PT-07-885 rfta. P -s-til- 5
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Miami Shores Village F1er►11r 7y tttt
-e. 10050 N.E.2nd Avenue
? 3! Wcrk, asstficaV W8w
3
- ±t Miami Shores, FL 33138-0000 r M I
Phone: (305)795-2204 1 rt»r7 #a#tt5APPROVED. ..y ......
Issueitate.514�Zt347FExpiration: 1W3
Project Address P .........._......._ _...._. _...____..._.. . ........ ......... ......._..... _ ._._..
529 NE 106 Street 1122310140110
Miami Shores Village, FL Block: Lot: JAN GRIFFIN
Owner-Information........ ...-............... ... ._...............Address.................................................................--................Phone............................-------..............Cell.......................----
JAN GRIFFIN 529 NE 106 ST
MIAMI SHORES FL 33138-2045
........................................................... ...................
Contractor(s) Phone Cell Phone : Valuation: $ 1,000.00
HOMEOWNER
Total Sq Feet: 0
Type of Work: Exterior Available Inspections:
Color: PALE OATS
Inspection Type
Additional Info:
Final
Classification: Residential
Color: PALE OATS_Approved Code Comments: BEN MOORE-WALLS-PALE
Color: PALE OATS_Approved Color:PALE OATS—Denied
Fees Due Amount Total Amt Paid 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
Total: $67.30 MAY ,!, � PAID
In consideration of the issuance to me of this permit,I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining
thereto and in strict conformity with the plans,drawings,statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this
permit I assume responsibility for all work done by either myself,my agent,servants,or employes. I understand that separate permits are required for ELECTRICAL,
PLUMBING,MECHANICAL,WINDOWS, DOORS, ROOFING and SWIMMING POOL work.
OWNERS AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
construction and zoning . Futhermore, I authorize the above -named contractor to do the work stated
May 04, 2007
Authorized Signature:Owner / Applicant / Contractor / Agent Date
Building Department Copy
Friday, May 4, 2007 1
_ Miami Shores Village + { MAY 0 2 2007
Building Department ZS
10050 N.E.2nd Avenue,Miami Shores,Florida 33138 B Y.___(--____-----------
Tel:(305)795.2204 Fax: (305)756.8972
BUILDING Permit No.9M5
PERMIT APPLICATION Master Permit No.
FBC 2004
Permit Type (circle): uilding Electrical Plumbing Mechanical Roofing
Owner's Name(Fee Simple Titleholder) Gf r �Sne# 6® PY 00
2.�t e.� .� l s�R
Owner's Address 5 � �� m
City l(Am 1 Sgaaa state 1T l_ • Zip 3 313
Tenant/Lessee Name Phone# 30 S J'O - Ll 23 &ZI #
Job Address(where the work is being done) 01 F- 1
City Miami Shores Villa2e AGS. Coun Miami-Dade Zip 33 l�"
FOLIO/PARCEL#
Is Building Historically Designated YES NQ-
Contractor's Company Name S S-LF Phone# .3 6,T eD Z
Contractor's Address
City State Zip
Qualifier Name Phone#
State Certificate or Registration No. Certificate of Competency No.
Architect/Engineer's Name(if applicable) Phone#
sd
Value of Work For this Permit$ S�U� Square/Linear Footage Of Work:
Type of Work: ❑Addition ❑Alteration w ❑ Repair/Replace ❑Demolition
Describe Work: 2' Ti Nf^s- G t'j !DLC
tn-t GQ
ee
Submittal Fee/$ Permit Fee$ CCF$ 6p CO/CC
Notary$ 5,w Training/Education Fee$ i 2 D Technology Fee$
Scanning$ Radon$ DPBR$ Zoning$
Bond$ Code Enforcement$ Double Fee$
Structural Review.$ Total Fee Now Due$ 6730
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$2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
Signature4
Signature
O nt Contractor
The foregoing instrument was acknowledged before me this oC The foregoing instrument was acknowledged before me this
day of20 by h 1u �t �y �:. day of ,20 by
who is personally known to me or who has produced Nit ; who is personally known to me or who has produced
tO$ 0 As identification and who did as identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
Sign: Sign:
Print: 4416k L ! ' 9 Print:
My Commission Expires: My Commission Expires:
APPLICATION APPROVED BY: Plans Examiner
Engineer
Zoning
(Revised 02/08/06)
1
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 p2inted
V Slp,rs� B�NS1i Ml�t Mno,tF
Walls: k-PA P-0-8)+!, - �li `+�b �AL C'AT5
Fascia: W iTF (' �YIS7—, c, Attach color Samples
Drip Cap/Drip Ed e:J>A�j 1 Zl G77 with numbers
Soffit: w u v F-
Roof: f.i
Flower Bins: o
m
Shutters: I a
Q
Awnings: N. A
Chimney:
Doors and Door Jams: H T 5:- E Kf ^, `
Garage Doors:_ C.> H% T-$=- ExIf
Railings: f 1A
2166-60
Fences: C
0
Decorative Metal: �� ,qE
a
All brick(simulated or regular):
Stucco Banding: A�j/C-
3
Any other Stucco Features: p
Accessory Buildings:
Other:
167-60
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: 4/Z310-
r r Agent J
APPLICA APPROVED BY: Date: s 3'y,
P Z O FICIAL
"MUST BE ATTACHED WITH PURPLE BUILDING APPLICATION"