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PT-06-2453 Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138-0000 - Phone: (305)795-2204 Fax: (305)756-8972 Permit Permit Status: APPROVED Issue Date: 10/3/2006 Expires: 04/01/2007 Permit Number: PT-9-06-2453 Owner's Name: RICHARD AND JOSEPHINE CAMACHO one: (305)757-7057 Permit Type: Paint Parcel#: 1132060131980 Work Classification: New Block: Lot: Job Address: 152 101 Street NE Section: PB: Miami Shores Village, FL 33138- Contractor(s) Phone Primary Contractor Total Square Feet: 0 HOME OWNER Yes Total Valuation: $ 500.00 Re uired Ins ections Additional Information Final Type of Work: Exterior Color: 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-9-06-26276 $67.30 Education Surcharge $0.20 Total: Notary Fee $5.00 OCT ® 6 rAID Permit Fee $60.00 Technology Fee $1.50 Total: $67.30 ubllu ccj Building Department File Copy NOTICE: In addition to the requirements of this permit, there may be additional restrictions applicable to this property that may be found in the public records of this county. AND THERE MAY BE ADDITIONAL PERMITS REQUIRED FROM OTHER GOVERNMENTAL ENTITIES SUCH AS WATER MANAGEMENT DISTRICTS,STATE AGENCIES,OR FEDERAL AGENCIES. Applicant Signature Miami Shores Village Building Department ,1 zoos 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 Tel: (305)795.2204 Fag:(305)756.8972 -------- BUILDING 1 � V Permit No. Pr — PERMIT APPLICATIONS Master Permit No. FBC 2004 Permit Type(circle): Building Electrical Plumbing Mechanical Roofing Owner's Name(Fee Simple Titleholder) 4 KD &MWk Phone# 30S 7,5-,7- 7OS7 Tenant2essee Name Phone# Job Address(where the work is being done) �✓ ��� l 0 / S l R ! City M ami Shores Villaee County Miami-Dade Zip 33132 FOLIO/PARCEL# Is Building Historically Designated YES NO Contractor's Company Name 6 W/ye/? Phone# 3 a-r- S575` TZ FO wyIZ� Contractor's Address ( -5- Z to / 17% Cityrf A m% S h r)x State F LZip 3 /3 J' Qualifier Name Phone# State Certificate or Registration No. Certificate of Competency No. Architect/Engineer's Name(if applicable) Phone# Value of Work For this Permit$ -5-0 01 Q U Square/Linear Footage Of Work: Type of Work: ❑Addition ❑Alteration ew ElRepair/Replace El Demolition Describe Work: 10 US C �� Y�C 9/0 rL I t ,Fees,,,,, , ,,,, ,,� ,,� �r ,�***,�,r ,� ,� ,r* ,� Submittal Fee$ Permit Fee$ ��� fl-- 060 CCF$ CO/CC n Notary$ Training/Education Fee$ 0-L0 Technology Fee$ fo Scanning$ Radon$ DPBR$ Zoning$ Band$ 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 IV 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 wil approued and a reinspes tio+ fee will be charged Signature (� �J��l� Signatureyoro iOwner or Agent rThe foreg in instrument was acknowledged efo a menthis The foregoing instrul dged before me this day o 20 by ,9� x9 day of who ispe ally known to me or who has produced P who is personally knhas produced q�'m a identification and who did take an oath. d who did take an oath. NOTARYP I Asa E NOTARY P ®�6>�Ur,idli`�SI017 i lo Exp :Jul �3,2w, Sign: Sign: Print: Pmt: My Commis ion1xpires: My Commission Expires: APPLICATION APPROVED BY: Plans Examiner Engineer Zoning (Revised 09109106) Miami Shores Village Paint Color Approval and Agreement Date: Owner's Name: /C �'��1 � �f�h7J7��(� Phone#: 36©F- 7.57-76j-,7 Job Address(where the work is being done): /S 2 N�` )O / S I-, City: Miami Shores Village County: Miami-Dade Zip: 3 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 minted walls:_ C 0 C lu X SLD 6,3 5"r Fascia:—C i�V Yo J&- C S LO Gy 5'Y Attach color Samples Drip Cap/Drip Edge: with numhPrc Soffit: 091-�,®X, C-6*y SW -5/ Roof: Flower Bins: Shutters: G� 4l l TE Awnings: P/49- Chimney: Al,4- Doors and Door Jams: C Il Ivl(a 10 C L 0-t Su) 6!S- , Garage Doors: C/�k/ 'd k CC/I-Y S W 60-c' nN Railings: 1�/.� g ° a W Fences: �(/ 1' �' C Decorative Metal: All brick(simulated or regular : Stucco Banding: Any other Stucco Features: Accessory Buildings: Other: 6054 ■■■■■■■■■■■■■■■■■■■■■■■■.■■■■.■■■■■■■■■■■■■■.■■■■...----- Ca ,n Clay OWNER'S AF AVIT: I cert' that all the foregoing information is accurate and that all work will be done in compgapee w'th all p is 'le law egulating construction and zoning. Signature: G��'�l"� Date: Owner or Agent /00 APPLICATION APPROVED BY: Date: /� � 0 P& 6FFICIAL **MUST BE ATTACHED WITH PURPLE BUILDING APPLICATION"