DS-09-1826Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Mnspection Number: INSP - 128612
Permit Number: DS -11 -09 -1826
Inspection Date: December 09, 2010
Inspector: Bruhn, Norman
Owner: ALLEGRA, FRAN
Job Address: 1160 NE 98 Street
Miami Shores, FL 33138-
Project: <NONE>
Contractor: GULF BUILDING CORP
Permit Type: Driveways /Sidewalks /Slabs
Inspection Type: Final
Work Classification: New
Phone Number
Number 1132050180390
Phone: (954)492 -9191
Building Department Comments
new pavers at front driveway and walkway to house
Passed j
Inspector Comments
iC____ ( "
- c)
o.
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
December 09, 2010
Page 1 of 1
Miami Shores Village
Building Department
>0050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
BUILDING
PERMIT APPLICATION
FBC 2004
Permit Type (circle):
Roofing
Permit No.
Master Permit No.
VZ(OMWM1V,
La NOV 0 5 2069 ID
BY:ev ®000ae
cr,a_q_Aa,
Owner's Name (Fee Simple Titleholder) �Cra ft Phone #
Owner's Address 490 AIE
City 6 1, ( 19cc State r ( Zip 3 ? 1 ,3 0
Tenant/Lessee Name Phone #
Job Address (where the work is being done)
City Miami Shores Village County Miami -Dade Zip
FOLIO / PARCEL #
t1 (v 41V- ST c r
Is Building Historically Designated YES NO
Contractor's Company Name GU u-b i4 (7 Cop p
Contractor's Address &33 , 'r'ebi c fil(„■-‘1„ ,4.1
City FT. LA,./ 6(1, (1 eta- lt,, "State f" 1
Qualifier Name )01N 4 Sc} 2.
LGC 15111 c1
State Certificate or Registration No.
Phone #
Zip
Phone #
°19/ . 1442 -II 9/
Certificate of Competency No.
Architect/Engineer's Name (if applicable)?Ctenfr LP.L.Ac Phone #
Value of Work For this Permit $ J 35k5, at-a- a' Square / Linear Footage Of Work: 7o'3 Q, p
Type of Work: DAddition ['Alteration %New ❑ Repair/Replace ❑ Demolition
Describe Work: ,tom 'kit U, S A t e•,T b9A t-D e L.l0 'i A-J 0 wR LkC6df- J
-W 4C) ctL
****** *** ** ***** *,r *** ***** * * * ** * * * *** * ees********************************************
Submittal Fee $ Permit Fee $
Notary $ Training/Education Fee $
CCF $ CO /CC
Technology Fee $
Scanning $ Radon $ DPBR $ Zoning $
Bond $ Code Enforcement $ Double Fee $
Structural Review. $ Total Fee Now Due $
See Reverse side —>
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 not be appr a reinspection fee will be charged.
Signature
Owner or Agent n S
The foregoing instrument was acknowledged before me this 0
day of �' 'r%Q[20O`I,by H011(e�P.'4fc14
who is personally known.' or who has produced
As id-;'fication
NOTARY PUBLI
Sign:
Print:
My Commission Expires:
Contractor
The foregoing instrument was acknowledged before me thisZ?
day of , 20 , by (b %Ai 3CX e,er ,
who is personally known to me or who has produced
e56F FLORID1
F. Gonzalez
Commission # DD49175€
Tres: JAN. 02, 201(
Bonded Thru Atlantic Bondin • Co., Inc
GI
* * * * * * * * * * * * * * * * * * * * * * * **
as identification and who did take an oath.
Print: r /ia
)471141 ./Ors
11,, 0 My Commission Expires: /� /®
**** �x*****,****************** * ** ** ** * *** * * ** * ** **,* * ** **** ** * ** * * * ** * * * * * ** * * * **
APPLICATION APPROVED BY:
62.jt�� /�'" Plans Examiner
(Revised 07/10/07)
Engineer
Zoning