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PL-15-2162 -4 x.'12 yKos y,� Miami Shores Village P61mtt Plultlbttt Iiantlal ` 10050 N.E.2nd Avenue NE 7w SSS Pool PlIYat ' Miami Shores,FL 33138-0000 " �— � h..'Pofmit`S"*APPROVED Phone: (305)795-2204 �LORLp� r Expiration: 04/06/2016 Project Address Parcel Number Applicant 358 NE 101 Street 1132060135280 PATRICE AND SCOTT SMITH Miami Shores, FL 33138- Block: Lot: Owner Information Address Phone Cell PATRICE AND SCOTT SMITH 358 101 Street MIAMI SHORES FL 33138- 358 101 Street MIAMI SHORES FL 33138- Contractor(s) Phone Cell Phone Valuation: $ 2,000.00 ROSMEL POOL INC (305)592-7900 h Total Sq Feet: 0 Type of Work:POOL PIPING Available Inspections: Type of Piping: Inspection Type: Additional Info: Main Drain Bond Return: Final Classification:Residential Scanning:3 Rough Review Plumbing Review Plumbing Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $1.20 Invoice# PL-8-15-56836 DBPR Fee $3.38 08/24/2015 Credit Card $50.00 $193.96 DCA Fee $3.38 Education Surcharge $0.40 10/09/2015 Check*13082 $ 193.96 $0.00 Permit Fee $225.00 Scanning Fee $9.00 Technology Fee $1.60 Total: $243.96 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 Aff IDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction n zonin ermore,I authorize the above-named contractor to do the work stated. L October 09,2015 Authorized Signature:Owner / Appl t / Contractor / Agent Date Building Department Copy October 09,2015 1 Inspection Worksheet 1 Miami Shores Village &PIS-2-1 9 10050 N.E.2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 inspection Number: INS P-242111 Permit Number: PL-8-15-2162 Inspection Date: August 22, 2016 Permit Type: Plumbing - Residential Inspector: Hernandez, Rafael Inspection Type: Final Owner: SMITH, PATRICE AND SCOTT Work Classification: Pool- Private Job Address:358 NE 101 Street Miami Shores, FL 33138- Phone Number Parcel Number 1132060135280 Project <NONE> Contractor: ROSMEL POOL INC Phone: (305)592-7900 Bullding Department Comments POOL PIPING Infractio Passed Comments INSPECTOR COMMENTS False Inspector Comments Passed Failed Correction Needed Re-Inspection D Fee No Additional Inspections can be scheduled until re-inspection fee is paid Miami Shores Village ,~- ----- -� Building Department AUG 24 2015 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 _— Tel:(305)795-2204 Fax:(305)756-8972 INSPECTION LINE PHONE NUMBER:(305)762-4949 FBC 20L� BUILDING Master Permit No. (?Jpp— 1S-- PERMIT _PERMIT APPLICATION Sub Permit No. PL I S7 - 216Z [--]BUILDING ❑ ELECTRIC ❑ ROOFING REVISION ❑ EXTENSION ❑RENEWAL PLUMBING ❑ MECHANICAL E]PUBLIC WORKS [] CHANGE OF ❑CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: OJS$ NX 1 O i ST. City: Miami Shores County: Miami Dade Z113: 331345 Folio/Parcel#: 1 ► • 3Sz o o . 015 -SZ80 Is the Building Historically Designated:Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER:Name(Fee Simple Titleholder): sc a++ Sno ii-im Phone#: Address: 'b5 8 wi; . t O 1 ST_ City: 5iWe4s State: F L Zip: 55%BS Tenant/Lessee Name: k3 1 A. Phone#: Email: CONTRACTOR:Company Name: (1n�a,•.e 1 l��is Ir-sc. Phone#: 2yo5-'Sala.-'1900 Address: OLI5 IW&Aj NO 5f - S 4 0- City: City: L:�)0'-.%1 State: FL Zip: 33.1 (aG Qualifier Name: — Phone#: State Certification or Registration#: 0--Pc-I+-45(o$Oy Certificate of Competency#: DESIGNER:Architect/Engineer: IA,2 v;o. +tcN-Ylr�%n d e-2, q-1 ,'ll(,0Dhone#: 2925-505 •5-1 L4 Address: 1 34441 54a) 2,Q 7R!CjC_ City: "'.innnl State: 47L Zip: 1'1S Value of Work for this Permit:$ O Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition Description of Work: ?.0 01 ET 1 tNc-- Specify color of color thru tile: Submittal Fee$ Permit Fee$ 2-L5L �y CCF$ CO/CC$ 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) •P Bonding Company's Address w) A City State Zip Mortgage Lender's Name(if applicable) 1 P• Mortgage Lender's Address 1 Q� 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$2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property Is subject to attachment. Also,a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Si natur Lg= —X- Signature g T OWNER or AGENT CONTRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this .?iD day of 3 QIU 20 t S ,by C) day of J c-) 20 ►h by iAL who g jpwho is ersonally known me or who has produced as me or who has produced as identification and who did take an oath. identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Sign: Sign: 464 CV wnll� Print: Ma��oS ��Z Print: M4•��oS MG✓i—�ne7., Seal: Y;., Seal: �P MARCOS A MARTINEZ MARCOS A MARTINEZ .= MY COMMISSION#FF 008989 *; *= MY COMMISSION#FF 008989 =*' EXPIRES:Ma 15 EXPIRES:May 15,2017 %; •.,,.ap r y 2017 '„$f,ky r• Bonded Thru Notary Public Underwr ters tended Thru Netary Public Underwriters k k4W*k a9 kdk k .ki�k.k�k.b�k�k�B�YM�k�w----**w* �k APPROVED BY �' r S Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014)