PT-07-1065 Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-50281 Permit Number: PT-5-07-1065
Scheduled Inspection Date: July 10, 2015 Permit Type: Paint
Inspector: Rodriguez,Jorge
Inspection Type: Final
Owner: ROSE, ROBERT Work Classification: New
Job Address:29 NW 106 Street
Miami Shores, FL Phone Number
Parcel Number 1121360060220
Project: <NONE>
Contractor: HOME OWNER
Building Department Comments
PAINT
Inspector Comments
Passed 49
Failed
Correction ❑
Needed
Re-Inspection ❑
Fee
No Additional Inspections can be scheduled until
re-inspection fee is paid.
July 09,2015 For Inspections please call: (305)762-4949 Page 32 of 35
Permit Afo- PT-5-07-1055
�s�jORrys r Miami Shores Villageype-Paint
Permit T
10050 N.E.2nd Avenue Worts Classification:New
r
Miami Shores,FL 33138-0000 Permit Status-A;PPR�VED"
" .� Phone: (305)795-2204 ,
F[ORiDP'
- Ape Expiration: '11!2012007
Project Address Parcel Number Applicant
29 NW 106 Street 1121360060220
Miami Shores Village, FL Block: Lot: ROBERT ROSE
Owner Information Address Phone Cell
ROBERT ROSE 29 NW 106 ST
MIAMI SHORES FL 33150-1245
Contractor(s) Phone Cell Phone Valuation: $ 1,000.00
HOME OWNER
j Total Sq Feet: 0
Type of Work:Exterior Available Inspections:
Color: PALE SAGEBUSH/GRAND HERON Inspection Type:
Additional Info:
Final
Classification:Residential
Color: PALE SAGEBUSH/GRAND HERON—Approved Code Comments:BEHR-WALLS-PALE
Color: PALE SAGEBUSH/GRAND HERON—Approved Color: PALE SAGEBUSH/GRAND HERON—Denied
Fees Due Amount Total Amt Paid I Amt Due
CCF $0.60 --
Education Surcharge $0.20 $0.00 $0.00
Notary Fee $5.00
Permit Fee $60.00 Payment Type:
Technology Fee $1.50
Total: $67.30 i. MAY -? ; PAID
I j I CIA C1
In consideration of the issuance to me of this permit, I 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.
May 24, 2007
Authorized Signature:Owner / Applicant / Contractor / Agent Date
Building Department Copy
Thursday, May 24, 2007 1
Miami Shores Village 0561Mt
Building Department artment i
10050 N.E.2nd Avenue,Miami Shores,Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
BUILDING Permit No. �Tl- 1 •,
PERMIT APPLICATION VJ Master Permit No.
FBC 2004 MAY 2 4 2007
Permit Type: PAINT PERMIT BY'---06
Owner's Name(Fee Simple Titleholder) F�ObOe+ L'�P( f L1&J�OK .Phone# 305- -1,s8-"I z0G _
Owner's Address 24 NW
City State T�A Zip �J 3
Tenant/Lessee Name Phone#
E-MAIL:
Job Address(where the work is being done) L Q mw t aD $t
City Miami Shores Villa e County Miami-Dade Zip
FOLIO/PARCEL#
Is Building Historically Designated YES NO_.,�K_
Contractor's Company Name I-Jay-An 0(uo e Phone#
Contractor's Address
City State Zip
Qualifier Name Phone#
State Certificate or Registration No. Certificate of Competency No.
OWNER BUILDER:
Value of Work For this Permit$ 10-00 ' Type of Work: ❑Addition/ ❑Alteration/ ❑New/[IRepair/Replace
'[
Describe Work:_ III ln
Application is hereby made to obtain a permit to do the work and installations as indicated. 1 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 YPUR PAYING .TWICE FOR
IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER dR 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$2500,the applicant must promise in good faith that a copy of the
notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also,a cer4led copy of the r1corded notice
of commencement must be posted at the job site for the first inspection which occurs seven(7)days after the building permit is issued. /n the absence of such posted notice,the
inspection will not be approved and a reinspection fee will be charged.
Permit Fee$ CCF$ Technology Fee: -S
Training/Education Fee$ . 2Q Notary$ .CO -Code Enforcement$
Double Fee$ Zoning$ Total Fee Now Due$ G- -Du ,
See Reverse side
i
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 sampk. r
Walls: 1 2 3 4 A - - - le: with mane and
Fascia: 1 2 3 4 ber.
Drip Cap/Drip Edge: 1 2 3 4
Soffit: 1 2 3 4 1
Roof: 1 99 3 4
Flower Bins: 1 2 3
Shutters: 1 4
1 Body:Pale Sagebrush ECC-38-1-
-_
Awnings: 1 2 3 4 2 "
Chimney: 1 2 3 4
Doors and Door Jams: -1—C2 3 4
Garage Doors: 1 2 3 4 — 2 Tram:Grand Heron ECC-37-21
Railings: 1 —2-3— 4 3 --
Fences: 1 2 3 4
All brick(simulated or regular): 1 2 3 4
3
Stucco Banding: 1 2 3 4 3 accent:Freshwater Marsh ECC-37-30
Any other Stucco Features: 1 2 3 4 — -
4
Accessory Buildings Other:
OWNER'S AFFIDAVIT: I certifythat all the foregoing information is accurate and that all work will be done in
g g
compliance with all applicable laws regulating construction and zoning.
Signature Signature
Owner or Agent Contractor
The forego' instrument was acknowledged before me this L� The foregoing instrument was acknowledged before me this
day of GG,20
KI oac—o FVb�—(T, day of ,20_,by ,
who is known to me or who has producedON4 -5/TUCQ is+personally known to me or who has produced
As identifi * nd who did take an oath. as identification and who did take an oath.
NOTARY U IC: >. 4 4;0�� NOTARY PUBLIC:
Sign: °�° 9� r�N Sign:
Print: "i `e'r"MPrint:
My Com ssion Expire �yfj�g�QTMy Commission Expires:
oo>
APPLICATION APPROVED BY: Plans Examiner
Preservation Board
Code Enforcement
(Revised 04/24/07)