DS-13-1643Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP- 195667 Permit Number: DS -7 -13 -1643
Scheduled Inspection Date: July 26, 2013
Inspector: Rodriguez, Jorge
Owner: ,
Job Address: 571 NW 113 Street
Miami Shores, FL 33168-
Project: <NONE>
Permit Type: Driveways /Sidewalks /Slabs
Inspection Type: Final
Work Classification: Addition /Alteration
Phone Number
Parcel Number 1121360211140
Contractor: MG EXCELLENCE SERVICE CORPORATION Phone: (786)247 -7067
aunaing uepartment comments
DRIVEWAY AND APPROACH
INSPECTOR COMMENTS False
July 26, 2013 For Inspections please call: (305)762 -4949 Page 8 of 17
Inspector Comments
Passed
Failed
Correction
Needed ❑
Re- Inspection ❑
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
July 26, 2013 For Inspections please call: (305)762 -4949 Page 8 of 17
( - L
Miami Shores Village
Building Department
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:_ '-?"3 A)Ld l)
FBC 20 P
Permit No. ) �Lt
Master Permit No // O-/ �O C - Zd V0
ROOFING
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel #:
Is the Building Historically Designated: Yes NO Flood Zone:
OWNER: Name (Fee Simple Titleholder):
p )! Phone #: 7�6
Address: 0 (i
qL
City: r�-� State: Zip: f so
Tenant/Lessee Name: Phone #:
Email:
CONTRACTOR: Company Name: ° (a
Address: i " G
City:
Quali
State
Conu
DES]
o - -- • uvuvrr.
Value of Work for this Permit: $ Do, OD Square/Linear Footage of Work: � V
Type of Work: OAddition ❑Alteration ONew ORepair/Replace ❑Demolition
Description of Work: . r J v A-V_ Cf_ ArA
e
Colo" thru d1e:
u
Submittal Fee $ Permit Fee $ CCF $ CO /CC $
Scanning Fee $ Radon Fee $ DBPR $ Bond $
Notary $ Training/Education Fee $ Technology Fee $
Double Fee $ Structural Review $
TOTAL FEE NOW DUE $
01,
Bonding Company's Name (if applicable)
Bonding Company's Address
City
State
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
City
State
Zip
.N*
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 Signature
O g ent C ntractor
The foregoing instrument was acknowledged before me this The foregoing instrum was acknowledged before me this
day of , 200 by K , day of J , 20 , by 1 ,
who is p sona known to me or who has produced who is personally known to me or who has produced
As identification and who did take an oath.
NOTARY PUBLIC:
Sign: h '-`C/ v
Print: WtW
My Commission Expires:
APPROVED BY
V o1 00fida
9010%
ssw
P,g-.ye alo� Aslllll^'yJ
.AJ r,00, 14 1Li1'
Examiner
Structural Review
as identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
M Co mi F,o,w
My NcmrY?V gtatg
gel Psi o Z 198011
Nel on Ef
• MV Cotncn 812018
(Revised 5/2/2012)(Revised 3 /12/2012)(Revised 07/10/07 )(Revised 06 /10/2009)(Revised 3/15/09)
Zoning
Clerk
II7G/1LllI l'7v I%I — a,...,...v .... —.. — — __ _ . —,
DADE COUNTY ,FLORIDA.
RECORD SURVEY F.I.P.
A"
SCALE 1 "= 20'
xsl.�w..a ri
_ 1
ILO ;19,
SO K 6
THERE MAY BE EASEMENTS AND /OR
OTHER INSTRUMENTS AFFECTING THIS
PROPERTY,RECORDED IN THE PUBLICS
RECORDS NOT SHOWN ON THIS
SURVEY.
REFERENCE BENCH MARK:
DADE COUNTY B.M. N -566
ELEV. =10.7W
FLOOD ZONE: X
PP �� 1 ✓`�
01- J� CZI,
O
Q
t
W
xbL§T 6" •� & F.I.P.
05'4' ,�. Pip
,o w 0.45'
0
e
LOT 18,
BLOCK 6
4
V
z
U
1
Q
t-
b
V
0
C)
Z
LOT 17,
BLOCK 6
N
0.30' o 0.50'
r°7 °• U B.O.B. v
133.0' (M &R) y -
o.H
F.D.H. F.I. } N89 °5UlWE 8.0' (M R) ® " 5' SIDEWALK
.
(BJC) 0
I�- 11' PARKWAY
.9 15— 18' ASPHALT
ENT
NW 113th STREET PAVE""
(50' TOTAL R/W)
11.39' 11.50'
THIS SURVEY DOES NOT REFLECT OR DEIERYINE OWNINSW
MM 70 OF THE ABSIW OF TITLE WILL HAVE TO BE MADE TO DEIERMNE RECORDED
INSTRUMENTS, 9 ANY AFFECIINO THE PROEM. THS SURVEY IS SUBJECT TO OEDICATIDNS.
UMIiA710N8, RISiRIC110N5. RM WA7M OR EASEMENTS OF RECORDS. LEGAL. DES VTION
PROM BY MIX. THE UAKITY OF THIS SURVEY LS IN= TO THE COST OF THE SURVEY.
WWORDIM ENCROACHMENTS, IF ANY, ARE NOT SHOWN FIRM HIS NOT ATOM TO
LOCATE FOOTING AND /OR FOWW WO AND /OR UNDERGROUND DII'ROVEIIFNI'S OF ANY NATUREE,
IF SfIDW WAR= ARE REFERRED TO AN ASSUMED M UNDIAM IF SHOWN, ELEVATRIIIS ARE
Rrn' n Tn N.R.V.n. (IF 1929.
DATE OF FIELD WORK 06 -23 -2012
FOR:
REVISED ON
HSL PROPERTY HOLOINGS,LLC
REVISED ON
ARTURO R. TOIRAC P.L.S.M 3102
ORDER NO 12'0606
NOT VALD wMoir IW SWNA IX AND THE ORK;aNAI.
THIS SURVEY IS NOT COVERED BY
RN9E'D SOY, OF j� FLOPo SIRftM AND
PROFESSIONAL LIABILITY INSURANCE
MAPPER, A A l I