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DEMO-15-2215 )C-9 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax:(305)756-8972 Inspection Number: INSP-242555 Permit Number: DEMO-8-15-2215 Scheduled Inspection Date: October 20,2015 Permit Type: Demolition Inspector: Diaz,Osvaldo Inspection.Type: Final Owner: WOLLOWICK,JOSH Work Classification: Plumbing Job Address:1255 NE 99 Street Miami Shores, FL 33138-2642 Phone Number (305)531-0970 Parcel Number 1132050090100 Project: <NONE> Contractor: SKYLA PLUMBING INC Phone: (954)773-5323 Building Department Comments PLUMBING DEMOLITION infractio Passed Comments INSPECTOR COMMENTS False Inspector Comments Passed s Failed Correction Needed Re-Inspection ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is paid. October 19,2015 For Inspections please call: (305)762-4949 Page 18 of 42 permit vo. QM , Miami Shores Village ` #type. ��iCl�Ei)itlt ' 10050 N.E.2nd Avenue NEt `v k assi adon Plumbing Miami Shores,FL 33138-0000 Permit Status,APPt�CI`11®�3., Phone: (305)795-2204 t u mor$;12/2015 Expiration: 02/29/201 Project Address Parcel Number Applicant 1255 NE 99 Street 1132050090100 JOSH WOLLOWICK Miami Shores, FL 33138-2642 Block: Lot: Owner Information Address Phone Cell JOSH WOLLOWICK 1255 NE 99 Street (305)531-0970 FL 33142- 1255 NE 99 Street FL 33142- Contractor(s) Phone Cell Phone I $ 500.00 Valuation: SKYLA PLUMBING INC (954)773-5323 Total Sq Feet: 0 Type of Demo:Plumbing Available Inspections: Additional Info:PLUMBING DEMOLITION Inspection Type: Classification:Residential Final Scanning: 1 Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $0.60 Invoice# DEMO-8-15-56898 DBPR Fee $2.00 08/28/2015 Credit Card $50.00 $58.60 DCA Fee $2.00 Education Surcharge $0.20 09/02/2015 Credit Card $58.60 $0.00 Permit Fee $100.00 Scanning Fee $3.00 Technology Fee $0.80 Total: $108.60 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 a loyes. I understand that separate permits are required for ELECTRICAL,PLUMBING,MECHANICAL,WINDOWS,DOORS,ROOFING and SWIMMING OL work. OWNERS AFFIDAVIT: I certify that all the foregoing information is accurate an th all wo will bedo n compliance with all applicable laws regulating construction and zoning. Futhermore,I authorize the above-namedtractor a work t t 2, 2015 Authorized Signature:Owner / Applicant / Contractor / e t ate Building Department Copy September 02,2015 1 Miami Shores Village . -k7 711 J Building Department 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 20 BUILDING Master Permit No. VSm0,6- o202 PERMIT APPLICATION Sub Permit No.T7CMl) I----2,ZI ❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL 010"LUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP nn CONTRACTOR DRAWINGS JOB ADDRESS: I o�55 /V E '?9 City: Miami Shores County: Miami Dade zip: Folio/Parcel#: Is the Building Historically Designated:Yes NO Occupancy Type: Load: ' Construction Type: Flood Zone: BFE: FFE: OWNER:Name(Fee Simple Titleholder)j(1S f4 ow G/� Phone#: 3QK-- s3 y©� Address: %J�� /�/F i�.��v!-P�o�2F �°nufL� . S L)i -rg City: Z. State: �(_, zip: 33/ 3 8 Tenant/Lessee Name: Phone#: '30S"- S3 O Email: )ew Q1o.<df L.,_gz co wa e- COJ\,\ CONTRACTOR:Company Name: Phone#: �L 7 -52 3`53,13 Address: �1�iW►�Oin:!:) ! i ve , Co VII-) City: State: Zip: 3-30,4'e;> t® Qualifier Name: .MCAQ,0&f AnCt% Phone#: 7?0 2502- State Certification or Registration#: Certificate of Competency#: DESIGNER:Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit:$ So o� o o Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace 2eDemolition Description of Work: et"'kb L n rl h ' to n..s :-:�°s*Ax.si yyFFmeeeep�p�{��■p d �� .�Qaz : kllrfe�ll�ItilFaelfl6i Ooil! .. a til l4iR'': 'A duq Vl"4111 4\ ; Specify co,14,44f�Gu Submittal Fee$ �, .a. 4rii Pettnit Feed$ /e'�� "� CCF$ CO/CC$ -" y' Scanning Fee$ Radon Fee$ DBPR$ Notary$ Technology Fee$ Training/Education Fee$ 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 Cir yam' '�e �n ` 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$2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also,a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature Signatore OWNER o AG T CONTRACTOR The foregoing instrument was acknowledged before me this The foregoing instru nt was acknowledged before me this day of /��$,�� 20 by ' a of t Le, 20 l S , by 6rW I TJ /-��=uvVf)E- ,who is personally knower 4c�i' � 1tG� who is personally known to me or who has produced as Wgor who has produced as identification and who did take an oath. identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Sign: �i�� Sign: Print: �� l3 ce�c�� a�I Print: <tl 1522) Seal: „��,, Seal: �.•� y SAM ROORIQUEZ Y p`B(% CARMEN DE BERNARDI ^��l l -Bli c. Florida Notary Public-State of Florida ft*IFF 204400 o Q My Comm.Expires Mar 1,2018 : MY COM. dun 22,2019 o; APPROVED BY 3 l 1 Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014)