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PAINT'Inspection Number: INSP -5512 Inspection Date: 06/13/2006 Inspector: Grande, Claudio Owner: ROLPH, RODNEY & FRANCES Job Address: 453 92 Street NE Miami Shores Village, FL Project: <NONE> Contractor: HOME OWNER Building Department Comments Monday, June 12, 2006 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Block: Permit Number: PT -1 -06-64 Permit Type: Paint Inspection Type: Final Work Classification: Miscellaneous Phone Number (305)762 -6756 Parcel Number 1132060140260 Lot: Passed y 414, Failed Correction Needed Re- Inspection Fee ($75) No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments y L& J,'ELL ,L. igrgair Page 1;of 2 BUILDING PERMIT APPLICATION FBC 2001 / Permit Type (circle): Building Owner's Name (Fee Simple Title !der) City / ri ,/Y; t State Tenant/Lessee Name Owner's Address Job Address (where the work is being done) City Miami Shores Village Is Building Historically Designated YES Contractor's Company Name ,// I r -'.- A Contractor's Address City Qualifier Architect /Engineer's Name (if applicable) $ Value of Work For this Permit �; .� i ✓ t � Type of Work: ['Addition ❑ Describe Work: a ,4rr j Y, 4 t c2 Total Fee Now Due $ ' (Continued on opposite side) Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 (-/ Electrical Pluming St . State County Miarpi -Dade NO V Phone # Zip Phone # Phone # ,`4 State Certificate or Registration No. Certificate of Competency No. ❑New Code Enforcement $ Structural Plan Review. $ Permit No. P 7 C - L Master Permit No. Mechanical Zip Phone # Square Footage Of Work: ❑ Repair/Replace 7 Zip �'� -c * * * * * * * * * * * * * * * * * * * * * * * * * * ** F ees * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Submittal Fee $ Permit Fee $ % . C • CCF $ 1 U Cj • CO /CC Training/Education Fee $ 0 - 60 Technology Fee $ f Notary $ Scanning $ Radon $ Zoning Bond $ Roofing ❑ Demolition 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. 1 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: 1 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 be approve a reinspection ,� wi be charged. Signature NOTA Sign: Print: My Comm ssion Expires: chc 05/13/03 Owner or Agent Y i ' UBLIC: NO ' PUBLIC -STATE OF FLORIDA I aAy Yorlen dez • :ft, tlanV :�,c APPLICATION APPROVED BY: Signature Contractor The fore oing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this day of � A NI , 2()6 b —1 gALI P/--( day of , 20 _ , by who is personally known to me or who has produced who is personally known to me or who has produced [D As identification and who did take an oath. as identification and who did take an oath. NOTARY PUBLIC: Sign: Print: My Commission Expires: * * ** ********************************************************************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** ** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *** * *** * * * * * * * * * * * *s * * *s * * * * * * * Plans Examiner Engineer Zoning Contractor's Company Name (if applicable) Phone # ***************************************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** All elements on the site must be listed and indicate the color to be painted Job Address (where the work is being done) City Miami Shores Village County Miami-Dade Zip Is Building Historically Designated YES NO Date ,p Owner's Name ,� /� Owner'sAA dress t 3 4) City / / 'Z fk State Walls • Drip Cap /drip Edge ,, beta* Soffit / /ebeZ4/ Fascia Roof Flower bins Shutters Awnings Chimney Doors and door jams Garage doors Railings /A/ //-- 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 applicable laws regulating construction and zoning. - /1 Signature APPLICATION APPROVED BY: Miami Shores Village Paint Color Approval and Agreement er or Agent P& Z Official Phone # Zip ,.Tg/ 3k g(9,S 7 C7s T SW 6387 Compatible Cream chc 0/18/03 Issue Date: 1/9/2006 Expires: 09/30/2006 Owner's Name: RODNEY & FRANCES ROLPH Permit Type: Paint Work Classification: Miscellaneous Job Address: 453 92 Street NE Contractor(s) Phone Primary Contractor HOME OWNER Yes Comments: PAINT EXTERIOR OF HOUSE Additional Information Type of Work: Exterior Color: COMPATIBLE CREAM, FRECH ROAST Additional Info: 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: Miami Shores Village, FL 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 Amount $1.80 $0.60 $5.00 $60.00 $1.50 $68.90 Permit Invoice Number PT - 1 - 06 - 23364 Total: Parcel #: Block: Section: ,33 Amt Due $68.90 Permit Status: APPROVED Permit Number: PT-1-06-64 Phone: (305)762-6756 1132060140260 Lot: PB: Total Square Feet: 0 Total Valuation: $ 3,009.00 Reciuired Inspections Final Amt Paid 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. Date Legal Description Owner/Lessee / Tetuan Owner's Address Contracting Co Qualifier State # Architect/Engineer Bonding Company Mortgagor Permit Type (circle on WORK DESCRIPTION y APPROVED: Zoning Mechanical PERMIT APPLICATION FOR MIAMI SHORES VILLAGE 1 Job Address ; 95 q S7 Tax Folio Historically Designated: Yes No Master Permit # 7 M. 7('; lif C R(')/phi SS# Phone Municipal # Competency # Ins. Co. Address Signature of owner and/or Condo President Date Notary as to Owner and/or Condo President Date My Commission Expires: FEES: PERMIT' U RADON Address Address Address Phone ELECTRICAL PLUMBING MECHANICA ROOFING PAVING FENCE SIGN (. Square Ft. Estimated Cost (value) WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO 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.) Application is hereby made to obtain a permit to do work and installation as indicated above, and on the attached addendum (if applicable). I certify that all work will be perfom►ed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits are required for ELECTRICAL PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK. OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in complianwith all applicable laws regulating construction and zoning. Furthermore, I authorize the above -named contractor to do the work stated. f ,� Notary as to li'tiac" q'Kiit Lkvuil u"Btdlder 'My Commission '3. _ .. .. ' .iii ' :c . C.C.F. NOTARY 3 BOND TOTAL DUE 6 S Electrical Date Structural Engineer MIAMI SHORES VILLAGE Paint Color Approval and Agreement DATE: AV v2 7 OWNER'S NAME: /�`'15'4v _ ,' �s � /T D/) 7 a4 PHONE: �� o s 2� oZ a 7- ADDRESS: /S j ,�. 9,2 S ********************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** ADDRESS OF SITE: CONTRACTOR & LICENSE (if applicable) COMPANY NAME: PHONE: All brick (simulated or regular) Stucco Banding Any other stucco features Accessory Buildings Other sam APPROVED: v ilding Official ( j; 7 � D1 e ********************************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** All Elements on the site must be listed and indicate the color to be painted. Walls Fascia Soffit Roof Flower Bins Shutters Awnings Chimney Doors and door jams Garage Doors Railings Fences Decorative Metal r) 0 0 FAWNMIST r� 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 I authorize the above -named contractor, if applicable, to do the work stated. rtriermore , the paint colors will be as per the attached Signature of Ow ate Signature of Contractor Date *********************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** WHEN PAINTING IS FINISHED, CALL FOR FINAL INSPECTION BUILDING ELECTRIC ": PLUMBING Owner of Building Contractor or Builder Legal Description Address of Building Lot MIAMI SHORES VILLAGE, FLORIDA PERMIT N? 8157 Work to be performed under this Permit ,w Architect Bl. CONTRACTOR OR BUILDER BY A Subdi- vision Value of Project This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the appl cation herefor in strict compliance with all ordinances pertaining thereto and w th the understanding that the work wi:l be performed in compliance with ar plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoke at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which th permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances an regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes respor sibility for work done by his agents, servants or employees. Signed: t , f } r� -¢` 1,+' „,+L' - t... By INSPECTOR In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance wit r ordinances anad r on pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper autho i'es of Miami Share i1agf In accepting this permit I assume responsibility for all work done by either myself, my agent, servant or employee. DATE ��� ' / � 194 Contra License No. Amt. of Permit w.t AUTHORITY APPLICATION FOR BUILDING PERMIT Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build- ing or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of the work. Date , 19 Owner's Name and Address .,- ,,,= e-- ,c t No Stree` Registered Architect and /or Engir_eer- Name and address of licensed contractor Lot Block Subdivision_ Street and Number where work is to be done /A': �_ - ° Location and legal description of lot to be built on: State work to be done and purpose of building (by floors) __ Permit No MIAMI SHORES VILLAGE ExQ � r te------------- - - - - - -- - — BUILDING INSPECTION DEPARTMENT 9___ and for no other purpose. New Building Remodeling Addition Repairs No. of Stories To be constructed of Kind of foundation Roo Covering Estimated Total cost of improvements $__ f �' Amount of Permit $ e Zone cubage required ____ Plan Cubage Distance to next nearest building ______Size of Building Lot Maximum live load to be borne by each floor_ I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may be sent to - The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Supplement, and has complied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such st bcgntra¢ tors, oq work to pe performed under this permit, as are licensed by Miami Shores Village. / Remarks (Signed) t>t STATE OF FLORIDA, COUNTY OF DADE. Ss. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap- peared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. L' � Date___a -✓ Disapproved Date (Signed) Read, Sworn to and Subscribed before ine. Notary Public, State of Florida Building Inspector My Commission Expires PLANNING BOARD DATE' Chairman Member Member Member Member ____ —_____ Member Council Approved Date Disapproved Date NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has been obtained from the Planning Board. A re- inspection fee of $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and /or workmanship.