PL-06-2811Jul 23 12 05:55p INTERNATIONAL
305 - 824 -8577
p.5
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP - 176203
Permit Number: PL -11 -06 -2811
Scheduled Inspection Date: July 23, 2012
Inspector. Hernandez, Rafael
Owner: WATSON, LEONARD
Job Address: 165 NW 99 Street
Miami Shores, FL 33150-
Project: <NONE>
Contractor:
NATIONAL POOL LEAKS
Permit Type: Plumbing - Residential
Inspection Type: Final
Work Classification: Pool - Private
Phone Number
Parcel Number 1131010230390
Phone: 305 -559 -1020
Building Department Comments
FOR POOL
Passed
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Inspector Comments
"2-3 1 Z
July 20, 2012
For Inspections please call: (305)762 -4949
Page 36 of 43
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
BUILDING
PERMIT APPLICATION
FBC 2004
Permit No. it'Q -2( I
ster Permit No.
Permit Type (circle): Building Elecalkal. Mechanical Roofing
Owner's Name (Fee Simple Titleholder) C1,10 v4 i I Wat[s;A Phone # (i614' ZbC — 5Kty
Owner's Address /I:43- - A(ff‘795,
City (6i ► _51101.4) State r/ Zip 3 ' 50
Tenant/Lessee Name_ Phone #
Job Address (where the work is being done) / (5— AAA) 9 '
City Miami Shores Village County Miami -Dade
FOLIO / PARCEL # j 1 - 3101" 003 -fD30
Zip �j31 50
Is Building Historically Designated YES NO lr
Contractor's Company Name Al al 10 1/1C11 V 0 6l J.eu V
Contractor's Address /56 05- ; t.,1 (D 141
Phone # (306: /020
City lira' rill 'll J State f Zip 33/-7 ('
Qualifier Name �1�Pcjdlr(��t Phone # l ) T 6 A9/
State Certificate or Registration No. dC PC_d t- 3- -3-37 Certificate of Competency No.
Architect/Engineer's Name (if applicable) VI C.jche
Phone # (30s) S"s ° 8139'
y'
Value of Work For this Permit $ 2- Square / Linear Footage Of Work:
Type of Work: ['Addition
❑Alteration tew ❑ Repair/Replace ❑ Demolition
Describe Work: _ / 1 7 (V ) - U lorni jI 11
** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** ** *Fees *********** * * * * * * * * * *( * * * * * * * * * * * * * * * * * * **
Submittal Fee $ Permit Fee $ /0 CCF $ \ ` w CO /CC
Notary $ Training/Education Fee $ , 40 Technology Fee $ '
Scanning $ ' Radon $ DPBR $ Zoning $
Bond $ Code Enforcement $ Double Fee $
Structural Review. $ Total Fee Now Due $ ` T 6 . V
See Reverse side -*
DEC 2 QPAID
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 &1b/) fra-b6)20
Owner or Agent
The foregoing instrument was ackno ledged before me this
day of , 20 G,by L 2C %� ,C.tJ C7eA=
who is personally known to me or who has produced Q r
Signature
Contractor
The foregoing instrument was acknowledged before me this OS
day of 0 , 20 , by \ c,CO)'"
who is personally known to me or who has produced DA e. J�
P Y p �
As identification and who did take an oath. \k \fx as identification and who did take an oath.
NOTARY UBIIhK•
Sign:
Print:
My Commission Exp es:
"r4%, MARIA VERONICA BUTCHER
MY COMMISSION # D0601613
********* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
NOTARY PU3LIC:
Sig
Pri t:
MARIA VERONCCt RJ'TCHER
MYCOMMISS1ni. n 01613
OF P.•
407) 30114163
Flaitsa Notary 2rrrcc.co!^
My Commission'xpir>s:
***********************************' qr * * * * ** * ** * ** * * * * * * * * * ** * * * * * **
APPLICATION APPROVED BY:
(Revised 02/08/06)
Plans Examiner
Engineer
Zoning
L
Miami Shores Village ;•°FIVD
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 09'
Permit Type: PLUMBING
OWNER: Name (Fee Simple Titleholder):
Leo UgfoN
JUN 212012
Permit No. 773
Master Permit No. 13t' PO G 7o
Phone#: 13o6 32)3 - 519a,
Address: 165 Nu) q q 5r
City: ti■AHi° 6hoP 6 State: FL zip: 33)5o
Tenant/Lessee Name: Phone#:
Email:
JOB ADDRESS: 16 (3 ft.)W 13'3 Cr:
City: Miami Shores
County:
Miami Dade Zip: 35O
Folio/Parcel #:
Is the Building Historically Designated: Yes
NO Flood Zone:
CONTRACTOR: Company Name: MOTi010Ri Pool 1)e6:4j1‘)
Address: 2i42," 5W IL) hue, - Surte lc Q.) %
Phone#:
(2,o6 55 - l o a, o
City: H AH i State: 1=L
Qualifier Name: 01IR6bo eol)A5UeZ
cPC 1461g146
State Certification or Registration #:
Contact Phone#:
DESIGNER: Architect/Engineer:
Email Address:
3311.
Phone#:
Certificate of Competency #:
f eAo3 3 ofi oniAIPool )e5rgli coti
Phone#:
Value of Work for this Permit:
$ Square/Linear Footage of Work:
Type of Work: ❑Address ❑Altteeration
Description of Work:C�'�ti -'~
❑New ❑Repair/Replace ❑Demolition
pry+ -v—r Pt c , -1,,
Submittal Fee $ Permit Fee $ I •00 CCF $ CO /CC $
Scanning Fee $ Radon Fee $ DBPR $ Bond $
Notary $ Training/Education Fee $ Technology Fee $
Double Fee $ Structural Review $ 1
TOTAL FEE NOW DUE $ ` 0-3
• -
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 FLRCTRICAL 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
Owner or Agent
The fore oing instrument was acknowledged before me this
day of t— , 20 12., by CJ's- \J%4 V O ?
who is personally known to me or who has produced rt--- 1 1�
As identification and who dich(jetoath.
jip
Sign:
S
/110,1,11;0%1W TAB .x.%
NOTARY PUBLIC:
My Commission Expires:
Signature
Contractor
The foregoing instrument was acknowledged before me this .
day of .A101gIR , 20 2 , by
who is personally known to me or who has produced
as identification and who did take an oath.
NOTARY PUBLIC:
Sign: (ROCI;;Z:i:5::27--
Print: (060 o i . 5;i09
My Commission Exp' <- ,;<Y ROSARIO D. SILVA
) .._...
2!(�" �r '•:° �; Notary Public, State of Florida
1°FFF"" �oQ Commission #DD903514
'toiitiP My Commission Expires Jun. 30, 2013
*••**+F ******** a••*** a. *d•*+p**+k+bx•*****a•+I ** *+k****** * *+k****** ***** S+N+N********* *** * ***••***** ********+k+ *** *******
•
APPROVED BY Plans Examiner Zoning
Structural Review
(Revised 07 /10 /07XRevised 06 /10/2009)(Revised 3/15/09)
Clerk