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PT-07-2260Z.4.1 -6) 'kK61 Q Lt - , BUILDING PERMIT , APPLICATION FBC 2004 Permit Type: PAINT PERMIT Owner's Name (Fee Simpl Owner's Address City_/j?1 /4 6 d 06 State Tenant/Lessee Name E -MAIL: Job Address (where the work is being done) City FOLIO / PARCEL # Is Building Historically D OWNER BUILDER: Describe Work: Double Fee $ ,z,3 5 ',240) Miami Shores Village signated YES Contractor's Company Name Contractor's Address City Qualifier Name State Certificate or R Permit Fee $ CCF Training /Education Fee $ Zoning $ Miami Shores Village Bu lding Department 10050 b.2nd Avenue, Miami Shores, Florida 33138 Tel: ( 05) 795.2204 Fax: (305) 756.8972 iilo`tlm Iowa Titleholder) Lows / eee0 tlU 67� �9r�E (4EA2) ounty Miami -Dade S Permit No. _P 0 cr Master Permit No. Zip Phone # .� Phone # Novi 0 0 4? q gca- 909:5 Phone # 305 — 7 769- 15W/ Z i , ) Phone # 3o5 - 7c,- /86.3 Zip Certificate of Competency No. i fey Value of Work For this Permit $ 306>Z Type of Work: 0 Addition / ® Alteration / ['New / ❑ Repair /Replace Application is hereby made to ottain a permit to do the work and installations as indicated. 1 certify that no work or installation has commenced prior to the issuance of a permit s regulating construction in this. jurisdiction. I understand that a separate permit must he secured tirr and that all work will he performed to meet the standards of all la EL.ECTRICAI. WORK. Pt.UMI3lNG, SIGNS. WELLS. POOLS. FURNACES, BOILERS. HEATERS, TANKS and AIR CONDITIONERS, ETC..... "WARNING TO OWNER: YOUR FAILURE TO RE 'ORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FO IMPROVEMENTS TO YOUR PROPERTY. IF YOU INT ND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY 6EFOR RECORDING YOUR NOTICE'OF COMMENCEMENT." Notice to Applicant: .4s a condition to the issuance of a building rrmit 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 delivered to the person whose property is subject to attachment Also. a certified copy oldie recorded notice of commencement must be posted at the job site for the first inspe ion which occurs seven (7) days after the building permit is issued. In the absence of such posted notice. the inspection will not he approved and a reinspeclion fee will be cha ged. **** **********Fees*********************** *******************x* *****x7.9e Technology Fee: otary $ Code Enforcement $ Total Fee Now Due $ See Reverse side — Directions: Please circle corresponding number to appropriate color sample. Walls: Fascia: Signature Drip Cap /Drip Edge: Soffit: Roof: / i I JJ ( a /�4 Flower Bins: Shutters: ' Awnings: NOTARY PUBLI Sign: Print: © PAINT COLOR APPROVAL AND AGREEMENT All elements on the site must be listed and indicate the color to be painted 2 3 3 3 3 4 4 4 4 4 4 / 0� L Doors and Door Jams: 1 2 4 vtia Garage Doors: _XU 2 3 4 Railings: ,tt/ 2 3 4 Fences: 2 3 4 All brick (simulated or regular): 1 3 4 Stucco Banding: Any other Stucco Features: / Accessory Buildings ./V Other: OWNER'S AFFIDAVIT: I certify that ail the fo compliance with ap`�� I y . re_ulatin, o caner or gent The foregoing instrument wa.• - cknowledged before me day of IverV . 20 07 by kW)" &4J I r1� who is personally known to me or who has produced identification and who did take an oath. My Commission Expires: 12421 /ifi 3 NOTARY PUBLIC: Attach color sample nv ission Expires: 11 790D -4 Granite Boulder Chalk White • WW41 ignature M The foregoes msst as-acknowledged before me this day or 20 '. by who is personally known to me or who has produced as identification and who did take an oath. MY COMMISSION S eliKeZOS APPLICATION APPROVED BY: Plans Examiner Preservation Board t i AS, o,.~ Code Enliweement Contractor formation is accurate and that all work will be done in and zoning. *********Se ********d:xxxx xxxxx *x:x4r` caw ******dz &xxxx*xuunYeSxxxxxxxxx *$ *xxxxkstixkwww*x3rxx #x xxxxx*xdexx *xxxx 0 0 (Revised 04/24/O7