PL-13-1558a
Inspection Worksheet'
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone; (306)795 -2204 Fax: (306)768 -8972
inspection Number:.INSP- 209986 PermitNumber. PL-7-1.3-108
Scheduled Inspection Date: April 01, 2014 Perini. Type; Plumbing - Residential
Inspector Diaz, Osvaldo
Owner: GARCUA JOHN
Job Address: 169 NW 904 Street
Miami Snores, FL
Project: <NONE>
Inspection Type: Final
Fork Classification: Pool - Private
Phone Number
Parcel Number 1121360131370
Contractor: "' ROSMEL POOL INC Phone: (306)592 -7900
Comments
NEW PLUMBING PIPING FOR SWIMMING POOL
False
Inspector Comments
Passed lam
Fated
Correction`
Needed
Re-inspection
Fee
No Addlional Impections can be scheduled unfit
wlnsftection fee is paid.
March 31, 2014 For Inspections please call: (305)782.4949
Page 34 of 50
Y r
Miami Shores Village C E
JUL 12 203
Building Department �j
[ -_s
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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 20
BUILDING Permit No.
PERMIT APPLICATION Master Permit No. "
l-
Permit Type: PLUMBING
JOB ADDRESS: _ Z e "t"
City: Miami Shores County: Miami Dade Zip: 33/.x®
Folio/Parcel #:
Is the Building Historically Designated: Yes NO X Flood Zone:
OWNER: Name (Fee Simple Titleholder): Phone#:
Address: 1� l iii' 14 Scl.Y '
City: State: Zip: 3
Tenant/Lessee Name: 01,4 Phone #•
Email: >044
CONTRACTOR: Company Name: _ J101ei 11Q� Phone#. _3_ a5-35Z 7i,cio
Address: d e �5 Ajca) '36 :511
City: �r� State: zip: 3.3146
Qualifier Name: Phone#. 55 J J j00
State Certification or Registration #: e"o�G Certificate of Competency #:
Contact Phone#: Email Address: �s�a/ �'i��J. e.0-44
DESIGNER: Architect/Engineer: 41"a,O i /°��, G Phone#: 3-0,/7 J` DV7 /2S7
Value of Work for this Permit: $ -/- 421-- Square/Linear Footage of Work: X6 51
Type of Work: ❑Address ❑Alteration ❑New ❑Repair/Replace ❑Demolition
Submittal Fee $ Permit Fee $, . ; Y CCF $ CO /CC $
Scanning Fee $
Radon Fee $
Notary $ Training/Education Fee $
Double Fee $ Structural Review $
DBPR $ Bond
Technology Fee $
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 condition t the issuance of a building permit with an estimated value exceeding $2500, the applicant must
promise in good faith t t a copy oft notice of commencement and construction lien law brochure will be delivered to the person
whose property is sub' ct to attachme . Also, a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspec ' which o rs even (7) days after the building permit is issued In the absence of such posted notice, the
inspection will appr ved a leinspectionfee will be charged.
S' afore 1 Signature
Owner or g nt Contractor
The foregoing instrument ged before me this The foregoing instrument was acknowl dged before �I me��this4Y
day of Z 20 /3 , by G cam-- day of 2 , 20 , , by r �"1 CL_ ,
who is personally known to me or who has produced who is p=%ma1y1uQwwn to me or who has produced
As identification and who did take an oath. as identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
Sign:
Print:
My Commission Expires:
MARCOS A. MARTINEZ
MY COMMISSION # FF OM
EXPIRES: May 15, 2017
Bonded Thru Notwy PW* Under rbrs
APPROVED BY -2,1 1 -Plans Examiner
I
Sign:
Print:
My Commission
C
MARCOSA. MWNEZ
MY COMMISSION # FF 00W
EXPIRES: May 15, 2017
Bonded Thor Notwry PuV, 0ndeMbm
Zoning
Structural Review Clerk
(ReviseO /12/2012)(Revised 07 /10 /07)(Reviwd 06110/20o9)(Revised 3/15/09)