PT-16-2595 i
F
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-267629 Permit Number: PT-9-16-2595
Scheduled Inspection Date: March 30, 2018 Permit Type: Paint
Inspector: Naranjo, Ismael Inspection Type: Final
Owner: PIERRE, BENISOI Work Classification: Addition/Alteration
Job{Address:39 NW 101 Street
Miami Shores, FL Phone Number (305)759-3803
Parcel Number 1131010180210
Project: <NONE>
Contractor: HOME OWNER
Building Department Comments
EXTERIOR PAINT Infractio Passed Comments
INSPECTOR COMMENTS False
Inspector Comments
Passed -
Failed
assed -
Failed
Correction ❑
Needed
Re-Inspection ❑ `
Fee I
i
No Additional Inspections can be scheduled until
re-inspection fee is paid.
,
March 29,2018 For Inspections please call: (305)762-4949 Page 4 of 39
Perrn t NO. PT-9-16-2595
Miami Shores Village � Permit Type:Faint
10050 N.E.2nd Avenue NW PerI A� lit/oxkCiass�rcation:Addition/Alteration
Miami Shores, re 33138-0000 00
Permit Status;APPROVED
Phone: (305)795-2204
R�RIDp'
Issue Date:912112016 Expiration: 03/20/2017
Project Address Parcel Number Applicant
39 NW 101 Street 1131010180210
Miami Shores, FL Block: Lot: BENISOI PIERRE
Owner Information Address Phone Cell
BENISOI PIERRE 39 NW 101 ST (305)759-3803
MIAMI SHORES FL 33150-1266
Contractor(s) Phone Cell Phone Valuation: $ 500.00
HOME OWNER
..v— Total Sq Feet:
fi 4
Type of Work:Exterior Available Inspections:
Color: Inspection Type:
Additional Info:EXTERIOR PAINT Final
Classification:Residential
Color:_Approved Code Comments:WALLS-BEIGE
Color:_Approved_ Color:_Denied
Fees Due AmountPay Date Pay Type Amt Paid Amt Due
CCF $0.60
Education Surcharge $0.20 Invoice# PT-9-16-61408
09/20/2016 Cash $66.60 $0.00
Notary Fee $5.00
Permit Fee $60.00
Technology Fee $0.80
Total: $66.60
In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations
pertaining thereto and in strict conformity with the plans,drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In
accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes., I understand that separate permits are
required for ELECTRICAL,PLUMBING,MECHANICAL,WINDOWS,DOORS,ROOFING and SWIMMING POOL work.
OWNERS AFF I IT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
constructiT anToiFuthermo I authorize the above-named contractor to do the work stated.
September 21, 2016
A t rize ignatu e:Owner / Applicant / Contractor / Agent Date
Building Department Copy
September 21,2016 1
Miami Shores Village 7BYI:
��va�L�g 20 2016
Building Department cAA
10050 N.E.2nd Avenue,Miami Shores,Florida 33138
Tel:(305)795.2204 Fax:(305)756.8972
INSPECTION'S PHONE NUMBER: (305)762.4949 u C�G
BUILDING Permit No. 1 — 1 —ZV I
PERMIT APPLICATION Master Permit No.
FBC 20
Permit Type:PAINT
OWNER:Name(Fee Simple Titleholder): P I 1 l_ �,��J� ' Phone#:
Address: �"1 N Yy V ' S
City: State: 'F 10 V- I f�q Zip: ,
Tenant/Lessee Name: Phone#: N O .Prn h Q
Email:
JOB ADDRESS:
City: Miami Shores County: Miami Dade Zip: a-3 L'75 Q
Folio/Parcel#:
Is the Building Historically Designated: Yes NO Flood Zone:
CONTRACTOR:Company Name: 1\�r Phone#:
Address:
City: State: Zip:
Qualifier Name: Phone#:
State Certification or Registration#: Certificate of Competency#:
Contact Phone#: Email Address:
Value of Work for this Permit:$VO Square/Linear Footage of Work:
Description of Work: `QX-}-C r,- Oy i7 01 t _1
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.....
"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$2500,the applicant must promise in good faith that a copy of
the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also,a certified copy of the
recorded notice of commencement must be posted at the job site for the first inspection which occurs seven(7)days after the building permit is issued. /n the absence of
such posted notice,the inspection will not be approved and an inspection fee will be charged.
***************************************Fees********
Permit Fee$ CCF$ 0 .6d Notary$ r TraininglEducation Fee$ 0 . �2_0
Technology Fee$ 0 .80 Double Fee$ TOTAL FEE NOW DUE$ �cl b • (-3c)
PAINT COLOR APPROVAL AND AGREEMENT
All elements on the site must be listed and indicate the color to be painted
DIRECTIONS: Please circle corresponding number to appropriate color sample.
Walls: 1 2 3 4
Attach color sample with name and number.
Fascia: 1 2 3 4 0 4
Drip edge: 1 2 3 4 0
1. , G
Soffit: 1 2 3 4
Roof: 1 2 3 4
Flower Bins: 1 2 3 4
Shutters: 1 2 3 4
2.
Awnings: 1 2 3 4
• T �
Chimney: 1 2 3 4 �,• _ G�_ ��
Doors&Jambs:1 2 3 4
Garage Doors: 1 2 3 4 a
Railings: 1 2 3 4 r
Fences: 1 2 3 4 `\
All Brick: 1 2 3 4
Stucco Bands: 1 2 3 4
4.
Other Stucco
Feature: 1 2 3 4
Accessory Bldg: 1 2 3 4
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.
L=
Signature: Signature:
Owner or Agent h Contractor
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
day of Sc� 20 6 by�x1j S Q i 1�1'e rrt day of ,20_,by_
who is personally known to me or duced who is personally known to me or who has produced
T)f'NeY ItC)Q&- As identif ation and who id take an oath, as identification and who did take an oath.
NOTAR PU C: NOTARY PUBLIC:
Sign: Sign:
Print: Print:
My Commission Expires: YANADY PRIErO My Commission Expires:
MY COMMISSION#FF 214031
********************* xPIy�S:March 25,2019
APPROVED BY: 1A t 1� Code Official
Preservation Board