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PT-08-2044 y y/ WO W' r Miami Shores Village g M 10050 N.E. 2nd Avenue h � � x E eF Miami Shores, FL 33138-0000 ,,g� Phone: (305)795 -2204y N h 1 Expiration: 061011 A Project Address Parcel Number Applicant 118 NW 103 Street 1131010220030 Miami Shores, FL 33150 Block: Lot: BRIDGET COLEMAN Owner Information Address Phone Cell BRIDGET COLEMAN 118 NW 103 Street MIAMI SHORES FL 33150 -1236 Contractor(s) Phone Cell Phone Valuation: $ 1, HOME OWNER Total Sq Feet 0 Type of Work: Exterior Available Inspections: Color: Inspectio Ty pe. Additional Info: Final Classification: Residential Color: Approved Code Comments: WALLS - BROWN / BRICK, Color: Approved_ Color: Denied Fees Due Amount Total Amt Paid Amt Due CCF $0 Education Surcharge $0.20 $ 0.00 $ 0.00 $ 0.00 Permit Fee $60.00 Technology Fee $1.50 Payment Type: Total: $62.30 C1 fed ® PAID 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 1 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 December 03, 2008 Authorized Signature: Owner / Applicant / Contractor / Agent Date Building Department Copy Wednesday, December 3, 2008 1 k 9 Miami Shores Village P M Building Department m�z, 10050 NE 2 nd Ave Miami, F133138 (305)795 -2204 (ph); (305)756 -8972 (fax) ATTENTION YOUR PAINTING PERMIT REQUIRES A FINAL INSPECTION FROM THE BUILDING DEPARTMENT. This permit is valid for 180 days. If it is not finalized during this period of time, the permit will expire, and it will require payment of a renewal fee to reinstate it and to be able to call final inspection to close the permit. PLEASE, WHEN FINISH YOUR PAINTING; CALL THE BUILDING DEPARTMENT AT 305- 795 -2204 TO SCHEDULE YOUR FINAL INSPECTION IN ORDER TO CLOSE YOUR PERMIT. Owner or contractor's signature Thank you for your cooperation Miami Shores Village 2 4 2308 Building Department !- 100.50 N.E.2nd Avenue, Miami Shores, Florida 33135 Tel: (305) 795.2204 Fax: (305) 756.8972 BUILDING Permit No. PERMIT APPLICATION Master Permit No. FBC 2004 Permit Type PAINT PERMIT Owner's Name (Fee Simple Titleholder) L ��+ �,�—d— ;�T Phone # Owner's Address City Vn&r D Stat Zip ':'S I so Tenant/Lessee Name Phone # E- MAIL: Job Address (where the work is being done) City Miami Shores Village County Miami -Dade Zip FOLIO 1 PARCEL # Is Building Historically Designated YES NO Contractor's Company Name Phone # Contractor's Address city_ State Zip Qualifier Name Phone '# State Certificate or Registration No. Certificate of Competency No. OWNER BUILDER: t Value of Work For this Permit S Type of Work: ❑ Addition 10 Alterat6 f 'tINe* It 0 It ' it /ReMace Describe Work: Application is hereby made to obtain a permit to do the work and installations as indicated. 1 certify that no work or installation has price M the issuence of a permit and that all work will be wromied to meet the standards of all laws regulating construction in this jurisdiction. 1 uitderstand that a penV*'+ st tlq tip ELECTRICAL WORK. PLUMBING, SIGNS, WELLS. POOLS. FURNACES, BOILERS, HEATERS, TANKS And AIR CONUTIONERS, ETC.... '` "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOT � MA RESU IN . a PAVOW 't'WIcF FOR' IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO 013'rA! »1Ct St1 +t�Llft l: y AN.A NEY BEFOR[ RECORDING YOUR NO'riCE OF COMMENCEMENT. ti Now I M�.. Notice to : I pplicant: As a condition to the issuance of a building permit with an estl VIA* notice of commencement and construction lien law brochure will be delivered to the pl�ltM u� a, t o>r d nwicv of izommencemem must he posted at the jab site fear the,irst inspection which occurs seven (7) days after the building permit is ht the of soh parted nottice. the inspection gill not he apprmwd and a reinspection fee will be charged. Permitfee $ CCF3 Technology Fee: Training /Education Fee S Notary S Code Enforcement S Double Fee S Zoning S Total Fee Now Due S See. Reverse side t 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: 1 2 3 Attach color samples with name and Fascia: I 2 3 4 number. Drip Cap /Drip Edge 1 2 4 �� rJ� � /- Soffit: 1 2 3 4 r��'K Roof: I 2 3 4 Flower Bins: 1 2 3 4 Shutters 1 2 3 4 Awning 1 2, 3 4 2 r d t' I l e Chimney: 1 2 3 4 Doors and Door Jams: 1 2 3 4 Garage Doors: 1 3 4 Railin(ys: 1 2 3 4 3 Fences: I 2 3 4 All brick (simulated or regular & 2 3 Stucco Banding-: 1 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. Signatur ��,, p Signature Owner or Agent Contractor The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this day of ��_. 200 by aCj tAt day of .20 _, by who is pe •%onally known to me or who has pn►duced 1� C r ;_ who is personalty known to me or who has pr( iuc:ed t As identification and who did take an oath. as identification and who did take an oath. NOT 1' IBLI NoTARV PUBLIC: Sign: Sign: Print: E*W!Wftll Print: My Commission Expires: '� My Commission Expires: APPLICATION APPROVED BY: Plans Fkaminer Preservation-Board , 0�1' Codet;nRitcement (Revised 04 /24/0; Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP- 100600 Permit Number: PT -11-08 -2044 Scheduled Inspection Date: January 29, 2010 Permit Type: Paint Inspector: Bruhn, Norman Inspection Type: Final Owner: COLEMAN, BRIDGET Work Classification: New Job Address: 118 NW 103 Street Miami Shores, FL 33150- Phone Number Parcel Number 113101022003 Project: <NONE> Contractor: HOME OWNER Building Department Comments EXTERIOR PAINT Inspector Comments Passed Failed Correction Needed Re- inspection ❑ _ _ Fee No Additional Inspections can be scheduled until re- inspection fee is paid. January 29, 2010 For Inspections please call: (305)762 -4949 Page 1 of 8 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP - 100600 Permit Number: PT -11 -08 -2044 Scheduled Inspection Date: January 29, 2010 Permit Type: Paint Inspector: Bruhn, Norman Inspection Type: Final Owner: COLEMAN, BRIDGET Work Classification: New Job Address: 118 NW 103 Street Miami Shores, FL 33150- Phone Number Parcel Number 1131010220030 Project: <NONE> Contractor: HOME OWNER Building Department Comments EXTERIOR PAINT Inspector Comments Passed El Failed Correction ❑ Needed Re- Inspection a Fee No Additional Inspections can be scheduled until re- inspection fee is paid. January 29, 2010 For Inspections please call: (305)762 -4949 Page 1 of 8