RC-13-2664Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP- 207131 Permit Number: RC -11 -13 -2664
Scheduled Inspection Date: February 13, 2014 Permit Type: Residential Construction
Inspector: Rodriguez, Jorge
Inspection Type: Final
Owner: SHIPPEE, HELEN Work Classification: Alteration
Job Address: 1400 NE 104 Street
Miami Shores, FL Phone Number
Parcel Number 1122320320270
Project: <NONE>
Contractor: ANN CREST CONSTRUCTION INC Phone: (305)986 -8981
comments
KITCHEN CABINETS REMODEL
INSPECTOR COMMENTS False
February 13, 2014 For Inspections please call: (305)762 -4949 Page 24 of 26
Inspector Comments
Passed° _
Failed
Correction
Needed ❑
Re- Inspection ❑
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
February 13, 2014 For Inspections please call: (305)762 -4949 Page 24 of 26
Miami Shores Village
AU'* ilding 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
FBC 20
Permit No.
Master Permit No. 13 266 f
ROOFING
JOB ADDRESS: 1 400 N E I D+ --Y+
City: Miami Shores County: Miami Dade Zip: 33-172 8
Folio/Parcel #: I i '�2Z�3Z ~�3Z—' �7 i1D
Is the Building Historically Designated: Yes
OWNER: r Q
Name (Fee Simple Titlehold
Addreccw ! 1 0t� N�5 1 10
Zone:
385 —3 F9-463B
city: W *415} State: P11. z.:33133
Tenant/Lessee Name: Phone #:
Email:
CONTRACTOR: Company Name:
Address: 11 4V S W
city: ly) 0 Y� i
Qualifier Name:
State Certification or Registration #:
Contact Phone #:
DESIGNER: Architect/Engineer:
hur' • Phone #: CQ5 SIB 0991
State: ffj== zip:
W12 Phone #:
014 D-9 Certificate of Competency #:
Email Address:
wom CAA) SCI& Vale, Phone • 5 (0— �1B
Value of Work for this Permit: 'j.5, b `� Square/Linear Footage of Work:
Type of Work: ❑Additio'�nOAlteration ONew
Description of Work:`/
Color thru tile:
OB -�i;47 -!F+_.
ODemolition
Submittal Fee $ V 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 CompamyxNNalne (iWpficable)
Bonding Company's Address
City
State
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
City
State
s
zip
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
Contractor
The foregoing instrument was acknowledged before me this , The foregoing instrument was acknowledged before me this St.
day of , 20 A, by MEL) !Eakl taS day of QCAftL , 20ta, by S(�('rp_ cfto ,
who is personally known to me or who has produced, � who is personally known to me or who has produced
*SJW-!Mb -M-ac 4- As identification and who did take an oath.
NOTARY PUBLIC:
— as identification and who did take an oath.
NOTARY PUBLIC:
I
Sign: tptlY Pue4 IZAGUIME Sign: M. ANDREW PAGUIRRE
Print. W COMMISSION # DD OW75 W COMMIS # DO 995475
* i * Print:
WW My Commission Exp s: '��fl� " " My Commissi pires'�lmllo
APPROVED BY
l 4L- � Plans Examiner
Structural Review
(Revised 5/2/2012)(Revised 3/12/2012) )(Revised 06 /10 /2009 )(Revised 3 /15 /09)(Revised 7/10/2007)
Zoning
Clerk