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PAINTROOF PAINT IN WHITE -°' MAI 1 1 2007 0 ,4 Passed nspector Comments Failed Correction Needed Re- Inspection Fee ($75) No Additional Inspections can be scheduled re- inspection fee is paid. until Inspection Date: 05/10/2007 Inspector: Grande, Claudio Owner: FREEMAN, PATRICIA Job Address: 1151 99 Street NE Miami Shores Village, FL Project: <NONE> Contractor: HOME OWNER Building Department Comments Wednesday, May 9, 2007 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 CL Block: Permit Type: Paint Inspection Type: Final Work Classification: New Phone Number Parcel Number 1132050180070 Lot: Page 2 of 2 PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date [ l' 4 1 )Job Address I ( S ( it) • E (1 St Tax Folio Legal Description Historically Designated: Yes No Owner/Lessee / Tenant F e A E ( 1 ,- l) Master Permit # Owner's Address ( ( ( Al 1 •' J Phone 3 0 5 — S a D 0 Contracting Co. ���� C �r, q � �. Qualifier 'C., / !�A l� z /1 ee r F1 State # • Architect/Engineer Bonding Company Mortgagor Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION r Q - VC"( I * 'T q - 1 - /1 .42- 1'L 0 S (A- S l Cl Cam_ Square Ft. a 0 0 0 5 " WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO 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.) Application is hereby made to obtain a permit to do work and installation as indicated above, and on the attached addendum (if applicable). I 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, SIGNS, POOLS, ROOFING and MECHANICAL WORK. OWNER': FIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws r - g constru on an • onin :. urtherm • e, I authorize the above -named contractor to do the work stated. • ignature of owner d/or ondo President Date Signature of Contractor or Owner- Builder Date Ph"? &A CZEM Notary as to Owner and/9r CQ do r esi Date Notary as to Contractor or Owner- Builder Date My Commission Expire ..p.RY ri CFFi NOTARY SE i O. % f ^ PARA ANN FUG,' 4 . COMMISSION NUMEE,: CC360191 MY COMMISSION EXP. APPROVED: Zoning Mechanical Building [- �-' -� Estimated Cost (value) 15 / / �- 0 O '' 0 0 My Commission Expires: FEES: PERMIT '-k RADON C.C.F. 4 I, NOTARY Electrical Plumbing Engineering