PL-11-2061Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
-20`
Inspection Number: INSP- 166373 Permit Number: PL -11 -11 -2061
Scheduled Inspection Date: January 09, 2012
Inspector: Hernandez, Rafael
Owner: MILLER, EDWARD
Job Address: 142 NW 100 Street
Miami Shores, FL 33150-
Project: <NONE>
Contractor: LES FAUNCE INC
Permit Type: Plumbing - Residential
Inspection Type: Final
Work Classification: Addition /Alteration
Phone Number (305)807 -4045
Parcel Number 1131010220340
Phone: (305)606 -1853
Building Department Comments
REMOVE AND REPLACE KITCHEN SINK ABD LAUNDRY
WASHING MACHINE. KITCHEN AND LAUNDRY ROOM.
Passed
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Inspector Comments
January 06, 2012
For Inspections please call: (305)762 -4949
Page 10 of 47
rt:i7C17' Miami Shores Village
s rt 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
BUILDING
PERMIT APPLICATION
FBC 20
Permit Type: PLUMBING
OWNER: Name (Fee Simple Titleholder): 144/ 71, ?e'/ so / 7� Pon#: 36C-707-X06-
Address: 110 /1 6,7L r�
City: ,' 1 5keq State: l'� Zip: J.� � �i
/1
Phone#:
Permit No.
Master Permit No. �C p C -1/ ' //' ,20Jr'
pl H2aoJ
Tenant/Lessee Name:
Email: ezyld oe
JOB ADDRESS:
iN✓e57A,DS,Cdj'�`
/ 2 Ni/ /00 5'74Pee71—
City: Miami Shores County: Miami Dade Zip: 5 3 / J, 1
/
Folio/Parcel #: / 1 31 0/ o a (2 3 VO
Is the Building Historically Designated: Yes NO Flood Zone:
CONTRACTOR: Company Name: P se rQ /vim r e .Tone #: 7 —
Address: ,') . S-1
City: Pa ! /rg- State: P -+ g..
Zip: 3X .04S
Qualifier Name: PC( x--Ea �i. r» c v5 �,,.� of Phone #:
State Certification or Registration #: (' I& /VA % 7 Certificate of Competency #:
Contact Phone# Email Address:
DESIGNER:Are,t�,
J honef :
Value o Work t'otiu!rmit: $ Square/Linear Footage of Work:
Type o}W k:
scr40\
❑Newt 1 I$#T�epair/Replace
.e_ igee l/i4 a y "7D r % 1
❑Demolition
+
: r� s A/e, -71-ie'4 i , �eP %c e l IU f'n,e 04- P
�xa��x• x�xx• �x�x�x: u��x�x��x�xx��x+ �x�x��xa��+ x+ xa��x�x�n�x���+ ���x�x�Fees���ua�a�a�a�x�x��x�m�x�x�xm���xa����xx: �xmx :�x�x:x�a�x�+xx�x��x��x���x�x�x
Submittal Fee $ Permit Fee $
/5--v
Scanning Fee $ Radon Fee $
Notary $ Training/Education Fee $
Double Fee $ Structural Review $
CCF $ CO /CC $
DBPR $ Bond $
Technology Fee $
TOTAL FEE NOW DUE $
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} tIDAVIT: 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 occur. en ) days after the building permit is issued. In the absence of such posted notice, the
inspection will not be approved z d a reinspec ion fee will be charged.
Signature
Owner or Ag t Contractor
The foregoing instrument was acknowled ed b ' The foregoing instrument was acknowledged be ore me 'isAd
day o . �s.. Jl��� . day of .. J ✓� %%�
N1y Public Stall at r� / ' Notary Public State
who i l y g♦r . �'4!r h: s p duced who is rspi�a n9 tagWeriettw Tf as pro.: ced
My Commlu Qfl EE112102
Ep O t and who . ' take an oath.
Signature
Sign:
Print:
My Commission Expires:
IC:
Sign:
Print:
My Commission Expires:
* * * * * * * * * * * * * * * * * * * * * * * * * * *:. ***********************************************:* o ************* ******* **** *** ****
APPROVED BY
)4—"f Plans Examiner Zoning
(Revised 07 /10 /07)(Revised 06 /10 /2009)(Revised 3/15/09)
Structural Review Clerk
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
BUILDING
PERMIT APPLICATION
FBC 20
Permit No. L
Master Permit No. V- CA l r 2-03
OWNER: Name (Fee Simple Titleholder): / t Pk D pP2 / 50% f; D11 4Puh ofn� #: � L
- 87�
e S4b IS Permit Type: PLUMBING
Address: / R G N k- l/ 5 f'Pr f_
City: /If .fin ■ 54o eel State: Zip: 33/C/
Tenant/Lessee Name: Phone #:
Email:
JOB ADDRESS:
City:
Folio/Parcel #:
/VD? /U) /00 5"-7Peet
Miami Shores County:
11 -310] 0.2,2 03 /b
Miami Dade
zip: 33 ( 5G
Is the Building Historically Designated: Yes
CONTRACTOR: Company Name:
NO Flood Zone: Al O
Ps p lx..( cu 6 j-,¢, Phone #: igo "3 f �^ S
Address: 3 S(9 its/ j T
City: ®p9 — Ln d C k State: a Qs-c-
Qualifier Name: i9 S 6-U ? & "'
State Certification or Registration #: C L� ( l 6-4 z S % Certificate of Competency #:
Contact Phone #: Email Address:
DESIGNER: Architect/Engineer: Phone#:
Phone #: 3O 5 7t6 -73 xi
Value of Work for this Permit: $ e2g Square/Linear Footage of Work: 15C
Type of Work: ❑Address DAlteration ❑New ORepair/Replace
Description of Work:
ODemolition
***** ** **************** *+ x***** ********* Fees******+ x********+ x********* **a :**m+x****** **+x***
Submittal Fee $ �• Permit Fee $ /6 O CCF $ CO /CC $
Scanning Fee $ Radon Fee $ DBPR $ Bond $
Notary $ Training/Education Fee $ Technology Fee $
Double Fee $ Structural Review $
TOTAL FEE NOW DUE $
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 w seven (7) days after the building permit is issued. In the absence of such posted notice, the
inspection will not be proved and a recnspection fee will be charged.
Signature
9/
Owner or Xgent
The foregoing instrument was acknow :. g= ∎
!�
day of MP , 20 ._1—, by ir /1
who is personally known to me tvo s produced
this 4
As identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
My Comnn
Contra'.
The foregoing instrument was acknowledged before
day of p/® V , 20 I( , by
who is personally known to me or who as produced L
as identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
My C
***************************************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
APPROVED BY
~ i/ Plans Examiner
Structural Review
(Revised 07 /10 /07)(Revised 06 /10/2009)(Revised 3/15/09)
Zoning
Clerk