MC-06-547Inspection Date: 03/29/2006
Inspector: Perez, JanPierre
Owner: LITHGOW, AMELIA
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Job Address: 1250 95 Street NE
Miami Shores Village, FL 33138-
Project: <NONE>
Contractor: BOSTICK DEREK
Permit Type: Mechanical - Residential
Inspection Type: Final
Work Classification: New
Block:
Phone Number
Parcel Number 1132060144070
Lot:
Building Department Comments
Tuesday, March 28, 2006
Page 2 of 2
Passed
Inspector Comments
7/7)\
ti
\
OW
Failed
Correction
Needed
Re- Inspection
Fee
($75)
No Additional Inspections can be scheduled
re- inspection fee is paid.
until
Tuesday, March 28, 2006
Page 2 of 2
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
BUILDING
PERMIT APPLICATIO
FBC 2001
Permit Type (circle): Building
Permit No. Q,06
Master Permit No.
Electrical
Plumbing
Owner's Name (Fee Simple Titleholder) D e Phone #
Owner's Address l Z 5 ® 1.4. C.. "5-4.1.•
St,
City M ; - v✓(; S1 evees State fie_..
Tenant/Lessee Name
Zip 33i'3 2
Phone #
Job Address (where the work is being done) 1 LS-0 AI. € . 7 S'1'' S+.
City Miami Shores Villa • e County Miami -Dade Zip
Is Building Historically Designated YES NO !'
Contractor's Company Name - e c..4S. + i.H�T,�
Phone ' # >z
Contractor's Address /3 2 3 7 ,s-4,-,/ /,j 2 =r= .4. atC. lc. .
,
City 1'2'7/ Jam; State 7.---;:e- Zip ✓` - / 2 7
Qualifier .p6.0-4 f 7-Let- e
State Certificate or Registration No.0 ' (O 57 t{ 2a, Certificate of Competency No.
Architect/Engineer's Name (if applicable) Phone #
$ Value of Work For this Permit
Square Footage Of Work:
Type ofWork: DAddition DAlteration ['New D Repair/Replace
❑Demolition
Describe Work:
*******#***re
it Submittal Fee $ Permit Fee $ CCF S-3- 00 CO /CC.
Notary $ Training/Education Fee $ 1- 00 • Technology Fee $ .S - -7Z-
Scanning $. • ( Radon $ Zoning Bond $
Code Enforcement $ Structural Plan Review. $
Total Fee Now Due $
(Continued on opposite side)
MAR 1 o PAID
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 ail
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
Owner or Agent
The foreoing; nstrument was ac !edged before me this
day of L 1, 20Q , by s�p /Arki1%46 Pty c, tax E
w is ersonally known to me or who has produced
•
NOTARY PUBLIC:
Sign:
Print
My Commission E ' es:
Signature
Contractor
The foregoing instrument was acknowledged before me this 5 ( ck.
e'2_ day of /1 09-Y ), 20 Qk, by 61 ) Cif, rrr'tvC)
who is personla llLknown to me or who has produced
As identi ; - 'on and who did take an oath.
* * * * * * * * * * * * * * * * * * * * * * * **
as identification and who did take an oath.
NOTARY PUBLIC:
JULIA GORDON- TAYLOR
.4 MY COMMISSION # DD 108690
W EXPIRES: April 14, 2006
Sign:
Print:
My Commission Expires: tkil ' ''1 9 0 t 2cr) 6
* * * * * * * * * **
GILDA PIN •
MY COMMISSION # DD 318121
EXPIRES: May 10, 2008
PAINYMOVVOR
APPLICATION APPROVED BY:
Chc 05/13/03
Plans Examiner
Engineer
Zoning