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PT-09-1756 /'n 53 .fie A ""r 3 iY Jv�i Y T p - 9H � Miami Shores Village � 10050 N.E. 2nd Avenue Miami Shores, FL 33138 - 0000 Phone: (305)795 -2204 � Expiration: 04/26120 f Project Address Parcel Number Applicant 1070 95 Street 1132050120030 Miami Shores, FL Block: Lot: JANENE CHURCH Owner Information Address Phone Cell JANENE CHURCH 1070 NE 95 ST � MIAMI SHORES FL 33138 -2548 {, Contractor(s) Phone Cell Phone Valuation: $ 1,000.00 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: Final Color Approved_ Color: _Denied Fees Due Amount Invoice # Total Amt Paid Amt Due CCF $ PT-1 0-09 -36229 $ 62.30 $ 62.30 Education Surcharge $0.20 $ �'�� Miscellaneous Fee $1.50 Permit Fee $60.00 Scanning Fee $0.00 Total: $62.30 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 October 28, 2009 Authorized Signature: Owner / Applicant / Contractor / Agent Date Building Department Copy October 28, 2009 1 Miami Shores Village Building Department ULI 2 6 1.00-50 N. I - '.2tid AVC[We. Miami Shores. Florida 331 38 B Tel: ( 795.2204 Fax: (305) 756.8932 Y: BUILDING Permit No. PERMIT APPLICATION Master Permit No. FBCMM Permit Type: PAINT PERMIT )K Owner's Name (Fee Simple Titleholder) �j Nu) Phone('D�) Owner's Addres_sj D 0 WE " City M;MN State F zi Tenant/Lessee Name ) Phone # E-MA IL - I 4 Job Address (where the work is being done) A)C City _ Miami Shores Villw_ye_ County Miami -Dade - Zip FOLIO / PARCEL 4 11 Sao cwa ( ) Is Building Historically Designated YES NO 11 J Contractor's Company Nam, Ali� Phon Conti Address City_ State zip .2,1 1 Qualifier Name' Phop- f State Certificate or Registration No. Certificate of Competency No. OWNER BUILDER: Value of Work For . this Permt 1 1WO Type of WT k: ❑ d I ition ❑ A Iteration rg&ew /Ej Repair/Replace Describe Work: ftc LQ Application is hereby made to obtain a permit to (to the work and installations as indicated. I Certify (hatno work or illqallatioii has commenced prior to the iSSLIMICe Ofapermit and that s ecu red 161 at all work will be perlormed to meet the standards of laws regulating constriction in this ittrisdiction. I understand that a separate permit must be secul ELFCTRICAl. WORK. PI.tJMBING..SKJNS, WEIJ,S. POOL.S, 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 FOP IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE, OF COM M ENCENI ENT." Notice to. Ipplicant: 4s a condition to the issuance q1'a building permit with an esfinutica' value exceeding $2500, the applicant must promise in that a copy qI'the notice o/ commencement anti construction lien Ittiv brochure will be delivered to the person whose properij is subject to attachment. Also. a certified copy ()f1he ret•orelcd notice q1'eorninenceinew must he posted at the job site for the first inspection which occurs seven (7) days after the building permil is issued In the absence q1'such posted notice. the inspection will not he approved and -a reinspectionfiee will be charged. Permit Fee CCF Technology Fee: Training/Education Fee Notary $ Code Enforcement Double Fee $ Zoning $ Total Fee Now Due $ See Reverse side -4 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. Walls: I ? 4 Attach color samples with name and Fascia: 1 2 3 4 Drip Cap /Drip L Ile: I 2 -- 3 4 Soil 0 ? 3 4 1 2 26 -2 i erc -,i Glaze 226 -2 Flower Bins: I 2 3 4 Shutters: 1 2 3 4 Awnings 1 2 3 4 2 Chimney: I 2 3 4 Doors and Door .lams: I 2 3 4 Garage Doors: 1 2 3 4 228 - Opal Fire 228 - Rail1110s: I 2 3 4 3 Fences: _2 1 2 3 4 All brick (simulated or regular 1 2 3 4 Stucco Banding: 1 2 3 4 Any other Stucco Features I � 4 4 Accessory 131111dings Other: be 04 1VL Fn w 1— ezQ'I° "r Frt_"t OWNER'S AFFIDAVIT: 1 certify that all the foregoing information is accurate and that all work will be done in compliance with all ap licable laws regulating construction and zoning. Signal re Signature (Owner or Agent Contractor The foregoing insu•ument was acknowl t A' e me this - 7 The foregoing instrument was acknowledged before me this day of 20&j. by _ A of 20 _. by who is personally to me or who has produced_ who is personally known to me or who has produced As identification and who did take an oath. as identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Sign:. JAI A Sign: _— Print: v ES.QELLER Print: MY COMMISSION # DD 88208,5 My Commission I: xpires: * * EXPIRES: September 28,2011 My Commission Expires: �'r � Bonded Thru Budget NOtAty Bervim APPLICATION APPROVE IO BY: Plans Examiner Preservation Board Code Enforcement (Revised 04 /24/0; i Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP- 127782 Permit Number: PT -10 -09 -1756 Scheduled Inspection Date: March 09, 2010 Permit Type: Paint Inspector: Bruhn, Norman Inspection Type: Final Owner: CHURCH, JANENE Work Classification: New Job Address: 1070 NE 95 Street Miami Shores, FL Phone Number Parcel Number 1132050120030 Project: <NONE> Contractor: HOME OWNER Building Department Comments PAINT EXTERIOR OF THE HOUSE Inspector Comments Passe W' af, Failed Correction ❑ Needed Re- Inspection a Fee No Additional Inspections can be scheduled until re- inspection fee is paid. March Os, 2010 For Inspections please call: (305)762 -4949 Page 7 of 34 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP- 127782 Permit Number: PT -10 -09 -1756 Scheduled Inspection Date: March 09, 2010 Permit Type: Paint Inspector: Bruhn, Norman Inspection Type: Final Owner: CHURCH, JANENE Work Classification: New Job Address: 1070 NE 95 Street Miami Shores, FL Phone Number Parcel Number 1132050120030 Project: <NONE> Contractor: HOME OWNER Building Department Comments PAINT EXTERIOR OF THE HOUSE Inspector Comments Passed El Failed Correction ❑ Needed Re- Inspection ❑ Fee No Additional Inspections can be scheduled until re- inspection fee is paid. March 08, 2010 For Inspections please call: (305)762 -4949 Page 7 of 34