RC-11-2200Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP- 167089 Permit Number: RC -11 -11 -2200
Scheduled Inspection Date: May 24, 2012 Permit Type: Residential Construction
Inspection Type: Final
Owner: , DUSA ACQUISITION LLC Work Classification: Addition /Alteration
Job Address: 455 NE 91 Street
Miami Shores, FL 33138-
Inspector: Bruhn, Norman
Project: <NONE>
Contractor: COLONY ACQUISITION CORP
Phone Number (305)496 -7442
Parcel Number 1132060140140
Phone: (305)496 -7442
Building Department Comments
KITCHEN AND BATHROOM REMODEL. FLOORING AND
DRYWALL REPAIR
Passed
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Inspector Comments
May 23, 2012
For Inspections please call: (305)762 -4949
Page 1 of 33
Miami Shores Village
OCTIMLE"
NgV?8211
Building Department BY: ' `®
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
Permit No PC II— (qV`/
Master Permit No.
Permit Type: BUILDING ROOFING
OWNER: Name (Fee Simple Titleholder): 117(ye/ LIJ
Address: L709 09 S& /32
City: /f/e'a/'p State: FL_
Phone#: 3s ° '9t ` ;1yqL-
Zip: 33/t3
Tenant/Lessee Name: 6
Phone#: 36-7;7- 1-616 ` 1t 4/4 7
It
Email: 7 5/0e /a c ; 1 f e"s.0ll
JOB ADDRESS: 40T 9/ ....lee
City: Miami Shores County:
Folio/Parcel#: 320c-0/4i-0/V0
Is the Building Historically Designated: Yes NO Y'
Miami Dade
Zip: , /1-3
Flood Zone:
CONTRACTOR: Company Name: (Lk' y delis i 5 7te •: t Leo Phone#: SOC— 996 ° NW.
Address: : r x °-L
City: rr / f AudiR:dal .. State: FL- Zip: 333/ �.
Qualifier Name: c Phone#:
State Certification or Registration #: 1-_d e C2 IaL ?OJ Certificate of Competency #:
Contact Phone#: ? ° Li? 4'1—/ii Z Email Address: ... e /ft t g y911a..[ f_ e.
DESIGNER: Architect/Engineer: i /d.' e Gd 4�GS� -' . / /G� i' fswo�za lee i /" 4: Phone*. 30-C--- 4/49i2 2 D
Value of Work for this Permit: $ 9.5)000 r. Square/Linear Footage of Work: 070
Type of Work: OAddition �j ��j teration
New epair epl )) UDemoliti
Description of ...n. �.i 1 C C�' f l/I /� i �'yfv)
r If •
*** **************a aa**a.***********°aa***p * *******a** *a**** **** * *** * * *** *****.a********
Submittal Fee $ Permit Fee $ /seU cnu CCF $ CO /CC $
Scanning Fee $ Radon Fee $ DBPR $ Bond $
Notary $ Training/Education Fee $ Technology Fee $
Double Fee $ Structural Review $
TOTAL FEE NOW DUE $ 7 / :%I
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 FT .FCTRICAL 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 $2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspection h occurs seven (7) days after the building permit is issue the absence of such posted notice, the
inspection will not b /pprL ved and a reinspection fee will be charged.
Signature
Owner or Agent
The foregoing instrument was acknowledged before me thist-1
day of /YDVPmi)er, 20 0 , b
who is personally known to me or who has produced
As identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print
My Commission Expires:
Signature
Contractor
The forego i g instrument was acknowledged before me
day of 4, ) V 20/7 , by
who is personally known to me or who has produced
as identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print
dtc
APPROVED BY
My Commission Expir
,,$gtss! * JAOQUELYN S. ROBL EDO
:+c MY COMMISSION # EE 035515
EXPIRES: February
Bonded Thru Notary Pubflc U16, 2015 nderwriters
Plans Examiner
Structural Review
(Revised 07 /10 /07)(Revised 06 /10 /2009)(Revised 3/15/09)
Zoning
Clerk
PERMIT # !l-._
CONTRACTOR: C f t ' It J)Si1DA
SUBMITTAL DATE: I A 61 e .11
ADDRESS: zm z 5 9\li „ on si \
NAME: aLA A 151 De ill
RESUBMITAL DATES:
PROJECT TYPE: armgawarniriventuit
ZONING
FIRE
STRUCTURAL
IMPACT FEES
iszyt)Y - �p ,,e --// J </"
,,, 9 s /�/ 9 Us" C
ELECTRICAL .-� 1/7
HRS/DERM
P M NG
NOC I
\fj \ '' MECHANICAL .r ' ‘,
e l
'71\ )ovik,
BLDG
it )9, t zap
Prepared by and return to:
Albertelli Law
5�f h�
5404 Gypres enter Drive, Suite 300
Tampa, Florida 33609
Our File Number: TPA10 -26048
as a necessary incident to the fulfillment of conditions
contained in a title insurance commitment issued by it.
CFN: 20110776279 BOOK 27897 PAGE 4615
DATE:11/17/2011 02:13:02 PM
DEED DOC 1,176.00
HARVEY RUVIN, CLERK OF COURT, MIA -DADE CTY
Property Appraisers Parcel I.D. (folio) Number (s): (folio) Number (s): 11 32060140140
SPECIAL WARRANTY DEED
This Special Warranty Deed, made this L day of November, 2011, by Residential Funding Company,
LLC F/K/A Residential Funding Corporation, having its place of business at: 2711 North Haskell Avenue
11th Floor, Dallas, TX 75204, here by called the grantor,
to Dusa Acquisition LLC, Florida Limited Liability Company, whose Post Office address is: 45 NE 39th
Street, Miami, Florida 33137, hereinafter called the grantee,
WI T N E S S E T H:That grantor, for and in consideration of the sum of $10.00 and other
valuable considerations, receipt whereof is hereby acknowledged, by these presents does grant,
bargain, sell, aliens, remises, releases, conveys and confirms unto grantee, all that certain land
situate in Miami -dade County, Florida, viz:
LOT 20, BLOCK 49, OF MIAMI SHORES SECTION 2, ACCORDING TO THE PLAT
THEREOF, RECORDED IN PLAT BOOK 10, PAGE 37, OF THE PUBLIC
RECORDS OF MIAMI -DADE COUNTY, FLORIDA
Property address: 455 NE 91st Street, Miami, Florida 33138
TOGETHER with all the tenements, hereditaments and appurtenances thereto belonging or in anywise
appertaining.
TO HAVE AND TO HOLD the same in fee simple forever.
GRANTORS WILL WARRANT and forever defend the right and title to the above - described real property
unto the Grantees against the claims of all people, claiming by , through or under Grantors, but not otherwise.
(wherever used herein the terms "grantor" and "grantee" included all the parties to this instrument, and the heirs, legal representatives and assigns of individuals, and
the successors and assigns of corporation.)
IN WITNESS WHEREOF, the grantor has caused these presents to be executed in the name, and its corporate
fEt) imp
Prepared by and return to:
Albertelli Law
�4ZU �l�l1rL.
5404 Cypres enter Drive, Suite 300
Tampa, Florida 33609
Our File Number: TPA10 -26048
as a necessary incident to the fulfillment of conditions
contained in a title insurance commitment issued by it.
Property Appraisers Parcel I.D. (folio) Number (s): (folio) Number (s): 11 32060140140
SPECIAL WARRANTY DEED
This Special Warranty Deed, made this ji day of November, 2011, by Residential Funding Company,
LLC F/K/A Residential Funding Corporation, having its place of business at: 2711 North Haskell Avenue
11th Floor, Dallas, TX 75204, here by called the grantor,
to Dusa Acquisition LLC, Florida Limited Liability Company, whose Post Office address is: 45 NE 39th
Street, Miami, Florida 33137, hereinafter called the grantee,
W I T N E S SE T H:That grantor, for and in consideration of the sum of $10.00 and other
valuable considerations, receipt whereof is hereby acknowledged, by these presents does grant,
bargain, sell, aliens, remises, releases, conveys and confirms unto grantee, all that certain land
situate in Miami -dade County, Florida, viz:
LOT 20, BLOCK 49, OF MIAMI SHORES SECTION 2, ACCORDING TO THE PLAT
THEREOF, RECORDED IN PLAT BOOK 10, PAGE 37, OF THE PUBLIC
RECORDS OF MIAMI -DADE COUNTY, FLORIDA
Property address: 455 NE 91st Street, Miami, Florida 33138 ye ®f� /��ff/
TOGETHER with all the tenements, hereditaments and appurtenances thereto belonging or in anywise
appertaining.
TO HAVE AND TO HOLD the same in fee simple forever.
GRANTORS WILL WARRANT and forever defend the right and title to the above - described real property
unto the Grantees against the claims of all people, claiming by , through or under Grantors, but not otherwise.
(wherever used herein the terms "grantor" and "grantee" included all the parties to this instrument, and the heirs, legal representatives and assigns of individuals, and
the successors and assigns of corporation.)
IN WITNESS WHEREOF, the grantor has caused these presents to be executed in the name, and its corporate
seal to be hereunto affixed, by its proper officers thereunto duly authorized, the day and year first above written..
Signed, sealed and delivered
Residential Funding Company, LLC F/K/A Residential
in the presence of: Funding Corporation
Witness signature
Print witness
Wf they
Alit !PP Ate-
Pnnt ,rtness name
State of
County of
/ / /1i /e,
me: 1 er ?1 gird
Titl Processing Management Officer
the foregoing instrument was acknowledged before me this _ day of November, 2011 by
(Corporate Seal)
as for for Residential
Fundin Com ' an LLC F A Reside al Fundin Co • oration. He /she is personally known to me or who has produced
driver license(s) as identification.
Notary Public
Print Notary Name
My Commission E • ires:
Notary Seal
Escrow #:
TPA 10 -26048
Page 2 of 2
COLONY ACQUISITIO\ CORD
• 7670 SW 132 Place
• Miami, FL 33183
• (305) 496 -7442
• kmspellacy @gmail.com
RE: Permit Number — RC 11 -11 -2200
To Whom It May Concern:
Per requirements of Miami Shores Village please allow this letter to serve as
notification that Colony Acquisition Corp will perform the demolition and
remodeling/repairs as outlined in the plans attached and approved. Demolition will
commence one business day following receipt and posting of subsequent permits in
accordance with Miami Shores Village Building Department requirements. If you
require additional information or authorization please do not hesitate to contact Kevin
Spellacy via the contact information above.
Re s,
Co ony Acquisition Corp
George H Scholl
SWORN TO AND SUBSCRIBED before me this day of 1-lr 1'1
Affiant is . impersonally known to me, .. produced as
identification.
JACQUELYN a
• ; MY COMMISSION # EE 035515
Bonded Thru NotarFebruary u Users
DUSAACQUISITIO\ LLC
• 7670 SW 132 Place
• Miami, FL 33183
• (305) 496 -7442
• kmspellacy @gmail.com
RE: Permit Number — RC 11 -11 -2200
To Whom It May Concern:
Per requirements of Miami Shores Village please allow this letter to serve as
notification that Colony Acquisition Corp is authorized to perform the demolition and
remodeling/repairs as outlined in the plans attached and approved. Demolition will
commence one business day following receipt and posting of subsequent permits in
accordance with Miami Shores Village Building Department requirements. If you
require additional information or authorization please do not hesitate to contact Kevin
Spellacy via the contact information above.
DU A Acquisition LLC
George H Scholl
SWORN TO AND SUBSCRIBED before me this day of t /9`%
Affiant is personally known to me, .- .___ _, produced - --
identification.
S. ite „��,,.,, 1 ROBLEDO,.:.
'r; �awaYnl
ir_`nd tin MY COMMISSION # EE 035515
+;* EXPIRES: February 16, 2015
Alip Bonded Thru Notary Public Underwriters
NOTICE OF COMMENCEMENT
A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF FIRST INSPECTION
PERMIT NO.' )1 242-0 TAX fOLIO NO.// -32o6,-6111 -61,16
STATE OF FLORIDA:
COUNTY OF MIAMI -DADE:
THE UNDERSIGNED hereby gives notice that improvements will be made to certain real
property, and in accordance with Chapter 713, Florida Statutes, the following information
is provided in this Notice of- Commencement
1. egal description of rroperty and street/address: I/55-A- �/
11111111111111111 1111111111 11111 1111111111111
CFN 2101 1 80854946
OR Bk 27936 Ps 11751 (1139)
RECORDED 12/21/2011 10 :02:04
HARVEY RUVIN, CLERK OF COURT
11IAIII- LADE COUNTY, FLORIDA
LAST PAGE '
Space above reserved for use of recording office
2. Description of improvement: ..4f1MTEgrifff , : ,=b, 4
3. Owner(s) name and address:
Interest hi property. Own,/
Name and address of fee simple titleholder.
4. Contractor's name, address and phone number.
5. Surety: (Payment bond required by owner from contractor, if any)
Name, address and phone number.
Amount of bond $
6. Lender's name and address:
it/
6
k 01. .4
/VA
7. Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as provided by
Section 713.13(1Xa)7., Florida Statutes h �A �¢
Name, address and phone number i tR- t 00 ` 3 Ave_ Sulk 2Z) F +. Laftaltritith j FL.
333 °J 14
8. In addition to himself, Owners designates the following person(s) to receive a copy of the Uenor's Notice as provided In Section
713.13(1)(b), Florida Statutes.
Name, address and phone number i ri 5/9 1 o cAl
9. Expiration date of this Notice of Commencement
(the expiration date Is 1 year from the date of recording unless a different date Is specified)
WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT ARE CONSIDERED
IMPROPER PAYMENTS UNDER CHAPTER 713, PART I, SECTION 713.13. FLORIDA STATUTES, AND CAN RESULT IN YOUR PAYING TWICE FOR
IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE
FIRST INSPECTIO OU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK
OR RECORDING OUR OTICE OF COMMENCEMENT.
Signature(s) , Own
Prepared
Print Name
e/Office
ATE OF FLOR
UNTY OF M
e foregoing in
dividually, or
Personally Imo
s) or Qwner(- s)' 1 • rized cer/Director/Partner/Manager
KA
isrif64 at. Prepared By
4c4k..el 1 Print Name
3 f1ltrn i .v Title/Office
as acknowled • before me this Of / day of 01 Lit
'
:I -I, J,aa
for
of identifi )) •ice .�
biic: ��I:. iii✓ �1��!r��
VERI CATION PURSUANT TO SECTI • N 52 , ` ORIDA STATUTES
Under penalties of perjury, I declare that 1 have read the foregoing and
that the facts stated in ft are true, to the best of my knowledge and belief.
s rr
Signature(s) of Owner(s) or Owner(s)'s Authorized Officer/Director /Partner/Manager who signed above:
JACQUELYN S. ROBLEDO
MY COMMISSION t 8: 635515
• R Folsom 16,
SWIM CC' 11.00A% irArtr:
0421val Ned In 11:1,3 tra 2- of
Ct D 2O / 1
WITNESS in" _ d and Oi'fiGid
HARVEY 4, CLERK, of Circuit eitd Ccarty Courts
(Ai D.C.
By
Permit No: 11 -2200
Job Name:
December 9, 2011
Miami Shores Vivage
Building Department
Building Critique Sheet
1) Provide all permit applications prior to any further reviews.
2) Corrections must be made for Electrical.
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
Page 1 of 1
Plan review is not complete, when all items above are corrected, we will do a complete plan
review.
If any sheets are voided, remove them from the plans and replace with new revised sheets and
include one set of voided sheets in the re- submittal drawings.
Norman Bruhn CBO
305 - 795 -2204