FW-13-2445Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP- 203756
Scheduled Inspection Date: December 02, 2013
Inspector: Rodriguez, Jorge
Owner: GROPPER, ADAM
Job Address: 9901 NE 13 Avenue
Miami Shores, FL
Project: <NONE>
Contractor:
DOMINION BUILDERS LLC
t3unamg uepanment comments
REPLACE GATES
Permit Number: FW -10 -13 -2445
Permit Type: Fence/Wall
Inspection Type: Final
Work Classification: Wood Fence
Phone Number
Parcel Number
INSPECTOR COMMENTS False
1132050090480
Phone: (305)661 -2700
Inspector Comments
Passed ,7fy�� CREATED AS REINSPECTION FOR INSP - 202080. South gate does not
a e properly
Failed
Correction ❑
Needed
Re- Inspection ❑
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
November 27, 2013 For Inspections please call: (305)762 -4949 Page 12 of 24
Miami Shores Village
Building Department
11 I
10050 N.E.2nd Avenue Miami Shores Florida 33138
°1� Tel: (305) 795.2204 Fax: (305) 756.8972
A , INSPECTION'S PHONE NUMBER: (305) 762.4949
BUILDING
PERMIT APPLICATION
Permit No.
FBC 20 10
Master Permit No. 13 — c ?Li'4 5
Permit Type: BUILDING FE^K E..
JOB ADDRESS: a cr o t AJ F_ i--.s & y e—
City: Miami Shores County: Miami Dade Zip: ' l no
Folio/Parcel #• `� • _ R a ®S - Q - 0 416
Is the Building Historically Designated: Yes NO te-11, Flood Zone:
OWNER: Name (Fee Simple Titleholder): APaNL :�, Phone #:
Address: Q 9 ® ! Al r--" / ;k' A- �
City: M / Asp"! ! S tj7oe ec State: Zip: 33 t 3
Tenant/Lessee Name: Phone #:
Email:
DESIGNER: Architect/Engineer: Phone#:
Value of Work for this Permit: $ -'�0 ®-o Square/Linear Footage of Work:
Type.of. Work: OAddition UAlteration ONew ORepair/keplace ODemolition
Description of Work: X �LACL 6 r S
Color thru tile:
Submittal Fee $ SO . CDO Permit Fee $
Scanning Fee $ Radon Fee $
Notary $ Training/Education Fee $
Double Fee $ Structural Review $
CCF $ CO /CC $
DBPR $ Bond $
Technology Fee $
TOTAL FEE NOW DUE $
Bonding Company's Name (if applicable)
Bonding Company's Address
City
State
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
City
State
* y s
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, FURNAMISM TERS, 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 b a ov and a reinspection fee will be charged.
Signature Signature
O er or Agent Contractor
The for in instrument was acknow edged before me this The fore ing instrument was acknowled ed before me thial
day of 120 a by ,ls, day of 20 ,/, by
who is personally known to me or who has produced who is personally owns ntwh has produced
As identification and who did take an oath. as identification and who did take an oath.
NOTARY PUBLI s '4kt+ KARI A GROPPER NOT
=• MY COMMISSION # EE032278
�•,, may, EXPIRES October 05, 2014
Sign: 1M.Com Sign:,
Commission Expires:
APPROVED BY
Plans Examiner
Structural Review
(Revised 3 /12/2012)(Revised 07 /10 /07)(Revised 06 /10/2009)(Revised 3/15/09)
A 1 A GROPPER
MY COMMISSION # ES032278
RES October 05, 2014
My Comr>Iission Expires:
Clerk
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