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PT-10-12 f ,. ar Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138-0000 �. 1g,. � ors. 3 � � � � k 3 � •}•� Yf,TMT�' � 3D ff " Phone: (305)795 -2204 3 3 qW, Expiration: Project Address Parcel Number Applicant 1201 101 Street 1132050250080 Miami Shores, FL 33138 -2608 Block: Lot: MALCOLM BARRY DUFF Owner Information Address Phone cell MALCOLM BARRY DUFF 1201 101 Street MIAMI SHORES FL 33138 -2608 Contractor(s) Phone Cell Phone Valuation: $ 0 .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: Final Color Approved_ Color: _Denied Fees Due Amount Invoice # Total Amt Paid Amt Due CCF $0.00 PT -1 -10 -36738 $ 65.00 $ 65.00 $ 0.00 Education Surcharge $0.00 Notary Fee $5.00 Permit Fee $60.00 Scanning Fee $0.00 Technology Fee $0.00 Total: $65.00 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. January 05, 2010 Authorized Signature: Owner / Applicant / Contractor / Agent Date Building Department Copy January 05, 2010 1 Miami Shores Village Building D RECD � J 10050 N.I -:2nd AVenlle, Miami Shores. f lorida 33139 Tel: (305) 195.2209 Fax: (305) 756.8972 BUILDING Permit No. PERMIT APPLICATION Master Permit No. FBC 2004 Permit Type: PAINT PERMIT Owner's Name (Fee Simple Titleholder) C 6 L Lj Phone # 3 a f Owner's Address _k S — City_o_, IA State �= r_� Zip 3 -3 ( 3 S Tenant /Lessee Name _ Phone # E -MAIL: [` y a - _ ) Job Address (where the work is being done) ` Z a � ✓J E ( S S City _ Miami Shores Villa(-Ye County Miami -Dade Zip i FOLIO / PARCEL # Is Building; Historically Designated YES _ NO Contractor's Company Name — W t� J ��'C Phone # Contractor's Address _State Zip Qualifier Namc Phone # State Certificate or Registration No. o r ( L of Competency No. OWNER BUILDER: 0 W N l`.-V �-- Value of Wort: For this Permit $ 5C)O-c Type of Work: ❑ Addition / ❑ Alteration / ❑New / ❑ Repair /Replace Describe Work: 2 0 (% t 1 'V\ c r Application is hereby made to ottain a permit to do tllc work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a porno( and that all ssrork will be perlbrmed to meet the standards ofall laws re;,ulatim,construction in this jurisdiction. I understand that a separate permit must be seamed 161 - ELECTRICAL WORK. PIA)MBING, SIGNS. WELLS. POOLS. I'URNACES, BOILERS. 1- [HATERS, 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 WITH YOUR LENDER OR AN ATTORNEY REFOR[ RECORDING YOUR NOTICE OFCOMMENCENIENT." Notice to. I ppl icarn: :1.s a condition to the issuance ol'a building permit with an estimated value exceeding $ 2500. the applicant nntst promise in good faith 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. lso, a cerliJied copy ojthN recorded notice of contmencente:rt nuisi he posted at the job site far 1he inspection which occurs seven (7) days after the building permit is issued. In the absence grsuch posted notice. the inspection will not he approved and a reinspection./ee will be charged. Permit Fee $ CCF $ G Technology Fee- Training/Education Fee $ Notary $ Code Enforcem Double Fee $ Zoning $ Total Fee Now Due $ See Reverse side -� PAINT COLOR APPROVAL AND AGREEMENT All elements on the site must be listed and indicate the color to be painted Directions: Please circle corresponding dumber to appropriate color sample. Walls: 1 ? ' 4 Attach color samples with name and Fascia: _ 1 2 3 4 number. Drip Cap /Drip Edge: 1 2 4 _ Soffit I -� - - - -- , 4 1- - - - -- - - i Roof: I 3 4 Plower Bins: 1 2 3 4 Shutters: 1 2 3 4 Awnin,us 1 2 3 4 2 Chirnney: 1 2 3 4 Doors and Door Jams: 1 2 3 4 Garage Doors: 1 2 3 4 Railings: 1 2 3 4 3 Fences: 1 2 3 4 All brick (simulated or 1 2 3 4 Stucco Banding: I 2 3 4 Any other Stucco Features: 1 2 3 4 4 Accessory Buildings Other: OWNER'S AFFIDAVIT: 1 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_ Signature (.honer oi A Contractor , The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this day of -,_ - - _ 20 1 0 by 4 PJtkX -N I � W Qw Cr— "- day o1 . 20 by who is personally known to me or who has produced I01� who is personally known to me or who has produced 1111 / // As identif\\`\ �1�I .� l t7P i an oath. as identif and who did take an oath. No "rARY PUBLI iftos •.!p� ��,� NOTARY PUBLIC: Sign: Sign: — Print: — ____ -- NOTARY PUBL1C . - Print: My Commission Expires: N, Commission # My Commission Expires: /trntntt0 .APPLICATION APPROVI'D BY: Plans Examiner Preservation Board t� t" Code Linlbrcement (Revised 04/24/0 4 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP - 132601 Permit Number: PT- 1 -10 -12 Scheduled Inspection Date: March 29, 2010 Permit Type: Paint Inspector: Bruhn, Norman Inspection Type: Final Owner: DUFF, MALCOLM BARRY Work Classification: Addition /Alteration Job Address: 1201 NE 101 Street Miami Shores, FL 33138 -2608 Phone Number Parcel Number 1132050250080 Project: <NONE> Contractor: HOME OWNER Building Department Comments Inspector Comments Passed ei c-, 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 5 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 - 132601 Permit Number: PT- 1 -10 -12 Scheduled Inspection Date: March 29, 2010 Permit Type: Paint Inspector: Bruhn, Norman Inspection Type: Final Owner: DUFF, MALCOLM BARRY Work Classification: Addition /Alteration Job Address: 1201 NE 101 Street Miami Shores, FL 33138 -2608 Phone Number Parcel Number 1132050250080 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 5 of 27