Loading...
PT-06-331 n 2-4 A14 . 2.It6,/cxv Miami Shores e Villag �antc�rF , Building Department 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 Tel:(305)795.2204 Fax:(305)756.8972 BUILDING R EIVED Permit No.Tni!�(D - PERMIT APPLICATION FEB 1 2 6 ster Permit No. FBC 2001 - Permit Type(circle): uilding Electrical Plumbing. Mechanical Roofing Owner's Name(Fee Simple Titleholder)a_�d� ,I /z 6 j�e-Z Phone# Owner's Address IV•((". J/O.S % City > "V-W/ Statej L Zip _�3 Tenant/Lessee Name Phone# Job Address(where the work is being done) O � City Miami Shores Villa e County Miami-Dade Zip , Is Building Historically Designated YES NO Contractor's Company Name 4CD YYl"Z 'Phone# Contractor's Address City State Zip Qualifier State Certificate or Registration No. Certificate of Competency No. Architect/Engineer's Name(if applicable) a VOR Phone# o,;WtLLr0U $Value of Work For this Permit J quare Footage Of Work: Type of Work: ❑Addition ❑Alteration Zew ❑ Repair/Replace El Demolition Describe Work: - Submittal Fee$ Permit Fee$ (�0 CCF$ CO/CC. Notary$s, Training/Education Fee$ d. 40 Technology Fee$ Scanning$ Radon$ Zoning Bond$ Code Enforcement$ Structural Plan Review.$ Total Fee Now Due$ G77 . 30 (Continued on opposite side) 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,POOL$,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 =Owner occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the and a reins ection fee will be charged. Signature or Agent Contractor The forMoing instrument was acknowledged before me this 13 The foregoing instrument was acknowledged before me this day of 1 =�--J:Z) ,20C�;by LQ r ay of ,20___,by who is personally known to me or who has produced whdyi onally known to me or who has produced As identification and who did take an oath. ,4T as identification and who did take an oath. NOTARI P LIC• NOTARY PUBLIC: Sign: /\./ / Sign. Print: I A Print: My Commis ion Expires: My Commission Expires: ************************************************************************************************************ APPLICATION APPROVED BY: Plans Examiner I t(S(10 Engineer Chc 05/13/03 a ` 13 Zoning Miami Shores Village Paint Color Approval and Agreement Date Owners Name�� /� - �i7�7 Phone# Owner's Address city hG���' i S State /<= Zip >/� �//,�7 Job Address(where the work is being done) 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 2 Fascia Drip Cap/drip Edge Soffit Roof Flower bins Shutters Awnings a,&2.17 i eft Gi/L�NiLJ Chimney 0 Doors and door jams U) s 1 Body:Daybreak Sun ECC-11-1' Garage doors 2 Trim:Daisy Field ECC-11-2 Railings 3 Accent:Whispering Oaks ECC-11-3 Fences Decorative metal All brick(simulated or regular) , Stucco banding Any other stucco features Accessory Buildings Other ************************************************************************************************************ OWNER'S AFFIDA certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable lawre�Wating nstruction and zoning. Date Si afore Owner or en - APPLICATION APPROVED BY: Date p&Z Official chc 6/18/03 CANCELLED