PT-05-1012Issue Date: 12/1/2005
Owner's Name: ANDRES OBRADOR
Permit Type: Paint
Work Classification: New
Job Address: 85 108 Street NE
Miami Shores Village, FL 33138-
Miami Shores Village
10050 N.E. 2nd Avenue
Miami Shores, FL 33138 -0000
Phone: (305)795 -2204 Fax: (305)756 -8972
Permit
Expires: 11/30/2006
Contractor(s)
Phone
Primary Contractor
Additional Information
Type of Work:
Additional Info:
Color.
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.
Building Department File Copy
Applicant Signature
Parcel #:
Block:
Section:
Permit Status: APPROVED
Permit Number: PT -11 -05 -1012
Phone: 305/758 -7376
1121360110480
Lot:
PB:
Total Square Feet 0
Total Valuation: $ 300.00
Required Inspections
Final
Fees Due
CCF
Education Surcharge
Notary Fee
Permit Fee
Technology Fee
Total:
Amount
$0.60
$0.20
$5.00
$60.00
$1.50
$67.30
Amt Due
$67.30
Invoice Number
PT - 11 - 05 - 1096
Total:
DEC
Amt Paid
-
0
NOTICE: In addition to the requirements of this permit, there may be
additional restrictions applicable to this property that may be found in the
public records of this county.
AND THERE MAY BE ADDITIONAL PERMITS REQUIRED FROM OTHER
GOVERNMENTAL ENTITIES SUCH AS WATER MANAGEMENT
DISTRICTS, STATE AGENCIES, OR FEDERAL AGENCIES.
BUILDING
PERMIT APPLICATION
FBC 2001
Owner's Name (Fee Simple Titleholder)
Owner's Address r � ^ / v L()
City_414A m /S/ o/�C'� State
Tenant/Lessee Name
Contractor's Company Name
$ Value of Work For this Permit. 3oo . cs c
Type of Work: °A °Alteration
Describe Work: j� o vs t- P4/4/1 4 / M/7
Notary $ Training/Education Fee $
Scanning $
Total Fee Now Due $
(Continued on opposite side)
Miami Shores Village I Z
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
Permit Type (circle): Building Electrical mbing Mechanical Roofmg
Al i> /f � b — One # '" T X 2/
❑New
Radon $ Zoning
Code Enforcement $ Structural Plan Review. $
Zip
Permit No. P li0S- toi.
ster Permit No.
J33 /C r
Phone #
Job Address (where the work is being done) ,571/1/ 6--
City Miami Shores Villa l e ' County Miami -Dade Zip
Is Building Historically Designated YES NO
Phone #
Contractor's Address
City State Zip
Qualifier
State Certificate or Registration No. Certificate of Competency No.
Architect/Engineer's Name (if applicable) Phone #
Square Footage Of Work:
Repair/Replace ° Demolition
* * *** * ** ** ** * * ** * * ** * * ** * ** F ees * ** * ** * ** *** * * ** * * * * * ** * * * * ***
Submittal Fee $ Permit Fee $ £L 0 o� • CCF $ „ CO /CC.
Technology Fee $
Bond $
(L7SE D).z9�-
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 occurs seven (7) days after the building permit is issued In the absence of such posted notice, the
inspection will not be approved and a reinspection fee will be charged
Signature
Sign:
Print:
My Comm
Owner or Agent
The foregoing instrument was acknowledged before me this 23
day of , iok
who is personally known to me or who has produced
As identification and who did take an oath.
NOTARY PUBLI
r. . o.. , 009 My Commission Expires:
'�`i
nded 2
* * * * * * * * * * * * ** **********************w i * *fir **** * * * * * ** * * * * ***** * *, * * ** * *** *** ** * * * * * *** * * * * * * **
APPLICATION APPROVED BY:
chc 05/13103
Signature
Contractor
The foregoing instrument was acknowledged before me this
(day of ,20by
who is personally known to me or who has produced
as identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print
** ** * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
2 9 6 Plans Examiner
Engineer
Zoning
x '1 1 idi;
Miami Shores Village
Paint Color Approval and Agreement
Date
Owner's Name 44/A44
4/A 4 ‘1 -002 Phone # g 3 0J"2sY - yfl(
Owner's Address g-s /V - fit/ -
City IMAM S,4 D2Cc State
Job Address (where the work is being done) i
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
Drip Cap /drip Edge
Soffit
Roof
Flower bins
Shutters
Awnings
Chimney
Doors and door jams
✓ -
Garage doors
Railings
Fences
Decorative metal
All brick (simulated or regular)
Stucco banding
Any other stucco features
Accessory Buildings
Other
***************************************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
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.
Signature
Owner or Agent
APPLICATION APPROVED BY:
Zip .we t
HC -115
BENJAMIN MOORE®
COLOR PREVIEW® HC
Date / /4i/OS
Date
//Mgr
cinc 6/18/0