PT-07-575 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-3-07-575 Owner Address:
Invoice Number: PT-3-07-27950 305 NW 111 ST
Applicant: ROSEBEL CHARLOT MIAMI SHORES, FL 33168
Company Name:
Job Address:
305 111 Street NW
Miami Shores Village, FL 33168-
Date Payment Type Check Number Amount Change
Friday, March 30, 2007
03/30/2007 Cash $62.30 $0.00
Total Payment: $62.30
Page 1 of 1
Permit No. PT-3-07-575
,SNoaes h�ErMiami Shores Village Pam*Type:Paint
10050 N.E.2nd Avenue
n woi'ik�i a+5`S1fiCi9ttf91Yi Now
Miami Shores,FL 33138-0000
ti— Phone: (305)795-2204 P@fm#Stems:APPROVED
ioRiow
lmw -31WW"' Expiration: 09125/2007
Project Address Parcel Number Applicant
...- -......
305 NW 111 Street 1121360010730
Miami Shores Village, FL 33168- Block: Lot: ROSEBEL CHARLOT
Owner Information - Address Phone _ _ Cell
ROSEBEL CHARLOT 305 NW 111 ST (305)754740
MIAMI SHORES FL 33168-3303
........-,
Contractor(s) Phone Cell Phone i Valuation: $ 1,000.00
HOME OWNER
Total Sq Feet: 0
Type of Work:Exterior Available Inspections:
Color:APPLEASANCE/POP CORN
InspectionType:
Additional Info:PAINTING Final
Classification: Residential
Color:APPLEASANCE/POP CORN—Approved Code Comments:BEHR PAINT-APPLESAUCE
Color:APPLEASANCE/POP CORN—Approved Color:APPLEASANCE/POP CORN—Denied
Fees Due Amount Total Amt Paid I Amt Due
CCF $0.60
Education Surcharge $0.20 $0.00 $0.00 $ 0.00
Permit Fee $60.00
Technology Fee $1.50 Payment Type:
Total: $62.30 uO
MAR PAID
In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations
pertaining thereto and in strict conformity with the plans,drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In
accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are
required for ELECTRICAL,PLUMBING,MECHANICAL,WINDOWS,DOORS,ROOFING and SWIMMING POOL work.
OWNERS AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
construction and zoning. Futhermore, I authorize the above-named contractor to do the work stated.
March 29, 2007
Authorized Signature:Owner / Applicant / Contractor / Agent Date
Building Department Copy
Thursday,March 29, 2007 1
Miami Shores Village
Buildi
' ng Department MAR 2 3 .2007 �J
3
10050 N.E.2nd Avenue,Miami Shores,Florida 33138
Tel:(305)795.2204 Fax:(305)756.8972
BUILDING ISI
W^. Permit No.�
PERMIT APPLICATION (4*0& Master Permit No.
FBC 2004
Permit Type(circle): Building Electrical Plumbing Mechanical ,,jRoofing
(F /
Owner's Name(Fee Simple Titleholder) �j pk ZCLS7—s—Phone#Cay 33-74_j97A—�f
Owner's Address'
City f" Sh.o dQ_. State F1 Zip
Tenant/Lessee Name Phone#
Job Address(where the work is being done) �( 7L/- t� . 1 I 13
City Miami Shores Villap-e County Miami-Dade Zip 33 ltj�
FOLIO/PARCEL#
Is Building Historically Designated YES NO
Contractor's Company Name W x)T_� Phone#
Contractor's Address
City State Zip
Qualifier Name Phone#
State Certificate or Registration No. Certificate of Competency No.
Architect/Engineer's Name(if applicable) Phone#
Value of Work For this Permit$ Square/Linear Footage Of Work:
Type of Work: Mddition. ❑Alteration /Kew ❑ Repair/Replace ❑Demolition
Describe Work:
Submittal Fee$ Permit Fee$ ( �//�'�D CCF$ CO/CC
Notary$ Training/Education Fee$ ( J' Technology Fee$
Scanning$ Radon$ DPBR$ Zoning$
Bond$ Code Enforcement$ , Double Fee$
Structural Review.$ Total Fee Now Due$
See Reverse 3 0 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 fust 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.
SiSignature
Owner or Agent ' Contractor
n w a led ed before me thi �e foregoing instrument was acknowledged before me this
!7
The foregoing i7 e t as c g �� g g g
day of 20 b day of ,20_,by
who is p nally known to me or who has produced who is personally known to me or who has produced
As identification and who did tatan oa as identification and who did take an oath.
1pnv vU
NOT TH SMITH NOTARY PUBLIC:
* * MY COMMISSION
0
r9 F FO�-�v Bo otary services
Sign:
P ® Print:
My oin fission Expires: Q 7 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: 1J� Phone#:��,�� ')�,S�� I� '� (�1� D
Job Address(where the work is being done): ,75?S
City_ Miami Shores Village County: Miami-Dade Zip: (�
Is Building Historically Designated?: YES NO V
Contractor's Company Name(if applicable): Phone#:
....................0 a a N 0 0....0 0 N 0 0 0 0 0 E x E 0.....0 0 0 0 E\0 0 E 0 0 0 a 0 0 0 a 8.......x 0 0.•1
All elements on the site must be listed and indicate the color to be punted
Walls:. 0
Fascia: ` Attach color Samples
Drip Cap/Drip Edge: ` y with numbers
Soffit:
Roof-.-
Flower
oof:Flower Bins:
Shutters: 1
Awnings: 1`A
Chimney:
i
Doors and Door Jams:
Garage Doors: I
Railings:
Fences:
Decorative Metal: C,-\
All brick(simulated or regular): IW3C
Stucco Banding: NA
Any other Stucco Features: �A
Accessory Buildings:
Other: ,,/ct ' of
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: Date:
Owner or Agent
APPLICATION APPROVED BY: Date: ='
P&Z OFFICIAL
**MUST BE ATTACHED WITH PURPLE BUILDING APPLICATION**
�n h
f ,• R1
D E A 5
Use midtoned colors to add
warmth and visual depth to
-- — your home.Pair midtones with
OAM lighter colors for contrast and
to highlight features such as
window frames and trim.
Before making a color
decision,test paint
on the surface where it will
be applied.Changing light,
^�- surface texture and other
factors can make a great
a difference in the overall
„ - -- " appearance of a color.
1
1 Body:Applesauce 350C-3`
2 Trim:Popped Corn W-B-2001
3 Accent:Book Binder 140F-6"