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DEMO-10-142Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP - 134444 Scheduled Inspection Date: August 31, 2011 Inspector: Hernandez, Rafael Owner: KOTALIK, KENNY Job Address: 950 NE 100 Street Miami Shores, FL 33138- Project <NONE> Contractor: THE NEW MIAMI SHORES PLUMBING Permit Number: DEMO-1-10-142 Permit Type: Demolition Inspection Type: Final Work Classification: Plumbing Phone Number Parcel Number 1132060340200 Phone: (305)751 -2446 Building Department Comments AS PER CONVERSATION WITH PL CONTRACTOR, OK TO EXTEND THEM 60 DAYS. NB Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments August 30, 2011 For Inspections please call: (305)762 -4949 Page 1 of 34 Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305) 762.4949 BUILDING PERMIT APPLICATION FBC 20 Permit No. MAR 2 ®, 2011 BY: •-• OOOOOOOOOOO BOODODO 1 Master Permit No. Permit Type: PLUMBING L OWNER: Name (Fee Simple Titleholder): V Q nn o _I O� 1 t 14- Phone #: 30S 751-044 Address: \0Q Nw 144 City: M \G r'\% State: 1° ` zip: 3316'8. Tenant/Lessee Name: Phone #: Email: JOB ADDRESS: (1 5 O NE_ loo S� City: Folio/Parcel #: Miami Shores County: Miami Dade 11- 3206 - O 4 - ozoo Is the Building Historically Designated: Yes NO Zip: 33138 Flood Zone: CONTRACTOR: Company Name:T1 -- I".W N1GM■ Store% 1 IU bwi lPhone#: 305.751- 2444 Address: 900 Nu) 144 ' + City: NI\ VD` 111- State: Pt zip: 3 316 8 Qualifier Name: De V11'11 S 1\4e LC.t l \A Phone #: 3 05'751.244 6 State Certification or Registration #: C. FC ©1 q 70G. Certificate of Competency #: Contact Phone #: Email Address: no 6 f 1 1 0 MYJI rl G) A®I, . C CY) DESIGNER: Architect/Engineer: Phone #: Value of Work for this Permit: $ 2,400 Square/Linear Footage of Work: Type of Work: ❑Address ❑Alteration ` I _ New ❑Repair/Replace ❑Demolition Description of Work: Pe new pi v r b t rl c De. ok L "no r' PZ r tv rF di" Dernd- 2-(o-4C *s tlsksFSk*nR*****ffiisgsk ****•O ..i... .. ;•; rFskAysAskskik *****Feesdtsk=kska$tk*ak* ak*sk**** ik* da> a3e>e***-- ** *J:***:%:kx<sh$+$A *** Submittal Fee $ Permit Fee $ CCF $ Scanning Fee $ Radon Fee $ DBPR $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ CO /CC $ Bond $ 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 $2500, the applicant must promise in good faitlz that a copy of the notice of commencement and construction lien law brochure will he delivered to the person whose property is subject to attacIwie n. .11s o. a certified copy of the recorded notice of conunencemeni nut.si he posted at the job site for the first inspection which occurs .seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature Owner or Agent j The foregoing instrument was acknowledged before me this l day _ ,20 /L,by fl y 1-0ti1K. , who is personally known to me or who hak produced As iden ion and who did take an oath. ARY PUBLIC:., APPROVED BY MY COMMISSION # DD753505 EXPIRES March 16, 2012 FloddimotaryseMce.com *F*i<*R*k*e*;c*k* * : r..: a:: k:' ax: gASrk. axxsRAask =RsR=k>k=kA:sk*skaeAYB:h sFA4skskk****** s:( c**** ABSkaF> YasaFa;¢ *> kr..x> k* *aYS$Aa***xk***k*HaRa:kskh:*** The foregoing instrument was ackno day of Mardi , 20 // , by edged before7" e b '5 /` who is personally known to me or who has produced as identification and who did take an oath. PUBLIC: Print: :0 My Co � ;� �`z(ilftlf.sCQMMISSiQN #101531365 EXPIRES March 1620ov s-o Flomallotaryservice corn >9 &0953. _ ..._ _ -. Plans Examiner Structural Review (Revised 07 /l0 /07)(Revised 06 /10/2009)(Revised 3/15/09) Zoning Clerk Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 BUILDING PERMIT APPLICATION FBC 2004 Permit Type: ullen.1 F02. PI-Lx118INCP Permit No. Master Permit No. AMC IEm JAN 2 8 2010 BY. `!= ....... DEi O 10 Owner's Name (Fee Simple Titleholder) V -eevl' ' Z 1 l Phone # 3 OS -`l 51- Z44 G CI Owner's Address "Igo NW 4 4- S-# • City , yarn 1 State Zip 3 3 ( G 'a• Phone # Tenant/Lessee Name E-MAIL: Job Address (where the %Fork is being done) (.1� 0 NE 100 54— hores Village County Miami -Dade Zip �'� 1 3 S. City Miami S FOLIO / PARCEL # �. Is Building Historically designated YES NO__ Contractor's Company Tame' flew IYIIAw i s /toVps r I n falvpne # 3O - 751-2446 Contractor's Address 900 rn1c;IJ j4 � �'� • J City 1\1 1 State Pi Zip ,33 I G S Qualifier Name (DeruilS H' LC( u9 fr( , I an , Phone # State Certificate or Reggistratippn No. a F C 0 (q 205 Certificate of Competency No. E -MAIL: ar)SP)2tui'lrblvtJ ei QQJ. C )r7 , Architect/Engineer's Narpe (if applicable) Phone # ° a Value of Work For this permit $ Square / Linear Footage Of Work: Type of Work: ❑Ad41ition DAlteration :New Describe Work: )1044(0 QS 12r Q \c�S ` . 0 Repair /Replace Demolition * ste * *,e * ***it *** * * ** * * *xx *x * * ** * Fees_ * * * *, , **le*it * * *x * * *xx *# x * *x *w *** xx ubmittai Fee $;• co Notary $ Scanning $L)' JL/ Radon $ Bond $ Permit Fee $ 1 Training /Education Fee $ 0- Structural Review. $ DPBR $'. CCF $ I' CO /CC Technology Fee $ $ Code Enforcement $ Double Fee $ Total Fee Now Due $ 5i-K) See Reverse side -+ 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 taws 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 Owner or Agent The foregoing instrument was acknowledged before me this day of-5‘16 R,h , 20 t(), by )(0 , 9 -S e ., who is personally known to me or who has produced ..- As identification and v(liptilitillitAke an oath. NOTARY PUBLIC: Sign: Print: a, • ;uoss90•� lc'90i n Signatu Contractor The foregoing instrument was acknowledged before me this day of , 2Q /d, by D.20Y1 \S ML1491II►1 who is personally own to me or who has produced a8" as identification -. yd who did take an oath. Y PUBLIC: ilki& Print: S�o .•.aJ is tt •W17 •k. - l� My Commission Expires: �s�9 /� �dx?�,.•�;a My Commissi .n r "' EXPIRES March 16, 2012 es S IU " s ( 3::. 0163 Florlde NoteryService.com * * * * * * * ** **** * ** *, , ,ti* * **, xo�, , ***eita l'�1'IP19� *** , ************************** *** * * * ** *** * * *** * *** * ** * * * *** ** APPLICATION APPROVED BY: (Revised 02/08/06) Plans Examiner Engineer Zoning Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 950 100 Street Miami Shores, FL 33138- Expiration: 08/09/2010 950 100 Street MIAMI SHORES FL 33138 -2513 Contractor(s) Phone Cell Phone THE NEW MIAMI SHORES PLUMBING (305)751 -2446 (786)553 -5424 Valuation: Total Sq Feet: $ 2,400.00 0 Type of Demo: Plumbing Additional Info: DEMOLITION Classification: Residential Fees Due CCF Education Surcharge Permit Fee Scanning Fee Submittal Fee Submittal Reversal Fee Technology Fee Total: Amount $1.80 $0.60 $100.00 $3.00 $50.00 ($50.00) $2.40 $107.80 Invoice # Invoice Total Amt Paid Amt Due DEMO- 1- 10 -3692f $107.80 $107.80 $0.00 Check #: 4936 Building Department Copy For Inspections please call: (305)762 -4949 Available Inspections: Inspection Type: Final March 01, 2010 2