PL-12-421n
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
1E
Inspection Number: INSP- 170982 Permit Number: PL- 3- 12-421
Scheduled Inspection Date: March 23, 2012
Inspector: Hernandez, Rafael
Owner: MONTERO, CARLOS
Job Address: 1245 NE 92 Street
Miami Shores, FL 33138-
Project: <NONE>
Contractor: CONINMAQ LLC
Permit Type: Plumbing - Residential
Inspection Type: Final
Work Classification: Addition /Alteration
Phone Number (786)282 -4809
Parcel Number 1132050270280
Phone: (786)285 -3073
Building Department Comments
PL WORK FOR KITCHEN REMODEL
Passed
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Inspector Comments
March 22, 2012
For Inspections please call: (305)762 -4949
Page 11 of 15
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 Type: PLUMBING
Permit No,
Master Permit No.
11.---42-1 ,.
K�,IZ 911
Phone#: �C�
OWNER: `Name (Fee Simple Titleholder): \) � \ \
1
Address: , t� �y
City: C°''<\
Tenant/Lessee Name:
Email:
State:
Zip: 3 D
Phone #:
JOB ADDRESS:
City: Miami Shores
Folio/Parcel #:
County:
Miami Dade
Zip:\
Is the Building Historically Designated: Yes
NO Flood Zone:
CONTRACTOR: Company Name: 132471;4 a D
Address: / 1-13 S /
City:
Qualifier Name:
State Certification or Registration eeg�gistration #:
Contact Phone #: 3413 ° ,® 725 Email Address:
DESIGNER: Architect/Engineer: Phone #:
Phone #: 30 ( i‘92
State:
Zip: 351 t
Phone #3O5° 929 " 72e
Certificate of Competency #:
Value of Work for this Permit: $ Square/Linear Footage of Work:
Type of Work: Address DAlteration UNew ❑Repair/Replace ❑Demolition
Description of Work. ,-C' `'CC
` F I
�x�xx:�x�x****�x�x�a+x+x�x*** * �*******x:***a: ******* Fees+ x*+ x******* ************ ***************+x******
Submittal Fee $ Permit Fee $ iee CCF $ CO /CC $
Scanning Fee $ Radon Fee $ DBPR $ Bond $
Notary $ Training/Education Fee $ Technology Fee $
Double Fee $ Structural Review $
TOTAL FEE NOW DUE $ T) O ° (00
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 apprrovied and a reinspection fee will be charged.
Signature (;'���
Owner or Agent
The for - :'oi., ins ment was ac . wl
day of I , 't , 20 IZby
Signature
Contractor
The forego] g ins ment ackno
day o i , 2O ,, by
-- loo is ally known me r who has produced
APPROVED BY
os
iv ,G ?Otte e. State P 23 2015
1 �0
--1/4 P cas Co mtast h Na ionat Notary Assn
.., s; Ihtoo4
5Lg, gon e0
NOTARY
Sign:
Print:
y Commissio
as identification and who did take an oath.
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Structural Review
(Revised 07 /10 /07)(Revised 06 /10/2009)(Revised 3/15/09)
* * * *** ****** ***** ** * * * * *******
Zoning
Clerk