DEMO-11-1755Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP - 164803
Scheduled Inspection Date: October 05, 2011
Inspector: Hernandez, Rafael
Owner: , SHORES SQUARE INVESTMENTS
Job Address: 9025 BISCAYNE Boulevard
Miami Shores, FL 33138 -0000
Project: <NONE>
Contractor: BLUE BAR PLUMBING INC
Permit Number: DEMO -9 -11 -1755
Permit Type: Demolition
Inspection Type: Final
Work Classification: Plumbing
Phone Number
Parcel Number 1132060110051 -25
Building Department Comments
PLUMBING DEMOLITION
Passed
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Inspector Comments
October 04, 2011
For Inspections please call: (305)762 -4949
Page 31 of 49
Miami Shores Village
10050 N.E. 2nd Avenue
Miami Shores, FL 33138-0000
Phone: (305)795 -2204
Project Address
Parcel Number
9025 BISCAYNE Boulevard
Miami Shores, FL 33138 -0000
1132060110051 -25
Block: Lot:
Applicant
SHORES SQUARE INVESTMENT
Owner Information
Address
Phone
Cell
SHORES SQUARE INVESTMENTS
3850 BIRD Road
MIAMI FL 33146-
Contractor(s)
BLUE BAR PLUMBING INC
Phone
CeII Phone
Valuation:
Total Sq Feet:
$ 1,500.00
0
1
Type of Demo: Plumbing
Additional Info:
Classification: Commercial
Scanning: 1
Fees Due
CCF
DBPR Fee
DCA Fee
Education Surcharge
Permit Fee
Scanning Fee
Technology Fee
Work without Permit Fee
Amount
$1.20
$2.00
$2.00
$0.40
$100.00
$3.00
$1.80
$100.00
Total: $210.20
Pay Date Pay Type Amt Paid Amt Due
Invoice # DEMO -9 -11 -42111
09/27/2011 Check #: 1463 $ 210.20 $ 0.00
Available Inspections:
i
Inspection Type:
Final
1
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 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. Futhermore, I authorize the above -named contractor to do the work stated.
Authorized Signature: Owner / Applicant / Contractor / Agent
Building Department Copy
September 27, 2011
Date
September 27, 2011
1
Miami Shores Village
Building Department SP 2 3 2011
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
Permit No.
Master Permit No
Permit Type: PLUMBING
OWNER: Name (Fee Simple Titleholder): 'E)1-\l(266 gt)A l,..)V . Phone #: S05/777.
Address: ..3$�CO'!!tio goko Ae- 3/
City: Afii 1I4t' State: fi_
Tenant/Lessee Name: f f ,y)A)AO 1- 7murA /-1 //..4 Phone #: O 5/266 - 8885
Zip: 3�1
Email:
JOB ADDRESS: q_02 215vQ
City: Miami Shores County: Miami Dade Zip: S
Folio/Parcel #:
Is the Building Historically Designated: Yes NO Flood Zone:
CONTRACTOR: Company Name: 1 CAt-e. tJ �' ( t�^'�- J at"1.— Phone #: � et 86 2;73'
Address: J Le)
City: 4/ .,,. State: e-(-- Zip: --L-3/ de
Qualifier Name: 1)
State Certification or Regist tion #: C. r e.. d S 6 /741 Certificate of Competency #:
Contact Phone #: Email Address:
DESIGNER: Architect/Engineer: Phone #:
Phone #:
Value of Work for this Permit: $ / ,540. O° Square/Linear Footage of Work:
Type of Work: ❑Address ❑Alteration UNew ❑Repair/Replace
Description of Work: a� NJ aS
Demolition
***** * * * * * *** ** * * * * * * * * * * * *** * * * * * ** ** Fees***** * * * * * * * * * * * * * * * *** * *** *** * * * *, * * * * * * * **
Submittal Fee $ Permit Fee $ (� ° CCF $ CO /CC $
Scanning Fee $ Radon Fee $ DBPR $ Bond $
Notary $ Training/Education Fee $
Double Fee $ Structural Review $
Technology Fee $
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. o, a certified copy of the recorded notice of commencement must be posted at the job site
for the first in ection which occurs seven days after the building permit is issued. In the absence of such posted notice, the
inspection will no q approved and a,feinspfct' fee will be charged.
Signature
Owner or Agent
The fore oing instrument was acknowledged before me this Z-3
day of , 20 IL, by-1:4,.} -736
who is personally known to me or who has produced y
As identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
RICARDO E.
My Commission Exp. s: NOTARY PUBLIC
STATE OF FLORIDA
Comm# DD971115
E-� 412914
** * * * * * * **
Contractor
The foregoing instrument was acknowledged before me this Z
day of gc'P , 20 R , by 0 601/4,4.-CA V'e
who is personally known to me or who has produced %-
as identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
My Commi
(022 4 4 ,(14
RICA
ARY PUBLIC
STATE OF FLORIDA
Comm# DD971115
-- -�..,... 3114!2014
APPROVED BY .*"/' Plans Examiner Zoning
Structural Review Clerk
(Revised 07 /10 /07)(Revised 06 /10/2009XRevised 3/15/09)