PT-06-1379iOro
prr 2, S(
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
BUILDING U
la EVTE Permit No. i o6 — 1379
PERMIT APPLICATION
MAY 2 3 2006 IIII
FBC 2004 , _ B Y: �.
Permit Type (circle). Building Electrical
Owner's Name (Fee Simple Titleholder)
Owner's Address 9 7i0 I "E3 I`SC
City VVVOt Vvt( O vP
Tenant/Lessee Name
Contractor's Company Name
Contractor's Address
Value of Work For this Permit $ / / 000
Type of Work: ['Addition DAlteration
Describe Work: �1
Structural Review. $
Miami Shores Village
Building Department
Is Building Historically Designated YES NO V
State Zip 3
Master Permit No.
Phone #
W, e r Phone #
Square / Linear Footage Of Work: i® L
eo •l /LJ CCF $ CD
O
Submittal Fee $ Permit Fee $
Notary $ Training/Education Fee $
Scanning $ Radon $ DPBR $
Technology Fee $
Bond $ Code Enforcement $ Double Fee $
Total Fee Now Due $
* * * * * * * * * * * * * * **
CO /CC
P
See Reverse side —*
Plumbing Mechanical Roofing
ileCt Phone# 30 5 `f / / -Ar2S
Job Address (where the work is being done) C I 70 1 IS co-vie 6 l v
City Miami Shores Village County . Miami -Dade Zip 3 3 / 3
FOLIO / PARCEL #
City State Zip
Qualifier Name Phone #
State Certificate or Registration No. Certificate of Competency No.
Architect/Engineer's Name (if applicable) Phone #
0 Repair/Replace ❑ Demolition
Zoning $
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 A1?Fll)AVIT: 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 oft notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachm Also, r ed copy of the recorded notice of commencement must be posted at the job site
for the first inspection which oc after the building permit is issued. In the absence of such posted notice, the
inspection will not ' approve and a re;4 on fee l be charged.
Signatur Signature
er or Agent Contractor
The foreg ing instrum- t was acknowledged before me this The foregoing instrument was acknowledged before me this
day of r 20( by /'L (ClC.L t , day of , 20 , by
who is perso i known to me or who has produced who is personally known to me or who has produced
As identification and who did take an oath. as identification and who did take an oath.
44 NOTARY _ C: •, , *Pre
q�+
Don --0091
Sign:
Print:
My Co ission Expires:
APPLICATION APPROVED BY:
(Revised 07/08/06)
l
r° a'L
NOTARY PUBLIC:
Sign:
Print:
My Commission Expires:
Plans Examiner
Engineer
Zoning
Paint Color Approval and Agreement
Date 0/3
OC
Owner' Name
Owner's Address
City frVin 1
Job Address (where the work is being done)
City Miami Shores Village
Is Building Historically Designated
r
-to 1 B.ec
? / '9/
U S State PlPs
YES NO ■/
Contractor's Company Name (if applicable) (IT 1A./ / 1/ A em/
***************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** **************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
All elements on the site must be listed and indicate the color to be painted
Walls
Fascia 4 ili h 1 ��
Drip Cap /dri Ede 010 n V►r b j fr~-
Soffit t/l/
Roof 44 JT
Flower bins
Shutters
Miami Shores Village
Awnings
A q
Chimney t---t-t \LW %s
Doors and door jams datiAl jw
Garage doors
doors
Railings
Fences ( ' .ems Wi
Signature
�o Bra BJv
q f �
County Miami -Dade Zip 3 3) 3 3
Decorative metal
All brick (simulated or regular) Ty'
Stucco banding
Any other stucco features
Accessory Buildings
Zip 33e?
Other
***************************************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
OWNER'S AFFIDAVIT: I certify ' at all the foregoing information is accurate and that all work will be done in compliance with all
applicable laws regulating . nstruc : on and zoning.
APPLICATION APPROVED BY:
Owner or Agent
P& Z Official
Phone# 3 OS qcf
Phone # 3 1 T s3f
0
N
0
Cn
0
Date
Date
mellow yellow
43 \
chc 6/18/03
Permit Type: Paint
Work Classification: New
Job Address: 9701 BISCAYNE Boulevard
Comments:
EXTERIOR PAINTING
Additional Information
Miami Shores Village, FL 33138-
Building Department File Copy
Applicant Signature
Miami Shores Village
10050 N.E. 2nd Avenue
Miami Shores, FL 33138 -0000
Phone: (305)795 -2204 Fax: (305)756 -8972
Permit
Issue Date: 6/1/2006 Expires: 11/19/2006
Owner's Name: GUSTAVO ARTUNDUAGA
Contractor(s) Phone Primary Contractor
HOME OWNER
Yes
Type of Work: Exterior Color. GOLDEN STRAW AND WHITE DOVE
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.
Parcel #:
Block:
Section:
Permit Status: APPROVED
Permit Number: PT -5 -06 -1379
Phone: (305)756 -5600
1132060143320
Lot
PB:
Total Square Feet 0
Total Valuation: $ 1,000.00
Required Inspections
Final
Fees Due
CCF
Education Surcharge
Notary Fee
Permit Fee
Technology Fee
Total:
Amount
$1.20
$0.40
$5.00
$60.00
$1.50
$68.10
Invoice Number
PT - 5 - 06 - 24913
Total:
Amt Due
$68.10
c.0 . JuN 0 nu
Amt Paid
$68.10
$68.10
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.