PT-10-93 s �✓ u'
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Miami Shores Village'
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10050 N.E. 2nd Avenue
Miami Shores, FL 33138-0000 �z
Phone: (305)795 -2204 '
Expiration: 7/ 1
Project Address Parcel Number Applicant
815 91 Terrace 1132060050240 LAUTARO JACOBSON
Miami Shores, FL 33138- Block: Lot:
Owner Information Address Phone Cell
LAUTARO JACOBSON 815 91 Terrace
MIAMI SHORES FL 33138 -
Contractor(s) Phone Cell Phone Valuation: $ 1
HOME OWNER
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: BEHR - WALLS - MORNING SUNL Final
Color. _Approved_ Color. _Denied
Fees Due Amount Invoice # Total Amt Paid Amt Due
CCF $0.60 PT -1 -10 -36856 $ 61.60 $ 61.60 $ 0.00
Education Surcharge $0.20
Permit Fee $60.00
Technology Fee $0.80
Total: $61.60
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 taws regulating
construction and zoning. Futhermore, I authorize the above -named contractor to do the work stated
January 22, 2010
Authorized Signature: Owner / Applicant / Contractor / Agent Date
Building Department Copy -
January 22, 2010 _ 1
Miami Shores Village MOTEWT I
Building Department JAN 2 0 2010
•
10050 N.6.2nd Avenue. Miami Shores. Florida 33138 B .... K - 1 . 0
.:_ -. - - --
Tel: (305) 795.2204 Fax: (305) 756.8972
BUILDING PermitN9. 4 1�
PERMIT APPLICATION Master Permit -N-6
FBCOM
Permit Type: PAINT PERMIT
Owner's Name (Fee Simple Titleholder) 1 110TA20 _ ,1G 0,,350/1) Phone # 6 'S 1`_ 1- 7 l
Owner's Address S lU E
City/* /,q. j Sho e a-s Stat Zip 1 1 3 IV
Tenant/Lessee Name e� Phone # 12,) _
E -MAIL: - - - - -— - /rf.
Job Address (where the work is being done) /V C �J/
City �^ Miami Shores Village County Miami -Dade Zip 3 3 13{
FOLIO / PARCEL #
Is Building Historically Designated YES NO
Conti actor's Company Name Phone #
Contractor's Address
City___ State Zip
Qualifier Name Phone #
State Certificate or Registration No. Certificate of Competency No.
OWNERBUILDER: �.9UiA20 t1r9000
Value of Work For this Permit $ � . 0 Type of Work: ❑ Addition ! ❑ Alteration / (]New /El Repai-r/Replace
Describe Work: P4/'., 7 -
Application is hereby made to obtain a permit to do (lie work and installations as indicated. I certify that no work or installation has commenced prior to the iswa+u a of a permit
and that all work will tie performed to meet the standards of all laws regulating construction in this jurisdiction. 1 utxlerstaatd that a separate permit nnisobe :., mired tier
ELU`C'TRICAL WORK. PLUMBING, SIGNS, WELLS_ POOt.S, FURNACE'S, 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 7'O YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR t,F DER.Oit AN ATTORNEY REFORt.
RECORDING: YOUR NOTICE OF COMMENCEMENT."
Notice to. I ppl icani: As a condition to the issuance q!a building permit with an estimated value exceeding %25(X1. the applicant roust prornise in good faith that a cry# cf they
notice o/cornntencenient and construction lien law brochure will be delivered to the person whose property is subject to attacbMInt. Nsa u (-- rtified copy of the recosried notice
of contme nce ment must he posted at the job site for the first inspection which occurs seven (7) days after the building permit is ,issued. In the absenceurf such posted notice. the
inspection will not he approved and a reinsnection fee will he charged.
Permit Fee $ CCF S Technology Fee: (1
Training /Educatioti Fee $ O_ ' OLKJ Notary $ Code Enforcement $
Double Fee $ Zoning S Total Fee Now Due S
See Reverse side -3
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.
4 name and
Fascia: 1 2 4
Drip Cap /Drip Edge: 1 2 3 4
Soffit: I 2 3 4 r
Roof; t 2 3 4
Flower Bins: 1 2 3 4
360A -2 P
Shutters: 1 2 3 4 Morning Sunlight
Awnings: I 2 3 4!___
Chimney: I 2 ' 4
Doors and Door .lams: 1 2 3 4 r
Garage Doors 1 2 3 4
Railings: 1 2 3 4 3
Fences: 1 2 3 4
All brick (simulated or regular 1 2 3 4
Stucco Banding: 1 2 4
Any other Stucco Features l 2 3 4 4
Accessory Buildings Other:
OWNER'S AFFIDAVIT:I certify that all the foregoing information is accurate and that all work will be dons in
compliance with , I applicable laws regulating construction and zoning.
Signature Signature
Owner or Agent Contractor
The foregoing ins� was acknowledged before me this 1 49 The foregoing instrument was acknowledged beforeane this
day of OA I. 20 16). by LNffmo bWL76 9n ._ day of .20 _• by
who is p ersonall y known to me or who has piudueed_ r/ who is personally known to me or who has produced
As identification raid who did take an oath. as identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
Sign: Sign:
Print: ' -� REZ Print:
My Commission Expires *: MY COMMISSION # DD669042 My Commission Expires:
EXPIRES April 30, 2011
• . � c _Service. m
ic•k: 4e fe eY ieie 4c o4 * & *ie ilr is is a: Y .x4e r. xie �r &aY Y 4e s4 ib�dr k &'ki: * *eY *iet•ksY�de tkic a4,k'aie,t,t ie9lr it * &d:.iF ir+t •k ie Y.et��4tic
APPLICATION APPROVED BY: � an 4. kaminer
I Preservation Board
' "" � , .: • �'t -- .w Code Rnlirrcement
(Revised 04/24/0,
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP - 133898 Permit Number: PT- 1 -10 -93
Scheduled Inspection Date: March 02, 2010 Permit Type: Paint
Inspector: Bruhn, Norman
Inspection Type: Final
Owner: JACOBSON, LAUTARO Work Classification: New
Job Address: 815 NE 91 Terrace
Miami Shores, FL 33138- Phone Number
Parcel Number 1132060050240
Project: <NONE>
Contractor: HOME OWNER
Building Department Comments
PAINT EXTERIOR
Inspector Comments
Passed
Failed
Correction ❑
Needed
Re- Inspection ❑
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
March 01, 2010 For Inspections please call: (305)762 -4949 Page 8 of 27
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP - 133898 Permit Number: PTA -10 -93
Scheduled Inspection Date: March 02, 2010 Permit Type: Paint
Inspector: Bruhn, Norman
Inspection Type: Final
Owner: JACOBSON, LAUTARO Work Classification: New
Job Address: 815 NE 91 Terrace
Miami Shores, FL 33138- Phone Number
Parcel Number 113206005024
Project: <NONE>
Contractor: HOME OWNER
Building Department Comments
PAINT EXTERIOR
Inspector Comments
Passed El
Failed
Correction
Needed
Re- Inspection ❑
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
March 01, 2010 For Inspections please call: (305)762 -4949 Page 8 of 27