DS-11-401POOL DECK ADDITION
Pass
Inspector Comments
ec
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled
re- inspection fee is paid.
until
Inspection Date: March 25, 2011
Inspector. Bruhn, Norman
Owner: MARINO, STEPHEN
Job Address: 1249 NE 97 Street
Miami Shores, FL 33138-
Project: <NONE>
Contractor: NU SPACE INC
Building Department Comments
March 25, 2011
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
'Inspection Number: INSP - 156901
Permit Number: DS- 3- 11-401 I
For Inspections please call: (305)762 -4949
Permit Type: Driveways /Sidewalks /Slabs
Inspection Type: Final
Work Classification: Addition/Alteration
Phone Number 305 - 812 -0629
Parcel Number 1132050090410
Phone: (561)319 -6883
Page 1 of 1
BUILDING
PERMIT APPLICATION
FBC 20
JOB ADDRESS: 12 41 NG. 1 ,1 .t
City:
Is the Building Historically Designated: Yes
Miami Shores Village parErnEn
Building Department MAR 0 7 2011
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972 BY : ...e
INSPECTION'S PHONE NUMBER: (305) 762.4949
Permit No. DS (( t O 1
Master Permit No. QS ■ 112. 1
Permit Type: BUILDING
OWNER: Name (Fee Simple Titleholder): Si M NAVA MA XIMO Phone #:
Address: `ZI q kg (4
City: IA tPM% S State: Zip: 33
Tenant/Lessee Name: Phone #:
Email:
Miami Shores County: Miami Dade Zip: 3
Folio/Parcel #:
NO X. Flood Zone: k
CONTRACTOR: Company Name: IV V SAC s D JCi Phone #:
Address: I1l fl % s, S 1L.
City: „ �( State: ft.— Zip: 331447
Qualifier Name: _ MPd .d0 7-.4) PM M1/41 O Phone #: 746 411 3610
State Certification or Registration #:GAL, O61.2-` W 2, Certificate of Competency #:
Contact Phone #: Email Address: rn iilit GG .Il�O 6 )5 ke. • e AA
Di b'YG�NEIV Teliitecf/Eitnieer :. `P+A`T .P O QOM. l i /O "Phan ' `" . ,
V z' i 1
Value of Work for this Permit: $ a Square/Linear Footage of Work , �i 4 2 ° ' F
Type of Work: UAdc.ress — Z]k')teration New ❑Repair/Replace
Description of Work: ?Ock E Pb■ 111 0k1
JDemolition
COLOR THROUGH ROOF TILE IS REQUIRED acknowledged by:
* * * * *A * ** * * * * * * * * * *** *** * * * * * * * * * * * ** F ees * * * * ** ****** * * * * * * *** * * * * * * * * **** * * * * * * * * **
Submittal Fee /3 ' 13 Permit Fee $ /��° CCF $ CO /CC $
Scanning Fee $ Radon Fee $ DBPR $ Bond $
Notary $ Training/Education Fee $ Technology Fee $
Double Fee $ Structural Review $
TOTAL FEE NOW DUE $
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
day of
who •
NOTARY
Owner or Agent
The foregoing instrum was acknowledged before me this
,20JL,by
ersonally
_
a
0
�'
ati,Q �,iQ •
Commiss7
.5 My Commission Ex
,o_ February 07,
•
res
012
It . • . 1 1 1. 1 .11 _1
C4
� 10111/1Z
NOTARY
•� S o� ., ��;
� • My Commission Expires
Feb_u 'l2
W
1gn. _doh
Print: Op A
My Commissiorkxpires:
APPROVED BY
4 14 a
(Revised 07 /10 /07)(Revised 06 /10 /2009)(Revised 3/15/09)(rev6/4/10)
Plans Examiner
Signature
day of
who is
Contractor
The foregoing i strument was acknow edged before me this
OP
10 ,20 by
Sign:
Print: —"_
My Commiss n Expires:
Structural Review Clerk