PT-09-1148Scheduled Inspection Date: June 15, 2010
Inspector: Bruhn, Norman
Owner: BUTLER, ROBERT
Job Address: 123 NE 97 Street
Miami Shores, FL 33138-
Project: <NONE>
Contractor: OWNER
Building Department Comments
June 14, 2010
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP - 119047 Permit Number: PT -7 -09 -1148
For Inspections please call: (305)762 -4949
Permit Type: Paint
Inspection Type: Final
Work Classification: New
Phone Number (786)556 -2919
Parcel Number 1132060132440
.c/vs
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Inspector Comments
Page 1 of 25
Scheduled Inspection Date: June 15, 2010
Inspector: Bruhn, Norman
Owner: BUTLER, ROBERT
Job Address: 123 NE 97 Street
Miami Shores, FL 33138-
Project: <NONE>
Contractor: OWNER
Building Department Comments
June 14, 2010
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP- 119047 Permit Number: PT -7 -09 -1148
Permit Type: Paint
Inspection Type: Final
Work Classification: New
. Phone Number (786)556 -2919
Parcel Number 1132060132440
Passed
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Inspector Comments
For Inspections please call: (305)762 -4949
Page 1 of 25
Protect Address
123 97 Street
Miami Shores, FL 33138-
1132060132440
Block: Lot:
ROBERT BUTLER
Owner Information
ROBERT BUTLER
Miami Shores Village
10050 N.E. 2nd Avenue
Miami Shores, FL 33138 -0000
Phone: (305)795 -2204
Fees Due
CCF
Education Surcharge
Notary Fee
Permit Fee
Technology Fee
Total:
Amount
$0.60
$0.20
$5.00
$60.00
$1.65
$67.45
Address
Parcel Number
123 97 Street
MIAMI SHORES FL 33138 -2332
Authorized Signature: Owner / Applicant / Contractor / Agent
Building Department Copy
Phone
(786)556 -2919
Expiration: 01/06/2010
Applicant
CeII
Valuation:
Total Sq Feet:
Type of Work: Exterior
Color yellow tan
Additional Info:
Classification: Residential
Color: yellow tan_Approved
Color: yellow tan_Approved_
Code Comments:
Color yellow tan_Denied
Invoice #
PT -7 -09 -35346
Check #: 8964
Total Amt Paid Amt Due
$ 67.45 $ 67.45 $ 0.00
$ 500.00
1000
Date
For Inspections please call:
(305)762 -4949
Available Inspections:
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.
July 10, 2009
July 10, 2009 1
T21
BUILDING
PERMIT APPLICATION
FBC 2004
Permit Type: PAINT PERMIT f�
Owner's Name (Fee Simple Titleholder) '� % /dU e--
Owner's Address /?- 3 /1/4, - 7 0
City f / c S State
Miami Shores Village
Building Department
10050 N.E.2nd Avenue. Miami Shores, Florida 33138
Tenant /Lessee Name / /
E -MAIL: j t, 7 ' /gf" &ihi Ilr He
ll Q 1;
Job Address (where the work is being done) / 3 A/ , 7
City Miami Shores Village County Miami -Dade
FOLIO / PARCEL # r/ - O a 3 V o
NO 7�
Is Building Historically Designated
YES('
Contractor's Company Name 5 fi
OWNER BUILDER: (7 1 L7
Training /Education Fee $ Q • oO fl
MCIEME
L 1U ' j
(305) 795.2204 Fax: (305) 756.8972
Permit No. PrO9' 114\c
Master Permit No.
Zip ;3 3/3
Phone #
Phone #
Technology Fee:
Phone # 50s 7 ` al i 2--
Zip 3 38'
Contractor's Address
City State Zip
Qualifier Name Phone #
c Competency
State Certificate or Registration No. Certificate o f No.
Value of Work For this Permit $ pOCf a Type of Work: ❑ Addition/ ❑ Alteration / ['New / ❑ Repair /Replace
Describe Work: 4,Ai7 o )7Sr474
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 performed to meet the standards; of all laws regulating construction in this_ jurisdiction. I understand that a separate permit must he secured f
EI.ECTRICAI. WORK. PI.UMRING, SIGNS. WELLS. 000L S. BOILERS. HEATERS. TANKS and AIR CONDITIONERS. ETC
"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 WITI•I YOUR LENDER OR AN ATTORNEY BEFORE
RECORDING YOUR NOTICE OF COMMENCEMENT."
Notice to Applicant: As a condition to the issuance ofa huilding permit with an estimated value exceeding $ 2500. the applicant must promise in good jahh that a cope of the
notice of commencement and construction lien law brochure will he delivered to the person whose property is subject to attachment. Also. a certified copy oft to recorded notice
of commencement muss he posted at the job sire for the frrt inspection which occurs seven (7) days after the building permit is issued In the absence of such posted notice. the
inspection mi11 not he approved and a reinspection fee ualll be charged. p ***�YoY
**** ************** itx $a********u***** *rsk*Feeswwwww :t & at3: vt * *** *********:eae+4********1<** .
Permit Fee $ 60.00 CCF $ 0'4
J
Notary $ Code Enforcement $
Double Fee $ Zoning $ Total Fee Now Due $ (.Q7
See Reverse side —÷
Directions: Please circle corresponding number to appropriate color sample.
Walls:
Fascia:
Drip Cap /Drip Edge: Q 2 3 4
Soffit: 1 2 3 4
Roof
Flower Bins:
Shutters:
Awnings: 1
Chimney: c . 2
Doors and Door Jams:
Garage Doors: _ I 2
Railings:
Fences:
All brick (simulated or regular):
Stucco Banding:
Any other Stucco Features:
Accessory Buildings 6 Pet
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
owner or Agent Contractor
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
day of . 20 — by day or . 20 _. by
whet is personally known to me or who has pnnduced who is personally known to me or who has produced
as identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
Sign: Sign:
Print: Print:
My Commission Expires: My Commission Expires:
** * * * * * * * * * * * * * * * * *a+t*** ** *********, t********* ** ** *a **** ****** *** t * *,r****** * ***** r *,t ******** qtr *,t+Tr+Y+t,t+lr,t*** * ***
APPLICATION APPROVED BY: PlansBxaminer
Preservation Board
Code Enforcement
As identification and who did take an oath.
1 2
1
PAINT COLOR APPROVAL AN.D AGREEMENT
AU elements on the site must be listed and indicate the color to be painted
2
1 2 3
3 4
3 4
3 4
3 4
3 4,
3 4
3 4
3 4
3 4
3 4
3
4
Other: /11 yydrr2 .
A if
4
4
Attach color samples with name and
II
Signature
•
(Revised 04124/0