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PL-11-1281Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 (1.--11,Y(30 Inspection Number: INSP- 162082 Permit Number: PL -7 -11 -1281 Scheduled Inspection Date: January 18, 2012 Inspector: Hernandez, Rafael Owner: RODRIGUEZ, JOHN Job Address: 5 NW 106 Street Miami Shores, FL 33150- Project: <NONE> Permit Type: Plumbing - Residential Inspection Type: Final Work Classification: Pool - Private Phone Number (305)776 -0889 Parcel Number 1121360060240 Contractor: NATIONWIDE POOLS INC Phone: (954)227 -7665 Building Department Comments POOL PIPING Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments January 17, 2012 For Inspections please call: (305)762 -4949 Page 9 of 49 Miami Shores Village Building Department iUL 16 R 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. PLI t — a I Master Permit No. Permit Type: PLUMBING OWNER: Name (Fee Simple Titleholder): 64Ckra, S J - �,�� \O t City:-�1, Ct FP6 State: �. Tenant/Lessee Name: Phone #: Email: Address: Phone #:egla - 4 4 7 - tigt 3, zip: b JOB ADDRESS: `� t�l 0,,.� L (f\ I SA- City: Miami Shores County: Miami Dade Folio/Parcel #: 1, - \ i - ) zip: S 3 15 Is the Building Historically Designated: Yes NO oi' Flood Zone: CONTRACTOR: Company Name: r<.,` 0 i () (' Pd ©b-rif‘ c_ Phone#: 4 S'j _ `'_,i % Address: I. Ct W Li 6 c4- City: PCD tif‘-eCIP 6 -- State: FL- Zip: 33 9 Qualifier Name: � @ i AA 'N, 11.4 _C Phone#: - ,9Q ?— 7 ‘IL State Certification or Registration #:c�C `p C_ 14576 i t Certificate of Competency #: Contact Phone #: Cj _l ` (ld ' 4' ‘ (4 mail Address: DESIGNER: Architect/Engineer: C,i6 e cty 1 t Y ( e vs - .-`"'y Phone #: e 64- ? 12 - ?4 zi Value of Work for this Permit: $ C"))� Type of Work: ❑Address teration Description of Work: � \ 11 Square/Linear Footage of Work: New ❑Repair/Replace ❑Demolition ***** ****+ x***************** ***** **** ***Fees **** *** ** ************* ** * * * ** v*+x****** *** Submittal Fee $5-0 • :,,' Q Permit Fee $ "�CCF $ CO /CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ TOTAL FEE NOW DUE $ 1 8) •671;1- 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 A)H'N'IUAVIT: 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 rei pection fee will be charged. Signature Owner or Agent I Contractor The foregoing instrument was acknowledged before mee this i The foregoing instrument was acknowledged before me this Lc) day of , 20 IL, by k` -�j V� O(« 63\- ci(�T! day of , 20 , by , who is personally known to me or who has produced w ..1.10 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. Sign: Print: My Co ROBIN E HUGLI Notary Public - State of Florida Commission # D0793483 A y Cor mission (Expires Sign: Print: y Commission Expires: IC: ROBikr r "lUGLI PI tate of Florida 00793483 **** **************+x***** ** , ,. * ********************************************** ** * *** ****** ****** *** * * ******** Plans Examiner APPROVED BY Structural Review (Revised 07 /10 /07)(Revised 06 /10/2009)(Revised 3/15/09) Zoning Clerk