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PL-12-1875 Inspection Worksheet Miami Shores Village 10050 N.E.2nd Avenue Miami Shores, FL ­n woo Phone: (305)795-2204 Fax: (305)756-8972 I ._., Inspection Number: INSP-179611 Permit Number: PL-10-12-1876 Scheduled Inspection Date: March 20,2013 Permit Type: Plumbing - Residential Inspector: Hernandez,Rafael Inspection Type: Final Owner: MENDOZA, MARIEDY Work Classification: Addition/Alteration Job Address: 10667 NE 11 Avenue Miami Shores, FL 33138-2120 Phone Number Parcel Number 1122320280310 Project: <NONE> Contractor: SANTINACHO ENTERPRISES INC Phone: (786)443-9590 Building Department Comments PLUMBING FOR NEW ADDITION Infractio Passed Comments INSPECTOR COMMENTS False I Inspector Comments Passed Failed Correction Needed Re-Inspection ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is paid. March 19 2013 For Inspections please call: (305)762-4949 Page 7 of 49 Miami Shores Village Building Department i OCT o 0 201 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 2 L n � BUILDING Permit No. PERMIT APPLICATION Master Permit No. /2 C f 7 7� Permit Type:PLUMBING JOB ADDRESS: W49 7 N' cf• J/ Ave City: Miami Shores County: Miami Dade Zip: f Folio/Parcel#: i Is the Building Historically Designated:Yes NO f Flood Zone: OWNER:Name(Fee Simple Titleholder): /"l��t e�9' t°'�� Phone#: Address: /O 7 A° City: �' State: -°' Zip: 3 1� TenandLessee Name: Phone#: Email: J CONTRACTOR:Company Name• � ►`� � e Phone#- 5 Address: rr City: x� State:i� Zip: Qualifier Name: An�caJ o ) UVC1t Cam. Phone#: State Certification or Registration#: � Certificate of Competency#: Contact Phone#:7 —b t A 16 16 Email Address: DESIGNER:Architect/Engineer: Phone#: Value of Work for this Permit:$ L47M SquarelLinear Footage of Work: Type of Work: ❑Address Zl�Alteration ONew ORepair/Replace LiDemolitiori F Description of Work: eev1 rav rrr - dam. 4- w��� ��x���xx��xxs�xx�sx���x�����s��w��exFeesa�xax������x�ax���a.a��a�•x�se�+xaxx�a�xwrs��sa Submittal Fee$ � —�Permit Fee$ �J CCF$ CO/CC$Li Scanning Fee$ 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 Zi p 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 EMPROVEMENTS 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$2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also,a certified copy of the recorded notice commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is iss d. In the absence of such posted notice, the inspection will not be approved and a reinspection fee wil be charged. Signature Signatu Owner o gent Contractor The foregoing nnss ment was acknowledged b fore a this The foregoing instrument was acknowledged before me this day of �"J ,20 s'by ;" day of �+ ,20 j-,by `-� `y �7 , who is ppkrnwa a or who has produced who is ersonally o to me or who has produced As identification and who did take an oath. as identification and who did take an oath. NO PUBLIC: NOT Y PUBLIC: L R COHEN W COMMISSION#EE10 Sign: Si a n 8M 05,2015 Print: �-✓� C �J p Print: thTOU h 18t Stye Irre mae AMR My Commission Expires: ? • ° My WMISSIM 9 DD 876910 My Commission Expires: EXPIRES:Apra 26,2019 WUBwoN*ywen kNkpRdB&kbN�*MNkBkAFk6NN+R�BF k#kI+ddkNFk+Nei+kkHsF&+kd+�A+Nk+NkkkkkdNRkFF+k�KNN$F+FBd+PWBkkNfikNN+NR4'FK«fNNB+FNkhhKakkkp4K6N#4 APPROVED BY �� l° �( Z' Plans Examiner Zoning Structural Review Clerk Revised 3/12/2012)(Revised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09) ,:•� l•.J•uY ••,•=, " .1�4i '' ;'4in:• 't _ '.ICJ? iuu,, (r�•i 1'1' :k lt:u•• •r .air"•i1f rat' �j�'S��"�" 't+. ;o r:.ui 44 mi":<.:�..''..:, ». {+ .,4 ,�'-' «a'�,'F•: 1�,.•b11�:::t;.�;,� VIi4liT•C1.Ai9S , • W'�•"+ ^i;�j4�4. 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