FW-11-1402Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP- 162772 Permit Number: FW -8 -11 -1402
Scheduled Inspection Date: October 22, 2012
Inspector: Bruhn, Norman
Owner:
Job Address: 105 NW 92 Street
Miami Shores, FL 33150-
Project: <NONE>
Contractor: ESR FLORIDA CONSTRUCTION INC
Permit Type: Fence/Wall
Inspection Type: Final
Work Classification: Wood Fence
Phone Number
Parcel Number 1131010331050
Phone: (305)812 -2716
Building Department Comments
SHADOW BOX WOODEN FENCE 5' HIGH
AS PER BLDG OFFICIAL, OK TO EXTEND PERMIT 60
DAYS ONLY. 7/31/12
Inspector Comments
Passed J/ v� b� 1
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
October 19, 2012
For Inspections please call: (305)762 -4949
Page 1 of 45
Miami Shores Village
Building Department
%0Z1V 1
AUG 711 LW-
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
04 , Tel: (305) 795.2204 Fax: (305) 756.8972
INSPECTION'S PHONE NUMBER: (305) 762.4949
BUILDING Permit J-1.10 I� 14-0e)—
PERMIT APPLICATION Master Permit No.
FBC 20
Permit Type: BUILDING PROOF lv
OWNER: Name (Fee Simple Titleholder):19,v.74,v
Address: L ()' U) 2 ") S
r�
City: (k t / i ? " State:
Tenant/Lessee Name:
Email:
�tG- w Phone #: cow )6
Zip: 33 16`6
Phone #:
JOB ADDRESS:
/175 Ala) JO
City: Miami Shores
Folio/Parcel #:
County:
Miami Dade Zip: 3;3/ c7 L)
Is the Building Historically Designated: Yes
NO l/ Flood Zone:
CONTRAC OR: Com y Name: Phone #:
Address: = ®.
City:
Qualifier Name: 14,44121W1949 / °e -
State Certification or Registration #: e 6 C 5 0 Certificate of Competency #:
Contact Phone #: C70 5 c I .2 7 4 4Email Ad. ess:
DESIGNER: Architect/Engineer: fl
Phone #:
545 'fca 7f‘
Zip: 3 51i)
Value of Work for this Permit: $
Type of Work: DAddition
Description of Work:
Zip
Phone #: ?0$ c9ci CC
o 3 , ?J115-
are/Linear Footage of Work:
URepair/Replace
ODemolition
* * * * * * * * * * * * * * * ** x*x:*** **** * *** ** x ***** Fees** **+x*+ ******** ****** *******************a ***
a� O
Submittal Fee $ Permit Fee $ p�,..] ,�d CCF $ CO /CC $
Scanning Fee $ Radon Fee $
Notary $ Training/Education Fee $
Double Fee $ Structural Review $
TOTAL FEE NOW DUE $ R14
DBPR $ Bond $
Technology Fee $ -
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, BOTI.RRS, 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 sev ' ) days after the building permit is issued. In the absence of such notice, the
inspection will not b.' a %proved and a r n fee will be charged.
Signatur Signature
Owner or Agen _ , �j
The fore oing instrument was a, kn edged\befor�me this �./
day of �'�J� , 20 i by
— who i. persoaall) own to me or who has produced ��
identification and who did take an oath.
NO
TA
Sign:
Print:
My Commission Expires: ' m
.0) a.
= k�k+ h***** Hj****** ske k= k***** �k******** ahj kN�sh�kj k�k�# d��k�k�ktk�k***** N� ek***�k�h�k�k�k�k�k�k�k�k�k�k�k N�k****�k.k=k�k�k****...._ Ni *N *** *° d+********
Sign:
Print:
My Commission Expires.4n ;. tlN,;
APPROVED BY
Plans Examiner
Zoning
Structural Review Clerk
(Revised 07 /10 /07)(Revised 06 /10/2009)(Revised 3/15/09)
Planning and Zoning Criteria
Miami Shores Village
10050 N.E. 2nd Avenue
Miami Shores, FL 33138 -0000
Phone: (305)795 -2204 Fax: (305)756 -8972
Folio Number:1131010331050
Owner's Name:
Job Address: 105 92 Street
Owner's Phone:
Total Square Feet: 130
Miami Shores, FL 33150 -
Total Job Valuation: $ 950.00
Contractor(s)
ESR FLORIDA CONSTRUCTION INC
Phone
(305)812 -2716
Primary Contractor
Yes
Planning and Zoning Criteria and Comments
Approved: Yes Date Approved: 8/4/2011: Yes
Comments: