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PT-07-2160Permit Status: APPROVED Issue Date: 1012612007 1 Expiration: 0462212008 Project Address Parcel Number Applicant 1351 NE 102 Street 1132050230170 Miami Shores, FL 33138- Block: Lot: DERK RUSHING Owner Information DERK RUSHING 1351 NE 102 Street MIAMI SHORES FL 33138 -2619 Contractor(s) Phone Cell Phone COMPLETE HOME PAINTING BY MICt 305 - 895 -1368 (305)215 -0016 Type of Work: Exterior Color: 926, 955, 1224 Additional Info: Classification: Residential Color: 926, 955, 1224—Approved Color: 926, 955, 1224 Approved_ Code Comments: BEN MOORE - WALLS - Color: 926, 955, 1224_Denied Fees Due Miami Shores Village ®pane? a 10050 N.E. 2nd Avenue Education Surcharge $0.60 Miami Shores, FL 33138 -0000 $5.00 Phone: (305)795 -2204 $60.00 Technology Fee Permit Status: APPROVED Issue Date: 1012612007 1 Expiration: 0462212008 Project Address Parcel Number Applicant 1351 NE 102 Street 1132050230170 Miami Shores, FL 33138- Block: Lot: DERK RUSHING Owner Information DERK RUSHING 1351 NE 102 Street MIAMI SHORES FL 33138 -2619 Contractor(s) Phone Cell Phone COMPLETE HOME PAINTING BY MICt 305 - 895 -1368 (305)215 -0016 Type of Work: Exterior Color: 926, 955, 1224 Additional Info: Classification: Residential Color: 926, 955, 1224—Approved Color: 926, 955, 1224 Approved_ Code Comments: BEN MOORE - WALLS - Color: 926, 955, 1224_Denied Fees Due Amount CCF $1.80 Education Surcharge $0.60 Notary Fee $5.00 Permit Fee $60.00 Technology Fee $1.50 Total: $68.90 Phone Valuation: $ 2,500.00 Total Sq Feet: 0 Total Amt Paid Amt Due $ 0.00 $ 0.00 $ 0.00 Payment Type: Available Inspections: Inspection Type: Final In consideration of the issuance to me of this permit, 1 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 October 25, 2007 Authorized Signature: Owner / Applicant / Contractor / Agent Building Department Copy Thursday, October 25, 2007 1 sle BUILDING Miami Shores village Building Department 10050 N.E;.2nd Avenue. Miami Shores. Florida 33135 M-1 '0I 79C 2204 F i0I 7�c on7' Permit No. l l cn PERMIT. APPLICATION Master Permit No. FBC 2004 Permit Type: PAINT PERMIT ?Owner's Name (Fee Simple Titleholder) De,-k, R,5A,% i W M,,,.,4m Phone # ( Y 75-1-off/ Owner's Address-1-3 .1 I N 6 10 A nd 5trer I- City Htrm; 5horC,5 State t'i_ Zip 33/3g- Tenant /Lessee Name E-MAIL: Phone # xJob Address (where the work is being, done) 13 t O n/(r %oAtid 5h ec k _ City _ Miami Shores Villa<re County Miami -Dade Zip 3 FOLIO / PARCEL # - 3,�(J Is Building Historically Designated YES _ NO Contractor's Company p Y Name _ Contractor's Address /Y76 yG J City_ / State ror Zip Qualifier Name I C 4 C Z Phone # State Certificate or Re-istration No. Certificate of Competency No. OWNER BUILDER: Value of Work For this Permit $ Describe Work: Type of Work: ❑ Additlo ❑ Alteraa 'on / ❑New / ❑ Repair /Replace H e, !> 4f., � t4r_/ mot' 01 -, - Application is hereby made to obtain a hermit to do the wort: and imialla ons as indicated. I certify thatno work or installation has commenced prior to the issuance of a permit and that all wort: will be perl'o n ed to meet the standards ofall laws regulating construction in this jurisdiction. I understand that a separate permit must he secured fix' ELFCTRIC'AI. WORK. PHIMBING, SIGNS. WELI,S. POOLS, I'LIRNAC ?S, BOILI :. RS, HEATERS, TANKS and AIR CONDITIONERS. ETC..... "WARNING TO O«1NER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FO IMPROVEMENTS TO 1'OUR PROPERTY. IP 1'OU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFOR RECORDING YOUR NOTICE, OF COMME NCF.NIENT." Notice to Appl ican /: . 1.1' (7 C011dlllor7 /O II)L' 1S.S/r(n7C'e gf a h:rildin, pel'nill IIV /l7 an C's7/177a/C'd VQ/1JC' eacG'('ding K ��nn, t11e ap1J1tC'atll /17LLS/ 11l'Qt /II,SC' In go(Id /al /h /17(11 U C'rlpl' O/'Ihc' notice of commencemcni and collstructiorl hen lent brochure: sail( be delivered to the person whose property is subject to attachment. 41so, a certified c.'opy gfthe rec'or(led notice o/' cornrnenc•emeni must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. hi the absence gf s'uch posted nolic'e. the inspection still not he approved and a reinspection fee will be charged >:xi:x >:xr.i:xxrr.r. >: xie r.xi.•r.xxr. xa<r. x�c *xi: 9: �': r. xi:xxA; Fees *sac x>:>: xxx� :i:xx�Yxxxxic *i:xr:ici:zi:xic i; i:xr. r. i:xxic i; r. is is 9:x Permit Fee $ (go CC $� 1 •-60 Technology Fee: 1 � Training /Education Fee $ t ® Notary $ UU Code Enforcement $ Double Fee $ Zoning $ Total Fee Now Due $ ( 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 h asc I Drip Soffit Roof: Flow Shutt Awni Chin, Door Gara Railil Fenc All b Stec Any Acce 3 4 a: I 3 4 Cap /Drip Cdge: 1 2 4 4 er Bins: 1 2 W 4 ers� 1 2 � i 4 ngs: I 2 � 4 ney: �� b 2 3 4 s and Door Jams: I fkyKl- Doge. Gat-a( co Banding: 1 2 3 4 other Stucco Features: I 2�VIPr-) 4 SS01'y BlllldlllgS .0' Other: Attach colt a 2 3 OWNER'S AFFIDAVIT: I certify that all the foregoing information is accur compliance with all applicable laws regulating construction and zoning. own nature Signature JX V g Owner or Agent Cr o racto 'The 1iorc<oin_, it strun,ent was acknowledged before me this The for of g ' strum t was acknowly)lged befor me thil / by day of .20 �Zby -- �` K / u _ day o -0U 5 who is personally known to me or who has produced -- who is personally knOWn to me or who has produced As identification and who did take an oath. ;�—— �dentificacion and who (lid t1�t� (fib 4i NOTARY PUBLIC: NOTARY B ♦SLJ�; °�5�4'cs S Sign: c !ii/�s "C_. — Sign: e Print: Print: _ P CIA ' My Commission Eixpires: �t .S�`f COS�`e3c�9 My Commission Expires: �.1� �g25 1p .;,�• 0 •'2��% % %��HYY. •i: %% % %Y %• Y. Y. YX%'%%%% Xl• C% Y% Y.X%% %Y % % %Y % % % % % % % % % % % % % % % % % % % % %Y % %% CIO, es'• APPLICATION APPROVED BY: _&v(4 � Plans Examiner Preservation Board 1�' I' "�? •.�.e!. Code CMlbreement (Revised 04/24/0 Doors: _ 3 4 4 _ 1 l0s: f 2 2 t G 3 4 4 es: 1 2 2 Nl 3 4 4 rick (simulated or regular : I Attach colt a 2 3 OWNER'S AFFIDAVIT: I certify that all the foregoing information is accur compliance with all applicable laws regulating construction and zoning. own nature Signature JX V g Owner or Agent Cr o racto 'The 1iorc<oin_, it strun,ent was acknowledged before me this The for of g ' strum t was acknowly)lged befor me thil / by day of .20 �Zby -- �` K / u _ day o -0U 5 who is personally known to me or who has produced -- who is personally knOWn to me or who has produced As identification and who did take an oath. ;�—— �dentificacion and who (lid t1�t� (fib 4i NOTARY PUBLIC: NOTARY B ♦SLJ�; °�5�4'cs S Sign: c !ii/�s "C_. — Sign: e Print: Print: _ P CIA ' My Commission Eixpires: �t .S�`f COS�`e3c�9 My Commission Expires: �.1� �g25 1p .;,�• 0 •'2��% % %��HYY. •i: %% % %Y %• Y. Y. YX%'%%%% Xl• C% Y% Y.X%% %Y % % %Y % % % % % % % % % % % % % % % % % % % % %Y % %% CIO, es'• APPLICATION APPROVED BY: _&v(4 � Plans Examiner Preservation Board 1�' I' "�? •.�.e!. Code CMlbreement (Revised 04/24/0 Inspection Date: 01/08/2008 Inspector: Grande, Claudio Owner: RUSHING, DERK Job Address: 1351 102 Street NE Miami Shores, FL 33138- Project: <NONE> Contractor: COMPLETE HOME PAINTING BY MICHAEL Buildina Department Comments Permit Type: Paint Inspection Type: Final Work Classification: Addition /Alteration Phone Number I1.1MI' 1 Parcel Number Lot: 1132050230170 Phone: 305 -895 -1368 PRESSURE CLEAN AND PAINT EXTERIOR NOT ROOF Inspection Worksheet un Miami Shores Village b 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Date: 01/08/2008 Inspector: Grande, Claudio Owner: RUSHING, DERK Job Address: 1351 102 Street NE Miami Shores, FL 33138- Project: <NONE> Contractor: COMPLETE HOME PAINTING BY MICHAEL Buildina Department Comments Permit Type: Paint Inspection Type: Final Work Classification: Addition /Alteration Phone Number I1.1MI' 1 Parcel Number Lot: 1132050230170 Phone: 305 -895 -1368 PRESSURE CLEAN AND PAINT EXTERIOR NOT ROOF Inspector Comments Passed cc Failed E]_ Correction Needed ❑ Re- Inspection Fee ($75) No Additional Inspections can be scheduled until re- inspection fee is paid. 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