PT-06-438 Miami Shores Village
. k Building Department
• 10050 N.E.2nd Avenue,Miami Shores,Florida 33138
)0, Z Z[Z4 10( Tel: (305)
' SEWED 72
BUILDING FE 2 06 Permit No.�T- Cho -- 4-3 5
PERMIT APPLICATION Mas r Permit No.
FBC 2001
Permit Type(circle): uilding Electrical Plumbing Mechanical Roofing
Owner's Name(Fee Simple Titlehol er Q QGw 5 t Q Q Phone# r
l 3C- `j--+ - C1 1
Owner's Address i O N Lol
City i(� State Zip 33 i t Q
Tenant/Lessee Name N / Phone# N 'A
Job Address(where the work is being done) 1(0-} rU t�-p
City Miami Shores Village County Miami-Dade Zip t 50
Is Building Historically Designated YES NO X
Contractor's Company Name W ne r' Phone#
Contractor's Address
City State Zip
Qualifier
State Certificate or Registration No. CAK MLEDetency No.
Architect/Engineer's Name(if applicable) "' Phone#
$Value of Work For this Permit 11)eDo 0 Square Footage Of Work:
Type of Work: ❑Addition ❑Alteration ❑New ❑ Repair/Replace
❑Demolition
Describe Work: -Paul 4- OtS
**
Submittal Fee$ Permit Fee$ ::;)o 00 CCF$ O• (00f CO/CC
O .
Notary$ S. OTraining/Education Fee$ C.--O Technology Fee$ 1
Scanning$ Radon$ Zoning Bond$
Code Enforcement$ Structural Plan Review.$
Total Fee Now Due$ Jiz�-7 �O
(Continued on opposite side)
Bonding Company's Name(if applicable)
Bonding Company's Address
City State Zip
Mortgage Lenders 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: 1 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.
SignatureQ]0 7gent
SiOwner or 2, r4 Contractor
The foregoing instrument was acknowledged before fne this r%Ojoregoing instrument was acknowledged before me this
day offi S M .T�Sday of ,20_,by ,
who is personally known to me or who has produced who is personally known to me or who has produced
As identifi ation and who did take an oath. as identification and who did take an oath-
If
NOTA Y BLI `' , Of ORM NOTARY PUBLIC:
rleHernandez sign:
Sign:
Print: t iies: 2.'> 2009 Print:
My Commis ion Expires: My Commission Expires:
*************************************************************** ********************************************
APPLICATION APPROVED BY: Plans Examiner
Engineer
Zoning
chc 05/13/03
Miami Shores Village
Paint Color Approval and Agreement
Brat,
tct c-1 S x `C1`� Phone#
Owner's Name _
Owner's Address
City �r�:�m� �ylUi c"� State Zip
Job Address(where the work is being done) 1 c- "} �� ?� 7:�:>
City
Miami Shores Village County Miami-Dade Zip 0
Is Building Historically Designated YES NO X
applicable) N f
Contractor's Company Name(if' A- Phone#
All elements on the site must be listed and indicate the color to be painted
Walls
Fascia
Drip Cap/drip EdgeQ—>
Soffit
Roof / A
Flower bins N
Shutters N /
Awnings
Chimney
Doors and door jams N
Garage doors N p Bonj ur Beige
20 Y 49/176
Railings
Fences N
Decorative metal N
All brick(simulated or regular) N �`
Stucco banding N �`
Water Chestnut
Any other stucco features 30YY 62/127
N ' _ NC9
Accessory Buildings nn
Other Fronk Pp Z c� _ Pj
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 A ent r,
Date
APPLICATION APPROVED BY.
P&Z OB"1C1a1 chc 6/18/03
r
°C I, Miami Shores Village
10050 N.E. 2nd Avenue
Miami Shores, FL 33138-0000
. - ��
rePhone: (305)795-2204 Fax: (305)756-8972
FNs+N 9,
°R'°A Permit
Permit Status: APPROVED
Issue Date: 2/24/2006 Expires: 02/22/2007 Permit Number: PT-2-06-438
Owner's Name: ANGELA DIAZ-VIDAILLET one:
Permit Type: Paint
Parcel#: 1131010330890
Work Classification: Miscellaneous
Block: Lot:
Job Address: 107 93 Street NW Section: PB:
Miami Shores Village, FL
Contractor(s) Phone Primary Contractor Total Square Feet: 0
HOME OWNER Yes Total Valuation: $ 1,000.00
ommen Re uired Inspections
EXTERIOR PAINTING
Final
Additional Information
Type of Work:Exterior Color:BROWN BAG,BONJOUR BEIGE,WATEF
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-2-06-23903 $67.30
Education Surcharge $0.20 Total:
Notary Fee $5.00 MAR 0 1 PAID
Permit Fee $60.00
Technology Fee $1.50
Total: $67.30 CIG -±A-- Z 2-:.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