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RC-11-128Inspection Number: INSP - 156705 Permit Number: RC -1 -11 -128 Scheduled Inspection Date: March 21, 2011 Inspector: Bruhn, Norman Owner: BELLINSON, JENNIFER Job Address: 9205 NE 4 Avenue Miami Shores, FL 33138- Project: <NONE> Contractor: ORONI INC Building Department Comments REPAIR DRYWALL DAMAGE CAUSED BY MOLD REMOVAL Passed�� c�i j/ � T Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments March 18, 2011 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 For Inspections please call: (305)762 -4949 Permit Type: Residential Construction Inspection Type: Final Building Work Classification: Alteration Phone Number Parcel Number 1132060140230 Phone: (305)685 -0412 Page 30 of 37 I nspection Type: Final PE Certification Shutter Final Window Door Attachment Tie Beam Slab Termite Letter Framing Insulation Drywall Screw Shutter Attachment Window and Door Buck Ceiling Grid Fill Cells Columns Declaration of Use Protect Address Owner Information Miami Shores Village 10050 N.E. 2nd Avenue NE Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 9205 NE 4 Avenue Miami Shores, FL 33138- 1132060140230 Block: Lot: JENNIFER BELLINSON Contractor(s) ORONI INC Phone Cell Phone (305)685 -0412 Fees Due CCF DBPR Fee DCA Fee Education Surcharge Permit Fee Scanning Fee Technology Fee Total: Amount $0.60 $2.00 $2.00 $0.20 $100.00 $3.00 $0.80 $108.60 Address Parcel Number Authorized Signature: Owner / Applicant / Contractor / Agent Building Department Copy January 28, 2011 Phone JENNIFER BELLINSON 9205 NE 4 Avenue MIAMI SHORES FL 33138 -0000 1 Approved: In Review Comments: Date Approved: : In Review Date Denied: Type of Construction: Stories: Front Setback: Left Setback: Bedrooms: Plans Submitted: Certificate Date: , Bond Retum : Occupancy: Single Family Exterior: Rear Setback: Right Setback: Bathrooms: Certificate Status: Additional Info: Classification: Residential Pay Date Pay Type Amt Paid Amt Due Invoice # RC -1 -11 -39898 01/28/2011 Credit Card $ 108.60 $ 0.00 Applicant 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. January 28, 2011 Date Cell Available Inspections: 1 BUILDING PERMIT APPLICATION FBC 2004 Job Address (where the work is being done) Contractor's Company Name _Ott [ l Ju(r Type of Work: ['Addition Describe Work: Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 DAlteration Is Building Historically Designated YES NO ❑New w1 Repair/Replace AAo Structural Review. $ Total Fee Now Due $ JAN 2 5 1011 ... Permit No. gC)) Master Permit No. 64 1. /i' Permit Type (circle): Building Roofing Owner's Name (Fee Simple Titleholder) APIY1 ti Gf , /Sa 1 dPhone # Owner's Address -/ 0 C NE i"(JT Cityl"U / SI S St to Zip 731 ' G Tenant/Lessee Name N� Phone # City Miami Shores Village County Miami -Dade Zip FOLIO / PARCEL # 1137-C & 42) Z-10 Phone# (7 Contractor's Address Z '- s.. ) - G i City ∎ M '4 State Zip . "316.g - Qualifier Named �S (k / Phone # State Certificate or Registration No aC 1 2_571 -,.1 Certificate of Competency No. Q'Rt O Architect/Engineer's Name (if applicable) Phone # Value of Work For this Permit $ 760 Square / Linear Footage Of Work: Demolition 4 aza ********* * * * * * * ** * * * * * * * * * * ** * * * * * * *: F * * *** * * * * * * * *** ** ** * * * ** *** **a* Submittal Fee $ Permit Fee $ / e v CCF $ Notary $ Scanning $ Radon $ DPBR $ Bond $ Code Enforcement $ Double Fee $ CO /CC Training/Education Fee $ Technology Fee $ Zoning $ See Reverse side -4 Bonding Company's Name (if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State 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 4 " Signature er or Agent NOTARY PUBLIC: t Sign: Print: My Commission Expires: [1 tlffit5��1;y'; ;g aAdva so . srootigsui APPLICATION APPROVED BY: + !�; (Revised 07/10/07) NOTARY PUBLIC: axon o Sign: Print: My Commission Expires: Contractor The foregoing instrume was acknowledged before me this The foregoing instrument was acknowledged before me this day of ,20 ,by 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. Plans Examiner Engineer Zoning qzoc t-flk � 1( elIf >� ''k ,_\,, X - SUBJECT TO COMPLIANCE WITH ALL FEDERAL STATE AND COUNTY RULES AND REGULATIONS 1 Miami Shores VIII; A8 . 1 APPROVED !ZONING DEPT 1d30 Kfl8I qzoc t-flk � 1( elIf >�