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PT-10-28Project Address Owner Information Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Parcel Number 600 GRAND CONCOURSE Miami Shores, FL 1132060172010 Block: Lot: SUSAN BENKE Address 600 GRAND CONCOURSE MIAMI FL 33138 -2474 Type of Work: Exterior Color: Additional Info: Classification: Residential Color. _Approved Color: _Approved_ Code Comments: Color: _Denied Fees Due CCF Education Surcharge Notary Fee Permit Fee Technology Fee Total: Amount $1.20 $0.40 $5.00 $60.00 $1.60 $68.20 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 Expiration: 07/06/2010 Phone Invoice # PT -1 -10 -36759 Check #: 4572 Total Amt Paid Amt Due $ 63.20 $ 63.20 $ 0.00 PT -1 -10 -36760 $ 5.00 $ 5.00 $ 0.00 Applicant Valuation: Total Sq Feet: $ 1,665.00 0 January 07, 2010 Date Cell For Inspections please call: (305)762 -4949 Available Inspections: Inspection Type: Final January 07, 2010 1 • Inspection Number: INSP- 132813 Permit Number: PT- 1 -10 -28 Scheduled Inspection Date: June 25, 2010 Inspector: Bruhn, Norman Owner: BENKE, SUSAN Job Address: 600 GRAND CONCOURSE Project: <NONE> Contractor: Building Department Comments June 24, 2010 Miami Shores, FL 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: Addition /Alteration Phone Number Parcel Number 1132060172010 Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments e ad , & ci - 4e(c(ec( Page 2 of 12 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 BUILDING Permit No. \ b -' -l) PERMIT APPLICATION Master Permit No. FBC 2004 Permit Type: PAINT PERMIT Owner's Name (Fee Simple Titleholder) ? 4 al' St ctft Miami Shores Village Building Department Eehke , Owner's Address 400 G'e'GoNck. Come P @q, ese, City (`I`1Clt4nl SkOtf State Zip 313}* Tenant/Lessee Name Phone # -9 E -MAIL: :_�► RE „ Cell NRo)I1r-k31- Phone #CAOS) r Job Address (where the work is being done) G 00 &VON& CaIA.COU. tie_ City Miami Shores Village County Miami- ade Zip .S a1. FOLIO / PARCEL # ) t —S,) -0 Oil --..0 10 4 Let 1( °`' SVd Iv le -r-1- )-d'L 10 Is Building Historically Designated YES NO Isi1; l0 • �l. o -i - t �O,�C I. Contractor's Company Name Contractor's Address City State Zip Qualifier Name Phone # State Certificate or Registration No. Certificate of Competency No. OWNER BUILDER: iasa eryke_. Phone # Describe Work: wall uiviA.lufi' Value of Work For this Permit $ ,( 65,00 Type of Work: ❑ Addition / ❑ Alteration / M / ['Repair /Replace (316 -14- - t-o ®°f col o - �tiFt t � l - d t tr`t Kew et Ott `44ietA vI Application is hereby made Co 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 he secured hrr EI.I:CTRICAI. 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: pplicant: As a condition to the issuance ofa building permit With an estimated value exceeding $ 2500. the applicant must promise 117 good faith that a colt of the notice of commencement and construction lien law brochure will be delivered to the person whose properly is subject 10 attachment. Also. a certified copy of the recorded notice of commencement must he posted at the job site for thefirst inspection which occurs seven (7) days after the building permit is issued In the absence of such posted notice. the inspection will not approved and a reinspeclion fee will be charged. ******** * * * * ** ** * * * * * * * * * ** * * * * * * * ** * ** F ** ** * ** * * ** ** * * * * * * * * * * * * * * * * ** Permit Fee $ (e • Q7 CCF $ l . Z0 Technology Fee: 1 • (00 Training /Education Fee $ (7• 4,./ Notary $ • Code Enforcement.$ Double Fee $ Zoning $ Total Fee Now See Reverse side -� our Val I rascia: Directions: Please circle corresponding number to appropriate color sample. Signature Drip Cap /Drip Edge: offit: Roof Flower Bins: Shutters: Awnings: Chimney: Doors and Door Jams: Garage Doors: 1 Railings: Fences: All brick (simulated or regular): Stucco Banding: 2 Any other Stucco Features: Accessory Buildings \IJO i\()ow , \tk t cs0 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. 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 1 2 3 3 4 3 4 3 4 3 4 3 4 , 3 3 Other: gen( r The foregoing instrument was acknowledged before me this co day o a20 t"`. by OOj,�V D k . who is personally known to me or who has produced R AD 4 4 4 Attach color samples with name and number. Signature Contractor The foregoing instrument was acknowledged before me this day of . 20 • by who is personally known to me or who has produced As k sntifica Lion and dialittitbitn oath. as identification and who did take an oath. NOTARY PUB �, ` \\ `\ 1d19 /i�� NOTARY PUBLIC: Sign: . .46, 4 00 0■ , .NZ Sign: Print: ? : \. , . - �• _ Print: F-_ 3'' t. ir , = My Commission Expires: • . 1� ct) ' *x* ****** ******* **** ******* ** p ****Vg�tri0001,***xdeie****x4** dealt*************** ** *********** ****** J�J \ i / �� , nu ut(PM " Plans Examiner Preservation Board Code Enloreemen( (Revised 04/24/0% 1 1 1 1 1. 1 1 1 1 1 TANK INSTALLATION [011 TANK SIZE [11/ 1Th. [2] • [02] TANK MATERIAL [03] OUTLET DEVICE [04) _MULTI-CHAMBERED [Y / N] [05] OUTLE-T FILTER [06] LEGEND [07] WATERTIGHT [08] LEVEL [09) DEPTH TO LID DRAINFIELD INSTALLATION [10) AREA [1] [2] SOFT [11) DISTRIBUTION BOX HEADER [1,2] NUMBER OF DRAINLINES [13) DRAINLINE SEPARATION [14] ,._ __DRALNLINE [15] DEPTH OF COVER / [16] ELEVATION [ABOVE/BELOW] ' BM [17] SYSTEM LOCATION [18] DOSING PUMPS [19] AGGREGATE SIZE , [20] AGGREGATE EXCESSIVE FINES [21] AGGREGATE DEPTH FILL / EXCAVATION MATERIAL [22] FILL AMOUNT [23] FILL TEXTURE ' [24] EXCAVATION DEPTH [25] AREA REPLACED [26] REPLACEMENT MATERIAL EXPLANATION OF VIOLATIONS / REMARKS: [ 1 [ 1 1 i CONSTRUCTION [APPROVEDIDISAPPROVED]:' •—. FINAL S EM [APPROVED ISAPPROVED]: • 4016 (Page 2), 10/97 (Previous Editions May Be Used) NOTICE: In 'Number: 5744.002-4016-4 additional restr . the public records 1 1 1 1 1 1 1 1 [37] [38] [39] FILLED / MOUND SYSTEM [36) DRAINFIELD COVER SHOULDERS SLOPES STABILIZATION ADDITIONAL INFORMATION [40] UNOBSTRUCTED AREA [41] STORMWATER RUNOFF [42] ALARMS [43] MAINTENANCE AGREEMENT [44] BUILDING AREA [45] LOCATION CONFORMS WITH [46] FINAL SITE GRADING [47] CONTRACTOR --." /4 r, gpiER 7 7 i'57) [27] SURFACE WATER FT [28] DITCHES FT [29] PRIVATE WELLS FT [30] PUBLIC WELLS FT [31] IRRIGATION WELLS FT [32] POTABLE WATER LINES FT [33] BUILDING FOUNDATION FT [34] PROPERTY LINES FT [35] OTHER FT SITE ABANDONMENT 1 [49] TANK PUMPED 1 [50] TANK CRUSHED & FILLED/ CHD DATE: PT 1: Applicant PT 2: Installer/Contractor PT 3: Building Department PT 4: Health Department CHD DATE - ,L2L2J O Page 2 of 3