PT-09-1880PAINT EXTERIOR OF THE HOUSE
Passed 6 � y
Inspector Comments
CC-
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled
re- inspection fee is paid.
until
i nspection Number: INSP - 129251
Permit Number: PT -11 -09 -1880 1
Inspection Date: June 14, 2010
Inspector: Bruhn, Norman
Owner: FERNANDEZ, LEONARD
Job Address: 101 NW 107 Street
Miami Shores, FL 33168 -4308
Project: <NONE>
Contractor: HOME OWNER
Building Deuartment Comments
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
June 15, 2010
For Inspections please call: (305)762 -4949
Permit Type: Paint
Inspection Type: Final
Work Classification: New
Phone Number
Parcel Number 1121360100160
Page 1 of 1
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
Owner or Agent Contractor
The foregoin instrument w acknowledged before me this foregoing instrument was acknowledged before me this
day of ' , 20 ( i�;t. k. 0 ( pk,fr V of Vut , 20 , by ' 6 (jL � `g.__
who is personally known to me or who has prod ced who • o me or who has produced
As identification and who did take an oath. : _ _ . = as identification and who did take an oath.
Comrnisslon #i: DD 4..)6152
Bonded By National Nctaiy.Assn.
NOT • Y�,yLZ
s:
Priii wa° �`� ary �ubGt Sate of iu
My Commissio
APPLICATION APPROVED BY:
Chc 05/13/03
NOTARY PUBLIC•
Sign:
Print: �
My Commission tip`i-res
************ * * * * * * * * * * * * * * * * ** * * * * * * * * * * * **
Took Public �P
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/ v yCorrr;Qs ,20 17
C orrlroinilln ,r Fain I /720
* * * * * * * * * * * * * * ** **
Plans Examiner
Engineer
Zoning
Project Address
Miami Shores Village
10050 N.E. 2nd Avenue
Miami Shores, FL 33138-0000
Phone: (305)795 -2204
101 107 Street
Miami Shores, FL 33168 -4308
1121360100160
Block: Lot:
LEONARD FERNANDEZ
Owner Information
Fees Due
CCF
Education Surcharge
Notary Fee
Permit Fee
Scanning Fee
Technology Fee
Amount
$0.80
$0.20
$5.00
$60.00
$0.00
$0.80
Total: $66.60
Building Department Copy
Address
LEONARD FERNANDEZ
101 107 Street
MIAMI SHORES FL 33168 -4308
Valuation:
Total Sq Feet:
$ 1,000.00
Parcel Number
Contractor(s)
HOME OWNER
Phone
Cell Phone
Phone
Type of Work: Exterior
Color:
Additional Info:
Classification: Residential
Color: _Approved
Color: _Approved_
Code Comments: WALLS - LT. YELLOW / FASCIA, C
Color. _Denied
Authorized Signature: Owner / Applicant / Contractor / Agent
Invoice #
PT - 11 - 09 - 36413
Total Amt Paid Amt Due
$ 66.60 $ 66.60 $ 0.00
Expiration: 05/16/2010
Applicant
Cell
For Inspections please call:
(305)762 -4949
Available Inspections:
Inspection Type:
Final
1
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.
November 17, 2009
Date
November 17, 2009 1
BUILDING
PERMIT APPLICATION
FBC 2004
IVliami Shores Village
Building Department
000 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972 Permit No. lYfO
Tenant/Lessee Name Phone #
Master Permit No.
Permit Type: PAINT PERMIT - V/fr/
Name (Fee Simple Titleholder) Q / ' a/V/AR A 1 /eRNPAtch Z / Phone # 3 °5 75/ / /,
Owner's Address /0/ NW /0 7 5/
City Mt/4M1 5 ,'c9$ State /" Zip 33/S
E -MAIL:
Job Address (where the work is being done) /a/ /1/I1 `® 7_3T
T
City Miami Shores Village County Miami -Dade Zip
FOLIO / PARCEL #
NO X
is Building Historically Designated YES
Contractor's Company Name IQ Ou'tko
Contractor's Address
City
Qualifier Name
State Certificate or Registration No. Certificate of Competency No.
State
Phone #
Zip
Phone #
OWNER BUILDER:
Value of Work F hisPPee - m it $ Typerif wo ❑ Ad 'tion / ❑ Alteration / ❑New /Repair /Replace
Describe Work: 1 t — e 0
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 he performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that a separate permit must he secured kw
ELI:C1'RICAI. WORK. PLUMBING, SIGNS, WELLS. POOLS, FURNACES, BOILERS. HEATERS, 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 l'ROPERTY. 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 $2500. the applicant must promise in good that a copy of the
notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also. a certified copy oldie recorded notice
of commencement must he posted al the job site, for the.#rsl inspection which occurs seven (7) days after the building permit is issued in the absence of such posted notice. the
,inspection will not he approved and a reinspection fee will he charged.
x*xxxxxxaxat****' xxdice&******x*****xxxx'kxa' F eesaru'xx ******ic$oY4tde********xrrxx �ex
x*
Permit Fee $ CCF $ Technology Fee:
Training /Education Fee $ • Notary $ Code Enforcemen $-
Double Fee $ Zoning $ Total Fee Now Due $ / / / 0 /' /r!
everse side —�
Directions: Please circle corresponding number to appropriate color sample.
f Walls:
Signature
Fascia:
Soffit:
Roof
Flower Bins:
Shutters:
1
Drip Cap /Drip Edge:
1
Awnings:
Chimney:
Doors and Door Jams:
Garage Doors: 1
Railings:
Fences: 1
AIJ brick (simulated or regular):
Stucco Banding:
Any other Stucco Features:
Accessory Buildings
owner or Agent
The fbreg in instrtment • ti apl:howledged
day of . 20 6. y
is perc ally known to me
PAINT COLOR APPROVAL AND AGREEMENT
All elements on the site must be listed and indicate the color to be painted
2
2
fore m
has p+uduced
3 4
3 4
3 4
3 4
3 4
3 4
3 4
3 4
3 4
3
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.
/. and w did take an oath.
NOTARY 1 1 ' ' I I �• „ NOTARY PUBLIC:
Sin: 1 ti-
■ . L � � $>>og n:
g .a
+
Print: � � "4. 'Q1V tot a`
My Commission Expires: 4 c�0��g Commission Expires:
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itV
APPLICATION APPROVED BY: Plans Examiner
4
4
4
4
Signature
Contractor
e foregoing instrument was acknowledged before me this
. 20 . by
s personally known to me or who has produced
as identification and who did take an oath.
Attach color samples with name and
number.
Preservation Board
t tllSmok-Co
Code Enforcement
(Revised 04/24/0