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CC-08-532 (4) Miami Shores a Villag Building Department M� 2 g 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 B Y_ ' " mo®••••--_ Tel:(305)795.2204 Fax:(305)756.8972 INSPECTION'S PHONE NUMBER: (3057 762.4949 FBC 20 BUILDING Permit No.(',(•, 0-8-- PERMIT APPLICATION Master Permit No. Permit Type: BUILDING ROOFING JOB ADDRESS: I Iml r Vy\/ V 1'111 City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: Is the Building Historically Designated:Yes NO Flood Zone: OWNER:Nameee e der : wt � Simple p Titl Address l City: Q A State: 7E Zip: Tenant/Lessee Name: Phone#: Email: CONTRACTOR:Company Name: Phonk.— —t2t(nc��C)3 Address: YBq tee �� S City: -��{,'Y1Ckv State: ' Zip: `��` Qualifier Name: Phone#: State Certification or Registration#: G.0r, ©T D$n t Certificate of Competency#: CV-S Contact Phone#: Email Address: DESIGNER:Architect/Engineer: Phone#: Value of Work for this Permit:$ Square/Linear Footage of Work: Type of Work: DAddition OAlteration ONew ORepair/Replace ODemolition Description of Work: Color thru tile: Submittal Fee$ Permit Fee$ CCF$ CO/CC$ Scanning Fee$ Radon Fee$ 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 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 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 absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature Signature Owner or Agent Contractor The foregoing instrument was acknowledged before me this The forego' ms lent was ackn ledged befor me this day of ,20_,by day of YM1 201',_!w , who is personally known to me or who has produced who is p onally Town to or who b produced As identification and who did take an oath. as identification and who did take an oath. NOTARY PUBLIC: NOTARYUBLIC: Sign: Sign. AAovtA ClAUO 4�� t Flo ida Print: Print: ,• �; "fV tate o r My Commission Expires: + y Ea 1reS EE 12881 0 23. 1 My COmm1SSlOn S'*` . 3 M Comm A Commission# % ,`, Bonded Through National Notary Assn. ;p,,; APPROVED BY �� Plans Examiner Zoning Structural Review Clerk (Revised 5/2/2012)(Revised 3/122012)XRevised 06/10/2009)(Revised 3/15/09)(Revised 7/10/2007) ................... Inspection Worksheet Miami Shores Village 10050 N.E.2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 ICU IN Ir.W. Inspection Date: 04/1§/2008 P rmit Type: Commercial Construction r Inspectc AM Inspection Type: Drywall Screw Owner: CHARTER SCHOOL Work Classification: Alteration Job Address: 113015 Avenue NW Miami Shores Village,FL 33138- Phone Number Parcel Number 112136000060 Project: <NONE> Block: Lot: Contractor: ARENAS CONSTRUCTION Phone: 305-759-4438 uilding Department Comments new partition wall new door Inspector Comments Passed cc 1 A5 -CPO. Failed EJ_ Correction Needed Re-inspection Fee A ($75) No Additional Inspections can be scheduled until I --b re-inspection fee is paid Monday,April 14, 2008 Page 2 of 2 A Inspection Worksheet `ea Miami Shores Village :. „:.. 10050 N.E. 2nd Avenue Miami Shores, FL .� Phone: (305)795-2204 Fax: (305)756-8972 Inspection Date: 04/16/2008 Permit Type: Commercial Construction Inspector: Rodriguez,Jorge Inspection Type: Framing Owner: , CHARTER SCHOOL Work Classification: Alteration Job Address: 11301 5 Avenue NW Miami Shores Village,FL 33138- Phone Number P Parcel Number 112136000060 Project: <NONE> Block: Lot: Contractor: ARENAS CONSTRUCTION Phone: 305-759-4438 Building Department Comments new partition wall new door ®� Inspector Comments Passed —04 41 14, d t Failed Correction Needed Re-Inspection Fee ($75) No Additional Inspections can be scheduled until re-inspection fee is paid . Tuesday,April 15, 2008 Page 2 of 2 Inspection Worksheet Miami Shores Village .�. sxe nsumj ---- 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Date: 04/16/2008 Permit Type: Commercial Construction Inspector: Levrock,.lames Inspection Type: Drywall Screw Owner: , CHARTER SCHOOL Work Classification: Alteration Job Address: 113015 Avenue NW Miami Shores Village,FL 33138- Phone Number Parcel Number 112136000060 Project: <NONE> Block: Lot: Contractor: ARENAS CONSTRUCTION Phone: 305-759-4438 Building Department Comments new partition wall new door Inspector Comments Passed 14-14.. _0 r Failed Correction a Needed Re-Inspection Fee ($75) No Additional Inspections can be scheduled until re-inspection fee is paid . Tuesday,April 15, 2008 Page 2 of 2 > . Y Inspection Worksheet ." Miami Shores Village _ 10050 N.E.2nd Avenue Miami Shores, FL a 16. �y Phone: (305)795-2204 Fax: (305)756-8972 Inspection Date: 04/15�/ 0�08• Permit Type: Commercial Construction Inspector: (JCis�1 �V r Inspection Type: Framing Owner: , CHARTER SCHOOL 2008Work Classification: Alteration Job Address: 113016 Avenue NW Miami Shores Village,FL 331 - Phone Number Parcel Number 112136000060 Project: <NONE> Block: Lot: Contractor: ARENAS CONSTRUCTION Phone: 305-759-4438 Building Department Comments new partition wall new door Inspector Comments Passed cc Failed Correction Needed Re-Inspection Fee ($75) No Additional Inspections can be scheduled until re-inspection fee is paid. Monday,April 14, 2008 Page 1 of 2