PT06-927 Miami Shores Village rfly� 42,10(,,
BuildingDepartment 42fo
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10050 N.E.2nd Avenue,Miami Shores,Florida 33138
Tel: (305)795.2204 Fax: (305)756.8972
BUILDINGMC MEWT Permit No.PTCYC:::� — qz�
PERMIT APPLICATIOD qp 1 006 111 Master Permit No.
FBC 2004
BY -- - - ------
Permit Type (circle): Building Electric 1 -- mg Mechanical Roofing
Owner's Name(Fee Simple Titleholder) Phone# 7 7 5736 F1
Owner's Address�/� to A) �'a ' 5 T /�-t�GL /:A c J� /Z 5-/k)
CityT`i4 JI 4c:25 State Zip 3 3/ 3
Tenant/Lessee Name Phone#
Job Addresswhere the work is being �/� �� ✓r' � *" 41(D� /Z L
( g done) 7
City Miami Shores Village County Miami-Dade Zi 3 '>/ '✓
FOLIO/PARCEL#
Is Building Historically Designated YES NO,�_
Contractor's Company Name 4c) Y-Y1'e— cxj-)v--) iff�Y Phone#
Contractor's Address
City State Zip
Qualifier Namel�
State Certificate or Registration No. e i ica e o ompe ency No.
Architect/Engineer's Name(if applicable) Phone#
Value of Work For this Permit$ �� ✓'`� Li Square/ ~
q do,9kgk4?f Works
Type of Work: ❑Addition ❑Alteration ew ❑ Repair/Replace ❑Demolition
Describe Work: 779iJ D
Submittal Fee$ Permit Fee$(� CCF$ CO/CC
Notary$ Training/Education Fee$ 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 inspec . which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the
inspection will n be pproved and a reinspection fee will be charged.
Signature Signature
Oycn r or Agent Contractor
The foregoing instrument was acknowledged before me this /0' The foregoing instrument was acknowledged before me this
day of 20 OG,by /41Q(d}c�dU F} t 5�e� day of ,20_,by ,
who is personally known to me or who has produced — who is personally known to me or who has produced
..........I ..............GtB N T....s......
;..'
atERi �
AN � tib oath. as identification and who did take an oath.
I JIM,
"= Expires 8/24/2008
NOTARY PUBLIC= �, NOTARY PUBLIC:
_��� O Ff15' F Notary Assn. HSC.
Sig Sign:
Print: A rt)4 (,q —Be N t f E z Print:
My Commission Expires: & --.R 4—06 My Commission Expires:
APPLICATION APPROVED BY: Plans Examiner
t/1 / Engineer
f <<( Zoning
(Revised 02/08/06)
Miami Shores Village
10050 Northeast Second Avenue
Miami Shores,Florida 33138-2382
Telephone: (305)795-2207
Fax:(305)756-8972
www.miamishoresvillage.com
Paint Color Approval and Agreement
DATE: A-
OWNER'4
NAME: )/+"e A A0A)J4 %s N C-T2 PHONE: J0-
ADDRESS:
ADDRESS: „if/& A)C1� y`-��5�- f�ki`>!�G y f�iyc�cti�i� A LIZ s^). 7 Lt cl
ADDRESS OF SITE:
CONTRACTOR&LICENSE(if applicable)
COMPANY NAME: PHONE:
All Elements on the site must be listed and indicate the color to be painted.
Walls: �L � •�
Fascia:
Drip Cap/D '
Sol,
Ro f: cJ F!l T ✓ O
Flo Iins: /ym
Shutter .
Awnings:
Chimney:
`
Doors and door jams: rn
\Garage Doors:
Railings:
Z
Fences: C
Decorative Metal:
W
All brick (simulated or regular):
Stucco Banding: v'
Any other stucco features: ` S
Accessory/Buildings: a \A J
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 authorize the above-named contractor, if applicable, to do the
work stied. Furthermore, the paint colors will be as per the attached samples.
s
,_. S- gw/ tura ofOwner --� f` Date Signature of Contractor Date
APPROVED:
j WHEN PAINTING IS FINISHED, CALL FOR FINAL
INSPECTION
i
Building bfficial Date
,SNREs L,t� Miami Shores Village
�0 10050 N.E. 2nd Avenue
Miami Shores, FL 33138-0000
,�- os Phone: (305)795-2204 Fax: (305)756-8972
oRiuP
Permit
Permit Status: APPROVED
Issue Date: 4/12/2006 Expires: 04/11/2007 Permit Number: PT-4-06-927
Owner's Name: EDWARD RISHER one:
Permit Type: Paint
Parcel#: 1132060133420
Work Classification: New
Block: Lot:
Job Address: 9125 2 Avenue NE Section: PB:
Miami Shores Village, FL
Contractor(s) Phone Primary Contractor
Total Square Feet: 0
Total Valuation: $ 400.00
Comments:
Re uired Inspections
ROOF PAINTING 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 X0.60 PT-4-06-24428 $62.30 $62.30
Education Surcharge $0.20 Total: $62.30
Permit Fee $60.00
Technology Fee $1.50
Total: $62.30
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 9 nature