DS-13-2855Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-220710
Scheduled Inspection Date: October 03, 2014
Inspector: Rodriguez, Jorge
Owner: ,
Job Address: 102 NE 106 Street
Project:
Contractor:
Miami Shores, FL 33138-2037
<NONE>
MG EXCELLENCE SERVICE CORPORATION
tsunamg uepanment comments
NEW CONCRETE APPROACH
6" thick, 3000 psi concrete required.
Permit extended, work was pending zoning approval.
Permit Number: DS -12-13-2855
Permit Type: Driveways/Sidewalks/Slabs
Inspection Type: Final
Work Classification: New
Phone Number (786)371-8479
Parcel Number 1121360050080
INSPECTOR COMMENTS False
Phone: (786)247-7067
Inspector Comments
Passed CREATED AS REINSPECTION FOR INSP-204925. Sod must be finished
Failed
Correction ❑
Needed
Re -Inspection a
Fee
No Additional Inspections can be scheduled until
re -inspection fee is paid.
October 02, 2014 For Inspections please call: (305)762-4949 Page 23 of 29
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 No.
PERMIT APPLICATION
Permit Type:
JOB ADDRESS:
City:
Folio/Parcel#:
BUILDING
).?- /J v'7
LJ
Is the Building Historically Designated: Yes
OWNER: Name (Fee Simple
CM—VED
DEC 2 0 2013
FBC 20
Master Permit No.Djr 13 5: 5 -
ROOFING
County: Miami Dade Zip:
Address:%(3'-'% X-) R- s
City: —" AAS[.[s0i If- State:
Tenant/Lessee Name:
Email:
CONTRAC
TOR: Company
o�ir
Address: T"1
City:
Qualifier Name:
NO
Zone:
JAC Zip:
State Certification or ReRegistration #: Certificate of Competency #:
Contact Phone#: S3 r W2 1 � Email Address:
DESIGNER: Architect/Engineer:
Value of Work for this Permit: Q� S uare/Linear Fooj t�ge of Work: ZED
Type of Work: ❑Addition ❑Alteration New ❑Repair/Replace ❑Demolition
Color thru tale:
Submittal Fee $ 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 $_ & q,, 600
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 abuilding 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.
Sia ,re Signature.
Owner or Agent -� Contractor
The foregoing instrument was acknowledged before me this / The fore oing instrument was acknowledged -before me this
day of 20 , by day o ; 20 by
Cwho is personally known tom or who produced ' o is personally known to me r who produced
As identification and who did take an oath. as identification and who did take an oath.
NOTARY PUBLIC: Z" Z-1 NOTARY PUBLIC: l"
W1 "M
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APPROVED BY
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My, Commission Expir . t
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(Revised 5/2/2012)(Revised 3/12/2012) )(Revised 06/10/2009)(Revised 3/15/09)(Revised 7/10/2007)
GENERAL NOTES AND SPECiI=ICATiONS:
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8CLOWES,40 FEMYANG ASMWW FOR AMD IM PMMMS0 OF=NPRGTOL CONTRACTOR 04" PQ7W
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SHALL BE CLEAN 400 DESMS SWWl BE FMMDVW FROM tie WE TIE GWRAGTORSMOLL MAKE WOW TO MANTAN
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DICEM:R 2013
Commission
Revlslons
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A-1
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