FW-11-2265Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP- 173496 Permit Number: FW -12 -11 -2265
Scheduled Inspection Date: May 15, 2012
Inspector: Bruhn, Norman
Owner:
Job Address: 9190 NW 1 Avenue
Miami Shores, FL
Project: <NONE>
Contractor: ESR FLORIDA CONSTRUCTION INC
Permit Type: Fence/Wall
Inspection Type: Final
Work Classification: Wood Fence
Phone Number
Parcel Number 1131010160030
Phone: (305)812 -2716
Building Department Comments
2 AREA OF FENCE ON 2 SIDES OF EXISTING HOUSE
Pass{ .2
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Inspector Comments
CREATED AS REINSPECTION FOR INSP- 167460.
May 14, 2012
For Inspections please call: (305)762 -4949
Page 21 of 22
i
EP
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
FBC 20
Permit Type: BUILDING
ROOFING
� 1VED
DEC 062011
BY:
Permit No. FUJI -9;),(05
Master Permit No. RC .,1
OWNER: Name (Fee Simple Titleholder): 0 Z-1,6
Address: 5100 616-r
City:
if 12 :s
State:
Phone #: 305 6' ,l 35 f
Zip: 53/ 113
Phone#:
JOB ADDRESS: ��'� 4k w
City: Miami Shores County:
ii
Folio/Parcel #:
Miami Dade
5/01-0/17 —15o 50
Zip: 53
Is the Building Historically Designated: Yes NO
Flood Zone:
CONTRACTORR ompany F/P 0/19 -' akr5r �;P�� Pho4.7 4 Y6 X W74
00 t )(' //5aL72
Zip: 5 i3
Address:
City:
Qualifier Name:
o-11,42760 teCZeS Phone#: .5 J 037.9-V.74
State Certification or Registration #: oo Certificate of Competency #: -r-et) (.1% Z
Contact Phone#:
Email Address:
DESIGNER: Architect/Engineer: A®(�:fzo
Value of Work for this Permit: $ /41146 .
Type of Work: ❑Addition ❑Alteration
Description of Work: e*
Phone (2 I6
Square/Linear Footage of Work: -70 -Ye
❑New ❑Repair/Replace
❑Demolition
*****+x ********* x• x***+ x***m **+ x+ x**+ x********* F/ ees* .,x,"r`�++xwx:**** *a��x�x ******
Submittal Fee "_ � �_��!I Permit Fee $ /C .QCF $ . CO /CC $
Scanning Fee $ Radon Fee $ _ DBPR $ Bond $
Notary $ Training/Education Fee $ Technology Fee $
Double Fee $ Structural Review $
I
TOTAL FEE NOW DUE $
Bonding Company's Name (if applicable)
Bonding Company's Address
City State Zip
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 CONDmONERS, 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
wner or Agent
The foregoing ins " ment was acknowledged before me this ,,,:e447 The foregoing instrument was acknowledged before me this PO
day of f '61 I , by , day of .2O ,i20 .11_, by A1Pi(1Yhd A- (6n�,e/ / #'
who is personally known to me or who has produced who is personally o �Q me or who has _produced
As identification and who did take an oath.
NOTAR PUBLIC:
My Commission Expires: tit arc*"
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�k�k�kN�+�HiskN��k *�k*** " lull�R** A•'* iF11s'a ikik
P "s MY COMMISSION # PE076226
APPROVED BY . '.1 ,r EXPIRES March 21: 2015P1a
(407) 398-0153 MorideNotp.r6c. M e.coi 3
4:d /cd
(Revised 07 /10 /07)(Revised 06 /10/2009)(Revised 3/15/09)
is Examiner
Structural Review
NOTARY
Sign:
Print
tification and who did take an oath.
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My Commission Ex AE:
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Clerk