produced
as identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
My Commission Expires:
%.-, APPROVED BY: Code Official
0
Preservation Board
Miami Shores Village
Building Department
10050 N.E. 2nd Avenue
Miami Shores, FI 33138
Tel: 305-795-2204
Fax: 305-756-8972
11/20/2015
9025 NE 4 Avenue
Miami Shores FL
RE: Process No.PT-3-14-565
Address: 9025 NE 4 Avenue
Dear Owner,
Our records indicate that the above referenced permit has expired without obtaining the
proper permit approval. In order to serve you better, we need to keep our files up to date.
As per section 105.3.2 of the Florida Building Code, "An application for a permit for any
proposed work shall be deemed to have been abandoned 180 days after the date of filling, unless
such application has been pursued in good faith or a permit has been issued."
Please be advised that open permits will hinder your ability to refinance or sell this property.
Please contact the Building Department, within 15 days of receipt of this letter in order to
take care of this matter.
S incerely,
(:111(tf 19)1,1—
Ismael Naranjo, CBO
Building Department Official
305-795-2204