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PT-06-945 Permit Receipt Permit Number: PT-4-06-945 Invoice Number: PT-4-06-24454 Applicant: JUAN AND SOFIA GIRALDO Company Name: Date Payment Type CheckNum Amount 04/21/2006 Check CC/VS $67.30 Total Payment: $67.30 °,ANC E��ED Friday,April 21, 2006 Page 1 of 1 1y,bRs � Miami Shores Village $ 10050 N.E. 2nd Avenue Sol. 861OP" Miami Shores, FL 33138-0000 = ted Phone: (305)795-2204 Fax: (305)756-8972 oRuopA Permit Permit Status: APPROVED Issue Date: 4/20/2006 Expires: 04/12/2007 Permit Number: PT-4-06-945 Owner's Name: JUAN AND SOFIA GIRALDO one: (305)757-2911 Permit Type: Paint Parcel#: 1132060130810 Work Classification: Miscellaneous Block: Lot: Job Address: 9617 MIAMI Avenue N Section: PB: Miami Shores Village, FL 33150- Contractor(s) Phone Primary Contractor Total Square Feet: 0 HOME OWNER Yes Total Valuation: $ 210.00 omments: Re uired Inspections EXTERIOR PAINTING Final Additional Information Type of Work:Exterior Color:LITE GREEN AND GRAY 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-4-06-24454 $67.30 Education Surcharge $0.20 Total: U,Notary Fee $5.00 Permit Fee $60.00 APR 21 PAID Technology Fee $1.50 Total: $67.30 Building Department File Copy NOTICE: In addition to the requirements of this permit, there may be additional restrictions applicable to this property that may be found in the public records of this county. AND THERE MAY BE ADDITIONAL PERMITS REQUIRED FROM OTHER GOVERNMENTAL ENTITIES SUCH AS WATER MANAGEMENT DISTRICTS,STATE AGENCIES,OR FEDERAL AGENCIES. Applicant Signature -- Miami, Shores Village mS (8(C)(, Building Department 4w`PA C-0 r 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 q AM +12.1 I Oho Tel:( 2204 Fax:(305)756.8972 BUILDING CEOD Permit No. T0� PERMIT APPLICATION _ 12 2Q05 aster Permit No. FBC 2004 Permit Type(circle): Building Electrical Plumbing Mechanical Roofing pA41 Owner's Name(Fee Simple Titleholder) 700)N G`NAL D D Phone# J 05— 7S7 o" 9 I r Owner's Address ?(0// Ah Al/A/n/ A af- City M AM( Sk10A1-.$ State Zip 33150 Tenant/Lessee Name Phone# - Job Address(where the work is being done) 5A I"E- A S A 601/ City Miami Shores Village County . Miami-Dade Zip FOLIO/PARCEL# Is Building Historically Designated YES NO k--- Contractor's Company Name 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) Phone# Value of Work For this Permit$ 21 V+ Square/Linear Footage Of Work: Type of Work: ❑Addition ❑Alteration ❑New lj� Repair/Replace ❑Demolition Describe Work: PAik)'r £'kTF_X i oR W 4 Submittal Fee$ Permit Fee$ _ � �� CCF$ CO/CC Notary$ Training/Education Fee$ Technology Fee$ Scanning$ Radon$ DPBR$ Zoning$ Bond$ Code Enforcement$ Double Fee$ Structural Review.$ Total Fee Now Due$ 60-7aSi PAID nu nSee Reverse 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 fiction. I understand that a separate permit must be secured for ELECTRICAL WORK,PLUMBING,SIGNS, construction in this jurisdiction. J p 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 w. Signature Owner or Agent Contractor The foregoing instrument was acknowledged before me this 12- The foregoing instrument was acknowledged before me this day a 1 L ,20 CO(:�b� N �t CD. day of ,20__,by who is personally known to me or who hseproduced who is personally known to me or who has produced D As identification dTT c �an oath. as identification.and who did take an oath. NOTARY PUBLIC: colnme11y Iye�� l A NOTARY PUBLIC: �n 1171ssion# D andel dedu PtreS; S DD47(4S Sign: � tic nct 7 2 g Sign: Print �� c• Print: My Commi Sion Expires: My Commission Expires: APPLICATION APPROVED BY: G v �Y Plans Examiner Engineer Zoning (Revised 02/08/06) Miami Shores Village Paint Color Approval and Agreement Date Owner's Name A IlJ GiRAL30 Phone# 309,7y'T 7-91 f Owner's Address g617 A1t iA44i AK ' City /1?��n'i Son Job State ^L- Zip `331 SP Job Address(where the work is being done) AS Aho Uf City Miami Shores Village County Miami-Dade Zip Is Building Historically Designated YES NO V Contractor's Company Name(if applicable) Phone# ************************************************************************************************************ All elements on the site must be listed and indicate the color to be painted Walls M-TE Gaff l Fascia Drip Cap/drip Edge C c." Soffit CRO Roof �I Flower bins t i�- — 71r a L Attach Color Samples Shutters With Numbers Awnings Chimney Doors and door jams Garage doors Railings r-k Fences Decorative metal All brick(simulated or regular) - Stucco banding Any other stucco features 4�os �yVpLC S 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 Date 0 Owper or Agent C APPLICATION APPROVED BY: k Date P&Z Official clic 6�ts�o� CANCELLER