PT-12-2210r.
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INS P-181906 Permit Number: PT -11 -12 -2210
Scheduled Inspection Date: December 17, 2012
Inspector: Bruhn, Norman
Owner: LLC, DEVINELLA
Job Address: 9165 PARK Drive
Miami Shores, FL
Project <NONE> .
Contractor: KEN CONSTANTINO BUILDERS INC
Permit Type: Paint
Inspection Type: Final
Work Classification: Addition /Alteration
Phone Number (305)785 -8990
Parcel Number 1132060141350
Phone: (321)725 -2837
Building Department Comments
EXTERIOR PAINTING
Infractlo Passed Comments
INSPECTOR COMMENTS
False
Inspector Comments
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
December 14, 2012
For Inspections please call: (305)762 -4949
Page 25 of 41
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 (Fe Simple Titleholder):
Address: 4 6 cr y W 1 AvX t. 0 a-
•i, IVED
NOV 2 -i 7,01Z
Phone #: /O5 77/ • a/9Q
City: {M ( oftWI
Tenant/Lessee Name:
Email:
6 ( ilft
State: PLOO.6
Zip:
Phone #:
JOB ADDRESS:
°1 pAetic 012l vi
City: Miami Shores County:
Folio/Parcel #: f (• 120 (- G (4 • (3 S--O
Is the Building Histoiically Designated: Yes NO
Miami Dade Zip:
31(35
Flood Zone:
CONTRACTOR: Colmpany Name: jCr Uhl Co US 114A111NO (gin (4 S
Address: 22 1 14.) • Wi 6( (- S °'D'c, (A6 44 11A
Phone #:
City: 14k4 EA-1 = State: - Zip: 3 2-1 (
Qualifier Name: dL) op STAri l't°/�v Phone#: - t9 63' /7,
State Certification or Registration #: C g C_k I l $ c'% Certificate of Competency #:
Contact Phone #: I • ' -( 4 S ' 17 t co Email Address:
Value of Work for this Permit: $ 1 S-60
Description of Work:1 6`F' Lt 414- Mi iron /t%!;
Sq '< 'near Footage of Work: 000 S.F.
Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or ins • lation has commenced prior
to the issuance of a perjnit and that all work will be performed to meet the standards of all laws regulating cons ction in this jurisdiction. I
understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POO , FURNACES, BOILERS,
HEATERS, TANKS and AIR CONDITIONERS, ETC r4
f
"WARNING TO OWNER: YOUR FAILURE TO RECORD NOTICE OF
COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR
IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTE TO OBTAIN
FINANCING, 'CONSULT WITH YOUR LENDER OR AN ATTO Y BEFORE
RECORDING YOUR NOTICE OF COMMENCEMENT."
Notice ce to oe c As a c and construction the issu nc law brochure permit with an ed estimated ted value exceeding $2500, the applicant must pro ' ise in good faith that a copy of
Notice to Applicant: As a c ndttion to the issuance of a building '
of tile person whose property is subject to attach 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 peinit is issued. In the absence of
such posted notice, the inspection will not be approved and an inspection fee will be charged
+ six * ****** ** * * *** * * * ** x****** ** *** * * * * ** Fees*************** * * *** * * * * ******** * * * *** * *** **
Permit Fee $ CCF $ Notary $ Training/Education Fee $
Technology Fee $ Double Fee $ TOTAL FEE NOW DUE $
PAINT COLOR APPROVAL AND AGREEMENT
All elements on the site must be listed and indicate the color to be painted
L IRECTIQNS: Please circle corresponding number to appropriate color sample.
• ans:
2
Fs�scia: l 2 : 3
Drip edge: 1 2 3
Soffit: 1
, R of 1
▪ ower Bins'. I
-Matters:— 1
li
ASsaiiugss 1
C,:- 1
deers- 8r- Jazn*1
Garage Doo
mss;-• 1
1
1 2 3 4
S uccoo Bands: 1 3 4
Other Stucco �� /
COGv�".) Feature: 1 2 4
ccessory BI
OWNER'S AFFIDAVIT: I Ce • that all the foregoing information is accurate and that all work will be done in compliance with all
applicable laws regulating con$truction and zoning.
V
Signature. dam.
Signature:
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
Attach color sample with name and number
1.
n
SW 6112
Biscuit
SW 6113
Interactive Cream
SW 6114
Bagel
The fo
day of
ag
NOTA
Sign:
Print:
My turnmission Ez
Owner 4r gent
oing s J - nt was 'ac
2012, b0
rsonal y own to m� or who has produced
ideti if_cation and who did take an oath.
ll Contractor
ed efore me this The fo going i stru ent was ackn wledged
day o 20, by rJ 1
this )
o is p known o e or who has produced
12 flcation and who did take an oath.
N t, ''FARY PUBLIC':
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2015
sty MY Gomm EE 12681'
„ mission # ssn
r Na 23, 20
My Comm Expires Sep
Commission # EE 128810
led Through National Notary Assn.
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uc tL Code Official
* * * * * * * * * * * * * * * **
APPROVED BY:
Preservation Board