PT-07-155Issue Date: 1/26/2007
Owner's Name: WAYNE HOOKS
Permit Type: Paint
Work Classification: Addition /Alteration
Job Address: 11004 2 Avenue NW
Contractor(s)
HOME OWNER
Phone Primary Contractor
Yes
Additional Information
Miami Shores Village, FL
Expires: 07/25/2007
Type of Work: Exterior
Additional Info:
Color. SHADOW WHITE
Classification: Residential
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 will be done in compliance with all applicable laws regulating construction
and zoning. Futhermore, I authorize the above -named contractor to do the work
stated.
Fees Due
CCF
Education Surcharge
Notary Fee
Permit Fee
Technology Fee
Total:
Amount
$0.30
$0.10
$5.00
$60.00
$1.50
$66.90
Invoice Number
PT - 1 - 07 - 27311
Total:
N.)121
Amt Due
$66.90
Amt Paid
JAN 2 6PAID
Building Department File Copy
Applicant Signature
Miami Shores Village
10050 N.E. 2nd Avenue
Miami Shores, FL 33138 -0000
Phone: (305)795 -2204 Fax: (305)756 -8972
Permit
Permit Status: APPROVED
Permit Number: PT -1 -07 -155
Phone:
Parcel #: 1121360020240
Block: Lot:
Section: PB:
Total Square Feet 0
Total Valuation: $ 500.00
Required Inspections
Final
NOTICE: In addition to the requirements of this permit, there may be
additional restrictions applicable to this property that may be found in the
public records of this county.
AND THERE MAY BE ADDITIONAL PERMITS REQUIRED FROM OTHER
GOVERNMENTAL ENTITIES SUCH AS WATER MANAGEMENT
DISTRICTS, STATE AGENCIES, OR FEDERAL AGENCIES.
Inspection Number: INSP- 134573 Permit Number: PT -2 -10 -155
Scheduled Inspection Date: April 06, 2010
Inspector: Bruhn, Norman
Owner:
Job Address: 1600 NE 104 Street
Project: <NONE>
Contractor:
Miami Shores, FL
Building Department Comments
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Permit Type: Paint
Inspection Type: Final
Work Classification: Addition /Alteration
Phone Number
Parcel Number 1122320320420
Passed
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Inspector Comments
April 05, 2010
For Inspections please call: (305)762 -4949
Page 13 of 25
BUILDING
PERMIT APPLICATION
FBC 2004
Permit Type (circle):
Owner's Name (Fee S' 1 Ttl h ld ) \ A > 1
Owner's Address
City
Tenant/Lessee Name
Building
Is Building Historically Designated YES NO �✓
Contractor's Company Name
Contractor's Address
Miami Shores Village JAN 2 6 PAID
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
Master Permit No.
Electrical Plumbing Mechanical Roofing
imp e i e o er JV
1 U 4— i/,'Lja 2—A-2) A L
r+ M o vn. E. 5 State 1 L Zip 3 3v, 8
ve---> Phone # Let 954- 74, -iPee
Phone #
Permit No O7
Job Address (where the work is being done) I (0 4- /j, , 7, ^r n A .,
City Miami Shores Village County Miami -Dade Zip 3 3 ( (. V
FOLIO / PARCEL #
Phone #
City State Zip
Qualifier Name Phone #
State Certificate or Registration No. Certificate of Competency No.
Architect/Engineer's Name (if applicable) Phone #
Value of Work For this Permit $ Square / Linear Footage Of Work:
Type of Work: ❑Addition ❑Alteration ❑New ❑ Repair/Replace ❑ Demolition
Describe Work:
******** * *** **** * ** * * ** *** ** **** * * ***** ees** *********** * **** **** * ***** * * **** *** ** * * * **
Submittal Fee $ Permit Fee $ W CCF $
Notary $ 4 00 Training/Education Fee $ ( - ro Technology Fee $
Scanning $ Radon $
CO /CC
DPBR $ Zoning $
Bond $ Code Enforcement $ Double Fee $
Structural Review. $ Total Fee Now Due $ 60 10
See Reverse side —+
Bonding Company's Name (if applicable)
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 ke approved afrd a r inspection fee will be charged.
Signature
The for oing instrument was acknowledged bef..: me oG /
11 ger
-
day of
S. /i
who is personally . own to me or who has produced
/ As identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
My Commission Expires:
* * * * * * * * * * * * * * * * * * * * * * * * * * * * *
APPLICATION APPROVED BY:
(Revised 02/08/06)
wner or Agent
by
0"
ss
% Oc
Signature
Contractor
The foregoing instrument w acknowledged before me this
day of ,20_
ho is personally known to me or wh as produced
as identification and o did take an oath.
NOTARY PUBLIC:
Sign:
Print:
My Commission Expires:
************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
Plans Examiner
Engineer
��' C Zoning
Walls:
Fascia:
Miami Shores Village
Paint Color Approval and Agreement
Date: -27 a - 7
Owner's Name: W S , H o . S Phone #:
Job Address (where the work is being done): 10 0 �}- N
City: Miami Shores Village County: Miami -Dade Zip: — 3 3 ((o e
Is Building Historically Designated ?: YES NO ✓
Contractor's Company Name (if applicable):
All elements on the site must be listed and
\Aj ti i
Drip Cap /Drip Edge:
Soffit: Ft ( t
Roof: j-{
Flower Bins:
Shutters:
Awnings:
Chimney:
\ t - (
Doors and Door Jams: \/J
Garage Doors: \ J (-1 ( L
Railings:
Fences:
Decorative Metal:
All brick (simulated or regular):
Stucco Banding:
Any other Stucco Features:
Accessory Buildings:
Other:
OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be
done in compliance with all app icabl : 1. ws re .. lating construction and zoning.
Signature: l , Date: r ZC d
Owner or Agent
APPLICATION APPROVED BY:
0
L
CL {c. ,S4- -249 - (Se$
Z 4d
Phone #:
indicate the color to be minted
Attach color Samples
with numbers
WHITE SHADOW 44 -3(WW) r
Date: C i`"CP (
* *MUST BE ATTACHED WITH PURPLE BUILDING APPLICATION **
peturn to: I
Miami Shores Village
10050 N.E. 2nd Avenue
Miami Shores, FL 33138 -0000
(Bill To 1
WAYNE HOOKS
11004 2 Avenue
MIAMI SHORES, FL 33168-
Date
Fee Name
02/23/2009 Expired Permit Renewal Fee
Monday, February 23, 2009
Invoice
Miami Shores Village
10050 N.E. 2nd Avenue
Miami Shores, FL 33138 -0000
Phone: (305)795 -2204 Fax: (305)756 -8972
Invoice Number: PT -2 -09 -34020
Invoice Date: February 23, 2009
Permit Number: PT -1-07 -155
Bond Number:
Comments:
Fee Type
Calculated
Total Fees Due:
Fee Amount
$60.00
$60.00
,
Payments
Date Pay Type Check Number Amount Paid Change
02/23/2009 Credit Card $60.00 $0.00
Total Paid:
$60.00
Total Due: $0.00
Project Address
11004 2 Avenue
Miami Shores, FL
Miami Shores Village
10050 N.E. 2nd Avenue
Miami Shores, FL 33138-0000
Phone: (305)795 -2204
Parcel Number
1121360020240
Block: Lot:
Owner Information
WAYNE HOOKS
11004 2 Avenue
MIAMI SHORES FL 33168-
Valuation:
Total Sq Feet:
$ 500.00
0
SENAMMW
Phone
Type of Work: Exterior
Color: SHADOW WHITE
Additional Info:
Classification: Residential
Color: SHADOW WHITE Approved
Color: SHADOW WHITE Approved_
Code Comments:
Color. SHADOW WHITE Denied
Fees Due
CCF
Education Surcharge
Expired Permit Renewal Fee
Notary Fee
Permit Fee
Technology
Total:
Amount
$0.30
$0.10
$60.00
$5.00
$60.00
$1.50
$126.90
Authorized Signature: Owner / Applicant / Contractor / Agent
Building Department Copy
Invoice #
PT -1 -07 -27311
Check #: 1727
PT -2 -09 -34020
Total Amt Paid Amt Due
$ 66.90 $ 66.90 $ 0.00
$ 60.00 $ 60.00 $ 0.00
Applicant
WAYNE HOOKS
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 will be done in compliance with all applicable laws regulating
construction and zoning. Futhermore, I authorize the above -named contractor to do the work stated.
February 23, 2009
Date
Expiration: 08/23/2009
Cell
Available Inspections:
PROVE[
Inspection Type:
Final
February 23. 2009 1