PL-11-1475Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP- 163215 Permit Number: PL -8 -11 -1475
Scheduled Inspection Date: September 06, 2011
Inspector: Hernandez, Rafael
Owner: QUACKENBUSH, HUNTER
Job Address: 860 NE 91 Terrace
Miami Shores, FL 33138-
Project: <NONE>
Contractor: AFFORDABLE IRRIGATION, INC
Permit Type: Plumbing - Residential
Inspection Type: Final
Work Classification: Sprinkler System
Phone Number
Parcel Number 1132060050340
Phone: 305 -681 -6322
Building Department Comments
INSTALL SPRINKLER SYSTEM EXISTING WELL FROM
TILE OLD SPRINKLER SYSTEM
Passed
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Inspector Comments
September 02, 2011
For Inspections please call: (305)762 -4949
Page 19 of 36
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Horida 33138
Tell: (305) 795.2204 Fax: (305) 756.8972
BUILDING O Permit No. 0! ICS
PERMIT APPLICATION Master Permit No
FBC20
30%gV11)
t,
Permit Type (circle): Building Roofing
Owner's Name (Fee Simple Titleholder)) Phone #
Owner's Address ,d (,4 y L[y e o c FI CIGe/(i
City 0,0/14-/- State (-7=4. Zip 3 3/3 r 2 /,
Tenant/Lessee Name Phone #
Email
Job Address (where the work is being done) r� 0 e
City Miami Shores Village County Miami -Dade Zip 3 3 /31 3 Z /e
FOLIO /PARCEL# /7^ 32-06 DO(_ 1%0
Is Building Historically Designated YES NO
Contractor's Company Name
Contractor's Address
City :A/rr,
Qualifier Name Ty1jv/%Co
Flood Zone
State
(.
State Certificate or Registration No
Contact Phone
(3rJ 310 '- 5'4'0 / z
Zip 3 3/ �t
Phone # Cc3 ®,J 6 SI- p 3 Z Z
Certificate of Competency No. 9‘,00 0,-2/ 9
E-mail "i � r.4a 6 A' 'e ! tc-Cs ce %lf • We. 7.
Architect/Engineer's Name (if applicable) Phone #
Valnne of Work Foil- tGuas Permiit $
Type of Work°
Deem -Rile WJorl$e
(Addition
PO
(Alteration
Square/ n 1near Footage 011'?' WJ an t:
11 Repair/Replace.
0 Demolition
Submittal Fee $ Permit Fee $ /5D CCF $
Notary $ . Training/Education Fee $ Technology Fee $
Scanning $ . . Radon $ DPBR $ Zoning $
Bond $ Code Enforcement $ Double Fee $
Structural Review. $ Total Fee Now Due $
CO /CC
See Reverse side -te
ooding 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 $2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose properly is subject to attachment. Also, a. certified copy of the recorded d - notice of commencement must be .posted at the job site
for the first inspection which occurs seven.-(7) days after the building Permit is issued. In the absence of'such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
Signature
Signature
Owner or Agent w f Clontiactor
The foregoing instrument was acknowledged before me this g7/4".. The foregoing instrument was acknowledged before me this SPi�
day o uof u$P 20 it, by !� 11 if re A. U/a �-/Ce n etry of led cQ S7' , 20 /f , by 02 - Co F®- °7� f
who is_ugaz 1y known to me or who has produced who is personal known to me or who has produced
As identification and who did take an oath. as identification and who did take an oath.
N` STARY P )(,I€l✓o
Sign:
Print:�ti�Cp �•t
My Commission Expires:
MARCO ROS
MY COMMISSION # DD 706232
EXPIRES: August 19, 2011
• Bonded Thm Notary Pubric Underwriters
APPLICATION APPROVED BY •
(Revised 07/10/07)
NOTAi'zY PUiItLIC:
Sign:
Print:
My,mmission Expires:
NOTARY Ptfl LIC•STATE OF FLORIDA •
ore Toledo
�g C®f>�'ti(6>OD #DD815435
Exigrec AUG. 22, 2012
aye " "` THROATEARIV M(9E8 in
*****>; e**** ******* * ***** ** *** * *****>k****** ? #* *fie * *4:* *;e*****#”***** * **
Plans Examiner
Engineer
Zoning
• Clerk checked
a
la s 2 - ;,i3rr Zo7
f� E C (s 7; n,
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A-7-44 -A) e ' &o .A
CC# 96P000219
Affordable Irrigation, Inc.
198 NW 139 Street
Miami, FL 33168
Tel: (305) 681 -6322
,U z
L
0 till C/c eiv f3 u sji
e6° 4! `ry
Pfrftivit 6 4' °n4I
NOTARY PUBLIC -STATE OF FLORIDA
Jorge Toledo
s;,•<< Commission #DD815435
\,,,, Expires: A JJ . 22, 2012
BO TSRU AMANTI ING CO., INC.