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PL-12-1695Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 �C -<Z -ll09" Inspection Number: INSP - 182585 Permit Number: PL -9 -12 -1695 Scheduled Inspection Date: December 10, 2012 Inspector: Hernandez, Rafael Owner: PREGO, MARTIN Job Address: 280 NE 107 Street Miami Shores, FL 33161- Project: <NONE> Contractor: HOME OWNER Permit Type: Plumbing - Residential Inspection Type: Final Work Classification: Addition /Alteration Phone Number (305)458 -5793 Parcel Number 1122310130460 Building Department Comments UPDATE PLUMBING FIXTURES AND PIPIES Infractio Passed Comments INSPECTOR COMMENTS False Passed 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- 178364. no access December 07, 2012 For Inspections please call: (305)762 -4949 Page 33 of 41 Miami Shores Village Building Department OCT o 5 2012 ED 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 BY: INSPECTION'S PHONE NUMBER: (305) 762.4949 BUILDING PERMIT APPLICATION Permit Type: PLUMBING JOB ADDRESS: t 1 kG Z"' 6 FBC 20 tD Permit No. L ` 2-11409S Master Permit No. RC -1 a- I (93 City: Miami Shores County: Miami Dade Folio/Parcel #: l\ Z )_'3 \ of 3r kc Is the Building Historically Designated: Yes NO Flood Zone: 'y, OWNER: Name (Fee Simple Titleholder): i. e< Icy 4. PIS Phone #: (505) Li' S D - Si 93 Zip: 33r0 r Address: 2 7 " j \—� City: F( r Zip: 33 i (°' Tenant/Lessee Name: Phone #: Email: CONTRACTOR: Company Name: \-_;` ‘ W.Vt\A, Address: City: \.N\ State: Qualifier Name: Phone #: e,185(o 1 State Certification or Registration #: Contact Phone #: DESIGNER: Architect/Engineer: zip: I l0 •j Phone #: 78 (01 i r% hQPO Certificate of Competency #: 0© 1 1 q Email Address: Phone #: Value of Work for this Permit: $ ) r i Type of Work: ❑Address Description of Work: Square/Linear Footage of Work: ❑Alteration ❑New ❑Repa it to ❑Demolition ******** * * * * * * * * * * * * *** * * * * * * * * * * * * * * ** Fees************* * * * * * * * * * * *** * * * * * * *,* * * * * * * * ** Submittal Fee $ Permit Fee $ CCF $ CO /CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ TOTAL FEE NOW DUE $ O' 10 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 afier 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 Signature Aks),b,, Owner or Agent Contractor The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this 36-01 day of , 20 _, by , day of ®G O6 et/ , 20 12.-, by (r( � Fo1, f ems- , who is personally known to me or who has produced who is personally known to me or who has produced b Rau c'rs As identification and who did take an oath. L1 c e rt se. as identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Sign: Si Print: Print: My Commissi My Commission Expires: 4c*4e4t4::F4:4e****k*** k4t9e ***Y** * ** ***9.******kY:Y **** ***Y4e** k****kk4c**** ***k** APPROVED BY • yri,rr • PATRICIA ELENA CEPERO *� *_ Commission # EE 141550 L.* *E II,N� My Commission Expires - *7;40°.•• November 14, 2016 Plans Examiner Zoning Structural Review Clerk (Revised3 /12 /2012XRevised 07 /10 /07)(Revised 06 /10 /2009)(Revised 3/15/09)