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PL-12-1276Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 13Pp-12 -1270 Inspection Number: INSP- 175710 Permit Number: PL -7 -12 -1276 Scheduled Inspection Date: November 30, 2012 Inspector: Hernandez, Rafael Owner: DENIS, CAMILLE AND MARIE Job Address: 10330 NW 2 Avenue Miami Shores, FL 33150- Project <NONE> Contractor: CUSTOM POOLS Permit Type: Plumbing - Residential Inspection Type: Final Work Classification: Pool - Private Phone Number (786)426 -7904 Parcel Number 1121360161090 Phone: (305)255 -5315 Building Department Comments REPLACE POOL PUMP Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments jt( November 29, 2012 For Inspections please call: (305)762 -4949 Page 1 of 13 - • t Miami Shores Village Building Department 90050 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 Permit Type: PLUMBING JOB ADDRESS: /3 3aa A Lt/ "!/ e. - City: Miami Shores County: Folio/Parcel #: /6 — 1/ 3 6 °' 01' "° /07 0 Is the Building Historically Designated: Yes FBC20 Permit No. f71--1 — I2�� Master Permit No �'�� Miami Dade Zip: .33/3F NO t/ Flood Zone: OWNER: Name (Fee Simple Titleholder): &1-/P1 // /e, be/id /-5 Phone#: Address: /033 0 miJW a / City: /11/ / ji% e s Tenant/Lessee Name: -- State: e4-4-- Zip: 33/3f' Phone#: Email: CONTRACTOR: Company Name: (-,US7V N RO S Phone#: 30,5 5 5 5.3/ 5 Address: /.poi 50 Sul /3i _sr A. /" d City: ,41/ r% Qualifier Name: Jl hd XI ,4 i /o State: fe- Zip: 33 /�‘ Phone#: 305 aa5 S .� 3 /5 State Certification or Registration #: OPe q- 5 /S Certificate of Competency #: W ..5 49:›0 7/S 3.S ®dJ4', "Ye, Phone#: Contact Phone#: 305 744 -3 aS 3 Email Address: DESIGNER: Architect/Engineer: A✓/%�- Value of Work for this Permit: $ 62 ‘2 Square/Linear Footage of Work: Type of Work: ❑Address ❑Alteration New MRepair/Replace ❑Demolition Description of Work: /ilT4)- �- ��%i �� — �� IC¢ e e-X / 5 /1//j 11/2 KP relay, 80.11 a 04E �►saTcR i $ g' Submittal Fee $ /. °if Permit Fee $ fe, 6 � r Scanning Fee $ Radon Fee $ Notary $ Training/Education Fee $ Double Fee $ Structural Review $ CCF $ CO /CC $ DBPR $ Bond $ Technology Fee $ TOTAL FEE NOW DUE $ re Bonding Company's Name (if applicable) /Wit Bonding Company's Address City State Zip Mortgage Lender's Name (if applicable) N� 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 condi promise in good faith that a co whose property is subject to a for the first inspection whic inspection will he issuance of a building permit with an estimated value exceeding $2500, the applicant must the notice of commencement and construction lien law brochure will be delivered to the person nt. Also, a certified copy of the recorded notice of commencement must be posted at the job site rs seven (7) days after the building permit is issued In the absence of such posted notice, the a reinspection fee will be charged. Signature /111 O' er or t Contractor The foregoing instrument was acknowledged before me thisAf The forego 1 _ __ day of diee, , 200-- , by ( r77 // /e ,% '/i00/s , day of J C/M , 20 /2, by c:/ei IN 1C-file © who is personally known to me or who has produced who is personally known to me or who has produced As identification and who did take an oath. NOTARY PUBLIC: Sign: Print: as identification and who did take an oath. lit, or or I_ se I t' Bawd Thru Nary Public �Uers MY COMMISSION # EE 129586 My Commission Expires: , NOTARY PUBLIC: * ** * **** ***** * *** * * **** ** **** ************************************** ** * * * ***s* * ** * * * *** *** **a* * *s** *may * * * ** APPROVED BY f /'l �Z'' Plans Examiner Zoning Structural Review (Revised3 /12/2012XRevised 07 /10107)(Revised 06/10 /2009XRevised 3/15/09) Clerk