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PT-17-274 Inspection Worksheet Miami Shores Village 10050 N.E.2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-275855 Permit Number: PT-2-17-274 Scheduled Inspection Date: October 05, 2017 Permit Type: Paint Inspector: Naranjo, Ismael Inspection Type: Final Owner: ROMANCHUK, RYAN &WHITNEY Work Classification: Addition/Alteration Job Address: 1061 NE 91 Terrace Miami Shores, FL 33138- Phone Number Project: <NONE> Parcel Number 1132050010070 Contractor: HOME OWNER Building Department Comments paint exterior house Infractio Passed Comments INSPECTOR COMMENTS False Inspector Comments Passed Failed CO Correction ❑ Needed Re-Inspection ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is paid. October 04, 2017 For Inspections please call: (305)762-4949 Page 3 of 28 Permit NO. PT-2-17-2'74 `gam°Rs y,` Miami Shores VillagePermit Type:'Paint s� tr 10050 N.E.2nd Avenue NE rry� IlVcsrkCJassif�cati©n:Addition/A#fetation Miami Shores,FL 33138-0000 Phone: (305)795-2204 PAmft, Permit Status:APPROVED �OR'lD� Issue.Date:21212017 Expiration: 08/01/2017 Project Address Parcel Number Applicant 1061 NE 91 Terrace 1132050010070 Miami Shores, FL 33138- Block: Lot: RYAN&WHITNEY ROMANCHUlo Owner Information Address Phone Cell RYAN&WHITNEY ROMANCHUK 1061 NE 91 Terrace �. MIAMI SHORES FL 33138- 1061 NE 91 Terrace MIAMI SHORES FL 33138- Contractor(s) Phone Cell Phone Valuation: $ 1,500.00 HOME OWNER _......., _ �wm. Total Sq Feet: 0 Type of Work:Exterior Available Inspections: Color:white Inspection Type: Additional Info:paint exterior house Final Classification:Residential Color:white—Approved Code Comments: Color:white_Approved_ Color:white—Denied 1 Fees Due - Amo]00 Pay Date Pay Type Amt Paid Amt Due CCF Invoice# PT-2-17-62806 Education Surcharge Notary Fee 02/02/2017 Credit Card $68.20 $0.00 Permit Fee $ Technology Fee Total: $6 In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans,drawings,statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by eithermyself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL,PLUMBING,MECHANICAL,WINDOWS,DOORS,ROOFING and SWIMMING POOL work. OWNERS AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Fut rmore,I authorize th ve-named contractor to do the work stated. February 02, 2017 Authorized Signature:Owner / Applicant / Contractor / Agent Date Building Department Copy February 02, 2017 1 z� Miami Shores Village =BIY: Building Department 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 Tel:(305)795.2204 Fax:(305)756.8972 INSPECTION'S PHONE NUMBER:(305)762.4949 BUILDING Permit No. Plr2- n- 274 PERMIT APPLICATION Master Permit No. FBC 20 Permit Type:PAINT -q OWNER:Name(Fee Simple Titleholder): W�1 i-l'1Q L., 0-0 C h 1 ` Phone#: 2-1 -3 Address: �pl2( N E IST T c v►-c�c� City: YNI;C"k- swe-, CS State: U111-V Zip: 31 �- Tenant/Lessee Name: Phone#: Email: V (.I� V & d-i7v • C.-) rye JOB ADDRESS: 10 (I Ne City: Miami Shores County: Miami Dade Zip: 3 311 Folio/Parcel#: Is the Building Historically Designated: Yes NO Flood Zone: V1 O CONTRACTOR:Company Name: D e V- C O r1 5-1 V-L,(_ },pn Phone#: -1 �Z --1 Address: 1 301 &C s T 13 u c el r2,,I City: �--E - L_-"_U_Je -61Ca2 State: r� Zip: ✓ 3 3 O� Qualifier Name:_P-LXk h f--0YYI cJ_W�I LC�- Phone#: -11-7 - 3 K- 6i't-7 State Certification or Registration#: CD C S Z4 l0 3 3 Certificate of Competency#: Contact Phone#: Email Address: Value of Work for this Permit:$ V50 p Square/Linear Footage of Work: drC-0 Description of Work: 10A� r><k Q_.K}Q.--� Jr 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$2500,the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also,a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven(7)days after the building permit is issued. In the absence of such posted notice,the inspection will not be approved and an inspection fee will be charged. /�I Z o Permit Fee$ �� CCF$_l7"'�" Notary$ Training/Education Fee$ Q • t Technology Fee$ »-rt- -J- Double Fee$ TOTAL FEE NOW DUE$_ 1 . too 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 Fascia: 1 2 3 4 Attach color sample with name and number Drip edge: 1 2 3 4 Soffit: 1 2 3 4 1. Roof: 2 3 4 Flower Bins: 1 2 3 4 Shutters: 1 2 3 4 Awnings: �1 2 3 4 2. Chimney: ( 11 2 3 4 Doors&Jambs:1 2 3 4 N white 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 4. 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. Signature: _�C �/ Signature: Owner or Agent Contractor The foregoing instrument was acknowledged befDe me this k� The foregoing instrument was acknowledged before me this day of ?F- w ,20 U,by I11��'Id�ey I ROmdr►&(i day of 20_,by ' who is personally known to me or who has produced who is personally known to me or who has produced 1_)r&QV lI�6`( As identification an id take an oath. as identification and who did take an oath. NOTAR P C: NOTARY PUBLIC: Sign: Sign: Print: Print: My Commission Expires: My Commission Expires: APPROVED BY: Code Official Preservation Board YANADY PRIETO MY COMMISSION#FF 214031 :.; " • :o EXPIRES:March 25,2019 ', of Fd` Bonded Thru Notary Public underwriters