RF-11-553Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP - 157761
Permit Number: RF -3 -11 -553
Scheduled Inspection Date: October 04, 2011
Inspector: Bruhn, Norman
Owner: CARROLL, BARBARA
Job Address: 1461 NE 103 Street
Miami Shores, FL
Project: <NONE>
Contractor: ESR FLORIDA CONSTRUCTION INC
Permit Type: Roof
Inspection Type: Final
Work Classification: Gutters
Phone Number
Parcel Number 1132050310190
Phone: (305)812 -2716
Building Department Comments
GUTTERS
Passed
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Inspector Comments
October 04, 2011
For Inspections please call: (305)762 -4949
Page 2 of 26
1
Project Address
Miami Shores Village
10050 N.E. 2nd Avenue NE
Miami Shores, FL 33138 -0000
Phone: (305)795 -2204
Parcel Number
Applicant
1461 NE 103 Street
Miami Shores, FL
1132050310190
Block: Lot:
BARBARA CARROLL
Owner Information
Address
1461 NE 103 ST
MIAMI SHORES FL 33138 -2625
Phone
Cell
Contractor(s) Phone Cell Phone
ESR FLORIDA CONSTRUCTION INC (305)812 -2716 (302)279 -4726
Type of Work: Gutters
Additional Info:
Classification: Residential
Scanning: 2
Fees Due
CCF
DBPR Fee
DCA Fee
Education Surcharge
Permit Fee - Repairs
Scanning Fee
Technology Fee
Total:
Amount
$1.20
$2.00
$2.00
$0.40
$100.00
$6.00
$1.60
$113.20
Pay Date Pay Type
Invoice # RF -3 -11 -40482
04/08/2011 Check #: 1318
03/30/2011 Check #: 1308
Amt Paid Amt Due
$ 63.20 $ 50.00
$ 50.00 $ 0.00
Available Inspections:
Inspection Type:
Final
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 08, 2011
Authorized Signature: Owner / Applicant / Contractor / Agent
Building Department Copy
Date
April 08, 2011 1
u1
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
INSPECTION'S PHONE NUMBER: (305) 762.4949
Permit No. t 1
it MAR 3 0 2011
BY:—
u
BUILDING
PERMIT APPLICATION
FBC 20
Permit Type: BUILDING
OWNER: Name (Fee Simple Titleholde
Address: 1 +L f NE /0 3r
' S
/��
City: ! •1 '. Ctievi Stiorec i
C State: F' L
Tenant/Lessee Name: t I eel /i
Email: T 1 t ? €. / o
Master Permit No.
JOB ADDRESS: /440 I f(-)
S T"
City: Miami Shores County:
Folio/Parcel #: `— 3P-0 9'0
Is the Building Historically Designated: Yes
CONTRACTOR: Company Name:
Address: 0 t o t � 0
City:
ar 0 (I Phone#: .30 s-- 7.g1=?4, .
Zip: g..3 f kn.'? 6;1E'
Phone#:
Miami Dade
Zip: 3 ^�iy S
NO
_a
State:
Qualifier Name:
State Certification or Registration #: FR/0 34 1.2-.
Contact Phone #:3o '— 7/ W Email Address:
Flood Zone;
LLC ` 0 y Phone#: 30s' 'c(. . " [ /4
l (.3 rh 'Cvi . � r s
Zip: 2'3 ?
Phone #:
Certificate of Competency #: j e_ 00 Co o/
DESIGNER: Architect/Engineer:
Value of Work for this Permit: $
Type of Work: ❑Addition UAlteration
Description of Work: ui~rS
Phone #:
Square/Linear Footage of Work:
❑New ❑Repair/Replace
❑Demolition
* * ** * * * *** * * * * * * * * **** *** * * ***** ** * ** Fees :** ** **** * *** * * ** x * ***:x*:x**** * *** *** * * *** *
Submittal Fee $ D 00 Permit Fee $ i® ®60 CCF $ CO /CC $
Scanning Fee $ Radon Fee $ DBPR $ Bond $
Notary $ Training/Education Fee $ Technology Fee $
Double Fee $ Structural Review $
TOTAL FEE NOW DUE $ �•�!
Bondng 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 vi . Signature
Owner or Agent
The foregoing instrument was acknowledged before me this
day of ____Iil '20 /4, by
who is personally known to me or who has produced
As iden6. - ion and who didake an oath.
NOTARY PUBLIC:
Sign:
i
My Commission Expires:
Contractor
The ff re offing instrument was /acknowled_ed before me thi
daybf vl T/ , 20 a, by
4e//ej
who is personally known to me or who has produced
as identification and who did take an oath.
NOTARY PUBLI ,mgptigl,YC-STA7'&0° �A
Naha Marksman
7. Commission C. 2012
* * * * * * * * * * * * * * * * * * * * * **
APPROVED BY
ALAIN B DURAND
Notary Public - State of Florida n 41
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ieiarfritr0�
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Structural Review
(Revised 07 /10/07)(Revised 06 /10/2009)(Revised 3/15/09)
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Clerk
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F1P--iound 3/4" iron pipe unless otherw4
Centerline, P/L =Property Line, CONC=
Fence, WF / /—.- = Wood Fence, O/L=
Block Structure, SWLK = Sidewalk,
T = Tangent, A= Arc, CH Nord, C
Curvature, I.D. --Identification
F.N. = Found Nail, B/L - Bas`
14, p1A
Bearings are assumed on -
1'.
CITY
COPY
- 553
Miami Shores Village
APPROVED
BY
DATE
ZONING DEPT
BLDG DEPT
i:%
/"7ir
FEDERAL
SUH.IFCT TO COMPLIANCE WITH ALL
STATE AND COt IN re RUI_FS AND RFGULATIONS