RC-11-627Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
'Inspection Number: INSP - 158210
Permit Number: RC -4 -11 -627
Inspection Date: May 03, 2011
Inspector: Bruhn, Norman
Owner: EUGENE, KERMITH & LOUIS
Job Address: 524 NW 113 Street
Miami Shores, FL 33168-
Project: <NONE>
Contractor: JOHN DALTON LLC
Permit Type: Residential Construction
Inspection Type: Final
Work Classification: Addition/Alteration
Phone Number
Parcel Number 3021360210860
Phone: (561)394 -2619
Building Department Comments
2 BATHROOM REMODEL
4/19/2011 - NEED NOC BEFORE INSPECTIONS 4/26/11
noc in file
Passed
Inspector Comments
See engineers report. NB
CC----
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled
re- inspection fee is paid.
until
For Inspections please call: (305)762 -4949
May 03, 2011
Page 1 of 1
PERMIT# IJ —Co 2:1
CONTRACTOR: "Jilin a li-011 LLC--
SUBMITTAL DATE: 4111
2 O /1
ADDRESS: 52A- No,) 11 T
NAME: LOU (S E( )0F.4 ,1f._
RESUBMITAL DATES:
PROJECT TYPE: 190,4-1111(091M5 gejniCACA
ZONING
FIRE
STRUCTURAL
IMPACT FEES
/7/1/1-1/2-
ELECTRICAL /Z627ty ze-,
HRS/DERM
PLUMBING
NOC
qiiii 43 1 WI-ae9
MECHANICAL
BLDG
April 8, 2011
FERNANDO GOMEZ -PINA, P.E.
CONSULTING ENGINEER
250 CATALONIA AVE, SUITE #404
CORAL GABLES, FL 33134
TEL: (305) 461-2188
FAX: (305) 461-2238
Miami Shores Village
Building Department
10050 NE 2nd Avenue
Miami Shores, Florida 33138
Re: Walls Envelope for
Existing Bathrooms
524 NW 113 ST
Miami Shores, Florida 33168
Dear Sirs:
This is to inform you that in the above referenced project, the envelope of the
partitions walls were built with 1 /2" Durock board, attached to wood partitions with screws at
6" o/c and %2" Durock board over P.T. furring on CBS exterior and R -4 insulation.
If you have any question, please do not hesitate to contact this office;
Fernando Gomez -Pina, P,E.
FGP /ym
NOTICE OF COMMENCEMENT
A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF FIRST INSPECTION DE
PERMIT NO 1 1 c (La 4 , 2 , TAX FOLIO NO.3 co- ( a < <%* 4
STATE OF FLORIDA:
COUNTY OF MIAMI -DADE:
THE UNDERSIGNED hereby gives notice that improvements will be made to certain real
property, and in accordance with Chapter 713, Florida Statutes, the following information
is provided in this Notice of Commencement.
1111111111111111111111111111111111111 11111111
CFN 201 1 R02!$277
OR Bic 27659 Ps 43121 (fps?
RECORDED 04/20/21011 09:43:41
HARVEY RUVIN, CLERK OF COURT
MIAMI -DADE COUNTY, FLORIDA
LAST PAGE
1 Space above reserved for use of recording office
1. Legal description of property and street/address: !UL ` ( irk. lit c G- rrp_
2. Description of improvement:
3.Owner(s) name and address:
Interest In property: $ 1401
Name and address of fee simple titleholder.
4. Contractor's name, address and phone number.
trirlyN
5. Surety: (Payment bond required by owner from contractor, H any)
Name, address and phone number.
Amount of bond $
6. Lender's name and address:
7. Persons within the State of Florida designated by Ownerupon whom notices or other documents may be served as provided by
Section 713.13(1)(a)7., Florida Statutes,
Name, address and phone number.
8. In addition to himself; Owners designates the following persons) to receive a copy of the Lienor'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 date of recording unless a different date Is specified)
WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT ARE CONSIDERED
IMPROPER. PAYMENTS UNDER CHAPTER 713, PART I, SECTION 713.13. FLORIDA STATUTES, AND CAN RESULT IN YOUR PAYING TWICE FOR
IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE
FI -r INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK
DRDI► YO . OTCE OF COMMIENCEMENT.
s) of Owne )' Authorized • «'/Dinector/Partner/Manag
Prepared By L0U` a'� [ ±' , .f ...J • Prepared By
Print Name Print Name
Title/Office Title/Office
STATE OF FLORIDA
COUNTY OF MIAMI -DADE
The foregoing instrument was acknowledged before me this.
ey
❑ Individually, or ❑ as for
.Q'Personally known, orproduced the following type of identification:
t• Signature of Notary Public:
Print Name:
(SEA-)
day of ' A-Pr.i L
. 1/401U
`\u 1
c SiI
Under penaiiies of perjury; I declare that I have read tt:W f 1 of and
• that the facts stated in it are true, to the best of my knowledge aan nd belief :.
Signature(s) of Owners) or Owner(s)'s Authorized Officer /Director/Partner/Manager who s
By
• . •a\0\1 %k�..
•
123.x1 -62 "ttglit OF FLOR A, *AUNTY o
1 HEREBY CE TIFl M:.?i' is .is a bads wycitit
2riglnsl fill 19ru t $ o: aar a
P� it �na;t , E.D. 20 =..-.,�,
aayhand and O, dill ! 0.t COWLS
By —A _ -
By
�p°�aR�0
p : c'.
1
i
Project Address
Miami Shores Village
10050 N.E. 2nd Avenue NW
Miami Shores, FL 33138 -0000
Phone: (305)795 -2204
Parcel Number
Applicant
524 NW 113 Street
Miami Shores, FL 33168-
3021360210860
Block: Lot:
KERMITH & LOUIS EUGENE
Owner information
Address
Phone
CeII
KERMITH & LOUIS EUGENE
285 NE 82 Street
MIAMI FL 33138-
285 NE 82 Street
MIAMI FL 33138-
Contractor(s)
JOHN DALTON LLC
Phone CeII Phone
(561)394 -2619
Valuation:
Total Sq Feet:
$ 5,500.00
0
1
Approved: In Review
Comments:
Date Approved: : In Review
Date Denied:
Type of Construction: BATHROOM REMODEL
Stories:
Front Setback:
Left Setback:
Bedrooms:
Plans Submitted:
Certificate Date:
Bond Retum :
Occupancy: Single Family
Exterior:
Rear Setback:
Right Setback:
Bathrooms:
Certificate Status:
Additional Info:
Classification: Residential
Fees Due
CCF
DBPR Fee
DCA Fee
Education Surcharge
Permit Fee
Scanning Fee
Technology Fee
Work without Permit Fee
Total:
Amount
$3.60
$2.48
$2.48
$1.20
$165.00
$12.00
$4.80
$165.00
$356.56
Pay Date Pay Type
Invoice # RC -4-11 -40595
04/11/2011 Credit Card
04/19/2011 Check #: 271
Amt Paid Amt Due
$ 50.00 $ 306.56
$ 306.56 $ 0.00
Available Inspections:
Inspection Type:
Final PE Certification
Drywall
Miscellaneous
Window Door Attachment
Tie Beam
Final
Framing
Insulation
Truss lnsp
Columns
Foundation
Window and Door Buck
Fill Cells Columns
Wire Lathe
Declaration of Use
F. Termite Letter
F. Elevation Certificate
In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations
pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In
accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are
required for ELECTRICAL, PLUMBING, MECHANICAL WINDOWS, DOORS, ROOFING and SWIMMING POOL work.
OWNERS 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. Futhermore, I authorize the above -named contractor to do the work stated.
April 19, 2011
Authorized Signature: Owner / Applicant / Contractor / Agent
Building Department Copy
Date
April 19, 2011
1
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
Y:
Permit No. T-C 1l 'TO L+7
Master Permit No.
Permit Type: BUILDING
OWNER: Name (Fee Simple Titleholder):1_Jjfs715 Phone #: �� ��
Address: 3...95-
, 96 l� /c- ��
City: p74)///
State: /` .-- Zip: '31 ✓�
Tenant/Lessee Name: Phone #:
Email:
JOB ADDRESS: 3-194. N IAU 1) 3 S�
City: Miami Shores County: Miami Dade Zip: q�� 9�/ ?P
Folio/Parcel #:
Is the Building Historically Designated: Yes NO Flood Zone:
CONTRACTOR: Comp Name:
Address: / 57i 6 % c
City: Bo e4 2 ,l' g ilU✓% State: Zip:
Qualifier Name: a L't 0 CS Phone #:
State Certification or gistration #: Certificate of Competency #: C C 0 1 ,ki,P-c./
Contact Phone #: 7-8dWI —i0 ci3 Email Address:
DESIGNER: Architect/Engineer:
Phone #: 56/ % d c/9
. 3 " - S ' 0 ®�
Value of Work for this Permit: $
Type of Work: Address
Description of Work:. • / /�
/-
DAlteration
Phone #:
Square/Linear Footage of Work:
ONewIRepair/Replace
❑Demolition
COLOR THROUGH ROOF TILE IS REQUIRED acknowledged by:
********* *** *** * ** * ** ** ** * ** * * * *** ** ** *F ************* *** * * **** * **** ***** ** **** * *** **
// O
Submittal Fee $ Permit Fee $ `b s� CCF $ CO/CC $
Scanning Fee $
Double Fee $ Structural Review $
Radon Fee $ DBPR $ Bond $
Training/Education Fee $ Technology Fee $
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, BONERS, 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 be approved and a reinspection fee will be charged.
Signatur
The for
day of
who is
/ fit
_
Agent
Owner or
oin ::instrument was a . owled h ed
20Q� ,by .,_);
rsonalllkn wn to or who has produce
V tide/ntification and who did take an oat
Signature
The foregoing
day of
NOT '�, 'U;LIC:
Sign:
Print:
My Commission Expires:
oigai
Contractor
nstrument was acknowledged before me this
20 L by
o is personally known to me or who has produced
as identification and who did take an oath.
NOTARY PUBLIC: 44,3
Sign:
�5ro 00 749740
Print:
My Commission Expire °T
*************************************** ii' 7@ **7k*7j'* Yti'* ii'*** 11C*****'* ********* ** **7%1i'A'X'y[fY9CY@****1k******* **7:'*7ti******'****
APPROVED BY
(Revised 07 /10 /07)(Revised 06 /10 /2009)(Revised 3/15/09)(rev6/4/10)
Plans Examiner
Structural Review
Zoning
Clerk
PERMIT #: // '7
1, efioilit
Miami Shores Viiiage
Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
RECEIPT
DATE: ��l -1/
ractor
❑ 0 ner
❑ Architect
Picked up 2 sets of plans and (other) 6f/--'a4V-31 / C
Address: �'C•�
From the building department on this date in order to have corrections done to plans
And /or get County stamps. I understand that the plans need to be brought back to Miami
Shores Village Building Depart r entr Conti ► perm' ing process.
Fr ,
Acknowledged by:
PERMIT CLERK INI
IAL:
RESUBMITTED DATE:
oII
PERMIT CLERK INITIAL: (.0
Permit No: 11 -627
Job Name:
April 19, 2011
Miami Shores VViIIage
Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
Page 1 of 1
Building Critique Sheet
1) A mechanical permit application must be submitted prior to any further review.
2) The plans do not include an accurate scope of work. What is being done?
Plan review is not complete, when all items above are corrected, we will doa complete plan
review.
If any sheets are voided, remove them from the plans and replace with new revised sheets and
include one set of voided sheets in the re- submittal drawings.
Norman Bruhn CBO
305 - 795 -2204
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 No. P I
BUILDING
PERMIT APPLICATION
FBC 20
Permit Type: BUILDING /,, +�
OWNER: Name (Fee Simple, holder): �-/�% % �'�9 4flQ% Phone #: 716 �� �� °�
Address: Sal / W �/�
City: ✓2 /A7?/ ilieU
ZaMgln-
A.PR 1 1.21411
11- ►2
Master Permit No.
State: r
Zip: Jfil6.417
Tenant/Lessee Name: Phone #:
Email:
JOB ADDRESS: &Rile A/W //
City: Miami Shores
Folio/Parcel #: /• 00, 0V -0'60
Is the Building Historically Designated: Yes NO Flood Zone:
County:
Miami Dade Zip: 33/6?
CONTRACTOR: Compan Name: —,l i rnete/1 laeffOl'1 -f Phone #:
R%
Address: /V /id
City: /V • /712,6W State: 1P14 Zip: 33/ £/
Qualifier Name: Jam £0)4 4- ® Phone #: �ai6 ° 554 `
State Certification or Registration #: C / MO O 29 Certificate of Competency #:
Contact Phone #: 3"' 696 "5/J2 Email Address:
DESIGNER: Architect/Engineer: Phone #:
*16'-'°
Value of Work for this Permit: $
Square/Linear Footage of Work:
Type of Work: Address D- Iteration DNew ,Repair/Replace ❑Demolition
Description of Work: � C*14266117177&
COLOR THROUGH ROOF TILE IS RI UIRED acknowledged by:
Submittal Fee $ Permit Fee $ (5--6- ..' -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 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 n e approved and a reinspection fee will be charged.
Signatu
The for
day of
Owner or A t
going instrument was acknowledged before me thi
20 U , by Loa5 €L `°
who is personally known to me or who has produced
As identification and who klio 1 oath.
.. pow `
NOTARY PUBLIC:
Sign:
Print:
My Commission Expires:
APPROVED BY
ddd' l./L . • ..... • \�\
Signature
Contractor
The forego ng instrument was acknowledged before me this eV
day of , 20 1/ , by Ci4-ti ,
who is personally known to me or who has produced
as identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print: �,i�id a
x•P�sarramac,�rtns�'
My Commission Expires: Maria � I► n-G Cia
Commission Teresa
y..;„.F ExPiree MAR. 31, 2013
NONDzDTHROATLINZICIONDMG ao.M.
**************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
[ f3— `'Plans Examiner
Structural Review
(Revised 07 /10 /07)(Revised 06 /10 /2009)(Revised 3/15/09)(rev6/4/10)
Zoning
Clerk
Protect Address
Miami Shores Village
10050 N.E. 2nd Avenue NW
Miami Shores, FL 33138 -0000
Phone: (305)795 -2204
Parcel Number
Applicant
524 NW 113 Street
Miami Shores, FL 33168-
3021360210860
Block: Lot:
KERMITH & LOUIS EUGENE
1
Owner Information
Address
Phone
Cell
KERMITH & LOUIS EUGENE
285 NE 82 Street
MIAMI FL 33138-
I
285 NE 82 Street
MIAMI FL 33138-
Contractor(s) Phone CeII Phone
J&J CARDONA CONSTRUCTION INC (305)696 -5112 (786)556 -3084
Valuation:
Total Sq Feet:
$ 600.00
0
1
Type of Work: PLUMBING
Type of Piping:
Additional Info:
Bond Retum :
Classification: Residential
Scanning: 1
Fees Due
CCF
DBPR Fee
DCA Fee
Education Surcharge
Permit Fee
Scanning Fee
Technology Fee
Work without Permit Fee
Total:
Amount
$0.60
$2.25
$2.25
$0.20
$150.00
$3.00
$0.80
$150.00
$309.10
Pay Date Pay Type
Invoice # PL-4-11-40596
04/11/2011 Credit Card
04/19/2011 Check #: 271
Amt Paid Amt Due
$ 50.00 $ 259.10
$ 259.10 $ 0.00
Available Inspections:
Inspection Type:
Top Out
Final
Underground
In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations
pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In
accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are
required for ELECTRICAL, PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work.
OWNERS 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. Futhermore, I authorize the above -named contractor to do the work stated.
Authorized Signature: Owner / Applicant / Contractor / Agent
Building Department Copy
April 19, 2011
Date
April 19, 2011 1
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP - 158229 Permit Number: PL -4 -11 -628
Scheduled Inspection Date: April 29, 2011
Inspector: Hernandez, Rafael
Permit Type: Plumbing - Residential
Inspection Type: Final
Owner: EUGENE, KERMITH & LOUIS Work Classification: Addition /Alteration
Job Address: 524 NW 113 Street
Miami Shores, FL 33168-
Project: <NONE>
Contractor: J &J CARDONA CONSTRUCTION INC
Phone Number
Parcel Number 3021360210860
Phone: (305)696 -5112
Building Department Comments
PLUMBING WORK FOR BATHROOM REMODEL
Passed
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Inspector Comments
Apri128, 2011
For Inspections please call: (305)762-4949
Page 9 of 16
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP - 158236
Permit Number: EL -4 -11 -629
Scheduled Inspection Date: April 28, 2011
Inspector: Devaney, Michael
Owner: EUGENE, KERMITH & LOUIS
Job Address: 524 NW 113 Street
Miami Shores, FL 33168-
Project: <NONE>
Contractor: ALL QUALITY ELECTRICAL SERVICES, INC
Permit Type: Electrical - Residential
Inspection Type: Rofi
Work Classification: Addition /Alteration
Phone Number
Parcel Number 3021360210860
Phone: (305)968 -7832
Building Department Comments
ELECTRICAL WORK FOR BATHROOMS REMODEL
Passed
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Inspector Comments
April 27, 2011
For Inspections please call: (305)762 -4949
Page 9 of 22
1
Project Address
Miami Shores Village
10050 N.E. 2nd Avenue NW
Miami Shores, FL 33138 -0000
Phone: (305)795 -2204
Parcel Number
Applicant
524 NW 113 Street
Miami Shores, FL 33168-
3021360210860
Block: Lot:
KERMITH & LOUIS EUGENE
Owner Information
Address
Phone
CeII
KERMITH & LOUIS EUGENE
285 NE 82 Street
MIAMI FL 33138-
i
285 NE 82 Street
MIAMI FL 33138-
Contractor(s) Phone
ALL QUALITY ELECTRICAL SERVICE. (305)968 -7832
CeII Phone
Valuation:
Total Sq Feet:
$ 600.00
0
1
Type of Work: ELECTRICAL
Additional Info: BATHROOM REMODEL
Classification: Residential
Scanning: 1
Fees Due
CCF
DBPR Fee
DCA Fee
Education Surcharge
Permit Fee - Additions/Alterations
Scanning Fee
Technology Fee
Work without Permit Fee
Total:
Amount
$0.60
$2.25
$2.25
$0.20
$150.00
$3.00
$0.80
$150.00
$309.10
Pay Date Pay Type
Invoice # EL -4-11 -40597
04/11/2011 Credit Card
04/19/2011 Check #: 271
Amt Paid Amt Due
$ 50.00 $ 259.10
$ 259.10 $ 0.00
Available Inspections:
Inspection Type:
Final
Meter Box
Alteration
Relocation
Fire Alarm
Service Change
Underground
W. W.
In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations
pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In
accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are
required for ELECTRICAL, PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work.
OWNERS 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. Futhermore, I authorize the above -named contractor to do the work stated.
April 19, 2011
Authorized Signature: Owner / Applicant / Contractor / Agent
Building Department Copy
Date
April 19, 2011
1
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: Electrical
OWNER: Name (Fee Simple Titleholder):
Address: E
City:m 1 A 1
pte�S ' (fete
Permit No.
X7,'3
PR 1 1 2111
11 -con
Master Permit No.
Phone #: %P 3 OCR
State: i7I //7/67e
Zip5S'/ ,r?
Tenant/Lessee Name: Phone #:
Email:
JOB ADDRESS: 5d.- L CJ (13 i7 r'
City: Miami Shores County: Miami Dade Zip: .33 / 3
Folio/Parcel #:
Is the Building Historically Designated: Yes
NO >' Flood Zone:
CONTRACTOR: Company Name: 41 [ 1 ;4y Et e 4_1 uo'ce5
Address: 1 7 5- 5 uc .rC
City: M ( . ; State: FC
Qualifier Name: S a 04 1uc i [ i I f b o i ( AJ C.
State Certification or Registration #: -K . 6 . C 3 t
Contact Phone #: 305- i? t�. ' -%$,.3 Z Email Address: a ! (9 (i � /% ' 'e /. c �' 4 C .47 f'
bR
Ttvc. Phone #: 0 �" �C 8' 1$.i ?_
Zip: 33167
Phone #: J �S 5-&$- 23,E 2.
j b Certificate of Competency #: 0 5 coot -F M
DESIGNER: Architect/Engineer: Phone #:
Value of Work for this Permit: $ CO ®o Square/Linear Footage of Work:
Type of Work: ❑Address UAlteration UNew ®Repair/Replace UDemolition
Description of Work: Z-7)L14-Cc C v1le '/0 CPI 6,
ADS 6 Sm oXe Del e. c7 -5
******** * * * * ** ** * * * * * * * * * ** ** ** * * * * * * ** Fees************* * * * * * * * * * ** ** * ** * ** * * * * * * * * * * **
Submittal Fee $ Permit Fee $ /(-1-6"' C U CCF $ CO /CC $
Scanning Fee $ Radon Fee $ DBPR $ Bond $
Notary $ Training/Education Fee $ Technology Fee $
Double Fee $ Structural Review $
TOTAL FEE NOW DUE $ O` •'O
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 t be approved and a reinspection fee will be charged.
Signatur
atig
Owner or Ag 1
The fo -going instrument was knowled:ed before me this 11 The foregoing instrument was acknowledged before me this
day o ,20,1 ,by �1. , day of i 1
�t!►iri
who is persc}na ly known to''me or who has produce
Idei
rtification and who did take an oa
Signature
../d'iY1/kte,"( 7
/1,e7/
Contractor
Sign:
Print:
My Commission Expires:
,<S6C..0410I%
x 10'
I SP
APPROVED BY � !L - 2 /1,1,j2 P/1 / Examiner Zoning
Structural Review Clerk
, 20 by 5/F44 L< i
own to me or who has produced
as identification and who did take an oath.
NOTARY PUBLIC'
Sign:
P
My Commissio
•
STATE OF F
Comm* EE , . 9
Expires 12/7/2014
(Revised 07 /10 /07XRevised 06 /10 /2009)(Revised 3/15/09)
April 19, 2011
FERNANDO GOMEZ -PINA. P.E.
CONSULTING ENGINEER
250 CATALONIA AVE, SUITE #404
CORAL GABLES, FL 33134
TEL: (305) 461-2188
FAX: (305) 461-223E1
Miami Shores Village
Building Department
10050 NE 2nd Avenue
Miami Shores, Florida 33138
Re: Interior Remodeling for
Kermith Eugene
524 NW 113 ST
Miami Shores, Florida 33168
Dear Sirs:
This is to inform you that in the above referenced project, the envelope of the
partitions walls were built with 1/2" Durock board, attached to wood partitions with screws at
6" o/c and 1A" Durock board over P.T. furring on CBS exterior and R -4 insulation. The
finish will be with ceramic tile.
The following revisions will apply:
1. No exhaust fans in the bathrooms as they both have an exterior window.
2. There will not be air conditioning, window units or otherwise.
If you have any question, please do not hesitate to contact this office;
Sincere
ernando Gomez -Pina, P,E.
FGP /ym