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PT06-1083 y • •U 40 Miami Shores Village ` 4 s? pm Buil®ling Department . • 1I • 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 • • • Tel:(305)795.2204 Fax:(305)756.8972 • • • • BUILDING • • Permit No.PERMIT APPLICATION11CCEIVtj APR 2 7 20 - aster Permit No. • FBC 2004 • Permit Type(circle): uilding Electrical Plumbing Mechanical oofing • Owner's Name(Fee Simple i LFkEaD ij4�fl `Aal*F k- /KOMn 7D • Owner's Address City T-AM Z: aSq 0 KgS State F L Zip • Tenant/Lessee Name M S. 4 (/E �� y� ��Phone# .1 5- �o� `t3f- 7s9/ • . . • • • • • Job Address(where the work is being done) 144 2?0�E City Miami Shores Village County Miami-Dade Zip ;�,`3 -.zi�5 • • FOLIO/PARCEL# 1[ - 3 2 D(o - ®17*- 10.20 Is Building Historically Designated YES NO�_ . • Contractor's Company Name MIA Phone# • Contractor's Address ' City State Zip Qualifier Name Phone# r State Certificate or Registration No. f Competency No. Architect/Engineer's Name(if applicable) Phone# • Value of Work For this Permit$120,.1 Square/Linear Footage Of Work: eE(.j X 72 � • Type of Work: ❑Addition ❑Alteration ❑New XRepair/Replace ❑Demolition • Describe Work: P4.7_,�JT RdCF to ff j-TE 6.,j o emEN r 'rz�4- 3_) • � 1!***•*************•**********•****•****Fees*****•**********•****•*•**•************•***• Submittal Fee$ Permit Fee CCF$ (00 CO/CC • • Notary$ 5•QU Training/Education Fee$ z7C Technology Fee$ I. Scanning$ Radon$ DPBR$ Zoning$ • Bond$ Code Enforcement$ Double Fee$ • Structural Review.$ Total Fee Now Due$ t0� 3 • • • • • See Reverse side • • • 0 • . • • • • • • • • • of 4 Bonding Company's Name(if applicable) N/ • • • Bonding Company's Address • • City • • State Zip • t Mortgago Lender's Name(if applicable) N� Mor gage Lender's Address • • • • • City State Zip • Application is hereby made to obtain a ptrmit to coo the work and installations as indicaterti ed. Lcfy 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 • Eonstruction 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 OU AN 'ATTORNVEY 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 sFbject 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 r7) days after the building permit is issued. In the absence of such posted notice, the • Inspection wall not by approved and areinspection fee will be charged. • • Signatee , Signature N114 . • Owner or Agent Contractor The fore ping instrument was acknowledged before methiise foregoing instrument was acknowledged before me this • day of r ,20. �� c_FJr��f ,20 by • tvho is personally known to me or who has produced who is personally known to me or who has produced As identific46"g,and who did take an oath. as identification and who did take an oath. • NOTARY LI NOTARY PUBLIC: ass'e�` • • gign: Sign: Print: �f�r'��a � • Print: My Co is Expires: ' ��/ My Commission Expires: • .APPLICATION APPROVED BY: PlansExaminer • • • s • • Engineer • ��' Zoning (Revised 02/08/06) • • • • • � � Miami Shores Village Paint Color Approval and Agreement Date n-26--L P � Z.�/l,�'7—y Phone# Owner's NameAl-FSEW �l`)��'�� 4 Owner's Address E. D- N� S 1�EET FlN1z State S(1"t;�'tS Zip 33(3 ' City IL1= 1 <S� Job Address(where the work is being done)T 0 Nr) S j E-ET City Miami Shores Village County Miami-Dade Zip — Is Building Historically Designated YES NO Contractor's Company Name(if applicable) VIA Phone# All elements on the site must be listed and indicate the color to be painted Walls Fascia Drip Cap/drip Edge Soffit Roof Flower bins Shutters Cry Awnings Chimney Doors and door jams Garage doors Railings Fences Decorative metal All brick(simulated or regular) Stucco banding Any other stucco features 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. i ,r Date _,�� Signature ./ z -- Owner or Agent i APPLICATION APPROVED BY: Date P&Z Official clic 6/18103 OREs � Miami Shores Village 10050 N.E. 2nd Avenue ow Miami Shores, FL 33138-0000 Phone: (305)795-2204 Fax: (305)756-8972 ras ORiQp' Permit Permit Status: APPROVED Issue Date: 4/28/2006 Expires: 10/24/2006 Permit Number: PT-4-06-1083 Owner's Name: ALFREDO AND JEANNINE SARMIENTO one: (305)431-7592 Permit Type: Paint Parcel#:_ 1132060171020 Work Classification: New Block: Lot: Job Address: 590 102 Street NE Section: PB: Miami Shores Village, FL 33138- Contractor(s) Phone Primary Contractor Total Square Feet: 0 HOME OWNER Yes Total Valuation: $ 1,000.00 Comments: Re uired Inspections ROOF PAINT Final Additional Information Type of Work:Exterior Color:WHITE 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-4-06-24625 $67.30 $67.30 Education Surcharge $0.20 Total: $67.30 Notary Fee $5.00 Permit Fee $60.00 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