PL-12-507Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: I NSP- 175524
gPP- 12 - 505
Permit Number: PL -3 -12 -507
Scheduled Inspection Date: July 09, 2012
Inspector: Hernandez, Rafael
Owner: FREDRICKS, THOMAS
Job Address: 433 NE 91 Street
Miami Shores, FL
Project: <NONE>
Contractor: MARS POOLS
Permit Type: Plumbing - Residential
Inspection Type: Final
Work Classification: Pool - Private
Phone Number
Parcel Number 1132060140120
Phone: (954)214 -2844
Building Department Comments
POOL MAIN DRAIN, PIPING AND SKIMMER
Passed
Lo
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Inspector Comments
CREATED AS REINSPECTION FOR INSP- 171453. need to fix side walks
07/6/12 - SIDE WALK TO BE REPAIR LATER WITH DRIVEWAY PERMIT
PER NB.
July 06, 2012
For Inspections please call: (305)762 -4949
Page 24 of 26
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lams Shores Villa
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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
OWNER: Name
Address:
City:
rit V.
Permit No.
Master Permit No.
Tenant/Lessee Name:
fre/ Iy 92 7997 yei `iod . C'e/si
Email:
JOB ADDRESS: 43 /(l 9/ sf
Phone #:
City: Miami Shores County: p
Folio/Parcel #: / / -3Qo L—� ),q (9/20
Is the Building Historically Designated: Yes
CONTRACTOR: Company Name:
Address:
City:
Qualifier Name:
State Certification or Registration #: C',PC/c457922-
Miami Dade
Zip: '3/ 3g
st/v
41.5
C/OS' /fw l #2 l'uF
NO Flood Zone:
r—
a2 /5
/saa
Phone #: ,7 S-2/` `20 W
Zip: ?538 -1
Phone#: Y 2/5' .28 qy
Contact Phone #:
DESIGNER: Architect/Engineer:
Email Address:
A'roil 5
Certificate of Competency #:
l�gigot) /.S 4 4'i D/•
Phone #:
Value of Work for this Permit: $ 0(/ t2, 0V Squ
Type of Work: Address / Alteration
Description of Work: rte/ /r 4,'l 4491;1
ew
e/Linear Footage of Work:
CIRepair/Replace p
ODemolition
* *** * * * ** * ****** ****** * * *** ** x**+x******Fees*** ray * * ** ***************** *** ***wax ***
Submittal Fee $ Permit Fee $` .. Scanning Fee $ Radon Fee $
Notary $ Training/Education Fee $
Double Fee $ Structural Review $
CCF $ CO /CC $
DBPR $ Bond $
Technology Fee $
TOTAL FEE NOW DUE $ I CXU • 31'
• •
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 approved and a reinspection fee will be charged.
Owner or Agent
The foregoin, /nstrument was acknow edged before me th�iss /9
/'
day of �T� /_7 ,201,2 , , by T omen ,e'i ,Gel s
who is ,personally known to me or who has produced Ft-
Z.—
As identification and who did take an oath.
NOTARY PUBLIC:
!COMM 'il
)
llfe,. 86 e
EXPIRE 5: April 19 °.
Fl. Name, 114
a +n,.4yo, e,
r"
Contractor
The foregoing ins ent was acknowlledd ed .efore me thi
day of /' , 20 lam' by U/
who is personally known to me or who has produced
as identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
T t= ;Y
My Commission pa w.° WF!Vp ' � R T `%
1�i�� Cf�M1i141S lUh� i, E101;.1.R
c.R � IRES: April 0 20 ;4
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APPROVED BY
44" (3 ( Plans Examiner Zoning
(Revised 07 /10 /07)(Revised 06 /10 /2009)(Revised 3/15/09)
Structural Review Clerk
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
Date: y� Z
Permit #: 40, f ° 51°-
Plumbing Critique Sheet
#7-€4- Dater /0/4/ _ /4-0 !�,
Review Completed by: Rafael Hernandez
Chief Plumbing Inspector