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WS-05-1043Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP -264 Permit Number: WS -12 -05 -1043 Scheduled Inspection Date: March 05, 2012 Inspector: Bruhn, Norman Owner: HORVATH, TRACY Job Address: 67 NW 103 Street Miami Shores, FL 33150 -1233 Project: <NONE> Contractor: IMBURGIA CONSTRUCTION SERVICES, INC. Permit Type: Windows /Shutters Inspection Type: Shutter Final Work Classification: Shutters Phone Number Parcel Number 1121360131090 Phone: 305/525 -5707 Building Department Comments Passed iN/� cJ�j✓ Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments March 02, 2012 For Inspections please call: (305)762 -4949 Page 30 of 30 BUILDING PERMI FBC 2 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 Type: BUILDING 1 ING OWNER: Name (Fee Simple Titleholder : A ! a VI 1. Phone #: 954 • S29, 6200 Address: (Dl N\K t.■ S TQ II City: tkialiVkk Sn 1 S State: Zip: ,150 Tenant/Lessee Name: Phone #: Email: Y U1.1 a vuutQ@qatti y c�` 1, cc m RECEIVED FEB 242012 Permit No. UUSOS -* I093 Master Permit No. JOB ADDRESS: (f.)1 ti\M lb JttO( City: Miami Shores County: Miami Dade ?13150 Folio/Parcel #: Is the Building Historically Designated: Yes NO Flood Zone: CONTRACTOR: Company Name: 111-\tor (AI 0, Ctesir Phone#: Address: OriS 1\1E— 1 t-11 S T City: 0214-1 (P *4 Z State: Zip: 3 Qualifier Name: Phone #: State Certification or Registration #: 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 UNew ❑Repair/Replace ❑Demolition Description of Work: rN(t r t _ l ) COc t CA-0 5K__ gr-tilr11 ( . ***************************************Fees*** *,*ip ., 1,*„********************************** Submittal Fee $ Permit Fee $ 1l o. • Q€Fm$ • 00 CO /CC $ Scanning Fee $3, 00 Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ TOTAL FEE NOW DUE $ S • o) / • r 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 deliv red to the person whose property is subject to attachment. Also, a certified copy of the recorded notice f commencement must be po ed at the job site sted notice, the for the first inspection which occurs seven (7) days after the building permit is iss inspection will not be ..proved and a reinspection fee will be charged. Signa wner or Agent The foregoing instrument was acknowledged before me this day of Zy , 20 YZ, by 1 i HOZjArni , w who is personally known to me or who has produced 1 0 who is personally known to me or who has produced likabsence of such Signatur kt The foregoing instrument was acknowledged be . , me this ontractor day of , 20 _, by As identification and who did tn oa �\ \\ake 1I11 U a/1111, ..a 31 f�th. ,, / //i Sign: Lam`" j6\%%\° � NOTARY PUBLIC: Print: My Commission Expires: as identification and who did take an oath. NOTARY PUBLIC: Sal\ * * * * * * ** * * * * * * * * * * *** * * *** * * ** *** * * * * * * * * * * * ** * * * ** * *** x yx** *4 :*a a ik :*** * * *** ****x:**** * ** **** * * **** APPROVED BY Plans Examiner ��`?• S)\ \� _ �. 10x.:Cotainisc�oit & f res: 49A1 i S s --__ ® 41„;:, 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 N.A15 OS-1043 Owner's Name (Fee Simple Title Holder). Owners Address: (01 t■.\\M tflajs' ('t City: 4tox t Shorgs 10Pki tAorvatb Phone #: 95q S29 0200 State : Job Address (Of where work is being done): gel N\ to3 St-at Zip Code: 33156 City: Miami Shores State: Florida Zip Code:3315C3 Contractor's Compan Name: till 6lIkCe(1 1onst- ttActic5ls) Phone #: Address:. 5 IVI�t.. � 1 City: N (271-F-f.. State: Zip Code: Qualifier's Name : Lic. Number: Architect/ Engineer of Record Name: Phone #: Address: City: State: Zip Code: Describe Work: (N15 (/ rLL fA. nc."..1 T7f I hereby certify that the work has been abandoned andlor the contractorlarchitect is unable or unwilling to complete the contract. I hold the B i ding ial and th Miami Shores harmless for all legal in en Signatu o ) r Agent The foregoing instrum was aknowledged before me this25dayof I'i ,20Rby •1 -J tt.i' Who is personally known to me or who has produced Notary Pub Sign: Seal: ,��" Q .1 ..O,04s On°tiice fication. \ 1K/°° • Signature Contractor or ' . ct The foregoing instrument was akn ledged before me this day of , 20 by who is personally known to me or who has produced as n f'Lu 9p,,° \ Notary Public: ,, Si n: ,j# e'�� .,---,_ Seal: go ,, � r� 13-73o P\ckays .. �33Fs Sw Nevmore St. N. 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Sign up for a box online at usps.com/poboxes. ********* * * ** * * * * * * * * * * * * * * * * * * * * * * * * * ** Bi11 #: 1000402840424 Clerk: 06 All sales final on stamps and postage Refunds for guaranteed services only Thank you for your business ********* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** ********* * * ** * * * * * * * * * * * * * * * * * * * * * * * * * ** HELP US SERVE YOU BETTER Go to: https : / /postalexperience.com /Pos TELL US ABOUT YOUR RECENT POSTAL EXPERIENCE YOUR OPINION COUNTS _,, * * * * * * * * * * * * * * * * * * * * * * ** ..y * * * * * * * * * * * * * * * * ** Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami BUILDING PERMIT APPLICATIO FBC 2001 Permit Type (circle): es, Florida 33138 ) 756.8972 Electrical ti -Cb. -) ' Permit No. - Master Permit No. Plumbing Mechanical Roofing Owner's Name (Fee Simple Titleholde7)-7—--AC Y 4-11:::342-V c1-44-1 Phone # ( O5) 7'5 / Owner's Address (..'1 ' i 1•I 103 ST City H 1 Cl r i 1 SbDr'C to , Tenant/Lessee Name Phone # Zip 33 lasO Job Address (where the work is being done) City Miami Shores Village Is Building Historically Designated YES 4;7 'KILO t o3 5T County Miami -Dade Zip NO Contractor's Company Name 1 ZZ C, 13 c, i cDre S State '"P-f )22-0 Contractor's Address 1338 (S _) City'RDY -' St LVC C. Qualifier •"11--1©m'-y--aCt S rt 1 d __.r5 Ir-� 33150 Phone # 772 )34o • 07 0'2j Zip 34G1'&3 State Certificate or Registration No. Certificate of Competency No. Architect/Engineer's Name (if applicable) Phone # Type of Work: ❑Addition ❑Alteration Describe Work: 11-1St-CI I (1 Ct -H Gtr Square Footage Of Work: UNew ❑ Repair/Replace ❑ Demolition p� by r r i CC( r-) S le—Nk te. r S s * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Permit Fee $ �I �. M� CCF $ 1 • 80 . CO /CC. Technology Fee $ 4 • Zoning Bond $ ining/Education Fee $ Radon $ Code Enforcement $ 0.40 Structural Plan Review. $ Total Fee Now Due $ (Continued on opposite side) 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. 1 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 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. Signature Signature Owner or Agent Contractor The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this day of , 20 by , day of , 20 by 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: NOTARY PUBLIC: Sign: Sign: Print: Print: My Commission Expires: My Commission Expires: **************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** APPLICATION APPROVED BY: Chc 05/13/03 * * * * * * ** ***** *t * * * * * * * * * * * * * * * * * * * * * * * * * * * ** " Engineer Zoning Protect Address Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Permit NO S- 12 -05 -1 .- Pennit;Type: Windows /Shutter Work Classification: Shutters Permit Status: APPROVED /2005 Expiration: 09/05/2008 Parcel Number Applicant 67 NW 103 Street Miami Shores, FL 33150 -1233 1121360131090 Block: Lot: TRACY HORVATH 1 Owner Information Address Phone Cell TRACY HORVATH 67 NW 103 ST MIAMI SHORES FL 33150 -1233 Contractor(s) IZZO BUILDERS INC Phone Cell Phone Valuation: Total Sq Feet $ 2,500.00 0 1 Type of Work: No of Openings: 7 Additional Info: Classification: Residential MAR 0 5 2008 LM'S 5 Fees Due CCF Education Surcharge Notary Fee Permit Fee Scanning Fee Technology Fee Total: Amount $1.50 $0.50 $5.00 $170.00 $9.00 $4.50 $190.50 Total Amt Paid I Amt Due $ 0.00 $ 0.00 Payment Type: $ 0.00 Available Inspections : 1 Inspection Type: Shutter Final Shutter Attachment 1 In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. 1 understand that separate permits are required for ELECTRICAL, PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work. OWNERS AFFIDAVIT: 1 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. Futhermore, I authorize the above -named contractor to do the work stated. March 05, 2008 Authorized Signature: Owner / Applicant / Contractor / Agent Building Department Copy Date Wednesday, March 5, 2008 1