Pl-13-1130Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP- 198173 .
Scheduled Inspection Date: December 30, 2013
Inspector: Diaz, Osvaldo
Owner: VOGTNER, ALINA
Job Address: 53 NE 98 Street
Miami Shores, FL
Project: <NONE>
Contractor:
CFC1428617 A & C PORTELA PLUMBING
uwaing Department comments
REMODEL KITCHEN AND MASTER BATH
Passed Ef
Failed
Correction
Needed
Re- Inspection ❑
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Permit Number: PL -5 -13 -1130
Permit Type: Plumbing - Residential
Inspection Typet
Work Classification: Addition /Alteration
Phone Number (954)452 -0110
Parcel Number 1132060131140
INSPECTOR COMMENTS False
Inspector Comments
CREATED AS REINSPECTION FOR INSP- 191945.
Phone: 3051343 -2115
December 27, 2013 For Inspections please call: (305)762 -4949 Page 2 of 28
Miami Shores Village
Building Department ` p`
10050 N.E.2nd Avenue, Miami Shores, Florida 33138 MAY
Tel: (305) 795.2204 Fax: (305) 756.8972 2 2 2013
INSPECTION'S PHONE NUMBER: (305) 762.4949 ,' ?' ' �•
FBC 20, /() - --
BUILDING Permit No.
PERMIT APPLICATION master Permit No. lei- Lf ° C 3 ° 8"4-6,
Permit Type: PLUMBING
JOB ADDRESS: 5-
;S IJ e2 -
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel #: 11 - 3 z0k - b & 3 -1 L40
Is the Building Historically Designated: Yes NO 1�ej Flood Zone:
OWNER: Name (Fee Simple Titleholder): Phone#:
91 S`+- .
City: \ 4-"A S State: . Zip: 33 L3 ZIr'
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR: Com any Name: c s - ( I p` y�'
Pj� / � `)k('hone#: 3jjj L- La6LC1�il
Address: -33 A-W"e-
City: Tai cri-Y�i/l t � State: -E Zip:-
Qualifier Name: /) I/ �C; ✓ rG (C— Phone#:
State Certification or Registration #: C- t—C 17 2&2( 2 Certificate of Competency #:
Contact Phone #: Email Address:
DESIGNER: Architect/Engineer: Phone
Value of Work for this Permit: $ WOO. Square/Lirwar Footage of Work: �� s�� We �
Type of Work: OAddress IdAlteration ONew )(Repair/Replace ODemolition
Description of Work:
w
Submittal Fee $ Permit. Fee $
�C CF $ CO /CC $
Scanning Fee $
Notary
Radon Fee $ DBPR $ Bond $
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
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
City
State
Zip
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 . nspection fee will be charged.
Signature Signature
Owner or Agent
The foregoing instrument was acknowledged before me this -V!�
day of -� 4 , 20 6, by Am r,ies�)f rA,
who is personally known to me or who has produced_QLtj ?-35
OJSS 58 ' As identification and who did take an oath.
NOTARY
Print: PGA U�
My Commission Expires:
APPROVED BY
ty 6iowm / 187=
i ggM;Fdx=y07.1017
Contractor
The foregoing instrument was acknowledged before me this-la""-
day of , 20 -I-,> by Ui L'. lP I &
who i personall know to me or who has produced
Examiner
Structural Review
(Revised 3 /12/2012)(Revised 07 /10 /07)(Revised 06 /10/2009)(Revised 3/15/09)
identification and who did take an oath.
NOTARY
Sign :`"� ter,
Print: V'
My Commission Exp'l
MY c01"SS1oN r EE87M
EXPiRE4: Fetruery07��017
Zoning
Clerk