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PT-09-1496 3 Miami Shores Village a E rz 3Y� 10050 N.E. 2nd Avenue n Miami Shores, FL 33138 -0000; Phone: (305)795 -2204 �3 2 . ref Expiration: 0/10/2999 Project Address Parcel Number Applicant 173 108 Street 1121360100260 Miami Shores, FL 33168 -4312 Block: Lot IRMIDE VALCIN Owner Information Address Phone Cell IRMIDE VALCIN 173 108 Street MIAMI SHORES FL 33168 -4312 )z Contractor(s) Phone Cell Phone Valuation: $ 1, 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: BEHR - WALLS - VANILLA CONE Final Color. Approved_ Color. _Denied Fees Due Amount Invoice # Total Amt Paid Amt Due CCF $ PT -9-09 -35854 $ 67.30 $ 67.30 $ 0.00 Education Surcharge $0.20 Notary Fee $500 Check #: 1770 Permit Fee $60.00 Technology Fee $1.50 Total: $67.30 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. 1 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. September 30, 2009 Authorized Signature: Owner / Applicant / Contractor / Agent Date Building Department Copy September 30, 2009 1 �S 1 Miami Shores Z Village w � g � B uildzng Department SEP 0 8 2009 100)0 N.!_;.2nd Avenue. Miami Shores, Florida 33134 Tel: (305) 795.2204 Fax: (305) 756.8972 BY:. - - -- BUILDING Permit No. KT 04P�cp PERMIT APPLICATION Master Permit No. FBC Permit Type: PAINT PERMIT Owner's Name (Fee Simple Titleholder) _ EMI VALLI Phone # Owner's Address ` b_ N W t 0 4, aA City+kk ltu Bti`� State �1�, Zip Tenant /Lessee Name Phone # E -MAIL: �� •'�- �`V - t: ("ov�iC(!, - "�� (Jac` Job Address (where the work is being done) l 3 N J 1 0 tj S - city Miaini Shores Villa <ge County Miami -Dade Zip FOLIO / PARCEL # is Building Historically Designated YES NO Contractor's Company Name t(,(� ��/ Phone # Contractor's Address City__ State Zip T Qualifier Name Phone # State Certificate or Registration No. Certificate of Competency No. OWNER BUILDER: Value of Work For tit i ermit $ L a e Type of ork: ❑ ddition I ❑Alteration / ❑ 1'w / epa Replace Describe Work: O Application is hereby niade to obtain a I rntit 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 (hat all work will be performed to meet the standards of all laws regulating construction in this iurisdiction. I understand that a separate permit must he secured 14. El,l- iCTR1CAl WORK. Pf,UMBING, SIGNS. WEIJ,S. POOt,S, PURNACI S, BOILER& 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 PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSUL7"WI"I YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF CONIMENCEMENT." Notice lo. . I pplicani: as a condition 101111' issuance qfa building permit with an estimated value exceeding $ 25M, the al)plicant must promise in goadfailb that a copy of the notice of commencement and construction lien lasv brochure will be delivered to the person whose property is subject to attachment. also. u certified copy elf the recorded notice of conunencenteni must be posted at the job sire for the firs! 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 be charged. Permit Fee $ CCF v Technology Fee: Training /Educatign Fee$ ' 010 Notary $ �. Code Enforcement $ Double Fee $ Zoning $ Total Fee Now Due $ � SEP 0 s PAID 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 number to appropriate color sample. Walls: l 2 3 4 Attach color _ Fascia: 1 2 3' 4 Drip Cap /Drip Edge: L 2 3 4 Soffi - -- _ —I -� - -- , 4 Roof 3 4 Flower Bins: 1 2 3 4 Shutters 1 2 3 4 Awnings 1 2 KIw 3 4 Chimney: I 2, ` 3 4 6YDWY) Doors and Door - Tarns: I 2 , Wit - 4 Garage Door s. _ I __ 2K 3 4 Railings: I 1 Q 4 - - Fences: 1 3 4 1► r All brick (Sinutlated or re(ular I 2 3 4 Stucco Banding: I 2 3 4 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 compliance with all applicable laws regulating construction and zoning. Signature Vd ) 6 G^A— Signature Owner or Agent Contractor The fo min inst umen was a • cnowle red befo e met i; The foregoing instrument was acknowledged before me this_ day of' _ �y _ M&, day of . 20 — , by who is 3er 'xtally kno/w'nn (o time or who has pioduced� who is personally known to me or who has produced tQ�ktl�nt n an who did take ati C%% I F as identification and who did take an oath. NO NOTAR BL C: ��`t' ti� TARY PUBLIC: 1 y Sign: on Print: _ _ Print: My Commission 1 -.xpires: T f t• My Commission Expires fr -fff iefffffffffffffieffff *fiaffffat x�i ffffffffff�: fffffdrfieffffffat& fatfatffffffffffffffff :ffffffatffffffff APPLICATION APPRQVI?D BY: Plans Examiner Preservation Hoard Code (Abrcement (Revised 04 /24/0; A Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP- 123993 Permit Number: PT -9 -09 -1496 Scheduled Inspection Date: March 09, 2010 Permit Type: Paint Inspector: Bruhn, Norman Inspection Type: Final Owner: VALCIN, IRMIDE Work Classification: New Job Address: 173 NW 108 Street Miami Shores, FL 33168 -4312 Phone Number Parcel Number 1121360100260 Project: <NONE> Contractor: Building Department Comments Inspector Comments Passe J ` eLf Failed Correction ❑ Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. March 08, 2010 For Inspections please call: (305)762 -4949 Page 2 of 34 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP- 123993 Permit Number: PT -9 -09 -1496 Scheduled Inspection Date: March 09, 2010 Permit Type: Paint Inspector: Bruhn, Norman Inspection Type: Final Owner. VALCIN, IRMIDE Work Classification: New Job Address: 173 NW 108 Street Miami Shores, FL 33168 -4312 Phone Number Parcel Number 1121360100260 Project: <NONE> Contractor: Building Department Comments Inspector Comments Passed El Failed Correction Needed Re- Inspection ❑ Fee No Additional Inspections can be scheduled until re- inspection fee is paid. March 08, 2010 For Inspections please call: (305)762 -4949 Page 2 of 34