DEMO-13-1148Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP- 192374 Permit Number: DEMO -5 -13 -1148
Scheduled Inspection Date: May 31, 2013
Inspector: Rodriguez, Jorge
Owner:
Job Address: 155 NW 91 Street
Miami Shores, FL 33150-
Project: <NONE>
Contractor: MG EXCELLENCE SERVICE CORPORATION
Permit Type: Demolition
Inspection Type: Final Building
Work Classification: Building
Phone Number
Parcel Number 1131010000220
Phone: (786)247 -7067
Building Department Comments
DECORATIVE KEYSTONE IN FRONT OF HOUSE AFTER
THE FACT
Infractio Passed Comments
INSPECTOR COMMENTS
False
Passed
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Inspector Comments
s `tz)2b M,u
A-2 7.0
May 31, 2013
For Inspections please call: (305)762 -4949
Page 12 of 16
CONTRACTOR:
SUBMITTAL DATE:
ADDRESS: 155 nrw 4( sour
RESUBMITAL DATES:
PROJECT TYPE:
STRUCTURAL
ELECTRICAL
PLUMBING
FIRE
IMPACT FEES
HRS/DERM
Miami Shores Village
:_E_E[
Building Department MAY 2 3 2013
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: BUILDING
JOB ADDRESS: 1 15-75— A q / . 67-
FBC2o10
Permit No. l�.1//&t-t e,
Master Permit No. I Lirk
ROOFING
City: Miami Shores
Folio/Parcel #:
Is the Building Historically Designated: Yes
County:
Miami Dade
Zip:
OWNER: Name (Fee Simple Titleholder): 1AZ aa
Address:
City: State: P5
Tenant/Lessee Name:
NO Flood Zone:
Email:
CONTRACTOR: Company Name: NI
Address: An &" / %
City:
a Phone#: c -TZ0 6
State:
Zip: -3 3e0
Qualifier Name: �' i Phone#:
State Certification or Registration #: e6I 15 / /19e Certificate of Competency #:
Contact Phone#: Email Address:
DESIGNER: Architect/Engineer: Phone#:
of Work for this Permit: $ S®C.)
Type of Work: DAddition DAlteration
Description of Work: I J
Square/Linear Footage of Work:
DNew DRepair/Replace emolition
S �0 .. f /12764) Of 7-4._,
0'
Color thru tile:
***************************************F nr**************** *1��k�k�M�k****�Rb�N+N�k*** *+k+ ***
Submittal Fee $ `S� Permit Fee $ /�� �y CCF $ CO /CC $
Scanning Fee $ Radon Fee $ DBPR $ Bond $
Notary $ Training/Educadon Fee $ Technology Fee $
Double Fee $ Structural Review $
TOTAL FEE NOW DUE $ Y.
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 FI.ECTRICAL 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 app `oved and a reinspection fee will be charged.
Signature
The foregoing ins
day of
Own or Agent
ent was acknowledged before me this
by
who is personall known
o me or who has produced
As identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
My Commission Expires:
* * * * * * * * * * * * * * * * * * * **
APPROVED BY
Signature
Contractor
The foregoing instrument was acknowedged before me this o2%
day of 20 _a by /14/ G (fdYe' .
me or who has produced
as identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
My Commission Ex
*********** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
Plans Examiner
Structural Review
(Revised 3 /12/2012)(Revised 07 /10 /07)(Revised 06/10/2009)(Revised 3/15/09)
Zoning
Clerk
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Lkskor
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'R_EC
MAY 2 3 " 013
iminr. Mail=
Cjamill Whores iflage
APPROVED
ZONING DEPT
BLDG DEPT
BY
DATE
SUBJECT 10 CC IPLIANCE WITH ALL FEDERAL
STATE ANL) CGIJNI ribLES AND REGULATIONS