PT-16-66 i
G
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL I
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-261482 Permit Number: PT-1-16-66
Scheduled Inspection Date: October 27, 2017 Permit Type: Paint
Inspector: Porta Jr,Jose Inspection Type:LF al
Owner: C/O SASHA BERDEGUER, ROBERT Work Classification: Addition/Alteration
UrIOC WN
Job Address:,67.1 NE.105_Street
Miami Shores, FL 33138-2053 Phone Number
Parcel Number 1122310120100
Project: <NONE>
Contractor: HOME OWNER
Building Department Comments
PAINT Infractio Passed Comments
INSPECTOR COMMENTS False
t
Inspector Comments
Passed F\-7—] CREATED AS REINSPECTION FOR INSP-250676. Not ready for
inspection. Need to secure building permit and pass required inspections.
The stucco work should be cover under the master permit not yet issued.
RC-1-16-67
Failed
Correction
Needed
Re-Inspection ❑
Fee ,
No Additional Inspections can be scheduled until
reinspection fee is paid.
f
October 26, 2017 For Inspections please call: (305)762-4949 Page 2 of 30
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Miami Shores Village ,
Building Department ��� � i �,
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel:(305)795-2204 Fax:(305)756-8972 Iii Y:
INSPECTION LINE PHONE NUMBER:(305)762-4949 S
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PAINT Master Permit No. �� V
PERMIT APPLICATION Sub Permit No.
JOB ADDRESS: G a /�� �D S 11-e,7
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#: Is the Building Historically Designated:Yes NO
OWNER: Name(Fee Simple Titleholder): °'lf't�/ Phone#: ?0 Yg -
Address: !YG a 9 S c,� !D�/ s
City: 17>9r/a'Mi" State: F� Zip: <S -3 /k6.
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR:Company.Name: 0(_Ot_ . Phone#:
Address:
City: State: Zip:
Qualifier Name: Phone#:
State Certification or Registration#: Certificate of Competency#:
Value of Work for this Permit:$ 1 Sco•.-z Square/Linear Footage of Work:
Description of Work: S e c o R/tea S/C-a' �Mov�li� 'e't ���Gz � to/?417 f �A �cn�v4
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,PLUMBING,SIGNS,WELLS,POOLS, FURNACES,BOILERS,
HEATERS,TANKS,AIR CONDITIONERS,ETC.....
I
"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$2500,the applicant must promise in good faith that a
copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also,a certified
copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven(7)days after the building permit is issued.
In the absence of such posted notice,the inspection will not be approved and an inspection fee will be charged.
Permit Fee$ CCF Fee$ Notary$
Technology Fee$ Training/Education Fee$ Double Fee$
TOTAL FEE NOW DUE$
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.
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Walls: � 2 3 4 .
� Attach color sample with name and number ;.
Fascia: 1 t 2 J 3 4
Drip edge: 1 2 -3 4
1.
Soffit: 1 (Z 1 3 4
Flower Bins: 1 2 3 4
Shutters: 1 2 3 4
Awnings: 1 2 3 4
" Chimney: 1 2 3 4
Doors&Jambs: 1 2 3 4
Garage Doors: 1 2 3 4
Railings: 1 2 3 4
3.
Fences: 1 2 3 4
All Brick: 1 2 3 4
Stucco Bands: 1 2 3 4
Other Stucco
Feature: 1 2 3 4 4•
Accessory Bldg: 1 2 3 4
OWNER AFFIDA certi tha all Eforeg informati n is accurate and that all work will be done in compliance with all
applicable I s regulati con truct n a
1
Signature Signature
OWNER or AGENT CONTRACTOR
The foregoing instrument was acknowledged beforemethis The foregoing instrument was acknowledged before me this
day of J"4� 20 ( (v by day of 20 by
�F4-1�(� (--'who is personally known to I ,who is personally known to
me or who has produced (::k— 7Odr-z2 as me or who has produced as
identification and who did take an oath. identification and who did take an oath.
NOTARY PUBLIC: ��i�iiiiiuu�iii NOTARY PUBLIC:
-S Sil
lies
Sign: _ 612016 Sign:
Print: - 4Q�ARy ' = Print:
Seal: �, E�EE153059 `�Q Seal:
�N
OF
APPROVED BY: Code Official
Historic Preservation Board
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Heavy Cream
PPU5-10"