DS-12-1517Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
nspection Number: INSP- 177646
Permit Number: DS -8 -12 -1517
Inspection Date: November 29, 2012
Inspector: Bruhn, Norman
Owner: , BARRY UNIVERSITY
Job Address: 11300 NE 2 Avenue Flood Hall
Miami Shores, FL 33138 -0000
Project: BARRY UNIVERSITY
Contractor: EMERALD CONSTRUCTION CORPORATION
Permit Type: Driveways /Sidewalks /Slabs
Inspection Type: Final
Work Classification: Addition /Alteration
Phone Number
Parcel Number 1121360010160 -19
Phone: (954)241 -2583
Building Department Comments
REMOVE AND REPLACE 4" SIDEWALKS THAT ARE
BROKEN AROUND THE PERIMETER
Passe
//..
Inspector Comments
CREATED AS REINSPECTION FOR INSP- 177212. A maximum of 1/2"
transition from parking lot to ramp
Cleanup concrete debris and resod. NB
ec_
gl
?id
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled
re- inspection fee is paid.
until
For Inspections please call: (305)762 -4949
November 29, 2012
Page 1 of 1
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
ECE VED
AUG oq,d .2
Permit No. iMi(i9S11—
Master Permit No.
Permit Type: BUILDING ROOFING
JOB ADDRESS: �! i 2c 4,/ ,/A 41. .4.2e. Fl o oa
City: Miami Shores County: Miami Dade Zip: 36 )
Folio/Parcel #:
Is the Building Historically Designated: Yes NO Flood Zone:
OWNER: Name (Fee Simple Titleholder)::' 7- Phone#:
Address: // 3 cv v-
City: /% /9%n/ S40,61 State: Pica i Zip: Si;1 1-S
Tenant/Lessee Name: Phone#:
Email: Jy40 (),x1.411•`as(r-7 • €
CONTRACTOR: Company Name: �fdcl 1 1 C3401 Phone#:
Vir'aK 1 ' Gt5e;
Address: / '
City: 4//41) 5-&,),-6,1- d State: ,. A7'.- Zip: 33 I Ito %
Qualifier..��jjam "'i s. _ / /41- Phone#:
State Certification or Registration #:'(..:6e. ,i I l t ,7. Certificate of Competency #:
Contact Phone#: Email Address:
DESIGNER: Architect/Engineer: Phone#:
Value of Work for this Permit: $ , c Square/Linear Footage of Work: lO0
Type of Work:. 046lddiaon Witiyon ONew 'Repair/Renlace
Description of Work: 6 V41eMOVe CNYi r
e, ce 7
ODemolition
ak re.
Color thru tile:
*+a**** ******+x�x�x� *** * *�n�x***�x�x�x�x****a�+ *** Fees�xa��x+ x*** �x**** �x******* a�x��x**** ****** **�na+�:�u *****
Submittal Fee $n
coo
. Permit Fee $ �L..c2 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) /4/4
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 CONDMONERS, ETC
OWNER'S AltIDAVJT:. I certify that all a foregoing information is accurate and that all work will be done in compliance with all
applicable laws regul .4otnstrikti1n zning.
"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 `Applicyant: ` =As a condition to the issuance of a tbil(ld(ng 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 perrrait is issued. glrz .the'gbsepce jof such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
Owner or Agent /�
The fore oing instrument was acknowledged before me this D
day of (Au/ ,20 by MIGQGML G(LI AJ
who is personally known to me or who has produced
Signature
Contractor
The foregoing moment was acknowledged before me this
Zis personally known to me or produced
As identification and who did take an oath. as identification and who did take an oath.
Sign:
Print: ': " , EERY J. YA �•� .J �d . _
w
My . Cumnusion .
.� Jollathpn Cuesta w• P.1
=Co! 1 14EE841198
'0' ! �e
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NOTARY PUBLIC:
My Commission Ex
APPROVED BY /6 Examiner
Zoning
Structural Review Clerk
(Revised 3 /12/2012)(Revised 07 /10 /07)(Revised 06 /10 /2009)(Revised 3/15/09)