PL-11-805fo
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
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Inspection Number: INSP - 160357 Permit Number: PL -5 -11 -805
Scheduled Inspection Date: August 10, 2011
Inspector: Hernandez, Rafael
Owner: , CK PROPERTY SOLUTIONS, LLC
Job Address: 10618 NE 11 Avenue
Miami Shores, FL 33138-
Project: <NONE>
Contractor: MG PLUMBING & SPRINKLER SERVICE
Permit Type: Plumbing - Residential
Inspection Type: Final
Work Classification: Addition /Alteration
Phone Number
Parcel Number 1122320280630
Phone: (305)525 -9236
Building Department Comments
PLUMBING WORK FOR INTERIOR REMODEL
Passed
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Inspector Comments
CREATED AS REINSPECTION FOR INSP- 159426.
August 09, 2011
For Inspections please call: (305)762 -4949
Page 10 of 29
BUILDING
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 I�
Permit No.
PERMIT APPLICATION
FBC 20
loot 06X911
Permit Type: PLUMBING
OWNER: Name (Fee Simple Titleholder): %t( / t 1U& 4403161 -- Phone #: 03.-1.3N-10972—
Address: 209 ite 9,°5 fr df 7
City: %144%4' SLore it-- State: PC--
Tenant/Lessee Name: AO—
Email: V j t[� KgF6} e:S. c,Wl
Zip: 3 ' / 3r
Phone #:
JOB ADDRESS: /ow /Gf' I(
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel #: 2232- - D2• -8 - 063 0
Is the Building Historically Designated: Yes
NO Flood Zone:
CONTRACTOR: Company Name: 4/('' st3 �.J P2.�M its �%4'L GEPho 3 Q = ,Sze -9 134'
Address: /Z (f /1i G4), 01 -0 3 Sr`
City: 44ria/14 r �/t s State: / =C • Zip: 33/ !o
Qualifier Name: -ham 14 /O/d-A -of/ Phone #: ,�' '�Z� } z3
State Certification or Registration #: e r-e Or4c/ 2 0 Certificate of Competency #:
Contact Phone #: 3 OX-1-:LS-2—S--9 2- 3 a Email Address: f 4- te74 -7.V 6 e ,Y/'/ )
DESIGNER: Architect /Engineer: SW>, re404910103t kip—A% der 7-6-7c73 Phone #: 9.tV- 5"54"070!
Value of Work for this Permit: $ 1,/iz e ° D Square/Linear Footage of Work:
Type of Work: Address ❑Alteration
❑New
Description of Work: R.-1')Z-.4d.2"-r— PLu-i - A.C.?ufa
1 , 7?
Cr3'1tepair/Replace ❑Demolition
4"--w 7 r".1.i 2 arei 77412,0-0,7
•x*** **** ************ :***** ****** * *** ** Fees **** * * ** x****m ************* ***:x ********** **
Submittal Fee $ Permit Fee $ lS6 CCF $ CO /CC $
Scanning Fee $ Radon Fee $ DBPR $ Bond $
Notary $ Training/Education Fee $ Technology Fee $
Double Fee $ Structural Review $
TOTAL FEE NOW DUE $ l (U o KI)
Bonding 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 � // 4'cr1,e
Owner or Agent
The foregoing instrument was acknowledged before me this
day of u, _ , 20 1 , by
who ,i
personally known to m
Signature �� GtJ
Contractor
The foregoing instrument was acknowledged before me this S
day of L t , by
or who has produced who 's personally known to a or who has produced
As identification and who did take an oath. as identification and who did take an oath.
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NOTARY PUBLIC:
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(407)398.01C3 FlorldallotaryServICe.com
APPROVED BY
(Revised 07 /10 /07)(Revised 06 /10 /2009)(Revised 3/15/09)
Plans Examiner Zoning
Structural Review Clerk