WS-11-651 (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 - 170183
Scheduled Inspection Date: February 22, 2012
Inspector: Bruhn, Norman
Owner: WOOLIN, RACHEL
Job Address: 489 NE 95 Street
Miami Shores, FL 33138-
Permit Number: WS -4 -11 -651
Project: <NONE>
Contractor: F&F CONSTRUCTION SERVICES INC
Permit Type: Windows /Shutters
Inspection Type: Final
Work Classification: Window /Door Replacement
Phone Number
Parcel Number 1132060140640
Phone: (954)454 -1948
Building Department Comments
INSTALLATION OF 12 IMPACT WINDOWS AND 2 IMPACT
DOORS
Passed
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 - 158348.
CC-
February 21, 2012
For Inspections please call: (305)762 -4949
Page 38 of 52
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. w S t l (05 I
Master Permit No.
BUILDING
PERMIT APPLICATION
FBC 20
Permit Type: BUILDING ROOFING ,.,n r p
OWNER: Name (Fee Simple Titleholder) Of \ l� �l�tJ ` Phone #:•' ` 7 ` ®�
Address:
City: State: Zip:
Tenant/Lessee Name: Phone#:
Email:
JOB ADDRESS:
City: Miami Shores County:
Miami Dade
Zip: '3 131
Folio/Parcel #:
Is the Building Historically Designated: Yes
NO Flood Zone:
CONTRACTOR: Compan Name: fi F Co U.S v' L c-t 0 v.. Phone#: O 5 ?-T — I q`27
Address: 7, 1-7 0°7 ��- �1
City: ? 4 L 16, K— State: f ��1 Zip: 35 q
Qualifier Name: ' e 14J S l—t \ '. Phone#:
State Certification or Registration #: 6 C lf) G5 0 Sl If I 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: DAddition OAlteration °� ONew� • Repair/Replace ODemolition
Description of Work: (2 vAtt 0 c) u '
+ x******* *** * *** ************ ***x �� *** ***** Fees** x��x�x**** �x* �x�x�x�n�x+ x**** x� *�x�x�x *�x�x+x�x�x+x *�x�xa� *� ***mix
Submittal Fee $ Permit Fee $76. Ut CCF $ CO /CC $
Scanning .Fee $ Radon Fee $ DBPR $ Bond $
Notary $. " Training/Education Fee $ Technology Fee $
Double Fee $ ' Structural Review $
TOTAL FEE NOW DUE $ ' r...0
,.
AWit
$ . •
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 property js- subject io attaekmerft. Also, a certified copy of the recorded notice of commencement must be posted at the job site
for the fir, t '' , ection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the
inspection;, approve a reinspection fee will be charged.
Signature
Owner or Agent
The foregoin instrument was acknowledged before mee� this ue� 5
��
day of ` uJ, 20 j2,.by 9,KHOL W�d�ldgN
who is personally known to me or who has prod d
\ \\\111`��i woo
As identification 4pl'who dMC �- iforoath.
er
aC
NOTARY PUBLIC:
Sign:
Print:
My Commission Expires:
�/ /1111111111111 \ \ \ \ \�\
Signature
Contractor
The foregoing instrument was acknowledged before me this
day of J I (I , 20 � ? by
who is /ersona y la�sm 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:
My Commis
Zoning
Clerk
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 / ARCHITECT
Permit N.LUS I ° I
Owner's Name (Fee Simple Title Holder):
Owner's Address:
Phone #:
City: State : Zip Code:
Job Address (Of where work is being done): civ s
City: Miami Shores State: Florida Zip Code
Contractor's Company Na e: F
Address: 2' (7 Pcn
City: i o ' (C
r(r7 S "FC(U Cr-tocq
State:_+'4
Phone #:
Zip Code:0t)i
Qualifier's Name : V(c t U
Architect/ Engineer of Record Name:
Address:
City: State: Zip Code:
Lic. Number: CO(oO S ��
Phone #:
Describe Work: Ll.) 1 rs Dat,..) + DZ) ( 2 4
I hereby certify that the work has been abandoned and/or the contractorlarchitect is
unable or unwilling to complete the contract. I hold the Building Official and the
Miami Shores harmless for all legal involvement.
Signature 1141C Signature
owner or Agent
The foregoing instrument was aknowledged before me
this l day of cra, ,2d 2 ;by L J
Who is�ergonall err$ or who has produced s personallysl Hawn to me or who has produced
Contractor or Architect
The foregoing instrumt was aknowledged before me
this Zt day of r'e- % , 20Z y
I ,
...
Notary Publ' . n '' ,, �
Sign:
. o rn = ti ' Seal: b �
,�
as indentification.
Notary Pu
Sign:
Seal: