PL-13-2453Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL P I 13
Phone: ( 305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP- 202149 Permit Number: PL -10 -13 -2453
Scheduled Inspection Date: February 12, 2014 Permit Type: Plumbing - Residential
Inspector: Diaz, Osvaldo Inspection Type: Final
Owner: KUYPER, NICOLAAS C Work Classification: Pool - Private
Job Address: 878 NE 91 Terrace
Miami Shores, FL Phone Number
Parcel Number 1132060050320
Project <NONE>
Contractor: SUNSET POOL AND SPA Phone: (305)804 -1068
L9161 i4 1i 1Ta fl�-j
NEW POOL PIPING
INSPECTOR COMMENTS False
Inspector Comments
Passed EZ . 1
VLlLe � 1. pie"
Failed Pe -S C a 6—� � car -
Correction bl
Needed ❑ L
Re- Inspection ❑
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
February 11, 2014 For Inspections please call: (305)762.4949 Page 7 of 39
Miami Shores Village
Building Department I OCT 3 0 2013
10050 N.E2nd Avenue, Miami Shores, Florida 33138 - -_
Tel: (305) 795.2204 Fax: (305) 756.8972
INSPECTION'S PHONE NUMBER: (305) 762.4949
BUILDING
PERMIT APPLICATION
Permit Type: PLUMBING
JOB ADDRESS:
P
FBC 20
Permit No.p
Master Permit No.
City: Miami Shores County: Miami Dade Zip :��
Folio/Parcel#: IL
Is the Building Historically Designated: Yes NO Flood Zone:
OWNER: Name (Fee Simple Titleholder): ► GO k CLa S hone#: %1 - & 646K
Address: ® -re rra C e
City: YAi O V_Y l S \'�6C(? State' :
Tenant/Lessee Name: Phone#:
Email:
r
CONTRACTOR: Company Name: S e) V% sr7e *t- ® S Phone#• . 3 t D y
Address: 1 Ss 3c..,Q i 03 '� C �
City: 1L ®O- Or- 1 State: Zip: 33 17-45
a
Qualifier Name:
q®S_ t)q -1 /l
State Certification or Registration #
w is Z�icy :
Contact Phone#: -106 R' Email Address: 9_. 42 tBt f �1�
DESIGNER: Architect/Engineer. )6 e _L% v� -1- e E(` r�. 0 j_ _ Phone#: —aS-� CZ�
Value of Work for this Permit: $ 6 0 o ®+ SquareAUnear Footage of Work: tS D
Type of Work: OAddress
ODemolition
Descrlp n:A
ork:
4�¢7r'
v �
.air
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3,
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Submittal Fee $ Permit Fee $
Scanning Fee $ Radon Fee $
CCF $ CO /CC $
DBPR $ Bond $
Notary $ Tndning/Education Fee $ Technology Fee $
Double Fee $ Stmctural Review $
TOTAL FEE NOW DUE $ 2 2j7
Bonding Company's Name (if applicable) A/ / YA-
Bonding Company's Address
City
State
Mortgage Lender's Name (if applicable) (f l� /A
Mortgage Lender's Address
City
ME
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 Signaturd
OvATer or Agent Contractor
The foregoing instrument was acknowledged before me this 2,7 The foregoing instrument was acknowledged before me this
day of QG� , 20 t3 by day of i� !�1'� . 20,3, by
who is personally known to me or who has produced who is personally known to me or who ba% produced
As identification and who did take an oath. as identification and who did take an oath.
NOTARY
Sign: U
Print: L
My Commission I
M BULNES
Notary Public - State of Florida
My Comm. Expires Jun 23, 2017
Commission #t FF 030282
Bonded Through National Nfty Asss.
APPROVED BY Plans Examiner
Structural Review
(Rmised3 /12012)(Revised 07 /10 /07XRevised 06 110/2009)(Revisad 3/15/09)
NOTARY
Sign:
Print
ref
My Commrs3
,'•� ",
�' �,
M BULNES
Notary Public - Stais of F iorida
• s : •
My Comm. Expires Jun e, 2017
',,,''`,,,
Commission #F FF 030252
ritar4r4e�trinkdrQnk
Zoning
Clerk
CHAMSEPIC SUMCE,
"We "re Thankful For YourTankfuU"
ft0. Box 431911 -Miami, FWjda 33243
(305)661-MS- Fax (305) 251 -31 o3
DigAal8eePet (305) 824943,3
AM ff"q
aim INSPECDON KR REPORT
MASTFA SEPTIC rAMK
CWVACTOt
STATE OF FLOR M C@IiTII�IE#y
C1CO SM0941 t67
Dada C.C. 9608
Std Uvmm 9S -1167
Custorner's I arr�e: Mr. Herman
A&lress: 878 NE 91st Ter., North Miami, FL
(Streea) (CAY) (State) (Z #
Phone: 321- 295 -6878
(Area Code)
Date: 05/09/2013
(Mordw (Will) (Year)
At the time of inspection.
Yes No
The tank was in proper working condition: g U
The dTainfleld was working property. g U
The solid deflection deuice was working properly: 0 d
The tank lids were in good condition: U
The tank was pumped at inspection: p
Comments. At the time of the ins_pection,J the fiberglass Tank and the
Drafnfleld were found to be in good worldne condition
Septic k*wtion _ l�,oQ
Pump Out -- $200.Qo
Solid Def. Lice
lid We Aec:epc:
Locating Device F�
Amount due PAID
ALL INSPECTIONS ARE BASEL) AT THE TIME OF INSPECTION
C�rr lv
Pumpouts + Residential • Commercial • Drainfields • Installed & Repair
ftw Inst8114th ms • Septic Tank Inspections • Septic Tank Lids + Maintenance Contracts
Bacteria Treatments a Grease Traps Pumped & Pressure Wasbed • Water Jetting