RF-12-732Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
(2 _S-79
Inspection Number: INSP- 172738 Permit Number: RF -4 -12 -732
Scheduled Inspection Date: August 14, 2012
Inspector: Bruhn, Norman
Owner: , BARRY UNIVERSITY
Job Address: 11300 NE 2 Avenue Health & Sports
Miami Shores, FL 33138 -0000
Project: BARRY UNIVERSITY
Contractor: CERTIFIED ROOFING SPECIALIST INC
Permit Type: Roof
Inspection Type: Final Roof
Work Classification: Repair Roof
Phone Number
Parcel Number 1121360010160 -23
Phone: (954)781 -7663
Building Department Comments
DO MAINTENANCE ON ROOF AND REPAIR ALL NORTH
FLASHING
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Inspector Comments
August 13, 2012
For Inspections please call: (305)762 -4949 Pay"
, jA
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 20
Permit Type: BUILDING ROOFING
Permit No.
Master Permit No.
BY:ooa!'O o oe s ti
OWNER: Name (Fee Simple Titleholder): 1iM b V� ( UZ 1TI
Address: U O N �- *4 City: M vavv■ J I kWf -$ State: Ft
Tenant/Lessee Name:
Email:
Phone #: jod - F ? / 9Jr
Zip:
Phone #:
JOB ADDRESS: 1 1 3 0 t) /" £ 2—N1)
City: Miami Shores County:
Folio/Parcel #: 11- 2-13(0-000-00S-0
Is the Building Historically Designated: Yes
1Tark Cri-S
ZAP: 33i6 )
Miami Dade
Flood Zone:
CONTRACTOR: Company Name: i4.4 * T i Stow--; a 11 J Phone#k 9 1 7n / - 766
Zip: 230 6 `l
Qualifier Name: Phone #: (Sj) 1)1- 76‘3
State Certification or Registration #: CC-C. 0 2-714 1 Certificate of Competency #:
Contact Phone#: t st1) 7 T1- 7 t ` 3 Email Address:1- X44."(1 S @ Ct?b J Cgo r4 aAf t e� �1 e O UP, a "1
DESIGNER: Architect Engineer: 4 Phone #:
Address: 34.4.
City: PbA4PA/•10 - State: FLA-
W U 6e►
Value of Work for this Permit: $ / 0l I. 1 a
Type of Work: °Addition °Alteration
Description of Work: 3)0 "Prt NTH&) A 4C- -
fle4dH�
Square/Linear Footage of Work:
°New Repair/Replace
01..1 /2xaF.S. alt /air 4Lc-
°Demolition
No✓a3
*** * * *** ** ** ear * * * ****** * * * * * ** * * * **** * *F * ** ** * * ** * ** * * * *** * ***** **** * * * *** * * * **** ****
,59cdd jCCF $ CO /CC $
DBPR $ Bond $
Technology Fee $
Submittal Fee $ Permit Fee $
Scanning Fee $ Radon Fee $
Notary $ Training/Education Fee $
Double Fee $ Structural Review $
TOTAL FEE NOW DUE $ o�O' 0E9-
Bonding Company's Name (if applicable) /)
Bonding Company's Address
City State Zip
Mortgage Lender's Name (if applicable) ,J /1IF
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.CTRICAL 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 $2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the
inspection will not be approved and a einspection fee will be charged.
Signature .rfj- Signatur
The fore:
day o /A�., ,. , 2 by
gent
acknowledged before me
who is personally known to me or who has produced
As identification and who did take an oath.
NOT • ; Y PUBLIC:
C6
My Co
si ' • , : ', : COMMISSION # DD 857544
l� EXPIRES February 03, 2013
(407) 388-0183 F
The foreg
day of .y ibL 204 , 'y
who is personally known to me or who has produced
as identification and who did take an oath.
Sign.
Print:
My Comm;
M. LA 'RICELLA
xPIUSIY COMMISSION # DD 857544
•
(407) 398-0183
EXPIRES February 03, 2013
Florldallotery$erWoo.4om
***** **, x** ***** ******* ******+ i< e******* ***** *, x+ s*******, x, aew****, x** ***** ********,r•********* six•i, ********* ***** * * ***
APPROVED BY
Plans Examiner
Structural Review
(Revised 07 /10 /07)(Revised 06 /10/2009)(Revised 3/15/09)
Zoning
Clerk