PT-07-2106Miami Shores Village )01,KK�
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax:
BUIL.D.ING
PERMIT, APPLICATION
FBC 2004
Permit Type: PAINT PERMIT
(305) 756.8972
Permit No. I - l %
0 M O �• EW v aster Permit No.
1
gn;hI
B
Owner's Name (Fee Simple Titleholder) ,` d (7 /&?
Owner's Address 52. f \ A. ergs' ? -�
City l�'k1Cra"\fv:q 11-4",j State F .
Tenant/Lessee Name
E -MAIL:
f(Ob Phone # 3-- 336 c` llG(
Zi
Phone #
Job Address ) eta.
where the work is being done) C. C
( �2
City Miami Shores Village County Miami -Dade
FOLIO / PARCEL #
Is Building Historically Designated YS --/ i
Contractor's Company Name \ W Phone #
Contractor's Address
City
Qualifier Name
State Certificate or Registration No. Certificate of Competency No.
zip X31 5 o
State
Zip
Phone #
OWNER BUILDER: neL
Value of Work For this Permit $ 1
Describe Work: pci,,f CA \ot-
Type of Work: ❑ Addition / ❑ Alteration / ['New / ❑ Repair /Replace
ICY }C�SF _
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 he perl'ornied to meet the standards of all laws regulating construction in this jurisdiction. 1 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 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 .4s a condition to the issuance ofa building permit with an estimated value exceeding $2500. the applicant must promise in good that u 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 oldie 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.
4c�Y********* *iz **** ******>:****x4r********** Fees* * ******* *********u *i *******42ae** *aYxac******
Permit Fee $ 62 D OO / CCF $ I Technology Fee: 1
Training /Education Fee $ 01D Code Enforcement $
Double Fee $ Zoning $ T. ee Now Due $ `4, &OD
MIAMI S ORES VILLAGE
See Reverse side -
Directions: Pleas
Walls:
Fascia:
PAINT COLOR APPROVAL AND AGREEMENT
All elements on the site must be listed and indicate the color to be painted
circle corresponding number to appropriate color sample.
Drip Cap/Drip Edge.
So flit:
Roof:
2
4
Flower Bins:
Shutters:
Awnings: 1 2
Chimney: 1
Doors and Door Jams: 1 2
Garage Doors: 1
Railings: 1 2
Fences: 1
3
2
3 4
3 4
3 4
3 4
3 4
3 4
3
All brick (simulated or regular): 1 2
Stucco Banding:
Any other Stucco Features: ___
Accessory Buildin
Attach color samples with name and
number.
(.04m saed. 3 4-0E-2.
2 kAilvi
Vs 50
3
2 3 4
Other:
- ,
OWNER'S Ai4114 AVIT: I certify that all the foregoing information is accurate and that all work will be done in
compliance with a or;plicas - - regulating construction and zoning.
Own
The fore om instrument w
day of .204
who is person ly known to
NOTARY
Sign:
Print:
1.1B
IC:
ae4
s id
Signature
or Agent Contractor
acknowledged before me this fog The foregoing instrument was acknowledged before me this
160e-4.ha - day or .20 . by
c or who has produced AI-2.462.- who is perSonally known to me or who has produced
as identification and who did take an oath.
Ilia Ai iisire awl NOTARY PUBLIC:
Sign:
Print:
My Commission Expires:
tification and who did take oath.
oath.
/rim it_ „.49 10 I .1 .111
My Commission Eq tres:
ft
APPLICATION APPROVE
K. WASHINGTON
Notary Public, State of Florida
**.CommisalenAGSE4W909***
My comm. expires Sept 24,2010
BY:
Plans Examiner
Preservation Board
Code Enforcement
(Revised 04/24/0-i