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RC-11-952Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 nspection Number: INSP - 169996 Permit Number: RC -5 -11 -952 Inspection Date: February 16, 2012 Inspector: Bruhn, Norman Owner: RABALAIS, JEFFREY Job Address: 726 NE 92 Street 12 -L Miami Shores, FL Project <NONE> Contractor: CLN GROUP LLC Permit Type: Residential Construction Inspection Type: Final Work Classification: Alteration Phone Number (954)261 -9513 Parcel Number 1132060440500 Phone: (305)788 -2034 Building Department Comments KITCHEN CABINETS AND COUNTER TOP - ELECTRICAL WAS UPDATE IN 2007 GFI RECEPTACLES Passed x-16 Inspector Comments 41._ Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled re- inspection fee is paid. until February 15, 2012 For Inspections please call: (305)762 -4949 Page 1 of 1 (q Loot S 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. PC 1 Master Permit No. BUILDING PERMIT APPLICATION FBC 20 Permit Type: BUILDING ROOFING pp OWNER: Name (Fee Simple Titleholder): j4FP K F3/ 4 i is Address: . u -1 ° - 2 L City: #"d q MAY 2 I'Q Phone #: el,Ik 2ti /. State: Pi- Zip: 3 `)• 1(.5 Tenant/Lessee Name: Phone #: Email: JOB ADDRESS: 12- (P /U e 12. al. ZL, City: Miami Shores County: Folio/Parcel #: I t- �' 00 CP m 04' 9— 0 6 Is the Building Historically Designated: Yes Miami Dade zip: 6 NO Flood Zone: /J CONTRACTOR: Company Name: C at Phone#: 3B S ° '7 88 ' © 4 Address: 111 67 S- Vii_if. Z29 City: P ,A)t.. C4t tA. f �` State: r( zip: 4 3 1 s4 Qualifier Name: Lo 131 i NiN\ f A- Phone #: 30S- 7 6e - t o 3 4 State Certification or Registration #: CG,C 151 71s 3 Certificate of Compe ncy #: Contact Phone#: 3°5-1 b e - Z-O 1 Email Address: L / k V A 1 C L N C.c9n1 T vii ' vmi . coq DESIGNER: Architect/Engineer: Phone #: Value of Work for this Permit: $ Square/Linear Footage of Work: Type of Work: ❑Addition ❑1Allt``erppation ❑New ❑Repair/Replace ❑Demolition Description of Work: K [(alai l ai C /P, //u �� ( La&t2/cl. tAJ - UPI'j/. r 12 /1) 1490 -� . % � ri aFa 0.6..PL r 5 � p &rEC/ ),X >iid 4L// -07- 22,57 * * ** x********+ x****+ x********+x******** ** Fees* **** **+x**** ************* way * *** *** * ***** **** / a� Submittal Fee $ Permit Fee $ /©O CCF $ CO /CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ TOTAL FEE NOW DUE $ Bonding Company's Name (if applicable) Bonding Company's Address City ,.t . ' a> 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 o ° ement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issu sence of such posted notice, the inspection will not ' / . roved and a reinspection fee will be charged. Signatur wner or Agent The foregoing instrument was acknowledged before me this 2-3 day of 009 , 2b I , by who is personally known to me or who has produced As identification and who did take an oath. NOTARY PUBLIC: Sign: Print: NOTARY NMI F FLORIDA 0. 01.9. My CZ COMMISSICA D918302 Expires: BER 15, 2013 BONDED TH1iD ATL TIC BONDING CO„ BIC, My Commission Expires: APPROVED BY Signature Contractor The foregoing instrument was acknowledged before me this Z-3 day of 1"foq , 20 IL, by who is personally known to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: Plans Examiner Structural Review (Revised 07 /10 /07)(Revised 06 /10/2009)(Revised 3/15/09) Sign:.. Print: NOTARY PUBLIC - STATE OFFLORIDA '"' , Myrna Martinez "4 CisS1Otl #DD918302 My Commission Expires: • 1,4 :a. OInlnExpires: SEP. 1S, 2013 Et THRt: ATTI NTIC SOIMNIKOA/D. Zoning Clerk Ca, coh4 MEM -v was1 1E4 Miami Shores Village APPROVED BY DATE ZING DEPT BLDG DEPT J6 C- '( SUBJECT TO COMPLIANCE WITH ALL FEDERAL STATE AND COUN r JLES AND REGULATIONS A * peitOlaemiv,4, 1- St A L (60 - (2e,i(ekkeyvtizA- . 6f." CAS( K ►,-c 1 cm MlAM1 5 V, p- ALL x is -r/mq wort wets UfgjgkcL cfi tziGP L. PLiv T�