PT-07-796BUILDING
PERMIT APPLICATI
FBC 2004
Permit Type: PAINT PERMI
Owner's Name (Fee Simple Titleholder
•
City V f. ) l A State
Owner's Address
Tenant /Lessee Name
E -MAIL:
Job Address (where the work is being done
City Miami Shores Village County
FOLIO / PARCEL #
Is Building Historically Designated YES
1
4 =w A P
City to 4 • i State �—� Zip
Qualifier Name X4 -id _ two -t c t�-t t Phone #
State Certificate or Registration No. C GC(G f �j -3' Certificate of Competency No.
Contractor's Company
Contra rtrr's ddress
OWNER BUILDER:
Value of Work For this Permit $
Describe Work:
ame
luco
Miami Shores Village
Building Department
10050 N.E2nd Avenue. Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972 1
Permit No. V \�U
Master Permit No.
RECEIVED
V MS
9 s-k
Miami-Dade
NO L/
Phone # ``� — g4 . 447."
Zip 3 3 1
Phone #
Zip 3313
tmen-Asgtoit 1s4 - 7qa - 44+x"
CI s-y 7 . 12 —yy/C
w!/ Type of Work: ❑ Addition / ❑ Alteration / ['New / Repair / Replace
Application is hereby trade to Alain 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 he performed to must the standards of all laws regulating construction in this jurisdiction. I understand that a separate permit must he secured lisr
El,liCTRICAI. WORK. PLUMBING, SIGNS. WELLS. POOLS, FURNACES, BOILERS. (-(HATERS; 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 10 Applicant: .1s a condition 10 the issuance of building permit with an estimated value exceeding $ 2500. the applicant H promise in good fail /t dial a copy of the
notice of corun,encenuent and construction lien law brochure will be delivered to the person whose property is subject 10 attachment. Also. a certified copy of the recorded notice
of conunenceutent roust he posted at the job site for the,frst inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice. the
inspection will Hal he approved and a reinspection, fee will be charged
Permit Fee $ VJO CCF $ (2 '4 U Technology Fee: / • 51
Training %Education Fee $0 Notary $ Code Enforcement $
Double Fee $ Zoning $ Total Fee Now Due $
See Reverse side —>
Directions: Please circle corresponding number to appropriate color sample.
Walls:
Fascia:
Drip Cap /Drip Edge:
Soffit:
Roof:
Flower Bins: I / 3 4
I? 3 4
I lam' 3 4
Shutters:
Awnings
Chimney: 1 ' 3 4
Doors and Door Jams: I 2 4
Garage Doors: I 2
Railings:
Fences:
4
4
All brick (simulated or regular): I 2 3
I_ 2
Stucco Banding: 1 2
2 3 4
3
3
Any other Stucco Features: I 2 3
Accessory Buildings Other:
PAINT COLOR APPROVAL AND AGREEMENT
All elements on the site must be listed and indicate the color to be painted
OWNER'S AFFIDAVIT: 1 certify that all the foregoing information is accurate and that all work will be done in
coi pliance with all applicable laws regulating construction and zoning.
l/ v
i Owner or Agenl - 'l
The for 'going ni
instruent was acknowledged bel me thislD The for g 'ng instrument was acknowledged before me this
day of U . 2001. by _tl1 �tK><r !1Y(�1 Im (,v day of for
. 2U( 1. by m e if Oat
who is personally known to me or who has produced
A s identification and w So -pg as identification • d who did take ai
NOTARY Pl BLl 19‘,1\Ps\s‘s\00°D9 S 4 9 NOTARY PUBLIC: 0,a Qta Sign: �-� , � P • •coo b c -Co Sign:
Print: Ila i Print: + PO a i � L,
`*t 3 ga
r.r.>:************* Fie* ic******k*aYic**eYir**** *** 4**** ak******** *at &aYieaFi:*4raft*' ; ** **** ** t•* **• ******x*xxxx x * **** .
who is personally known to me or who has pioduced j
0M1- b .
4
4
4
4
L,ui5 ('2 1 -1 1 f27
ScA- if 10 ti
Sap-) Q L 0�
Contractor
g —3 D
APPLICATION APPROVED BY: Plans Examiner
Preservation Board
Code Enlbrcement
• ApP
ripro- tA%NS
(Revised 04/24/0
Project Address
Miami Shores Village
10050 N.E. 2nd Avenue
Miami Shores, FL 33138-0000
Phone: (305)795 -2204
40 98 Street
Miami Shores, FL
1132060130930
Block: Lot:
ELIZABETH ENTLER
Parcel Number
Contractor(s)
FLORIDA HOME IMPROVEMENT (954)792 -4415
Phone Cell Phone
Expiration: 09/14/2009
ELIZABETH ENTLER
40 NE 98 ST
MIA! SHORES FL 33138 -2335
Type of Work: Exterior
Color:
Additional Info:
Classification: Residential
Color: _Approved
Color. _Approved_
Code Comments:
Color. _Denied
Fees Due
CCF
Education Surcharge
Notary Fee
Permit Fee
Technology
Total:
Amount
$0.60
$0.20
$5.00
$60.00
$1.50
$67.30
Authorized Signature: Owner / Applicant / Contractor / Agent
Building Department Copy
March 18, 2009
Invoice #
PT - 4 - 07 - 28214
Total Amt Paid Amt Due
$ 67.30 $ 67.30 $ 0.00
Applicant
Valuation:
$ 1,000.00
Total Sq Feet: 0
Inspection Type:
Final
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 responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are
required for ELECTRICAL PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work.
OWNERS 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. Futhermore, I authorize the above -named contractor to do the work stated.
March 18, 2009
Date
Available Inspections:
1