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PT-06-1292V % Inspection Worksheet Miami Shores Village � 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 V Inspection Date: 0713112006 AUG 0 1 Inspector. Grande, Claudio Fn Owner. EKLUND, GLENWOOD AND JEANNE Job Address: 1460102 Street NE Miami Shores Village, FL 33138- Project: <NONE> Contractor. HOME OWNER Ri lrfinn nanartmant [:nmmanta Permit Type: Paint Inspection Type: Final Work Classification: Repair Phone Number (305)758 -9095 Parcel Number 1132050240250 Block: Lot: I L I I — ­ . Inspector Comments Passed Failed El Correction Needed Re- Inspection Fee ($751 No Additional Inspections can be scheduled until re- inspection fee is paid. Friday, July 28, 2006 Page 1 of 3 Miami Shore's Village Building Department o w 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 BUILDING PERMIT AP FBC 2004 i I r - Permit No. °` ! _`1 Z ICATIU ;MAY, $' "'' Master Permit No. f1 n � Permit Type (circle): Owner's Name (Fee Simple Tit Owner's ddress Z City Wee Tenant/Lessee Name Job Address (where the City Miami S'. FOLIO / PARCEL # _ Is Building :Historically Contractor's Company Contractor's Address City Qualifier Name State Certificate or Regi e ric Plumbing a State __ Zip is being done) 6140 A16 I # mated YES NO_*"�__ Phone # State Zip Phone # No. Certificate of Competency No. Architect Engineer's Nam (if applicable) Phone # Value of Work For this Permit $�`��6 0 • Square l Linear Footage Of Work: Type of Work: � ]Altai w Repair Describe Work: j h",0q& Submittal Fee $ Notary $ S—CE Scanning $ Bond $ Structural Review. $ it x Permit Fee $ °,,I. '� CCF $ O� J CO /CC iining/Education Fee $ � � �J Technology Fee $ Radon $ 13PBR $ Zoning $ Code Enforcement $ Double Fee $ Total Fee Now Due $ See Reverse side —� Bonding Company's Name (if applicable) Bonding Company's Address City State Zip .V Mortgage Lender's Name (if applicable) Mortgage Lender's Address City - State Zip. 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..... 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. "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) dRs after the building permit is issued. In the absence of such posted notice, the inspection will 9Q be approved and a reinspectio will be charged Owner or Agent The foregoing instrument was actowwledged before me this day of 20yj_JC- -t n y_1< who is personally-1mown to me or who has produced C'L ' As identification and who did take an oath. NOTARY PUBLIC: APPLICATION APPROVED BY: (Revised 02/08/06) 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 identification and who did take an oath. NOTARY PUBLIC: Sign: Print: My Commission Expires: Plans Examiner Engineer zoning - -, Miami Shores Village .`� Paint Color Approval and Agreement Date �% -P�0�1 �U Phone # Owner's Name „ A. ® � % ' <!' Owner's Address State C Zip cit- _i� ' Job Address (where the work is being done). /% o /�� /0 V,17�-4 City Nliami Shores Village County - Miami -Dade Zip Is Building Historically Designated YES NO- Contractor's Company Name (if applicable) ��"z" 'ci'�'^�`'�` Phone # All elements on the site must be listed and indicate the color to be painted Walls Fascia Drip Cap /drip Edge Soffi Roof Flower Shutters Awnings Chimney Doors and door jams Garage doors Railings Fences Decorative metal All brick (simulated or regular) Stucco banding Any other stucco features Accessory Buildings Other . Attach Color Samples With Numbers OWNER'S AFFID T: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws reg a�4ng construction and zoning. Date Signature Owner or Agent APPLICATION APPROVED BY: Date chc 5/18103 M Z Official Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Fax: (305)756 -8972 Permit Permit Status: APPROVED Issue Date: 5/19/2006 Expires: 11/1412006 Permit Number: PT -5-06 -1292 Owner's Name: GLENWOOD AND JEANNE EKLUND one: 305)758 -9095 Permit Type: Paint Work Classification: Repair Job Address: 1460 102 Street NE Miami Shores Village, FL 33138- Contractor(s) Phone Primary Contractor HOME OWNER Yes Comments: REPAINT ROOF WITH HIGH QUALITY SEALER Additional Information Type of Work: Exterior Color. WHITE Additional Info: ROOF Classification: Residential In consideration of the issuance to me of this permit, I agree to perform the work covered nereunoer 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. Fees Due Amount CCF $0.60 Education Surcharge $0.20 Notary Fee $5.00 Permit Fee $60.00 Technology Fee $1.50 Total: $67.30 Building Department File Copy Applicant Signature Parcel 41 1132050240250 Block: Lot Section: PB: Total Square Feet 0 Total Valuation: $ 1,000.00 Final Invoice Number Amt Due I Amt-P PT -5-06 -24853 $67.30 Total: uw 19 PAID C- C NOTICE: In addition to the requirements of this permit, there may be additional restrictions applicable to this property that may be found in the public records of this county. AND THERE MAY BE ADDITIONAL PERMITS REQUIRED FROM OTHER GOVERNMENTAL ENTITIES SUCH AS WATER MANAGEMENT DISTRICTS, STATE AGENCIES, OR FEDERAL AGENCIES.