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RC-3-12-543, 65 NW 110th StInspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 inspection Number: INSP-192480 Permit Number: RC-3-12-543 Inspection Date: May 31, 2013 Permit Type: Residential Construction Inspector: Rodriguez, Jorge Inspection Type: Final Owner: BARTHELEMY, ODETTE Work Classification: Alteration Job Address: 65 NW 110 Street Miami Shores, FL 33168- Project: <NONE> Contractor: WPH CONSTRUCTION COMPANY Build Comments RE SHEATING ROOF DECK 928 SQ FT PLYWOOD 05/28/2013 - EXPIRATION DATE EXTENDED PER MASTER PERMIT. Phone Number (305)757-9851 Parcel Number 1121360030590 INSPECTOR COMMENTS False Phone: (305)244-2392 Inspector Comments Passed CREATED AS REINSPECTION FOR INSP-192184. REPLACE BROKEN TILES. COUNTER FLASHING MISSING FASTNER. ❑ SEALS COUNTERFLASHING FASTNERS Failed Correction ❑ Needed Re -Inspection ❑ Fee No Additional Inspections can be scheduled until re -inspection fee is paid. For Inspections please call: (305)762-4949 May 31, 2013 Page 1 of 1 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 Permit Type: BUILDING JOB ADDRESS: K, N _�N 11 0 S FBC,s2O Permit N Master Permit No. r-4 ' �� C& LJ v ROOFING City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: Is the Building Historically Designated: Yes NO Flood Zone: OWNER: Name (Fee Simple Titleholder): OD C F_ L �ny Phone#: City: I W h'! 1 s5k oQx6�_ State: Zip: Tenant/Lessee Name: Email: Phone#: CONTRACTOR: Company Name: Ali- C%D PiV Phone#: �311 S C;Z� <�-f23 Address: lC� ,�� /�� %6 AveI Y �!l • i�) %r J .F[ W City: A State: � Zip: .3 3 j 4/9 Qualifier Name: 5 Phone#: State Certification or Registration #: G /_"s i'3Y7� Certificate of Competency #: Contact Phone#: 30 S a ��FZ �J �1 �' Email Address: W ?,K e o-.,4 ��-�- '_P G X Coin. DESIGNER: Architect/Engineer: Phone#: Value of Work for this Permit: $ ,�. � �= Square/Linear Footage of Work: ,9 Type of Work: ❑Addition ❑Alteration ❑New giRepair/Replace ❑Demolition Submittal Fee $ Permit Fee $ /t�� — CCF $ CO/CC $ Scanning Fee $ Radon Fee $ Notary $ Training/Education Fee $ DBPR $ Bond $ Technology Fee $ Double Fee $ Structural Review $ TOTAL FEE NOW DUE $ Bonding Company's Name (if applicable) Bonding Company's Address City State Mortgage Lender's Name (if applicable) _ Mortgage Lender's Address City Zip Zip 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..... 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. "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 a reinspection fee will be charged. Signature �� Signature r Owner 'or Agent Contractor The foregoing instrument was acknowledged before me this (% The foregoing instrument was acknowledged before me this �D i day�f � , 20 f Y FO 2 7 Z� ;3#flAP—le{'Lyday of �1' 20 ��Y ©l7� i / � 46ho is personally known to me or who has produced / w 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 PUBLIC: Sign: (v" Print: /�/v0 az f l� My Commissio x ANDRE E. JOSEPH �* MY COMMISSION # DD947195 EXPIRES December 16, 2013 com APPROVED BY / / ' �� Plans Examiner Structural Review NOTARY PUBLIC: Sign: Print: /f S My Commission ANDRE E. JOSE H `c MY COMMISSION # DD947195 EXPIRES December 16, 2013 ,,' r ��• `, FlorWeNolary3e�wks.Com r 9e9e*�tir9e 9c9eatir9e 9e 9c -01$3 �k9e 9e*9e+ Zoning Clerk (Revised 3/12/2012f(Re)7ised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09)