PT-07-1247 �04 247
�sN°RMS A Miami Shores Village P!BllW TyOr Paint
10050 N.E.2nd Avenue Work C/as "rtabon, NOW
Miami Shores,FL 33138-0000
Phone: (305)795-2204 Pe�'�/afus-APPROVED
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� ,�i5 1 7 Expiration: 12/12/2007
Project Address Parcel Number Applicant
235 GRAND CONC 1132060133620
Miami Shores Village, FL 33138- Block: Lot: ROBIN CARNEY
Owner Information Address Phone Cell
ROBIN CARNEY 270 NE 92 ST
L.
MIAMI SHORES FL 33138-3132
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Contractor(s) Phone Cell Phone Valuation: $ 1,000.00
HOME OWNER Total Sq Feet: 0
Type of Work:Exterior Available Inspections:
Color:BEIGE/CREM/LIGHT GRAY Inspection Type:
Additional Info: Final
Classification:Residential
Color: BEIGE/CREM/LIGHT GRAY_Approved Code Comments:BEN MOORE-WALLS-
Color:BEIGE/CREM/LIGHT GRAY_Approved_ Color: BEIGE/CREM/LIGHT GRAY—Denied
Fees Due Amount Total Amt Paid 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 PAID
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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.
June 15, 2007
Authorized Signature:Owner / Applicant / Contractor / Agent Date
Building Department Copy
Friday,June 15, 2007 1