FW-12-1616Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
�2-►3zc6.
Inspection Number: INSP- 177899
Scheduled Inspection Date: September 11, 2012
Inspector: Rodriguez, Jorge
Owner: , BARRY UNIVERSITY
Job Address: 11300 NE 2 Avenue
Miami Shores, FL 33138-
Project: BARRY UNIVERSITY
Contractor: MOSS & ASSOCIATES LLC
Permit Number: FW -8 -12 -1616
Permit Type: Fence/Wall
Inspection Type: Final
Work Classification: Iron/Ornamental
Phone Number
Parcel Number 1121360010160
Phone: (954)410 -3250
Building Department Comments
REPAIR OF EXISTING FENCE GATES
Inspector Comments
Passed
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
September 10, 2012
For Inspections please call: (305)762 -4949
Page 13 of 20
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 1
Permit No. e w 12 44,
Master Permit No. 46 Pk" ! 3
BUILDING
PERMIT APPLICATION
FBC 20 to
Permit Type UILDING ROOFING
OWNER: Name (Fee Simple Titlehglder : �0►e1 IV\s\tvGCsxki Phone#: 306— /( °'
Address: `� �V 1
LI
tl3OO AE r
City: 1� \�ati- 6 is State: FL— Zip: Z31 b 1
Phone#: 605- t99 -3060
Tenant/Lessee Name: ` 'D-Me-
Email: 10 #6.,10,46 1�0��`�•o -cty 4Av.
JOB ADDRESS: t )30O 4 F 2s, (� L
City: Miami Shores County: Miami Dade
Folio/Parcel #: 11 oil 3b B 0000
Is the Building Historically Designated: Yes
Zip: 3311 [
NO
Flood Zone:
CONTRACTOR: Company Name: I" k0`}J k ksso -t"RS i L1-4- Phone#: f)54— "1( t — 41%9
Address: 2101 I1` I�_1,Ac-b) ,5 A-41 E. d JsNvCL 300
City: �i4d -c4I. State: , 1 FL— Zipp: t3�i�,
Qualifier Name: C1^6e1 \ L1 n‘ W LC�C1[.� Phone#: 1 ' . 4 s o�9
State Certification or Registration #: G.� t 50 b IA/ Certificate of Competency #:
Contact Phone#: 4.64 - LP ° 50c4A Email Address: S LS t r40- 0.- r o 55 er 0A ICArd\
DESIGNER: Architect/Engineer: n ICA& 1 — Orr Phone#: 606 —535 — rig Si
Value of Work for this Permit: $ t 1500. e0 Square/Linear Footage of Work:
Type of Work: ❑Addition ❑Alteration ❑New $Repair/Replace ❑Demolition
Description of Work: kir' IN eZIN 6V n 'L
********* * * ** *** *+r**** **** ********* * ***Fe a ********** ********* * * * *****+x***+r******x * **
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 $ �' 0
a
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 the absence of such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
% '�
Signature
Owner or Agent
The for 'ns went was acknowledged before me this
day of , by KA t� 1®l CL.
Signature
The fore oing ins
day ,
Contractor
ent w 20gscknowll!e�ed before me this
a, by X111
who is personally known to me or who has produced who is personally known to me or who has produced
As identification and who did take an oath. as identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
My Commission Ex
* * * * * * * * * * * * * * **
APPROVED BY
a
a
,•,,•r p,,,, MICHELLE A. SAG 3'
Vie; % Notary Pules - State of Ronda
e My Comm. Expires Jul 6, 2014
Commission # DD 972411
" °t° Bonded Through Assn.
'',..�°; �.. h National Notary
NOTARY PUBLIC:
Sign:
Print:
My Commission
x**** acv.*** ** ** ** ******w* * ********
Plans Examiner
Structural Review
(Revised 07 /10107)(Revised 06 /10/2009)(Revised 3/15/09)
•
•4, /,
19
Notary Public • State of Florida
• My Comm. Expires Jul 6, 2014
e Commission # DD 972411
'"*RA ,, r`' Beaded Through Natal Rotary Assn
Zoning
Clerk