RF-13-1587Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP - 195296 Permit Number: RF -7 -13 -1587
Scheduled Inspection Date: July 25, 2013
Inspector: Bruhn, Norman
Owner: SFARA, VERONIQUE
Job Address: 1080 NE 105 Street
Miami Shores, FL 33138-
Project: <NONE>
Contractor: RAINBOW RAIN GUTTERS CO
5unamg Department comments
INSTALL GUTTER AND DOWN SPOUT
Permit Type: Roof
Inspection Type: Final
Work Classification: Gutters
Phone Number (305)799 -2006
Parcel Number 1122320280090
INSPECTOR COMMENTS False
Phone: (305)261 -0440
July 25, 2013 For Inspections please call: (305)762 -4949 Page 15 of 33
Inspector Comments
Passed
Failed
Correction
Needed ❑
Re- Inspection ❑
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
July 25, 2013 For Inspections please call: (305)762 -4949 Page 15 of 33
Miami Shores Village - --
Building Department JUL X013
90050 N.E.2nd Avenue, Nami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
INSPECTION'S PHONE NUMBER: (305) 762.4949 ____ -_
W 20
BUILDING Permit No.
PERMIT APPLICATION Master Permit No._ 1
Permit Type: BUILDING ROOFING
JOB ADDRESS: „ � �j - uols
City. 1Vliami Shores County: hfiami Dade Zip:
FolioMarceW.
Is the Building Historically Designated.: Yes NO Flood Zone:
OWNER: Name (Fee Simple
City: I�
TenanMessee
Email.•
State: EL Zip: J�N 1
CONMCTOR:ConVanyN=e:,,, 0-010boop4i n Phone*. DQV 0��/ q 0
Address:
to 7,'S
city r® f State: l��' Zip: M ?L�
Qualifier Name: d2 I �d2 Phone#: -71
State Certification or Registration #: r- Certificate of Competency #: 0 5 Lo 0 q- 249,
Contact Phone#: Email Address: Z�
DESIGNER: Architect/Engineer. pho .
Value of Work for this Permit: $ 1 6D d' SquareWnear Footage of Work: 1 l t,./
Type of Work: DAddition 1]Alteration ew ORepairMeplace
Dew notion of Work: — _ � ®� / & C ."p P ,7- `1
Color lhru lk:
Submittal Fee $ , _ Permit Fee $ Ou CCF $ CO /CC $
Scanning Fee $ Radon Fee $ DBPR $ Bond $
Notary $ Tn"ng/Education Fee $ Technology Fee $
Double Fee $ Structural Review $
TOTAL FEE NOW DUE $
M
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
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 t ab ce of s posted notice, the
inspection will not be approved and a reinspection fee will be charged.
v
Signature Signature
Owner or Agent
The foregoing instrument was acknowledged before me this
day of V , 20 Q, by V CQ(J J--bl - ,
who i perso y known to r who has produced �
As identification and who did take an oath.
NOTARY PUBLIC: AQ %%u► 11 lilt///,
Sign:
Print:
My C
APPROVED BY
Contractor
The foregoing instrument was acknowledged before me this! -
day of_cUL�t .201. by Le-A-- ie\, C)0 l 1 L•-
who is personally known to me or who linproduced *--- 17-�)
as identification and who did `takeman P it_
�����
NOTARY PUBLI . unrrru�r,,��
\\e��.� 1� 0 7,�
Sign: �f sJ�rvn
Plans Examiner.
Structural Review
(Revised 3/12/2012)(Revised 07 /10ffrXRevisW 06/10=09)(Revised 3/15/09)
Print:
My Commission Expires:
• 9�D�v�ddl0u
Stu
Zoning
Clerk
)L) 1 67 / Dlc;— -5 1—
CITY-STATE-ZIP CODE
HOME PHONE
1.0 GLOSS WHITE 1:1 BROWN
CLAY E] RED
WICKER DARK GREY
EGGSHELL IVORY
.. .. . ........
CUSTOMER'S SIGNATURE
RAINBOW RAIN GUTTERS. CO.
6f4l.101,111
AMOUNT
R��s
I
• . I