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PT-06-2877 Its, Miami Shores Village 10050 N.E. 2nd Avenue logo - ""'"' Miami Shores, FL 33138-0000 Phone: (305)795-2204 Fax: (305)756-8972 eNres'LN®a ° Permit Permit Status: APPROVED Issue Date: 12/4/2006 Expires: 06/02/2007 Permit Number: PT-11-06-2877 Owner's Name: BETTY WILLIAMS one: Permit Type: Paint Parcel#: 1131010331260 Work Classification: New Block: Lot: Job Address: 254 92 NW Section: PB: Miami Shores Village, FL Contractor(s) Phone Primary Contractor Total Square Feet: 0 HOME OWNER Yes Total Valuation: $ 1,000.00 Re uired Inspections Additional Information Final Type of Work:Interior&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-11-06-26861 $67.30 $67.30 Education Surcharge $0.20 Total: $67.30 Notary Fee $5.00 Permit Fee $60.00 Technology Fee $1.50 Total: $67.30 Building Department File Copy NOTICE: In addition to the requirements of this permit, there may be additional restrictions applicable to this property that may be found in the public records of this county. AND THERE MAY BE ADDITIONAL PERMITS REQUIRED FROM OTHER GOVERNMENTAL ENTITIES SUCH AS WATER MANAGEMENT DISTRICTS,STATE AGENCIES,OR FEDERAL AGENCIES. Applicant Signature - Miami Shores Village `. Building Department NOV 2 9 2006 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 BY:----- - ------------ Tel:(305)795.2204 Fax: (305)756.8972 BUILDING i ��� Permit No. X06 c� PERMIT APPLICATION Master Permit No. FBC 2004 Permit Type (circle):&Tider) El trical Plumbing Mechanical Roofing caw_ ir2 Inti 11 a3 `-) Owner's Name(Fee Simp �.5 � �I m,�' Phone# Owner's Address o SLA tk) q Zod lSt1^:P,P+ City� ICLVYI I t es State Qn r%c�a Zip 33150 Tenant/Lessee Name u JIN Phone# Job Address(where the work is being done) Z-5-LA NM -12 n(� 3he,6 City Miami Shores Village County Miami-Dade Zip 33 � FOLIO/PARCEL# Is Building Historically Designated YES NO Contractor's Company Name Phone# Contractor's Address City State Zip Qualifier Name Phone# State Certificate or Registration No. Certificate of Competency No. Architect/Engineer's Name(if applicable) Phone# Value of Work For this Permit$ Square/Linear Footage Of Work: Type of Work: Addition MKIteration w ' ❑ Repair/Replace ❑Demolition Describe Work: I r Submittal Fee$ Permit Fee$ `C/O O C) CCF$ GO' CO/CC Notary$ CD (�iraining/Education Fee$ - 20 Technology Fee$ Scanning$ Radon$ DPBR$ Zoning$ Bond$ Code Enforcement$ Double Fee$ Structural Review.$ Total Fee Now Due$ See 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 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 ins ,tion which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection wi n t be approved and a rein ec i fee will be charged. Signatorafore Owner or Agent Contractor The foregoing instrument was agknowledged Pefore me thil 2q The foregoing ins nt was acknowledged before me this day of r20�,by t I 5day of ,20 by n who is personally known to me or who has produced who is personally known to me or has produced As identification and who did take an oath. as identification.and did take an oath. NOTARY IC: NOTARY PUBLIC: Sign: Sign: Print: I,, Print: My Co fission Expires: _ `�=t00�mhsiot; �; q ,IMy Commission Expires: ** ** ************* ****** * * * l a:,.. ... MOt" kir oFF�o; on Thru � Atlantic Rondine('n APPLICATION APPROVED BY: C U Plans Examiner Engineer ZF(� Zoning (Revised 02/08/06) Miami Shores villageD MCum7m Paint Color Approval and Agreement NOV 9 2 6 Date: BY.- Owner's Y:-Owner's Name: Phone#: Job Address (where the work is being done): 25(--1 " )- City: Miami Shores Village County: Miami-Dade Zip: Is Building Historically Designated?: YES NO Contractor's Company Name(if applicable): Phone#: .....................0.0.0 0......0 E 0 0 a N 0 0 0 0 0 N..■0 0 0 0 E 0 0 0 0 0 N 0 0 0 0 N 0 0 0 0 0 0 M E.0000 E All elements on the site must be listed and indicate the color to be painted � 0,Walls: OAn Fascia: Q_ " Attach color Samples Drip Cap/Drip Edge: with numbers Soffit: '* Roof: Flower Bins: Shutters: Awnings: Chimney: nVl�a ) 1 Doors and Door Jams. Garage Doors: T Railings: Fences: Decorative Metal: All brick(simulated or regular): Stucco Banding: Q Any other Stucco Features: Aft Accessory Buildings: M3 Other: ..................0 E 0 N a 0 0 0 0 0 E S......a 0 a a 0 0 0 N 0 N 0 0 0 0 0 0 0.......0.0 0 0..0000 0 0.0 0■■ OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in co li ce with all applicable laeeging construction and zoning. Signatur . Date: NOU' Owner or Agent APPLICATION APPROVED BY: — Date: P$c Z OFFICIAL "MUST BE ATTACHED WITH PURPLE BUILDING APPLICATION"