WS-14-1700 11 (
l �
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-217277 Permit Number: WS-8-14-1700
Scheduled Inspection Date: April 17, 2015 Permit Type: Windows/Shutters
Inspector: Rodriguez,Jorge Inspection Type: Final
Owner: KURLANDSKI, GUY& SELIN Work Classification: Window/Door Replacement
Job Address:9301 N BAYSHORE Drive
Miami Shores, FL Phone Number
Parcel Number 1132050270560
Project: <NONE>
Contractor: M2 DEVELOPMENT GROUP Phone: (954)822-3590
Building Department Comments
REPLACE EXISTING WINDOWS (9)AND DOORS (10) infractio Passed Comments
INSPECTOR COMMENTS False
Inspector Comments
Passed '
Failed
Correction
Needed
Re-Inspection
Fee
No Additional Inspections can be scheduled until
re-inspection fee is paid.
April 16, 2015 For Inspections please call: (305)762-4949 Page 3 of 33
Miami Shores VillageRV`=CT;'TN11T
Building Department �'� X0,4
10050 N.E.2nd Avenue, Miami Shores,Florida 33138 BY:
Tel:(305)795-2204 Fax:(305)756-8972
INSPECTION LINE PHONE NUMBER:(305)762-4949
RC FBC 200
BUILDING Master Permi No. I T (0 8
PERMIT APPLICATION Sub Permit No.( �.)S— 1 �4 I�01)
�UILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
❑PLUMBING ❑ MECHANICAL PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
`1 CONTRACTOR DRAWINGS
L
JOB ADDRESS: 1�" N S T7-�,K: e-.
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#: Is the Building Historically Designated:Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name(Fee Simple Titleholder): J� ���A`IJ�s X + Phone#: p 2-
Address: S(,t�D(u,- ID2
City: State: Zip:
Tenant/Lessee Name: Phone#:
v kaJf)O s) 01 41'`I � O ��I toM
Email:_ d � r� nn
CONTRACTOR:Company Name: ,! (� Z40112 4r M ( �'� 019 Phone#: 95 2 �,
Address: 440 0 Vl j S1 Ti—ity: ��- �O 2-f��� , State: T Zip: 3 S-0 G,
Qualifier Name: W" i N Phone#: 2 3S 1 U
State Certification or Registration#: C-- (4C, 0� 2-2 (:) ) lCerttificate of Competency#:
DESIGNER:Architect/Engineer: �r_ "` Phone#:
Address: City: State: Zip:
Value of Work for this Permit:$ Square/Linear Footage of Work:
Type of Work: ❑ Addition Alteration ❑ New ❑ Repair/Replace ❑ Demolition
Description of Work:
Specify color of color thru tile:
Submittal Fee$ Permit Fee$ 3y 0 CCF$ CO/CC$
Scanning Fee$ Radon Fee$ DBPR$ Notary$
Technology Fee$ Training/Education Fee$ Double Fee$
Structural Reviews$ Bond$
TOTAL FEE NOW DUE$ �� R
(Revised02/24/2014)
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 ELECTRIC, PLUMBING, SIGNS, POOLS,
FURNACES, BOILERS, HEATERS,TANKS,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 he bsence of such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
9L— aL
Signature Signature
NER or AGENT CONTRACTOR
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
day of l7' , 20 by day of 20 by
who
oisis�personally known to C.) 1j:5y6U,,;Q�Di/4! GIe2 vha is personally known to
me or who has produced a7y��,�-7 TD� as me or who has produced 1-2�����S� L/
identification and who did take an oath. identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
Sign ign:
Print: JB /J.9 GJ/1�
p Notary ublic ale ul
aj( 8 Joanna M Feliciano Seal: dopa%, Notary Public State of Florida
' My C®mmiesion FF os2753 Joanna M Feliciano
expire•o1112/2018p` My Commission FF 082753
OF Expires Expires 01/12/2018
G
APPROVED BY Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)