DS-12-878J
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972 RC _ 1 -539
Inspection Number. INSP- 173666 Permit Number. DS- 5- 12-878
Scheduled Inspection Date: May 31, 2012 Permit Type: Driveways/Sidewalks/Slabs
Inspector. Bruhn, Norman
Owner: FORBES, JOHN
Job Address: 304 NE 99 Street
Miami Shores, FL
Project: <NONE>
Inspection Type. Final
Work Classification: Addition /Alteration
Phone Number (305)757 -7750
Parcel Number 1132060135600
Contractor: TCS CONTRACTING CORP Phone: (305)756 -8700
Building Department Comments
INSTALL NEW DRIVEWAY AT REAR OF HOUSE
Inspector Comments
PaSSed &Z
Failed
Correction ❑
Needed
Re- inspection ❑
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
May 30, 2012 For Inspections please call: (305)762 -4949 Page 15 of 26
Miami Shores Village
Building Department MAY 16 20 2
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972 - - _ - -
INSPECTION'S PHONE NUMBER: (305) 762.4949
ZI FBC 20
BUILD G Permit No.
PERMIT APPLICATION Master Permit No. n-G 1
Permit Type: BUILDING ROOFING
JOB ADDRESS: o S�C 9
City: Miami Shores County: Miami Dade Zip:
Foho/Parcel #:
Is the Building Historically Designated: Yes._
OWNER: Name (Fee Simple Titleholder):
Address: 3 C L I U F- S I
NO
4, U [ , f� C 6
Zone:
City: 0-) �IV r do State: �t-- Zip: 3
Tenant/Lessee Name: Phone #:
Email:
CONTRACTOR:
Address:
Name: ` �'i��' � �� "`'' �� Phone #:
N r— 101
?0 716 o
City: MS %ct4 ` State: Zip: 3 3((42,
Qualifier Name: Y10 V/ x Phone #: 3 o 9-qy i-i o d
State Certification or Registration #: (- (T",- l) 0 V ► ; '
Contact Phone #: ��a� Email Address:
DESIGNER: Architect/Engineer:
I
Certificate of Competency #:
4ijc
Value of Work for this Permit: $ �� �b SS uare/Linear Footage of Work:
Type of Work: DAddition DAlteration °'ONew A ORepair/Replace
Description of Work:
X00
Submittal Fee $ Permit Fee $ coo CCF $ CO /CC $
Scanning Fee $ Radon Fee $ DBPR $ Bond $
Notary $ Training/Education Fee $
Double Fee $ Structural Review $
Technology Fee $
ODemolition
TOTAL FEE NOW DUE $ 11 °
Bonding Company's Name (if applicable) I c
Bonding Company's Address
City State
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
City
State
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 bsenc f such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
Signature A k Signature
Owner or Agent Contractor
The foregoing instrument was acknowledged before me this
dayof )1 20)? by L0HN
who is p onally �own or who has produced
As identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print: = �.`NZW
M.A�
My Commission Expires:
The fore omg instrument was acknowledged before me this
day of A �j' , 20 E, by T m o -h- iy Sm l'7 i
who is personally known to me or who has produced R— L
APPROVED BY '"�.�Plans Examiner
Structural Review
as identification and who did take an oath.
NOTARY PUBLIC:
Sign: a • 3' s
Print:
My Commission Expires:
.940t1901E0.
(Revised 5/2/2012XRevised 3 /1212012XRevised 07 /10 /07XRevised 06 /10/2009XRevised 3/15/09)
Clerk
Miami Shores Village
10050 N.E. 2nd Avenue
t +► +r+�
Miami Shores, FL 33138 -0000
Phone: (305)795 -2204 Fax: (305)758-8972
Folio Number) 132060135600
Owner's Name: JOHN FORBES Owner's Phone: (305)757 -7750
Job Address: 304 99 Street Total Square Feet: 900
Miami Shores, FL Total Job Valuation: $ 2,600.00
Contractor(s) Phone Primary Contractor
TCS CONTRACTING CORP (305)756 -8700 Yes
Planning and Zoning Criteria and Comments
Approved: Yes Date Approved: 5/22/2012: Yes
Comments:
TC
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