PL-12-246Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP - 169915
12 2
Permit Number: PL -2 -12 -246
Scheduled Inspection Date: April 23, 2012
Inspector: Hernandez, Rafael
Owner: LADET, BIRGIT
Job Address: 46 NE 100 Street
Miami Shores, FL
Project: <NONE>
Permit Type: Plumbing - R
Inspection Ty
Work Classification: Additio
Phone Number
Parcel Number 1132060131220
Contractor: DONOVAN PLUMBING SERVICE INC Phone: (954)931 -7737
Building Department Comments
REPLACE SHOWER PAN VALVE WC LAV.
Passed
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Inspector Comments
0
April 20, 2012
For Inspections please call: (305)762 -4949
Page 12 of 33
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) 7614949
BUILDING
PERMIT APPLICATION
FBC 20
Permit Type: PLUMBING
OWNER: Name (Fee Simple Titleholder): Titleholder):
Address: /
City: 1' Mi 90, State:
RECEIVED
FEB 10 2012
Permit No. LA —2L-kico
Master Permit No.tC i2 --24S
Phone#:
Zip: 37 1,7
Tenant/Lessee Name: Phone #: d'
Email:
1 te &w
JOB ADDRESS: `
City: Miami Shores County: Miami Dade
Zip: 37130'
Folio/Parcel #:
Is the Building Historically Designated: Yes
NO Flood Zone:
Phone #: 4.1-9.91/7737
CONTRACTOR: Company Name: Ern./171/./01 %`%71/4
Address: 777 / A/i
City: ely State: 1
Qualifier Name: Ift? /Vj9 //i0:47 4)i%
State Certification or Registration #: RE i1 eV % /mod
Contact Phone #: /X L/ 1 / 7) 37 Email Address:
DESIGNER: Architect/Engineer:
Certificate of Competency #:
Phone #:
Value of Work for this Permit: $ 1 Aga ea Square/Lmear dotage. of Work:
Type of Work: ❑Address UAlteration p Q-yew .' ` epair/Replace
Description of Work: RePIICII g- � /weir ` ' ha44 J Vi,4
'UDemolition
k.9 , l�
* * ** ****** *+ x*******+x** ** * ********** * ** Fees* **** :****** ** +**** ** ***** ******* ***********
Permit Fee $ /V) CCF $ CO /CC $
Radon Fee $ DBPR $ Bond $
Training/Education Fee $ Technology Fee $
Structural Review $
Submittal Fee $
Scanning Fee $
Notary $
Double Fee $
TOTAL FEE NOW DUE $ 11 1 )( /
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.
Signature )Q 420
Owner or Agent Contractor
ing instrument was knowlec ged b ore e s The fore,- instrument was acknowledged before me this
I , ► 0„ by�.J�lt.�C day of Fo , 202— , by
sonally kn • wn to me or who has producedReArik who is personally known to me or who has produced
14-x.
The fo
day o
����who is pe
l/w
NOTA
Signature
ification and who did take an oath. as identification and whole
NOTARY PUBLIC:
Sign:
Print:
My Commission Expires: C‘v4 o, totp1040a
r %sr �i a 8 " I°
APPROVED BY
' ®> (cL Plans Examiner
Sign:
Print:
My Commission Expires:
Zoning
Structural Review Clerk
(Revised 07 /10 /07)(Revised 06 /10 /2009)(Revised 3/15/09)