DEMO-12-1990Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP- 180448 Permit Number: DEMO -10 -12 -1990
Scheduled Inspection Date: October 30, 2012
Inspector: Bruhn, Norman
Owner:
Job Address: 190 NW 102 Street
Miami Shores, FL 33150-
Project <NONE>
Contractor: APC ENGINEERING ENTERPRISES INC
Permit Type: Demolition
Inspection Type: Final
Work Classification: Building
Phone Number
Parcel Number 1131010230090
Phone: (305)219 -8267
Building Department Comments
REMOVE REAR ILLEGAL UTILITY ROOM
Infractio Passed Comments
INSPECTOR COMMENTS
False
Inspector Comments
Passed j
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
October 29, 2012
For Inspections please call: (305)762 -4949
Page 7 of 16
BU LDING
BU LDING
PERMIT APPLICATION
Miami Shores Village
Building Department
90050 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: BUILDING
JOB ADDRESS: 161 ® A.1= ietY , Q ®a .
City:
Miami Shores
Folio/Parcel #:
V ' CEOVE
OCT 2 22O 2
rep
FBC 20 I (D
Permit No.
Master Permit No NoDErt, ' � 99.0
ROOFING
County: Miami Dade
Zip: 23 1 a0
Is the Building Historically Designated: Yes NO
Flood Zone:
Phone #:
OWNER: Name (Fee Simple Titleholder): 19114 bCal' -T-4A f'Stv1r1 e Ats
Address: c (j 0/ .) ° l o �" a i
City: A tell .oc f State: F{, zip: O( b
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR: Company Name: 1 PG E -5 t`�►.e eP't In S Phone #: Lj 0
Address: 2 /56 ‘J c9
City: AM/1/4n . State: F(, Zip: 3<30
Qualifier Name: 24 (rId •� /Pe4 /i'
State Certification or Registration #: l d / (5/O°-)7 Certificate of Competency #:
Contact Phone #: Jb5 Z/1 - 2'26 ) Email Address: daft, dde j 4, •
Phone#:
Phone#:
DESIGNER: Architect /Engineer:
Value of Work for this Permit: $ D9i& c.D Square/Linear Footage of Work:
Type of Work: Addition DAlteration %f DNew JDRRepair/Re lace
Description of Work: ®e e4 /2B9jl
05 J, I + o� i yrta onfr l
M hru tile:
, g*WiR rt ************Fees*
Submittal Fee $
PriAD
demolition
<.., ..:•:..;.mom-- °�a�c�"��.w.s� -�
�k+ k+ k�N�k+ k�k�k�k�k�k+ ka�k�k�k�a�k�k�k�k�k�k�k�k�k�k�N�kN��k
Permit Fee $ c.' a Ba CCF $ CO /CC $
Scanning Fee $ Radon Fee $
Notary $ Training/Education Fee $
Double Fee $ Structural Review $
DBPR $ Bond $
Technology Fee $
TOTAL FEE NOW DUE $���
Bonding Company's Name (if applicable)
Bonding Company's Address
City State Zip
AJA/
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 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 not be approved and a reinspection fee will be charged.
Signature
Owner or Agent
The foregoing instrument was acknowledged before me this /6
, by le /li44rof ,
o me or who has produced
s identification and who did take an oath.
NOTARY PUBLIC:
Sign:`
Print:
kowi
atd
My Commission Expir
* * * * * * * * * * * * * * * **
APPROVED BY
*
'sS SANDY ROMERO
• E Netiry Public - State oI Florida
My Comm
* *'omNssion N EE 116040
Contractor
The foregoing instrument was acknowledged before me this /O
day of 20 .-by ,Pat/G;"
to me or who has produced
aminer
as identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print: S-a.1
P-61-itfiv-z.a°
My Commission Exkir :„
• V
4 ..0.14%a% SANDY ROMERO
��° Notary public - State of Florida 0
r , y TIN IDWINI lttpl NN6d1 2® &4 **
'� " �•' Commission # EE 116040
g
Structural Review Clerk
(Revised 3 /12/2012)(Revised 07 /10 /07)(Revised 06 /10/2009)(Revised 3/15/09)
......••
. ••••••••
F.I.P. 1/2"
(NO I,D.)
x
•
OCT 2 2 2012
QSe
H ALL FEDERAL
lend STREET.::. •.,::.':.'.:.....
.. .. .. ... " ��50' RIGHT —OF WAY (BY PLAT} ... °• • .*.-.°•••-• . • • ::.': • :• :..• • •.'.'....• :•.• • • • • • 16'1 ASPHALT PAVEMENT .'.'. °..• • •:.'. °..•. • :.' :..'.'. : • :. .
17.0' PARKWAY
75.00' (R&M)
is
35.00'
F• ••••••
'.•.•..':.'tom` .': .
•• :. :.•..•.•. Q •.•.
. :Z •- •>•• ..
•
0
M
to
c6
16.00'
1 In 14.00'
25.00'
ONE STORY CBS
RESIDENCE
# 190
55.00'
0
0
0)
10.13'
_,=_ 0.12'
F.I.P. 1/2"
(NO 1o)
t)
i
0' 10' 20
1 inch = 20' ft.
REMAINDER OF
LOT 1
BLOCK 2
I M REMAINDER OF
LOT2
K BLOCK 2
1%' REMAINDER OF
0 LOT 3'
BLOCK 2
.p.02'
35.00'
F.I.P. 1 /2"
(NO I.D.)
0
B.C.
F.I.P. 1/2"
(NO I.D.)
Notes:
NO VISIBLE ENCROACHMENTS ON THIS PROPERTY.
75.0• &M)
LOT 5
BLOCK 2
REMAINDER OF
LOT 4
BLOCK 2
F.I.P. 1/2"
(NO I.D.)
Property Address:
190 NW 102 ST
MIAMI, FL 33150
nlineLand
SURVEYORS,INC.
SURVEYOR'S CERTIFICAATION: I,THEERENB�Y CERTIFY THAT THIS BOUNDARY SURVEY IS A TRUE DIRECTION. THIS
AND CORRECT FLOORIDA BOARD OF P4'0 REPRESENTATION
WL IMNA•UR YORS IN CHAPTER61G178,FLORIDE OF
ADMINISTRATIVE CCII9E RV' '�"47 .'. FI RIDA STATUES.
•
fi.
STATE OF • cc-
FLORIDA
e�
SIGNED ; O,f ''•••...••••• c, FOR THE FIRM
FERNANDO V. GOI },E2uR► V4()%.`` P.S.M. No. 5259
STATE OF FLORIDA
NOT VALID WITHOUT AN AUTHENTIC ELECTRONIC SIGNATURE AND AUTHENTICATED
ELECTRONIC SEAL, AND /OR THE SIGNATURE AND /OR THE ORIGINAL RAISED SEAL OF A
LICENSED SURVEYOR AND MAPPER. THE SEAL APPEARING ON THIS DOCUMENT WAS
AUTHORIZED BY FERNANDO V. GOMEZ, P.S.M. NO. 5259 ON THE SURVEY DATE NOTED
HEREON.
Survey Date: 10/5/2012
Survey Code: 0 -7488
Page 1 of 2 Not valid without all pages.