PT-09-1705Project Address
169 110 Street
Miami Shores, FL 33161-
Owner Information
RUTH & ALFREDO MORALES
Miami Shores Village
10050 N.E. 2nd Avenue
Miami Shores, FL 33138-0000
Phone: (305)795 -2204
Fees Due
CCF
Education Surcharge
Miscellaneous Fee
Notary Fee
Permit Fee
Scanning Fee
Total:
Amount
$0.60
$0.20
$1.50
$5.00
$60.00
$0.00
$67.30
Address
Parcel Number
1121360030510
Block: Lot:
169 110 Street
MIAMI SHORES FL 33168 -4320
Type of Work: Exterior
Color.
Additional Info:
Classification: Residential
Color. _Approved
Color: _Approved_
Code Comments:
Color. Denied
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.
Authorized Signature: Owner / Applicant / Contractor / Agent
Building Department Copy
October 16. 2009
05
Pew T ;De Paint
k 1c catior .ldew
I Status PROVED
fi«t:. Expiration: 04/1 010
Phone
Applicant
Valuation:
Total Sq Feet:
Invoice #
Total Amt Paid Amt Due
PT -10-09 -36170 $ 67.30 $ 67.30 $ 0.00
. October 16, 2009
Date
RUTH & ALFREDO MORALES
CeII
$ 1,000.00
0
' For Inspections please call:
(305)762 -4949
Available Inspections:
Inspection Type:
Final
1
1
BUI.LD
PERMIT APPLICATION
FBC 2004
Permit Type: PAINT PERMIT
Owner's Name (Fee Simple Titleholder) FAAA \NI 0 rC1•Aq 1 Phone #
ka 9 KO U0
Owner's Address
City
Tenant/Lessee Name
E -MAIL:
Job Address (where the work is being done)
City Miami Shores Village County Miami -Dade
FOLIO / PARCEL #
Is Building Historically Designated YES
Contractor's Company Name
Contractor's Address
City
Qualifier Name
OWNER BUILDER:
Value of Work For this Permit $
Describe Work:
Miami Shores Village
Building Department
10050 N.E 2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
Permit No.r " nl s
Master Permit No.
State •
_AB
NO
State
Zip j3) S-
Phone #
Zip
OMOMEVIE
uLT
Zip
Phone #
State Certificate or Registration No. Certificate of Competency No.
Type of Work: ❑ Addition / ❑ Alteration / ['New / ❑ Repair /Replace
Application is hereby made to otlain a permit to do the work and installations as indicated. 1 certiI\ thatno work or installation has commenced prior to the issuance or 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 for
ELECTRICAL. 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 TWICC FOR
IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BCFOR[
RECORDING YOUR NOTICE OF COMMENCEMENT."
Notice to Applicant: .4 s a condition to the issuance of a building pertnit 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 Yulice
of commencement must he posted at the job site for Ihe,firsl inspection which occurs seven (7) days after the building permit is issued In the absence of such posted notice' the
inspection will rtol he approved and a reinspeclion fee will he charged.
xx* xxxxxx x4 y xxx�Yxxxxxx�YxxxxxxeYaYtie****i *** Feesxx&* k9raro:**** ie4eie' ir** **dr'*xxxxx -
'xx
Training/Education Permit Fee $ WOO CCF $ n • 0 Technology Fee:
Notary �Q Code Enforcement $
inin /Education Fee $ Na $
a g 0 �O Y r ,, ,
Double Fee $ Zoning $ Total' *ee Now Due $ e01 30
See Reverse side -,
Directions: Please circle corresponding number to
Walls: 2 3
Fascia: 1 3 4
4
Soffit: L 3 4
Roof: 1 3 4
4
4
4
4
4
Garage Doors: I 2 3 4
Railings: 1 2 3 4
Fences: 1 2 3 4
Flower Bins:
Shutters:
Awnings:
Chimney:
Doors and
Drip Cap /Drip Edge: 1
Door Jams:
All brick (simulated or regular):
Stucco Banding: . 1
Any other Stucco Features:
2
Accessory Buildings ccX N Other:
OWNER'S 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.
Signature ( �.1,�..1;IL 7 9 40 7 a Signature
Owner or Agent Contractor
The foregoing instrument was acknowledged before me this_
day of 5 4[ r 'py ► .. y fit .± day of . 20 T by
who is ,e sonally known me or who has produced who is personally known to me or who has produced
') '201 • ntiJica ion an who did take an oath. as identification and who did take an oath.
NOTA Y 1' 1 rrr1I I NOTARY PUBLIC:
Sign: ` ►1 J JJ� Sign:
Print: Print:
. My Commission Expires: My Commission Expires:
The foraii i Irume t was a • ;yy wl ged h ore
PAINT COLOR APPROVAL AND AGREEMENT
All elements on the site must be listed and indicate the color to be painted
3
3
2 3
appropriate color sample.
Attach c es with name and
er.
APPLICATION APPROVE[) BY: Plans Examiner
Preservation Board
r O Code Enforcement
(Revised 04 /24/0+
Inspection Number: INSP - 127210
Scheduled Inspection Date: April 15, 2010
Inspector: Bruhn, Norman
Owner: MORALES, RUTH & ALFREDO
Job Address: 169 NW 110 Street
Miami Shores, FL 33161-
Project: <NONE>
Contractor: HOME OWNER
Building Department Comments
PRESSURE CLEAN AND PAINT EXTERIOR OF THE
HOUSE
Passed `/
Failed
Correction
Needed
Re- Inspection
Fee
April 14, 2010
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspector Comments
For Inspections please call: (305)762 -4949
Permit Number: PT -10 -09 -1705
Permit Type: Paint
Inspection Type: Final
Work Classification: New
Phone Number
Parcel Number 1121360030510
Page 3 of 18
Inspection Number: INSP - 127210
Scheduled Inspection Date: April 15, 2010
Inspector: Bruhn, Norman
Owner: MORALES, RUTH & ALFREDO
Job Address: 169 NW 110 Street
Miami Shores, FL 33161-
Project: <NONE>
Contractor: HOME OWNER
Building Department Comments
PRESSURE CLEAN AND PAINT EXTERIOR OF THE
HOUSE
Passed
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Inspector Comments
April 14, 2010
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
For Inspections please call: (305)762 -4949
Permit Number: PT -10 -09 -1705
Permit Type: Paint
Inspection Type: Final
Work Classification: New
Phone Number
Parcel Number 1121360030510
Page 3 of 18