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PT-06-2525 ,- Miami Shores Village 10, Building Department De S � I 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 Tel: (305)795.2204 Fax:(305)756.8972 BUILDING P o*Szl / --, t" � pp Permit No. PERMIT APPLICATION `�--'I �:�{�`�� II Master Permit No. FBC 2004 OCT 1 0 2006 U Permit Type(circle): (LBuil nEl �ricatC==-----PIUfdtiin Mechanical Roofin g g tt- Owner's Name(Fee Simple Titleholder) L'tdC-r)A`-5KAW /549,A-i4 PEFp one# 3 05• —7 Sa !Gl 00 Owner's Address 1 Q%b QO 0VBT)4 !�FT CLEAT Z 00:31-1660-7-4 City 1- 41 1 i �7}-I�p�-E S State Zip 5515c) Tenant/Lessee Name 1J 4 1 Phone# Job Address(where the work is being done) &A%T)4 'g-Vr IzC—ISl" City Miami Shores Villaee County Miami-Dade Zip 3 �� FOLIO/PARCEL# -- Is Building Historically Designated YES NO V Contractor's Company Name 0 VJ Phone# Contractor's Address City State Zip Qualifier Name Phone# State Certificate or Registration No. Certificate of Competency No. Architect/Engineer's Name(if applicable) h Value of Work For this Permit$ S-00. 00 Square/Linear Footage Of Work: 11$40 Type of Work: ❑Addition 154AIteration ❑New ❑ Repair/Replace ❑Demolition Describe Work: p'A'n 0-60\_8 ss4TVwi o1? c>;--- . Submittal Fee S Permit Fee$_ CCF$ CO/CC Notary$ Training/Education Fee$ Technology Fee$ Scanning$ Radon$ DPBR$ Zoning$ Bond S Code Enforcement$ Double Fee$ Structural Review.$ Total Fee Now Due$ See Reverse side--> Bonding Company's Name(if applicable) • Bonding Company's Address r City State Zip Mortgage Lender's Name(if applicable) Mortgage Lender's Address City State Zip Application is hereby made to obtain apermit 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 4 Signature Owner or Agent Contractor The foreg ' instrument was ac owl ed before me this The foregoing instrument was acknowledged before me this day o '2006 by 'YJflday of 20—,by �who is personally known to me or who has produced. �whi is personally known to me or who has produced O =C�As identification and who did take an oath. as identification and who did take an oath. NOTARY P LIC: NOTARY PUBLIC: L Sign: Sign: Print: Print: My Commission Expires:xp My Commission Expires: APPLICATION APPROVED BY: Plans Examiner Engineer Zoning (Revised 02/08/06) Miami Shores Village Paint Color Approval and Agreement Date: l O Owner's Name: S Q�21 1E E Z Phone#: Job Address(where the work is being done): t 4'Je:;, N,,;,, s- City: Miami Shores Village County: Miami-Dade Zip: Is Building Historically Designated?: YES NO r/ Contractor's Company Name(if applicable): Phone#: ...............................................■............................0■1 All elements on the site must be listed and indicate the color to be printed Walls: &C-Ey - 'i� 44 Z Fascia: \N t-" TG Attach color Samples Drip Cap/Drip Edge: with numbers Soffit: NV T4-,T 8442 Roof: N Flower Bins: N A Shutters: W r-�Tem- Awnings: C-, Chimney: Doors and Door Jams: Garage Doors: yot--h 71--- Railings:- W H--i T-;F- Fences: N A A Decorative Metal: N 41 All brick(simulated or regular): Stucco Banding: -x Any other Stucco Features: 'a Accessory Buildings: t� Other: OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compli with all applicable laws regulating construction and zoning. Signature: Date: (O Owner or Agent / APPLICATION APPROVED BY: 17101 Date: ��61 P&Z OFFICI "MUST BE ATTACHED WITH PURPLE BUILDING APPLICATION" Miami Shores Village Paint Color Approval and Agreement Date: kO. 5-00 Owner's Name:la6f-rl-1 Phone#: -jpS, -Ic ' Job Address(where the work is being donee �.J*J ,O(QjTl--\ i:-, City: Miami Shores Village County: Miami-Dade Zip: Is Building Historically Designated?: YES NO Contractor's Company Name(if applicable): IJ a Phone#: ...........................■a a a a a a a a a a a a a a a a a a■■a a a a a a a a a a a a a a a a a a a a a a a a a a a a 0 f 1 All elements on the site must be listed and indicate the color to be minted Walls: GCzEl( - 343e,1 Fascia: V14t-+iTt'- Attach color Samples Drip Cap/Drip Edge: with numbers Soffit: Roof: a�' Flower Bins: Shutters: VN i- TE Awnings: N b Chimney: NA Doors and Door Jams: 'W*-t-rM Garage Doors: U -*+,,-� Railings: Fences: Decorative Metal: �.1�- All brick(simulated or regular): lu d Stucco Banding: A11� Any other Stucco Features: tJb Accessory Buildings: b Other: ■■a a a a a a a a a a a a a a a a a a a a a a a a a a a a a a a a a a a a a a a■...■a s■■a a a a a a a a a a a a a a a a a a a a a a a a a a a a l 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. I Signature: Date: 1 O- G-00 0 caner or Agent APPLICATION APPROVED BY: Date: P&Z OFFICIAL "MUST BE ATTACHED WITH PURPLE BUILDING APPLICATION" Receipt Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138-0000 Phone: (305)795-2204 Fax: (305)756-8972 Permit Number: PT-10-06-2525 Owner Address: Invoice Number: PT-10-06-26358 10417 NE 2 AVE Applicant: RAUL DUARTE MIAMI SHORES, FL 33138 Company Name: Job Address: 188 98 Street NW Miami Shores Village, FL Date Payment Type Check Number Amount Change Monday, October 16, 2006 10/16/2006 Check 485 $67.30 $0.00 Total Payment: $67.30 Page 1 of 1 °RES << Miami Shores Village 10050 N.E. 2nd Avenue one. - ""'� Miami Shores, FL 33138-0000 .� ,.t Phone: (305)795-2204 Fax: (305)756-8972 �L©RNp` Permit Permit Status: APPROVED Issue Date: 10/16/2006 Expires: 04/14/2007 Permit Number: PT-10-06-2525 Owner's Name: RAUL DUARTE one: Permit Type: Paint Parcel#:_ 1131010260020 Work Classification: Addition/Alteration Block: Lot: Job Address: 188 98 Street NW Section: PB: Miami Shores Village, FL Contractor(s) Phone Primary Contractor Total Square Feet: 0 HOME OWNER Yes Total Valuation: $ 200.00 Re uired Ins ections Additional Information Final Type of Work:Exterior Color: Additional Info: Classification:Residential 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. Fees Due Amount Invoice Number Amt Due Amt Paid CCF $0.60 PT-10-06-26358 $67.30 Education Surcharge $0.20 Total: Notary Fee $5.00 Permit Fee $60.00 C Technology Fee $1.50 Total: $67.30 OCT 16 PAIS Building Department File Copy 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. Applicant Signature