PL-13-417 Inspection Worksheet
Miami Shores Village
10050 N.E.2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-186601 Permit Number: PL-2-13-417
Scheduled Inspection Date:'April 24,2013 Permit Type: Plumbing - Residential
Inspector: Hernandez, Rafael Inspection Type: Final
Owner: PREDRAG STARCEVIC, KAREN BLAIR Work Classification: Addition/Alteration
Job Address:1225 NE 92 Street
Miami Shores, FL
Phone Number (305)751-9333
Parcel Number 1132050270300
Project: <NONE>
Contractor: CASTELLON PLUMBING CORP Phone: 305-553-1490
Building Department Comments
PLUMBING WORK FOR BATHROOM REMODEL Infractio Passed Comments
INSPECTOR COMMENTS False
Inspector Comments
Passed
Failed
Correction ❑
Needed
Re-Inspection
Fee
No Additional Inspections can be scheduled until
re-inspection fee is paid.
For Inspections please call: (305)762-4949
April 23 2013 Page 11 of 43
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Miami Shores Village
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Building Department f
90050 N.E.2nd Avenue,Miami Shores,Florida 33138
Tel:(305)795.2204 Fax:(305)756.8972
INSPECTION'S PHONE NUMBER:(3057 762.4949
FBC Zo
BUILDING Permit No.
PERMIT APPLICATION Master Permit No. i
Permit Type:PLUMBING
JOB ADDRESS: 12 Z f !F = l
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#:
Is the Building Historically Designated:Yes NO Flood Zone:
OWNER:Name(Fee Simple Titleholder): Phone#:
Address: /1
City: d�ll, c�2' S ��L '� State: s313
Tenant/Ussee Name: Phone#
Email:
CONTRACTOR:Company Name: Phone# eA
Address: 47f*ej 4ZA� 4
City: /��®� 45;i® t r State: ��� Zip: /E
Qualifier Name: c P Phone#: .P� , —
State Certification or Registration#: de W 4S-- _Certificate of Competency#:
Contact Phone#: Email Address:
DESIGNER:Architect/Engineer: Phone#:
Value of Work for this Permit:$ 2® OP 6 Square/Linear Footage of Work:
Type of Work: DAddress DAlteration ONew Akepair/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$
f
Y
PAINT COLOR APPROVAL AND AGREEMENT
All elements on the site must be listed and indicate the color to be painted
DIRECTIONS:Please circle corresponding number to appropriate color sample.
Walls: 1 2 3 4
Fascia: 1 2 3 4 Attach color sample with name and number
'
Drip edge: 1 2 3 4
Soffit: 1 2 3 4 1.
Roof- 1 2 3 4
Flower Bins: 1 2 3 4
Shutters: 1 2 3 4
Awnings: 1 2 3 4 2.
Chimney: 1 2 3 4
Doors&Jambs:1 2 3 4
Garage Doors: 1 2 3 4
Railings:
1 2 3 4 3.
Fences: 1 2 3 4
All Brick: 1 2 3 4
Stucco Bands: 1 2 3 4
Other Stucco 4.
Feature: 1 2 3 4
Accessory Bldg: 1 2 3 4
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.
Signature:
Owner or Agent Contractor
The foregoing instrument was ac w1coged me thi� 40 The foregoing instrument was acknowledged before me this
day of 20 3 day of FA2 201S-,by 0/
who is personally known to me or who has produced__JEf= who is AersonaIl known to me or who has produced
As identification and who did take an oath. as identification and who did take an oath.
NOTAR UBLIC NOTARY PUBLIC:
Sign: Sign: r
Print: Prints /23 7f 2;'(e 0q
apW.AULL FUEN I to AY Pp
My Commission Expires: _�.` *�'': Notary Public-State of Florida My Commission Expires�otP••.��% BEAMV k BURGOS
My Comm.Expires Mar 30,2014 * * MYCOMMISSIONHE052014
Commission#DD 976991
EXPIRE rll 2
015
oa o a ss eMr*0ug 41-OF 1 �
APPROVED BY:
Code Offidal
Preservation Board