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RC-09-682Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: IINSP -1 12351 Permit Number: RC -4 -09 -682 Scheduled Inspection Date: June 08, 2009 Inspector: Bruhn, Norman Owner: SAXON, MARY Job Address: 1285 NE 95 Street Miami Shores, FL Project: <NONE> Contractor: GRANITE KITCHEN DESIGN INC Permit Type: Residential Construction Inspection Type: Final Work Classification: Kitchen Cabinets Phone Number Parcel Number 1132060144020 Building Department Comments oPO Passed Failed #/e(6e-a? Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments bc I.._.. flG 'tflflfl nri 5 \k1eck im. Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 BUILDING PERMIT APPLICATION FBC Permit Type (circle): Building Roofing Owner's Name (Fee Simple Titleholder hone # 3OS °'7 0 - 7S' 4I McmEwMIM Jit APR 2 3 2009 Permit N0.12-CA99 -Con Master Permit No. Owner's Address City if e w+°, State A Zip 3 I. 3 rg 3 Tenant/Lessee Name Phone # Job Address (where the work is being done) i g E S S Cee- City Miami Shores Village County Miami -Dade Zip -3 l FOLIO / PARCEL # Is Building Historically Designated YES NO Contractor's Company Name 6r 'i a t�' ,t i : C i 9e,ii Phone # 5 - (?- ? 7? 5 r ,4 r F/, 5 3 070 City % c (ec /1 /, State f P ( Zip `a 3 o /c2 Qualifier Name J Vii' l%� 6r,-e' ^c' �. d' © Phone # � - S U c - ?ell- State Certificate or Registration No. Certificate of Competency No. o g f �� Qa C Contractor's Address Architect/Engineer's Name (if applicable) Phone # Value of Work For this Permit $ 40, op 6 e ®ed Square / Linear Footage, Of Work: b, ,( _ { Type of Work: ['Addition 'Alteration ['New ❑ Repair/Replace Describe Work: ��� a c k V.) a, Caa 'f'et a 'Y. ❑ Demolition a�x� *** *** ** **** * *** **** *** * * *:x� *** Fees* : �x�x **** *�x�x�x**** *�x*** *** * * * *** x *�x** **** ***** 2 3 POW**, ,�/ ubmittal ee $ ..; Permit Fee $/ �� C C F $ 0 .(00 CO/EC Notary $ `0,0 Scanning $ VL' Radon $ Training/Education Fee $ I -9,0 Technology Fee $ L -50 DPBR $ Zoning $ -Bond $ Code Enforcement $ Double Fee $ x Structural Review. $ Total Fee Now Due $ CQS IO 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, BEATERS, 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 # : ap ! roved id a reinspectipm FLORIDA )Co en#1' )71792 3 0"'",(4 Claudia . Cubinos 1\F Signature Owner or Agent The for•goi instrument was a owleddged befor day of ,A(1 , 200q by Contractor . e this 03 The fore oing strument was acknow; ' ged fore day of /' I , 2t r by •l , ;• who is personally known to me or who has produced • ®. n a entification and who did take an oath. OTARY PUBLIC: h. is p sonall yi known to me or who has produced t -1 o � ` entification and who did take an oath. NO ARY PUBLIC: Sign: Print My Commission Expires: * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** APPLICATION APPROVED BY: (Revised 07/10/07) $o Sign: Print: My Commission Expires: *** * ***** * * ***** * **************** *** * ** * ** x * ******* * *** * ***** iee( Plans Examiner Engineer Zoning This fns ment prepared B Name 'q r pr Address 1 • r a N.? Permit No. OOi * `g)" STATE OF COUNTY OF 1111111 11111 111111111111111 11111 111111111111 CFH 2009R0317228 OR BK 2684? Ps 2012; (1Pg) RECORDED 05/01/2009 1083404 Q '+IARigY RUVINt CLERK OF COURT► MIAMI —DADE COUNTY, FLORIDA z_Jr'iE NOTICE OF COMMENCEMENT Tax Folio No_443Q0 THE UNDERSIGNED hereby gives notice that Improvement will be made to certain real property, angin accordance with Chapter 713, Florida Statutes, the following information is provided in this Notice of Commencement. 1. Description of property: (legal description of property, and street address if available) YYl lam .4•V cc"' a' j Sec "j to- 3 7 (.._c3 •r °.Safi -t 3 - + L r�a'+ l.a`f c 33 DOAN 2. General description of impC ` l a r c r ao eo6q - p S i S u4 mioo S" improvement: // 3. Owner information lPS >t //ass- A) S/cc•e ►r G/ a. Name and address :L c r ° b. Interest in property: 444.0NL° c. Name and address of fee simple titleholder (U other than owner): 4. Contractor. a. Name and address: b. Phone number. 5. Surety e. Name and address: b. Amount of bond $ c. Phone number: 6. Lender a. Name and address: b. Phone number. 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: a. Name and address: b. Phone number: 8, In addition to himself, Owner designates the following person(*) to receive a copy of the Lienor's Notice as provided In Section 7.13.13(1)(b), Florida Statutes: a. Name and address: b. Phone number. 9. Expiration date of 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 1, 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 COMMENCING WORK OR RECORDING YOUR NOTICE OF OOM - CEMENT. na re . Owner or Owner's Authorized Officer/Director Partner /Manager Signatory's Title /Office The foregoing Instrument was acknowledged before me this 4 day of _(year) by 8 tr4tr Sal (yin (name of person) as Q (type 01 authority, ...e.g. officer, trustee, attorney In (act) for (name of party on behalf of whom Instrument was executed). *Co' offike i .2047 • Verification Pursuant to Signature of Notary Pu6tic = Stet of Florida Print, Type, or Stamp Commissioned Name of Notary Public Commission Number • Personally Known _., or Produced Identification !( Section 92.626. Florida Statutes Under penalties of perjury, f declare that I have read the foregoing knowledge and belief. STATE OF FLORIDA, COUNTY OF DADE I HEREBY CERTIFY Chet this is a copy of the original ed in this office on - -� AD2P. nd Official Seal. N, CLERK, of Circuit and County Courts D.C. %ITNES HA that the f- ;a ted In It are true to the best of my turaofN; °re re on Signing, Above • • • • •..• OOOOO OOOOOO • • • OO OOO 0000 00000 000000 000000 .... . • •. •• . • . •....• oo 000000 • • Snor p j � ''' eF ViI "g° BY ZONING DEPT BLDG DEPT SUBJECT TO COMPLIANCE WITH ALL FEDERAL STATE AND COUNTY RULES AND REGULATIONS e ite-U44- • •• • • • ••• • a, • • • • • • 41 • • • • • • **** • • • • • • • • • • • • • • • • • I 7 ii, • . • • . eee 7 ee . .0 rl,L j S kie Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, Phone: (305)795 -2204 Fax: (305)756 -89 Scheduled Inspection Date: June 04, 2009 Inspector: Devaney, Michael Owner: SAXON, MARY Job Address: 1285 NE 95 Street Miami Shores, FL Project <NONE> Contractor: JC ELECTRIC INC Permit Type: Electrical - Residential Inspection Type: Final Work Classification: Addition /Alteration Phone Number Parcel Number 1132060144020 Phone: (305)754 -6949 Building Department Comments Inspector Comments Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. //.71/"%r.- Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 BUILDING PERMIT APPLICATION FBC 20 p MGMEWg"� APR 2 8 200§ D BY: ir**--9--) Permit No. }...1 —1111/10Y Master Permit No. Permit Type; ELECTRICAL / Owner's Name (Fee Simple Titleholder) t4/ -}�2 r42 L 5A-AA 1 Re /e-;;;Phone # 4 5 Z'® 707/ Owner's A 2 � `J 0``i 7 "' ` 7� Address � � 5 /C). �Gj ` ?��� City (Milt' State PG- Zip 5 113 Tenant/Lessee Name Phone # Email / C/L) C tJ vz4 Job Address (where the work is being done) N C City Miami Shores Village County Miami -Dade Zip 3 '3 -3 ' FOLIO / PARCEL # Is Building Historically Designated YES NO Contractor's Company Name -5C- ' :—N c. Contractor's Address / / d2 (v d iS p, / / 3 e Std Flood Zone Phone # '363 '/ b9 (1 / City /t a, a State c Qualifier Name 3 fO i7G � l� 4 State Certificate or Registration NoEC o 64$ `1 0 yx" " • i✓�rtifieate of Compet�r#cy No. Zip 3 % kz# Phone # ,� 7.5 Y 6 S 4' Contact Phone -3c 'S—' G y 5 e, L.e Alec ,.,t�.6sut.,., Architect/Engineer's Name (if applicable) Phone # Value Qf Wort( For this Permit$ "C) b. Type of Work: ['Addition Describe Work: C. '7LL 5 5 • • • Square / Linear Footage rOfAWorks ['Alteration ❑New ❑ Repair/Replace ❑ Demolition **** ** *** *:x***>k>k**>k ****>K> >K>k>K>k*>K>e*>x>k*> **F >k> >k>x> *** * * ** **>k****>x *** **** *>x *>k*** * * ****>k*** Submittal Fee $ Permit Fee $ /GO' •4' `� CCF $ O'O CO /CC e Notary $ J�' 00 Training/Education Fee $ 0 � a O Technology Fee $ ` t ' 00 Scanning $ W Radon $ DPBR $ Zoning $ Bond $ Structural Review. $ Code Enforcement $ Double Fee $ Total Fee Now Due $ 199.19 See Reverse side -+ Bonding Company's Name (if applicable) Bonding Company's Address C1ty State Zip Mortgage Lender's Nan (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 ha commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulatin: 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 al 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 $2500, the applicant must promise in good faithh that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will n '"e approved a reinspection fee will be charged. A' 1 Signature t� Signature Owner or Agent nstrume t was day of ,20W1b i day of 4p / 2.1r,2041,byJ''e -eo� ►, who is p rsonally known to me or who has produced PR who is personally known to me or who has produced ..,„f. -,�.. ,gyp 19N ntification and who did take an oath.FO t✓ /236 �-.) 6 a 11.f identification and who did take an oath. Contractor ged be : me this The foregoing instrument was acknowledged before me this NOTAIe PUBLIC: Sign: Print: My Commission Expires: NOTARY PUBLIC: OP ,r ,,x'4161.0 > >�923 .i. ;40 �I frr �� ail �I,C�°1C� 9�� ; Print: X14 ..,�, o5, C 3 S 1 e! 4i %,6; ;� Q;b :1:" "yG My Commission Expires s, t'$ n t+ , "' \e; .sty OP ******** *:l:* ******* *: F*Ze*gexe ******** *:k**.k*: �k�k�kk At***** ******* *At***** **$ eog**k** **• F** ** * ***** * *** **aR:k ******* ** *** Sign: APPLICATION APPROVE (Revised 07/10/07) ans Examiner Engineer Zoning Clerk checked ADDENDUM TO BUILDING PERMIT APPLICATION AN APPLICATION FOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. IF A MASTER PERMIT HAS BEEN OBTAINED, THE OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS. PLEASE CIRCLE 0 DISCIPLINE APPLIED FOR: PLUMBING ELECTRICAL PERMIT # MECHANIC ITEM UNIT FEE ITEM UNIT FEE ITEM UNIT BATH TUB SWITCH OUTLETS 2.- SPACE HEATERS FEE DISHWASHER LIGHT OUTLETS 1- CENTRAL HEATING DISPOSAL RECEPTACLES / 7 NC (WIND) FLOOR DRAIN SERVICE TEMPORARY NC (CENTRAL) GREASE TRAP SERVICE SIZE IN AMPS DUCT WORK INTERCEPTOR SERVICE REPAIR/METER CHANGE REFRIGERATION LAVATORY APPLIANCE OUTLETS `?/ PROCESS AND PRESS PIPING LAUNDRY TRAY RANGE TOP UNDERGROUND TANKS CLOTHES WASHER OVEN / ABOVE GROUND TANKS SHOWER WATER HEATER U.F. PRESSURE VESSELS SINK. POT /3 COMP. MOTORS 0 -1 HP STEAM BOILERS SINK, RESIDENCE. MOTORS OVER 1 -3 HP HOT WATER BOILERS SINK, SLOP. MOTORS OVER 3 -5 HP MECHANICAL VENTILATION TEMPORARY WATER CLOSET MOTORS OVER 5 -8 HP TRANSPORTING ASSEMBLIES URINAL MOTORS OVER 8 -10 HP ELEVATORS /ESCALATORS WATER CLOSET MOTORS OVER 10 -25 HP FIRE SPRINKLER SYSTEMS INDIRECT WASTES MOTORS OVER 25 -100 HP COOLING TOWERS WATER SUPPLY TO: MOTORS OVER 100 HP VIOLATION A/C UNIT A/C WINDOW REINSPECTION FIRE SPRINKLER AIR CONDITIONERS HEATER -NEW INST. STRIP HEATER HEATER - REPLACE GENERATORS TRANSFORMERS LAWN SPRINKLER -WELL GENERATORS TRANSFORMERS SWIMMING POOL GENERATORS TRANSFORMERS WATER SERVICE SPECIAL PURPOSE. SEWER CONNECTIONS OUTLETS COMMERCIAL UTILITY -SEWER SIGN TUBES UTILITY -WATER SIGN TRANSFORMERS SEPTIC TANK SIGN TIME CLOCK RELAY FIXTURES FAINFIELD, 4" TILE /RES. ANTENNA PUMP & ABANDON SEPTIC TANK TELEVISION OUTLETS SOAKAGE PIT CU. FT. VIOLATION CATCH BASIN REINSPECTION DISCHARGE WELL ' DOMESTIC WELL AREA DRAIN ROOF INLET SOLAR WATER HEATER FIRE STANDPIPE POOL PIPING LAWN SPRINKLER SYSTEM GAS RANGE METER SET (GAS) GAS PIPING