Loading...
RC-09-1143 a Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP- 143710 Permit Number: RC -11 -09 -1865 Scheduled Inspection Date: May 19, 2010 Permit Type: Residential Construction Inspector: Bruhn, Norman Inspection Type: Final Owner: BURZYCKI, GWEN Work Classification: Miscellaneous Job Address: 50 NE 108 Street Miami Shores, FL 33161 -7036 Phone Number Parcel Number 1121360110040 Project: <NONE> Contractor: RHINO CONSTRUCTION Phone: (305)206 -6761 Building Department Comments install Hurricane straps. Inspector Comments Passe FINAL FOR HURRICANE STRAPPINGS Failed Correction ❑ Needed Re- Inspection ❑ Fee No Additional Inspections can be scheduled until re- inspection fee is paid. May 18, 2010 For Inspections please call: (305)762 -4949 Page 26 of 29 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- 118980 Permit Number: RC -7 -09 -1143 Scheduled Inspection Date: June 03, 2010 Permit Type: Residential Construction Inspector: Bruhn, Norman Inspection Type: Final Owner: BURZYCKI, GWEN Work Classification: Kitchen Cabinets Job Address: 50 NE 108 Street Miami Shores, FL 33161 -7036 Phone Number Parcel Number 1121360110040 Project: <NONE> Contractor: RHINO CONSTRUCTION Phone: (305)206 -6761 Building Department Comments RENOVATE KITCHEN, NEW CABINETS, LIGHTING, COUNTER TOPS, RENOVATE LAUNDRY AREA. REFINISH EXISTING FLOORS Inspector Comments Passe a r G "� Failed Correction ❑ Needed Re- Inspection ❑ Fee No Additional Inspections can be scheduled until re- inspection fee is paid. June 02, 2010 For Inspections please call: (305)762 -4949 Page 1 of 39 3 f: W � y 4 Miami Shores Village 10050 N.E. 2nd Avenue ' Miami Shores, FL 33138-0000 Phone: (305)795 -2204 k - K ;i, F Expiration: 07/1412010 Project Address Parcel Number Applicant 50 108 Street 1121360110040 Miami Shores, FL 33161 -7036 Block: Lot GWEN BURZYCKI Owner Information Address Phone Cell GWEN BURZYCKI 50 108 Street MIAMI SHORES FL 33161 -7036 Contractor(s) Phone Cell Phone Valuation: $ 1, 8 0 0.00 RHINO CONSTRUCTION (305)206 -6761 Total Sq Feet: 1800 Approved: In Review For Inspections please call: Comments: (305)762 -4949 Date Approved:: In Review Available Inspections: Date Denied: Inspection Type: Type of Construction: HURRICANE STRAP TRUSSES Occupancy: Single Family Final Stories: Exterior. Front Setback: Rear Setback: Left Setback: Right Setback: Bedrooms: Bathrooms: Plans Submitted: Certificate Status: Certificate Date: Additional Info: Bond Return: Classification: Residential Fees Due Amount Invoice # Total Amt Paid Amt Due CCF $1.20 RC -11 -09 -36394 $ 106.20 $ 50.00 Education Surcharge $0.40 Ai — Permit Fee - Additions/Alterations $100.00 RC -11 -09 -36394 $ 106.20 $ 106.20 $ 0.00 Scanning Fee $3.00 Check #: 1311 Submittal Fee $50.00 Submittal Reversal Fee ($50.00) Technology Fee $1.60 Total: $106.20 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 February 03, 2010 Authorized Signature: Owner / Applicant i Contractor / Agent Date Building Department Copy February 03, 2010 1 Miami Shores Village Q T "7 Building Department e JAN 1 ��' g p 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. "1 PERMIT APPLICATION Master Permit No. /L' C . ? -- 0 e 1 1 � 3 FBC 20 Permit Typ C ILDIN ROOFING - Owner's Namimp e TitlehX, ) Phone # ! 3 �� 1 Owner's Address 6 fns / �Ili r 21 City l /�v� !�1 fll`e S State D1� i { .A- Zip Tenant /Lessee Name Phone # Email d� Job Address (where the work is being done) J N4 City Miami Shores Village County Miami -Dade Zip FOLIO / PARCEL # j/ - 2 / 3 6 - d 11 -, 0 . Is Building Historically Designated YES NO / \ Flood Zone Contractor's Company Name 4✓VL � " t a 'J Phone # 3 P 5 1 Contrpctcr's Address ! G S �, Ci 04 City A� ; State Zip X 2 _'5 1 Z �1 Qualifier Name v L Phone # 3 P 5 s o 1 GL J State Certificate or Registration No. C 6 C 2 $ 3 Certificate of Competency No. 'Contact Phone 13 1) 5— ! 3 V 5 — ( L(C( E -mail Architect/Engineer's Name (if applicable) Phone # ° Value of Work For this Permit $ ( $ 00 i � d�i � Square /Linear Footage Of Work: f� Type of Work: ❑Addition ❑Alteration QNew Repair /Replace ❑ Dem ition Describe Work: t . Submittal Fee'$ " C:,� Permit Fee $ 7a CCF $ Notary $ Training /Education Fee $ Technology Fee $ 0- Scanning $ a o Radon $ DPBR $ Bond $ Double Fee $ Violation date: 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 whi occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be appro d a reinspection fee will be charged.. Signature Signature Owner or Agent Contractor The forego` g instrument was ac w�ledged be ore me this. The foreg oi instrument was acknowledged before me this,,-0-1— day of _ -� Cam 20 , by t ! ! day of 2e , by r+M & &Z' - who is nail y know to r who has produced who is p@4 onally ' known e or has produced As identification and who slid take an oath. as identification and who did take an oath. NOTARY P LIC: NOTARY P LIC: Sign: . ✓ Sign: r Print: Print: My Commission Expires: My Commission Expire • SWA1Np� at'` fl y P SUSAN DEE S( 1R rt * MY COMMISSION # p * * MY COMMISSION # DD 584985 EXPIRES: $ePtember 17, 2010 EXPIRES: S90wiber 17, 2010 °F " e004d Thm&'do � APPROVED BY /J'w Plans Examiner Zoning Engineer Clerk checked (Revised 07 /10 /07)(Revised 06/10/2009) K M*�Q1 s Miami Shores Village Pemift Type ResMenuat :oftlt cation E� 10050 N.E. 2nd Avenue ,. " Miami Shores, FL 33138 -0000 r S' APP'Rt7�lECf Phone: (305)795 -2204 • . F [OR[DP' Expiration: 0 116/201 0 Project Address Parc Number Applicant 50 108 Street 1121360110040 Miami Shores, FL 33161 -7036 Block: Lot: GWEN BURZYCKI Owner Information Address Phone Cell MIAMI SHORES F ...._. _... _ ..,..._..__.... _...._�.- ,..,_....�..._��...,. ..__... .._.,,..._ . . ........ . . . . ......... GWEN BURZYCKI 50 108 Street L 33161 -7036 Contractor(s) Phone Cell Phone Valuation: $ 24,000 ... 00 RHINO CONSTRUCTION (305)206 -6761 Total Sq Feet: 235 y Approved: No For Inspections please call: Comments: NO SURVEY (305)762 -4949 Date Approved:: No Available Inspections: Date Denied: 7/21/2009 Inspection Type: Type of Construction: KITCHEN REMODEL Occupancy: Single Family Drywall Stories: Exterior: Final Front Setback: Rear Setback: Framing Left Setback: Right Setback: Insulation Bedrooms: Bathrooms: Plans Submitted: Certificate Status: Certificate Date: Additional Info: Bond Return : Classification: Residential Fees Due Amount Invoice # Total Amt Paid Amt Due CCF $14.40 RC -7 -09 -35343 $ 623.25 $ 50.00 $ 573.25 Education Surcharge $4.80 Education Surcharge $4 RC -7 -09 -35343 $ 623.25 $ 623.25 $ 0.00 Permit Fee -Add itions/Alterations $570.00 Check* 122 Scanning Fee $15.00 Submittal Fee $50.00 Submittal Reversal Fee ($50.00) Technology Fee $1425 Total: $623.25 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 accuate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Futhermore, I authorize the above-name ,.d i°ontra for to do the work stated. August 03, 2009 Authorized Signature: Owner / Applicant t!'actor / Agent Date Building Department Copy August 03, 2009 -- ._...._.._.___._ 1 Miami Shores Village > Buildin g Department JUL 0 2009 p 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 B - BUILDING Permit NJ2� —1 143 — PERMIT APPLICATION Master Permit No. FBC 2004 Permit Type (circle). uildi Roofing Owner's Name (Fee Simple�Ti ° tleholder ff ) U V V1 'C % Phone # Owner's Address City ' K- State Tenant/Lessee Nam ' - 1 hone # Job Address (where the work is being done) City Miami Shores Village County Miami -Dade Zip FOLIO / PARCEL # — C � Is Building Historically Designated YES NO Contractor's Company Name . 61 0 (: W5 /G�� Phone # jo S &)&6 Contractor's Address l and (�� C L /�(/ 14t T #10 9 /�/l City 1 /i'M! ,,L State t" Zip 331 7—'4 Qualifier Name 49 - .A - mo 14 Z Phone # , ?0,5 ZdCo ("261 State Certificate or Registration No. Cl; C 49& 2Sb 3 Certificate of Competency No. Architect/Engineer's Name (if applicable) 2f env 1 62Phone # Value of Work For this Permit $ Square / Linear Footage Of Work: Type of Work: ❑Addition Alteration [ ❑ Repair/Replace ❑ Demolition Describe Work: l 'H GOUT - eAv R e 11/1 ' 41 mv ****F 0 v Submittal Fee $ Permit Fee $ CCF $ CO /CC Notary $ Training/Education Fee $ 4, 6 (J Technology Fee $ Scanning $ Radon $ DPBR $ Zoning $ Bond $ Code Enforcement $ Double Fee $ Structural Review. $ Total Fee Now Due $ See Reverse side -4 Bonding Company's Name (if applicable) Bonding Company's Address Al 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, FURNAgES, J30ILERS, 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 appr ved and a reinspection fee will be charged. Signature G� Signature g g Owner or gent Contractor The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged befor me this day of 20a by e I"�'�Uf21 day of C 20 by who is person y known to e or who has produced J' who is p onall know to e or who has produced ide \ , Omit did take an oath. as identification and who did take an oath. \,�� �•RO GFq � NOTARY PUBLIC: ��� ,. • • • • • • •.,s �i N NICA MERINO oN • / �i • � 161 I 9 Fs ••� * % `,� Notary Pubi'�c -State of Florida • Oct 2, 2009 , • y Commis` n fxp • a • Q A =�, ion G 4 2 5 Sign: i !09 Si p � p 236 • Pri ' Print: � 1 � •„� My Commission Expires � 2� •� Notary pubee;:•'�\� My Commission Expires: ��"f ' v� t o P ®e ��** ����: x�*: xx�: xx�x�: x��*: l! y�� ��* �: ��x����: x�:: xx�x�: �: x��x* x�z��* ���x�x�** xx�: x�xxx�: � *x���:x���x�:�x��x:��x�x 111 1111 f 1 11111 1 ��� APPLICATION APPROVED BY: G�� Plans Examiner lop Engineer Zoning (Revised 07/10/07) Planning and Zon"ling Criiter"a Miami Shores Village Permit No. RC-7-09-1143 10050 N.E. 2nd Avenue Miami Shores, FL 33138-0000 ... ........... ............. Phone: (305)795-2204 Fax: (305)756-8972 tN . ........ Issue Date: 7/20/2009 Expires: 7/20/2009 Folio Number) 121360110040 Owner's Name: GWEN BURZYCKI Owner's Phone: Job Address: 50 108 Street Total Square Feet: 235 Miami Shores, FL 33161-7036 Total Job Valuation: $24,000.00 ................ . . ... . . . ....... . .... . . .. . ................... ........... ....................... .......... . . .... . ...... .. . .............. Contractor(s) Phone Primary Contractor RHINO CONSTRUCTION (305)206-6761 Yes Planning and Zoning Criteria and Comments Approved: No Date Denied: 7/21/2009 Comments: NO SURVEY UNCLEAR IF PARTIAL GARAGE CONVERSION, NEED PLAN SHOWING EXISTING CONDITIONS CFN 20r-49RO532217 NOTICE OF COMMENCEMENT OR Bk 26950 P9 2722; (fps ) RECORDED 07/2312009 09:03.'58 A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF FIRST INSPECTION HARVEY RUVINY CLERK OF COURT MIAMI-DADE COUNTYP FLORIDA PERMIT NO— TAX FOLIO NO. LAST PAGE 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. 1.1- ai description ofpropertXanqstreet/address: Uu tj ridd r, C ' to 4?_J-T fjP.;jf& I n I A 2. Description of improvement: kkft o I 2J f 3. Owner(s) name and address: kul (0 W M - Ir - '-!I d n( Tf — 5 - rCee. - I Interest in property: Name and address of fee simple titleholder: A 4. Contractor's name and address: i b 4 -1 &(.�5 &-dall ih[t z; LAk et wi M I f- 5. Surety: (Payment bond required by owner from con n& Jok C M (W cont MqM Name and address: I HERMY CERM ow MIS Amount of bond $ 6. Lender's name and address: 7. Persons within the state of Florida designated by 0 ............ nts ma s 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 Notice as provided in Section 713.13(1)(b), Florida Statutes. Name and address: 10 9o OLL tLO_y oe 9. Expiration date of this Notice of Commencement: (the expiration date is 1 year from the date of recording unless a ddiff ate 1 4 e %;p ed) I - I I ox I S Sia ofj igna ur of Ownet/( Print Owner's Name Prepared by Sworn to and subscribed before me this 0. .20 Address: 1w MAN gF Notary Public ir )A ko_n', 7A 15W, CP Print Notary's Name 10 My commission expires: #DD 702M' 123.01-52 PAGE 4 &W 000909*61, 10 5 s:g Miami Shores Village Building g p t 10050 -NE 2 Ave, Miami Shores, FI 33138 - Tel: (305)795 -2204 e Fax; (305)756 -8972 RECEIPT PERMIT #: c � Oq �'� �� DATE: o� e Vq e V e 7 i Contractor ❑ Owner ❑ Architect e up. sets of plans an er) Av e Address: From the building department on this date in order to have corrections done to plans And/or get County stamps. I understand that the plans need to be brought back to Miami Shores Village Building Dement tcontinue permitting process. Acknowledged by. PERMIT CLEARK INITIAL: RESUBMITTED DATE: PERMIT CLEARK INITIAL: Y Miami Shores Village , l 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Expiration: 0111W2010 Project Address Parcel Number Applicant 50 108 Street 1121360110040 Miami Shores, FL 33161 -7036 Block: Lot GWEN BURZYCKI 1 � "I 11 - ' I I mj Owner Information Address Phone Cell GWEN BURZYCKI 50 108 Street MIAMI SHORES FL 33161 -7036 Contractor(s) Phone Cell Phone Valuation: $ 2, 500.00 CHARLES CULPEPPER 305 - 759 -8255 m ... Total Sq Feet: 235 Type of Work: PLUMBING For Inspections please call: Type of Piping: KITCHEN REMODEL (305)762.4949 Additional Info: Available Inspections: Bond Retum : Inspection Type: Classification: Residential Top Out Re Pipe Main Drain Underground Rough Heater Water Service Final Water Main Lavatory Fees Due Amount Invoice # Total Amt Paid Amt Due CCF $ PL -7 -09-35342 $ 200.15 $ 15015 Education Surcharge $0.80 low Permit Fee - AdditionstAlterations $190.00 PL -7 -09 -35342 $ 200.15 $ 200.15 $ 0.00 Scanning Fee $3.00 Check #:.109 Submittal Fee $50.00 Submittal Reversal Fee ($50.00) Technology Fee $4.75 Total: $200.15 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: 1 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 August 03, 2009 Authorized Signature: Owner / Applicant / Contractor / Agent Date Building Department Copy Auqust 03, 2009 _ 1 Miami Shores Village Buil t J UL. u 2009 lding Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 BY:• - - - °'" ° °• BUILDING Permit No. 0 o - PERMIT APPLICATION master Permit No. 7�, G I-114�) FBC 200/ Permit Type Plumbing Owner's Name (Fee Simple Titleholder • 1�2 C. A- 2 : - X% � 4 - Phone 4 Wo 'L6(o • 238 Owner's Address So e Lb 4 4/1 City M1�AKAI 51W^ State . Zip Tenant /Lessee Name Phone # E -MAIL: CL 1 xv►IS -' & hol M;RI I V�Nn Job Address (where the work is being done) City Miami Shores Village_ County Miami -Dade Zip 3316 I FOLIO / PARCEL # Is Building Historically Designated YES NO Contractor's Company Name �� 1 W -E . L.2 Phone# — — 3 - 7.2 - ,5f Oq , Contractor's Address City M i Cj m i State Fmr i_ c Zip l Qualifier Name cv y- Phone # State Certificate or Registration No. C•FC0 - 7 L4 Certificate of Competency No. E -MAIL: Oh6cl -k25 CV j 0 QL-2QQr C3 hD +mui I O M Architect /Engineer's Name (if applicable) $• ?I/L��G I Phone # fe1. 5g0 g1122 Value of Work For this Permit $ 2 Q� Square / Linear Footage Of Work: Type of Work: ❑Addition alteration ❑New ❑ Repair /Replace ❑ Demolition Describe Work: 1►'�5 i t�ti�. - ,�� v ^ — F NHS -�' 1 iJ `L NV �J - FCGts.yyCAej- Gcrl� js S (n bXS T wusl�.l�lv�IP -1� xk: *�xx9;>Y a4 iex'c:dc4::x�'c icx ak i; +F f. x>t : is r, is *r. ''; F s xx,� icxra:rxic * * *icrr.rrxi:xY i:xxx r. i:xxxr,xr. is i:xxr. xtxxx Submittal Fee $ Permit Fee $ CCF $ CO /CC Notary $ ��� Training /Education Fee $ n-(00 Technology Fee $ 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 All Zip Mortgage Lender's Name (if applicable) Mortgage Lender's Address u 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 appr ed d a reinspection fee wi be charged. Signature �QK Signature Owner or Agent ractor The fore oing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this�'�' day of by 5wity) r�tA( X day of 120 �, by act Y l f who is p onally kno to me or who has produced who ersonally know to me or who has produced As identi cope# #1ftho did take an oath. as identification and who did take an oath. NOTARY PUBLIC: 6R DGFg4 %/ NOTARY PUB. MONICA MERINO � \ON EXp�R •.• //� , ,oti,aY Pie Sign: b, 20i Fd+ �c Z % ^' i' y ommsso Expires Oct 2,2009 g Sign: �� oP.. DD 436255 Print: �i o B y ational Notary Assn.. • Print: V�I My Commission Ex ires: - - ea ••�c a p y Q • Bond �� o My Commission Expires: ��-- . ©V 4 • c Pub\ r.xx,4,c is r. ie ,t aF r. x,Y *,e,e,Fx aex,4 ,Y,F ; 9;r. ,: xicx xic ,tr ie rxr.xxic,'r,F 9: r, x exxrx9ex ,<,Fkxr.,r,txr.,ex,�,'�k,ei: aFxxatiexie ,Y,4 rxa'exic �: r. 9.-x r. i; is �r APPLICATION APPROVED Y: f Plans Examiner Engineer Zoning (Revised 02 /08/06) 10 dl Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756 -8972 Inspection Number: INSP- 118991 Permit Number: PL- 7- 09-11" Scheduled Inspection Date: March 15, 2010 Permit Type: Plumbing - Residential Inspector: Hernandez, Rafael Inspection Type: Final Owner: BURZYCKI, GWEN Work Classification: Addition /Alteration Job Address: 50 NE 108 Street Miami Shores, FL 33161 -7036 Phone Number Parcel Number 1121360110040 Project <NONE> Contractor: CHARLES CULPEPPER Phone: 305- 759 -8255 Building Department Comments INSTALLATION OF NEW SINK, NEW FAUCET AND DISHWASHER. WASHER/DRYER Inspector Comments Passed Failed / Correction Needed ❑ Re- inspection ❑ Fee No Additional Inspections can be scheduled until re- inspection fee is paid. March 12, 2010 For Inspections please call: (305)7624949 Page 4 of 29 Miami Shores Village � F 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 K'p W / Expiration: 01301201 Project Address Parcel Number Applicant 50 10$ Street 1121360110040 GWEN BURZYCKI Miami Shores, FL 33161 -7036 Block: Lot: Owner Information Address Phone Cell GWEN BURZYCKI 50 108 Street MIAMI SHORES FL 33161 -7036 Contractor(s) Phone Cell Phone Valuation: $ 5,0 00.00 EFJ ELECTRICAL CONTRACTOR (305)793 -3263 _.._ Total Sq Feet: 235 Type of Work: ELECTRICAL. For Inspectlons please call: Additional Info: KITCHEN REMODEL (305)762 -4949 Classification: Residential Available Inspections: Inspection Type: Underground Rough Final Meter Box Alteration Relocation Fire Alarm Service Change W. W. Fees Due Amount Invoice # Total Amt Paid Amt Due CCF $ EL-7-09-35341 $186.37 $ 136 37 Education Surcharge $1.00 Permit Fee - Additions/Alterations $175.00 EL -7 -09 -35341 $ 186.37 $ 186.37 $ 0,00 Scanning Fee $3.00 Check #: 109 Submittal Fee $50.00 Submittal Reversal Fee ($50.00) Technology Fee $4.37 Total: $186.37 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. August 03, 2009 Authorized Signature: Owner / Applicant / Contractor / Agent Date Building Department Copy Ausl 03, 2009 1 Al) Miami Shores Village � , ' NM Building Department ' jUL ` 4 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 00Q Tel: (305) 795.2204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305) 762.4949 BUILDING Permit No. ' A PERMIT APPLICATION Master Permit No. FB C 20 Permit Type; ELECTRICAL Owner's Name (Fee Simple Titleholder) Z v a w � cc lf tWell� _ Phone # ' 1 1 S 7 6f ' 210 Owner's Address t® �j �_= I City {�4�,'° %� State Zip Tenant/Lessee Name Phone # Email c06roiC b4��viil� e kp Job Address (where the work is being done) City Miami Shores Villaize County Miami -Dade Zip �l FOLIO / PARCEL # Z Is Building Historically Designated YES NO Flood Zone 0 Contractor's Company Name 1 �K 1C� Phone # Contractor's Address - � — City i / ,; State G . Zip Qualifier Name 4� r � Phone State Certificate or Registration No. Certificate of Competency No. / � �1�J Contact Phone E -mail fG� G C 7 (�ff7 / �Je #� oc - r# Nic7 Architect/Engineer's Name (if applicable) Phone Value of Work For this Permit $ _ Square / Linear Footage Of Work: ✓7 'S •r' Type of Work: ❑Addition [(Alteration ❑ ❑ Repair/Replace El Demolition Describe Work: 'C CU^ � *��� * *��:� * * * *� *�s��� Submittal Fee $ V�/ Permit Fee $ I r a' d CC $ CO /CC $ Notary $ Training/Education Fee $ 1 ' Oj Technology Fee $ Scanning $ Radon $ DPBR $ Bond $ Double Fee $ Violation date: y?n Structural Review. $ Total Fee Now Due $ 1 "(- ' 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 secure for- ELECTRICAL WORK, PLUMBING, SIGNS, WELL% POOLS, F,L(RNACE$ ;BOILERS, HEATERS, and AIR OVjTIONERS, 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 suc osted notice, the inspection will not be app4gved and a reinspection fee will be charged. Signature Signatu .a Owner or Age Contractor The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this day of �_ , 200q, by �t,o k C2G�L <l day of by who i ersrn nown to me or who has produced o is person 1 kno e or who has produced As identification and who did take an oath. as identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC• M ICA Sign: �: ��`� Si �6, 20> 9 Fs • ; a g Sign z v a°' Z Y ^ ion X Print: Q : a ° Pri - "rF _�, A 1 3a1 it : Banded By s My Commission Expires: ;��1p My o is ° �•�• , Bond��tA : �� °� APPROVED BY / /L, l/ o laps Examiner Zoning Engineer Clerk checked (Revised 07 /10 /07XRevised 06/10/2009) 0 Inspection Worksheet ate" Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL iA ` Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP- 119001 Permit Number: EL -7 -09 -1145 Scheduled Inspection Date: March 15, 2010 Permit Type Electrical - Residential Inspector: Devaney, Michael Inspection Type: Final Owner: BURZYCKI, GWEN Work Classification: Addition /Alteration Job Address: 50 NE 108 Street Miami Shores, FL 33161 -7036 Phone Number Parcel Number 1121360110040 Project: <NONE> Contractor: EFJ ELECTRICAL CONTRACTOR Phone: (305)793 -3263 Building Department Comme UPGRAE ELECTRICAL IN KITCHEN/LAUNDRY INSTALL NEW LIGHTING FIXTURE, FAN AND CARBOMONOXIDE DECTECTORS Inspector Comments Passed E'� Failed Correction Needed ❑ Re- Inspection ❑ Fee No Additional Inspections can be scheduled until re- inspection fee is paid. March 12 2010 For Inspections please call: (305)762 -4949 Page 5 of 29