PL-11-1715Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP- 164629 Permit Number: PL -9 -11 -1715
Scheduled Inspection Date: January 11, 2012
Inspector: Hernandez, Rafael
Owner: PUFF, MARTIN
Job Address: 1208 NE 98 Street
Miami Shores, FL 33138-
Project: <NONE>
Contractor: SKYLA PLUMBING INC
Permit Type: Plumbing - Residential
Inspection Type: Final
Work Classification: Addition /Alteration
Phone Number (786)553 -7400
Parcel Number 1132050090360
Phone: (786)260 -2296
Building Department Comments
NEW POWDER ROOM. 2 FIXTURES, LAVATORY, WC
ONLY
Passed
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Inspector Comments
January 10, 2012
For Inspections please call: (305)762 -4949
Page 9 of 37
PERMIT # J I - fl 14
C O 4A Co POI•Efekbh 0..
I (9011
ADDRESS: l 9-06 gn$-
CONTRACTOR:
SUBMITTAL DATE:
NAME:
RESUBMITAL DATES:
PROJECT TYPE:
0(2
ZONING
STRUCTURAL
74///
ELECTRICAL _
FIRE
IMPACT FEE
HRS/DERM
PLUMBING p'-���-,
V/ V(
MECHANICAL
NOC
Q:1 `
BLDG foltt
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
Permit No. 1 I
BUILDING
PERMIT APPLICATION
FBC 20
SEP 2.1 2011
Master Permit No.
15
Permit Type: PLUMBING
OWNER: Name (Fee Simple Titleholder): 0/1)94/177"1/4.1 /a: >f Phone #: —2cC16 533 - ?z' oo
Address: i, A'._ L 0' - '7'
City: i/ /t &2,�e" - /e),�,� State:
, - 1
Zip:
Tenant/Lessee Name: / Phone #:
Email:
JOB ADDRESS:
City:
Folio/Parcel #:
Miami Shores
Miami Dade
Zip: ?7---341
Is the Building Historically Designated: Yes
NO Flood Zone:
CONTRACTOR: Company Name: / %4 P&)M ! V%' ( Alt. Phone #: 9�cq 9-9-3 ` �-3
Address: oZ 0 ?O//' & %� P°
City: /-'70e. Cy U..»O 0 State: Fe- . Zip: 33e).2
Qualifier Name: SA /N u r c, At b�O r1J� 6 Phone #: 3.S-- 9-90 ' r79
State Certification or Registration, #: :C., �•C • i�lo/ 9'O 9-1 Certificate of Competency #:
Contact Phone #:.3 9-9e- 4// 99- Email Address:
DESIGNER: Architect/Engineer: Phone #:
Value of Work for this Permit: $ - t Square/Linear Footage of Work:
Type of Work: ❑Address ❑Alteration UNew ORepair/Replace ❑Demolition
Description of Work: /fi/ b 2(" l L b," ° )` z' z 411
Submittal Fee $ Permit Fee $ 1 v ® CCF $ CO /CC $
Scanning Fee $ Radon Fee $ DBPR $ Bond $
Notary $ Training/Education Fee $ Technology Fee $
Double Fee $ Structural Review $
TOTAL FEE NOW DUE $ 119V
Bonding Company's Name (if applicable)
Bonding Company's Address
City Stag Zip
Mortgage Lender's Name (if appli • le)
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
O . er or Agent
The foregoing instrument was acknowledged before me this/ 2i
day of ! , 20 / t by
NOTARY PUBLIC:
Sign:
Print:
My Commission Expires:
r who has produced
Contractor
The foregoing instrument was acknowledged before me this
day of
by
who is personally known to me or who has produced
identification and who did take an oath. as identification and who did take an oath.
'::�•"r; OHAU
My� # DD 952963
* * EXPiRRES: J#naaq 2014
NOTARY PUBLIC:
Sign:
Print:
NRIQUECHAU
P.4vr aMISSIoNI #DD85 8,9
E . Atm-418,2014
liti/t/auti_ (WV.
My Commission Expires:
* * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** ********************************************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
APPROVED BY
(Revised 07 /10 /07)(Revised 06 /10 /2009)(Revised 3/15/09)
Plans Examiner Zoning
Structural Review Clerk