Loading...
800 NE 95 St (10)BUILDING PERMIT APPLICATION FBC 2001 Is Building Historically Designated Notary $ Scanning $ Total Fee Now Due $ Architect/Engineer's Name (if applicable) Submittal Fee $ Permit Fee $ (Continued on opposite side) Miami Shares Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Permit Type (circle): Building Electrical Plumbing Mechanical Roofing Owner's Name (Fee Simple Titleholder) .. o" ? 0 7 w , .1 1 Phone # 30 5 75 (id cf Owner's Address 800 "t f 9l ` City /) , .1 i .I, C..1 State Fe- • Zip 3 /Id Tenant/Lessee Name Phone # 3S- 7,r7 — y bd" L > Address (where the work is being done) lT C -v- City Miami Shores Village County Miami -Dade Zip 5 313 8 YES Contractor's Company Name e �/1�14,0� ( 4/trive Phone # 2 0 J ---- ���� Contractor's Address /I/74 ,t',E /:0 City j 1 / C/714 / ( / State - Zip 3*‘ Qualifier �r +-G �� Z ( , ria $ Value of Work For this Permit 2. Training /Education Fee $ NO • Permit No. PT - 9 Master Permit No. State Certificate or Registration No. Certificate of Competency No. Q / y/ 3/ /1/U 4' 7 rD D Radon $ Zoning Code Enforcement $ Structural Plan Review. $ 6g- go q-`7 7 Phone # Square Footage Of Work: Type of Work: ❑Addition ❑Alteration ❑New Repair/Replace ❑Demolition Describe Work: ZO Z}G(i(o c i s ee, t f p/ (` �!jPJi ae **************************** i ~ o * * * * * * * * *,r * * * * * * * * * * * * * * * * * * ** CCF $ Technology Fee $ Bond $ CO /CC Bonding Company's Name (if applicable) Bonding Company's Address �✓J� City State Zip Mortgage Lender's Name (if applicable) Mortgage Lender's Address W / City State Zip 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 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: 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. "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 approved and a reinspection fee will be charged. Signature t At—ca c,C" /, �� Signature' 490 \._ ,e Owner or Agent Contractor The foregoing instrument was acknowledged before me this a The foregoing instrument was acknowledged before me this day of 4 /4 , 20 bG, by , day of , 20 _, by who is personally known to me or who has produced who is personally known to me or who has produced As identifica'%'� co .�CZ _ Commissi on DD096211 as identification and who did take an oath. NOTARY PUBL C: ,......) -.:;" .. _.-1 4'1 Expires April l0, 2006 NOTARY PUBLIC: Sign: IV, c ,„,„,,,o. Atlanti Annding Ca, Dr, Sign: My Commission Expires: My Conunission Expires: * *** * * * * * ** * *** * ** * * * * * * * * * * * * * * * *** 1vs* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** APPLICATION APPROVED BY: chc 05/13/03 Plans Examiner Engineer Zoning Date Owner's Name SC_ D 7, Pe ) w / Owner's Address "00 ,e • City Pi /4µ/ YAW.) State Job Address (where the work is being done) (CO rfi� QT City Miami Shores Village Is Building Historically Designated YES Name if applicable) et.ft,, �� �/ Phone # ;305 = tfS9� 13 Contractor's Company ( 1 P P / �; ***************************************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** All elements on the site must be listed and indicate the color to be painted Walls Fascia _ Drip Cap /drip Edge G� Soffit Roof /0"7- Flower bins Shutters Awnings Chimney Doors and door jams Garage doors w Railings L✓� Fences AVM.- Decorative metal eo All brick (simulated or regular) e Stucco banding Any other stucco features 6- '7 kr Accessory Buildings Other "/R ***************************************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done m compliance with all applicable laws regulating construction and zoning. �4e,0""` r (Signature / Miami Shores Village Paint Color Approval and Agreement / � APPLICATION APPROVED I3Y: County Miami NO Phone# 3 0S'Z. 5-7 aa L. Zip 3 3/3I Zip 3313e- Attach Color Samples With Numbers Date Date chc 6/18/03 Issue Date: 1/12/2006 Owner's Name: SCOTT PERWIN Permit Type: Paint Work Classification: Miscellaneous Job Address: 800 95 Street NE Contractor(s) Phone Primary Contractor COMPLETE HOME PAINTING BY MI 305 - 895 -1368 Yes Comments: EXTERIOR PAINTING Additional Information Type of Work: Exterior Color: WHITE 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 Expires: 01/10/2007 Invoice Number PT - 1 - 06 - 23379 Total: Parcel #: Block: Section: Permit Status: APPROVED Permit Number: PT- 1 -06 -79 Phone: (305)757 -4082 1132060410010 Lot: PB: Total Square Feet: 0 Total Valuation: $ 2,350.00 Required Inspections Final Amt Due $68.90 Amt Paid $68.90 $68.90 v � 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. nspectionNumber: :- INSP -56 Inspection Date: 02/16/2006 Inspector: Grande, Claudio Owner: PERWIN, SCOTT Job Address: 800 95 Street NE Project: <NONE> Miami Shores Village, FL Building Department Comments Wednesday, February 15, 2006 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Contractor: COMPLETE HOME PAINTING BY MICHAEL Block: Permit Number: PT- 1 -06 -79 Permit Type: Paint Inspection Type: PAINTING Work Classification: Miscellaneous Phone Number (305)757 -4082 Parcel Number 1132060410010 Lot: Phone: 305 - 895 -1368 Page 1 of 2 Inspector Comments L / Passed � Failed [ Correction Needed [ Re- Inspection Fee [ ($75) No Additional Inspections can be scheduled until re- inspection fee is paid. nspectionNumber: :- INSP -56 Inspection Date: 02/16/2006 Inspector: Grande, Claudio Owner: PERWIN, SCOTT Job Address: 800 95 Street NE Project: <NONE> Miami Shores Village, FL Building Department Comments Wednesday, February 15, 2006 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Contractor: COMPLETE HOME PAINTING BY MICHAEL Block: Permit Number: PT- 1 -06 -79 Permit Type: Paint Inspection Type: PAINTING Work Classification: Miscellaneous Phone Number (305)757 -4082 Parcel Number 1132060410010 Lot: Phone: 305 - 895 -1368 Page 1 of 2 CONTRACTOR /J Name a / / /"?. ?/ `i/ 9/ License No. D /v/ 3 Address /4,96 w //o 7 • 3 3// Telephone j,9px /4 Fax Qualifier auie,An , / \ d/y'z_ PROPERTY OWNER Name 9H f err 1I + 7 McUe I / Address ADO NF ell Slveer I; a rlai _CA vre_s fL 33/3 Home Telephone 303-751-- y' 0 8 Z Business Telephone Fax 30T- 751— 3 0 TYPE OF MANAGEMENT (✓ ) New Construction Enclosure Alteration Exterior Repair Alteration Interior Demolish Relocation of Structure Shell Only Foundation Only Add'I Attachment Other Add'I Detachment Other INSTRUCTIONS - The followi Step 1. APPLICATION Job Address: PERMIT TYPE (✓ ) Building Electrical Mechanical Plumbing LPGX Roofing Fence Other ARCHITECT Name License No. Address Telephone Fax • . ••• • 1 wi .• • • • • • • • ••• • • • • • • • • ••• ig steps must be taken to obtain a permit from the Miami Shores Village: • .. ••• .• Complete the attached perm appl nest besi,gne?bv the property owner and qualifier. Both signatures must be notarized. Please print or type to allow for a more aecurataprocassiyg pf four application. If roofing work will be done, a roofing application must be submitted •• • • • • • ••• •• along with this permit application. Step 2. Submit the completed application with all necessary documents to the Building, Planning and Zoning Department for processing. During the processing of your application, you may be asked to submit additional information. Gov ,t) 95 V- Address Apt. Folio Number Lot Block Subdivision P13 PG Current Use of Property Proposed Use of Property Tenant Information PERMIT CHANGE Chg. Contractor Renewal Revision Extension Supplement Reinspection (✓) ••• • • • • • • •• • • • • • • tiaster Permit No. •.•. • . • • •• Su bsidiary Permit N •• ••• • City Description Work /3' Zoning Square Feet Value of Work 2 4 Bldg Value Tax Assessed/Appraised Value Flood Zone Base Floor Elev. ENGINEER Name License No. Address Telephone Fax 3 313 State Zip � � 7 P � I"( "vet' • Linear Feet Units Floors PERMIT APPLICATION P bso--t62 Page 2 lic - State of Florida Signature of Notary SEAL: Personally known ••. • • • • • • • ••. • • • ••• • •• *. • - • • • • • • • ••• • • • PERMIT APPLICATION INIPORTANT NOTICES 1. DO NOT BEGIN ANY WORK WITHOUT HAVING RECEIVED YO•$ AND4itMff CARD. Applying for a permit does not grant the right to begin construction. HOURS OF CONSTRUCTION are limited to: Monday through Friday from 7:30 a.m. to 6:00 p.m., and Saturday from 8:00 a.m. to 5:00 p.m. No inspections will be conducted on weekends or holidays. 2. All construction of demolition areas MUST BE MAINTAINED IN A CLEAN, N NBActAls CONt) TION free from construction debris. 3. STREETS AND NEIGHBORING PROPERTIES SHALL BE KEPT FREE FRbM DiRI� �h • 4. SWALES MUST BE PROTECTED FROM BEING DAMAGED BY EQUIPMENT bR•VBH1CLES,•AIID MAY NOT BE USED FOR STORAGE. A bond is • required for work in or near the street/sidewalk. •• "' • 5. CONSTRUCTION TRAILERS ARE PROHIBITED ON SINGLE FAMILY RESIDENTIAL CONSTRUCTION SITES. Other construction may have a trailer which requires a separate permit. 6. PORTABLE TOILETS for a construction site require a separate permit. 7. DO NOT DISCHARGE WATER INTO THE RIGHT OF WAY OR STORM DRAINS without approval from the Building, Planning and Zoning Department. 8. EQUIPMENT AND MATERIALS SHALL BE STORED at least 10 feet from the edge of pavement. 9. Department of Health and Rehabilitative Services (HRS) approval is required for applications involving septic tanks. Department of Environmental Resources Management (DERM) and/or Miami -Dade Water and Sewer Department (MDWASD) approval is required for applications involving sewers. AFFIDAVIT - Please read carefully. Application is hereby made to obtain a permit to do work and installation as indicated. I, the OWNER of the property, certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits are required for ELECTRICAL, PLUMBING, POOL, EXTERIOR DOOR, MECHANICAL, WINDOW, FENCE, DRIVEWAY, ROOFING and SIGNS and there may be additional permits required from other governmental agencies. I, the OWNER of the property, have disclosed all information related to any work at the property performed in the prior twelve months to the Building Official. Further, I am fully aware that if the cumulative cost of work to my home or business under this and any other permit equals or exceeds fifty percent (50 %) of the fair market value of the structure, the entire structure must meet the present federal flood criteria for finished floor elevation. I am also fully aware that if the total cost of work to my home or business under this and any other permit exceeds fifty percent (50 %) of the replacement cost of the structure, then the entire structure must conform to the current code requirements of the Building Code. WARNING TO OWNER: Your failure to record a NOTICE OF COMMENCEMENT may result in you paying twice for improvements to your property. If you are spending more than $2,500 or intend to obtain financing, you may wish to consult with your attorney or lender before recording your Notice of Commencement. The Notice of Commencement must be recorded at: 22 N.W. 1st Street, 1°' Floor, (305) 679 -1078. Once recorded, the Notice of Commencement must be POSTED AT THE JOB SITE in accordance with Section 713 -35 of Florida Statutes. Review the brochure at Village Hall on Construction Lien Law and Choosing a Contractor. STATE OF FLORIDA, COUNTY OF MIAMI -DADE STATE OF FLORIDA, COUNTY OF MIAMI -DADE Si fr C�P�- Signature of o ner Signature of Contractor / Qualifier 'i 644y ,(i tUe l loth Print Name Print Name Sworn to and subscribed before me this Z o�� day of J QK trt: Sworn to and subscribed before me this day of �J Signature of Notary Public - State of Florida m ho, ' Michael I" �, , , 4 , SEAL: pew Atlantic g- "� OR, Produced Ide f &tat. Personally known OR, Produced Identification Type of Identification Produced: Type of Identification Produced: ELECTRICAL TYPE Minimum Fee QTY. 'r 'PE Dryer* • • • • : ; ; • QTY. • • 4 1 TYPE. 'Outlet, Appliance QTY. TYPE. Service Repair QTY. A/C Central 1 -3 Ton Fan Outlet, Wall Service, Temporary A/C Central 4 -7 Ton Fire Pump Ventilation, Cost Outlet, Switch Air Handler, Tons Ductwork, Cost of Signs Piping, Flammable Liquid A/C Central 8 -15 Ton Fixture - Fluorescent Oven Space Heater (kw) A/C Central 16-20 Ton Fixture Light Bath Fan - Vented, # Fireplaces, Number of Parking Lot Lights Pressure Vessel Spas/Hot Tubs A/C Central 20+ Ton Flood Lights Plugmold/Strip Subfeeds, No. of Amps A/C Window FPL - Load Central Posts Swim Pool, Commercial Air Conditioners Garbage Disposal Range/Range Top Swim Pool, Residential Chiller Generators, etc. Receptacles Switchboards Clear Violations Heat Recovery Refrigerator, Comm. (p/PH) Temp Serv., Construction Compactor Low -volt, Burglar Refrigerator, Domestic Temp for Test - 30 days Deep Freezer Low -volt, Fire Renew - Temp Service Water Closet Demolition Low -volt, Intercom/Teleph. Repair Circuits Water Heater Dishwasher Low -volt, Television Service, Number of Amps Water Heater New Water Re -pipe MECHANICAL TYPE QTY. T 'PE Minimum Fee Condensate Drain QTY. TYPE Generator QTY. TYPE Refrigeration, Tons QTY. A/C Central, Tons Cooling Tower Bath Tub Heating Strips, each Vent Hood, Cost A/C Wall/Win. Tons Dryer Vents, Number of Paint Booth Filter Replace Ventilation, Cost Pool Piping Air Handler, Tons Ductwork, Cost of Sprinkler Repair Piping, Flammable Liquid Cap - Fixture Periodic Inspections Barbecue Fire Sprinkler System Process/Pressure Piping Cap - Water Gas - Appliance Bath Fan - Vented, # Fireplaces, Number of Pump, Domestic Pressure Vessel Supply, AC Well Cap - Sewer PLUMBING TYPE A/C Condensate QTY. '1 YPE Drains, Roof QTY. TYPE Miscellaneous Fixture QTY. TYPE Soakage Pit Qkr Bath Tub Drinking Fountain Miscellaneous Repairs Solar Water Heater Bidet Filter Replace Pool Piping Sprinkler Repair Cap - Fixture Fountain Pump and Abandon Sprinkler System Cap - Water Gas - Appliance Pump, Domestic Supply, AC Well Cap - Sewer Gas - Natural Pump, Fire Stand Temporary Toilet Catch Basin Gas - Propane Pump, Re- circulate Temporary Water Closet Clothes Washer Gas Piping Pump, Replace - Pool Urinal Dental Chair Grease Trap Pump, Sprinkler Utility - Sewer Discharge Well L.e Maker Pump, Sump Utility - Water Dishwasher Lndirect Wastes Relay Repair Vacuum Pump Dis I osal Interceptor Roof Inlet Water Closet Domestic Well Laundry Tray Septic Connection Water Heater Drainfield, 4" Tile/Res. Lavatory Septic Tank Sewer Connection . Water Heater New Water Re -pipe Drains, Area Meter Set (Gas) Drains, Floor Minimum Fee Shower Water Service Drains, French Miscellaneous Equipment Sink Well, Supply Page 3 ••• • • • • • • • • • • • ••• • • • • • • ••• PERMIT APPLICATION • • ••• • • • • • • - - INSTRUCTIONS: Please indicate UV, type of vti.k begin performed and quantity(ies) in the space provided below. RECEIVED AND REVIEWED BY: DATE: SECTION BY , • E Zonin_ 4/ i til1AIYA Electrical Mechanical Plumbing Fire Public Works Structural 7 Building Official / l a) �� "O Page 4 OFFICE USE ONLY ❑ OWNER - BUILDER FORM (Attach) ❑ FIRE DEPARTMENT APPROVAL (Commercial / multi- family) ❑ CONCURRENCY (New Construction) ❑ OTHER (Specify & Attach) $3.00 per page (Scanning Fee) Miami Shores Village Bond Metropolitan Dade County (C.C.F.) $ l Inspector State Educational Fund State DCA (Radon) Code Enforcement Fine Zoning Review (Septic / Sewer) •. • • • • • ••• • ❑ IMPACT FEE (New Construction) ❑ OTHER (Specify & Attach) $ (¢.005 / sq.ft.) $ (¢.01 /sq.ft.) •.• • • • . . . . • • •• • • • • • • • •• • • • • ' • • • • • • • • • • ❑ PROOF OF OWNERSHIP (Attach) •• ••• •• • • •(F•ttach) • ❑ HRS / DERM APPROVAL • • : •. ... . • ( sq.ft. = x/1000 x ¢.60) • • • PERMIT APPLICATION CHECKLIST ❑ CONDO ASSOCIATION APPROVAL • • .J :BPI3QUPROVAL (Restaurants) ❑ CONTRACTOR REGISTRATION (On File) PERMIT FEES TOTAL $ g ISSUING OFFICIAL REVIEWED AND PREPARED BY: DATE: CONDITION OF APPROVAL Revised July 2001 10050 N.E. 2ND AVE., MIAMI SHORES, FL • (305) 795 -2207 • FAX (305) 756 -8972 • http://www.miamishoresvillage.com • Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Permit Number: BP2003 -16 Printed: 1 /7/2003 Applicant: AMY Owner: PERWIN JOB ADDRESS: 800 NE 95 Contractor COMPLETE HOME PAINTING Local Phone: 305 - 895 -1368 Parcel # 1132060410010 Fees: Description Amount FEE2003 -96 Building Permit Application Fee $60.00 FEE2003 -97 CCF $1.80 Total Fees: $61.80 Total Fees: $61.80 Total Receipts: $0.00 Permit Status: APPROVED Permit Expiration: 7/6/2003 Work: PRESSURE CLEAN & PAINT EXTERIOR If there is no permit package accessible on the job -site for inspectors to verify, there will be no inspections. Re- inspection fee is $50.00, which must be paid in advance before calling for another inspection. This Permit is granted to the contractor or builder named above to construct the ordinances pertaining thereto and with the understanding that the work will be perfc and approved by the proper municipal authorities. This Permit may be revoked at authorization. A further condition upon which this permit is granted is the understai ordinances and regulations pertaining to the work covered hereby whether shown c by his agents, servants or employees. Signed: (INSPECTOR) In consideration of the issuance to me of this permit, I agree to perform the work with the plans, drawings, statements or specifications submitted to the proper auth< myself, my agent, servants or employes. Signed: (Contractor or Building Permit PERWIN AMY ST Contractor's Address: 1476 NE 130 STREET Page 1 of 1 Legal Description: JONI HEIGHTS PB 96 -23 LOT 1 BLK 1 LOT SIZE IRREGULAR OR 15762 -2519 1292 Construction Value: Z. PAY TO THE ORDER OF 14 S 0 MEMO COMPLETE HOME PAINTING BY MICHAEL MICHAEL IWASKEWYCZ 1476 NE 130TH ST. PH. 305 - 895 -1368 NORTH MIAMI, FL 33161 Washingto utual Washinggtton Mutual Bank, FA North Miami/125th Street Financial Center 1728 900 NE. 125th Street 1 - 788 North Miami, FL 33161 1 Customer Ser•ice • '1 n .• r1 n • • -• • - •, • • n 3627 �/3/3- DATE 63 -8413 -2670 MIAMI. VILLAGE Paint C64hr; •ppraval and Agreement DATE: //a.716_,,,8 . ..• • • . OWNER'S NAME: S{io ftlGruvh� • .' laT„ PHONE: 30c- 757 - y6BZ ADDRESS: goo Nf f5'Skee,t At ant'S'litres GZ 73/3! ************ * * **r”8. * *. *ikak*'`4** ,,, * * * * * * * ** * ** * * * * * * * * * * * * * * * * * ** ADDRESS OF SITE:: : (4 © : 95 ..5 CONTRACTOR & LICENSE (i appl "b le) /v) 3 J COMPANY NAME: e /7� 9'�' PHONE e J f-f5 - - * * * * * * (-3 k * * * * * * * * * * * * * * * * ** All Elements on the site must be listed and indicate the color to be painted. Walls / 0, Fascia Gt)h.t.f Drip Cap/Drip Edge A7/19 Soffit GO 4..-" Roof w /kf Flower Bins N/. Shutters Awnings 14,11 Chimney /4/ 19 Doors and door jams Gv Garage Doors t Railings `" / Fences Decorative Metal M. / All brick (simulated or regular) A./* Stucco Banding Any other stucco features t /3' Accessory Buildings P/# Other OWNER'S AFF][DAVIT: 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. Furthermore , the paint colors will be as per the attached samples. /1643 - Y/4' : ` 0-7r)? Signat&re of Owner Date Signature of Contractor Date *********************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** WHEN PA][NTING IS FINISHED, CALL FOR FINAL INSPECTION APPROVED: � 1 j/'/ Building Offic al Date 4/23/01 °Ll 2 L( 44fb MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Bui ng Inspection Request Date (0 2 _, Type Insp'n 01 Permit No. eP®? (a . Name Q(LV 1 Address 300 )\\E Cl 5S+ Company -�� '* 1 ! Phone # Inspection Date Approved Correction Re- Insp'n Fee *0 60