BPP-11-2330l
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP- 173573 Permit Number: BPP -12 -11 -2330
Scheduled Inspection Date: May 21, 2012
Inspector: Bruhn, Norman
Owner: PENKWITT, PATRIK
Job Address: 520 GRAND CONCOURSE
Miami Shores, FL 33138-
Project: <NONE>
Contractor: VAN KIRK & SONS INC
Permit Type: Pools/Whirlpools /Hot Tubs
Inspection Type: Final
Work Classification: Addition /Alteration
Phone Number
Parcel Number 1132060171430
Phone: (954)755-4402
Building Department Comments
POOL RESURFACING
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- 167976. Provid eplans and
permit. NB
May 18, 2012
For Inspections please call: (305)762 -4949
Page 23 of 38
(.4 1 - 120dt,
B ILDING
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
DEC 1 6 261i
1
Permit No. I MO
Master Permit No.
Permit Type: BUILDING ROOFIN
OWNER: Name (Fee Simpl; Titleholder):
1 _t... '' Phone #:
Address: 0
City: 5telo' State: ' Zip:
Tenant/Lessee Name: Phone #:
Email:
JOB ADDRESS: 5 BCD 1 (1_,I.Askr —d
City: Miami Shores County: j'�
Folio/Parcel #: 1 I - (3 .O& _rs 0 I' - I .�`�
Miami Dade
Zip:
Is the Building Historically Designated: Yes NO Flood Zone:
CONTRACTOR: Company Name: Von %-j 'e
Addres : 1 �� a Z C -by- ,
City 42J( 42J( •'e-1 State:
I.AY .Phone# ` )
Qualifier Name: ellf-Y* Pe \61.r) ICJ r ) 0 i ,
State Certification or Registration #: �P Certificate of Compet
Phone#P'i 7 - (�°i0 Email Address:
DESIGNER: Architect/Engineer: Phone #:
Value of Work for this Permit: $ 1 t 'cl Square/Linear Footage of Work:
Type of Work: ❑Addition Alteration ❑New ❑Repair/Replace ❑Demolitio
�� sp
Description of Work: 1(�S_ (Y; .Y C1 it / I `-e Oc(S
Zip: 3 c
Phone#: � . �L �U
tency #:
********************* *+ x**************** Fees*************** ***** ********x:****:x**********
Submittal Fee $ Permit Fee $ i4!70" 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 State Zip
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
City State Zip
y-4 w
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 whi'" occurs seven (7) days after the building permit is issued. - In the absence of such posted notice, the
inspection will no .' e appr e and a reinspection fee will be charged.
Signature
er or Agent
The foregoing instrument ras
day of "Og 4 , 20 I, by
who is personally known to me or who has produced • L
As igHSPORPgiciiWhonliefii9ttri oath.
,. ",..,,, Roberti? Van Kirk m
NOTARY PUBLIC: x DD873761�)ripinrleiss:"°JUNt
E 07, 2013
nn
nor
Print:
My Commission Expires:
The foregoing instrument was ac
day of DftOvN60111 .20 I, by
who ' ersonally known to e or who has produced
as identification and who did take an oath.
ledged bef
m
this ra
NOTA . UBLIC
Ar.
Sign'
/
Patricia L Cobban
Pri t: Commission #DD845967
My Commission Expires;,,;,,,.•° Expires: FEB. 02, 2013
BONDED THRU ATLANTIC BONDING CQ, INC.
APPROVED BY Zr0 /"/ Plans Examiner Zoning
Structural Review
(Revised 07 /10 /07)(Revised 06 /10 /2009)(Revised 3/15/09)
Clerk
SUBJECT TO C(MPUANCE WITH AL,FED t:
STATE AND CC.0 f Y lUEF-S AND 19.EOULAfl