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DS-11-1940Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP- 165688 Permit Number: DS -10 -11 -1940 Scheduled Inspection Date: November 01, 2011 Inspector: Rodriguez, Jorge Owner: CHURCH, Job Address: 602 NE 96 Street Miami Shores, FL Project CHURCH Contractor: QUIRINO CONSTRUCTION CO Permit Type: Driveways /Sidewalks /Slabs Inspection Type: Final Work Classification: Addition /Alteration Phone Number (305)754 -9541 Parcel Number 1132060141410 Phone: (305)892 -1987 Building Department Comments SEAL AND STRIPE ASPHALT PAVING ON PARKING LOT ACROSS THE STREET FROM RECREATION DPT. Passed \in Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments PLEASE GO TO THE CHURCH OFFICE AND CHECK WITH THE RECEPTIONIST FOR PERMITS. October 31, 2011 For Inspections please call: (305)762 -4949 Page 10 of 17 Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 ( � c t r aA, INSPECTION'S PHONE NUMBER: (305) 762.4949 Permit No. 11 1I49 CM37, 713 OCT 2011 BUILDING PERMIT APPLICATION Master Permit No. FBC 20 Permit Type: BUILDING ROYFING OWNER: Name (Fee Simple Titleholder): 9') tbx,t 1 c.►oft..Q -S R kje6 Phone #:a.+E' 7f4 ' Address: (O Z IJE Cie, �T City: ( t A-4( 6 \OiSQS State: zip 3(35 Tenant/Lessee Name: Phone #: Email: JOB ADDRESS: (0Z Nom. City: Miami Shores County: Folio/Parcel #: ° 320.0 — Q 4 - 4 l Is the Building Historically Designated: Yes Cc,A) Miami ade zip: S3136 NO X Flood Zone: CONTRACTOR: Company Name: Q,i/4!iu 49 Phone #: 3!9-S 02- 1gY7 Address: % 7s �i % rN :�-4 City: Pli ' kf /49 bi J State: Ft. Zip: 5 311 Qualifier Name: ..I %yN A. g t a L/ 1,/b Phone #: 905 ker2. 4 917 State Certification or Registration #: C G C c G 4 ©l 14// Certificate of Competency #: Contact Phone #: 3 0 egg • P k f 7 Email Address: Qt, t /Z /Nb 4 /. t & i G®/ DESIGNER: Architect/Engineer: Phone#: Value of Work for this Permit: $ 39O 0 Square/Linear Footage of Work: Type of Work: ❑Addition ❑Alteration ❑New ❑Repair/Replace Description of Work: (° o‹-r -- pa £- ,l <), • ❑Demolition ******** *********************** ****** ** ees************** **********`***** ********** ***** Submittal Fee $ Permit Fee $ CCF $ CO /CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ TOTAL FEE NOW DUE $\ (,Q 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, BOITF,RS, 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. Owner or Agent The foregoing instrument was acknowledged before me this ZP day of ; 20 11 , by D sk.4 who is personally known to me or who has produced L .. As identification and who did take an oath. NOTARY PUBLIC: Signature C ntractor The foregoing instrument was acknowledged before me this c20 t'k day of (% Ct , 20 // , by who is ersonally known tom r who has produced as identification and who did take an oath. NOTARY PUBLIC: Sign: il Sign: t Print: Sy lV t tG. l,t L e+<,. Print: - Cyt /VI 4 , My Commission Expires: NOTE' PUBLIC -STATE OF FLORIDA, My Commission Expires: 0''1 Sylvia Halter I Commission # EE098053 , .,,..••' Expires: JUNE 08, 2015 * �x�x�xx�+ x: x+ u*** *�u+x�x�x�x *+x�xx�+xx�x��x **Isg ate enstasoottfl ********* * * ** ***+x************ APPROVED BY ef/6rJ��l Plans Examiner Structural Review (Revised 07 /10 /07)(Revised 06/10/2009)(Revised 3/15/09) //st-/f"-e/2 NOTARY PUBLICSTATE OF FLORIDA "* \ Sylvia Halter I Commssion # EE098053 Expires: JUNE 08, 2015 � • //9/04/4 Zoning Clerk 1 Permit NO. DS -10 -11 -1940 Issue Date: Not Issued Planning and Zoning Criteria Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Fax: (305)756 -8972 Expires:Not Issued Folio Number:1132060141410 Owner's Name: CHURCH Job Address: 602 96 Street Miami Shores, FL Owner's Phone: (305)754 -9541 Total Square Feet: 0 Total Job Valuation: $ 0.00 Contractor(s) Phone Primary Contractor QUIRINO CONSTRUCTION CO (305)892 -1987 Yes Planning and Zoning Criteria and Comments Approved: Yes Date Approved: 10/21/2011: Yes Comments: STATE OF FLORIDA DEPARTMENT' OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD 1940 NORTH MONROE STREET TALLAHASSEE FL 32399 -0783 FIRINO, JOHN ANTHONY IRINO CONSTRUCTION COMPANY 87 NE 119 RD NORTH MIAMI FL 33181 Congratulations! With this license you become one of the nearly one million Floridians licensed by the Department of Business and Professional Regulation. Our professionals and businesses range from architects to yacht brokers, from boxers to barbeque restaurants, and they keep Florida's economy strong. Every day we work to improve the way we do business in order to serve you better For information about our services, please log onto www.myfloridaiicense.com. There you can find more information about our divisions and the regulations that impact you, subscribe to department newsletters and learn more about the Department's initiatives. Our mission at the Department is: License Efficiently, Regulate Fairly. We constantly strive to serve you better so that you can serve your customers. Thank you for doing business in Florida, and congratulations on your new license! (850) 487 -1395 DETACH HERE NTV i wgm our ; `' 2211 OI1-1an Miami Shores Village BY VL17) APPROVED ZONING DEPT BLDG DEPT DATE SURIFCT TO COMPLIANCE WITH ALL FEDERAL STATE AND COUNTY RULES AND REGULATIONS CITY COPY