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BPP-10-325 1---- Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 i nspection Number: INSP - 140996 Permit Number: EL -3-10 -365 Inspection Date: May 11 2010 Permit Type: Electrical - Residential Inspector: Devaney, Michael Inspection Type: Final Owner: GUSTINGER, KURT Work Classifi cation: Alteration Job Address: 1216 NE 93 Street Miami Shores, FL Phone Number (305)751 -5554 Parcel Number 1132050270160 Project: <NONE> Contractor: JACQUES ELECTRIC Phone: (954)214 -8711 Building Department Comments / Inspector Comments Passed / ,{' CREATED AS REINSPECTION FOR INSP - 140855. coverall boxes. No LLL���LLJUJ receptacles withen 10' of water & all rec.to be G. F. I. protected with in use covers. Connect cable feeding pool heater. pump switch covered by fence. Need door and window alarms, Panel blanks. Failed El 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 11, 2010 Page 1 of 1 4 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 j Inspection Number: INSP 140855 Permit Number: EL -3 -10 -365 Scheduled Inspection Date: April 20, 2010 Permit Type: Electrical - Residential Inspector: Devaney, Michael Inspection Type: Final Owner: GUSTINGER, KURT Work Classification: Alteration Job Address: 1216 NE 93 Street Miami Shores, FL Phone Number (305)751 -5554 Parcel Number 1132050270160 Project: <NONE!>° Contractor: JACQUES ELECTRIC Phone: (954)214 -8711 Building Department Comments Inspector Comments Passed eS Failed Correction Needed Re- Inspection ❑ �,� Fee 60- to �� No Additional Inspections can be scheduled until 'qea I "6 re- inspection fee is paid. J,,,- ARA5 April 19, 2010 For Inspections please call: (305)762 -4949 Page 26 of 28 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 i nspection Number: INSP- 136831 Permit Number: BPP -3 -10 -325 Inspection Date: May 12 2010 Permit Type: PoolsWhirlpools /Hot Tubs Inspector. Rodriguez, Jorge Inspection Type: Final Owner: GUSTINGER, KURT Work Classification: Addition/Alteration Job Address: 1216 NE 93 Street Miami Shores, FL Phone Number (305)751 -5554 Parcel Number 1132050270160 Project: <NONE> Contractor: MARS POOLS Phone: (954)214 -2844 Building Departme Comments Inspector Comments Passed El 10 Failed Correction ` 0 ' Needed Re- Inspection ❑ Fee No Additional Inspections can be scheduled until re- inspection fee is paid. For Inspections please call: (305)762 -4949 May 12, 2010 Page 1 of 1 r y a f r z Miami Shores Village 10050 N.E. 2nd Avenue f M Miami Shores, FL 33138 -0000 f � r 3 Phone: (305)795 -2204 Expiration: 09115/201 Project Address Parcel Number Applicant 1216 93 Street 1132050270160 Miami Shores, FL Block: Lot: KURT GUSTINGER Owner information Address Phone Cell KURT GUSTINGER 1216 NE 93 ST (305)751 -5554 MIAMI SHORES FL 33138 -2941 Contractor(s) Phone Cell Phone Valuation: $ 9, 000.00 MARS POOLS (954)214 -2844 (954)741 -4124 Total Sq Feet: 2300 Approved: Yes Available Inspections: Comments: Inspection Type: Date Approved: 3/1212010: Yes Fence Date Denied: Final Type of Work: Swimming Pool Occupancy: Private Pool Deck Additional Info: POOL Bond Return : Walt Steel Classification: Residential Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $5.40 Invoice # BPP -3-10 -37165 Education Surcharge $1 .80 Permit Fee $270.00 03/19/2010 Check #: 1193 $ 146.40 $ 150.00 Scanning Fee $12.00 03/09/2010 Credit Card $ 150.00 $ 0.00 Submittal Fee $150.00 Submittal Reversal Fee ($150.00) Technology Fee $7.20 Total: $296.40 In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL, PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work. OWNERS AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Futhermore, I authorize the above -named contractor to do the work stated March 19, 2010 Authorized Signature: Owner / Applicant / Contractor / Agent Date Building Department Copy March 19, 2010 1 Miami Shores Village , Building Department A 2010 10050 N.E.2nd Avenue, Miami Shores,.Florida 33138 Tel: (305) 7952204 Fax: (305) 756.89 72 �'..... BUILDING Permit No. PERMIT APPLICATION Master Permit 1No. I O 3 FBC 2004 Permit Type (circle): Building Roofin Owner's Name (Fee Simple Titleholder) l� lf� , hone # -jq %6 Owner's Address 7 -16 C .9 s 2 City /fit, vrC� state 6L Zip 3 3/ 3 S Tenant/Lessee Name Phone # Job Address (where the work is being done) City Miami Shores Village County Miami -Dade Zip FOL / PARCEL # - J� 050d /D 0 Is Building Historically Designated YES NO Contractor's Company Name JON 9 /s T e Phone # vl 5�N1 V Contractor's Address !/ l 2 2 351 / a City r7r1 .5 e. s tate Zip . y Qualifier Name llll ,?,?Aq + n Q v � Phone # State Certificate or Registration No �� l�7 / ZG- Certificate of Competency No. Architect/Engineer's Name (if applicable) Phone # Value of Work For this Permit$ _� dO & Square / Linear Footage Of Work: 2 3 00 Type of Work: Addition [Alteration ❑New ❑ Repair/Replace ❑ Demolition Describe- Work: _ �t /� t L)C, _ r /i4 K 4 G7d � Fee $5 - Q 0 Permit Fee $ CCF $ 40 CO /CC , Notary $ Training/Education Fee $ Technology Fee $ Scanning $ Radon $ DPBR $ Zoning $ Bond`$ Code Enforcement $ Double Fee $ Structural Review. $ Total Fee Now Due See Reverse side -4 Boni. Company's Name (if apph&hle) Bonding Company's Address City° ' State zip Mortgage Lender's Name (if applicable) Mortr pe 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 appliccble laws regulating construction and zoning. "WAF°;NING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR' PAYI IG TWICE FOR IMPROVEMENTS TO. YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COV � `ENCEMENT." 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 l whose property is subject to attachment. Also, a certified copy of the record'ed 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 be approved and a reinspection fee will be charged Signature Signature Owner or Agent Contractor The foregoing instrument was acknowledged before me this The foregoi instru nt was acknowledged be ore me this day of , 20 l� by D 'r day of , 20 � by e v / who is personally known to me or who has produced L-- who is personally known to me or who has produced IF As identification and who did take an oath. as identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: j � !"71 CA WEND010 N TEW t T ' a rQ ENDO Sign Sign: r,.� F. EXPT ' : kpr.l9,z(it0 OFI EXFq ?. 7-010 Print - Print My Commission Expires: My Commission Expires: APPLICATION APPROVED BY: flans Examiner Engineer 3 / �a: Zoning (Revised 07/10(07) I PERMIT # CONTRACTOR: SUBMITTAL BATE: H I ADDRESS: ` NAME: C,� -1e4Z7 i RESUBMITAL DATES: PROJECT TYPE: > - Al qz �l r� ZONING FIRE I STRUCTURAL IMPACT FEES ELECTRICAL HRS /DERM ?LUMBIN j t/ NOC � IMECHANICAL ct�d 9e /� 111111 oil 111111111111111 w ,77069 CFA 201OR013V78 . 00 Bk 27199. F'9 38.011 (fps) RECORDED 03A0212010 103S.-Io HARVEY RUVINr .CLERK. t1F COURT ' Permit # ' RW� 01 MIAMI -GAGE COUNTY r FLORIDA Folia # LAST PAGE TE OF FLORIDA, COUNTY OF DADE ; NOTICE OF COMMEN ERP,9Y CEMEI',a that this is CERTIFY of fhe WOW th on o, The undersigned hereby gives notice that improvement will be ma to cart c m ylr property and.in accordance with Chapter713, Florida: Statutes, the fol A D tF1 7s provided inahis Notice of Commencemea: ` g�� ' N RUVIN, CLERK, of Ckw or 1. Legal Description of Property: Lot Block 40AR �'° I ?C engthy legal a hod Sub di jsI n/Cond nium: LUPe Street Address if available: Pl 2. General description of Improvement • 3.8. Own name and address .✓�/`G 3 �'!�'$ b: Interest in propertyc. /�tid�? l't" c.: Name and address of-fes sitnpte titleholder (if other th an Owner) . 41 a. Contractor name and address. rF/w G�D� �. v;S 02 �"S'"G1�1�1/e3f' . b. Contractor's phone number: (� 5-8. Surety name and address: b: Surety's. -phone number; c. Amount of.bond: .6.a- Lender name and address: b. Lender's phone number: 1 Persons within the State of Florida designated by Owner upon whom notices or other documents maybe served as provided by Section 713.13(1)(a)7., Florida Statutes: ,� Name �1 e C' l Address:: r� 9C - e b. Phone dumber g In addition to himself or herself the Ownet. designate s , to receive a copy of Uen6es Notice per Section 71&13(l)(b) Florida b. Phone number of person or entity designated by owner 9. ' Expiration data of nonce of commencement (the expiration date Is 1 year from the date of reoording amass a different date Is spedKied) ' WARNING TO OWNER: ANY PAYMENTS. MADE BY THE OWNER AFTER THE EXPIRATION ' OF THE NOTICE OF COMMENCEMENT ARE CONSIDERED IMPROPER - PAYMENTS UNDER CHAPTER 713, PART I, SECTION 713.13, FLORIDA STATUTES, AND CAN RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF. COMMENCEMENT MUST. BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU. INTRND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOU NOTICE OF COMMENCEMENT. Signatures) of Owner(s) or Owner(s)' Authorized Officer /Director /Partner/Manager B By P Name Pin Name Title/Office TitlefOff(ce STATE OF FLORIDA COUNTY OF BROWARD T4m t�ii�. t..'C. 1 da ' tsaiiw l3 �rh 1 75. : By 2 0 y0 Q Individuaily,•or ❑ as fo Personally known, or produced thefollowing type of Identification: �.. Signature of Notary Public: Print Name. (SEAL) rasp GWENDOLYN'S.STEWART my COMMISSION # DD54M VERIFICATION PURSUANT r0 SECTION 02,625, FLORIDA STATUTES � Wbl � 1101 EXPIRES: Apr. 19,20I {407) 11W nor WS NOWY sevioeoom Under penalties of perjury, I. declare that 1 have read the foregoing ant! that the facts stated In it are true, to the best of my knowledge and belief. Signature(s) of Owner(s) or Owner(s)' Authorized Officer /Director/Partner/Manager who signed above: By B g:treWrdinglfor=V=. notice of commencement revised 73.07.doo Planning and Zoning Criteria 9 e s Miami Shores Village Permit NO B P P - 3 -10 - 325 10050 N.E. 2nd Avenue Miami Shores, FL 33138-0000 a y y Phone: (305)795 2204 Fax: (305)756 8972 „r Issue Date Not Issued Facp(res: ®t Issued Folio Number) 132050270160 Owner's Name: KURT GUSTINGER Owner's Phone: (305)751 -5554 Job Address: 1216 93 Street Total Square Feet: 2300 Miami Shores, FL Total Job Valuation: $ 9,000.00 Contractor(s) Phone Primary Con MARS POOLS (954)2142844 Yes Planning and Zoning Criteria and Comments Approved: Yes Date Approved: 3/12/2010: Yes Comments: F "ETCH. OF BOUNDARY SURVEY ' - 2 aye Q Dec K '~ �`r�1i� _, .: Via: • a T: AJa Jr . _� �' � � ' • � / D!Jr'1D r s FG• Fif °Q �© L o 3 ; 51 rf Q;: 25 LS= rfl ° f'lo� • tt (� •� f 7-" /- Aao , z• - Q .. tree A= Boa G { t,7 p H N ^, n, r 1 i i ds h 1 • O cad I i ZoOO' ^ ' I t oo 0 �. Piro*- Sao 1 z« _ F A; NIcc ayeca `-•.S �. '�' tUDODCJI ROOD ' � � � � t 7'LR1P -AGC �� ft6`er4e eo D ar- j-" ' A4ef - 'V iqveg3 'nor LA I I I pi p D AP P ROV F — : LoT x3 SOT 2 mM -DARE COUN HEALTH DXPAitTME { IT fly- �1Z-7-S oc BEARINGS HEREON AIF I ARE REFERRED TO A�1�SS U7MED VALUE OF FOR THE " �E Pe91 _ --�' �® L SAID BEARING IS IDENTICAL. WITH THE PLAT OF, RECORD ACCORDIMG TOT Tii:... 0455 iE RTY FALLS WITHIN FLOOD ZONE: AE 1 PERMIT #: MIAMI SHORES VILLAGE APPROVED BY DATE ZONING STRUCTURAL ELECTRICAL `� �1�� L�''.dZJ % /L 15oglZ PLUMBING MECHANICAL BLDG. °� t SUBJECT TO COMPLIA - ,N ''fit ALL STATE AND COUNTY R .' _; C, FLORIDA DEPARTMENT OF �L mil./ Charlie Crist Ana M. Viamonte Ros, M.D., M.P.H. Governor State Surgeon General February 24, 2010 Michael Stewart 10605 NW 53 St Fort Lauderdale, FL 33351 RE: Contingency Letter Application Document No: AP953733 Centrax Permit Number: 13 -SC- 1122500 OSTDS Number: 1216 NE 93 St Miami, FL 33138 Lot: 3 +4 Block: 2 Subdivision: Dear Applicant: This will acknowledge receipt of an application dated 02/23/2010 for a permit to use an existing onsite sewage treatment and disposal system located on the above referenced property. There is no increase in sewage flow, rro change in characteristics compromising the integrity or function of the system. From a review of your completed application, it has been determined that your existing system is adequate for the proposed use.. This permit is granted for construction of a pool deck that will have no impact on the unobstructed area. If you have any questions on this matter, please call our office at (305) 625 -2500. Sincerely, Jos ph i er r, ng' ecialist II Enclosures cc: Miami -Dade County Health Department 1765 NW 167 St, Opa Locka, FL 33056 Phone: (305) 625 -2500 Fax: (786) 315 -2090 STATE OF FLORIDA PERMIT NO. DEPARTMENT OF HEALTH DATE PAID: ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM FEE PAID: APPLICATION FOR CONSTRUCTION PERMIT RECEIPT- APPLICATION FOR: [ ] Wew System Existing System [ ] Holding Tank [ ] Innovative [ ] Repair [ ] Abandonment [ ] Temporary [ ] APPLICANT: 90 - AGENT: 3' 1 t t / TELEPHONE: 9R1 MAILING ADDRESS: 1 "� s t' j e" 2 �2 f TO BE COMPLETED BY APPLICANT OR APPLICANT'S AUTHORIZED AGENT. SYSTEMS MUST BE CONSTRUCTED BY A PERSON LICENSED PURSUANT TO 489.105(3)(m) OR 489.552, FLORIDA STATUTES. IT IS THE APPLICANT'S RESPONSIBILITY TO PROVIDE DOCUMENTATION OF THE DATE THE LOT WAS CREATED OR PLATTED (MM /DD/YY) IF REQUESTING CONSIDERATION OF STATUTORY GRANDFATHER PROVISIONS. PROPERTY INFORMATION LOT: BLOCK: � SUBDIVISION: �� PLATTED: 1 m PROPERTY ID #: �'r�t �f,C ZONING: I/M OR EQUIVALENT: [ Y / N ] PROPERTY SIZE: s1 ACRES WATER SUPPLY: [ ] PRIVATE PUBLIC [ = 2000GPD [ ] >2000GPD IS SEWER AVAILABLE AS PER 381.0065, FS? [ Y / DISTANCE TO SEWER: FT PROPERTY ADDRESS: DIRECTIONS TO PROPERTY: j ;?" � 7 '��`, L. r`} BUILDING INFORMATION [ RESIDENTIAL COMMERCIAL _ Unit Type of No. of Building Commercial /Institutional System Design No Establishment Bedrooms Area Sgft Table 1, Chapter 64E -6, FAC r� 2. 3 4 [ ] Floor /Equipment Drain Other (Specify) SIGNATURE: ? l%� %'tt 1 A , _.;. DATE: DH 4015, 10/97 — Page 1 (Previous Editions May Be Used) Page 1 or 4 Stock Number: 5744- 001 - 4015 -1 APPLICATION FOR: Check type of permit, if "Other" specify type in blank. APPLICANT: Property owner's full name. AGENT: Property owner's legally authorized representative. TELEPHONE: Telephone number for applicant or agent. MAILING ADDRESS: P.O. box or street, city, state and zip code mailing address for applicant or agent. LOT, BLOCK, Lot, black, and subdivision for lot (recorded or unrecorded subdivision). If lot is not in a SUBDIVISION: recorded subdivision, a copy of the lot legal description or deed must be attached. DATE OF SUBDIVISION: Official date of subdivision recorded in county plat books (month /day /year) or date lot originally recorded. Dividing an approved lot into two or more parcels for the purpose of conveying a ownership shall be considered a subdivision of the lot. PROPERTY ID #: 27 character number for property. CHD may require property appraiser ID # or section /township /range /parcel number. ZONING: Specify zoning and whether or not property is in I/M zoning or equivalent usage. PROPERTY SIZE: Net usable area of property in acres (square footage divided by 43,560 square feat) exclusive of all paved areas and prepared road beds within public rights -of way or easements and exclusive of streams, lakes, normally wet drainage ditches, marshes, or other such bodies of water. Contiguous unpaved and non - compacted road rights -of -way and easements with no subsurface obstructions may be included in calculating lot area, WATER SUPPLY: Check private or public c= 2000 gallons per day or public > 2000 gallons per day. SEWER AVAILABILITY: Is sewer available as per 331.0065, Florida Statutes, and distance to sewer in feet. PROPERTY ADDRESS: Street address for property. For lots without an assigned street address, indicate street or road and locale in county. DIRECTIONS: Provide detailed instructions to lot or attach an area map showing lot location. BUILDING INFORMATION: Check residential or commercial. TYPE ESTABLISHMENT: List type of establishment from Table 11, Chapter 64E -, FAC. Examples: single family, single wide mobile home, restaurant, doctor's office. NO. BEDROOMS: Count all rooms designed primarily for sleeping and those areas expected to routinely provide sleeping accommodations for occupants. BUILDING AREA: Total square footage of enclosed habitable area of dwelling unit, excluding garage, carport, exterior storage shed, or open or fully screened patios or decks. Based on outside measurements for each story of structure. BUSINESS ACTIVITY: For commercial /institutional applications only. List number of employees, shifts, and hours of operation, or other information required by Table 11, Chapter 64E -6, FAC. FIXTURES: Mark Floor /Equipment Drains or Others and specify item or "NA" if not applicable. SIGNATURE / DATE: Signature of applicant or agent. Date application submitted to the CHD with appropriate fees and attachments. ATTACHMENTS: A site plan drawn to scale, showing boundaries with dimensions, locations of residences or buildings, swimming pools, recorded easements, onsite sewage disposal system components and location, slope of property, any existing or proposed wells, drainage features, filled areas, obstructed areas, and surface water. Location of wells, onsite sewage disposal systems, surface waters, and other pertinent facilities or features on adjacent property, if the features are with 75 feet of the applicant lot. Location of any public well within 200 feet of lot. For residences, a floor plan (residences) showing number of bedrooms and building area of each unit. For nonresidential establishments, a floor plan showing the square footage of the establishment, all plumbing drains and fixture types, and other features necessary to determine composition and quantity of wastewater. J_ 10 ft. 2 in. 75 ft. 5 in. P 2" MainDrain_ 2" Waterfall Line V Slide line 10 ft. 2 in. o / \ o 17 ft. � o Q� N i � I LID 100 ft. x REM— MW Miami Shores Village 10050 N.E. 2nd Avenue m Miami Shores, FL 33138-0000 s 3 Phone: (305)795 -2204 R'n , Expiration: 0911512010 Project Address Parcel Number Applicant 1216 93 Street 1132050270160 Miami Shores, FL Block: Lot: KURT GUSTINGER Owner Information Address Phone Cell KURT GUSTINGER 1216 NE 93 ST (305)751 -5554 MIAMI SHORES FL 33138 -2941 Contractor(s) Phone Cell Phone Valuation: $ 300.00 JACQUES ELECTRIC (954)214 -8711 Total Sq Feet: p Type of Work: HOOK UP FOR PUMP Available Inspections: Additional Info: ELECTRICAL In Typ Classification: Residential Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $0.60 Education Surcharge $0.20 Invoice # EL -3-10 -37232 Permit Fee - AdditionsiAlterations $225.00 03/19/2010 Check #: 1193 $ 229.60 $ 0.00 Scanning Fee $3.00 Submittal Fee $0.00 Technology Fee $0.80 Total: $229.60 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. March 19, 2010 Authorized Signature: Owner / Applicant / Contractor / Agent Date Building Department Copy March 19, 2010 1 Miami Shores Village 10 1, 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. t: L i (D-<*3(6 PERMIT APPLICATION Master. Permit No. t o- 3 VqS FBC 20 Permit Type: ELECTRICAL Owner's Name (Fee Si X36 Simple Titleholder). �/ �� C� /��/J�? 0 3�?s- 2 f Owner's Address . Ci ctiA 561e3 State L Zip Tenant/Lessee Name Phone # Email Job Address (where the work is being done) 1���aC93 5 f 2 r� City Miami Shores Villae County — Miami-Dade Zip 3 3 7 FOLIO !PARCEL # 0I60 Is Building Historically Designated YES NO Flood Zone Contractor's Company Name J1 �Pli�� .� Phone # Contractor'j Address Q --d! rr u Ci Ak O Dl tate Zip �Z q Qualifier Name 9k- Phone # State Certificate or Registration No. 6X 00 ! 7 Z Certificate of Competency N oo + Contact Phone E -mail al ell- A dOW V Aq/, ea-*q Architect/Engineer's Name (if applicable) Phone # Value of Work For this Permit $ �t/v + Square / Linear Footage Of Work: Type of Work: ❑Addition ❑Alteration New ❑ Repair/Replace ❑ Demolition Describe Work: w 0 ' Oomp lj IlD submittal Fee Permit Fee $ eVXSo 4P o CCF $ CO /CC $ Notary $ Training/Education Fee $ Technology Fee $ ' Scanning $ Radon $ DPBR $ Bond $ Double Fee $ Violation date: d Structural Review. $ Total Fee Now Due $ I ' 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 re- inspection fee will be charged Signature Signature Z Owner or-Agent Contractor The forego ing instrument was acknowledged before me this eg 2 The foro' g ins ent was acknowledged before m s �' day of � , 20 /d, by day of , 20�, by who is personally known to me or who has ffoduced Li 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 PUBLIC: NOTARY PUBLIC: Sign: Sig Print: air GWENDOLYN . S P MY CMMISSION # DD542394 My EXPIRES: Apr. 19.2010 Y O Commis O� �S: t�/1 �8 U1s3. M Y COMMISSION # DD542394 M %f EXPIRES: Apr. 19, 2010 X p %M Hoary semmoom RMtde Notary s. -, A-- APPROVED 4Y Plans F4aminer Zoning Engineer Clefk checked (Revised 07 /10 /07XRevised 06/10/2009) wo r Miami Shores Village ?, 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 F Q5 " Phone: (305)795 -2204 r� r », Expiration: 1 Project Address Parcel Number Applicant 1216 93 Street 1132050270160 Miami Shores, FL Block: Lot: KURT GUSTINGER Owner Information Address Phone Cell KURT GUSTINGER 1216 NE 93 ST (305)751 -5554 MIAMI SHORES FL 33138 -2941 Contractor(s) Phone Cell Phone Valuation: $ 300.00 MARS POOLS (954)214 -2844 (954)741 -4124 m_.. - _..... .: Total Sq Feet: 0 Type of Work: WATER FALL WATER LINE SLIDE Available Inspections: Type of Piping: POOL Inspection Type: Additional Info: PLUMBING Final Bond Return: Classification: Residential Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $0.80 Education Surcharge $0.20 Ir1VO1Ce # PL -3-10 -37233 Permit Fee - Additions/Aiterations $150.00 03/19/2010 Check* 1193 $ 154.6Q $ 0.00 Scanning Fee $3.00 Submittal Fee $50.00 Submittal Reversal Fee ($50.00) Technology Fee $0.80 Total: $154.60 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. March 19, 2010 Authorized Signature: Owner / Applicant / Contractor / Agent Date Building Department Copy March 19, 2010 1 ?`��� Miami Shores Village L � -TE 9 W Building Department 80, MAR D 2 2010 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 BUILDING Permit No. TL 1 PERMIT APPLICATION Master Permit No. FBC 2004 Permit Type Plumbing I Owner's Name (Fee Simple Titleholder) two � L)4� eN Phone # 3 1 9 5- 79'1— 370 Owner's Address 2 City `''!I' A [�l��✓'PS State I Zip 3 37 ,7 0 Tenant /Lessee Name Phone # E -MAIL: Job Address (where the work is being done) City Miami Shores Village Count Miami -Dade Zip FOLIO / PARCEL # Q i ! 016 Is Building Historically Designated YES NO Contractor's Company Name .t�T�S ��!/v /S _ Phone # A/,-/! F , � Contractor's Address � �� /�!� lV� 11/& 2 Cit /'l State Zip Qualifier Name � ci e l Phone # ^zYv v State Certificate or Regi ratio No L Iy ,f 2/ Certificate of Competency No. E- MAIL: )wp*z.S11o e Architect /Engineer's Name (if applicable) Phone # Value of Work For this Permit $ ,V , 00 Square / Linear Footage Of Work: Type of Work: ❑Addition ❑Alteration [New ❑ Repair/Replace JJ Q El Demolition X11 Describe Work: O� /� k Av /� W er r . 4Z -wo (9 Submittal "� Submittal Fee $GJ .00 Permit Fee $ l ✓Z ^ 1 CCF $ O' CO /CC Notary $ Training /Education Fee $ • Technology Fee $. _ in Scanning $ Radon $ DPBR $ Zoning $ Bond $ Code Enforcement $ Double Fee $ Structural Review. $ Total Fee Now Due $ 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 op roved and a reinspection fee will be charged. Signature Signature Owner or Agent Contractor The fore oing rument was acknowledged before ¢ ne his 2 The foregoing instrument was acknowle ed before and this day Of � > 20 /v, by da f� eJZ g,,/ y .of , 20 to , by who is personally known to fine or who has oduced_ who is personally known to me or who has produced ic�- /Q As identification and who did take an oath. as identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: OLYN vv tit 111111 r ,\ Q 31 '�,, Sign: � Sign: (L��— - �,....• .bd �. Print' 9 OfF� ® @ � EXPIRES: Apr. 19,2010 lorida Notary Service.com Print: My Commission Expires: My Commission Expires- - r.i;r.Fr,xr, kxrxicx *xxi;rxr'.tr.xxxxxr.r. icxr. r.xr. z': a: i:xr,xa; x`;xr. r.x xxr.r.ica';r.r,r.i ; r.xr.r.r.r.r.rr. xic iexaL r, ae iexr. �r rxxa4'wk ie�xx�; r�nF��� ` APPLICATION APPROVED BY: S S // /j sa��� c '�a 11 j1111IRlat►5` xamfiner .. Engineer .Zoning (Revised 02/08/06) 32 5 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP - 137411 Permit Number: PL -3 -10 -366 Scheduled Inspection Date: April 21, 2010 Permit Type: Plumbing - Residential Inspector: Hernandez, Rafael Inspection Type: Final Owner: GUSTINGER, KURT Work Classification: Pool - Private Job Address: 1216 NE 93 Street Miami Shores, FL Phone Number (305)751 -5554 Parcel Number 1132050270160 Project: <NONE> Contractor: MARS POOLS Phone: (954)214 -2844 Building Department Comments ADD MAINDRAINS IN WALL FOR ROCK WATER FALL, ADD WATER LINE FOR SIDE Inspector Comments Passed Failed � �( Correction Needed ❑ Re- Inspection ❑ Fee No Additional Inspections can be scheduled until re- inspection fee is paid. April 20, 2010 For Inspections please call: (305)762 -4949 Page 7 of 30