PL-13-6161 0
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP- 188232 Permit Number: PL- 3- 13-616
Scheduled Inspection Date: November 19, 2013 Permit Type: Plumbing - Residential
Inspector: Diaz, Osvaldo
Owner: ARRONTE, MIGUEL & CARLINA
Job Address: 890 NE 92 Street
Miami Shores, FL
Project: <NONE>
Inspection Type: Final
Work Classification: Addition /Alteration
Phone Number
Parcel Number 1132060050130
Contractor: I Ili M SERVICE AND REPAIR Phone: (786)380 -6911
tau
Comments
BATH AND KITCHEN REMODEL
INSPECTOR COMMENTS False
Inspector Comments
Passed
C "-1 Q.
Failed
Correction 1(
Needed
Re- Inspection ❑
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
November 18, 2013 For Inspections please call: (305)762 -4949 Page 3 of 31
Miami Shores Village
Building Department MAR 2 �0�3
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
INSPECTION'S PHONE NUMBER: (MS) 762.4949 (�
BUILDING Permit No.� r f
PERMIT APPLICATION Master Permit No. RU S (I 4
FBC 20 kD
Permit Type: PLUMBING
OWNER: Name (Fee Simple Titleholder): C Z i n A 7- ACLiZ, -fE Phone# 3&0 3Q6 _" V440
Address: 2(�5 C0W1(\'G A�oe . LPT 100,4-
City: �A State: - zip: X3314-0
Tenant/Lessee Name: Phone#:
Email: Y1 ra Aarz.Q Pi -r c VALM C.9-w1
JOB ADDRESS: �' �® AIC Q Z T
City: Miami Shores County: Miami Dade zip:
Folio/ParceW
Is the Building Historically Designated: Yes
CONTRACTOR: Company Name: -T'ot /q 5
Address: (7 (( ® 7 41W 2-o / S 9- 7--e
City: "I"
Qualifier Name: a
NO Flood zone:
C 2
Phnnc����Y soar
�k L / -Z Ae X 9
Zip: 3-300-
Phnn"'idkJ 3R V �� //
State Certification or Registration #: C PC l C( Z.S V ® f � Certificate of Competency #:
Contact Phone# ,280 em Email Address: I-0-d hfv
DESIGNER: Architect/Engineer:
Value of Work for this Permit: $ 3, 000 ' Square/Linear Footage of Work:
I LAv3
Type of Work: DAddress ;; nOAlteration ONew ORepair/Replace LIDemolition
Description of Work: j ��t iZ.C)oo -A S *t.lr -QJ e-Vy
Submittal Fee
Permit Fee $-17&2'Z S «.
CCF $ CO /CC $
Scanning Fee $ Radon Fee $ DBPR $ Bond $
IL
Notary $ TrainhWEducation Fes; $ Technology Fee $
Double Fee $ Structural Review $
TOTAL FEE NOW DUE $ °
N
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 $2500, the applicant roust
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued In the absence of such posted notice, the
inspection will not be approved and a reinspection fee will be charged
Signature Signature
Owner or Agent j
The foregoing instrument was acknowledged before me this
day of" ,20 a,byC NA �L
who is personally known to me or who has produced 11
As identification and who did take an oath.
The foregoing instrument
day of 7v1� q
who is WHY
NOTARY PUBLIC: u«11uu1 "�1 %i NOZ
Ar��i��
Sign: Sign:
Print: Print
Contractor
before me thisp�
d-igh's did pke an oath.
gA18
My Commission Expires:•, s��� c' •° My Commission Expires:
APPROVED BY -/-r- -3 Plans Examiner Zoning
(Revised 07/10/o7) {Revised 06110t2009)(Revised 3/15/09)
Structural Review Clerk
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JIFF ATWATAR.
CWO FWANMAL QFFIC9R STATE OF FLCIiIDAI
DEPARTMENT OF FINAiMML SERVICES
DIVISION OPWORKERS' COMPENSATION
' • C"'11r -IOATE OF ELgrTIeQ1*.T4?:18E Fil'I,E.MPT FROM .FIr RIDA WORKERS' -COMPENSATION LAW
CONSTRUCTIONJNDU$TRY EXEMPTION
"It t %rU ls1§ That tltO'WIVidupl 98te,+d:b0I*W brae e1a01*1 to be ox®mpt from f1wids •WptkeW rompsttsatIbn Jaw.
-Ef f9CTWE DATE: 412112013 EXPIRATION DATE: 40/2015'
.P!ERSONt STEELE 9ARPJOS JUAN R
FEIN: 6EZ297102
SUSINEU NAME AND ADDRESS:
I S M SERVICE AND REPAIR If
607 NW 201 ST TER
HIALEAH FL 33015
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IRON OR STEEL• DOOR ANb W04[)OW PLUMBING NOO AND
SRECTION FRAME INSTALLATION DRIVERS
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