The URL can be used to link to this page

PT-06-2922 ,- ---- { w�., :� Miami Shores Villagee --------------- 'BuildingDepartment 9ooz S o p 30 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 A� Tel:( 6.8972 BUI DING DEC 0 5 20 Permit No. aD " Zq 2 Z PERMIT APPLICATION BY-__________ __ ____Master Permit No. FBC 2004 Permit Type(circle): Building Electrical Plumbing Mechanical Roofing Owner's Name(Fee Simple Titleholder)�; ISA. �, Phone# �� ld--6- 'J 9 A7 Owner's Address q1319 W l t/ T 4e ( rG�. e— City /ll� i u.M , J'G n�2 State -- Zip - Tenant/Lessee Name Phone# Job Address(where the work is being done)��`a-.x'1.2 a City Miami Shores Village County Miami-Dade Zip FOLIO/PARCEL# 112//,5j�; 0(010 � 0 Is Building Historically Designated YES NO Contractor's Company Name twJ` '� q;, Phone �_ tT�� ) ' QQ�/ Contractor's Address 6,0 CiState -f=� Zip Z Qualifier Name / n S y ®yS, State Certificate or Registration No. Certific e o ompetency No. Architect/Engineer's Name(if applicable) Phone# Value of Work For this Permit$ -` Square I Linear Footage Of Work: Type of Work: ❑Addition ❑Alterationew Elair/Re lace Re p p El Demolition Describe Work: 0a,`� IA+U—lj,}A.� Submittal Fee$ Permit Fee$_ (00 ' CCF$ "�� CO/CC Notary$ Training/Education Fee$ (0 Technology Fee$ Scanning$ Radon$ DPBR$ Zoning$ Bond$ Code Enforcement$ Double Fee$ ,..w., Structural Review.$ Total Fee Now uv �+ s" f See Reverse sid _ -0.2PAID cer4c IZ94 Bonding Company's Name(if applicable) a Bonding Company's Address a City State Zip Mortgage Lender's Name(if applicable) rn)A 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$2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person co o the recorded notice o commencement must be posted at the job site whose property is subject to attachment. Also, a certifiedpy f f p I for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged Signature Signature Owner or Agent Contractor The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this day of C 20 DL,by U AV) L P&b day of ,20___,by who isersonally known o me or who has produced who is personally known to me or who has produced As identification and who did take an oath. as identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Sign: Sign: Print: - tSCafrn L v Print: My Commission Expires: l'• r$ " V My Commission Expires: CAATION APPROVED BY: ` ` Plans Examiner Engineer Zoning 2/08/06 ■iii. ROSE C.ESCARVW Y NOWY PUM-Stateof Floor rNY Cow.Eom Apr 10,2010 •".."�a�r Commission 9 00 541943 Yom^ Miami Shores Village R Paint Color Approval and Agreement I Date: ' ab Owner s Name: /LL t � �. H Phone (#: Job Address(where the work is being done): City: Miami Shores Village County: Miami-Dade Zip: l Is Building Historically Designated?: YES NO t--- Contractor's Company Name(if applicable): A We c Phone#: 3J a/yq 0 �j, All elements on the site must be listed and indicate the color to be minted Walls: Fascia: Attach color Samples with numbers Drip Cap/Drip Edge: Soffit: Ra Roof: R�. S' Flower Bins: , Shutters: Awnings: Idg"bj Chimney: ©� oF�'� Doors and Door Jams: Garage Doors: ]lit Railings: Fences: Decorative Metal: All brick?(simulated or regular): Stucco Banding: Any other acco Fcatures: �Q Accessory Buildings: ,SU1 Other: III mmmommmommmmmommmmmmmmmonsomommmmmmmmosoommmmmomenommmmmmmmmmmmmummmmmmmomommoR 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: Of Date: I Owner or Ag—en-:F APPLICATION APPROVED BY: Date: &CZ OFFICIAL **MUST BE ATTACHED WITH PURPLE BUILDING APPLICATION**