PT-10-306ti
Inspection Number: INSP - 136541 Permit Number: PT -3 -10 -306
Scheduled Inspection Date: March 29, 2010
Inspector: Bruhn, Norman
Owner:
Job Address: 10570 NE 3 Avenue
Project <NONE>
Miami Shores, FL
Contractor: HOME OWNER
Building Department Comments
paint exterior o the house
Passed
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
March 26, 2010
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspector Comments
dc_
For Inspections please call: (305)762 -4949
Permit Type: Paint
Inspection Type: Final
Work Classification: New
Phone Number
Parcel Number 1122310130430
Page 9 of 27
Inspection Number: INSP - 136541 Permit Number: PT -3 -10 -306
Scheduled Inspection Date: March 29, 2010
Inspector: Bruhn, Norman
Owner:
Job Address: 10570 NE 3 Avenue
Project: <NONE>
Miami Shores, FL
Contractor: HOME OWNER
Building Department Comments
March 26, 2010
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
For Inspections please call: (305)762 -4949
Permit Type: Paint
Inspection Type: Final
Work Classification: New
Phone Number
Parcel Number 1122310130430
paint exterior o the house
Passed
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Inspector Comments
Page 9 of 27
BUILDING
PERMIT APPLICATION
FBC 2004
Permit Type: PAINT PERMIT
Owner's Name (Fee Simple Titleholder) ti Phone 11
Owner's Address i VC-
City State Zip
Tenant/Lessee N
E -MAIL:
Job Address (where the work is being done) /V I --
City — Miami Shores Village
FOLIO / PARCEL #
OWNER BUILDER:
Miami Shores Village
Building Department
10050 N.E.2nd Avenue. Milani Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
County
Miami-Dade
Is Building Historically Designated YES NO ✓
Contractor's Company Name ' OUNO/r Phone #
Contractor's Address
City State Zip
Qualifier Name Phone #
State Certificate or Registration No. Certificate of Competency No.
Value of Work For this Permit $ / S O Type of Work: ❑ Addition / ❑ Alteration / ❑New / ❑ Repair /Replace
Describe Work: 7
.? 7
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 he performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that a separate permit must he secured lirr
ELECTRICAL WORK. PLUMBING, SIGNS, WELLS. POOLS, FURNACES, BOILERS. HEATERS. TANKS and AIR CONDITIONERS, ETC
"WARNING 7'O 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 . I ppl icon!: .4s a condition to the issuance of cr 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 properly is subject to attachment. Also. a cerl/fted copy of the recorded notice
of commencement must he posted al 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 he approved and a reinspeclionfee will he charged.
...*..... **.Yetxxuxxxxxxxxxxstx .*.......F .*.* .....xxxxuuxx4axxx wxxx
Permit Fee $ (0 0 ! CCF $ a • Technology Fee: OA O
Training /Education Fee $ 0 • Notary $ Code Enforcement $
Double Fee $ Zoning $ Total Fee Now Due $ X1000. (.00
See Reverse side a
Permit No.
Master Permit No.
Phone #
.30r
303IIw9
to,
BY:.
tO
$.fig 397
Zip
Directions: Please circle corresponding number to appropriate color sample.
Walls:
Fascia:
Drip Cap /Drip Edge:
Soffit:
Roof:
Flower Bins:
Shutters:
Awnings:
Chimney:
Doors and Door Jams:
Garage Doors:
Railings:
Fences:
PAINT COLOR APPROVAL AND AGREEMENT
All elements on the site must be listed and indicate the color to be painted
2
All brick (simulated or regular):
Stucco Banding: l 2 3 4
Any other Stucco Features:.. l 2 3 4
Accessory Buildings Other:
3
3
4
4
4
4
4
4
3 4
3 4
3 4
3 4
3 4
3 4
Attach color samples with name and
3
2 black— III
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 d ((�� ✓. C .tJ"'- 2 � Signature
Contractor
The foregoing instrument was acknowledged before me this_
day of . 20_.by
to is personally known to me or who has produced
as identitication and who did take an oath.
Owner or Agent
The forego g instrument � - w � as wilt wled ::d hefo " m tl�is 1
day ot - +!S Lr � ID by
w is i: ersona ly wi o me or who has pruduced' 1
iden ' ` 'ttion s d who did take an oath.
NOT RV P ii/i� i NOTARY PUBLIC:
Sign: .." i . l. ` J 1 , Y1► ® 11 Sign:
Print: 1.L� .j� 0; • Print:
My Commission Expires: ��' My Commission Expires:
s ,, . -. 0
°tee
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APPLICATION APPROVED BY: Plans Examiner
Preservation Board
Code Ent'orcement
(Revised 04 /24/0 i