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PT-09-1410Project Address 154 111 Street Miami Shores, FL 33168 -4323 Owner Information JIAM GONZALEZ Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Address Contractor(s) HOME OWNER Phone Cell Phone Fees Due CCF Education Surcharge Notary Fee Permit Fee Technology Fee Total: Amount $0.60 $0.20 $5.00 $60.00 $1.50 $67.30 Expiration: 02/20/2010 Parcel Number 1121360030450 Block: Lot: 154 111 Street MIAMI SHORES FL 33168- Phone Type of Work: Exterior Color: Additional Info: Classification: Residential Color. _Approved Color. _Approved_ Code Comments: Color: _Denied Invoice # PT - 8 - 09 - 35708 Total Amt Paid Amt Due $ 67.30 $ 67.30 $ 0.00 Applicant JIAM GONZALEZ Cell Available Inspections: Inspection Type: Final l Valuation: $ 1,000.00 Total Sq Feet: 0 For Inspections please call: (305)762 -4949 In consideration of the issuance to me of this permit, :l 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 a :curate 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 Building Department Copy / Contractor August 24, 2009 Agent Date August 24, 2009 1 BUILDING PERMIT APPLICATION FBC 2004 Permit Type: PAINT PERMIT Owner's Name (Fee Simple Titleholder) () I Q fetal 6®I1 r ! e 7 Phone # ri e 2 - 6 3 1 A6 ,r.g* Owner's Address / 3 Air 141, f 1 1 tt Gil. i L 3' City ,./t4 r ct. cau 1' State F (-- Zip 3 3 1 6 S Tenant/Lessee Name Phone # E -MAIL: Job Address (where the work is being done) p A/44,/, (( 1 . 7 City Miami Shores Village County -,FL Miami -Dade 1/" Zip FOLIO / PARCEL # C l 2. 34 0 0 3 — ® O Is Building Historically Designated YES NO Contractor's Company Name Contractor's Address City State Zip Qualifier Name Phone # State Certificate or Registration No. OWNER BUILDER: i t 61, WI cot' Z eIe 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. Master Permit No. Phone # Certificate of Competency No. Uld 2 0 D 4 0 j ®0 r 0 ° Type of Work: ❑ Addition / ❑ Alteration / ['New / [✓�Repair/Replace �. Fit- F 0 cir&q s uv& 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 _ "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. ******** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** F * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Permit Fee $ (40 ' CCF $ © ' 0 Technology Fee: Training/Education Fee $0.19. _/ Notary Code Enforcement $ Double Fee $ Zoning $ Total Fee Now Due $ (01 See Reverse side -> Directions: Please circle corresponding number to appropriate color sample Walls: pi 2 3 4 Fascia: Drip Cap/Drip Edge: _ 1 2 3 4 Soffit: 1 Roof: 1 Flower Bins: 1 2 3 4 Shutters: 1 Awnings: 1 2 Chimney: 1 2 Doors and Door Jams: _l 2 Stucco Banding: Accessory Buildings NOTARY P Sign: Print: My Commission Expires: APPLICATION APPROVED BY: PAINT COLOR APPROVAL AND AGREEMENT All elements on the site must be listed and indicate the color to be painted 2 2 2 3 3 3 3 3 3 1 2 3 Other: 4 4 4 4 3 4 4 4 Garage Doors:_l 2 Railings: 1 2 3 4 Fences: 1 2 3 4 All brick (simulated or regular): 1 2 3 4 Any other Stucco Features:_1 2 3 4 Attach color samples with name and number. 5 'c lf7 1 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 v �i�Liti `� � Signature Contractor The foregoing i The foregoing instrument was acknowledged before me this day ofA, , 20, by ", day of , 20 , by who is personally known to me or who has produced � /' who is personally known to me or who has produced i1? 4 - 1 As identification and w did take an oath. as identification and who did take an oath. (f L, (itt I t, 4■IOTARY PUBLIC: 'iN *.•\-° t ., * , 4- 'va e My Commission Expires: a © "� ' � ' � c,, � Plans Examiner Preservation Board Code Enforcement (Revised 04/24/07) 6 Inspection Number: INSP - 135795 Permit Number: PT -8 -09 -1410 Scheduled Inspection Date: May 04, 2010 Inspector: Bruhn, Norman Owner: BLOCK BANK, H&R Job Address: 154 NW 111 Street Miami Shores, FL 33168 -4323 Project: <NONE> Contractor: HOME OWNER Building Department Comments May 03, 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 Type: Paint Inspection Type: Final Work Classification: New Phone Number Parcel Number 1121360030450 PRESSURE CLEAN AND PAINT EXTERIOR OF THE HOUSE Passed 7 Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments CREATED AS REINSPECTION FOR INSP- 133375. CREATED AS REINSPECTION FOR INSP- 122855. Not Ready Area around door must be completed. NB cc, Page 6 of 11 Scheduled Inspection Date: May 04, 2010 Inspector: Bruhn, Norman Owner: BLOCK BANK, H&R Job Address: 154 NW 111 Street Miami Shores, FL 33168 -4323 Project: <NONE> Contractor: HOME OWNER Building Department Comments May 03, 2010 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP- 135795 Permit Number: PT -8 -09 -1410 For Inspections please call: (305)762 -4949 Permit Type: Paint Inspection Type: Final Work Classification: New Phone Number Parcel Number 1121360030450 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 CREATED AS REINSPECTION FOR INSP- 133375. CREATED AS REINSPECTION FOR INSP- 122855. Not Ready Area around door must be completed. 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