EL-12-1156Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: I NSP- 175086
Permit Number: EL -6 -12 -1156
Scheduled Inspection Date: August 20, 2012
Inspector: Devaney, Michael
Owner: ROBBIN, DAN AND JOSEPHINE
Job Address: 810 NE 100 Street
Miami Shores, FL 33138-
Project: <NONE>
Contractor: MOODY ELECTRIC INC
Permit Type: Electrical - Residential
Inspection Type: Final
Work Classification: Generator
Phone Number
Parcel Number 1132060340060
Phone: (305)758 -2000
Building Department Comments
GENERATOR INSTALLATION
Passed
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Inspector Comments
August August 17, 2012
For Inspections please call: (305)762 -4949
Page 9 of 33
? 11 /tGA�j°
D
PERMIT APPLICATION
FBC 20
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: Electrical 46/4/ OWNER: Name(Fee Simple Titlehollder): j 4 IZP Phone #: 3195 -- 2_9f- 9(� l
Address: C 0 other , /el .57--",
City: / ; dl svt t° �4c9/1,e75 State: it-" C, Zip: 357.0
Tenant/Lessee Name: Phone #:
Email:
Permit No. EL 12+ 115
Master Permit No.
JOB ADDRESS:
City: Miami Shores County:
Miami Dade
Zip:
Folio/Parcel #: /
Is the Building Historically Designated: Yes
NO Flood Zone:
CONTRACTOR: Company Name: �0 60 ° ; et % � �- � 06 � 6 Phone #: 3C/ S-' 7 8 Z O
Address: 6 6 q /U 1 10 5
City: / A . / State: zip: /ce)
pp r te'
Qualifier Name: UA 4 �/ evd'/ Phone #:
State Certification or Registration #: o I l ( Certificate of Competency #:
Contact Phone #: ,105 75 o c Email A'dadr s:
DESIGNER: Architect/Engineer: /� Phone#: 505
Value of Work for this Permit: $ 5#61e, . 0® ° Square/Linear Footage of Work:
Type of Work: °Address °Alteration °New ORepair/Replace °Demolition
Description of Work: F fell /AWALL .417 t/,
Submittal Fee $ 6& OP Permit Fee $ .3.--O' / !' CCF'$ CO /CC $
Scanning Fee $ PitiG Radon Fee $ DBPR $ Bond $
Notary $ Training/Education Fee $ Technology Fee $
Double Fee $ Structural Review $
TOTAL FEE NOW DUE $ �� —1 i 25
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 pe it 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 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 wil;� t be approved and a reinspection fee will be charged.
Signature
Owner or Agent
r
The foregoing instrument was acknowledged before me this (-
day of 5 , 201 1--; by VAN' fu._, (k 1 s, , day of V I. 2' - , 201 ; by
who is personally known to me or who has produced r(-- I 'J 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: ����`�'sV18 u� / /// /* NOTARY PUBLIC:
s. o' *
The foregoing instrument was acknowledged before m- this
Sign:
Print: ®���,\p )
4i
IIIIUi11
My Commission Expires:
Sign:
Print:
My Commissio
Sy�s.,=r'_ MY COMMISSION # DD 979267
�s
EXPIRES: May 11, 2014
,titti Bonded Thru Notary Public Underwriters
+k+krk�k+k�kKs *N�+k�k+k�k�k�kN �k�k�k�k **** ************** * *********** * ****************** . * *' ******* **** ************
APPROVED BY
Plans Examiner /mod% /G Zoning
Structural Review Clerk
(Revised 07 /10 /07)(Revised 06 /10 /2009)(Revised 3/15/09)
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP - 175168
Permit Number: PL -6 -12 -1172
Scheduled Inspection Date: August 20, 2012
Inspector: Hernandez, Rafael
Owner: ROBBIN, DAN AND JOSEPHINE
Job Address: 810 NE 100 Street
Miami Shores, FL 33138-
Project: <NONE>
Contractor: SUBURBAN PROPANE
Permit Type: Plumbing - Residential
Inspection Type: Final
Work Classification: Gas
Phone Number
Parcel Number 1132060340060
Phone: 305 -891 -8393
Building Department Comments
INSTALL 10' OF NATURAL GAS LINE
Passed
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Inspector Comments
August 17, 2012
For Inspections please call: (305)762 -4949
Page 10 of 33
Ac-/ if CERTIFICATE LIABILITY INSURANCE
..'
DATE IMM/DDYYY)
02/17/2012
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: if the certlficete holder Is an ADDITIONAL INSURED, the policy(Ies) must be endorsed. If SUBROGATION IS WAIVED, subject to
the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the
certificate holder In lieu of such endorsement(!]
PRODUCER USA, INC.
445 8011111 STREET
MORRISTOWN, NJ 07960.8454
Attn: Morristown.Cefreguect@Morsh.com Fax 212- 948.0979
J08990- ALL-CAS -12.13 CUE
NAME:
PA
tPgtl&N e. EMI: I WC, No):
A€ND ARIL.
INSURERS) AFFORDING COVERAGE
NAIC
INSURER A : Liberty Mutual Fire Insurance Company
23035
INSURED - -
SUBURBAN PROPANE PARTNERS, L.P.
1 SUBURBAN PLAZA
P.O. BOX 206
WHIPPANY, NJ 07981 -0206
■
INSURER B • Utterly Insurance Corporation
42404
INSURER C :
$ 2,000,000
INSURER O ;
$ 250,000
INSURER E :
PERSONAL & ADV INJURY
INSURER F:
COVERAGES
CERTIFICATE NUMBER:
:1
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WIIICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR
TYPE OF INSURANCE
ADDL
JIISR
OUBR
WI
POLICY NUMBER
— POLICY EFT
rMMIDUIYYYYI
- POLICE Bill'
(MMIDDI YY)
.LIMITS
A
A
GENERAL
X
_ ,
LIABILITY
COMMERCIAL GENERAL LIABILITY
ICLAIMS -MADE I X I OCCUR
TB2- 631507975032
03/01/2012
03/0112013
EACH OCCURRENCE
$ 2,000,000
DAMAGE TO RENTED
PREMISES 1Ea oocu MEEpL
MED EXP (Any one person)
$ 250,000
$ 10,000
PERSONAL & ADV INJURY
$ 2,000,000
GENERALAGGREGATE
$ 2,000,000
_GEM-AGGREGATE LIMIT APPLIES PER:
X 1 P O L I C Y I I ! LOC
PRODUCTS - COMP /OP AGO
$ 2,000,000
$
AUTOMOBILE
X
X
X
LIABILITY
ANY AUTO
ALL OWNED
HIRED AUTOS
X
SCHEDULED
NON-OWNED
AUTOS
AS2- 631 - 507975 -042
03/01/2012
03101/2013
CO SINGLE LIMIT
J.Ea
$ 2,000,000
BODILY INJURY (Per person)
$
BODILY INJURY (Per accident)
$
PROTER1YDAMAGE
(Per ecddent)
$ -.
$
UMBRELLA L IA8 -
EXCESS LIAB
OCCUR
CLAIMS -MADE
N I A
_
WA7 -63D- 507975.012 (AO$)
-
03101/2012
03/01/2013
-
EACH OCCURRENCE
$
AGGREGATE
DED [ J RETENTION$
X WC STATU- I LOTH -
NUB L..FB
$
$ 1,000,00T
B
WORMERS COMPENSATION
AND EMPLOYERS' LIABILITY YIN
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICERIMEMBER EXCLUDED? I N I
(Mandatory In NH)
It pee describe under
DESCRIPTION OF OPERATIONS below
E.L. EACH ACCIDENT
E.L. DISEASE - EA EMPLOYEE
$.. '1,000,000
E.L. DISEASE - POLICY LIMIT
1 000000
$
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space le requtred)
EVIDENCE OF COVERAGE. •
CERTIFICATE HOLDER
MIAMI SHORES VILLAGE
ATTN: BUILDING DEPARTMENT
10050 NE 2ND AVENUE
NORTH MIAMI BEACH, FL 33138
CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES RE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
of Mash USA Inc.
Manashi Mukherjee ,.- x"Ca.Ano eotwk i to
®1908 -2010 ACORD CORPORATION. All rights reserved.
ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD
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 200
Permit Type: PLUMBING
OWNER: Name (Fee Simple Titleholder):
Address: (' dG�• �:
City: /67a' 4,j P �✓�! or- S
Permit No.
Master Permit No
2- -e>e,r.e (//
/moo S J/
State: l
;T IVE
JUN 262012
Phone #: 3e —Z 7 89/474/
Zip: 337,..3
Tenant/Lessee Name: Phone #:
Email:
JOB ADDRESS: /
)00 5 /-
City: Miami Shores
County: Miami Dade
Zip:
FoliolParcel #:
Is the Building Historically Designated: Yes
NO Flood Zone:
CONTRACTOR: Company Name: Off ' )7AD 4P�46-' Phone #: 303-- '/ �4.3 S 3
Address: /449/ 11167
City: ,A/'/'! /7l' State: 1`=e— Zip: 03« /
Qualifier Name: SUa-1 i /47,72".&,,A
State Certification or Registration #: Certificate of Competency #:
Phone #:
Contact Phone #: Email Address:
DESIGNER: Architect/Engineer: Phone #:
Value of Work for this Permit: $ l t— • Square/Linear Footage of Work: \ O cci ( 4
ONew ORepair/Peplace ODemolition
Description of Work: (4 X11 / is L. o r\ 1 L, 0!
Type of Work: OAddress OAlteration
******+ x******* ******x:****x:x:******m+ nor*** Feesa:********* *+ x******** *****m**:x************* **
Submittal Fee $ Permit Fee $ /5-6
Scanning Fee $ Radon Fee $
Notary $ Training/Education Fee $
Double Fee $ Structural Review $
CCF $ CO /CC $
DBPR $ Bond $
Technology Fee $
TOTAL FEE NOW DUE $ '� I l-• I O
Bonding Company's Name (if applicable)
Bonding Company's Address
City State
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
City State
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 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 . , pproved and a reinspection fee will be charged.
Signature / S:. i��, / Pu � Signature
Owner or Agent
The foregoing instrument was acknowledged before me this
day of 20 (2-, by Dar10--- a b 1 t 3�
who is personally known to me or who has produced 'd' `- � \ �,/
As identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
My Commission Expires:
**+ k***+ h+ k**Na*ak************* *******
APPROVED BY
.%`,",'3W.L to
.. \gym? q=
/tttttl1111110
Plans Examiner
Contractor
The foregoing instrument was ��acknowledged before me thi saS
day of ' rt , 20 by )U1I Jf ? pc'
who is personally known to me r who has produced
as identification and who did take an oath.
My Commission Expire °:»; o ono ?MAIM
* MY COMMISSION #EEAI3
EXPIRES: June 15, 2015
FOF �ioA`O BaideAihruli,�
H��k�ks k�kNaN�KaN�H�**** ik�kih�k�hsR�k�kH�ikH��k +k�kN�ik�k�k+hH=�hKc+k*** *** * �h ***
Structural Review
(Revised 07 /10 /07)(Revised 06 /10 /2009)(Revised 3/15/09)
Zoning
Clerk
a! Cony
v1 L_ &e paw I 1'
Fe_ /z01 eve
,g40114 12°6
116 b �d
v.
APPROVED
ZONING DEPT
SUBJECT 10 CCh,�pil ` CE WITH ALL FEDERAL
AND Cr ijN I f riLL:ES AND REGULATIONS
Suburban Propane
1491 N. E. 130th Street
N. Miami, FL 33161
305_ 8
g Qualifier
Job Address
Longest Run
i otui BTU's
,,"041N/2 ,6/4"
rece.
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#;5'
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... �r- ! f i. (J
$tpL
N
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP- 175088
Permit Number: DS -6 -12 -1157
Scheduled Inspection Date: July 26, 2012
Inspector: Rodriguez, Jorge
Owner: ROBBIN, DAN AND JOSEPHINE
Job Address: 810 NE 100 Street
Miami Shores, FL 33138-
Project: <NONE>
Contractor: MOODY ELECTRIC INC
Permit Type: Driveways /Sidewalks /Slabs
Inspection Type: Final
Work Classification: New
Phone Number
Parcel Number 1132060340060
Phone: (305)758 -2000
Building Department Comments
SLAB INSTALLATION FOR GENERATOR
Passed
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Inspector Comments
July 25, 2012
For Inspections please call: (305)762 -4949
Page 6 of 26
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
B IL ING
PERMIT APPLICATION
Permit Type: BUILDING
JOB ADDRESS: E0 ME 100 jf
FBC 2010
Permit No. D5- 12 -1 t$1
Master Permit No. EL- 2.- 1 15 10
ROOFING
City: Miami Shores County: Miami Dade Zip:
FoliolParcel #:
Is the Building Historically Designated: Yes NO Flood Zone:
OWNER: Name (Fee Simple Titleholder): 'a./° ` et il /11; �--� 64� Phone #: 36. -�'? 9 ' r( i,
Address: / 0i /VL , f, _�-
City: Ai; 4,/ I 51'
� it S State: �� Zip:
Tenant/Lessee Name: Phone #:
Email:
CONTRACTOR: Company' INI Name: + (-/I Uv�ru G In
Address: /►6 q lV td QO S
City: 1 1, l� f i1 / State: Pt/ Zip: 33/5-0
�®
Qualifier Name: Ot /-/ls 'J A 00 /r Phone #:
State Certification or Registration #: �61 /f q Certificate of Competency #:
Contact Phone #: 7 Xg6:70 Email dress:
Phone #: '7Jg"Z:ZO
DESIGNER: Architect/Engineer:
Phone #:
Value of Work for this Permit: $ g ®0 ` 0 Square/Linear Footage of Work:
Type of Work: ❑Addition DAlteration UNew ORepair/Replace ODemolition
Description of Work: . L, B /4 ATP"LL 6 °P./h .4 ctitei
Color thru tile:
************ ****** ***+ x**** **+ x**m ******* Fees** **** *+ x***+ x* *******+ x+ x*+x*********** *********
Submittal Fee $ Sb .00 Permit Fee $ / X> oa CCF $ CO /CC $
Scanning Fee $ pR/D 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 State i' Zip
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
City State / Zip
Application is hereby made to obtain a permit to d6 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 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 no a approved and a reinspection fee will be charged.
Signature
//
Owner or Agent A
The foregoing instrument was acknowledged before me this T The forgoing instrument wasacknow geed before me this
day of p�Z _ , 20 _ -by \J IC_ (1 t3 , day of
who is personally known to me or who has produced
as identification and who did take an oath.
NOTARY PUBLIC:
P
who is personally known to me or who has produced
11I t1I ury,��
As identification and ‘\‘111 ,+ takes S v
0*:
NOTARY PUBLIC:
Sign:
Print:
My Commission Expires:
APPROVED BY ie ld' Plans Examiner
Structural Review
(Revised 3 /12/2012)(Revised 07 /10 /07)(Revised 06 /10/2009)(Revised 3/15/09)
Sign:
Print:
My Commis
,,' MARY PAT BRIGGS
4. MY COMMISSION # DO 979267
:9 EXPIRES: May 11, 2014
Bonded Thru Notary Public Underwriters
* * **
Zoning
Clerk
Planning and Zoning Criteria
Miami Shores Village
10050 N.E. 2nd Avenue
Miami Shores, FL 33138 -0000
Phone: (305)795 -2204 Fax: (305)756 -8972
Permit NO. DS -6 -12 -1157
Issue Date: Not Issued
Expires:Not Issued
Folio Number:1132060340060
Owner's Name: DAN AND JOSEPHINE ROBBIN
Job Address: 810 100 Street
Miami Shores, FL 33138-
Owner's Phone:
Total Square Feet:
Total Job Valuation:
0
$ 800.00
Contractor(s)
MOODY ELECTRIC INC
Phone
(305)758 -2000
Primary Contractor
Yes
i
Planning and Zoning Criteria and Comments
Approved: Yes Date Approved: 6/28/2012 : Yes
Comments:
06/26/2012 12:02 FAX 1 800 685 7530
DATA SCAN FIELD SERVICES @001
*********************
*** TX REPORT lc**
*********************
TRANSMISSION OK
TX/RX NO 2689
RECIPIENT ADDRESS 93057541333
DESTINATION ID
ST. TIME 06/26 12:01
TIME USE 00'42
PAGES SENT 1
RESULT OK
Permit 11 o: 'c2-1156
Job Name:
June 26, 2012
Miami Shores Village
Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
Page 1 of 1
Building Critique Sheet
1) The generator must be a minimum of 10 from side lot line and 5' from rear.
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
305-762-4859
RA ) 5 - -75
(4e4 II: l'-'1A0
Permit o: 12 -1156
Job Name:
June 26, 2012
Miami Shores Viiiage
Building Department
Building Critique Sheet
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
Page 1 of 1
1) The generator must be a minimum of 10 from side lot line and 5' from rear.
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 - 762 -4859
FAX — /59f1333
NOTICE OF COMMENCEMENT
A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF FIRST INSPECTION
PERMIT NO. TAX FOLIO NO. I /-32() -03-/-0066
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.
111111111111111111111111111111111111111111111
CFt4 2012R0489383
OR I .k 28184 Ps 4422; (1 p s )
RECORDED 07/12/2012 10 :36 :31
HARVEY MIN? CLERK OF COURT
MIAMI -GAGE COUNTY? FLORIDA
LAST PAGE
Space above reee for use of reco office
1. Legal description of property and street/address:
'3/1.S8
2. Description of improvement:
/-1 oae-- op - eL.�c =%%C' I e.4 L.
3. Owner(s) name and address: >/� �� ' f A /
Interest in property:
Name and address of fee simple titleholder: /U/Pc
4. Contractor's name, address and phone number: �� i GTh. //JC'
64 VIA) fii ft/.4i4/ PC, 3 /s-,0
5. Surety: (Payment bond required by owner from idiftractor, if any)
Name, address and phone numb : A)
Amount of bond $ i
6. Lender's name and address:
7. Persons within the State of Florida designated by Owner upon who
Section 713.13(1)(a)7., Florida Statutes,
Name, address and phone number:
A-
STATE OF FLORIDA, COUNTY OF DADE
I HCRCBY CERTIFY that Uiisisa tam copy of the
odgi >1 e 9 ,s' - on day of
• __
may . e served
C
8. In addition to himself, Owners designates the following person(s) to receive a co
713.13(1)(b), Florida Statutes. I, tt� n
Name, address and phone number: /U 4
the Lienor's Notice as provide.' in Section
9. Expiration date of this Notice of Commencement: t /r
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 Al- 1 ER 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 INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK
OR RECORDING YOUR NOTICE OF COMMENCEMENT.
Signature(s) orb: or O r ' Au/Zize cer /Director /Partner /Manage
Prepared By �i��:b , �__y Prepared By
Print Name pAmtEL Apr A.1 Print Name D A) /gL 1et)A &Ai
Title /Office Title /Office
STATE OF FLORIDA
COUNTY OF MIAMI -DADE
The foreRoing instrument was acknowledged before me this
AIJIEL R(kb/ J3°
r dividually, or ❑ as for
d Personally known, or ❑ produced the following type of identifi
Signature of Notary Public:
Print Name:
(SEAL)
VERIFICATION PURSUANT TO SECTION 92.525. FLORIDA STATUTES
Under penalties of perjury, I declare that I have read the foregoing and
that the facts stated in it are true, to the best of my knowledge and belief.
/1 day of -V-061-1
. a/ 2-
Signs
By
Owner
ner(s)' th• Officer /Director/Partnr /Mana
123.0 =t' PAGE3 12/11
By
PERMIT #: Ds- t2--I1S1
Miami Shores Village
APPROVE BY
ZQMINO EISPT
MARY PAT BRIGGS
f4„ MY COMMISSION # Dt) 979267
EXPIRES: May 11, 2014
Ws Bonded Thru Notary Pole Unftwriters
2o KW 4E4E4A-root