PL-13-1882 Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INS P-197570 Permit Number: PL-8-13-1882
Scheduled Inspection Date: November 20, 2013 Permit Type: Plumbing - Residential
Inspector: Diaz, Osvaldo
Inspection Type: Final
Owner: ,JEFFREY BRODER&IRIS ROMERO Work Classification: Pool - Private
Job Address: 1130 NE 92 Street
Miami Shores, FL Phone Number
Parcel Number 1132050270430
Project: <NONE>
Contractor: AQUARAMA POOL INC Phone: (954)529-4552
Building Department Comments
Infractio Passed Comments
NEW POOL PIPING INSPECTOR COMMENTS False
Inspector Comments
Passed °
Failed
Correction ❑
Needed
Re-Inspection a
Fee
No Additional Inspections can be scheduled until
re-inspection fee is paid.
November 19,2013 For Inspections please call: (305)762-4949 Page 11 of 40
V
Miami Shores Village h
Building Department AUG Z0'
90050 N.E.2nd Avenue,Miami Shores,Florida 33138
Tel:(305)795.2204 Fax:(305)756.8972 L - -
INSPECTION'S PHONE NUMBER:(305)762A949
FBC 20
BUILDING Permit No.
PERMIT APPLICATION Master Permit Nob /" z,?
Permit Type:PLUMBING
JOB ADDRESS:— 11 -3 0
City: Miami Shores County: Miami Dade Zip: :?s 1
Folio/Parcel#:
Is the Building HistoricaIIy Designated:Yes NO ® , Flood Zone:
OWNER:Name(Fee Simple Titleholder): s� ��� Phone#:
Addres � `1�.�— SA-
Cl i State:
�-- Zip:- 5 1'2�
TenandUssee Name: Phone#:
Email:
CONTRACTOR:Company e: --Phone#:
Address: '3®4 ' � 'So
City: 'AA-YE-5-Ti:g-4 State:
Qualifier Name: a;;. 'Z-44 Q L�cD Phone#•
State Certification or Registration#: (PE Certificate of Competency#:
Contact Phone#: mail A Tess:
DESIGNER:ArchitectlBngineer: t U�A Phone#:
Value of Work for this Permit:$ \50(Q SquareMnear Footage of Work:
Type of Work: DAddress OAlte n &New ORepair/Replace ODemolition
Description of Work•
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$
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 /2/,� Signature
er or Agent Contractor
The foregoing ins"lit was acknowledged before me this '06 The foregoing instrum as acknowledged before a this
day of Cpl 20 yz,by Z� �YMV day of l 20 l3 by
who is persoA to me or who has produced who is personally known to me or who has produced
As identification and who did take an oath as identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
Sign: 'A 4�2� Sign: --� A la�-,X
Print: Print n
„ Zelda Andrea ," Zelda Andreu
My Commission pines: My Comm;cap n Expires'
e Commission#EE091055 Commission#EE091055
Expires; MAY 05,2015 ,,,,• Expires: MAY 05,2015
BOND TARO ATLk\TJC BONDUiG CO.,INC. Bo,,DED TARO AT"ynCBiDNWNG CO.,IF+t
APPROVED BY Z�'' Plans Examiner Zoning
Structural Review Clerk
(Rmised3/12/2012)Mevised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09)