RC-13-1121Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP- 191890 Permit Number: RC -5 -13 -1121
Scheduled Inspection Date: June 19, 2013
Inspector: Rodriguez, Jorge
Owner: TIBBITT, DANIEL AND SERENA
Job Address: 11 NE 110 Street
Miami Shores, FL 33161 -7043
Project: <NONE>
Contractor: SKYLINE CONSTRUCTION & RESTORATION CORP
Permit Type: Residential Construction
Inspection Type: Final
Work Classification: Alteration
Phone Number
Parcel Number 1121360040300
Phone: (305)316 -0906
Building Department Comments
Stucco exterior to remove brick facade.
Infractlo Passed Comments
INSPECTOR COMMENTS
False
Inspector Comments
Passed
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
June 19, 2013
For Inspections please call: (305)762 -4949
Page 22 of 38
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
Permit Type: , I DING
&A 5i.
JOB ADDRESS: 1 d J
City: Miami Shores County: Miami Dade Zip: '5 3'd(
Folio/Parcel #:
Is the Building Historically Designated: Yes NO Flood Zone:
. ECEIVE. --.t
MAY 2 1 2013
FBC 20
Permit No.
Master Permit No.-"
liter
1210,, 13-
ROOFING / I
OWNER: Name (Fee Simple Titleholder): 42airt,-C / 7(‘ 7 f
Address: ! 4 //cit.
Ci ty: 1�/ •An s 5 L0 /''f State: /
Tenant/Lessee Name:
Email: E: J1 1 1 r Q �^62 ; r COW
CONTRACTOR: Company Name: 8
eirdtvtdi-r-r, Vi ii Phone #: 30-r 3/4- 0904
Address: L (Trn4) I ?b
City: � e €"." J State: 6--
Qualifier Name:
State Certificatio J ' or Regis ton #(rci,5/7 '.16 Certificate of Competency
/ l / �•
Contact Phone#:�d„ �� �Z Email Address: j10 `7 &s1 / //�.a_- t z eLi. r
DESIGNER: Architect/Eni veer: / ` Phone#:
Phone #: J _I 7J
zip: 3 316'/
Phone#:
Zip: 35 oJ'S
Phone#: ?cta. V7" ?a
Value of Work for this Permit: $ 7 00 Square/Linear Footage of Work: 90 S-
Type of Work: °Addition °Alteration °New Repair/Replace °Demolition
Description of Work: � e_e,o
Color thru tile:
**** * * * * * *+x****** * **Iie* *** ray * *** x * **** *F *** * ****** *** *** ** ** *+ +x***** * *** ***** *,x ****
PO aA±-
Submittal Fee $ Permit Fee $
Scanning Fee $ Radon Fee $
CCF $ CO /CC $
DBPR $ Bond $
Notary $ Training/Education Fee $ Technology Fee $
Double Fee $ Structural Review $
TOTAL FEE NOW DUE $ S (DC
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 FTFCTRICAL WORK, PLUMBING, SIGNS,
WFTJ S, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC
OWNER'S Al Ji'IJAVIT: 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 Signature �` l
Owner or Agent Contractor
The foreg i g instrument was a knowledged efore m his )0 The forego g instrument was ackn
day of , 20 0, by �GL 67/7t , day of , 200 , by
who is personally known to me or who-has -pa d who is personally known to me or wholas-produeed
As identification and who did take an oath. as identification and who did take an oath.
NOTARY PUB
ed before i- this
NOTARY PUBLIC
Sign:
Print:
Qpfs
`. MARYLIN TORANO
cold sSiON #EE212630
ExPIKEz AMC 28, 2016
My Commissi
n Expires:
R.YLIN TORANO
COMM13310N # EE212630
±- e28,2016
My Commissio' Expires: jte_ ne,- 742/ (°1916
***************************************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
APPROVED BY
Plans Examiner Zoning
Structural Review Clerk
(Revised 3 /12/2012)(Revised 07 /10 /07)(Revised 06/10t2009)(Revised 3/15/09)
Azgass' ; 1/ A/5 Pei Si , ,?lrnrn' or -e.�s , ?G , 3316/
PEFiMil #:
Miami Shores Village
APPROVED
BY
DA I
ZONING DEPT
BLDG DEPT
_ _
SUBJECT in CCAIPLIPNCE WI iH ALL FEDERAL
STATE ANL) C IJN I 'f HULLS AND REGULATIONS
CI Y
COPY
itAa) S-lueu)
Saope of Woo&
57 -Co 74 e...14/Slinl e4dIcte/e. /all