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PT06-2156 01 Miami Shores Village Building Department 3' n(.,o?VA 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 Tel: (305)795.2204 Fa 305)756.8972 71 BUILDINGPermitNo. 0 6 PERMIT APPLICATIO AU/G, 15 2006� y Master Permit No. FBC 2004 3Y: CU_L,____ Permit Type(circle): Building Electrical Plumbing Mechanical Roofing Owner's Name(Fee Simple Titleholder) a `�"`�- a�,,ICe►� Phone# Owner's Address t 'JY Iy r(& 1" CityML ac& ► S State R Zip 1 Tenant/Lessee Name Phone# Job Address(where the work is being done) g B"kv`e City Miami Shores Village County Miami-Dade Zip FOLIO/PARCEL# Is Building Historically Designated YES NO Contractor's Company Nam - Phone# Contractor's Address CityState 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$ �� qua /Linear Footage Of Work: b �� Type of Work: ❑Addition ❑Alteration ❑New Repair/Replace ❑Demolition Describe Work: ®fez-_ a� ************************ ees,�******,**** ****** *****�r** * *******�,�**,� Submittal Fee$ Permit Fee$ (J ��' CCF$ O CO/CC in Notary$,_�� Training/Education Fee$ Technology Fee$ - Scanning$ Radon$- DPBR$ Zoning$ Bond$ Code Enforcement$ Double Fee$ Structural Review.$ Total Fee Now Due$GO - See Reverse side Q 8 PAID 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 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 Signature O er or Agent Contractor The fore omg instrument was ackWal dged before me this �� The foregoing instrument was acknowledged before me this day of UST 20 Q;byl�A�l K( da of ,20 b Y _, y who' ersona.11y 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: O(Film ` �5• Print: My Commission Expires: = ' My Commission Expires: APPLICATION APPROVED BY: l l b Plans Examiner Engineer Lam`l Zoning (Revised 02/08106) Miami Shores Village . Paint Color Approval and Agreement Date VI�-e r Phone# J Owners Name -IA-3 3-A l�k Owner's Address State 1 Zip City Job Address(where the work is being done) City Miami Shores Village County Miami-Dade Zip Is Building Historically Designated YES NOIV_ _ a Phone# Contractor's Company Name(if' applicable) ************************************************************************************************************ All elements on the site must be listed and indicate the color to be painted Walls Fascia Drip Cap/drip Edge Soffit lo rn� Roof. Flower bins Shutters Awnings Al ' bronzed be�ge Chimney Doors and door jam Garage doors Railings �n Fences A Decorative metal i J/ 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. Date Signature Owner or Age�at 2 ( �u Date APPLICATION APPROVED BY: p&Z Official chc 6/18/03 Receipt Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138-0000 Phone: (305)795-2204 Fax: (305)756-8972 Permit Number: PT-8-06-2156 Owner Address: Invoice Number: PT-8-06-25915 134 NE 100 ST Applicant: SCOT AND CHERYL MARKEN MIAMI SHORES, FL 33138 Company Name: Job Address: 134 100 Street NE Miami Shores Village, FL 33138- Date Payment Type Check Number Amount Change Friday, September 8, 2006 09/08/2006 Check 1718 $67.30 $0.00 Total Payment: $67.30 Page 1 of 1 ORE Miami Shores Village f 10050 N.E. 2nd Avenue Miami Shores, FL 33138-0000 Phone: (305)795-2204 Fax: (305)756-8972 �iiiriiaP Permit Permit Status: APPROVED Issue Date: 9/7/2006 Expires: 03/06/2007 Permit Number: PT-8-06-2156 Owner's Name: SCOT AND CHERYL MARKEN one: (305)758-3411 Permit Type: Paint Parcel#: 1132060132150 Work Classification: New Block: Lot: Job Address: 134 100 Street NE Section: PB: Miami Shores Village, FL 33138- Contractor(s) Phone Primary Contractor Total Square Feet: 0 HOME OWNER Yes Total Valuation: $ 500.00 Comments: Re wired Inspections TO REPLACE PERMIT 2003-219 Final WALLS BRONZE BEIGE TRIM BABY TURTLE 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 $0.60 PT-8-06-25915 $67.30 Education Surcharge $0.20 Total: �� ]f Notary Fee $5.00 I I Permit Fee $60.00 SEP 0 8 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