PL-13-1530 A �
Inspection Worksheet
Miami Shores Village
10050 N.E.2nd Avenue Miami Shores, FL Y4�
Phone: (306)795-2204 Fax: (305)756-8972
Inspection Number: INSP-194889 Permit Number: PL-7-13-1530
Scheduled Inspection Date: September 17,2013 Permit Type: Plumbing- Residential
Inspector: Diaz, Osvaldo
Inspection Type: Final
Owner: BROMLEY, MICHAEL Work Classification: Addition/Alteration
Job Address:142 NW 99 Street
Miami Shores, FL
Phone Number
Parcel Number 1131010240040
Project: <NONE>
Contractor: ACA CONSTRUCTION INC Phone: (305)788-8914
Building Department Comments
REPLACE FIXTURE IN TWO BATHS Infractlo Passed Comments
INSPECTOR COMMENTS False
Inspector Comments
Passed
21
Failed
Correction ❑
Needed
Re-Inspection ❑
Fee
No Additional Inspections can be scheduled until
re-inspection fee is paid.
September 17,2013 For Inspections please call: (305)762-4949 Page 10 of 39
Miami Shores Village = a�
Building Department !'►� m ��
10050 N.E.2nd Avenue,Miami Shores,Florida 33138
Tel:(305)795.2204 Fax:(305)756.8972
INSPECTION'S PHONE NUMBER:(305)762.4949
FBC 20 L C)
BUILDING Permit No. FL, l�
PERMIT APPLICATION Master Permit No.'_C, 1 `� I
Permit Type: PLUMBING
JOB ADDRESS: 142 NW 99 ST
City: Miami Shores County: Miami Dade Zip: 33150
Folio/Parcel#: I I—31 — 01 ' 0-X 00'4<:)
Is the Building Historically Designated:Yes NO X Flood Zone:
OWNER:Name(Fee Simple Titleholder):B&L REALTY HOLDINGS, LLC Phone#:305-519-6968
Address:3900 NW 2ND AVE
City:
MIAMI State: FL Zip: 33127
Tenant/Lessee Name: N/A Phone#:
Email:
CONTRACTOR:Company Name: ACA CONSTRUCTION, INC Phone#: 305-219-3448
Address: 10725 SW 55 TER
City:
MIAMI State: FL zip: 33165
Qualifier Name: Aindk!es L--'�ey,%mss Phone#: 3► s' �" ' 3`'!� 2�
State Certification or Registration#: G F C- Z'7 6A S' Certificate of Competency#:
Contact Phone#: 305-219-3448 Email Address: ANDRESLEMUS @YMAIL.COM
DESIGNER:Architect/Engineer: Phone#:
Value of Work for this Permit:$750 Square/Linear Footage of Work:
Type of Work: UAddress OAlteration UNew URepair/Replace ODemolition
Description of Work: REPLACE SHOWER HEAD AND VALVE IN SHOWER, REPLACE VANITIES IN TWO BATHROOMS
REPLACE FAUCETS IN BOTH BATHROOMS
Submittal Fee$ ° t Permit Fee$ /46 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. n the absence of such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
Signature UK,V Signature
O r or ent —c4 actor
The foregoing instru nt was acknowledged before me this 9 The foregoing instrument was acknowledged before me this 9
day of JULY zo 13 by MICHAEL BROMLEY day of JULY 20 6 by ANDRES LEMUS
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. as identification and who did take an oath.
I
NOTARY PUBLIC: NOTARY PUBLIC:
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Sign: Sign: le r
Print: RONNI B Print: RONN - -
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My Commission Ex � [�I�jI�ISSIQN#EE000573 My Commissi rt ° e ®
ICY CONJ IS--'+ON 0 5-E000573
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ar�r ?��IRES October 01,2014 r`tPIRES October 01,2014
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APPROVED BY '�3 Plans Examiner Zoning
Structural Review Clerk
(Revised3/12/2012)(Revised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09)