DS-15-3068 Y j
Inspection Worksheet
Miami Shores Village
10050 N.E.2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-249171 PermitNumber: DS-12-15-3068
Scheduled Inspection Date: March 23,2016 Permit Type: Driveways/Sidewalks/Slabs
Inspector Rodriguez,Jorge Inspection Type: Final
Owner: BARBICK, BRIAN Work Classification: New
Job Address:1122 NE 98 Street
Miami Shores,FL 33138- Phone Number
Parcel Number 1132050180370
Project <NONE>
Contractor. CHAMPION CONCRETE Phone: (305)252-8055
Building Department Comments
PAVER OVER CONCRETE DECK Infractio Passed Comments
INSPECTOR COMMENTS False
EXPIRED PERMIT DS 15-1130
Inspector Comments
Passed PERMIT CARD WILL BE 11 THE MAIL BOX
Failed
Correction ❑
Needed
Re-Inspection
Fee
No Additional Inspections can be scheduled until
re-inspection fee is paid.
March 22,2016 For Inspections please call: (305)762-4949 Page 5 of 34
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Miami Shores Village
10050 N.E.2nd Avenue NE s
Miami Shores,FL 33138-0000
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Phone: (305)795-2204
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Expiration: 0 14/2016
Project Address Parcel Number Applicant
1122 NE 98 Street 1132050180370
Miami Shores, FL 33138- Block: Lot: BRIAN BARBICK
Owner information Address Phone Cell
BRIAN BARBICK 1122 NE 98 ST
MIAMI SHORES FL 33138-2508
Contractor(s) Phone Cell Phone
Valuation: $ 4,860.00
CHAMPION CONCRETE (305)252-8055 (786)402-4802
Total Sq Feet: 940
Approved:In Review Available Inspections:
Comments: Inspection Type:
Date Approved::In Review Final
Date Denied: Foundation
Type of Work:PAVER OVER CONCRETE POOL DECK Additional Info: Review Planning
Bond Retum: Classification:Residential Review Building
Scanning:3
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due
Bond Type-Owners Bond $500.00 Invoice# DS-12-15-58020
CCF $3.00 03/18/2016 Check#:3295 $651.00 $0.00
DBPR Fee $2.00
DCA Fee $2.00 Bond#:3021
Education Surcharge $1.00
Notary Fee $5.00
Permit Fee $125.00
Scannin.wfee $9.00
Technofo-dy Fee $4.00
TotalP $651.00
MEN
In considdration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations
pertaining_Etiereto and in strict conformity with the plans,drawings,statements or specifications submitted to the proper authorities of Miami Shores Village. In
accepting'fhis permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are
required f0MLECTRICAL,PLUMBING,MECHANICAL,WINDOWS,DOORS,ROOFING and SWIMMING POOL work.
OWNER _AFFIDAVIT: I certify that all the foregoin information is accurate and that all work will be done in compliance with all applicable laws regulating
constructi ', nd zoning. Futherm I authorize the named contractor to do the work stated.
March 18,2016
Authorized Signature:Owner / Applicant / Contractor / Agent Date
Buildfing Department Copy
March 1-8',2016 1
b� .6�`' Miami Shores Village
Building D 7BY:
15
g epartment
10050 N.E.2nd Avenue,Miami Shores,Florida 33138
Tel:(305)795-2204 Fax:(305)756-8972
INSPECTION LINE PHONE NUMBER:(305)762-4949
FBC 20114
.BUILDING Master Permit No. Ds t S—wros
PER IT APPLICATION Sub Permit No.
,r BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION PAfON EWAL
❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: I Z'2 A !; R
Com: Miami Shores County: Miami Dade Zio:
Folio/Parcel#: Is the Building Historically Designated:Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
w.
OWNER:Name Fee Simple Titleholder): &4e, Phone#:
Address:
City: State: Zip: 7�
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR:Company Name:- ` �%� Phone#:
Address: ® s
City: State: Zip
Qualifier Name: Phone#:
State Certification or Registration#: r Certificate of Competency M Yd1R!WL2;
91
DESIGNER:Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit:$ 1 KQ Square/Linear Footage of Work: CW® 671:,
Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition
Description of Work: ` A65 := & L (�
Specify color of color thru tile:
Submittal Fee$ 6B Permit Fee$ �. �r CCF$ oo CO/CC.$ ®. V
Scanning Fee$ dv Radon Fee DBPR$ 6o Notary$
Technology Fee$ Training/Education Fee$ � Double Fee$ G>
Structural Reviews$ Bond$ szo
TOTAL FEE NOW DUE$ 15�.
(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$2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be d livered to the person
whose property is subject to attachment. Also,a certified copy of the recorded notice of commencement must posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued. in the absence uch posted notice, the
inspection will not be approved and a reinspection fee will be charged.
s
Signature Signature
OWNER or AGENT ONTRACTOR
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
_drk
ay of C ,20,��, by _da of e— 20 .by
i
who is personally known to who is personally know to
me or who has produced ?i�-! � as me or who has produced O-- s
identification and who did take an oath. identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBU
Si n: Sign:
tint Print:
Seal: ,�dN Notary Pubft Stale of Florida Seal:
Joanna AA Feliciano 40gig Publicof Florida '
' FF 082753
my commission
+ � Expires 0 111 2/2 01 8 156750
* * ************************************ *******sa
APPROVED BY �%rpl.ns Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)
NE 98th STREE ' D
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Property A't &cA!I I*NE f$SHIM
Miami Shores FL 33138
( IN FEET ) Folio No.: 1 f 3Zt"1U3V0:•
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