PT-09-2063 /-� Miami Shores Village RE? ttWEb
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v� Building Department
DEC 1 � t
V 10050 N.t,.2nd Avenue. Miami Shores.. Florida 33139 -
Tel: (305) 795.2209 Fax: (305) 756.8972_
BUILDING Permit No. t°'
PERMIT APPLICATION Master Permit No.
FBC &MO
Permit Tyne: PAINT PERMIT q
Owner's Name (Fee Simple Titleholder) _ _7A r^ES PANJ Phone # ?O -r
Owner's Address 1 S � �� �'— - 5 - T
City State, Zip
Tenant /Lessee Name Phone # s_
E-MAIL: - - - -- AQAY Yl bed .Tb bl"�' � • �
Job Address (where the work is being done) 1 1 Al /A/ l st / k6 _
City Miami Shores Villa �_ye County Miami -Dade Zip
FOLIO / PARCEL # //- 3J0 /_ pj�- bd 4?D
Is Building Historically Designated YES NO _f
Contractor's Company Name Phone # 3� U —
Contractor's Address d. kJ b �Q 4 �2— - 3 1 7 City_ -�—� 1Q Jt'L State L` (, Zip 6
Qualifier Name � A A i h� �f (. L c G S Phone #
State Certificate or Registration No. !f Certificate of Competency No.
OWNER BUILDER:
o
Value of Work For this °mit $ 7ze Type of Wor ❑ Addition / ❑ Alteration / ❑New / ❑ Repair /Replace
Describe Wo 55 U le CU L! 576 M S Cc
Njo
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 sorb: will be perlornied to meet the standards of all laws regulating construction in this jurisdiction. I understand that a separate permit must he secured ktr
ELEC'T'RIC.'AI. WORK. PLUMBING, SIGNS, WELLS. POOLS, FURNACF BOILI :. RS. HEATERS, TANKS and AIR CONDITIONERS, ETC.....
"WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE Of COMMENCEMENT MAY RESULT IN YOUR PAVING TWICE POR
IMPROVEMENT'S TO YOUR PROPERTY. IF YOU INTEND TO ORTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFOR[
RECORDING YOUR NOTICE OF COMMENCEMENT."
Notice to. I pplicant: As it condition to the issuance ol'a huilding permit with an eslinraled value exceeding $2500. the applicant must promise in good lijith dial a copy of the
notice gfconune and construction lien lair brochure will he delivered to the person whose property is subject to attachment. 11 1so. ar certified copy gfthe recorded notice
of cornrnencentew must he posted at the job sire for the,rrst inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice. the
inspection hill not he approved and a reinspection will he charged.
` , r %U Permit Fee $ , L"V CCF $ Technology Fee:
Training/Education Fee $ Notary $ Code Enforcement $
Double Fee $ Zoning $ Total Fee Now Due $
See Reverse side -4
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
Walls: 1 4 Attach( and
Fascia: 1 2 3 4
Drip Cap/Drip Edge: 1 2 3 4
510 -4 Balsam 510 -4
Soffit I � ' J 3 4
Roo(. 2 3 4
Plower Bins: I 2 3 4
Shutters: 1 2 3 4
Awnin,us: I 2 3 4 2
5 3 -1 Mother Of Pearl 513 -1
Chimney: I 2 3 4
Doors and Door,lams: 1 2 3 4 —~
Garage Doors: I 2 3 4
Raifin_s: I 2 3 4 3
Fences: 1 2 3 4
All brick (simulated or redUHU ): I 2 3 4
Stucco Banding: l P, 2 3 4
Anv other Stucco Features. 1 3 4 4
Accessory Buildings A Other:
OWNER'S AFFIDAVIT: 1 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_ � '—"` Signature
or Agent Contractor
The foregoing insuun a was acknowledged before me this 1, The foregoing instt7�ment s itcknowl ed before a thi • (D
( 1- Y
day of �C pxrlrt 20. by _� 1V day of 20 by
who is personall known to me or who has pmduced_ who is pers Ti who produce
�t)e> -1 Zeyl�n identification and who d" take an oath. � Q`� z7 as id i and who did take an oath.
NO "rARV PURL W: NOTARV PUB IC:
g Sign:
Sign: —
E' Print: ... �'
Print: '
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My Commission Expires: ��r o AZELEINERAYMOND My Commission E:xpir s: DANIA GARCIA`
� � ` Notary Public, State of Fl ft = J" YjP���i Comm# DD0854292
*' Commloslo iliDDS78702 IL
Florida NotMOks., Inc
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APPLICATION APPROVI?[) BY: Plans Examiner
Preservation Board
Code E:ntiucement
1 (Revised 04/24K) ;
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Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
nspection Number: I ISIS P- 131659 Permit Number: PT -12 -09 -2063
Inspection Date: May 03, 2010 Permit Type Paint
Inspector. Bruhn, Norman
Inspection Type: Final
Owner: PANN, JAMES Work Classification: New
Job Address: 9153 NW 1 Avenue
Miami Shores, FL Phone Number
Parcel Number 1131010160080
Project: <NONE>
Contractor:
Building Department Comments
Inspector Comments
Passed
! � ;
Failed El
Correction
Needed ❑
Re- Inspection ❑
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid
For Inspections please call: (305)762 -4949
May 03, 2010 Page 1 of 1
S
3
�, Pant
� Miami Shores Village
10050 N.E. 2nd Avenue
Miami Shores, FL 33138 -0000`
�g
Phone: (305)795 -2204 -
Expiration: 06119/2010
Project Address Parcel Number Applicant
9163 1 Avenue 1131010160080
Miami Shores, FL Block: Lot: JAMES PANN
Owner information Address Phone Cali
JAMES PANN 9153 1 Avenue
MIAMI SHORES FL 33150 -2248
Contractor(s) Phone Cell Phone Valuation: $ 0.00
—. Total Sq Feet: 0
Type of Work: Exterior For Inspections please call:
Color: (305)762 -4949
Additional Info: Available Inspections:
Classification: Residential
Inspection Type:
Color. Approved Code Comments: PITTSBURGH PAINT - WALLS, BF Final
Color Approved_ Color. _Denied
Fees Due Amount Invoice # Total Amt. Paid Amt Due
Permit Fee $60.00 PT -12 -09 -36657 $ 60.00 $ 60.00 $ 0.00
Scanning Fee $0.00
T Check #:1015
Total: $60.00
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 wilt be done in compliance with all applicable laws regulating
construction and zoning. Futhermore, I authorize the above -named contractor to do the work stated
December 22, 2009
Authorized Signature: Owner / Applicant / Contractor / Agent Date
Building Department Copy
December 22, 2009 1