PL-11-1022Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP - 160631
Scheduled Inspection Date: June 17, 2011
Inspector: Hernandez, Rafael
Owner: GONZALEZ, SONSIRE
Job Address: 154 NW 111 Street
Miami Shores, FL 33168 -4323
Project: <NONE>
Contractor: AFFORDABLE IRRIGATION, INC
Permit Number: PL -6 -11 -1022
Permit Type: Plumbing - Residential
Inspection Type: Final
Work Classification: Sprinkler System
Phone Number
Parcel Number 1121360030450
Phone: 305 - 681 -6322
Building Department Comments
INSTALL LAWN SPRINKLER SYSTEMS & WELL
Passed
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Inspector Comments
June 16, 2011
For Inspections please call: (305)762 -4949
Page 9 of 12
Miami Shores Viilage
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33 38
Tel: (305) 795.2204 Fax: (305) 756.8972
BUILDING
PERMIT APPLICATION
FBC 20
Permit Type (circle): Building Roofing
Owner's Name (Fee Simple Titleholder)
Owner's Address / 3'30" /1/-
City At, 9 /21 e State C-- Zip 33
Tenant/Lessee Name Phone
17, 77:1 7
Permit No,
Master Permit No,
Y:............
ON 4 Phone 0 7J" 77/-
Email
Job Address (where the work is' being done)
/1/ ki /7/ St/iee 7.
_,774P
City Miami Shores Village County Miami-Dade Zip 7
FOLIO / PARCEL #
Is Building Historically Designated
YES
NO (ic Flood Zone
Contractor's Company Name o V..40 Phone 6322-
Contractor's Address
City /2(...52,01 7 •
State P 61, " Zip
Qualifier Name C.;9 I Phone # 5 � jj 11/- (I? z-
State Certificate or Registration No. Certificate of Competency No. Az,
•Contact Phtme [30 r rt- 6 3 2, 2— E-mail dJ27 Ci'd 64 &- ge Aro ter
Arehitect/Engineer's Name (if applicable) Phone 0
Value of Work For this Permit ‘,2, 1#6/0
Ty of Wicrk: DAddi ion
111,
eseribe Work:
NAlteration
Square / Line
['New
r Foot ge $
f W prk:
LI Repair/Replace
11 Demolition
Submittal Fee $ Training/Education Fee $
Notary $ . Technology Fee $
Scanning.$ Radon $ • DPBR $ Zoning $
Bond $ Code Enforcement $ Double Fee $
Structural Review. $ total Fee *Now Due $ al*.50
Permit Fee $
. .
5-0
CCF $ . •
CO/CC •
See Reverse side
onding 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
Zone C Gi iat
t or
Contractor
The foregoing instrument was acknowledged before me this 3 " The foregoing instrument was acknowledged before me this 3"
day of , 20 f( , by , day of „5 V h e. , 20 i 1, by M P iz Co to sSet s ,
who is ersonally 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. as identification and who did take an oath.
NS1'AR`Y P i LIC:
Sign:
Print: A,1 CO 7a,1.1 —C
My Commission Expires:
MARCO ROSAS
-__ MY COMMISSION # DD 706232
EXPIRES: August 19, 2011
`^ Bonded Trim Notary Public Underwriters
N I TAAY FIJI: >LIC:
Sign:
Print:
My t►' mission E Tres:
NOTARY PUHLIC.STATE OF FLORIDA
is Jorge Toledo
Commission #DD815435
si, „,,' Expires: AUG. 22, 2012
BONDED TRAP ATLANTIC »ONDLI6 CO3,IIVC
APPLICATION APPROVED ': Y Plans Examiner
• (Revised 07 /10/07)
Engineer
Zoning
Clerk checked
JlU .4 0 3 2011
BY :,
SURJFCTTO COMPLIANCE WITH ALLFEDEM.
STATE AND COUNTY RULES AND REGULATIONS
.7 4
j?Y
/S"y.A).w 574a ,.
1t lei 3 40.E rS
CC# 96P000219
Affordable Irrigation, Inc.
198 NW 139 Street
Miami, FL 33168
Tel: (305) 681 -6322
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NOTARY PUBLIC -STATE OF FLORIDA
e" "4, Jorge Toledo
) Commission #DD815435
• Expires: AU 22, 2012
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