PT-07-1273 Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-53016 Permit Number: PT-6-07-1273
Scheduled Inspection Date: July 10, 2015 Permit Type: Paint
Inspector: Rodriguez,Jorge
Inspection Type: Final
Owner: ALEX VITAL,ANATASE CINEUS Work Classification: New
Job Address: 196 NW 95 Street
Miami Shores, FL 33150- Phone Number
Parcel Number 1131010330660
Project: <NONE>
Contractor: HOME OWNER
Building Department Comments
paint
Inspector Comments
Passed R1
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 35 of 35
Permit NO. PT-6-07-1273
Miami Shores Village M Permit Type: Paint
10050 N.E.2nd Avenue m Work Classification: New
Miami Shores,FL 33138-0000 Per■ ■ ■ I
l Phone: (305)795 2204
Peanit Status:APPROVED
- Issue Date:7/13/2007 Expiration: 01109/2008
Project Address Parcel Number Applicant
196 NW 95 Street 1131010330660
Miami Shores, FL 33150- Block: Lot: ANATASE CINEUS
Owner Information Address Phone Cell
ANATASE CINEUS 196 NW 95 Street
MIAMI SHORES FL 33150-1712
Contractor(s) Phone Cell Phone Valuation: $ 300.00
HOME OWNER
Total Sq Feet: 0
Type of Work: Exterior Available Inspections:
Color:salmon/beige Inspection Type:
Additional Info:
Final
Classification:Residential
Color: salmon/beige—Approved Code Comments:salmon walls
Color:salmon/beige_Approved_ Color:salmon/beige—Denied
Fees Due Amount Total Amt Paid I Amt Due
CCF $0.60
Education Surcharge $0.20 $62.30 $62.30 $ 0.00
Permit Fee $60.00
Technology Fee $1.50 Payment Type:Check/Number: 169
Total: $62.30
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.
July 13, 2007
Authorized Signature:Owner / Applicant / Contractor / Agent Date
Building Department Copy
Friday,July 13, 2007 1
�Llalc Miami Shores Village
inovz l � JUN 8 2007
�'1St4 - Building Department BY:(? oSAD ( n� V, 10050 N.E.2nd Avenue,Miami Shores,Florida 33138
-
••.......
qr1 Tel: (305) 795.2204 Fax: (305) 756.8972
BUILDING m�� 6-� Permit No. `
PERMIT APPLICATION ds� Master Permit No.
FBC 2004 (Cn 3)
Permit Type: PAINT PERMIT `� 1
Owner's Name(Fee Simple Titleholder) A I� U/ a I Phone#
Owner's Address /U.�J134.1 zej '
City �I�d wti .3)Wr•eI State -r(,p r7 afa Zip 3 3/S j
Tenant/Lessee Name Phone#
E-MAIL:
Job Address(where the work is being done) l`I( 9,51 J4-ed
City Miami Shores Village County Miami-Dade Zip
FOLIO/PARCEL# //3/D/0330C 6
Is Building Historically Designated YES NO ✓
Contractor's Company Name ),Njr Phone#
Contractor's Address
City State Zip
Qualifier Name Phone#
State Certificate or Registration No. Certificate of Competency No.
OWNER BUILDER: YE O
Value of Work For th�Mof
$ Type of Work: ❑ Addition/"Q Alteration/ ❑New/❑Repair/Re&ce
Describe 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,E
"WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN ZU.
RPAYING (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$2500,the applicant must promise in good faith that a dopy of the
notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also,a certified copy of the recorded notice
of commencement must be posted at the job site for the first inspection which occurs seven(7)days after the building permit is issued. /n the absence of such postdd notice,the
inspection will not be approved and a reinspection fee will be charged.
Permit Fee$ d/ 0 •co CCF$ ((420 Technology Fee: . �t J I • Jv
Training/Education Fee$ t L Notary$ Code Enforcement$ c n
Double Fee$ Zoning$ Total Fee Now Due$ 2 vG
QUL1 2� See R rse side
1
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: 2 3 4
Y _
Fascia: 1 2 3 4 fir:
Drip Cap/Drip Edge: 1 (2) 3 4
Soffit: 1 Z) 3 4
l _�
Roof: 1 2 3 4
Flower Bins:_1 2 3 4
Shutters:—l— 2 3 4 ) -, ,
Awnings: 1 2 3 4 4 - \
Chimney: 1 23 4
Doors and Door Jams: 1 2 3 4
Garage Doors: 1 Q 3 4
Railings:—I--2 3 4
Fences:-1-2-3— 4
All brick(simulated or regular):_1 3 4
Stucco Banding:—1— 2 3 4
Any other Stucco Features: 1 23 4
Accessory Buildings Other: 1 iAc 6o [�-a1nG 4
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.
Signature-6�" Signature
Owner or Agent Contractor
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
day of 17�,20�,by //J/16�1 rit day of ,20_,by ,
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. as identification and who did take an oath.
NOTARY P BLIC: NOTARY PUBLIC:
Sign: Sign:
Print: S Print:
MyT-
OF
�misMy Commission Expires:
My Comsion DD281037 Expires December 03,2007
APPLICATION APPROVED BY: Plans Examiner
Preservation Board
T I U Code Enforcement
\ (Revised 04/24/07)