PL-12-13Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL r):+ Phone: (305)795 -2204 Fax: (305)756 -8972 (1.
Inspection Number: 1NSP- 173157 Permit Number: PL- 1 -12 -13
Scheduled Inspection Date: May 07, 2012
Inspector: Hernandez, Rafael
Owner:
Job Address: 9190 NW 1 Avenue
Miami Shores, FL
Project: <NONE>
Contractor: MG PLUMBING & SPRINKLER SERVICE
Permit Type: Plumbing - Residential
Inspection Type: Final
Work Classification: Addition /Alteration
Phone Number
Parcel Number 1131010160030
Phone: (305)525 -9236
Building Department Comments
PLUMBING WORK FOR INTERIOR REMODEL
Passed
Failed
Correction
Needed
Re- lnspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Inspector Comments
CREATED AS REINSPECTION FOR IN -168426. NO WATER COMING
OUT OF THE TOP SPOUT. 5/4/1
May 04, 2012
For Inspections please call: (305)762 -4949
Page 46 of 50
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
Lit JAN0r
G FF
BY . ._�_ -.,-
BUILDING Permit No. 1l IF 1 C�
PERMIT APPLICATION Master Permit No. 1— ,2 _
FBC 20
Permit Type: PLUMBING
Owner's Name (Fee Simple Titleholder) - r"'HUTA S -4 /"2 G - C Phone #
Owner's Address ) 7c39- rn/ 6 / —
City %l /,t7/t. Cn a ( State
Tenant/Lessee Name
Zip
Phone #
U S
Email ) G) '''1-e _C/ ^ {i') 07, r+, ,o /e - C awl Job Address (where the work is being done) /MO Q /l% / r _✓ 1/� J )1 be I" ( 5-114/14 3 S
City Miami Shores Village County Miami -Dade Zip 3 3 / 1`D
FOLIO / PARCEL # // - .? /d /— Q /14.- 100 3
Is Building Historically Designated YES NO Flood Zone
Contractor's Company Name ll1/4/ / / f ;t., , jL C /ICe -Phone # .7 C7 '";
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 aficr 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
Owner or Agent
The foregoing in "rument was acknowledged before me this
day ofl %T 521°i2 20 / l , by �i' ,i �Cr ° � �.s-) ,
who is personally known to me or who has produced pc
0 -' q.5-3 `7f- l Z/As enti ica take an oath.
NOTARY PUBLIC:
My Commission Expi
JAMAL L SCOTT
MY COMMISSION # EE076226
,.; EXPIRES March 21, 2015
"{ (�`I 3
* * * * ** *** * * ** * * * * * . r * * * *F'4 iaiAmlee itt * * **
APPROVED BY
Signature C(/
Contractor �f�
The foreg. mg instrument was acknowledged before me this. -
da : fry
o is pe
onally known to me
by .112f4 cL
r who has produced
entification and who did take an oath.
NOTARY PUBLIC•
NOTARY
Sign;
Pr
P
E OF FLORIDA
MONS
DD830155
:•taber 12, 2012
L
... .'01 SPORAI ED
BONDED TN
My Commis
n Expires:
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7-1—'1.— Plans Examiner
(Revised 07 /10 /07)(Revised 06/10/2009)
Engineer
Zoning
Clerk checked