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BP-05-936Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-248708 Permit Number: BP2005-936 Scheduled Inspection Date: December 18, 2015 Inspector: Rodriguez, Jorge Owner: OWNER, Owner Job Address: 78 NW 107 Street Miami Shores, FL 33168 - Project: <NONE> Contractor: HOME OWNER Permit Type: Imported Permit Inspection Type: Final Work Classification: <NONE> Phone Number Parcel Number 1121360070070 Building Department Comments EXTERIOR PAINTING Passed Failed Correction Needed Re -Inspection Fee No Additional Inspections can be scheduled until re -inspection fee is paid. Infractio Passed Comments INSPECTOR COMMENTS l t Inspector Comments False LCV -, i c�� i K &.tc Sod=f NL -Ca rc- 2,-c8-c� December 17, 2015 For Inspections please call: (305)762-4949 Page 17 of 41 Miami Shores Village tr Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Ter.(3057952204=Fax:� (3O51756.8972 � ati.G `de J � �a lid' BUILDING PERMIT APPLICATION FBC 2001 110. 2925 Permit No. QS - 93 Master Permit No. Permit Type (circle): Building Electrical Plumbing Mechanical Roofing A 3c5 Owner's Name (Fee Simple Titleholder) Mcdv-; r c eS ratj- Phone # :Qs— 154- 'nen' / 321-72% Owner's Address 7� N(A) I©7 S1rec4" City wo..,yt I SVtoeeS State r (pr; dam. Zip Tenant/Lessee Name Phone # Job Address (where the work is being done) `? g N Iii% (9 l City Miami Shores Village County Miami -Dade Zip 331 %s' Is Building Historically Designated YES NO Contractor's Company Name (t71'ter Phone # Contractor's Address City State Zip Qualifier State Certificate or Registration No. Certificate of Competency No. Architect/Engineer's Name (if applicable) Phone # $ Value of Work For this Permit 1/ 100 CI•loi-e.(tc..(S\ Square Footage Of Work: Type of Work: Addition ❑Alteration New E Repair/Replace ❑ Demolition Describe Work: Poaini‘t,nCj Ot 6+nc Stvcc42 l4,6-74. 1� ciL4.cKs t.J ea4ei) .�4:. ,. Q ****************************Fees****************************** Submittal Fee $ .5D. 00 Permit Fee $ Notary $ Scanning $ Code Enforcement $ L20 CCF $ 1 •2O CO/CC __.. Training/Education Fee $ 0 .4 0 Technology Fee $ 1 • 50 Radon $ Zoning Bond $ Structural Plan Review. $ Total Fee Now Due $ &3, 600 13,10 . (Continued on opposite side) Bonding Company's Name (if applicable) s it 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 reinspectionfee will be charged. As/ Signature Xoti-uu Owner or Agent The foregoing instrument was acknowledged before me this 21-- day 2day of Signature Contracttor The foregoing instrument was acknowledged before me this , 20 nn, by HC. Nr - 1 Lc,re -t Dar --day of ,20 ,by who is personally known to me or who has produced Z1 c .- 4 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. b(,23- S51-32-St`t NOTARY 'UBLIC: Sign: Print: My Commiss'in Expires: Joie ********************** ********************* 4 JOSE aGOOLE Notary PaDNc. State of florid* 'WOW. Pfelrfabt No. DD0,95843 Bonded thrn-Awthur J. Gallagher & Co. NOTARY PUBLIC: Sign: Print: My Commission Expires: ******************************************************* APPLICATION APPROVED BY: Chc 05/13/03 **************************************************** 4 z7 Plans Examiner Engineer Zoning . ,t"•11 Miami Shores Village Paint Color Approval and Agreement Date Owner's Name Maw, r; .-b Ores � j- Phone # 30 5- 151 - q 30 g' Owner's Address 1 $ IJ u) 101 SA- r a ck City WI dolt SW, reS State j lOr3dc Zip 33168' Job Address (where the work is being done) 'IT /0U) 10 7 S / reC f City Miami Shores Village County Miami -Dade Zip Z, b?' Is Building Historically Designated YES NO V Contractor's Company Name (if applicable) V CcJ h'e'r Phone # ************************************************************************************************************ All elements on the site must be listed and indicate the color to be painted Walls ! erra. Per^.ck Fascia ,L very ye ( (Oki Drip Cap/drip Edge VJ 1A t re Soffit ✓off' y Vel lot( ) Roof WtA'‘ Flower bins 3V0r / le. 1 kW W IN ;1-e, f1- t - Doors and door jams Vory 'fe 11b) Garage doors J.- 1/or/ tie I / i ) Shutters Awnings Chimney Railings Fences Decorative metal W Li 1-e All brick (simulated or regular) ✓©ry /" 4,,/ Stucco banding Any other stucco features Accessory Buildings Other ************************************************************************************************************ TERRA PEACH 5065P IVORY YELLOW OW37 2P WALDEN WHITE OW141P • OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate applicable laws regulating construction and zoning. Signature .t.c_ Owner or Agent APPLICATION APPROVED BY: Ind that all work will be done in compliance with all P& Z Offici Date ,,7 2/20O6 Date Miami Shores Village 10050 NE 2nd Avenue Phone: 305-795-2204 Printed: 6/28/2005 Applicant: GARDERE Owner: DORESTANT JOB ADDRESS: 78 Contractor Local Phone: Parcel # 1121360070070 NW 107 Building Permit Permit Number: BP2005-936 DORESTANT GARDERE ST Contractor's Address: Page 1 of 1 Legal Description: 36 52 41 PB 42-33 DUNNINGS MIAMI SHORES EXT NO 3 LOT 7 Fees: Description Amount FEE2005-8903 Building Fee $60.00 FEE2005-8904 CCF $1.20 FEE2005-8905 Training and Education Fee $0.40 FEE2005-8906 Technology Fee $1.50 FEE2005-8907 Submittal Fee ($50.00) Total Fees: $13.10 Total Fees: $13.10 Total Receipts: $0.00 Permit Status: APPROVED Permit Expiration: 12/21/2005 Construction Value: $1,100.00 Work: EXTERIOR PAINTING Signed: (INSPECTOR) JUN 29PAID c—N . 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 responisibility for all work done by either myself, my agent, servants or employes. Signed: (Contractor or Builder) BY: