DS-06-2978Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
gpp -dam -2TO9
Inspection Number: INSP -34691 Permit Number: DS -12 -06 -2978
Scheduled Inspection Date: July 25, 2012
Inspector: Rodriguez, Jorge
Owner: WATSON, LEONARD
Job Address: 165 NW 99 Street
Miami Shores, FL 33150-
Project: <NONE>
Contractor: NATIONAL POOL LEAKS
Permit Type: Driveways /Sidewalks /Slabs
Inspection Type: Final
Work Classification: New
Phone Number
Parcel Number 1131010230390
Phone: 305 -559 -1020
Building Department Comments
SWIMMING POOL PAVERS DECK
Inspector Comments
Passed
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
July 24, 2012
For Inspections please call: (305)762 -4949
Page 40 of 40
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: E30 .t.
Gy..= f ,' .. J 56.8972 j�1
BUILDING ' i
Permit No
x
PERMIT APPLICATION BY __ � °� __Master Permit No.
FBC 2004
Permit Type (circle): Electrical Plumbin g Roofing
Owner's Name (Fee Simple Titleholder) Chu> 441(k / ,J(q -)Sn ✓i Phone # ( 3 b(c ' C3 7 (6'
Owner's Address / 6 C it, to f St
City ti I-440 i S k re S State F'
Tenant/Lessee Name
Zip 3,/.50
Phone #
Job Address (where the work is being done)
City Miami Shores Village
FOLIO / PARCEL #
County Miami -Dade
Zip/
Is Building Historically Designated YES NO V
Contractor's Company Name Ala (r0 v7G 1 ?60( 1.-ea t 5
Phone # [ U G-5-? (020
Contractor's Address / (96c .(A,1 (0 41
City( State 717 Zip
Name 4 % /iwc /O 2c) Phone # 5 ",t'(0,0
State Certificate or Registration No. l PUGS 339' Certificate of Competency No.
Architect/Engineer's Name (if applicable) t/d do/ ja,eew Phone #
Value of Work For this Permit $ .-(.itt./CJO0 -C
Type of Work: ❑Addition E1Alteration
Describe Work: fiP'7/ P
(3&$) S5z - 6/7?
Square / Linear Footage Of Work: 610x5
❑ Repair/Replace ❑ Demolition
CO
******** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Fees************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
Submittal Fee $
Permit Fee $ /00
Notary $ Training/Education Fee $
Scanning $ Radon $ DPBR $
Bond $ Code Enforcement $
Structural Review. $
CCF $ CO /CC
Technology Fee $
Zoning $
Double Fee $
Total Fee Now Due $
164.10
See vg se side --
10_C
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 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 (Oa'
day of 30 ,200(c,by
who is personally known to me or who has produced
s identification and who did take an oath.
NOTARY
Sign:
Print:
My Commissi
Expires:
40/.1°144, MARIA VERONICA BUTCHER
MY COMMISSION # DD601613
0r F�� EX PI R L.'S: Oct. 3, 2010
407 =•0153 Florida Notary Service.c. m
APPLICATION APPROVED BY:
(Revised 02/08/06)
Signature
tr
The foregoing instrument was acknowledged before me
day of 30 , 2006,, by
is
who is personally known to me or who has produced
S gn
Print:
as i, tification and who did take an
' UB
,i MARIA YtEONICA BUTCHER
- MMI!ION # I3 D601613
AIAXe1NP yel 3.2010 NOTA R
t
a
04
My Comm io xpires:
Plans Examiner
i
Engineer
Zoning
12/11/2006 15:45 MIAMI SHORES UILLAGF 93052343601 NO.807 P001
Miami Shores Village
Building Department
64100,14IgattAivenet
Miami Shores, Florida 33138
Tel: (305) 795,2204
Fax: (305) 7561972
Permit No. 1 Sg" 6
Job Name
Date
BUILDING CRITIQUE SHEET
Reviewer:
Claudio Grande C.B.0
305-795-2204 Ext 1430