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PT-09-1789 Miami Shores Pillage 10050 N.E. 2nd Avenuek _. Miami Shores, FL 33138 -0000 'h Phone: (305)795 - 2204 ,. Expiration: 05/0512010 Project Address Parcel Number Applicant 273 91 Street 1131010331310 Miami Shores, FL Block: Lot: FERMIN LEGUEN Owner Information Address Phone Cell FERMIN LEGUEN 273 N. W. 91 ST. Contractor(s) Phone Cell Phone Valuation: $ 200.00 Total Sq Feet: 0 Type of Work: For Inspections please call: Color. (305)762 -4949 Additional Info: Available Inspections: Classification: Residential Inspection Type: Color: Approved Code Comments: BEHR - WALL, FASCIA, DRIP CAF Final Color: Approved_ Color: _Denied Fees Due Amount Invoice # Total Amt Paid Amt Due CCF $0.60 PT- 10-09 -36264 $ 63.80 $ 63.80 $ 0.00 Education Surcharge $0.20 Permit Fee $60.00 Check #: 3218 Scanning Fee $3.00 Total: $63.80 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 Pillage. 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. November 06, 2009 Authorized Signature: Owner J Applicant / Contractor 1 Agent Date Building Department Copy November 06, 2009 1 `fE. Miami Shores Village' 10050 N.E. 2nd Avenue w Miami Shores, FL 33138 -0000 ism Phone: NIVI"I 77 Expiration: 05f06(2010 Project Address Parcel Number Applicant 273 91 Street 1131010331310 Miami Shores, FL Block: Lot: FERMIN LEGUEN Owner Information Address Phone Cell FERMIN LEGUEN 273 N. W. 91 ST. Contractor(s) Phone Cell Phone Valuation: $ 2 00.00 Total Sq Feet: Type of Work: For Inspections please call: Color: (305)7624949 Additional Info: Available Inspections: Classification: Residential Inspection Type: Color: Approved Code Comments: BEHR - WALL, FASCIA, DRIP CAF Final Color. Approved_ Color. _Denied Fees Due Amount Invoice # Total Amt Paid Amt Due CCF $0.60 PTA 0-09-36264 $ 63.80 $ 63.80 $ 0.00 Education Surcharge $0.20 Permit Fee $60.00 Check #: 3218 Scanning Fee $3,00 Total: $63.80 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, 1 authorize the above -named contractor to do the work stated. November 06, 2009 Authorized Signature: Owner / Applicant / Contractor / Agent Date Building Department Copy November 06, 2009 1 & �\�fl Miami Shores Village L ,M 1,510CA Building Department 10050 N.F2nd Avenue. Miami Shores. Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 BUILDING LRE CEOVE D Permit No. P 0 - 0 -1 7 . ....PERMIT APPLICATION .aster Permit No. FBC 2004 Permit Tyre PAINT. PERMIT Owner's Name (Fee Simple Titleholder) �/� �y�� Phone # 30 5 75 / O b ✓ / Owner's Address �'7 3 i(/W I / 6 e S City 4 9- State Z Zip 3315 Tenant/Lessee Name — `_. Phone # E-MAIL: Job Address (where the Work is being done) 2 7 3 AV A/ City _ Miami Shores Villa <te County Miami -Dade Zip 3 3) 5® FOLIO / PARCEL # Is Building Historically Designated YES NO Contractor's Company Name _ Phone # Contractor's Address City_ _ _ _ State Zip Qualifier Name Phone # State Certificate or Registrati No. Certificate of Competency No. OWNER BUILDER: Value of Work For this Permit $ 2 �ro _ ° ' Type of Work: ❑ Addition / ❑ Alteration /. ❑New / ❑ Repair /Replace Describe Wort:: 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 perlornx d to meet the standards of all laws regulatin construction in this jurisdiction. 1 understand that a separate permit must be secured fiw E1,1VTRICA1. WORK. PLl_1n RING, SIGNS. WELLS, POOLS, FURNACES. BOILI:RS, HEATERS, TANKS and AIR CONDITIONERS, ETC..... "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE Of COMMF,NCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPER "1'Y. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Notice to . I ppl icani: ;1s it condition to the issuance ql'a building permit with an estinuaied value exceeding $2500. the applicant Burst promise in good faith iltai a cope of the notice it 'commencement and construction lien limp brochure will he delivered to the person whose property is subjeci to attachment. ipso. ct'cert#ied copy of the recorded notice of cornmencemeni muse he posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence q /such posted notice. The inspection will not he approved and a reinsl2ectian fee 1e411 be charged. Permit Fee $ CCF $ Technology Fee: Training /Education Fee $ Notary $ Code Enforcement $ _ Double Fee $ Zoning $ Total Fee Now Due $ \ See Reverse side —> 1 PAINT COLOR APPROVAL AND AGREEMENT All elements on the site must be listed and indicate the color to be painted Direction Please circle corresponding number to appropriate color sample. Walls v I ? 3 4 Ott --I- with name and -i Fascia: I 2 3 :.r4 er. Drip Cap /Drip Edge 2 4 Soffit 1 ? ; .4 oil, ,bow,- O f Roo(': I 3 4 Flovver Bills'. 1 2 3 4 -- 360C-2 Shutters: I 2 3 4 Wickerware Awnings I 2 3 4 2 Chimney. 1 2 3 4 Doors and Door .lams: 1 2 3 4 Garage Doors: 1 2 3 4 Railings: 1 2 3 4 3 Fences: 1 2 3 4 All brier: (simulated or re (ular ): 1 2 3 4 Stucco Banding: 1 2 3 4 Any other Stucco f=eatures: 1 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 done in compliance with all applicable laws regulating construction and zoning. Signature Signature Owner r Agent Contractor The force ling instrument was ck Wedged befor me this The foregoing instrument was acknowledged before me this_ day ol'W1_. 20 (n by day of 20 _. by <r.nd �uho did take an oath. as identification and who did take an oath. NO "rARY IB Q r t � �� TARY PUBLIC: Sign: .L'`t��• . . — My Commission Expires: �e ,, c}� My Commission Expires: aYr.�•wz,'r�xxi* *dr ist aF :a: *,: #t t�xxic aY Y aY F 4rxxi & *sr,.. ,fir ie o:•k #�xx,ttxxar•k de icxf eY s'c�t #e4 ie *ir icy *aY aF ie Y *,ti:ic *icx: at aY�Yie do &ie nY it it F se at�x 0� APPLICATION APPROVEI) BY: Plans Examiner . Preservation Board Code Enlbreement -- (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- 128163 Permit Number: PT -10-09 -1789 Scheduled Inspection Date: April 06, 2010 Permit Type: Paint Inspector: Bruhn, Norman Inspection Type: Final Owner: LEGUEN, FERMIN Work Classification: New Job Address: 273 NW 91 Street Miami Shores, FL Phone Number Parcel Number 1131010331310 Project: <NONE> Contractor: Building Department Comments Inspector Comments Passed y Failed Correction ❑ Needed Re- Inspection ❑ Fee No Additional Inspections can be scheduled until re- inspection fee is paid. April 05, 2010 For Inspections please call: (305)762 -4949 Page 4 of 25 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP- 128163 Permit Number: PT -10 -09 -1789 Scheduled Inspection Date: April 06, 2010 Permit Type: Paint Inspector: Bruhn, Norman Inspection Type: Final Owner: LEGUEN, FERMIN Work Classification: New Job Address: 273 NW 91 Street Miami Shores, FL Phone Number Parcel Number 1131010331310 Project: <NONE> Contractor: Building Department Comments Inspector Comments Passed Failed Correction ❑ Needed Re- Inspection ❑ Fee No Additional Inspections can be scheduled until re- inspection fee is paid. April 05, 2010 For Inspections please call: (305)762 -4949 Page 4 of 25