PT-09-1912Protect Address
501 96 Street
Miami Shores, FL
Owner Information
Miami Shores Village
10050 N.E. 2nd Avenue
Miami Shores, FL 33138 -0000
Phone: (305)795 -2204
Address
Parcel Number
1132060171550
Block: Lot:
Valuation:
Total Sq Feet:
$ 900.00
RALPH ROSS
501 NE 96 ST
MIAMI SHORES FL 33138 -2735
Fees Due
CCF
Education Surcharge
Permit Fee
Scanning Fee
Technology Fee
Total:
Amount
$0.60
$0.20
$60.00
$0.00
$0.60
$61.60
Authorized Signature: Owner / Applicant / Contractor / Agent
Building Department Copy
�t-
PRO VE'
Expiration: 05118/2010
Phone
Type of Work:
Color:
Additional Info:
Classification: Residential
Color: _Approved
Color: _Approved_
Code Comments: WALLS - WHITE
Color: _Denied
Invoice #
Total Amt Paid Amt Due
PT -11 -09 -36449 $ 61.60 $ 61.60 $ 0.00
Date
Applicant
RALPH ROSS
For Inspections please call:
(305)762 -4949
Available Inspections:
November 19, 2009
CeII
Inspection Type:
Final
1
In consideration of the issuance to me of this permit, 1 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.
November 19, 2009 1
BUILDING
PERMIT APPLICATION
FBC`
Permit Type: PAINT PERMIT
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756 8972
Master Permit No.
C
Owner's Name (Fee Simple Titleholder) `i cl � p t �, / � � c S.5 Phone # 3C> . -
Owner's Address Sat N ,E ��� "l
City G r ��l I, r �) t \ S State I L ... Zip — 37) ( 3
Tenant/Lessee Name ,
E -MAIL: r1"Yb�l`�LLv 1
Job Address (where the work is being done)
Phone #
S tt E tt_S o b / R_
Permit No. VT ) ( - 0 6 1 - 1Q12.
City Miami Shores Village County Miami -Dade Zip
FOLIO / PARCEL #
Is Building Historically Designated YES NO t
Contractor's Company Name J
p Y T�' �°`LZE �G� � l �-F Phone #
Contractor's Address
City State Zip
Qualifier Name Phone #
State Certificate or Registration No. Certificate of Competency No.
OWNER BUILDER:
Value of Work For this Permit $ 6 0. o 0 Type of Work: ❑ Addition / ❑ Alteration / New / ❑ Repair /Replace
Describe Work:
Application is hereby made to Main 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..1 understand that a separate permit must be secured tier'
ELIiCTRICAI. WORK. PI.UMI3ING, SIGNS. WELLS. POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC
"WARNING TO OWNER: VOI R 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 nit' building permit with an estimated valued exceeding $ 2500. the applicant must promise in goodJailh that a copkof the
notice of commencement and construction lien icw brochure will be delivered to the person whose property is subject to attachment. Also. a certified copy oldie recorded notice
of commencement must he posted at the job site_far the first inspection which occurs seven (7) days after the building permit is issued In ihe:ahsence of such lusted notice. the
inspection will not he approved and a reinspeciion fee will be charged. •
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Permit Fee $ CCF $ Technology Fee:
Training /Education Fee $ Notary $ Code Enforceme t $
Double Fee $ Zoning $ . Total Fee Now Due $
n , .� 01 See Reverse side -->
Walls:
Fascia:
Drip Cap /Drip Edge:
Soffit:
Roof:
Flower Bins:
Shutters:
Awnings:
Chimney:
Doors and Door Janis:
Garage Doors: 1
Railings:
Fences:
Stucco Bandino
Directions: Please circle corresponding number to appropriate color sample.
The for a ing instrument was ackno
day nr ()V . 200 C. by
My Commission Expires:
PAINT COLOR APPROVAL AND AGREEMENT
All elements on the site must be listed and indicate the color to be painted
Owner or Agent
2
All brick (simulated or regular):
3
3
3
3
3
3
3
3
3
Any other Stucco Features: l 2 3 4
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.
ed )ed before me this
b
t. pin in
who is personally known to
m • or who Iris nuluced�,
nttftc� � t an wio t to •c.
NOTA
Sign:
Print: /
oath.
4
4
4
4
4
4
4
4
4
4
4
Attach color samples with name and
number.
Signature
Contractor
fr he foregoing instrument was acknowledged before me this
r I' . 20 . by
i is personally known to me or who has produced
as identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
My Commission Expires:
APPLICATION APPROVED BY:
Oft
Plans Examiner •
Preservation Board
Code Enforcement
(Revised 04/24/0;
Inspection Number: INSP- 129636 Permit Number: PT -11 -09 -1912
Scheduled Inspection Date: April 19, 2010
Inspector: Bruhn, Norman
Owner: ROSS, RALPH
Job Address: 501 NE 96 Street
Project: <NONE>
Contractor:
Miami Shores, FL
Building Department Comments
April 16, 2010
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
For Inspections please call: (305)762 -4949
Permit Type: Paint
Inspection Type: Final
Work Classification: New
Phone Number
Parcel Number 1132060171550
Passed
J
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Inspector Comments
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