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PT-10-277 r q .a �, A � t . *,v1.�r g Miami Shores Village, 10050 N.E. 2nd Avenue f s Miami Shores, FL 33138 -0000 ° Phone: (305)795 -2204 Expiration: 0812212010 Projec Address Parcel Number Applicant 909 99 Street „H 1132060340230 Miami Shores, FL 33138- Block: Lot: JOHN DOLL Owner Information Address _ Phone Cell JOHN DOLL 909 99 Street MIAMI SHORES FL 33138 -2568 Contractor(s) Phone Cell Phone Valuation: $ 1,000.00 HOME OWNER _ Total Sq Feet: 0 Type of Work: Exterior For Inspections please call: Color: (305)762 -4949 Additional Info: Available Inspections: Classification: Residential Inspection Type: Color. Approved Code Comments: WALLS -WHITE Final Color: Approved_ Color: _Denied Fees Due Am Invoice # Invoice Total Amt Paid Amt Due CCF $ 60 PT -2 -10 -37104 Education Surcharge $0.20 $66.60 $66.60 $0.00 Notary Fee $5.00 Permit Fee $60.00 Technology Fee $0.80 Total: $66.60 Building Department Copy RE C I? T2 1253 MCM1 063N7 CHARGE $6 " February 23, 2010 2 Miami Shores Village Building Department 1.0050 N.!_::2nd Avenue. Miami Shores. Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 BUILDING Permit No. PERMIT APPLICATION Master Permit No. FBC 2004 Permit Type: PAINT PERMIT 5 6 re� Owner's Name (Fee Simple Titleholder) M AI A Phone # l �e 11 Owner's Address 9 . 1 A/C �`� f/- City� � V [ � K 4 #vfi , � IState / Zip �C 3 Tenant /Lessee Name Phone # E -MAIL: Job Address where the work is being done)_ City __ Miami Shores Villa ge County Miami -Dade Zip FOLIO / PARCEL # Is Building Historically Designated YES NO Contractor's Company Name _ �" "" `- 0& 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 $ O a v Type of Work: ❑ Addition / ❑ Alteration ! ONew / ❑ Repair /Replace Describe Work: e� ✓� CG �!/�-� C t' v� 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 perlormed to meet the standards ol'all laws regulating construction in this jurisdiction. I understand that a separate permit must he secured liar ELECTRICAL WORK. PLUMBING. SIGNS. WELLS. POOLS, FURNACES, BOILERS, 14EATERS, 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 VOU IN'T'END TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORt RECORDING YOUR NOTICE OF COMMENCEMENT." Notice to. I pplicant:.4s a condilion to the issuance ol'a building hermit with an estimated value exceeding $255. the applicant must pt•omise in gtodj tdh that a cope of the notice of commencement and construction lien law brochure will be delivered to the person whose property is• subject to attachment. Also. a caeriified copy q(the recorded notice of conunencentew must he posted at the job siie,far the 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 jee will be charged. Permit Fee $ CCF $ Technology Fee: Training /Education Fee $ Notary $ Code Enforcement $ Double Fee $ Zoning $ Total Fee Now Due $ -- See Reverse side -3 PAINT COLOR APPROVAL AND AGREEMENT All elements on the site must be listed and indicate the color to be painted Directions: Please circle corresponding number to appropriate color sample. Walls: 1 2 3 4 Attach color samples with name and Fascia: I 2 3 4 number. Drip Cap /Drip Edge: 1 2 ; 4 Soffit: _ 1 -' 3 4 Roof': 1 2 3 4 Flower E3111s: I 2 3 4 Shutters I 2 3 4 �.J .mac - �..� . �� . •.L, . � Awnings 1 2 3 4 2 Chimney: 1 2 3 4 Doors and Door,lams: 1 2 3 4 Garage Doors: 1 2 3 4 Railings: 1 2 3 4 3 Fences: 1 3 4 All brick (simulated or regular 1 2 3 4 Stucco Banding: l 2 3 4 Any other Stucco Features: 1 2 .3 4 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 ap licable laws regulating construction and zoning. Signature Signature O wner or Agent (I Contractor The fir it r instrument was a o led )ed bet Ws 00� The foregoing instrument was acknowledged before me this day( 20�, by w. _ day al' 20 _.by wh is p •rsonally sown to r is or who has pioduced who is personally known to me or who has produced gtification a.nd wl did take an oath. as identification and who did take an oath. NO "rA ' Ptl 1 NOTARY PUBLICc Sign: Sign: Print: 1 0 My Commission Expires: ZQ��V � q,t „4z�Gty Commission Expires: APPLICATION APPROW-D BY: Plans Examiner Preservation Hoard Code C ;nliircement (Revised 04 /24/0; Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP - 136143 Permit Number: PT -2 -10 -277 Scheduled Inspection Date: March 29, 2010 Permit Type: Paint Inspector: Bruhn, Norman Inspection Type: Final Owner: DOLL, JOHN Work Classification: New Job Address: 909 NE 99 Street Miami Shores, FL 33138 - Phone Number Parcel Number 1132060340230 Project: <NONE> Contractor: HOME OWNER Building Department Comments Inspector Comments Passe v/ Failed Correction ❑ Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. March 26, 2010 For Inspections please call: (305)762 -4949 Page 8 of 27 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP- 136143 Permit Number: PT -2 -10 -277 Scheduled Inspection Date: March 29, 2010 Permit Type: Paint Inspector: Bruhn, Norman Inspection Type: Final Owner: DOLL, JOHN Work Classification: New Job Address: 909 NE 99 Street Miami Shores, FL 33138 - Phone Number Parcel Number 1132060340230 Project: <NONE> Contractor: HOME OWNER Building Department Comments Inspector Comments Passed Failed Correction ❑ Needed Re- Inspection ❑ Fee No Additional Inspections can be scheduled until re- inspection fee is paid. March 26, 2010 For Inspections please call: (305)762 -4949 Page 8 of 27