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PLC-12-1067 (2)Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 nspection Number: INSP-174709 Permit Number: PLC-6-12-1067 Inspection Date: January 16, 2013 Inspector: Hernandez, Rafael Owner: DE LA ROSA, TANYA Job Address: 9713 NE 2 Avenue Miami Shores, FL 33138- Project: <NONE> Contractor: MIAMI DADE ENVIROMENTAL Permit Type: Plumbing - Commercial Inspection Type: Final Work Classification: Septic Phone Number (305)756-6110 Parcel Number 1132060134220 Phone: 786-251-4099 Building Department Comments INSTALL A 1050 GALLONS SEPTIC TANK AND 542 SQFT OF DRAINFILED. 0 Inspector Comments Passed Failed Correction Needed Re -Inspection Fee No Additional Inspections can be scheduled until re -inspection fee is paid. • January 17, 2013 For Inspections please call: (305)762-4949 Page 1 of 1 2 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-175040 Permit Number: PLC-6-12-1142 Scheduled Inspection Date: June 27, 2012 Permit Type: Plumbing - Commercial Inspection Type: Final Owner: DE LA ROSA, TANYA Work Classification: Addition/Alteration Inspector: Hernandez, Rafael Job Address: 9713 NE 2 Avenue Miami Shores, FL 33138- Project: <NONE> Contractor: PRONTO PLUMBING INC Phone Number (305)756-6110 Parcel Number 1132060134220 Phone: (305)978-7755 Building Department Comments INSTALL WATER LINES FROM METER TO BLDG. OFFSET TO ACCOMODATE NEW SEPTIC SYSTEM. NEW WATER MAIN AND BACKFLOW PREVENTER. Passed Failed Correction Needed Re -Inspection Fee No Additional Inspections can be scheduled until re -inspection fee is paid. Inspector Comments 61k)I1( June 26, 2012 For Inspections please call: (305)762-4949 Page 23 of 36 Square/Linear Footage of Work: Miami Shores Village 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 BUILDING PERMIT APPLICATION FBC 20 jar g 7,y0 1 JUN 21 2012 1 j( : Permit No. FC—' ).' t 4-2. Master Permit No. 101 S Z 6 7 D haw( book /t-Qla-wtiO S(441-97 PLC- 1©67 Permit Type: PLUMBING OWNER: Name (Fee Simple Titleholder): 0'1) A,LA 1 5&- , L Lc_ Phone#: Address: Q 1 l l ? 01 L 1 City: jt-11 to "i • 5 h a v State: k Tenant/Lessee Name: S Lt p V c 5 P t v t 5 Email: . Phone#: Zip;j313S JOB ADDRESS: L t S 11 e City: Miami Shores Zkd /tv.E__ County: Miami Dade Zip: ”1 Folio/Parcel#: Is the Building Historically Designated: Yes NO Flood Zone: CONTRACTOR: Company Name: t�' fi b ch(?,/it/ Phone#:3 dS t�9%1 -2Z�� Address: it / 3('T' / City: Qualifier Name: 46.1 Phone#: State Certification or Registration #: e % 53 60 7 r Certificate of Competency #: s Contact Phone#30S''9 7 k - '7 7 zip: DESIGNER: Architect/Engineer: Email Address: Phone#: oel Value of Work for this Permit1614 : $ , L i ' Typeof. Work: ❑Address ❑Alteration ❑New ❑Repair/Replace ❑Demolition ,_Description of Work:. / !'l S r 4 ( ( (A1� `f Y (1 n rs d r .. -0 :6 (1 - 0FP5ET To &oof O D frr6. 14,1L ,, PO L ...'YST6NI, : _ yl,eieJ e 0 , cf0,1 - Submittal Fee $ " C-JLD Permit Fee $ea" CCF $ CO/CC $ Scanning Fee $ Radon Fee $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ DBPR $ Bond $ TOTAL FEE NOW DUE $ '<A bD- lb Bonding Company's Nami(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 accufate and that all work will be done in 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." t 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 conimenceinent must be posted at the job site for the first inspe lion which occur seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection wj1�( note approved and a inspection fee will be charged. Signature �. 1�. ' u Signature Owner or Agent The foregoing instrument was acknowledged before me this The forego] instrument was acknowledged before me this `,—_61^1 Contractor who is personally known to me or who has produced who is personally known to me or who has produced As identification and who did take an oath. NOTAR BLIC: Sign: Print: My Commission Exp ;eNkt, LAURA FA • EY •MY COMMISSION # EE53276 EXPIRES: March 16, 2015 I SOD.) --NOTARY aNotary Diaunt Ana. Co. ****************************** APPROVED BY Plans Examiner as identification and who did take an oath. NOTARY PUBLIC: Sign: • Print:. My Commission Expires:._, dllt,I,/ % (b • %�. si Zoning Structural Review Clerk (Revised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09)