PL-13-997Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
I'S -R3`�
Inspection Number: INSP - 191080
Permit Number: PL -5 -13 -997
Scheduled Inspection Date: June 26, 2013
Inspector: Hernandez, Rafael
Owner: MEADOR, STEPHEN
Job Address: 429 NE 102 Street
Miami Shores, FL 33138 -2452
Project: <NONE>
Contractor: CFC1428617 A & C PORTELA PLUMBING
Permit Type: Plumbing - Residential
Inspection Type: Final
Work Classification: Addition /Alteration
Phone Number (305)693 -8782
Parcel Number 1132060170790
Phone: 305/343 -2115
Building Department Comments
REMOVE AND REPLACE TOILET AND VANITY AT
EXISTING LOCATION REMOVE SHOWER AND INSTALL
NEW TUB
Infractlo 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
June 25, 2013
For Inspections please call: (305)7624949
Page 11 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) 762.4949
BUILDING
PERMIT APPLICATION
Permit Type: PLUMBING
JOB ADDRESS: X29 k.s, 102 SI✓,.
City: Miami Shores
Folio/Parcel #: (j 39-6(0 ° pi -64W
t)3'2711
9 .i,
a�so� - reOrn�o
FBC 20 C�(
Permit No. Y 13� 1 !
Master Permit No. �.G IS
County: Miami Dade Zip: 313'
Is the Building Historically Designated: Yes NO Flood Zone:
OWNER: Name (Fee Simple Titleholder): et A ert M earl r Phone #: 5005-- 639- g°4-%2
Address: zfq 2 03 6 K52_ • .
City: 1M'a n t State: EL Zip: `.5i3g
Tenant/Lessee Name: Phone #:
Email:
•
CONTRACTOR: Company Name: A -b. C. Qj 4e∎a Phone #: S '4 0 795
Address: � 65 emu)
City: Pk.
Qualifier Name: Arnim-Jo Phone #:
State Certification or Registration #: I (O(.P4I ?O i e-1 4702rtificate of Competency #:
Contact Phone #: Email Address:
DESIGNER: Architect/Engineer: Ii) Kl- Phone #:
State: T-1 Zip: ?4,ai33
Value of Work for this Permit: $
Type of, Work: OAddress'
1 esarrlptlon o1'Work:
2.foo5
I Alteration
Square/Linear Footage of Work:
ONew URepair/Reeplace
K�'165ie ° c'. r lct e al °' trIALr ofxxv:: c2-k- -6y`,-Vi(s icelliCre)
s ,,ser \f‘t t \ > f. , ,.
ODemolition
******* * * * * * *** * * * * * * * * * * * * * * * * * * * * * ** *Fees *.� * * * ** ** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
Submittal Fee $ Permit Fee $ f 57 CCF $ CO /CC $
Scanning Fee $ Radon Fee $ DBPR $ Bond $
Notary $ Training/Education Fee $ Technology Fee $
Double Fee $ Structural Review $
TOTAL FEE NOW DUE $
V
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
NIet-
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
Ztt
Owner or Agent
The foregoing instrument was acknowledged before me this
day of , 20 J, by `S„Ve, 011'1 M ec dc' c
who is personally known to me or who has produced FL t 01360 wh
q4. -Lo( -465()- ® As identification and who did take an oath.
NOTARY
Signature
The foregoing
day of
Sign:
Print:
My Commission Expires:
* * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
APPROVED BY
Contractor
rot
instrument was acknowledged before me this
, 20 15, by Ac cic n& lackeita.,
o me or who has produced
as identificatio
NOTARY ,_.! t LIC:
Sign:
Print:
did take an oath.
My Commission Expire
dr EXPIRES: Fdmimy07, 2017
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Plans Examiner
Structural Review
(Revised3 /12 /2012XRevised 07 /10 /07)(Revised 06 /10 /2009)(Revised 3/15/09)
Zoning
Clerk