RC-13-1193 Inspection Worksheet
Miami Shores Village
10050 N.E.2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-201422 Permit Number: RC-5-13-1193
Scheduled Inspection Date: October 24,2013 Permit Type: Residential Construction
Inspector: Rodriguez,Jorge
Inspection Type: Final
Owner: MARY ELLEN BENTON, DOUGLAS Work Classification: Addition/Alteration
QACIMCC
Job Address: 10108 NE 1 Avenue
Miami Shores, FL Phone Number
Parcel Number 1132060131560
Project: <NONE>
Contractor: ARCO CONSTRUCTION Phone: 305-892-6507
Building Department Comments
INSTALLATION IN CEILING R-19 NEW DRYWALL 1/2" Infractlo Passed comments
CEILING ONLY INSPECTOR COMMENTS False
Inspector Comments
Passed CREATED AS REINSPECTION FOR INSP-192440. No access, no one�'M home
Failed
Correction
Needed
Re-Inspection ❑
Fee
No Additional Inspections can be scheduled until
re-inspection fee is paid.
October 23,2013 For Inspections please call: (305)762-4949 Page 16 of 30
' Miami. Shores Village
Building� g MAY 3.0 2013
90050 N.E.2nd Avenue,Miami Shores,Florida 33138
Tel:(305)795.2204 Fax:(305)756.8972
INSPECTION'S PHONE NUMBER:(305)762.4949
II
C 20
BUILDING Permit No.
PERMIT APPLICATION Master Permit No
Permit Type: BUILDING ROOFING
JOB ADDRESS: &/® ls'i gllee
City: Miami Shores County: Miami Dade Zip:
Folio/Parcelk
Is the Building Historically Designated:Yes NO Flood Zone:
OWNER:Name(Fee Simple Titleholder): 40e34-6-e4.f Iel• 6A,?We�f Phone#:
Address: /0/0cF /,// X'Ve
City: j"Vox6a, State: 7't Zip:
TenantAxssee Name: Phone#:
Email:
CONTRACTOR:Company Name: Ace _ 4'e. Phone#:
Address: AZ,,0::- J0 V
City: � �6 sb®--r-� State:-- Zip: ?
Qualifier Name: .,e1 :�P_ }:'hone#:
State Certification or Registration#:fX� / C) of Competency#:
Contact Phone#. Email Address:
DESIGNER:Architect/Engineer: Phone#:
Value of Work for this Permit:$���� ` Square/Linear Footage of Work:
Type of Work: OAddition Alteration ONew ORepair/Replace LIDemolition
Description of Work: Zg��.,ti`� ik ,e _ "ML"--Q e� rail`
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Color thru tile: F,w.•rf
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Submittal Fee$ Permit Fee$.24_ CCF$ CO/CC$
Scanning Fee$ Radon Fee$ DBPR$ Bond$
Notary$ Training/Education Fee$_Technology Fee$
Double Fee$ Structural Review$
TOTAL FEE NOW DUE$ •
1 t
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 approved and a reinspection fee will be charged.
Signature �� Signa
Owner or Agent Con actor
The foregoi instrument5'by s ac VAIR fore a this The foregoing instrument wledged before me this
day of I-- '�, 1 day of .20_,by ,
who is rsolnall�y own t e or who ha produced who is personally known to me or who has produced
I'2 ratification and who did take an oath. as identification and who did take an oath.
NOTA LIC: - - NOTARY PUBLIC:
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Sign: yp� Sign:
Print ,�"a`'' xP`` ���2 aty PssQ
Print:
My Commissi I?x, �@sue, c,'30 My Commission Expires:
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APPROVED BY Plans Examiner Zoning
Structural Review Clerk
(Rell&d Orli 01 sed 07/10/07)(Revised 06110/2009)(Revised 3/15/09)
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