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PT-10-356Inspection Number: INSP - 137348 Permit Number: PT -3 -10 -356 Scheduled Inspection Date: March 24, 2010 Inspector: Bruhn, Norman Owner: GOMEZ, JORGE Job Address: 9969 NE 4 Avenue Project: <NONE> Miami Shores, FL Contractor: COMPLETE HOME PAINTING BY MICHAEL Building Department Comments March 23, 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: Addition /Alteration Phone Number (305)510 -0916 Parcel Number 1132060171230 Phone: 305 -895 -1368 Passed] Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments Page 10 of 20 BUI.LDING PERMIT APPLICATION FBC111111 Permit Type: PAINT PERMIT Owner's Name (Fee Simple Titleholder) Owner's Address ? /V fffti 'jive City W j L State E -MAIL: Job Address (where the work is being done) 9969' /./G /91/e. p County Miami -Dade Zip 3 )13 Fl City Miami Shores Village FOLIO / PARCEL # Is Building Historically Designated YES NO Contractor's Company Name CoSe l//Kr� /�I/ � � Phone # , ?9, Contractor's Address 4"7t 4./. /3 a City /0P4/ State • Qualifier Name! �1Q— lvQ'�''�G2 Phone # State Certificate or Registration No. Certificate of Competency No. t' ODD/ Vf 3J OWNER BUILDER: Value of Work For this Permit $ —! O Type of Work: I Addition ❑ Alteration / ❑New / Repair /Rep ace Describe Work: Miami Shores Village Building Department 10050 N.E.2nd Avenue. Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 �' 7 2-a° Phone # .240 3-- 7/ 7 t/ Permit No. Master Permit No:PT 10 ° �z Zip 33/ RS- Phone # .. 3D� ' - Te2 ^ 7/7 7' Zip 3 3/ 6 / BY: Application is hereby made to obtain a permit to do thew • a mstallati 's 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 he secured tier EI.I:CTRICAI. 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: .4s a condition to the issuance of a building permit with an estimated value exceeding $ 2500. the applicant muss promise in good faith that a copy oldie notice of commencement and construction lien law brochure will be delivered to the person whose properly is subject to attachment. Alsa a certified copy (Me recorded notice .of commencement must he 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 he approved and a reinspection fee will he charged. xx *xxxxxxx4xxxxxxxxxx xxxxxxxxxxxxz xx*x dcFeesxxxxx* ww*** wwx oFxxxYe :4xxxxxxxxrxxxxxrxxx$xxxit Y Permit Fee $ CCF $ Technology Fee: . Training /Education Fee $ . Notary '$ Code Enforcement $ Double Fee $ Zoning $ Total Fee Now Due $ (C1 • See Reverse side —) Signature Directions: Please circle corresponding number to appropriate color sample. Walls: f e i 2 3 Fascia: Drip Cap /Drip Edge: Soffit: Roof: Flower Bins: Shutters: Awnings: Chimney: Doors and Door Jams: Garage Doors: I Rai Ihuts: Fences: Stucco Banding: NOTARY PUBLIC: �� Sign: / "/ ea�" _ G My Commission Expires: Go All brick (simulated or regular): Any other Stucco- Features: PANT COLOR APPROVAL AND AGREEMENT All elements on the site must be listed and indicate the color to be painted 2 w +3 2 0 1 ' 3 2 I 2 u 3 2 W VC - 3 . Accessory Buildings 0 Other: The tirregoing instrument was.acicnowled d before me this a day of �. 2010. by / "i '7 r Sicr 6-oytt who is personally known to me or who has produced As identification and who did take all oath. Print: !i t( t,4 4�" _wPy -) L-1-- 4 4 4 4 4 4 4 4 4 4 4 Signature Print: Attach color samples with name and number. 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. Contractor The foregoing instrument was acknowledged before me this g day or YVIAaakt . 20 CO. by who is personally known ton me or who h as produced t 7 as identiticatio n��rrottt2v1io' 1kj pke an oath. NOTARY P BLIC: Sign: OP 4 : �\ 9I19Od ANY1ON ' = M Commission Expired ZLOZ1901£0 FL ©gIDA tti • .t l xxxxxx xxx xir ****xxv4„ l(Ae * **tr p lf* ******* * **** ****** **** ** ********C/4 �k .Z ** Qexx*:etc inear uu * 13T x. ARl.: , 1111 UU iC ll ae lIWaSic- � ,Y 2 Yvlsg �r,�; t � Preservation Board s 51,00 cape hatteras sand AC - 34 c Code Entorcement fr (Revised 04 /24/0