PT-14-274Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-207155 Permit Number: PT -2-14-274
Scheduled Inspection Date: August 26, 2014 Permit Type: Paint
Inspector: Rodriguez, Jorge Inspection Type• Final
Owner: , Work Classification: Addition/Alteration
Job Address: 101 NE 110 Street
Miami Shores, FL 33161-7045
Phone Number
Parcel Number 1121360040230
Project: <NONE>
Contractor: ACA CONSTRUCTION INC Phone: (305)788-8914
eumung Department comments
PAINT EXTERIOR OF HOUSE
INSPECTOR COMMENTS False
August 25, 2014 For Inspections please call: (305)762-4949 Page 4 of 39
Inspector Comments
Passed
Failed
Correction
Needed ❑
Re -Inspection ❑
Fee
No Additional Inspections can be scheduled until
re -inspection fee is paid.
August 25, 2014 For Inspections please call: (305)762-4949 Page 4 of 39
13
Miami Shores Village
Building Department
U�� \ 10050 N.E.2nd Avenue, Miami Stores, Florida 33138
lh Tel: (305) 795.2204 Fax: (305) 756.8972
INSPECTION'S PHONE NUMBER: (305) 762.4949
BUILDING Permit No.
PERMIT APPLICATION
FBC 20
Permit Type: PAINT
OWNER: Name (Fee Simple
Master Permit No. c__ -
FEB 13 26%
-(-9-4�
Address 3�r O Cj
City: State: !F- L Zip: 3 31 s'j
TenantIessee Name: ' '—� Phone#: ✓--
Email:
JOB ADDRESS: I C> 1 1`� 1 10 J-
1—city— Miami Shores County: Miami Dade
Folio/Parcel#:
Is the Building Historically Designated: Yes
NO ✓ Flood Zone:
305 -a. moi- 3%4% 4$
CONTRACTOR: Company Name: AS CA Phone#:
Address: )0''1 a -S SW ss 4c,--,--
City:
Gr/City: r -Y % j State: �(�, Zip: a315S
Qualifier Name: .0N=� =f -e S Cir —Y L.fs, Phone#: 3o5 -a 19 - 344!C
State Certification or Registration #: CI►C- )`Tl 11-7 2 _ Certificate of Competency #:
Contact Phone#: , Email Address: Gl Lerrn LA C,!,� " i , (am,
J
Value of Work for this Permit: $ 12, OC>C) 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.
Permit Fee $ �13 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
DIRECTIONS:, Please circle corresponding number to
ICui•
Walls: 1 t SG 1 2 3 4
Fascia: 1 vitt I2 / 3 4
Drip edge: 1 2 3 4
appropriate color sample.
Soffits 1
2
3
4
Roof: 1
2
3
4
Flower Bins: 1
2
3
4
Shutters: 1
2
3
4
Awnings: 1
2
3
4
Chimney: 1
2
3
4
Doors & Jambs: 1
2
3
4
Garage Doors: 1
2
3
4
Railings: 1
2
3
4
Fences: 1
2
3
4
All Brick: 1 2 3 4
Stucco Bands: 1 3 4
Other Stucco
Feature: 1 2 3 4
Accessory Bldg: 1 2 3 4
Attach color sample with name and number
2.
3.
9
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.
Si tureSignature:
O er r Agent Contractor
The foregoing instrument was acknowledged before me thisAA�' The foregoing instrument was acknowledged before me this125tlL
day of 1*—% , 20 j4by M i Cir ZGtG f 3Y of6 , 20; by--x:A.C1 Lej&njj4
who is p o y own me or who has produced who is per y kno to me or who has produced
As identification and who did take an oath. as identification and who did take an oath.
NOTARY PUBLIC:
My Commission Exp ir If ^
MY COMM'MM 0 EE000573
•Ab?�' EXPIRF$ f1 i b^ 01, 2014
APPROVED BY:
NOTARY PUBLIC:
Sign:
Print Y -J i(l 1 �an le— .
My Commission -tt*�' `.4, RON NI A �l-AB�K
*i MY COMMIMON # EE000573
Preservation Board