DEMO-10-1616 1
Inspection Worksheet
Miami Shores Village
10050 N.E.2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-151070 Permit Number: DEMO-9-10-1616
Scheduled Inspection Date:January 18,2011 Permit Type: Demolition
Inspector: Bruhn, Norman
Inspection Type: Final
Owner: BUTLER,JACQUELINE Work Classification: Building
Job Address:1461 NE 102 Street
Miami Shores, FL 33138-2621 Phone Number
Parcel Number 1132050240140
Project: <NONE>
Contractor: IMBURGIA CONSTRUCTION SERVICES, INC. Phone: 3051525-5707
Building Department Comments
SELECTIVE DEMOLITION OF EXISTING STRUCTURE
on hold due to bounce check, contractor kows about it.
11/09/10
Inspector Comments
Passed`iy�
Failed
Correction
Needed
Re-Inspection ❑
Fee
No Additional Inspections can be scheduled until
re-inspection fee is paid.
January 14,2011 For Inspections please call: (305)762-4949 Page 6 of 29
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BANK OF AMERICA, N.A. Page 001 of 001 H
EAST RETURN ITEMS Bank : 00075
Center :
Divider: 1,137
Code 3 B
A
Deposit Account:
Charge Account
Store/Reference:00000000000000
M4AMI SHORES VILLAGE
#DEPOSITORY ACCOUNT
10050 NE 2ND AVE tea• •
MIAMI SHORES FL 33138-2304
US r
Date of Notice: 11-4 =2010
Dear Valued Customer:
The item(s) below, which were deposited to your account, have been returned unpaid.
Therefore, we have charged them to your account. Fees for analyzed accounts are itemized
on the account analysis statement.
If you have any questions or need additional information, please contact one of our
Customer Service Representatives at 1-800-432-1000. Thank you ifor choosing Bank of
America.
Number of Returned Items: 1
Amount of Returned Item(s) : 825.30
SEQUENCE/ ABA NUMBER/ MAKER NAME/ RETURN REASON/ AMOUNT
DEP DATE DEP AMOUNT CHECK DATE Additional Data
Insufficient Funds 825.30
10/29/2010 2,409.63
4
NSF
This is a LEGAL COPY of your _
check.You can use it the same '• --- �_
what'ru would use the original
k I
A CONSTRUCTION SERVICES INC
6021 NE.CUA WE 7EHMCE
UM R 99138 5iri5980
RETURN REASON-A
NOT SUFFICIENT
FUNDS er $ gam an
1Q1 1- P 01ja S 1100
'C40=104Loko
+
- -
119003t,83112 41:066009 i S S1: 00 L ? 28 ?90611' .16nnnnnA ?; in.,6
Miami Shores Village
10050 N.E.2nd Avenue NES
Miami Shores,FL 33138-0000 F t {
n� +t
Phone: (305)795-2204
Expiration: 04/2312011
Project Address Parcel Number Applicant
1461 NE 102 Street 1132050240140
iaia l Shores, FL 33138-2621 Block: Lot: JACO ELINE BUTLER
�J
Owner information Address Phone Cell
JACQUELINE BUTLER 1461 NE 102 Street
MIAMI SHORES FL 33138-2621
Contractor(s) Phone Cell Phone Valuation: $ 12,000.00
IMBURGIA CONSTRUCTION SERVICE 305/525-5707 Total Sq Feet: 0
Type of Demo:Building Available Inspections:
Additional Info:demolition Inspection Type:
Classification:Residential Final
Scanning:4
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due
CCF $7.20 Invoice# DEMO-9-10-38881
DBPR Fee $5.40,. ,10/26/2010 Check#:3483 $402.00 $0.00
DCA Fee $5.
Education Surcharge $
Permit Fee $360.00
Scanning Fee $12.00
Technology Fee $9.60
Total: $402.00
In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations
pertaining thereto and in strict conformity with the plans,drawings,statements or specifications submitted to the proper authorities of Miami Shores Village. In
accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are
required for ELECTRICAL,PLUMBING,MECHANICAL,WINDOWS,DOORS,ROOFING and SWIMMING POOL work.
OWNERS 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. Futhermore,I authorize the above-named contractor to do the work stated.
October 26,2010
Authorized Signature:Owner / Applicant / Contractor / Agent Date
Building Department Copy
October 26,2010 1