PL-13-2405( . A., 4.
Inspection Worksheet
Miami Shores Village
10060 N.E. 2nd Avenue Miami Shome, FIL
Phone: (306).7W2204 Fax: (306}750-072
Inspection Number. II S P -201776 Pe*-, nu - m ber PL46 1.3 -
U6
SchoduW Inspection Date: March Orh 2044
Permit 'Type; PIUMbing - Residential
Inspector: Diaz, OsvAlloo Inspection Tylw.-Flhid
Ow * ner: MERA, ROIDFUGO & ADRIANA Work Classification: Pool w Private
Job Address'., 225 NE 96 Street
Miami ghqr", FIL,13130-2715 Phone Number
Project
Contractor
<NONE>
4 NEW POOL PIPING
Passed
Failed
C000ction
Needed
Re-Inspection
Fee
No Addwwrw Inspaearts c m be scheduted unto
ro-kooObn fee is; pW,
Inspector Comments
� -�Z-
�0�4
Parcel Number 113i06011140011
False
Phone-, (306ps"110
Mamb 05, 2014 For tospections please call: (30t.)702-4949 Page 1, -of'40
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
Permit Type: PLUMBING
OCT 222013
FBC 20
Permit No
Master Permit Noy �,. `� J - —) �`��
JOB ADDRESS: r�_J IV 4--
City: Miami Shores County: Miami Dade Zip: /
Folio/Parcew // - 3--? 0 6 - 0 / 3 9 /
Is the Building Historically Designated: Yes
NO ✓' Flood Zone:
OWNER: Name (Fee Simple Titleholder): -pt) Pd/Z l 9 0 "0/ Phone#:
Address: R ra)-i /V o 9?& 5%
City: / Ll &wl .5 /lD/a t-S State: f Zip: / 3k
TenanVUssee Name: Phone#:
Email:
CONTRACTOR: Comuanv Name: &15 TT /I / ®O L `; Phone#: 305` ®7 5 5 - 5 3 / 5
Address: Y 3®? ,S 0 S / / 5 %! * / 00
City: 1V1h" / State: i5 - Zip: 33 >k6
Qualifier Name: .J�� �N /� �/ e k,10 Phone#: , 3o s a?s a - 5 3 /
State Certification or Registration #: CPL 05 6 Y 3 Y- Certificate of Competency #:
Contact Phone#: 30J 07.5 .5 5 3 J 5 _ _ Email Address: r-a S /gip aOl s 6% J/ clf soa4 o /7 @-
DESIGNER: Architect/Engineer: _ �J C&fi le— FR&e l C.® Phone#: 31�&—
Value of Work for this Permit: $ 3 ono Square/Linear Footage of Work:
Type of Work: DAddress OAlteration ONew ORepair/Replace ODemolition
Description of Work: ice- (7 ®L- P/ 4 I iVd
Submittal Fee $ _ i �''- Permit Fee $ Z - CCF $ CO /CC $
Scanning Fee $
Radon Fee $
Notary $ TraininWEducation Fee $
Double Fee $ Structural Review $
DBPR $ Bond $
Technology Fee $
TOTAL FEE NOW DUE $ / f- . 665 -
}
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
Zi
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
Sign
Owner or Agent
The foregoing instrument was acknowledged before me this
day of ` ✓Te 2013 , by WO /2i-6 c O
who is personally known to me or who has produced
As identification and who did take an oath.
NOTARY PUBLIC:
J
Sign:
Print: 0
My Commission Expires:
UF -I M-/ R
VContractor
The foregoing instrument was acknowledged before me this
day of 4 , 20 Z3—, by /14 IV P &I�
who is personally known to me or who has produced
as identification and who did take an oath.
NOTARY PUBLIC:
APPROVED BY Z � DZQ Plans Examiner
Structural Review
(Revised 3 /12/2012)(Revised 07 /10W)(Revised 06110r2M)(Revised 3/15/M)
Zoning
Clerk