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RC-07-1966Inspection Number: INSP -62666 Permit Number: RC -9 -07 -1966 Scheduled Inspection Date: August 30, 2010 Inspector: Bruhn, Norman Owner: GORDON, JACK Job Address: 863 NE 92 Street Miami Shores, FL 33138- Project: <NONE> Contractor: ARCO CONSTRUCTION Building Department Comments ONE BATHROOM TO REPLACE TILE AND FIXTURES. Failed Correction Needed Re- Inspection Fee August 27, 2010 No Additional Inspections can be scheduled until re- inspection fee is paid. Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspector Comments (k For Inspections please call: (305)762 -4949 Permit Type: Residential Construction Inspection Type: Final Work Classification: Alteration Phone Number Parcel Number 1132060050040 Phone: 305 -892 -6507 Page 34of34 !D momn la SE� 1 9 200/, D BY: 0 0 BUILDING PERMIT APPLICATION FBC 2004 Permit Type (circle): Building Electrical Plumbing Mechanical Roofing Owner's Name (Fee Simple t - .: (.� Lp_ ©l• Phone # Cs,,, (-;. `p - ( VD, Owner's Address ': e e.._,,, ..---, `'-\-'.. City 'Oa 666-)M 1, S \A Q S.State F Tenant/Lessee Name Job Address (where the work is being done) 2 cp, 3 tS c - _ City Miami Shores Village FOLIO / PARCEL # Is Building Historically Designated YES NO Contractor's Company Name Contractor's Address City Qualifier Name State Certificate or Registration Architect/Engineer's Name (if applicable) Value of Work For this Permit $ 82049 Square / Linear Footage Of Work: Type of Work: Describe Work: 0. c / /74 ['Addition ['Alteration Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 State, 9 P Ptte W r/ Permit No.C' C- 1 itt ICY Master Permit No. Zip Phone # County Miami -Dade Zip J3 �,'3 Phone # q ?45- Zip • ; f 81 Phone # Certificate of Competency No. Phone # ['New ; '[ Repair/Replace ❑ Demolition ******** * * * * ** * **** ** ** * ** * * * * ** * * * * *** F * * * * * * * ** * ** * ** ** * ** * * ** *** * * ** Submittal Fee $ J" Permit Fee $ V- CCF $ S -40 CO /CC Notary $ 6,00 Training/Education Fee $ 7 150 Scanning $ 1 • (90 Radon $ DPBR $ Bond $ Code Enforcement $ Double Fee $ Structural Review. $ . Total Fee Now Due $ 2.15 - P'iLLt e�y ...r -- D p IA/44—K 4 °� ' Technology Fee $ 69. 10 Zoning $ 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. S . , � :i/ i ce . Sign Owner or Agent The egoinf. instrument was acknowledged before me this /3 day ofseP 1 20 7 by .i A dc- Go r c who is personally known to me or who has produced "o r;/. NOTARY PUBLIC: Sign: /J )) I Print: L- - l i My Commission Expires: (c, S ********************* 1** � * 4 * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** APPLICATION APPROVED BY: (Revised 02/08/06) N/A- The foregoing instrument w actor owledged before me this q 200 , , by /tar Co �`l tWil a to me or who has produced As identificati mr" lr ^ath as identification and who did take an oath. _ `o ROBERT BUTLER, JR. Notary Public, State of Florida My comm. expires Apr. 19, 2009 No. DD394765 NOTARY PUBLIC: Sign: Print: My Commission * * * * * * * * * * * * * * * * * ** �og 9o06(hN Plans Examiner Engineer Zoning NOTICE OF COMMENCEMENT A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF FIRST INSPECTION PERMIT NO. "�1 /T` R(KoTAX FOLIO NO. STATE OF FLORIDA: COUNTY OF MIAMI -DADE: THE UNDERSIGNED hereby gives notice that improvements will be made to certain real property, and in accordance with Chapter 713, Florida Statutes, the following information is provided In this Notice of Commencement. aTir1 "F" *Own d , iptio pJ prope /4'rf eet/add eS Description of improvement: Interest in property: Name and address of fee simple titleholder: 4. Contractor's name and addres 5. Surety: (Payment bond required by owner from contractor, if any) Name and address: Amount of bond $ 6. Lender's name and address: 7. Persons within the state of Florida designated by Owner upon whom notices or other documents may be served as provided by Section 713.13(1)(a)7., Florida Statutes, Name and address: 8. In addition to himself, Owners designates the following person(s) to receive a copy of the Lienor's Notice as provided in Section 713.13(1)(b), Florida Statutes. Name and address: 9. Expiration date of this Notice of Commencement: (the expiration date is 1 year from the date of recording unless a diff _ d - = lip specifi .' AL /i 4,i. i 41111017, Print Owner's Name . 1 1 -" )1 N (C.. ? C- Y1 - Prepared b Sworn to and subscribed before me this _64o ‘ ... ;,,, 1.7 ,2O— o the v,. � FLORIDA, SC CEM7FYthat this is OF FLO COUNTY D f?E a 'cr e w . e of , ®rigid?: in office ,day of '�ir q n .01( ��` �� �'�`�' , X1.0. 2u Notary Public Print Notary's Name My commission expires: 123.01 -52 PAGE 4 8/02 111111111111 i 11111111 1 11111111111111111111111 Vi/ITWE 7; . hand and Official Seel. HAR %W e, , IN, C. _ o , .' ; ; Y Cot* Courts By 1!./ . ' _ CFI4 2010R0527647 OR 8k 27377 Ps 19091 (ips) RECORDED 08/05/2010 09852:33 HARVEY RUVIN, CLERK OF COURT tiIAfI —DADE COUNTY? FLORIDA LAST PAGE