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PT-10-236 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP - 135681 Permit Number: PT -2 -10 - Scheduled Inspection Date: February 23, 2010 Permit Type: Paint Inspector: Bruhn, Norman Inspection Type: Final Owner: INTOYAN, HMAYAK Work Classification: Addition /Alteration Job Address: 85 NW 102 Street Miami Shores, FL Phone Number Parcel Number 113101018008 Project: <NONE> Contractor: HOME OWNER Building Department Comments 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 12 of 25 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP- 135681 Permit Number: PT -2 -10 -236 Scheduled Inspection Date: February 23, 2010 Permit Type: Paint Inspector: Bruhn, Norman Inspection Type: Final Owner: INTOYAN, HMAYAK Work Classification: Addition /Alteration Job Address: 85 NW 102 Street Miami Shores, FL Phone Number Parcel Number 113101018008 Project: <NONE> Contractor: HOME OWNER 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. February 22, 2010 For Inspections please call: (305)762 -4949 Page 12 of 25 Miami Shores Village 1 lax 9 713 HE Building Department FEB 1 0 10 10050 N.l2nd AVenUe, Miami Shores.. Florida 33138 Tel: (305) 79`;.2209 Fax: (305) 756.8972 :...... ..... ... BUILDING Permit No. T — �O►p PERMIT APPLICATION Master Permit N o. FBC 2004 Permit Tyre PAINT PERMIT Owner's Name (Fee Simple Titleholder) � i �^/ Phone # Owner's Address 1,2 City State _ /.moo Zip 3,3323 Tenant /Lessee Name Phone # GIViA1L: Job Address (where the work is being done) $ _ Aj ze 2 S: City ___. Miami Shores County Miami -Dade Zip 331 5 a FOLIO / PARCEL # Is Building Historically Designated YES NO Contractor's Company Name _ t_/i yI< C; / /)� Phone # � n2v ,4 X6ot Contractor's Address City__ _ _ State Zip Qualifier Name Phone # State Certificate or Registration No. Certificate of Competency No. OWNER BUILDER: Value of Wort. For this Permit $ �0. W Type of Work: ❑ Addition / ❑ Alteration / ❑New / ❑ Repair /Replace Describe Work: 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 pennit and that all work will be performed to meet the standards of all laws regulating construction in this iurisdiction. I understand that a separate pennit must be secured lit FLIVTRICAI. WORE. 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 VOUR LENDER OR AN ATTORNEY BEFORL RECORDING YOUR NOTICE OF COMMENCEMENT." Notice to.1 pp1 ic•anl: :T.s a condition to the issuance gl'u building hertnil with an estimated value exceeding x2500. the applicant nrlrst promise in gocxlfcrith that a cnpv of the notice of corumencemenl and construction lien law brochure will be deliverer! to the person whose property is subject to attachment. Als2 a certified copygf the recorded notice of conunencement nurse he posted at the job site for the inspection which occurs seven (7) days after the building permit is issued.d in the absence of such posted notice. the inspection ivill not he approved and a reinspeclion fee will be charged. Permit Fee $ CCF $ Technology Fee: . Training /Education Fee $ Notary $ Code Enforcement $ Double Fee $ Zoning $ Total Fee Now Due 1; '10� `� 111110 Q�� 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: I 2 3 4 Attach color samples with name and Fascia: I 2 3 4 number. Drip Cap /Drip Edge: 1 3 4 �G.�/�i1✓�.P� / ®5 Soffit I 3 4 Roof: 1 2 3 4 E Flower Bins 1 2 3 4 Shutters: I 2 3 4 Awnings 1 2 3 4 2 Chimney: 1 2 3 4 Doors and Door,lams: 1 2 3 4 Garage Doors: _ 1 _ 2 3 4 Railin I 2 3 4 3 Fences: 1 2 3 4 All brick (simulated or rqyular ): 1 2 3 4 Stucco Banding: l 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 a applicable laws regulating construction and zoning. Signatui Signature Owner or Agent ��tuulu ►U1111i Contractor The foregoing instrument was ac know\pt1' e�eq�trl'�te.tne thi The foregoing instrument was acknowledged before me this day of _ Ff_L �17 .20 by day of 20 _. by who is personally known to me or 141491i4*1cs who is personally known to me or who has produced As iclentific, u.dQ I �Ex tt as identification and who did take an oath: NOTARY PUBLIC: NOTARY PUBLIC: Sign: ( %?'�c —'- ��� Sign: _ ►�rn Princ Print: My Commission I:ixpires: My Commission Expires: APPLIC'A'TION APPROVED BY: Plans Examiner Preservation Board Code Enlorcement (Revised 04 /24/0.