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PL-16-3341 Permit NO. PL-12-16-3341 nFs t� Miami Shores Village Permit Type: Plumbing-Residential IT. 10050 N.E.2nd Avenue NE Per I Work Classification:Pool-Private r �- ""'`� Miami Shores, FL 33138-0000 Permit Status:APPROVED moo` Phone: (305)795-2204 •w*ea.w a FLORIDA` Expiration: 07/04/2017 Issue Date: 1!5/2017 Project Address Parcel Number Applicant 1130 NE 91 Terrace 1132050010410 BARBARA TER HORST Miami Shores, FL Block: Lot: Owner Information Address Phone Cell BARBARA TER HORST 1130 NE 91 Terrace (305)432-1775 MIAMI SHORES FL 33138- 1130 NE 91 Street MIAMI SHORES FL 33138- Contractor(s) Phone Cell Phone C � $ 3,800.00 Valuation: NATIONAL POOL DESIGN LLC (305)559-1020 Total Sq Feet: 450 Type of Work:REPLACEMENT OF SKIMNER UNIT PVC LIN Available Inspections: Type of Piping: Inspection Type: Additional Info: REPLACEMENT OF SKIMNER UNIT PVC LIN Main Drain Bond Return : Final Classification: Residential Scanning: 1 Rough Review Plumbing Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $2.40 Invoice# PL-12-16-62316 DBPR Fee $2.25 DCA Fee $225 01/05/2017 Credit Card $ 113.90 $50.00 Education Surcharge $0.80 12/12/2016 Check#: 1073 $50.00 $0.00 Permit Fee $150.00 Scanning Fee $3.00 Technology Fee $3.20 Total: $163.90 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. OWNER AFFIDAVIT: I erti that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating constr n and zoning. uth rmore, I Drize the above-named contractor to do the work stated. January 05, 2017 thorized igna u e:Owner / Applicant / Contractor / Agent Date Building Department Copy January 05, 2017 1 INSPECTION RECORD PLUMBING INSPECTION DATE INSP INSPECTION DATE INSP INSPECTION DATE INSP Foundation Zoning Final Stemwall ZONING COMMENTS Rough Slab Water Service Columns(1st Lift) 2nd Rough Columns(2nd Lift) Top Out Tie Beam Fire Sprinklers Truss/Rafters Septic Tank Roof Sheathing Sewer Hook-up Bucks Roof Drains Windows/Doors ELECTRICAL Gas Interior Framing INSPECTION DATE INSP LP Tank Insulation Temporary Pole Well Ceiling Grid 30 Day Temporary Lawn Sprinklers Drywall Pool Bonding Main Drain Firewall Pool Deck Bonding Pool Piping Wire Lath Pool Wet Niche Backflow Preventor Pool Steel Underground Interceptor Pool Deck Footer Ground Catch Basins Final Pool Slab Condensate Drains Final Fence Wall Rough HRS Final Screen Enclosure Ceiling Rough Driveway Rough PLUMBING COMMENTS Driveway Base Telephone Rough Tin Cap Telephone Final Roof in Progress TV Rough Mop in Progress TV Final Final Roof Cable Rough Shutters Attachment Cable Final Final Shutters Intercom Rough Rails and Guardrails Intercom Final MECHANICAL ADA compliance Alarm Rough INSPECTION DATE INSP Alarm Final Underground Pipe DOCUMENTS Fire Alarm Rough Soil Bearing Cert Fire Alarm Final Rough Soil Treatment Cert Service Work With Floor Elevation Survey Ventilation Rough Reinf Unit Mas Cert ELECTRICAL COMMENTS Hood Rough Insulation Certificate Pressure Test Spot Survey Final Hood Final Survey Final Ventilation Truss Certification Final Pool Heater STRUCTURAL COMMENTS Final Vacuum MECHANICAL COMMENTS INSPECTION DATE INSP Final Sprinkler Final Alarm Miami Shores Village RRCF--JVr . Building Department DEC 12 2016 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 BY: Tel:(305)795-2204 Fax:(305)756-8972 INSPECTION LINE PHONE NUMBER:(305)762-4949 FBC 201 " BUILDING Master Permit No. gPQ k -334o PERMIT APPLICATION Sub Permit No. i L m— to - X41 ❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL [PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP / Q / CONTRACTOR DRAWINGS JOB ADDRESS: 3y All L / 7-eel4- C- City: Miami Shores County: Miami Dade Zip: folio/Parcel#: Is the Building Historically Designated:Yes NO Occupancy Type: 5 1�� Load: Construction Type: ("itnD0 1 Flood Zone: BFE: FIFE: h '~ 3 ;�3Z ©S� -/77Y OWNER:Name(Fee Simple Titleholder): R" /otzf Phone#: Address: /1 .3,0 A/f g Z TE/2 fZ 2 G City: MM M1 cs#on-!J) State: /' L Zip: 331✓O Tenant/Lessee Name: N14 Phone#: Email: jz-l-10p_S r �� � G /�A/ L • c o� CONTRACTOR:Company Name: 4/4 tl onA J 1-90-0 -e1I, LC Phone#: 30S- Address: A -11'X3 City: M/,4,44 f --� State: `�— Zip: 3 �S Qualifier Name: �i LF'2'EI�f� j20b JZ46 UL''Z- Phone#: State Certification or Registration#:,/e Pd 1 41 7,GV j' Certificate of Competency#: V DESIGNER:Architect/Engineer: t e--To Phone#: Address: 13�'3dZ 6 IS-6 .S� City: A4 f-4 l I State: FL Zip: 3�3 77 vv Value of Work for this Permit:$ 8 ©0v' Square/Linear F �SCS Footage of Work: o Type of Work: El Addition [:1 Alteration E-1NewU✓ Repair/Replace ❑ Demolition Description of Work: %gyp�Cc cen-•e.►7� D!f ��rnne✓ Unit- ��L %;Ne � /�r,-�c�►� Specify color of color thru tile: Submittal Fee$ PC.I Permit Fee$ v CCF$ •• �-l� CO/CC$ Scanning Fee$ ego Radon Fee$ 23 DBPR$ 2 , ZS Notary$ Technology Fee$ 3 Training/Education Fee$ © ,80 Double Fee$ Structural Reviews$ Bond$ TOTAL FEE NOW DUE$ (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. Signature Signature g g OWNER or ENT C TRACTO The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this ��— day of Dd 20 G by ��—day of20 16 by G.a( fir` L`e'nvho is personally known to 10 kfingkioo is personally known to me or who has produced 100 as me or who has produced � as identification and who did take an oath. identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Sign: Sign: •ti yPVe��.,� MARIA THERESA PINO "';MP6e��•,, MARIA THERDPINOPrint: :'� �: ewy Print: =? •°=Seal: ' Wi Commission #FF 15368 Seal: � ACommission od:`* My Comm.Expires May 7,2017 o,�FoFMy Comm.Expire APPROVED BY -Zrl �� Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014)