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PT-10-1519Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP- 170192 Permit Number: PT -8 -10 -1519 Scheduled Inspection Date: February 22, 2012 Inspector: Bruhn, Norman Owner: WOOLIN, RACHEL Job Address: 489 NE 95 Street Miami Shores, FL 33138- Project: <NONE> Contractor: F&F CONSTRUCTION SERVICES INC Permit Type: Paint Inspection Type: Final Work Classification: Addition /Alteration Phone Number Parcel Number 1132060140640 Phone: (954)454 -1948 Building Department Comments PAINT Peasetl 0/.i nU C 0)_ a 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- 161023. CREATED AS REINSPECTION FOR INSP- 156691. CREATED AS REINSPECTION FOR INSP- 150385. Work exceeds permits - NEED TO REVISE PERMIT FOR GRAY PAINT. I.NARANJO color revised, Inspected & approved by A. Flores February 21, 2012 For Inspections please call: (305)762 -4949 Page 46 of 52 Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305) 762.4949 BUILDING PERMIT APPLICATION FBC 20 Permit Type: PAINT OWNER: Name (Fee Simple Titleholder): • � s;S Address: e :' � City: �lfL /// 6.1% .— State: Permit No. T t 1 V — w n 9 Master Permit No. Lboocy6 phone.. 7 % '. -o 79- Zip: t Tenant/Lessee Name: Phone #: Email: JOB ADDRESS: ij g % I� b' City: Miami Shores County: Miami Dade Folio/Parcel #: Is the Building Historically Designated: Yes NO Flood Zone: Zip: 531 ff CONTRACTOR: Company ame: Ff �C(`jG/ 712 a G (O-K Address: i(p (S7 - � CJZ Cit y: b� J State: 6 1 Phone #: ; © %2-Ctc -f ([2'7 Qualifier Name: RAC- t— ► (A,(1 k t State Certification or Registration #: �� L', ad) vol Contact Phone #: Phone #: Certificate of Competency #: Email Address: Zip: 0 (0 1 Value of Work for this Permit: $ Square/Linear Footage of Work: Description of 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 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 an inspection fee will be charged. ******** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Fees************* * * * * * * * * * * * * * * * * * * * * * * * * * * * *s ** x ;ANN1ti •� Permit Fee $ CCF $ Notary $ u •U Traming ashen Fee $ Technology Fee $ Double Fee $ TOTAL FEE NOW DUE $ . 00 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 Fascia: Drip edge: 1 Soffit: 1 Roof: 1 Flower Bins: 1 Shutters: 1 Awnings: 1 Chimney: 1 Doors & Jambs:l Garage Doors: 1 Railings: 1 Fences: 1 All Brick: 1 Stucco Bands: 1 Other Stucco Feature: 1 2 3 4 2 3 4 2 2 2 3 4 3 4 3 4 2 3 4 2 3 4 2 3 4 2 3 4 2 3 4 2 3 4 2 3 4 2 3 4 2 3 4 2 3 4 3 4 Accessory Bldg: 1 2 3 4 Attach color sample with name and number 1 2. 4. 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 re construction and zoning. Signature: Vj 1 Owner or Agent The forego ®®in'' instrument was ac,nowle, :ed before me' this y -'.( day of Pt� , 20, by ' • ' • W Cpl -ter' who is personally known to me or who has produced 10 As identification and who did take an oath. NOTARY PUBLIC: Sign: Print: My Commission Expires: of Contractor The foregoing instrument was acknowledged before me this day of 2--i 1;6 , 20 1? by who personal , known to me or who has produced as identification and who did take an oath. NOTARY,UBLIC: Sign: Print: My Commissi * * * * * * * * * ** * * * * * * * * * * * * * * *. * ** 0#:*** * *s *.* * * *t*s * * * * * *�: * ** ** ** * * * * *s APPROVED BY: \ * * * * * * * * * * * * * * * * * * * ** Code Official Preservation Board Miami Shores Viiiage Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 CHANGE OF CONTRACTOR 1 ARCHITECT Permit N. t 1� r ) 0 -- )9 9 Owner's Name (Fee Simple Title Hold ): 0 °°6 / Z Phone #: Owner's Address: City: State : Zip Code: 6 State: Florida CXA5'4v AteOvk Job Address (Of where work is being done): City: Miami Shores Contractor's Com . any N e: Address: 6? 1 cn C City: t�� C Qualifier's Name : C <<A Stater Architect/ Engineer of Record Name: Address: City: State: Zip Code: Zip Coder 3 (3 S' Phone #:*70x ` Zip Code:3'% oqf Lic. Number: o & o'[ Phone #: Describe Work: F'ii 1M-1- I hereby certify that the work has been abandoned andlor the contractorlarchitect is unable or unwilling to complete the contract. I hold the Building Official and the i Shores harmless for all legal involvement. Signatu er or Agent The foregoing ins ment was aknowledged before me this( day of ' .S ,2012,by t Who is personally known to me or who has produced ".■∎` "P�1 a0j°,p indentification. fix;/ Notary Public. Sign: Seal: OR ION , ,' ` \‘‘ Signature Contractor or Architect The foregoing instrument was aknowledged before me this a� , 2011-by wh • ersonally kno \ to me or who has produced as indentification. Notary Publi,� Sign: Ciat Seal: