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DS-10-468 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP - 138607 Permit Number: DS -3 -10 -468 Scheduled Inspection Date: May 27, 2010 Permit Type: Driveways /Sidewalks /Slabs Inspector: Bruhn, Norman Inspection Type: Final Owner: HURTAK, DONNA Work Classification: Addition /Alteration Job Address: 533 GRAND CONCOURSE Miami Shores, FL 33138 -2464 Phone Number Parcel Number 113206017135 Project: <NONE> Contractor: DOWER CONSTRUCTION INC Phone: (305)986 -4999 Building Department Comments Inspector Comments Passed r Failed Correction Needed Re- Inspection ❑ Fee No Additional Inspections can be scheduled until re- inspection fee is paid. May 26, 2010 For Inspections please call: (305)762 -4949 Page 5 of 15 `oA Miami Shores Village 10050 N.E. 2nd Avenue, Miami Shores, FL 33138 -0000 Phone: (305)795 - 2204' Expiration: 10102/201 Project Address Parcel Number Applicant 533 GRAND CONCOURSE 1132060171350 DONNA HURTAK Miami Shores, FL 33138 -2464 Block: Lot: Owner In formation _ Address Phone Cell SAN DONNA HURTAK w._ 533 GRAND CONCOURSE .�.��..._.u�.__..�..,._.....�� MIAMI SHORES FL 33138 -2464 Contractor(s) Phone Cell Phone Valuation: $ 6,500.00 DOWER CONSTRUCTION INC (305)986 -4999 (305)986 -4999 Total Sq Feet: 0 Approved: Yes Available Inspections: Comments: Inspection Type: Date Approved: 3/24/2010: Yes Final Date Denied: Sidewalk Type of Work: ENLARGE RAISED PATIO DECK IN REAR Additional Info: BUILDING Landscaping Bond Return : Classification: Residential Foundation Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $4.20 Education Surcharge $1.40 Invoice # DS - - - 37357 Permit Fee $195.00 03/22/2010 Check #: 1832 $ 50.00 $ 159.20 Scanning Fee $3.00 04/05/2010 Check #: 184b $ 159.20 $ 0.00 Technology Fee $5.60 Total: $209.20 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. April 05, 2010 Authorized Signature: Owner / Applicant / Contractor / Agent Date Building Department Copy April 05, 2010 1 NOTICE OF COMMENCEMENT' Illlll1111111111111111111111 {If11111111111111 A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF FIRST INSPECTION C- t= N 2 01 1 R 0 2 2 y 6 6 5 OR BI; 27237 F's 46227 (IP9) PERMIT NO. TAX FOLIO NO. REGORGED 04/05/2010 09:05:35 HARVEY RU4'INY CLERK OF COURT MIAMI -DACE COUNTYr FLORIDA STATE OF FLORIDA: LAST PAGE COUNTY OF MIAMI -DADE: THE UNDERSIGNED hereby gives notice that improvements will be made to certain teal :t property, and in accordance with Chapter 713, Florida Statutes, the following information c� is provided in this Notice of Commencement. t :`�,.v CJ f3ri ""• ^., J' a.aw� ��dp 44J.� '��.F � #� 7 Lr v 1 � "U ,: pace above reserved for use of recording office 1. Legal description of property and street/address: c6wce)Ltae� RPM (51 2. Description of Improvement 11/�w 3. Owner(s) name and address: G I Interest in property: Name and address of fee simple titleholder: 4. Contractor's name, a �� ss an phone bri 5. Surety: (Payment bond required by owner from contractor, if any) Name, address and phone number: Amount of bond $ __V 6. Lender's name and address: 7. Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as provided by Section 713.13(1)(a)7., Florida Statu Name, address and phone number: 8. In addition to himself, Owners designates the following person(s) to receive a copy of the Lienor's Notice as provided in Section 713.13(1)(b), Florida Statutes. ^� Name, address and phone number: AIAI 9. Expiration date of this Notice of Commencement: (the expiration date is 1 year from the date of recording unless a different date is specified) WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713, PART I, SECTION 713.13. FLORIDA STATUTES, AND CAN RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENC ING WORK ENC OR RECORDING YOUR NOTICE OF COMMENCEMENT. Signature(s) of Own (s) or S}w er s)' A 0orized Officer /Director /Partner /Manager Prepared By (� - - - - Prepared By Print Name DlU N L Print Name Title /Office Cjfi'�- _ Title /Office STATE OF FLORIDA COUNTY OF MIAMI -DADE The fore oing instrument as a le ged before me this day of �_ By �i didually,❑ as for Personally known, or ❑ produced the following type of identification: Signature of Notary Public: Print Name: (SEAL) EXPIRES August 21, 2013 VERIFICATION PURSUANT TO SECTION 92.525 FLORIDA STATUTES ti 3O8.Od53 . - .- ... .,,,. �Ior+daNOta ryServlce.com Under penalties of perjury, I declare that I have read the foregoing and that the facts stated in it are true, to the best of my knowledge and belief. Signa r s) of Owne (s or w er(s)'s Authorized Officer /Director /Partner /Manager who signed above: By By 123.01 -52 PAGE 3 11/07 I Miami Shores Village T1 rM 7T? T Buildin g Department artment 2 2 201 10050 NE.2nd Avenue, Miami Shores, Florida 33138 $Y; ................ Tel: (305) 795.2204 Fax: (305) 756.8972 Q }� ' BUILDING Permit No. MA PERMIT APPLICATION Master Pe rmit No .010 FBC 2004 �!' •�•""t�•`0 Permit Type (circle): 4 =uildin1toofing Owner's Name (Fee Simple Titleholder) Z)6V# � `'► Phone # V �E �v "F Owner's Address Cry � / � Uililua Q City t State _ l' `"' Zip Tenant/Lessee Name Phone Job Address (where the work is being done) City Miami Shores Village County Miami -Dade Zip FOLIO / PARCEL # Is Building Historically Designated YES Contractor's Company Name l✓W'X'' 6 A 16* tZZCV 0 A' ''Phone lt /V - GI�F • L � Contractor's Address q 1 0 0 PC City —Gl State Zip L Qualifier Name / Phone # State Certificate or Registration No. G f 2 C 7 1 Certificate of Competency No. Architect/Engineer's Name (if applicable) Phone # Value of Work For this Permit $ 1; / v p Square / Linear Footage Of Work: Type of Work: ElAddition ❑AlteraCio j [-]New r Repair/Replace El Demolition 1 Describe Work: �� �ev ! " I �" / 6, ��L -4G Submittal Fee $ SO •6D Permit Fee $ CCF$ COMU Notary $ Training/Education Fee $ Z . `� Technology Fee $ 5. Scanning $ . 0 0 Radon $ DPBR $ Zoning $ Bond $ Code Enforcement $ _ Double Fee $ Structural Review. $ Total Fee Now Due $ �I • ` Z- 0 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,-TANKS1and AIR CONDITIONERS, ETC..... h 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 ins which occurs seven (7) days after the building permit is issued In the absence of such posted notice, the inspection wi not be proved and a rei p coon fee will be charged Signature' Signature t Owner or Agent Contractor' The foregoing instrument was ackpowledged bet re me this The foregoing instrument was acknowledged before me this Y day of , 20 J , by � � ' , day of j 20M) by , o is personally known to or who has produced who ' personally ktt wn me or who has produced As ' ' r w�ie- cticLtakelQ th. as identification and who did take an oath. NOTARY PUBLIC• DAN MIS IO P. # DD917 NOTARY PUBLIC: '`' ;'c AAY COMM {SSWN # 00917231 EXPIRES August 21, 2013 007) 388 -0753 FlorJdgryp}a >-4 Sign: Sign: Print: My Commission Expires: , ?/�. f My Commission F tpirep.'' ..... > APPLICATION APPROVED BY: / �C� Js �' �fi�",.•' �Plns Examiner Engineer • .2 d Zoning (Revised 07 /10/07) Planning and Zoning Criteria R4 Miami Shores Village DS- 3- 10-'68 g Permit NO 10050 N. E. 2nd Avenue y g ro �- Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Fax: (305)756 -8972 F taRtDp' Issue Date: Not Issued [� t Issued Expires: Folio Number :1132060171350 Owner's Name: DONNA HURTAK Owner's Phone: Job Address: 533 GRAND CONCOURSE Total Square Feet: 0 Miami Shores, FL 33138 -2464 Total Job Valuation: $ 6,500.00 Contractor(s) _ Pho Prim C o n t r acto r DOWER CONSTRUCTION INC (305)986 -4999 Yes Planning and Zoning Criteria and Comments Approved: Yes Date Approved: 3/24/2010: Yes Comments: