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PT-05-1308 °, Miami Shores Village E 10050 N.E. 2nd Avenue "" Miami Shores, FL 33138 -0000 rss �� Phone: (305)795 -2204 Fax: (305)756 -8972 `QR11aA Permit Permit Status: APPROVED Issue Date: 12/22/2005 Expires: 12/22/2006 Permit Number: PT -12 -05 -1308 Owner's Name: SHAUN D & NADINE M DAVE ROGERS one: (305)756 -7345 Permit Type: Paint Parcel #: 1132060132040 Work Classification: New Block: Lot: Job Address: 121 100 Street NE Section: PB: Miami Shores Village, FL Contractor(s) Phone Primary Contractor Total Square Feet: 0 COMPLETE HOME PAINTING BY MI 305 - 895 -1368 Yes Total Valuation: $ 2,500.00 C omments : Re uired Ins ections EXTERIOR PAINTING Final Additional Information Type of Work: Exterior Color: MARITINE WHITE, BROOKLINE BEIGE Additional Info: BRADSTREET BEIGE, HAL 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: 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. Futhermore, I authorize the above -named contractor to do the work stated. Fees Due Amount Invoice Number Amt Due Amt Paid CCF $1.80 PT -12 -05 -23225 $68.90 $68.90 Education Surcharge $0.60 Total: $68.90 Notary Fee $5.00 DEC 2 8 PAID Permit Fee $60.00 Technology Fee $1.50 Total: $68.90 Building Department File Copy NOTICE: In addition to the requirements of this permit, there may be additional restrictions applicable to this property that may be found in the public records of this county. AND THERE MAY BE ADDITIONAL PERMITS REQUIRED FROM OTHER GOVERNMENTAL ENTITIES SUCH AS WATER MANAGEMENT DISTRICTS, STATE AGENCIES, OR FEDERAL AGENCIES. Applicant Signature t Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 w Phone: (305)795 -2204 Fax: (305)756 -8972 �io Permit Permit Status: APPROVED Issue Date: 1212212005 Expires: 12/2212006 Permit Number: PT -12 -05 -1308 Owner's Name: SHAUN D & NADINE M DAVE ROGERS one: (305)756 -7345 Permit Type: Paint Parcel #: 1132060132040 Work Classification: New Block: Lot: Job Address: 121 100 Street NE Section: PB: Miami Shores Village, FL Contractor(s) Phone Primary Contractor Total Square Feet: 0 COMPLETE HOME PAINTING BY MI 305 - 895 -1368 Yes Total Valuation: $ 2,500.00 omments: Re uired Inspections EXTERIOR PAINTING Final Additional Information Type of Work: Exterior Color: MARITINE WHITE, BROOKLINE BEIGE Additional Info: BRADSTREET BEIGE, HAL 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. Fees Due Amount Invoice Number Amt Due Amt Paid CCF $1.80 PT -12 -05 -23225 $68.90 $68.90 Education Surcharge $0.60 Total: $68.90 Notary Fee $5.00 Permit Fee $60.00 Technology Fee $1.50 Total: $68.90 NOTICE: In addition to the requirements of this permit, there may be Finance Copy additional restrictions applicable to this property that may be found in the public records of this county. AND THERE MAY BE ADDITIONAL PERMITS REQUIRED FROM OTHER GOVERNMENTAL ENTITIES SUCH AS WATER MANAGEMENT DISTRICTS, STATE AGENCIES, OR FEDERAL AGENCIES. Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP -4007 Per mit N PT - 12 - -1308 Scheduled Inspection Date: July 20, 2009 Permit Type: Paint Inspector: Bruhn, Norman Inspection Type: Final Owner: ROGERS, SHAUN D & NADINE M DAVE Work Classification: New Job Address: 121 NE 100 Street Miami Shores, FL Phone Number (305)756 -7345 Parcel Number 113206013204 Project: <NONE> Contractor: COMPLETE HOME PAINTING BY MIC HAEL Phone: 305 -895 -1368 Building Department Comments ,EXTERIOR PAINTING Inspector Comments Passed Failed Correction Needed Re- Inspection ❑ Fee a No Additional Inspections can be scheduled until re- inspection fee is paid. July 17, 2009 For Inspections pl se call: (305)762 -4949 Page 30 of 32 Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 BUILDING � � 7t �. Permit No. � 5 . PERMIT APPLICATION 3! 2 2,9, t r Permit No FBC 2001 w ' Permit Type (circle) Building Electrical Plumbing Mechanical Roofing 'Owner's Name (Fee Simp 'tlehold ✓�'2� �,> � _ Phone # _36_ 7:56 Owner's Address �` Zip Ci N 'I 1 � `+?� State Tenant/Lessee Name Phone # a X"Job Address (where the work is being done) f � l 1� - C ) 5 1- 1 City Miami Shores Village County Miami -Dade Zip Is Building Historically Designated YES �' NO Contractor's Company Namec! e (` 1 << r b / / Phone # Contractor's Address City f / State Zip __ 3 - / Qualifier State Certificate or Registration No. Certificate of Competency No. L yy_�z Architect/Engineer's Name (if applicable) Phone # $ Value of Work For this Permit Square Footage Of Work: Type of Work: ❑Addition ❑Alteration ❑New ❑ Repair/Replace El Demolition Describe Work: Submittal Fee $ Permit Fee $ CCF $ CO /CC Notary $ -D Training/Education Fee $ Technology Fee $ SCD Scanning $ Radon $ Zonin Bond $ Code Enforcement $ Structural Plan Review. $ Spo Total Fee Now Due $ Cj C L 1 (Continued on opposite side) Bonding Company's Name (if applicable) Bonding Company's Address - City State Zip , Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State Zip 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 performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC..... 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. "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 BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first 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 fee will be charged. ignature �' �'� Signature c. v Owner or Agent Contractor The foregoing instrument was acknowledged before me this - The fqor5egqmg instrument was a.0mowledged before me this day o , 2(=—�, by u �Z7� $ day of Q 03 by who is personally known to me or who has produced who is personally known to me or who has produced As identification and who did take an oath. i utification and who i , NOTA UBL C: NOTARY PUB IC: ;`p4 °'<' t'r�nunissiun N LIC 0 Q A 1 3, 20 Sign: Sign: d Print:a�. Print: My Comm ssion-Expires: Expires: 20Q9 So ded Thru Atlantic g In:. My Co fission Exp' es: APPLICATION APPROVED BY: ` ZY b /' Plans Examiner Engineer chc 05/13/03 Zoning -I G Agreement Date -_ Phone ' pwner's Name , l2 _ -- z Owners Address C /� r ( City t li') > ��i State Zip .lob Address (where the work is being done) 4 � Citv Miami Shores Village County Miami -Dade zip is Building Historically Designated YES NO Contractor's Company Name (if applicable �_.. - '� -L All elements nn the site must be listed and indicate the Walls t i Fascia r S IB Drip Cap/drip Edge v'- - maritime white 963 Soffit — Roof Flower bins broo" ne beige HC4 I Shutters Awnings Chimne} Doors and door jams !a I Garage doors 2B Railings °t bradstreet bei g e HC -48 Fences Decorative metal All brick (simulated or regular) t Stucco banding - Any other stucco features 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 ail applicable laws regulatutg construction and zoning. D ate I 'S i gnature N Owner or Agent r �1r21�:vTZrI�L p ". Date COC 6/1 9/0. Officia