PAINTBUILDING ITCTIMMI
PERMIT APPLICATIO
FBC 2001
Permit Type (circle): juilding
Architect/Engineer's Name (if applicable)
Electrical
$ Value of Work For this Permit 2 �
Describe Work:
Submittal Fee $
Notary C)
Scanning $
Code Enforcement $
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
Permit Fee $
Miami Sh , lllage
Building Department
Type of Work: ❑Addition ❑Alterationi ew
V CC
Training/Education Fee $)
Radon $ Zoning
Structural Plan Review. $
Total Fee Now Due $c C Ct�.
111
(Continued on opposite side)
Permit No. pi
Master Permit No.
Plumbing Mechanical Roofing
Owner's Name (Fee Simple Titleholder) y ( 5. ,.,- .' Phone # 'e- . �r( cC .
Owner's Address ,r b V'7 /Ye ;' / SI d <',e
City A' - ,-r I `-t State d=2 - Zip :3 . `3:/
Tenant/Lessee Name Phone #
ob Address (where the work is being done) dey $1,4, , ‘ 4e 4
City Miami Shores Villa _e County Miami -Dade Zip s S i / 1 S
Is Building Historically Designated YES NO
Contractor's Company Name 0 WV/ Phone # 3O5-- I9 J— /-4‘.?
Contractor's Address /C/ 76 j /(/ , /3U Sf
City P2/ W/ State Zip ,3 3 /,6J/
Qualifier , 4-4,
State Certificate or Registration No. Certificate of Competency No. 0/ V/ 3/
Phone #
Square Footage Of Work:
2 ti « ��I ` f -tom , ,
* * * * * * * * * * * * * * * * * * * * * * * * * * ** Fees * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
❑ Repair/Replace ❑ Demolition
CCF $ f CO /CC
Technology Fee $ 1 1
Bond $
Bonding Company's Name (if applicable)
Bonding Company's Address
City State Zip
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address �1// i
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.
chc 05/13/03
* * * * * * * * * * * * * * * * * * **
APPLICATION APPROVED BY:
er or Agent
The foregoing instrument was acknowledged before me this
day of �"� 20■�, by
who is perso ly known to me or who ha
As identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
Sign: 71114 4 It/ vL Sign
Print: cljC4 - 7'w�(4- yl-C._ Prin
My Commission Expires- NOTARY PUBLIC -STATE OF FLOR, MyiCo
i , - Michael Iwaskewyci.
Expires: APR. 10, 2010
Bonded Thru Ad:ndc Bonding Co., 'inc.
°nd /4g c 14 0 9
l'k
Plans Examiner
* * * * * * * * * * * * * * * * * * * * * **
3
Contractor
The fofeg instrument was �� `' rr acknowledged before me t is C 4
day of 4 , 2(1� by f e
who is personally known to me or who has produced
as identification aind who did take an oath.
* * * * * * * * * * * * **
0 07 ,
E0 Ore s f�4 #D 4 ajj
Engineer
Zoning
* * * * * * * * **
)D ate
Miami Slfllage
Paint Color Approval and Agreement
1/45
)t rOwner's Name ,"- �1� "e � `■
Owner's Address / 0 ' 9'7 5/r e e
Walls
City 1e �2% S ho? of State Zip 33/3
),Klob Address (where the work is being done) ,/,®� 9 7 SA
3' � /
City Miami Shores Village County Miami-Dade Zip
Is Building Historically Designated YES NO 'i
�r Mr hone
Contractor's Company Name (if applicable) ` .vh CierJ '43 4
°
****************************** * * * * * * * * * * * * ** * * * * * * * * * * * * * * * * ** ********* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
All elements on the site must be listed and indicate the color to be painted
.e 9'
Fascia
, - 970 A) 1 e .,[haw 11
Drip Cap/drip Edge a 1 ea Soffit ®m -9 7 0 ale L
Roof 1- 1
Flower bins 4 "1- ? 70 k)4 LJ17V)"
Shutters ,,
Awnings IIV/1.7
Chimney AtVi }�
Doors and door jams %�P 34 '/ — ° ✓ e - /s 9e
71-7- 9770
Garage doors
Railings
Fences 1/ / J
Decorative metal M /
All brick (simulated or regular) ran - 470
Stucco banding G _ /C 1
Any other stucco features ' • N / kr
Accessory Buildings / 4 1
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.
gnature
APPLICATION APPROVED BY:
Phone # J ®g - 7Sg 90
Date
Date
V/9/0fr
s
chc 6/18/03
Issue Date: 5/9/2006
Owner's Name: EMERY SWARTZ
Permit Type: Paint
Work Classification: New
Job Address: 1045 97 Street NE
Contractor(s) Phone Primary Contractor
COMPLETE HOME PAINTING BY MI 305 - 895 -1368 Yes
Comments:
EXTERIOR PAINTING
Additional Information
Miami Shores Village, FL 33138-
Miami Shores Village
10050 N.E. 2nd Avenue
Miami Shores, FL 33138 -0000
Phone: (305)795 -2204 Fax: (305)756 -8972
Permit
Expires: 10/31/2006
Type of Work: Exterior Color: HALE NAVY, WHITE DOWN
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.
Building Department File Copy
Applicant Signature
Parcel #:
Block:
Section:
Permit Status: APPROVED
Permit Number: PT -5 -06 -1165
Phone: (305)758 -9030
1132050170100
Lot:
PB:
Total Square Feet: 0
Total Valuation: $ 2,450.00
Required Inspections
Final
Fees Due
CCF
Education Surcharge
Notary Fee
Permit Fee
Technology Fee
Total:
Amount
$1.80
$0.60
$5.00
$60.00
$1.50
$68.90
Invoice Number
PT - 5 - 06 - 24713
Total:
Amt Due
$68.90
MAY 0 9 PAID
c-8G 4
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.
Inspection Date: 07/20/2006
Inspector: Desharnis, George
Owner: SWARTZ, EMERY
Job Address: 1045 97 Street NE
Project: <NONE>
Building Department Comments
Wednesday, July 19, 2006
Inspection Number: INSP -16527
Miami Shores Village, FL 33138-
Onspection 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 -5 -06 -1165
Permit Type: Paint
Inspection Type: Final
Work Classification: New
Phone Number (305)758 -9030
Parcel Number 1132050170100
Lot:
Phone: 305 - 895 -1368
Page 1 of 2
Inspector Comments
A
Passed
! c'
A
_ ° --1
/
, *1�
7 - (-1 - I
Failed
Correction
Needed
Re- Inspection
Fee
($75)
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Inspection Date: 07/20/2006
Inspector: Desharnis, George
Owner: SWARTZ, EMERY
Job Address: 1045 97 Street NE
Project: <NONE>
Building Department Comments
Wednesday, July 19, 2006
Inspection Number: INSP -16527
Miami Shores Village, FL 33138-
Onspection 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 -5 -06 -1165
Permit Type: Paint
Inspection Type: Final
Work Classification: New
Phone Number (305)758 -9030
Parcel Number 1132050170100
Lot:
Phone: 305 - 895 -1368
Page 1 of 2