PL-12-1817Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972 PIP S
Inspection Number: INSP- 179247 Permit Number: PL -10 -12 -1817
Scheduled Inspection Date: October 15, 2013 Permit Type: Plumbing - Residential
Inspector: Diaz, Osvaldo
Owner: MORGAN, MARY
Job Address: 307 NE 95 Street
Miami Shores, FL 33138-
Project: <NONE>
Inspection Type. F'nal
Work Classification: Addition /Alteration
Phone Number (305)606 -2098
Parcel Number 1132060136000
Contractor: POOL BOY PLASTERING, INC Phone: (954)571 -8313
Building Department Comments
PL FOR NEW POOL
INSPECTOR COMMENTS False
Inspector Comments
Passed 4f i&,A
Failedc.��_
Correction ❑ � � - ®s'�3
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- Inspection fee is paid.
October 11, 2013 For Inspections please call: (305)762 -4949 Page 3 of 25
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
FBC 20
Permit Type: PLUMBING
OWNER: Name (Fee Simple Titleholder):
city: I F r i ,1011
Tenant/Lessee Name:
Email: loll Q rel
JOB ADDRESS: 307 Ajte- q�
qy ' s q�
8yoaemmemeoo°000mo�
Permit No. V I � 2—
Master Permit No. MID
State: rT zip: T3 / 3 0
F
City: Miami Shores County: Miami Dade zip: 1y /17
Folio/Parcel #: ' P 3 ,20b 013-6000 O
Is the Building Historically Designated: Yes
WWI
Zone:
CONTRACTOR: Company Name: wit''!` P,06 is .a Phone#:
Address: &&21Do? z� # d I E
City: i State: Zip:
Qualifier Name: e- M Phone#: !n_
State Certification or Registration #: (& %V,� 7 q 2 7— Certificate of Competency #:
Contact Phone #: ��f��/ y "� �� Email Address: 01 P�� /;0 15006 6041
DESIGNER: Architect/Engineer:
Value of Work for tt Permit: $ O 0 Square/Linear Footage of Work:
Type of Work: 92ddress DAlteration ONe% ORepair/Replace
Description of Work:
s
Submittal Fee $ Permit Fee $ —2 2-� CCF $ CO /CC $
Scanning Fee $
Notary $
Radon Fee $
DBPR $ Bond $
Training/Education Fee $ Technology Fee $
ODemolition
Double Fee $ Structural Review $
TOTAL FEE NOW DUE $ `
Bonding Company's Name (if applicable)
Bonding Company's Address
City
State
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 $2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
Signature V w Signature
Owner or Agent
The foregoing instrument was acknowledged before me this
day of , 20Z , by
who is personally known to me or who has produced
As identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
� '�, GNENDQLYN B.B. S
My Commission Ex MY COMASSION # DD961586
`�g�0.�$ EXPIRES: April 19, 2011
I- X0.3 -NO (i_NoWy Di Anw. Co.
Contractor
The foregoing instrument was acknowledged before me this
day of , 20 _, by ,
who is personally known to me or who has produced
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
My Commission Expires:
sksk�Is: kBsak�ks# sk= k= kaksk�Is: kskskiksksk9kskikjkskskskskska• t: aksksk�kskskaki ksksk�kHi sk= kakaksksksksk�k�akskakakakakskak' ksk�k�k�k�k�ksksk�ak9k�Iask= ks ksk��kskHa�kz kak9ksk�Iasks ksRgaskskskak9kskHagssIaga :kakakaksksk
APPROVED BY Plans Examiner Zoning
Structural Review
(Revised 07 /10 /07)(Revised 06 /10/2009)(Revised 3/15/09)
Clerk
Miami Shores Village
Building Department
10050 N.E 2nd Avenu
Miami Shores, Florida 3313
Tel: (305) 795.220
Fax: (305) 756.897
Permit No.
Job Name
97
PLUMBING CRITIQUE SHEET