RC-15-133 Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-245218 Permit Number: RC-1-15-133
Scheduled Inspection Date: October 08, 2015 Permit Type: Residential Construction
Inspector: Rodriguez,Jorge
Inspection Type: Final
Owner: HART,JORDANA Work Classification: Alteration
Job Address:485 NE 92 Street
Miami Shores FL 33138-3154
'
Phone Number
0 305 577-9977
Parcel Number 1132060140280
Project: <NONE>
Contractor: MGM CONSTRUCTION, CORP Phone: (786)838-6106
Building Department Comments
CONVERSION OF UNPERMITTED ROOM BACK TO TWO Infractio Passed Comments
CAR GARAGE INSPECTOR COMMENTS False
Inspector Comments
Passed
Failed
Correction
Needed
Re-Inspection ❑
Fee
No Additional Inspections can be scheduled until
re-inspection fee is paid.
October 07,2015 For Inspections please call: (305)762-4949 Page 30 of 40
ala ami Shores Village
' g I JUL Ud. ��
Iding Department
5 N. 2nd Avenue, Miami Shores, Florida 33138
OP el: (305)795-2204 Fax:(305)756-8972
INSPECTION LINE PHONE NUMBER:(305)762-4949
FBC 20( H
DING Master Permit No.
PE MIT APPLICATION Sub Permit No.
BUILDING ❑ ELECTRIC ❑ ROOFING �EVISION ❑ EXTENSION ❑RENEWAL
❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS:
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#: Is the Building Historically Designated:Yes NO
Occupancy Type: Load: Construction Type: /v Flood Zone: BFE: FFE:
OWNER: Name(Fee Simple Titleholder). j O r -j 7d -' �1_ Phone#: 6/? 36z"""-
Address:
City: -�-� -�Y 0 (V S State: V Zip: 3 3 1 3
Tenant/Lessee Name: Phone#:
Email: �p /
CONTRACTOR: Company Name: �( (u rw? �� Phone#: 77&_,_
Address: l��4rD .Sc{, 6 Y r i;F e .0'a
City: /` L �-� Stated: tc Zip: 3 .2
Qualifier Name: 14 40� 4!f r- 'Ire" Phone#: 7&6 83 e
State Certification or Registration IS Z 2467 Certificate of Competency#:
DESIGNER:Architect/Engineer: Phone#:
Address: City: State: Zip:
.J
Value of Work for this Permit:$���� �� Square/Linear Footage of Work:
Type of Work: ElAddition ❑ Alteration ElNew /❑ Repair/Replace
P Demolition
Description of Work: 7`�(-0 O �
Specify color of color thru tile:
Submittal Fee$ Permit Fee$ . �� �7 CCF$ G y c0/CC$
Scanning Fee$ 03 Radon Fee$ Z_ �� DBPR$ �4 03 Notary$
Technology Fee$ r �- Training/Education Fee$ 0 Double Fee$
Structural Reviews$ Bond$ c f
TOTAL FEE NOW DUE$ 'T
(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 the absence of such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
Signature Signature
WAINER or AGENT CONTRACTOR
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
69 :7/ day of O 20 /,�_ by 09 day of,t 201 S by
✓J�lJy��
4T o is ne[ onally knonua-ado MLo MQ(ZFl1 0 ,who is personally known to
me or who has produced as me or who has produced
identification and who did take an oath. identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
Sign: Sign:
r
Print: C;rpc IX % Print:
j f „.• .......
Seal: '• •' MY COMMISSION#FF084828 Seal: or*rO Notary Public State of Florida
Sindia Alvarez
EXPIRES January .212018 4
8 My Commission FF 156750
(407)39"153 FloridallotaryService.com N64
of ads Expires 09/0312018
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iz
APPROVED BY Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)