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PT-07-27805 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-3-07-486 Owner Address: Invoice Number: PT-3-07-27805 50 109 Street NW Applicant: MARCEL NESTOR MIAMI SHORES, FL 33168 Company Name: Job Address: 50 109 Street NW Miami Shores, FL 33168-4315 Date Payment Type Check Number Amount Change Monday, March 19, 2007 03/19/2007 Cash $67.30 $0.00 Total Payment: $67.30 Page 1 of 1 _...................-.._.............................._.._.........._............................................... ....._.... ........... .........._...._......... .......... ... ........... ._...__... _ ........ ......... .. ............. _............._...-....._._......._...................................................._..........._........._..__..........._..._.....................-- _.......... ........... ......... .......................... .............. ........._...__......_ .. ......... ............. ... ........... ........_......._................................................._._..... ........................._........._....................._......... _..... _... .................................................................... ........__.........................__......_...._.......................... _._ F'e11: .. ­PT Miami Shores Village F3atl f y e Patn ? ) 10050 N.E.2nd Avenue Miami Shores, FL 33138-0000 0 � � �e Phone: (305)795-2204 1- ? St6hm P.P'R V.EU Isue:[#aie: 9� 5/2007 Project Address Parcel Number Applicant ......... _............. .._ ......... ._ _._............. ......... ..... _..... .._........_......... ................._._...._.. 50 NW 109 Street 1121360110210 Miami Shores, FL 33168-4315 Block: Lot: MARCEL NESTOR Owner Information Address Phone Cell MARCEL NESTOR 50 NW 109 Street MIAMI SHORES FL 33168-4315 .......................................................... ................. Contractor(s) Phone Cell Phone : Valuation: $ 1,000.00 HOME OWNER Total Sq Feet: 0 Type of Work: Exterior Available Inspections: Color:CAMEO WHITE 77 BENJAMIN MOORE Inspection Type: Additional Info: Final Classification: Residential Color:CAMEO WHITE 77 BENJAMIN MOORE_Approved Code Comments: BM Paint Walls-hug&kisses 097/ Color:CAMEO WHITE 77 BENJAMIN MOORE_Approved Color:CAMEO WHITE 77 BENJAMIN Fees Due Amount Total I Amt Paid I Amt Due CCF $0.60 ............................. Education Surcharge $0.20 $ 0.00 $ 0.00 $ 0.00 Notary Fee $5.00 :. Permit Fee $60.00 Payment Type Technology Fee $1.50 1 Total: $67.30 1 9 PAID In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans,drawings,statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either myself,my agent,servants,or employes. I understand that separate permits are required for ELECTRICAL, PLUMBING,MECHANICAL,WINDOWS, DOORS, ROOFING and SWIMMING POOL work. OWNERS AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning . Futhermore authorize the above -named contractor to do the work stated 71 �Ll e!r_4 k March 19, 2007 Authorized Signature I ne / Applicant / Contractor / Agent Date BuildingDepat; nt Copy Monday, March 19,2007 1 �Atl� 3I1310'� 1�'.Ib AH w/ kr• Awed . Miami Shores Village "A92 Building Department 10050 N.E.2nd Avenue,.Miami Shores,Florida 33138 Tel: (305)795.2204 Fax:(305)756.8972 6Y_AZ�0 BUILDING Permit No. Pr �_ " PERMIT APPLICATION Master Permit No. FBC 2004 Permit Type(circle): uilding Electrical Plumbing Mechanical Roofing Owner's Name(Fee Simple i e older) f�,2 C 2 Z Phone# �Q.s, 7 g®f Owner's Address 677 �, /�� e- 24 City W Za1W4 State rel Zip-- -� Z/ 4 ' Tenant/Lessee Name /f Phone# Job Address(where the work is being done) City 4�44CZ lij Miami Shores Village County Miami-Dade Zip FOLIO/PARCEL# Is Building Historically Designate YES . NO Contractor's Company Name 4 Ze Phone# Contractor's Address City State Zip Qualifier Name Phone# State Certificate or Registration No. Certificate of Competency No. Architect/Engineer's Name(if applicable) Phone# Value of Work For this Permit$ Square/Linear Footage Of Work: Type of Work: ❑Addition ❑Alteration ❑New [�Repair/Replace ❑Demolition Describe Work: Submittal Fee$ Permit Fee$ (L CC.11� ' CCF S 160 CO/CC Notary Training/Education Fee$ Q ozo Technology Fee$ ou Scanning$ Radon$ DPBR$ Zoning$ Bond S 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) 4i� 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 �����1`�lz Signature Owner or Agent Contractor The foregoing instrument was ackXr', edged before me this �Z The foregoing instrument was acknowledged before me this day of XICA ,20 O,by �eST V, day of .20 by , who is personally known tome or who has produced 9- 91141who is personally known to me or who has produced �J 91A11) As identification and who did take an oath. as identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Sign: 1pN#DD Sign: Print: AlArto Ski :'� Ey,P1HEs` pu�gc�nee+w"` Print: My Commission Expires: My Commission Expires: APPLICATION APPROVED BY: / Plans Examiner Engineer Zoning (Revised 02/08/06) Miami Shores Village Paint Color Approval and Agreement Date: Owner's Name: Phone#: Job Address (where the work is being done): 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 a:.inted Fascia: Attach color Samples Drip Cap/Drip Edge: Com,,-,e-, k--.3 �e Zl -�.- ""+h n,imhers Soffit: C Roof-- Flower Bins: oof:FlowerBins: Shutters: (A Awnings. _. Chimney: rJ � /> Doors and Door Jams: h Garage Doors: Lj � Railings: �-j l n Fences: t J 1,:,� Decorative Metal: r,j All brick(simulated or regular): Stucco Banding: Any other Stucco Features: Accessory Buildings: Cameo White 77 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. Signature:' f��Ci� -�� �2 Date: Owner or Agent APPLICATION APPROVED BY: t Date: — t3 P&Z OFFICIAL **MUST BE ATTACHED WITH PURPLE BUILDING APPLICATION**