DS-10-468 Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP - 138607 Permit Number: DS -3 -10 -468
Scheduled Inspection Date: May 27, 2010 Permit Type: Driveways /Sidewalks /Slabs
Inspector: Bruhn, Norman
Inspection Type: Final
Owner: HURTAK, DONNA Work Classification: Addition /Alteration
Job Address: 533 GRAND CONCOURSE
Miami Shores, FL 33138 -2464
Phone Number
Parcel Number 113206017135
Project: <NONE>
Contractor: DOWER CONSTRUCTION INC Phone: (305)986 -4999
Building Department Comments
Inspector Comments
Passed
r
Failed
Correction
Needed
Re- Inspection ❑
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
May 26, 2010 For Inspections please call: (305)762 -4949 Page 5 of 15
`oA Miami Shores Village
10050 N.E. 2nd Avenue,
Miami Shores, FL 33138 -0000
Phone: (305)795 - 2204'
Expiration: 10102/201
Project Address Parcel Number Applicant
533 GRAND CONCOURSE 1132060171350 DONNA HURTAK
Miami Shores, FL 33138 -2464 Block: Lot:
Owner In formation _ Address Phone Cell
SAN DONNA HURTAK w._ 533 GRAND CONCOURSE .�.��..._.u�.__..�..,._.....��
MIAMI SHORES FL 33138 -2464
Contractor(s) Phone Cell Phone Valuation: $ 6,500.00
DOWER CONSTRUCTION INC (305)986 -4999 (305)986 -4999
Total Sq Feet: 0
Approved: Yes Available Inspections:
Comments: Inspection Type:
Date Approved: 3/24/2010: Yes Final
Date Denied:
Sidewalk
Type of Work: ENLARGE RAISED PATIO DECK IN REAR Additional Info: BUILDING Landscaping
Bond Return : Classification: Residential Foundation
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due
CCF $4.20
Education Surcharge $1.40 Invoice # DS - - - 37357
Permit Fee $195.00 03/22/2010 Check #: 1832 $ 50.00 $ 159.20
Scanning Fee $3.00 04/05/2010 Check #: 184b $ 159.20 $ 0.00
Technology Fee $5.60
Total: $209.20
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.
April 05, 2010
Authorized Signature: Owner / Applicant / Contractor / Agent Date
Building Department Copy
April 05, 2010 1
NOTICE OF COMMENCEMENT' Illlll1111111111111111111111 {If11111111111111
A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF FIRST INSPECTION C- t= N 2 01 1 R 0 2 2 y 6 6 5
OR BI; 27237 F's 46227 (IP9)
PERMIT NO. TAX FOLIO NO. REGORGED 04/05/2010 09:05:35
HARVEY RU4'INY CLERK OF COURT
MIAMI -DACE COUNTYr FLORIDA
STATE OF FLORIDA: LAST PAGE
COUNTY OF MIAMI -DADE:
THE UNDERSIGNED hereby gives notice that improvements will be made to certain teal
:t
property, and in accordance with Chapter 713, Florida Statutes, the following information c�
is provided in this Notice of Commencement.
t :`�,.v CJ f3ri ""• ^., J' a.aw� ��dp 44J.� '��.F � #�
7 Lr v 1 � "U ,:
pace above reserved for use of recording office
1. Legal description of property and street/address: c6wce)Ltae� RPM (51
2. Description of Improvement 11/�w
3. Owner(s) name and address: G I
Interest in property:
Name and address of fee simple titleholder:
4. Contractor's name, a �� ss an phone bri
5. Surety: (Payment bond required by owner from contractor, if any)
Name, address and phone number:
Amount of bond $ __V
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 Statu
Name, address and phone number:
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, address and phone number: AIAI
9. Expiration date of this Notice of Commencement:
(the expiration date is 1 year from the date of recording unless a different date is specified)
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 INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENC ING WORK
ENC
OR RECORDING YOUR NOTICE OF COMMENCEMENT.
Signature(s) of Own (s) or S}w er s)' A 0orized Officer /Director /Partner /Manager
Prepared By (� - - - - Prepared By
Print Name DlU N L Print Name
Title /Office Cjfi'�- _ Title /Office
STATE OF FLORIDA
COUNTY OF MIAMI -DADE
The fore oing instrument as a le ged before me this day of
�_
By �i didually,❑ as for
Personally known, or ❑ produced the following type of identification:
Signature of Notary Public:
Print Name:
(SEAL) EXPIRES August 21, 2013
VERIFICATION PURSUANT TO SECTION 92.525 FLORIDA STATUTES ti
3O8.Od53 . - .- ... .,,,. �Ior+daNOta ryServlce.com
Under penalties of perjury, I declare that I have read the foregoing and
that the facts stated in it are true, to the best of my knowledge and belief.
Signa r s) of Owne (s or w er(s)'s Authorized Officer /Director /Partner /Manager who signed above:
By By
123.01 -52 PAGE 3 11/07
I
Miami Shores Village T1 rM 7T? T
Buildin g Department artment 2 2 201
10050 NE.2nd Avenue, Miami Shores, Florida 33138 $Y;
................
Tel: (305) 795.2204 Fax: (305) 756.8972 Q }� '
BUILDING Permit No.
MA
PERMIT APPLICATION Master Pe rmit No .010
FBC 2004 �!' •�•""t�•`0
Permit Type (circle): 4 =uildin1toofing
Owner's Name (Fee Simple Titleholder) Z)6V# � `'► Phone # V �E �v "F
Owner's Address Cry � / � Uililua Q
City t State _ l' `"' Zip
Tenant/Lessee Name Phone
Job Address (where the work is being done)
City Miami Shores Village County Miami -Dade Zip
FOLIO / PARCEL #
Is Building Historically Designated YES
Contractor's Company Name l✓W'X'' 6 A 16* tZZCV 0 A' ''Phone lt /V - GI�F • L �
Contractor's Address q 1 0 0 PC
City —Gl State Zip L
Qualifier Name / Phone #
State Certificate or Registration No. G f 2 C 7 1 Certificate of Competency No.
Architect/Engineer's Name (if applicable) Phone #
Value of Work For this Permit $ 1; / v p Square / Linear Footage Of Work:
Type of Work: ElAddition ❑AlteraCio j [-]New r Repair/Replace El Demolition
1
Describe Work: �� �ev ! " I �" / 6, ��L -4G
Submittal Fee $ SO •6D Permit Fee $ CCF$ COMU
Notary $ Training/Education Fee $ Z . `� Technology Fee $ 5.
Scanning $ . 0 0 Radon $ DPBR $ Zoning $
Bond $ Code Enforcement $ _ Double Fee $
Structural Review. $ Total Fee Now Due $ �I • ` Z- 0
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,-TANKS1and AIR CONDITIONERS, ETC.....
h
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 ins which occurs seven (7) days after the building permit is issued In the absence of such posted notice, the
inspection wi not be proved and a rei p coon fee will be charged
Signature' Signature t
Owner or Agent Contractor'
The foregoing instrument was ackpowledged bet re me this The foregoing instrument was acknowledged before me this
Y
day of , 20 J , by � � ' , day of j 20M) by ,
o is personally known to or who has produced who ' personally ktt wn me or who has produced
As ' ' r w�ie- cticLtakelQ th. as identification and who did take an oath.
NOTARY PUBLIC•
DAN MIS IO P. # DD917 NOTARY PUBLIC:
'`' ;'c AAY COMM {SSWN # 00917231
EXPIRES August 21, 2013
007) 388 -0753 FlorJdgryp}a >-4
Sign: Sign:
Print:
My Commission Expires: , ?/�. f My Commission F tpirep.'' ..... >
APPLICATION APPROVED BY: / �C� Js �' �fi�",.•' �Plns Examiner
Engineer
•
.2 d Zoning
(Revised 07 /10/07)
Planning and Zoning Criteria
R4 Miami Shores Village DS- 3- 10-'68
g Permit NO
10050 N. E. 2nd Avenue y g
ro
�- Miami Shores, FL 33138 -0000
Phone: (305)795 -2204 Fax: (305)756 -8972
F taRtDp'
Issue Date: Not Issued [� t Issued
Expires:
Folio Number :1132060171350
Owner's Name: DONNA HURTAK Owner's Phone:
Job Address: 533 GRAND CONCOURSE Total Square Feet: 0
Miami Shores, FL 33138 -2464 Total Job Valuation: $ 6,500.00
Contractor(s) _ Pho Prim C o n t r acto r
DOWER CONSTRUCTION INC (305)986 -4999 Yes
Planning and Zoning Criteria and Comments
Approved: Yes Date Approved: 3/24/2010: Yes
Comments: