RC-12-1592Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP- 177724 Permit Number: RC -8 -12 -1592
Scheduled Inspection Date: October 23, 2012
Inspector: Bruhn, Norman
Owner: HYNES, KIMBERLY
Job Address: 302 NE 100 Street
Miami Shores, FL
Project: <NONE>
Contractor: CRUZ R RODRIGUEZ
Permit Type: Residential Construction
Inspection Type: Final
Work Classification: Addition /Alteration
Phone Number
Parcel Number
1132060135470
Phone: (305)710 -7861
Building Department Comments
REMODEL BATHROOM, REPLACE TILES AND FIXTURES
Inspector Comments
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
October 23, 2012
For Inspections please call: (305)762 -4949
Page 7 of 18
PERMIT # gC./ 12- )1:12„
CONTRACTOR: ON C„1 W I
I /.
SUBMITTAL DATE: g
1 0`-)
ADDRESS: - / 2. NC 1004
NAME: 6 V 1X
lkiriCS
RESUBMITAL DATES:
PROJECT TYPE: 'het �1
OIR
A1,'u i
ZONING
FIRE
STRUCTURAL
IMPACT FEES
A , 0\4' C
ELECTRICAL
HRSIDERM
OK ,e 0-91.--o,---
PLUMBING
NOC
afi
MECHANICAL
ikh
BLDG
NOTICE OF COMMENCEMENT
A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF FIRST IINSPECTIO,N%
XAX FOLIO NOC /r„ 0`l IO l'2
PERMIT NO
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
eg
n
tion •f pro.;
� Jf�
2. Description of improvement:
and s et/ad • ess:
3. Owner(s) name and addr
Interest in property: rAfl r-
Name and address of fee simple titleholder:
4. Contr o name, a• , ress • Vone4 number:
91r0470'f4it''/`
1�l_l ✓rjr
/i P,= i •,;f1
11111111111111111 1111111111111111111111111111
CFN 2012R0605581
DR E;k 28245 Ps 23741 (fps)
RECORDED 108/28/2012 11:56317
HARVEY RUVINr CLERK OF COURT
MIAMI -DADE COUNTYr FLORIDA
LAST F'AGE
Sp
c
above reserved for use of recording office
1 P s
5. Surety: (Payment bond required by owner from contractor, if any)
Name, address and phone number: jr
Amount of bond $
6. Lender's name and address:
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(1)(a)7., Florida Statutes,
Name, address and phone number:
8. In addition to himself, Owners designates the following person(s) to receive a copy of the Lienor's Notice as provided in Section
713.13(1)(b), Florida Statutes.
Name, address and phone number:
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 PAY TWICE FOR
IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POS I EL) ON THE JOB S rP BEFORE THE
�1 I `p •' ` G WOR,
FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH Y r{ j
OR RECORDING YOUR NOTICE OF COMMENCEMENT /HEREBY CERTIFY that this rs a true
Signature(s) of Ow
Prepared By
Print Name
Title /Office
STATE OF FLORIDA
COUNTY OF MIAMI -DADE
The foregoing instrument was acknowledged before me this
By K,7r,Ibe-r.1l #-14 v .s
t4lndividually, or ❑ as for
Personally known, or DI produced the following type of identification:
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.
Signature(s) of Owner(s) or Owner(s)'s Authorized Officer/Director/Partner /Manager who signed above:
By By
er ne
,,,' _.
' Authorized Officer /Director /Partner /Nipfi: = ; . a. this o n
Prepared By
Print Nat ,
Titie/Offim ; r ' • o' mcu /t un•
0 day of cdv 1 20�
123.01 -52 PAGE 3 3/10
- 14e7na.1"lncx�(G
491 41,,, ELENAMARI(
4, MY COMMISSION # EE 163931
EXPIRES: February 25, 2016
3andstl Thm 6thlist Notary Wass
BUILDING
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
\l
-
BYAtj...6..N.:-....1:...LH:..2.... ....
FBC 20
Permit No. "PC- 1
PERMIT APPLICATION Master Permit No.
Permit Type: BUILDIN
JOB ADDRESS: _FO9 (06 490571—
City: Miami Shores County:
Folio/Parcel#: /13 ;10464/.3,1Y17
Is the Building Historically Designated: Yes
OWNER: Name (Fee Simple Titleholder):
Address: 2 ®� 49c7).
City: /14-,
ROOFING
Miami Dade Zip:
NO
Flood Zone:
Alyz7e:f., Phone#: 205.940-2174
State: Zip:
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR: Company Name: \
6)041 State: -'-at /
t
City: 0 e: /4"-7
Address: :P
360 'Cte.°) sa,/"'
Phone#: ,55y-e5,?867-•
Zip:
Qualifier Name: Phone#:
tI /1:5ZY Certificate of ComWency #:
Email Address: ar'429<ici ee. C61'47
Phone#:
State Certification or Registration #: C6Cie
Contact Phone#: 30$ -- 2/o ?26 /
DESIGNER: Architect/Engineer:
Value of Work for this Permit: $ ?0(90 Square/Linear Footage of Work:
Type of Work: DAddition DAlteration DNew *pair/Replace
Description Work: e-A.1 #0,"/ 4 4/4-
c
CIDemolition
rie;r7e,
Color thru tile: a
***************************************Fees***
Submittal Fee $ Permit Fee $ 410C CCF $ CO/CC $
Scanning Fee $ Radon Fee $ DBPR $ Bond $
Notary $ Training/Education Fee $
Double Fee $ Structural Review $
* **********************
Technology Fee $
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
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 ET ECTRICAL 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 • Gih.: 1t r%
O t' or A ent
The foregoing instrument was acknowle�dgedbefo.rr me this
day of AVgvs� , 201 , by k l/Mhe( ! t `y nes
who is personally known to me or who has produced
As identification and who did take an oath.
NOTARY PUBLIC:
My Commission Expires: 47;0;::;;'eit, ELENAMAFX
* MY COMMISSION # EE 163931
EXPIRES: February 25, 2016
APPROVED BY
Signature dr
dd " toContrac r
The foregoing instrument was acknow ged ed before(�me this �v
day of /-rw91/J , 2011- , by V r 16( )91/0,
who is personally known to me or who has produced
as identification and who did take an oath.
NOTARY PUBLIC:
U t ' Plans Examiner
Structural Review
(Revised 3 /12/2012)(Revised OIL1D /0`I)(Revised 06 /10/2009)(Revised 3/15/09)
Sign:
Print: E t-e NrY'la
My Commission Expires: a0 1;;;PZtf, ELENA MARK
* MY COMMISSION # EE 163931
EXPIRES: February 25, 2016
akIdgel
Zoning
Clerk
5n " ke.r, #. q
3o /f/cc2S,-
f'// jZ9' I re_
ADD SMOKE/CARBON MONOXIDE DETECTORS
ANY AND ALL CLOTH AND RUBBER
INSULATED CONDUCTORS TO BE REPLACED.
4
Alek/ 7ru5 Aiite. A.
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3; Nrdcei * Pi? k,
49 't-1 77 — /Pee n /6,
Fieo
SJ Aaheeo L t 4 lL Fxr[tier.
6� Alek Xe,
V grtokte &e& l '?.
RePlbee
Shores Village
STATE AND COl1NTY RULES AND REGULATIONS
4
1 BATHROOM RECEPTACLE ON 20 AMP CKT
AND G.F.I PROTECTED
KETCH OF SURVEY
Aug 27 12 05:34p
Cruz R. RodduezG.C.
305-936-0326
II. IS DOCUMENT WAS A COLORED BACKGROUND M(CROPRINTING LINE • •A K"'
AC# 6 2• 139 4 7.. SAT
..• 4 •. A
...DEPARIVISET 44' •1317SIREIS,' AND PROFENIONAL ''.REGULATION
• -•
"' • • • CONS=OCTION 12011STRY '.LIC BOW
SEQ# 11207190115
p.1
DATE
BATCH NUMBER
O1j19./20i2 3. 2 0 016 3 :
me
Named be low IS CERTIFIED `
Under the provisibne of aptfa
Expiration date : AUG 31, 2014
pA 1. •,_•\"•
4.0.10
141:1
:•• • • `A;
• ...RODRIGUEZ; • CRUZ . tei• • - •.•
ZLIDIV/DIIAL: 1. •
=
360 OCEAN BLVD " •
GOLDEN BEACH FL 3316 041.1:2 wr.
•
. • . •
,• ,.• - ,
. •!' • • , „ •!.• ZEN LAWSON
••• Xttit SC • • • • • • • • -:••• ; :••
SECRETARY
• • qpNTE RINIOR
DISPLAY AS REQUIRED SY LAW
029019-7
BUSINESS NNW / LOCATION
RODRIGUEZ CRUZ R
80 SW 8 ST ,
33130 MIAMI
U.S. PO
Pit
MIAV
PERMIT
THIS IS NOT A SRL - DO NOT PAY RENEWAL
RECEIPT NO.
STATED CGC001150 029019-7
2230
OWNER
RODRIGUEZ CRUZ R
Secirype BusIness
96 GENERAL BUILDING CONTRACTOR
TINS IS CtiLY A LOCAL
BUSINESS TAX RECEIPT. IT
DOSS NOT PENMIT TNN
MUER TO VIOLATE ANY
EXISTING mammal, OR
ZONING LAWN CP THE
cowry am cm.
DOES IT nom THE
mum FROM ArusENsatts:
PROW OR
TNfl HOI.DRB
UMS.
470ffervEn
.21441618112
000045.00
i. SE OMER SIDE
WORKEO/S
10
DO NOT FORWARD
RODRIGUEZ CRUZ R
360 OCEAN BLVD
GOLDEN BEACH FL 33160