DS-13-198Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP - 187126 Permit Number: DS -2 -13 -198
Scheduled Inspection Date: March 20, 2013
Inspector: Bruhn, Norman
Owner: RANK, BARBARA HAMM
Job Address: 9139 NE 10 Avenue
Miami Shores, FL
Project: <NONE>
Contractor: MEGATREND INC
Permit Type: Driveways /Sidewalks /Slabs
Inspection Type: Final
Work Classification: Addition /Alteration
Phone Number
Parcel Number 1132050130010
Phone: (305)305 -2213
Building Department Comments
RE -DO DRIVEWAY WITH BRICK PAVER DRIVEWAY
Infractio Passed Comments
INSPECTOR COMMENTS
False
Passed � J.f
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Inspector Comments
CREATED AS REINSPECTION FOR INSP- 186868. CREATED AS
REINSPECTION FOR INSP- 186479. CREATED AS REINSPECTION FOR
INSP- 185058. Remove all construction debris.
Resod all disturbed areas. NB
SAME COMMENTS
RESOD DISTURBED AREAS
CLEAN UP CONSTRUCTION DEBRIS (SAND IN DRIVE)
March 19, 2013
For Inspections please call: (305)762 -4949
Page 26 of 49
PERMIT # IS 7 1
CONTRACTOR: f 61.,..0-Ac-r Q l
SUBMITTAL DATE: `p 1 1
ADDRESS: ' l2 ( ikArt___
NAME: 1 ` )i.
RESUBMITAL DATES:
PROJECT TYPE:
STRUCTURAL IMPACT FEES
ELECTRICAL HRS/DERM
PLUMBING
MECHANICAL BL
NOTICE OF COMMENCEMENT
A RECORDED COPT MUST jBE POSTED ON THE JOB SITE AT TIME OF FIRST INSPECTION
PERMIT NO. 13-) ` TAX FOLIO NO.11 3ZO "OL3 Q
STATE OF FLORIDA:
COUNTY OF MIAMI -DADE:
THE UNDERSIGNED hereby gives notice thathmptavements will be made to certain teal
property, and In accordance with Chapter 713, Florida Statutes, the following Information
is provided In thls Notice•of Commencement.
C o n 'ED
p��an add�a
•
, ■J i� i 'L&.
ascription of improvement:
1+
CFN: 20130086083 BOOK 28470 PAGE 1805
DATE:02/01/2013 08:57:02 AM
HARVEY RUVIN, CLERK OF COURT, MIA -DADE CTY
Space above reserved
00
1
of rer.ordIng office
liti.Yr∎I1T11r! \M►Tt I .L'1111111 1i L+ a lliltiatl*t
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Owner(s) name and address:
Interest In property
Name and address of fee simple titleholder.
tor's name address and ohone number.
1e' 36s. 5. aJ
5. Surety: (Payrnent bond required by owner from contractor, !any)
Name, address and phone number.
Amount of bond $
8. 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(1Xe)7., Hoddd Statutes,
Name, address and phone number.
• 8.1n addition to himself, Owners designates the following person(s) to receive a copy of the Uenor'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 dots of recording unless a dltterent date Is specified)
WARNING TO OWNEIt ANY PAYMENTS MADE BV THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT ARE COMIC)
IMPROPER PAYMENTS UNDER CHAPTER 713, PART 1, SECTION 713.13. FLORIDA STATUTES, AND CAN RESULT IN YOUR PAYING.
IMPROVEMENTS TO YOUR PROPERTY. A NOTICE. OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE
FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING W
OR RECORDING YOUR NO ; E OF COMMEN • MENT.
/Director/Partner /Manager
Prepared By
Print Name
Title/Office
Prepared By
Print Name
Titte/Office
STATE OF FLORIDA •
COUNTY OF MIAMI -DADE
The
iltr nVInzetr.urznt fr"fi
❑ Individually, or GI as
d Personalty known, or
•s(�v
�
r 3 1"
'2
• :ill ::._:
AIM
VENEICE CAMMOCKTENNANT
Under penalties of perjury, 1 declare that I have read the foregoing and NOTARY PUBLIC, STATE OF FLORIDA
that the facts stated In It are true, to th ; beet of my knowledge and belief. �ry COMI M SION# DD86534I
Officer /Director /Partner/Marik"ge MIES: March 02+ 2013
1st State Insurance
BY
lyl�l
413,\IW,
ILDING
PERMIT APPLICATION
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
Permit Type: BUILDING
JOB ADDRESS: q/ 3q 1 A /0 tT v
City: Miami Shores County:
Folio/Parcel #: 11 ..32d 37-613 -too
Is the Building Historically Designated: Yes
FBC 20 1
Permit No.
Master Permit No.DS 1 3 °4C
ROOFING
Miami Dade
Zip: 33/38
8
NO Flood Zone:
\ OWNER: Name (Fee Simple Titleholder): Far 'R( Z R, Phone #: 3o 0 . ?1� • Y3f 7
i Address: et 13 f /d 9 ioye, b
City: ,q,ag. gh $ State: TGV Zip: 33/3€
Tenant/Lessee Name: Phone #:
Email: D Itor 4111 IA0 L . 00 4.01
CONTRACTOR: Company Name: /Weq 4 tend Phone #: eta 3 s 2zi.
Address: RJF�� W O P ✓ Leite-,
City: 4j t444/ State: IiOneig Zip: 33/9 9
Qualifier Name: Pe Van • Pp n Phone #: 3D5 36$ S. Z2/3
State Certification or Registration #: Nr•15 /' Sp� Cer ficate of Competenc #:
Contact Phone #: f30305. .22/3 Entail Address: % «5 r�� L
_;;DESIGNER: Architect/Engineer: Phone #:
Value of Work for this Permit: $ b4.." /e 0 Square/Linear Footage of Work:
�' •
Type of Work: UAddition ❑Alteration ONew epair/Rep1ace, t .DDemohfioii
,�`_ h
-_� Description of Work: � "' � " a�v E �Y"�YY, ai p�hi��i�G� -t.�
brl cK pquer► dh . .J
Color thru tile: ,) r ��
******** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Fees************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
Submittal Fee Permit Fee $ fo 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)
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,dpne in compliance with all
applicable laws regulating construction and zoning. , a ° i • °
"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 YOUL LENDER OR AN ATTORNEY BEFORE
RECORDING YOUR NOTICE OF CO11 MtNC IENtL'
:,: N:; w , ""
Notice to Applicant A4s a condition to the issuance of a buzk(mg unit with an estimated value weedipg $2100 the a ?licant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be de vexed tt 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 seve (7) days after the building permit is; issued, In the ihsenc Tof:sucht posted hotice, the
inspection will no e app j ved and a rein . s n feet ill be charged
Signature ' Signature
The foregoing ins e
day of
•
Qwner_or Agent
treent acknowledged before me this
Zo 1 »by baIA RA )12,
•
Contr-acto ,. ,
filie forreego ng instrument was acku wledgi d befote°me this3 l
o by e v1'0 ►� s
day of
c1 a
who is personally known to me or who has produced- .. who is personally known to me or wlta has produced
As identification add who did take an oath.' as identification and who did take an oath.
NOTARY PUBLIC:
Sign: iL ._ AL , �. 740
Print:. C AI// 11A1 '!! itri4.,!yt�.,
My Coinngticailkf a i\ EXPthES: iVfarcli' 2,2Q13
Bonded throe +gh 1st State Insurance
APPROVED BY
r NOTARY- PVGENIYA PAVLYUKOVA
NOTARY PUBLIC - STATE OF FLORIDA
Co M SSIO'' EE120596
Cep U m 4UG.10, 2C15
Sign: fl's�s.�
Plans Examiner
Structural Review
(Revised 5/2 /2012XRevised 3/12/2012) )(Revised 06 /10 /2009XRevised 3 /15 /09XRevised 7/10/2007)
=` •� /4 PAVbYU f OVA'
NOTARY BLIC - STATE OF FLORIDA
COM", rr' +.r.- E120596
311(0
Zoning
Clerk
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M'ami Shores