PL-09-443Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP - 109165
Permit Number: PL -3 -09 -443
Scheduled Inspection Date: March 02, 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
REMOVED KITCKEN AND BATHROOM FIXTURES
Passed
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Inspector Comments
March 01, 2011
For Inspections please call: (305)762 -4949
Page 2 of 44
Miami Shores Village
Building Departr nt
10050 N.E.2nd Avenue, Mianii Shores, Florida 33 138
Tel: ( 305) 795.2 204 F 2x; 005) 756.8972
BUILDING
PERMIT APPLICATIO
FBC 20
4-
(
Permit No. l Vn t .-
aster Permit No.
Permit Type: PLUMBING
Owner's Name (Fee Simple Titleholder) 4---14/1
Owner's Address
City State Zip
Tenant/Lessee Name . Phone #
Email
Job Address (where the work is being done) I t L (0" __
City Miami Shores Village County Miami -Dade Zip 3 r
FOLIO / PARCEL #
Is Building Historically Designated YES ' NO Flood Zone
Contractor's Company Name t-0 4 CR Phone #
Contractor's Address
Scl I. °I,
City INN aGtAAa". State Zip
Qualifier Name .c U \A"-{„57-0
State Certificate or Registration No. C 14 -2-tQO Z Certificate of Competency No.
Contact Phone E -mail
Architect/Engineer's Name (if applicable) Phone #
Phone # . 0 — Ea —2/c1?--S
-
Value of Work For this Permit $ Square / Linear Footage Of Work: 5 o-o
Type of Work FIAddition %]Alteration LNew ❑ Repair/Replace emolition
Describe Work> �T Gtti° j l t \f rV t2° S t >
CG4100(
******** * *** ** ** * * * * * * * ** * * * * * ** * * * * * *: Fees************* * *** * * * * ** * * * * * * * * * * ** * * * * * * * ** LI
Submittal Fee $ i �1 Permit Fee $ /-9 CCF $ CO /CC
Notary $ Training/Education Fee $ Technology Fee $
Scanning $ Radon $ DPt3R $ Zoning $
Bond $ Code Enforcement $ Double Fee $
Structural Review. $ Total Fee Now Due $
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 woik..�wjll be petformed to meet the standards of all laws regulating
construction in this jurisdiction. I understand that a separate permit must be e' 'Cured 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 rnust
promise in good faith that a copy of the otice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachme . Also, a certified copy of the recorded notice of commencement must be posted at the job site
for the first pe tion which occur. seven (7) days after the building permit is issued. In the absence of such posted notice, the
inspection ill ,t be approved any a r s ection fee will be charged.
illr
wit,
Owner ∎gent
Signat. e
Signature
Contractor
he foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
'day of 17 09 by day of ifC11C , 20d, by
who is personally kno to me or who has produced who S personallyAnnwu-te-rAe or who has produced
As identification and who did take an oath. as identification and who did take an oath.
NOTARY PUBLIC,
Sign:
Print:
pY PU@ LAU ARLEY
My Commission Expire. '1COMMISSi0t5 #DD646761
EXPIRES: March 16, 2011
Bonded Thru Budget Notary Serv1Ceu
NOTARY PUBLIC
My Commission
ja.
Nj;res: LAURA FARLEY
MY COMMISSION # DD 646761
EXPIRES: March 16,
Bonded Thru Budget Notary Ss'rvir;:;
********************** k. `.. * * * * *** * *** ** * *1k ** ** ************************** * * * ** * *** * * ** *** * ** * *** * ** * ****
APPLICATION APPROVED
Revised 07/10/07)
laps Examiner
Zoning
Engineer Clerk checked