PL-09-1715Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
OL-1 -12.1
nspection Number: INSP- 157028 Permit Number: PL -10 -09 -1715
Inspection Date: March 09, 2011
Inspector: Hernandez, Rafael
Owner: PAZ, EMMANUEL
Job Address: 1291 NE 102 Street
Miami Shores, FL 33138-
Project: <NONE>
Contractor: SEROTA PLUMBING CO
Permit Type: Plumbing - Residential
Inspection Type: Final
Work Classification: Addition /Alteration
Phone Number (239)565 -3103
Parcel Number 1132050200050
Phone: (305)672 -7252
Building Department Comments
RE DO PIPING, INSTALL PVC AS PER CODE AND
APPROVED PLANS
Passed
Inspector Comments
CREATED AS REINSPECTION FOR INSP- 127358. pending letter
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled
re- inspection fee is paid.
until
For Inspections please call: (305)762 -4949
March 09, 2011
Page 1 of 1
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7:2 'f(
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
c awrE
,.
OCT 1 9 2009
BY
BUILDING Permit No.P1 EPt - t 1 I S
PERMIT APPLICATION Master Permit No. f(-)
FBC 20
Permit Type: PLUMBING
Owner's Name (Fee Simple Titleholder) aZ, e-eera, t'DCV'CE Phone
Owner's Address
Z3-5$--3 t fl3
City State Zip
Tenant/Lessee Name
Email
Job Address (where the work is being done) act 14e
City Miami Shores Village County Miami -Dade Zip 33 :3 $
FOLIO / PARCEL #
Is Building Historically Designated YES
Phone #
Er
IOZ.
Contractor's Company Name �. P
Contractor's Address gq � �• `�
City INA ,ee; State
Qualifier Name R— IJ V e-4-.7\----0
NO
Flood Zone
Phone# cdS -4o1a -CBS
Zip i 3 G
Phone #
State Certificate or Registration No. C. Ft._ . Z. Li Certificate of Competency No.
Contact Phone '10 (.91 Z
E -mail
Architect /Engineer's Name (if applicable) Phone #
Value of Work For this Permit $ 0 add o o Square / Linear Footage Of Work: 1
Type of Work: ❑Addition E Iteration ❑New ❑ Repair/Replace ❑ Demolition
Describe Work:'C: 0 pS ( l µ C'e (Am ti-e nn(cs l �� ) iotJt`q(a( / C
cC S - CO' cl f est -1,0/ APeC Co u-S
* * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
Submittal Fee $ Permit Fee $
************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
CCF $
Trainin /Education Fee $ o�
.�'
Notary $
Scanning $ 45400 45400 Radon $ �
Double Fee $
DPBR $
Violation date:
CO /CC $
Technology Fee $ t' O
Bond $
Structural Review. $ Total Fee Now Due $_3qQ• 3
See Reverse side -*
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 ) days after the building permit is issued. In the absence of such posted notice, the
inspection be approved and a reins ction fee will be charged.
Signature
Owner or Ag
Signature
Contractor
T foregoing instrument was acknowledged before me this 1 0 The foregoing instrument was acknowledged before me this IQ
day of cCr , 200C(, by day of G , 2001 , by
who is personally known to me or who has produced
As identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
c
My Commission Expires:
* * * * * * * **
APPRO
LAURA FARLEY
MY COMMISSION # DD 646761
EXPIRES: March 16, 2011
rF F * Bonded Thru Budget Notary Services
***A* t********* * * * **
who is personally known to me or who has produced
as identification and who did take an oath.
NOTARY PUBLIC:
Plans examiner
i 1,
(Revised 07 /10 /07)(Revised 06/10/2009)
Engineer
Sign:
Print: L Ge_, v ✓GC. -
oaaaY,Rik I.AUMF
My Commissio x„: es:MyCOMMISSION #DD 646761
* ,1xvy'.
,ilii ; � EXPIRES: March 16, 2011
sr \o
Bonded Thru Budget Notary Serves
At OF F ��
Zoning
Clerk checked