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PT-09-1457 Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 �H�� % /�SY�3Hf s r fw'✓/rE� �� Phone: (305)795 -2204 sfa� yy 6R > Expiration: 0311312010 Project Address Parcel Number Applicant _ 280 107 Street 1122310130460 TAMARA TOMA Miami Shores, FL Block: Lot: Owner Information Address Phone Cell TAMARA TOMA 280 N. E. 107 ST. (300)575 -7806 Contractor(s) Phone Cell Phone Valuation: $ 1,000.00 HOME OWNER Total Sq Feet: 0 Type of Work: Exterior For Inspections please call: Color: (306)762 -4949 Additional Info: Available Inspections: Classification: Residential Inspection Type: Color: Approved Code Comments: WALLS, GARAGE DOOR, RAILIN( Final Color: . Cor. _Denied Fees Due Amount Invoice # Total Amt Paid Amt Due CCF $ PT -9-09 -35770 $ 62.30 $ 62.30 $ 0.00 Education Surcharge $0.20 Permit Fee $60.00 Technology Fee $1.50 Total: $62.30 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 September 14, 2009 Authorized Signature: Owner / Applicant / Contractor / Agent Date Building Department Copy September 14, 2009 1 Miami Shores Village : ry al �� Bui lding Department S-1EP 0 Mg sqk 1.0050 N.L;.2nd AVenue, Miami Shores, f lorida 33138 BY: _ -- - - - -- Tel: (3G5) 795.2204 Fax: (305) 75E.8972 .BUILDING Permit No. PERMIT APPLICATION Master Permit No. FBC Permit Type: PAINT PERMIT Owner's Name (l=ee Simple Titleholder) _ - A A4A / To Phone # 3p5 Owner's Address C tVC /67 6 _ City ,t4j&41 vfj 5 State �L Zip 33 i to l Tenant /Lessee Name Phone # E -MAIL: -- Job Address (where the work is being done) 4 8 0 Ng - JO7 _5T. City, Miami Shores Village County Miami -Dade Zip 3 [L,i FOLIO / PARCEL # j l - a2-3i - 013- 0z+41D / Is Building Historically Designated YES NO Y Contractor's Company Name _ nom Phone # Contractor's Address City_ State Zip Qualifier Name Phone # State Certificate or Registration No. Certificate of Competency No. OWNER BUILDER: � j)1 -115 2 (,cl t t__ G_ P A•1 'y - 7 - Value of Work For this Permit $- W Type of Work: ❑ Addition / ❑ Alteration / ❑New to ❑ Repair /Replace Describe Worlc: hA' /NT E X7 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 or permit and that all work will be performed to.meet the standards of all laws trgulaling constriction in this jurisdiction. I understand that a separate permit must be secured liar Ell:C•TRIC•AI. WORK. PLUMBING, SIGNS, WELLS. POOLS, I "URNACE ?S, BOILERS. HEATERS. TANKS and AIR CONDITIONERS, ETC..... "WARNING TO OWNER: YOUR FAiL,URE TO RECORD A NOTICE OF COMMENCEMENT MAV 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. I pplicant: as a condition to the issuance qfo building perrnit with an estimated value exceeding $ 2500. the applicant must promise in good faith that a copy of the notice of conunencement and construction lien low brochure will be delivered to the person whose property is subject to attachment. Also, a ceriiJied copy gfthe recorded notice qJ comnte nceuren! ntusi be posted at the job site , for ihe inspection which occurs seven (7) days alter the building permit is issued In the absence cif such posted notice. the inspection will not be approved and a reinspection fee 144/1 be charged. � *� *�� * *� *�� * ��:�,. * �, t* ��,>< �r*** �* � . r* FP, eS�aa* �* t *,r * * *�r * *s�r� *��r,r *�� / �� r��,t *�•xr�tx,: * ** Permit Fee$ W-co CCF$ l.J'�O Technology Fee: D Training /Education Fee $ 040 Notary $ Code Enforcement $ Double Fee $ Zoning $ Total Fee Now Due 3EP `- PAI See Reverse side -> PAINT COLOR APPROVAL AND AGREEMENT All elements on the site must be listed and indicate the color to be tainted Directions: Please circle corresponding number to appropriate color sample. walls: 1 2 3 4 Atta ci;l4lir samples with name and Fascia: 1 2 3 4 r " r Drip Cap/Drip Edge 1 2 4 -� Soffit: 1 2 3 4 Roof: 1 2 3 4 Flower Bins: I 2 3 4 I Shutters: 1 2 3 4 Awnings 1 2 3 4 ` Chimney: I 2 3 4 I Doors and Door .lams: 1 2 3 4 Garage Doors: I 2 3 4 Railings: l 2 3 4 Fences: 1 .2 3 4 All brick (simulated or re(ular 1 2 3 4 Stucco Banding: 1 2 3 4 i Any other Stucco Features: 1 2 3 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 applicable laws regulating construction and zoning. Signature W - Signature Owner or Agent Contractor The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this day of _ 20 _. by day of 20 _. by who is personally known to me or who has produced who is personally known tome or who has produced As identification and who did take an oath. as identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Sign.: Sign: — Print: Print: My Commission I :xpires: My Commission Expires: izr. xiezicxi:4ic ie *xirx *x:•k oYxeY Y� *at *r. *xa: 9r vY Y�xeY at eYx9t it$•k atr eYx4e Jc �Y aexxeY Y e:dc *a4xi:Fa:a'r 4r 4e iFxat s: at at 4c * *�k9:vYf.�•k'k ie�n:�tY t&i: xk ie k QexnY it it a: kzx APPLICATION APPROWI;D BY: Plans E?xarniner Preservation Board " 1• i Code Ealorc:ement (Revised 64/24101 PAINT COLOR APPROVAL AND AGREEMENT Ail 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: 1 2 3 4 number, Drip CapMrip Edge: 1 2 3 4 Soffit: 1 2 4 1 Roof: l 2 3 4 Flower Bins: 1 2 3 4 Shutters: 1 2 3 4 Awnings: 1 2 3 4 2 Chimney: 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: 2 3 4 All brick (simulated or regular). 1 2 3 4 Stucco Bandin 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 :com VaR licable laws regulating construction and zoning. Sign Signature t Contrac tor The foregoing in was ackno edged before me this The foregoing instrument was acknowledged before me this day of 20 03 , by 71�m afi j b rna. day of , 20 _, by , who is personally known to me or who has produce _ who is personally known to me or who has produced ?� As i cation and who did take an oath. as identification and who did take an oath. NOTARY P I ' NOTARY PUBLIC: Sign: Pritt: N J f P My Commission Expires: CWwm SON ion Expires: COMNAWN tom+ se, ase�rvr�r�r* �rt, enax: o- * *,x�rsat,r�r�r�r,r�r,�,u�,t�r wxr��r,�,tra�ta�r�rsrr *r�r �arr�r * *� APPLICATION APPROVED BY: Plans Examiner Preservation Board Code Enforcement (Revised 04124!07) Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP- 123494 Permit Number: PT -9 -09 -1457 Scheduled Inspection Date: February 23, 2010 Permit Type: Paint Inspector: Bruhn, Norman Inspection Type: Final Owner: TOMA, TAMARA Work Classification: New Job Address: 280 NE 107 Street Miami Shores, FL Phone Number (300)575 -7806 Parcel Number 1122310130460 Project: <NONE> Contractor: HOME OWNER Building Department Comments PRESSURE CLEAN AND PAINT EXTERIOR OF THE HOUSE Inspector Comments Passed Y Failed Correction ❑ Needed Re- Inspection ❑ Fee No Additional Inspections can be scheduled until re- inspection fee is paid. February 22, 2010 For Inspections please call: (305)7624949 Page 5 of 26 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP- 123494 Permit Number: PT -9 -09 -1457 Scheduled Inspection Date: February 23, 2010 Permit Type: Paint Inspector: Bruhn, Norman Inspection Type: Final Owner: TOMA, TAMARA Work Classification: New Job Address: 280 NE 107 Street Miami Shores, FL Phone Number (300)575 -7806 Parcel Number 1122310130460 Project: <NONE> Contractor: HOME OWNER Building Department Comments PRESSURE CLEAN AND PAINT EXTERIOR OF THE HOUSE Inspector Comments Passed Failed Correction ❑ Needed Re- Inspection ❑ Fee No Additional Inspections can be scheduled until re- inspection fee is paid. February 22, 2010 For Inspections please call: (305)762 -4949 Page 5 of 25