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PL-12-326 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-179185 Permit Number: PL-2-12-326 Scheduled Inspection Date: October 25, 2012 Permit Type: Plumbing - Residential Inspector: Hernandez, Rafael Inspection Type: Rough Owner: SPINNEY,JAMES&JANICE Work Classification: Addition/Alteration Job Address: 770 NE 91 Street 1 Miami Shores, FL 33138- Phone Number (904)262-7736 Parcel Number 1132060380010 Project: <NONE> Contractor: CASTELLON PLUMBING CORP Phone: 305-553-1490 Building Department Comments PLUMBING WORK FOR KITCHEN& BATHROOM Infractio Passed Comments REMODEL INSPECTOR COMMENTS False Inspector Comments Passed CREATED AS REINSPECTION FOR INSP-178858. Failed Correction ❑ Needed Re-Inspection ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is paid. October 24, 2012 For Inspections please call: (305)762-4949 Page 3 of 13 Miami Shores Village F B 2 7 "'2 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 BUILDING Permit No. PER PLICATION Master Permit No.9J 12-- F1 C Permit Type: PLUMBING OWNER:Name(Fee Simple Tititleho�r):A S r hl'�.� Phone#: 3D-5-40 Address:,/� �7� �� 11� City: /�KtK l 5 haa-s State: FL Zip: 33 13ab Tenant/Lessee Name: Phone#: Email: `) 5f I A 3/(o (AO, 6002 JOB ADDRESS: -7 20 /Jt-7 City: Miami Shores County: Miami Dade Zip:33)-3 k Folio/Parcel#: Is the Building Historically Designated: Yes NO Flood Zone: CONTRACTOR: Company Name: Phone#: - �s Address: q9 L ,g City: State: Zip: Qualifier Name: Phone#: (/,//rX- 2 State Certification or Registration#: �' �— Df�/'S Certificate of Competency#:� Contact Phone#: (_3DS .3�� ? ?Email Address: Z2 DESIGNER: Architect/Engineer: Phone#: ©O Value of Work for this Permit:$�� s�� Square/Linear Footage of Work: 5 O Type.of Work: ❑Address ❑Alteration ❑New )Repair/Replace ❑Demolition Description of Work: V-t l'C2:E�a 1 S Submittal Fee$ 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$ 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 Signature Owner or Agent ' Contractor The for1eoing instrument was acknowledged before me this 13 The foregoing instrument was acknowledged before me this day of ` elkwe, ,20 1 dayof r 20,Z?—,by e<t X who its personally nowp to me or who has produced / o is personally known to me or who has produced A id ratification and who d d take an oath. �1�yj, as identification and who did take an oath. °`P....-Z% BEATRIZA BURGOS NOTA BLI NOTARY PUBLIC: , MY COMMISSIONAEE052014 EXPIRES:April 7,2015 9TF) P°e Bonded Th 9 ary Services Sign: Print: 6,11*Ell 91 14BPrint. My Commission Notary Public,State Florida My Commission Expires: °`,,"R �� BEATRIZA.BURGOS CommisslonO EE 107495 * MY COMMISSION t EE 052014 My comm.expires June 2A,2016 s EXPIRES:April 7,2015 1191,0E Fl°�\oe BWed T1w Budget Notary Services kkk%k*kkkkkkkkk�kkkkKkkkk.k.kkkkk kkk%k%kkkkkkkkkkkkkkkkkkkkkk:kkkkk**.kkkkkkkkkffi#k% kkkkkkk.kkkkkkkkkkkkkk&kkkk%kk*k APPROVED BY �' ' Plans Examiner Zoning Structural Review Clerk (Revised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09)