PLC-13-1826 Miami Shores Village
Building Z. ����' 1
Department i; 2
10050 N.E.2nd Avenue,Miami Shores,Florida 33138 AUG 1 2��
Tel: (305)795.2204 Fax:(305)756.8972 LS Y.. 4q
INSPECTION'S PHONE NUMBER:(305)762.4949 0
FBC 20 I
BUILD826
tING Permit No 3
PERMIT APPLICATION Master Permit No02
Permit Type: PLUMBING
JOB ADDRESS:
City: Miami Shores County. Miami Dade Zip: 3313
Folio/Parcel#:
Is the Building Historically Designated:Yes Flood Zone:
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OWNER:Name(Fee Simple Titleholder): ° Phone#: (� —S71 j
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Address: �� T'
City: State:
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR:Company Name: LgQ Ga+. lvz"e Phonem zos_ 51 S7' 710® 3®j
Address: 00 A!A 6 14-5 S1-City:-&&1 AA1/QM/� State: Zip: 3 5 f��
QualifierName: Ly"d �&&-geel Phone#•
State Certification or Registration#: CIY- I�Z ��15� Certificate of Competency#:
Contact Phone#: ? -a�✓��'��l Email Address: lZP9oOi4MI ( Va hwvw C® ;"y
DESIGNER:Architect/Engineer: Phone#:
Value of Work for this Permit:$ 09" — � F
g ork:
Type of Work: ❑Address MAlterations ace ODemolition
Description of Work QA Wl�
Submittal Fee$ ®� Permit Fee$ 3dd. CCF$ CO/CC$
Scanning Fee$ Radon Fee$ DBPR$ Bond$
Notary$ Training/Education Fee$ Technology Fee$
Double Fee$ Structural Review$
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 comp. ince with all
applicable laws regulating construction and zoning.
"WARNING TO OWNER: YO _ r r ' y RECORD A NOTICE OF
COMMENCEMENT MAY RES v _ T k PAYING TWICE FOR
IMPROVEMENTS TO YOUR PR` PER 11, WYOU 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 inspection fee will be charged.
Signatfire �f Signature -4-/ Ila
l C wne or Agent Contractor 7The foregoing instrument was acknowledged before me this��ti-- The foregoing instrument was acknowledged before me/this
day of _,20 ,by jhe reS&• C u CC t oy� day of AW ,20/9 by �CRyi d &,a d L az• ,
who is o 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: NOTARY PUBLIC:
Si Sign:
Print: LAO V Print ���� �-�✓a�c 2`
My Commission Expires: OUR U 4 My Commission Expires:
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APPROVED BY /• /.I Plans Examiner Zoning
Structural Review Clerk
(Revised3/12/2012)(Revised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09)
Inspection Worksheet
Miami Shores Village
10050 N.E.2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-197088 Permit Number: PLC-8-13-1826
Scheduled Inspection Date: March 19,2014 Permit Type: Plumbing - Commercial
Inspector: Diaz,Osvaldo
Inspection Type: Final
Owner: , Work Classification: Addition/Alteration
Job Address:201 NE 95 Street
Miami Shores, FL 33138-0000
Phone Number (305)756-3711
Parcel Number 1132060133920
Project: <NONE>
Contractor: KING'S PLUMBING SERVICE INC Phone: (305)625-5450
Building Department Comments
RENOVATION OF EXISTING BATHROOMS Infractio Passed comments
INSPECTOR COMMENTS False
Inspector Comments
Passed
FailedS
Correction
Needed
Re-Inspection ❑
Fee
No Additional Inspections can be scheduled until
re-inspection fee is paid.
March 18,2014 For Inspections please call: (305)762-4949 Page 9 of 51