PT-07-1082 Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-50420 Permit Number: PT-5-07-1082
Scheduled Inspection Date: July 10, 2015 Permit Type: Paint
Inspector: Rodriguez,Jorge
Inspection Type: Final
Owner: HAYWARD, GREGORY Work Classification: New
Job Address:240 GRAND CONCOURSE
Miami Shores, FL Phone Number
Parcel Number 1132060133510
Project: <NONE>
Contractor: HOME OWNER
Building Department Comments
PAINT
Inspector Comments
Passed 41
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 33 of 35
Pelm#NOI I-5-"-1 082
stjOR T Miami Shores Village l 64 Type:paint
10050 N.E.2nd Avenue
Work :New
•" """' Miami Shores,FL 33138-0000 k
Phone: (305)795-2204 '
Expiration: 04/16/2008
Project Address Parcel Number Applicant
240 GRAND CONCOURSE Court 1132060133510
j Miami Shores Village, FL 33138- Block: Lot: GREGORY HAYWARD
Owner Information Address Phone Cell
r GREGORY HAYWARD 240 GRAND CONCOURSE
MIAMI SHORES FL 33138-2834
Contractor(s) Phone Cell Phone Valuation: $ 150.00
HOME OWNER
Total Sq Feet: 0
Type of Work:Exterior Available Inspections:
Color:WHITE Inspection Type:
Additional Info:
Final
Classification: Residential
Color:WHITE—Approved Code Comments:BEN MOORE-WALLS-NAVAJO
Color:WHITE_Approved_ Color:WHITE_Denied
?N 2 '
D V
OCT 2. 2007 '
Fees Due Amount Total Amt Paid 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: $67.30
In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations
pertaining thereto and in strict conformity with the plans,drawings,statements or specifications submitted to the proper authorities of Miami Shores Village. In
accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are
required for ELECTRICAL,PLUMBING,MECHANICAL,WINDOWS,DOORS,ROOFING and SWIMMING POOL work.
OWNERS AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
construction and zoning. Futhermore, I authorize the above-named contractor to do the work stated.
October 19, 2007
Authorized Signature:Owner / Applicant / Contractor / Agent Date
Building Department Copy
Friday,October 19,2007 1
I
Miami Shores Village c�5�1 �p
Building Department 1 , oWqr
10050 N.E.2nd Avenue,Miami Shores,Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
BUILDINGs7 r 7 9_` -�� Permit No.
PERMIT APPLICATI041
FBC 2004 L, MAY 2 5 2007 Lj Master Permit No.
BY: ---------
Permit Type: PAINT PERMIT R�
�/ 7 c,.(
Owner's Name(Fee Simple Titleholder)Atyly fit- �Rr-C,6 R y ��/ Phone# 3 0 .5 � S / S� �
Owner's Address a V O GR A AJ 0 C 0.1V C O URS �
Cityh'//P r" i 5 bf o it C-3 State �L I- Zip 33 13t
Tenant/Lessee Name Phone#
E-MAIL:
Job Address(where the work is being done) A Y O (IR A hl 1> C0 il/ G D U R S F
City ami Shores llaee County Miami-Dade Zip ._7.3/.3 R-
FOLIO/PARCEL#
Is Building Historically Desigl. xled YES O
Contractor's Company Name Phone#
Contractor's Address
City State Zip
Qualifier Name Phone#
State Certificate or Registration No. Certificate of Competency No.
OWNER BUILDER: YES/NO
,Err
Value of Work For this Permit$ $—Q .y O Type of Work: [IAddition/ ElAlteration/ ❑New/F_1Repair/Replace
th
Describe Work: I A/X' 7— 4-f0 0 S E M
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 issua*ce 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,tC.....
"WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT INUR PAYING TWICE FOR
IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER tit 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$2500,the applicant must promise in good faith that a opy of the
notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also,a cer4ified copy of the 1 ecorded notice
of commencement must be posted at the job site for the first inspection which occurs seven(7)days after the building permit is issued. /n the absence ofsuch post d notice,the
inspection will not be approved and a reinspection fee will be charged.
Permit Fee$ (LIL—) - `. ) CCF$ GC) Technology Fe .D
Training/Education Fee$ C) Notary$ 5 Code Enforce tt$ OCT 9 R =�
Double Fee$ Zoning$ Total Fee Now Due
MIAMI SHORES VI # gse Side
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: 1 2 3 4 Attach color unpla wlitn name
Fascia: 1 2 3 4
a�
Drip Cap/Drip Edge: 1 2 3 4 3
Soffit: 1 2 3 4 1 .2
Roof: 1 2 3 4
Flower Bins: 1 2 3 4 ``X.✓n.e G) rw
Shutters:-1 2 ( 3 1 4
Awnings:-1-2 3 4 2 �'
Chimney: 1 2 3 4 -
Doors and Door Jams: 1 2 3 4
Garage Doors: 1 2 3 4
Railings: 1 2 3 4 3
Fences: 1 3 4
All brick(simulated or regular): 1 2 3 4
Stucco Banding: 1 2 3 4 3
Any other Stucco Features: 1 2 3 4
Accessory Buildings Oth r: '
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 constru 'on and zoning.
Signa nature
ner r Agent Contractor
The foregoi instru as ackno ledged before me this The fo going instrument was acknowledged before me this
day of4personal
�y ,20 by ,
who isto me or who has pro uced — who is personally known to me or who has produced
s identification Tq,Whh did take an oath. as identification and who did take an oath.
r°`NOTAgr,NOTA `y: A NOTARY PUBLIC:
Sign: r "� `�` rL Sign:
Print: ' ' "' ��i be Print:
7-7FMy Commissi Expires: 9�/a,� ®o'�/G�fQQ�do�s My Commission Expires:
6,; 4Y .,' /y
c
APPLICATION APPROVED BY: Plans Examiner
r Preservation Board
l Ur y�c Code Enforcement
(Revised 04/24/07)