PL-12-1411Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL e2, 4�
Phone: (305)795 -2204 Fax: (305)756 -8972 I
Inspection Number: INSP- 188168 Permit Number: PL -7 -12 -1411
Scheduled Inspection Date: March 28, 2013 Permit Type: Plumbing - Residential
Inspector: Hernandez, Rafael
Inspection Type: Final
Owner: DOWNS, ANTONIE Work Classification: Addition /Alteration
Job Address: 1298 NE 97 Street
Miami Shores, FL 33138 -2560 Phone Number
Parcel Number 1132050090550
Project: <NONE>
Contractor: MG PLUMBING & SPRINKLER SERVICE Phone: (305)525 -9236
Building Department Comments
Infractio Passed comments
NEW LAVATORY,
NEW VALVE, NEW WATER CLOSET,
NE SINK FOR BATHROOM REMODEL INSPECTOR COMMENTS False
Inspector Comments
Passed CREATED AS REINSPECTION FOR INSP- 187772. CREATED AS
REINSPECTION FOR INSP -1 6446. .
Failed
Correction ❑
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
March 28, 2013 For Inspections please call: (305)762 -4949
Page 7 of 12
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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) 7614949
BUILDING
PERMIT APPPLICATION
FBC 20
Permit - : Pj. I.
Permit No. P I 1 9'— W
Master Permit No. C, 19—'
OWNER: Name (Fee Simple Titleholder): 1� 10 '„�_� ll
Address: ' ; 12-9 ? #j f- � 7 � S4'
M
City: __zip: l�
TenantUsseeName: _ Phone#:
Email: _
JOB ADDRESS:
12—
c
City: Miami Shores County: Miami Dade Zip: —� i
Folio/Parcel#:
is the �uldhug lisforically Designated: Yes ` NO Flood Zone:
CONTRACTOR: Company Name:
Address: >-00— - `*,I W
City:
M,
Zip:
State Certification or Registration#: C—=F-r— 'Certificate of Competency#:
Contact Phone#: Email Address:
DESIGNER: Architect/Engineer. Phone#:
4F A-69
Value of Work for this Permit. $ Square/Linear =epaidRepl(ace rk:
Type of Work: DAddress teration ONew
ODemolition
Description of Work: _ f-W It AAW 4 1 q PJ e 1f' _ - GL o'9 ':r- J t
Submittal Fee $ Permit Fee CCF $ COJCC $
Scanning Fee $ Radon Fee $ DBPR $ Bond $
Notary $ Traluing/Education Fee $ Technology Fee $
Double Fee $ Stractural 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 of 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 Signature Owl
Owner or Agent c%�. Contractor
Th�i instrument was ac w Bed bef ore m - . The foregoing instrument was acknowleed before me thi �
day o , 20 Eby y� '�- Q r6 day of J&� . 2d _4by �
r whorl rso Cknoown to me or who has produced who is personally known to me or who has produced_
�F-- As identification and who did take an oath. as identification and who did take an oath.
NOTA PU NOTARY PUBL
TAR
7FP0 ��- V TE OF FLORIDA
Sign:
Print:
My C
Sign:
LOIS SERMONS.
Print: ES 0ctoocr 12.2012
&+MA;I) THRVA13PCIC BONDING COMPANY INCOHPORAI ED
APPROVED BY 2+-/Z Plans Examiner
Structural Review
(Revised M /10M)IMevised 06/10/2009)(Revised 3/15/09)
Zoning
Clerk
� Mm.
Sign:
LOIS SERMONS.
Print: ES 0ctoocr 12.2012
&+MA;I) THRVA13PCIC BONDING COMPANY INCOHPORAI ED
APPROVED BY 2+-/Z Plans Examiner
Structural Review
(Revised M /10M)IMevised 06/10/2009)(Revised 3/15/09)
Zoning
Clerk