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PT06-1995 Miami Shores Village Building Department 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 Tel: (305)D9�204 Fax:(305)756.8972 � l BUILDING JUL 2 6 200 31er Permit No.VRX0 PERMIT APPLICATION p Permit No. FBC 2004 B Y --��: Permit Type(circle): Building Electrical Plumbing Mechanical Roofing Owner's Name(Fee Sim r Phone# 7o 5 Owner's Ad ss �© -2 S City5 Ao State Zip Tenant/Lessee Name Phone# Job Address(where the work is being done) l City Miami Shores Village County Miami-Dade Zip FOLIO/PARCEL# Is Building Historically Designated YES NO % ''// Contractors Company Name ffk ( Phone# Q J Contractor's Address City State Zip Qualifier Name Phone# State Certificate or Registration No. Certificate of Competency No. Architect/Engineer's Name(if applicable) �q�' Phone# �'� V9, Value of Work For this Permit S �z Square/Linear Footage Of Work: Type of Work: ❑Add' ' n RAlteration Kew ❑ Repair/Replace ❑Demolition Describe Work: Submittal Fee$ Permit Fee S CCF$ c �P CO//C-C Notary S Training/Education Fee$ i10 Technology Fee Scanning$ Radon$ DPBR S Zoning$ Bond$ Code Enforcement$ Double Fee$ ONl Structural Review.$ Total Fee Now Due$ See Reverse side—4 . 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,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 con KAIso, nce of a building permit with an estimated value exceeding$2500, the applicant must promise in good faith that a ce of commencement and construction lien law brochure will be delivered to the person whose property is subject to a certified copy of the recorded notice of commencement must be posted at thejob site for the first inspecti r ) days after the building permit is issued In the absence of such posted notice, the inspection will not ion fee will be charged. Signature Signature er or A nt Contractor The foregoing instrum at was acknowledged before me this The foregoing instrument was acknowledged before me this day of ,20___,b _ �. I'Yl I S , ,day of .20_,by , who is personally known to me or who has produced who is personally known to me or who has produced As identification and w as identification and who did take an oath. NOTARY P C• =�o►t st1��S1Uif ''� 'NOTARY PUBLIC: 2319 .o` Expfres•Jut 13,2V 4 40j, Bow Thn, AUanticROndino Sign: Sign: Print: k,y 0 Print: My Commis ' Expires: My Commission Expires: APPLICATION APPROVED BY: 7 Plans Examiner Engineer Zoning (Revised 02/08/06) Miami Shores Village Paint Color Approval and Agreement Date u'�5 MS Phone# Owners Name may► Owner's Address /a / 5 City 4:2"4/ f %e State Zip lC.l l Job Address(where the work is being done) _0 C, 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 Fascia uv L Drip Cap/drip Edge Soffit Roof ` L Flower bins Shutters A Awnings BENJAMIN MOORS® 069 Chimney Doors and door jams ti Garage doors Railings Fences Decorative metal All brick(simulated or regular) Stucco banding Any other stucco fea e Accessory Buildings Other, OWNER'S AFFIDAVIT: I ce that e foregoing information is accurate and that all work will be done in compliance with all appbcable laws regu ' g co c ' and zoning. Date Signature / Owner or Agent 7/7 _7�64 11 APPLICATION APP R VED BY: Date P&Z Off, �al chc 6/18!03 Miami shares Village � 10050 N.E. 2nd Avenue Miami Shores, FL 33138-0000 Phone: (305)795-2204 Fax: (305)756-8972 Permit Permit Status: APPROVED Issue Date: 7/27/2006 Expires: 01/23/2007 Permit Number: PT-7-06-1995 Owner's Name: EDWARD APONTE Phone: Permit Type: Paint Parcel#: 1121360070240 Work Classification: Miscellaneous Block: Lot: Job Address: 102 107 Street NE Section: PB: Miami Shores Village, FL 33138- Contractor(s) Phone Primary Contractor Total Square Feet: 0 Total Valuation: $ 2,000.00 Comments: Re uired Inspections PAI NT Final WALLS GOLDEN GATE313 033 TRIM CALICO BLUE 4B 707 Additional Information 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 $1.20 PT-7-06-25704 $68.10 $68.10 Education Surcharge $0.40 Total: $68.10 Notary Fee $5.00 Permit Fee $60.00 Technology Fee $1.50 Total: $68.10 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 Invoice Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138-0000 Phone: (305)795-2204 Fax: (305)756-8972 Bill To EDWARD APONTE Invoice Number: PT-7-06-25704 102 NE 107 ST Invoice Date: July 26, 2006 MIAMI SHORES, FL 33161-7032 Permit Number: PT-7-06-1995 Return to: Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138-0000 rtit ' PsIn tr � sst > � � Itrreus Date Fee Name Fee Type Fee Amount 07/26/2006 Notary Fee Fixed $5.00 07/26/2006 Education Surcharge Calculated $0.40 07/26/2006 Technology Fee Calculated $1.50 07/26/2006 Permit Fee Fixed $60.00 07/26/2006 CCF Calculated $1.20 Total Fees Due: $68.10 Payments Date Pay Type Check Number Amount Paid Change 07/26/2006 Credit Card $68.10 $0.00 Total Paid: $68.10 Total Due: $0.00 Wednesday, July 26, 2006