RC-10-09-1752 Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: I NSP - 138241 Perm N u mb er: R 0 -09 -1752
Scheduled Inspection Date: March 18, 2010 Permit Type: Residential Construction
Inspector: Bruhn, Norman Inspection Type: Final Building
Owner: CHAMBERS, TERRELL Work Classification: Alteration
Job Address: 10642 NE 11 Court
Miami Shores, FL 33138- Phone Number
Parcel Number 112232028045
Project: <NONE>
Contractor: ELTEC CONSTRUCTION & INVESTME Phone: (305)694 -1080
Building Department Comments
Repair & Replace living room wood floor.
Inspector Comments
Passe ��1 CREATED AS REINSPECTION FOR INSP- 127728. No Access NB 11:15
Failed
Correction ❑
Needed
Re- Inspection ❑
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
March 17, 2010 For inspections please call: (305)762 -4949 Page 17 of 20
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Project Address Parcel Number A pplicant
H'' 10642 11 COUrt 1122320280450
TERRELL CHAMBERS 'y
Miami Shores, FL 33138- Block: Lot:
Owner Information Address Phone Cell
10642 11 Court ��� ..._.
TERRELL CHAMBERS ry,
MIAMI SHORES FL 33138 -2123
Contractor(s) Phone Cell Phone
305 694 -1080 Valuation: $ 3,500.00
ELTEC CONSTRUCTION & INVESTME ._.w..
( ) (786)444 -5703
Total Sq Feet: 360
Approved: In Review For Inspections please call:
Comments: (305)762 -4949
Date Approved:: In Review Available Inspections:
Date Denied:
Inspection Type:
Type of Construction: Occupancy: Final Building
Stories: Exterior: Second Floor Slab
Front Setback: Rear Setback: Second Floor Tie Bond Beam
Left Setback: Right Setback: Final PE Certification
Bedrooms: Bathrooms: Shutter Final
Plans Submitted: Certificate Status: Tie Beam Bond Beam
Certificate Date: Additional Info: Window Door Attachment
Bond Return : Classification: Residential Slab
Termite Letter
Fees Due Amount Invoice # Total Amt Paid Amt Due Framing
CCF $2 Insu
RC $ 112.30 $ 50.00 „ 9 ,,' Floor Trusses
DBPR Surcharge $1.80
Education Surcharge $0.80 RC - 10 - 09 - 36224 $ 112.30 $ 112.30 $ 0.00 Drywall Screw
Permit Fee - Additions /Alterations $100.00 Trusses Pl Sub mittal
Permit Technology Fee $2.50 Roof Sheathing
Radon Surcharge $1.80 Spot Survey
Scanning Fee $3.00 Wall Sheathing
SubmittaK*e $50.00 Sh utter Attachment
Submittaf:'f;teversal Fee ($50. Footer Column Pads
Total:Q $112.30 Rake Beam
Window and Door Buck
ti.
Roof Trusses
rCZ).) Density
Fill Cells Columns
Wire Lathe
Stem Wall Footer
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In consi ation of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations
pertaining -- hereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In
accepting his permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are
required* ELECTRICAL, PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work.
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OWNEF&AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
construcWn and zoning. Futhermore, I authorize the above -named contractor to do the work stated.
November 02, 2009
Authorized Signature: Owner / Applicant / Contractor / Agent Date
Builing Department Copy
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Nove er 02, 2009 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 No. ") 0 -0 9 15 Z
PERMIT APPLICATION Master Permit No.
FBC 20
Permit Type: BUILDING ROOFING-
Owner's Name (Fee Simple Titleholder) 7 r, F C �3e - �s Phone # �g/104
Owner's Address N G # C
City M I it 5*41Lg S State F Zip � 3
Tenant/Lessee Name Phone #
Email
Job Address (where the work is being done) Al O, `r C 17
City Miami Shores Villa County Miami -Dade Zip
FOLIO / PARCEL #
Is Building Historically Designated YES NO Flood Zone
Contractor's Company Name �� h ;,?E Phone # ?Ab y g 4 15 - 7y r W s
Contract Address Op
City I� y `114 Ft ;14:1 State rl Zip g3AK 7
Qualifier Name Phone #
State Certificate or Registration No. Certificate of Competency No,
Contact Phone E -mail
Architect /Engineer's Name (if applicable) Phone #
Value of Work For this Permit $ won• O C7 Square / Linear Footage Of Work: 3
Type of Work: ❑Addition ❑Alteration [ ❑ Repair/Replace
El Demolition
Describe Work: �� E E /�N t�'Oa� wO o Off'
* * * * * *
Pubmitt�ae $ Va Permit Fee $ �� CCF $ 2�"I� CO /CC $
Notary $ 0 Training /Education Fee $ ' Technology F
Scanning $ 3 , Ra on $ ( 0 DPBR $ Bond $
Double Fee $ Violation date:
Structural Review. $ Total Fee Now Due $ - 1 7 n, B0
See Reverse side —�
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 Signature e '
Owner or Agent 41 Contractor
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
day of OC�J1� 1 6 TW ( (Q U alb 1 , day of be r, 20 ", by blaff
who is personally known to me or who has produced who is personally known to me or has produced FL-I L
.. - As identification and who did take an oath. as identification and who did take an oath.
NOTARY PUBLIC: NOTARY P LIC:
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Sign`.) 1 4 1 , Sign: C!_/
Print: �R Print: ST qRY t Uo-
My Commission Expire 71X- op p� iz � My Commission ExpZ
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APPROVED BY Plans Examiner Zoning
Engineer Clerk checked
(Revised 07 /10 /07)(Revised 06/10/2009)
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