DS-11-1231 (2)Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP- 170181 Permit Number: DS -7 -11 -1231
Scheduled Inspection Date: February 22, 2012
Inspector: Bruhn, Norman
Owner: WOOLIN, RACHEL
Job Address: 489 NE 95 Street
Miami Shores, FL 33138-
Project: <NONE>
Contractor: F&F CONSTRUCTION SERVICES INC
Permit Type: Driveways /Sidewalks /Slabs
Inspection Type: Final
Work Classification: Addition /Alteration
Phone Number
Parcel Number 1132060140640
Phone: (954)454 -1948
Building Department Comments
CONCRETE PARKING IN SWALE 15X28X6 IN
WIRE -MESH.
Passed
7L
Failed
d„6
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Inspector Comments
CREATED AS REINSPECTION FOR INSP- 161833.
February 21, 2012
For Inspections please call: (305)762-4949
Page 36 of 52
r
� ry
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
BUILDING
PERMIT APPLICATION
FBC 20
RECEIVED
FEB 16 2012
BY:
Permit No. D5 1 1 I2 3i
Master Permit No.
Permit Type: BUILDING ROOFING
>4 OWNER: Name (Fee Simple Titleholder): 1R d lU tom' 0 0®Q(--1 tJ Phone# 127? –5074
Address:
City: State: Zip:
Tenant/Lessee Name: Phone#:
Email:
S
B JOB ADDRESS:
qgct PIG G
City: Miami Shores County: Miami Dade Zip: 3 7 i J k
Folio/Parcel #:
Is the Building Historically Designated: Yes
NO Flood Zone:
®< CONTRACTOR: Company Name: t F y C 0 (45`� V' �'�e=11 0� Phone #:3OO.C" --C-2- C.° J �7 Z 7
Address: 7( (7 ?C37 (c ZJ
City: re (,A* 19 arc pi( State: I Zip: 3 t
Qualifier Name: /4 1,4-- l vi rLtic, (-42.._ 1 ,—,_ Phone #:
State Certification or Registration #: (C27 C- ( D5 (C(Certificate of Competency #:
Contact Phone#: Email Address:
DESIGNER: Architect/Engineer: Phone#:
Value of Work for this Permit: $ Square/Linear Footage of Work:
Type of Work: ❑Addition ❑Alteration New ❑Repair/Replace ❑Demolition
Description of Work: ® s "l a
i
************** *************+x*+x**** ** *** Fees * * ** x**** ********s+****+x***** *** x **** *** * ****
Submittal Fee $ Permit Fee $ 75' 00 CCF $ CO /CC $
Scanning Fee $ 3 .C,] Radon Fee $ DBPR $ Bond $
Notary $ Training/Education Fee $ Technology Fee $
Double Fee $ Structural Review $
TOTAL FEE NOW DUE $ icy. cX
Bonding Company's Name (if applicable)
. �1
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 $2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site
for the which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the
inspecti ' , t be tc`ved and a reinspection fee will be charged.
Signa Signature
Owner or Agent
Contractor
The foregoing instrument was acknowledged before me this /-5 The foregoing instrument was acknowledged before me this
�eday of , 20 a, by if-'4466r4.A-11 ▪ day of 15- F. , 20 i'�liy
who is personally known to me or who has produced who is personally known to me or who has produced
As identification and who did take an oath. as identification and who did take an oath.
NOTARY PUBLIC: \e����`` "� 111111f ° °4,,�� NOTARY PUBLIC:
=±'•. L
Sign: ' 1,I___-„„..0 • ®= Sign:
Print: - , ,' tea° ®— Print:
My Commission Expires:
ziszz, Vo o My Commis
° /// 1111 I ISI 111 \\\ \0,\\`�.
P" %. LAURA FARLE
O �$ COMMISSION H EE53276
c '•c t•:, March Ib, 2015
1A0434NO1 a.. - vaan I?iscwnt Assoc. Ca
sb*akelsnk****d+*s sk*N=***sk*sk*H+sk *H=/ �k+ k�( s�Nsk�ksk�kH��kskN�l k�k�k�N�k�k�k+ k+ k�k+ k�kskk�: sh�hHs�: �kN��k�ksh�k�k�k�ksk�kk�k* �k+ NskH�sk�kkH�+ ksk+ k�kW �h�i: �k�k�k* �k�k�k9�sksksk�kk�kshsF +ksk�k***
APPROVED BY ;)//1 Plans Examiner Zoning
Structural Review Clerk
(Revised 07 /10 /07)(Revised 06 /10/2009)(Revised 3/15/09)
Miami Shores Viiiage
Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
CHANGE OF CONTRACTOR 1 ARCHITECT
Permit NMl) ^ i Z 31
Owner's Name Fee Simple Title Holder): Phone #:
Owner's Address:
City: State : v. Zip Code:
9s-'
State: Florida Zip Code:
Job Address (Of where work is being done):
City: Miami Shores
Contractor Company Name: 'RC- C' & LJC 0
Address: e
City:
/State:
'�-
Qualifier's Name v1(;C F14 (e-te
Phone #:
3 (6C-S 2S-t q-
Zip Code:
Lic. Number: Obo
Architect/ Engineer of Record Name: Phone #:
Address:
City: State: Zip Code:
Describe Work: 1741244-ir(b 1m S
I hereby certify that the work has been abandoned and/or the contractorlarchitect is
unable o willing to complete the contract. I hold the Building Official and the
iami Shores harmless for all legal involvement.
Signatur
owner or Agent
The foregoing instrument was aknowledged before me
this'l day of .2c2 ,by .4e L wCl)
Who is personally known to me or who has produced
�-` 1 t7 `���unw,,�s indentification.
Notary Public: : xa/;:".'i
Sign: ! e :0
Seal: '--A ,,07,,ro�`0 / /�,•
• ,9 c
%Fz4RIDP . \'''
'' / /rrn i n n m'0
Signature
Contractor or Architect
The foregoing instrument was aknowledged before me
this ' 20124-
me or who has produced
as indentification.
Notary
Sign:
Seal: