RC-16-1005 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-260260 Permit Number: RC-4-16-1005
Scheduled Inspection Date:July 05,2016 Permit Type: Residential Construction
Inspector: Mesa, Michel
Inspection Type: Final Building
Owner: WILSON,WARREN Work Classification: Alteration
Job Address:9942 NE 4 Avenue Road
Miami Shores,FL Phone Number
Project: <NONE> Parcel Number 1132060171220
Contractor: ARENAS CONSTRUCTION Phone: (305)300-3103
Building Department Comments
CONVERT 1 1/2 BATH INTO 1 BATHROOM ADD 1 NEW Tact oPassed Comments
BATHROOM IN EXISTING BEDROOM. INSPECTOR COMMENTS False
Inspector Comments
Passed CREATED AS REINSPECTION FOR INSP-259701. 6-2-16
MASTER BATHROOM NOT AS PER PLANS, REVISION REQUIRED.
Failed
Correction D
Needed
Re-Inspection ❑
Fee
No Additional Inspections can be scheduled until
re-inspection fee is paid
f�
July 01,2016 For Inspections please call:(306)762-4949 Page 9 of 20
Miami Shores Village
Building Department artment "K
�
10050 N.E.2nd Avenue,Miami Shores,Florida 33138 JUN 2 4 2016
ax: )756-8972 BY.
VjZjEC7j7E t:(305)762-4949 -
FBC 20
BUILDING Master Permit No. K C I lam— I t�
PERMIT APPLICATION Sub Permit No.
[dUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
❑PLUMBING ❑ MECHANICAL []PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS:
City: Miami Shores Countv: Miami Dade Zip:
Folio/Parcel#: Is the Building Historically Designated:Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE:
OWNER: Name(Fee Simple Titleholder): 4eter o h Donn a. 6J( ()-ovx Phone#:(3 Or� '75 d4'
Address:_/►�� y Z /V& /9tt?ol in4 �o a
City: re s State: L // Zip: 33( 3
Tenant/Lessee Name: Own.urr A.rLI�-� �n� onn a. Phone#: C 3 r) 7)—k
Email: GU�w � � ro., 1n7 � � o\ r�.a�� • C �
CONTRACTOR:Company Name: t�1�S G��1S�1�5�C1�1�.� �n�C� phone#_'2 Z-00 -3ko'�N
Address: 2'�0 cAcj, cz t
City: Nom' Slc�'3QF� State: 'moi___ Zip:< -b\E j
Qualifier Name: JL^�Z.�k- �. � � Phone#:
State Certification or Registration#: Certificate of Competency#:
DESIGNER:Architect/Engineer: 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:: (Z-eCarJ r,y-- 6'; o f�n o V aj %'d v1 r C o,hj 2�e el i c X o\ O ts
+E2< tr n1`ee��t�h
Specify color of /qr thru tile:
Submittal Fee$ Permit Fee$ CCF$ CO/CC$
Scanning Fee$ 9, Radon Fee$ DBPR$ Notary$
Technology Fee$ Training/Education Fee$ Double Fee$
Structural Reviews$ Bond$
TOTAL FEE NOW DUE$ T y a
(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. }
1
Signature l/V �'' �• v '�" Signature
OWNER or AGENT CONTRACTOR
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
day of_ �- ,20 �by G� day of 20 �� , by
V ` VQ L--5��who is personally known to 7WR:� is personally known to
me or who has produced as me or who has produced`--K)V4 -U Q. W'�'Las
identification and who did take an oath. identification and who did take an oath.
NOTARY PUBLIC: yl NOTARY UBLIC:
� e �
Sign: _ Sign:
Print: ® S Print:
Seal: '✓i/ �����•• ve.`�.r' Q`.`� Seal: °
hotaryPuNicStateofFlorida
N11111111 _ Sinciia Alvarez
AAy Commission FF 156780
APPROVED BY L" Plans Examiner Zoning
.Structural Review Clerk
(Revised02/24/2014)
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