DEMO-13-2754Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-204428 Permit Number: DEMO -12-13-2754
Inspection Date: December 16, 2013
Inspector: Rodriguez, Jorge
Owner: EVERETT, HENRY AND FRANCES
Job Address: 9636 NE 2 Avanup
Miami Shores, FL 33138 -
Project: <NONE>
Permit Type: Demolition
Inspection Type: Final
Work Classification: Building
Phone Number (727)461-4370
Parcel Number 1132060132500
Contractor: ARCO CONSTRUCTION Phone: 305-892-6507
Building Department Comments
DEMO PERMIT FOR THE WALL
Infractio Passed Comments
INSPECTOR COMMENTS False
Passed
Inspector Comments
CREATED AS REINSPECTION FOR INSP-204161. REAR PARKING LOT
BEHIND CHASE BANK
Need complete permit
Failed
El
Correction
Needed
Re -Inspection ❑
Fee
No Additional Inspections can
be scheduled until
re -inspection fee is paid.
For Inspections please call: (305)762-4949
December 16, 2013 Page 1 of 1
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:
JOB ADDRESS:
WELDING
9
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FBC 20 IL
Permit No.
Master Permit NoUK, 011
ROOFING
La- IkIn :vok 9 i-1®
City: Miami Shores County: Miami Dade Zip:
Folio/Parcelt
Is the Building Historically Designated: Yes NO Flood Zone:
OWNER: Name (Fee Simple Titleholder):Er&0ee ,a EV�4,fI� Phone#:
Address: %C
City: State: Zip: 3 C
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR: Company Name: ,0 && —Phone#:
Address: /U'��/ ClI�J,
city:State: / ziP:
Qualifier Name: -,4j
State Certification or
Contact Phone#: Email Address:
Certificate of Competency #:
D 13WITRAM R ¢/ AAS
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of`�V'6h.-AU(1mbh,:t F: n ONew '1 1 6&o on
Description of Work: ge
Lj_ A9
Submittal Fee $ Permit Fee $
Scanning Fee $
Radon Fee $
CCF $ CO/Cc $
DBPR $ Bond $
Notary $ Training/Education Fee $ Technology Fee $
Double Fee $ Structural Review $
TOTAL FEE NOW DUE $
LACE'
FBC 20 IL
Permit No.
Master Permit NoUK, 011
ROOFING
La- IkIn :vok 9 i-1®
City: Miami Shores County: Miami Dade Zip:
Folio/Parcelt
Is the Building Historically Designated: Yes NO Flood Zone:
OWNER: Name (Fee Simple Titleholder):Er&0ee ,a EV�4,fI� Phone#:
Address: %C
City: State: Zip: 3 C
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR: Company Name: ,0 && —Phone#:
Address: /U'��/ ClI�J,
city:State: / ziP:
Qualifier Name: -,4j
State Certification or
Contact Phone#: Email Address:
Certificate of Competency #:
D 13WITRAM R ¢/ AAS
;. tVi AV q M A 0A i �h.." yQ��SIi 9C'��'f4 smi?
r9 :13 , o �gt.ry eisE4 Yy,'I}:i9p i .S•Quare/L l�.pfifu.�
Val Pu afQ�,,u a �.�. U�iTP.
of`�V'6h.-AU(1mbh,:t F: n ONew '1 1 6&o on
Description of Work: ge
Lj_ A9
Submittal Fee $ Permit Fee $
Scanning Fee $
Radon Fee $
CCF $ CO/Cc $
DBPR $ Bond $
Notary $ Training/Education Fee $ Technology Fee $
Double Fee $ Structural Review $
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
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 as reinspection fee will be charged
Sig n�� Signature
Owner or Agent
The foregoing instrument was acknowledged before me this 13
day ofa &�1 by maces m
or who has produced
ANA U. R. !WlMU
="108%
e .
at
dmh.E 13.2011
Sign: ter- --
Print:
My Commission Expires:
APPROVED BY
take an oath.
�Conttor
The fo oing instrument �as.ac)�iowledged before me this
day of ao;au, 20 l,�, by
who is personally known to me or whias produced
J. L;cutis- as identification and who did take an oath.
�v 1 "I � _ Plans Examiner
Structural Review
(Revised 3/12/2012)(Revised 07/10/07)(Revised 06/1On009)(Revised 3/15/09)
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