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DS-11-393 (2)f Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP - 170190 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 Number: DS -3 -11 -393 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 DRIVEWAY INSTALLATION Pass We djdillet Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments CREATED AS REINSPECTION FOR INSP - 156854. as per record signed by JR on 4/14/11 final inspection approved. dc---- February 21, 2012 For Inspections please call: (305)762 -4949 Page 44 of 52 L 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. D.St 393 Master Permit No. Permit Type: BUILDING ROOFING f 1.-R OWNER: Name (Fee Simple Titleholder): cic l' . I LOW( VGA Phone #) � 2 �� 7q —5.07q Address: 1 City: State: Zip: Tenant/Lessee Name: Phone #: Email: JOB ADDRESS: �- c( 'd v -1 Q 2 County: Miami Dade Zip: 3` 13 J g City: Miami Shores Folio/Parcel #: Is the Building Historically Designated: Yes NO Flood Zone: Ft r- C CONTRACTOR: Company Name: © il (-1113en Phone#: S-532 A 4717 Address: (F, 1 -1 '�i Lc ;2— a City: K ,, (i 'D ICC_ pu, l e---- State: l` Zip ®b nn Qualifier Name: ..2, 1 C- 1`-- C kit ke_.. s f Phone#: State Certification or Registration #: C C C Ct, 0 56 % 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 DAlteration New Repair/Replace ❑Demolition Description of Work: C e D' Co to Q c4-4, * *+ x**+ x********** ****** ****** *********** Res*+ x*** **+x****+s *********+ *********+x******** * ** Submittal Fee $ Permit Fee $ 75 .O° Scanning Fee $ 3 • V� Radon Fee $ Notary $ Training/Education Fee $ Double Fee $ Structural Review $ CCF $ DBPR $ Technology Fee $ CO /CC $ Bond $ TOTAL FEE NOW DUE $ '`7FS * d, 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 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 properly is for the st i inspectio Ject to cJzment. Also, a certified copy of the recorded notice of commencement must be posted at the job site which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the ved and a reinspection fee will be charged. Signatur Owner or Agent The foregoing instrument was acknowledged before me this 15 The foregoing instrument was acknowledged before me this day of FAR- , 20+2_, by ena.1 Kt.: (././a) (t) , day of I,3 -c 19 , 201:1-by onus/�/��/ who is personally known to me or who has kluced 1o® who is personally known to me or who has produced As identification lAho did e.ar�a h. as identification and who did take an oath. ry � Contractor NOTARY PUBLIC: Sign: Print: My Commission Expires: ILL zz APPROVED BY � Plans Examiner NOTARY PUBLIC: Sign: Print: My Commis Zoning Structural Review Clerk (Revised 07 /10 /07)(Revised 06 /10/2009)(Revised 3/15/09) 1 • 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 NM 1 —312? o!l Owner's Name (Fee Simple Title Holder) l ° &f)t1'r' 'IL/Phone #: Owner's Address: City: State : Zip Code: �( Job Address (Of where work is being done): l is--q 1 4 City: Miami Shores State: Florida Zip Code& ( �� Contractor's Company Name: i (Lk S UCT,Ot/\ Phone #3 J i =( 7 Address: City: RNA 6,U0z_ r State: Zip Code Oq Qualifier's Name : 1E (G i (q Lic. Number: i !off S Architect/ Engineer of Record Name: Phone #: Address: City: State: Zip Code: Describe Work: C rV C a-6 TC. Pelt:. Lta:v4-e I hereby certify that the work has been abandoned andlor the contractor /architect is unable or unwilling to complete the contract. I hold the Building Official and the Shores harmless for all legal involvement. Signatu Signature or Agent Contractor or Architect The foregoing instrument was aknowledged before me The foregoing ins nt was aknowledged before me this 44( ddayof (7 20(2-by who-it personally kn n to me or who has produced as indentification. this day of - 3,2&-,by ti'L tA AN -Air o me or who has produced \\\`\\`\��\‘ a I'Ji'jrification . o ✓9 Notary Public: Sign: Seal: -Wt. r4 ° ,�� ®•,•. •'• `ems \` 1111\\��\\` Nota Sign: Seal: