PT-10-58 »y
ON
Miami Shores Village „� 5 ,�,,� 171tjf <Pl�ttllt
10050 N.E. 2nd Avenue
Miami Shores, FL 33138 -0000
Phone: (305)795 -2204 r
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., X1110 Expiration: 07/121201
Project Address Pa rcel Number Applicant
F 268 102 Street 1132060134720
MICHAEL STOCK
' Miami Shores, FL 33138 Block: Lot:
Owner Information Ad _ Phone Cell
MICHAEL STOCK . , �..._, m.....,,.�...m_..___�,.N »_..�.. 268 102 Street � �~ _...�_ ..,......_.
MIAMI SHORES FL 33138 -2427
Contractor(s) Phone Cell Phone Valuation: $ 1,000.0 0
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, CHIMNEY - PINK / FASCI Final
Color: _Approved_ Color: _Denied
Fees Due Amount Invoice # Total Amt Paid Amt Due
CCF $0.60 PT -1 -10 -36817 $ 66.60 $ 66.60 $ 0.00
Education Surcharge $0.20
Notary Fee $5.00 Check #: 9049
Permit Fee $60.00
Technology Fee $0.80
Total: $66.60
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 14, 2010
Authorized Signature: Owner / Applicant / Contractor / Agent Date
Building Department Cop
January 14, 2010 1
Miami Shores Village
e
1.
Building Department
JAN 12 11
10050N.F.2nd Avenue, Miami Shores. Florida 33138 ' By:........�.........
Tel: (305) 795.2204 Fax: (305) 756.8972
BUILDING Permit --
PERMIT APPLICATION Master P"iti
FBC 2004
ti
Permit Type: PAINT PERMIT ;
Owner's Name (Fee Simple Titleholder) A — Phone # 75 7.S J
Owner's Address L) ess �- Z, to
re S� t
City — . `" . State Zip
Tenant/Lessee Name Phone #
E-MAIL: -- _ -L _ . t4j C.. 12. /J C
Job Address (where the work is being; done)
City Miami Shores Village County Miami -Dade Zip
FOLIO / PARCEL #
Is Building Historically Designated YES NO
Contractor's Company Name ; Phone #
Contractor's Address
City_ Zip
Qualif er Name Phone #
State Certificate or Registration No. Certificate of Competency No.
OWNER BUILDER: 1 v G 1\
t r 1 t
Value of Work For this Permit S Type of Work: ❑ Addition / [j Aiteratidn 1' 0Ne'1a)t-0Re�ir /Replace '
Describe Work: j? CA,
III 'I A A 't
Application is hereby made to ottain a permit to do the work and installations ac indicated. 1 to ttythftjjPwork or installation has oo m ttinccd prior to the is ice of a pemtu
and that all w(wk will be perl'ont d to meet the standards of all laws regulating constnicuaj nt 5 jurisdiction. I ynderstand that a separate i
y �,
ELECTRICAL WORK. PLUMBING. SIGNS, WELLS. POOLS, FURNACES, BOILERS. HEATERS. T/WKS Jff w f IR.NNOt' )WERS. c'3'C" .... h 1 t' l ; r
"WARNING TO OWNER: YOUR FAILURE. TO RECORD A NOTICE OF COMMFNC,iF,*F, f Y RESULT�; N VPAYIft TWICE FOR
IMPROVEMENTS 7'O YOUR PROPERTY. IF YOU INTEND '1'O OB'T'AIN FINANCINt;, CANS 11' l" .I Rns , #TTt€I+RidIEY f)<ESp(ftk
RECORDING YOUR NOTICE OF COMMENCEMENT." `'�
Notice to : I ppl icamt: .4s it condition to the issuance ol'a building pertnii with an estimated value eaceedtng $2300 . the auplicanl mars, pramive in gv)od faith shat ar Lvyn' cif ttic
notice of conrntencenzenl and c0nsiructiat lien lair• brochure will be delivered to the person whose property is subject 10 rxttach nt. Alsti. a certified try Ofihe ra arrded noticx
gf commencement must he posted at the job site_f nr the inspection which occurs seven (7) days af7er the building permit is tamed tit the'dbse a t{f. # ieatnctiits. tlir
inspection trill not be approi ed and a reinspection,fee trill be charged.
Permit Fee S -_ -_� CCF S 0 Technol[M Fee:
Training /Education Fee S Notary S Code Enforc S
Double Fee S Zoning $ Total Fee Now Due = - - -� W —
See Reverse side - ►
PAINT COLOR APPROVAL AND AGRtEMENT
All elements on the site must be listed and indicate the color to be painted
Directions: lease circle corresponding number to appropriate color sample.
Eye .�
Wall :: ' ' `� AtWebvaikir sot PW wide name and
Fascia: 1 2 3 4 `
Drip Cap /Drip Edge: 1 2 3 4
-- 1
Soffit- 2 4 �
Roof I ; 4
Flower Bins: 1 3 4
Shutters: l LA 3 4
Awnings: 1 2 3 4
Chimney I 2 3 4
Doors and Door .lams 1 2 "; 4 1
1
Garage Doors: I 2 •3 4 -
Railin -;s I 2 3 4 3
Fences: 1 2 3 4..
All brick (simulated or regular 1 2 3 4
Stucco Banding: 1 2 3 4
Anv other Stucco Features l 2 3 4
.-- 4
Accessory Buildings Other:
OWNER'S AFFIDAVIT: t certify that all the foregoing information is accurate and that all work will to done in
compliance with all applicable laws regulating construction and - 'zoning.
Y �
Signature Signature
Owner or Agent Contractor
The for m o j instrument was ackn led ed het? a me 's The foregoing instrument w�isackhowiedged before me this
day of �,. 20. by of 20 _ by
wh is p 12,00A rsonall , I wn to me or who has produced 'ho is per -=ally known to me or who htus produced
a id tid c+utio <u l w h id take m oath. as identification and who did take an oath.
NOTARY 1 -- — + NOTARY PUBLIC:
Sign: Sign:
1
Print: _,__ '�,�C Print
My Commission Expires: l'� ®�� „ "• ,,C luty Commi;sioa Expires:
$a:Y * #iFkie ik it *•k•kst *e,4r 4e et4r *9tr * * * #halr �itit #de iairAA *iRdkktdbiFil6 dk* sr# rtaAtdrwl kitrtrk, tdl+ t9t,l 4riretiealb ,t�ik ^h*te'Ar�kttlriktie #k #1F kkaf *trie Ye+kir* #etlr*
APPLICATION APPROVED RY: 1 Planilrxeminer
Preservation Board
Code FAif'(mx mien(
{Revised 04n410 r
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection N INSP- 133333 Perm N u m ber : PT- 1 - 10 -5
Scheduled Inspection Date: March 30, 2010 Permit Type: Paint
Inspector: Bruhn, Norman
Inspection Type: Final
Owner: STOCK, MICHAEL Work Classification: New
Job Address: 268 NE 102 Street
Miami Shores, FL 33138- Phone Number
Parcel Number 1132060134720
Project: <NONE>
Contractor: HOME OWNER
Building Department Comments
paint exterior of the house
Inspector Comments
Passed.,
J
Failed
Correction ❑
Needed
Re- Inspection ❑
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
March 29, 2010 For Inspections please call: (305)762 -4949 Page 7 of 16