PL-14-866Miami Shores Village
Building Department
40050 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
JOB ADDRESS:
FB
Permit No.
Master Permit No. il—c- • 14 51
90 z2 &6/%Z-'
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel #:
Is the Building Historically Designated: Yes
NO Flood Zone:
OWNER: Name (Fee Simple Titleholder): I,141.� CC) j07-444-73-2.— Phone #:
Address: 3 9 NI -Z3
City: !414,1 J t O 5 State: irt Zip: 3 3/
Tenant/Lessee Name: Phone #:
Email:
CONTRACTOR: ompany Nr�am�e,., / 9 � / ��� /Phone #:
1i�h V
Address: 1 r' 7 /. / / 3 /
City: State: r 0,/, /°�' Zip: ___
Qualifier Name: pi , y ,S f l'1 A' I Phone#:
State Certification or Registration #: C r . `/ 1 %6® 2Certific to of°,Rmpetency #: /, ��
Contact Phone#: 79% `J✓ 3 j 00mail Address: fY) I L� /y1 I �LL-� 1 /f� i G i 6.04-1/
DESIGNER: Architect/Engineer: Phone #:
Value of Work for this Permit: $ Square/Linear Footage of Work:
Type of Work: Address UAlteration New ■ ORepair/Replace ODemolition
Description of Work: P'. •-.)14C-C7 lL i Coa A Ste• (' .4.30 ST .-.12
**** **** ** ***********+x********* ***** Fees*+ u******* ************* ***** * ***+x********** **
Submittal Fee $ ad Permit Fee $ /®a ;-y CCF $ CO /CC $
Scanning Fee $ Radon Fee $ DBPR $ Bond $
Notary $ Training/Education Fee $ Technology Fee $
Double Fee $ Structural Review $
TOTAL FEE NOW DUE $ U 5. I(/ `
'
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, BOIT.RRS, 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.
TTh
Signature Signature
Owner or Agent
The foregoing instrument was acknowledged before me this_
day ofii ft f , 20/ , by 1910A9_6,
who is persouaRy lmpj +n to me or who has produced
As identification and who did take an oath.
NOTARY PUBLIC:
Sign:
My Commis
*** * * ***
Notary Public State of Florida
Joanna M Feliciano
F My Commission FF 082753
*6158gesOld > *w******
NOTARY
.flhIl.
The foregoing instrume
day of
who
7
this 2°t
,PSOD
Ltrc
me or who has produced
as identification and who did take an oath.
NOTARY PUBLIC:
Sign:
APPROVED BY Plans Examiner
Structural Review
(Revised3 /12/2012)(Revised 07 /10 /07)(Revised 06 /10 /2009)(Revised 3/15/09)
Print: 444(A) Car,} 2,4.662-
My Commission Expires: $ • (0. is
Zoning
Clerk
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number. INSP- 214203
Permit Number: PL- 4- 14-866
Scheduled Inspection Date: June 17, 2014 Permit Type: Plumbing - Residential
Inspector. Diaz, Osvaldo
Owner: GONZALEZ, ALAIN
Job Address: 9022 NE 8 Avenue 3M
Miami Shores, FL
Project <NONE>
Contractor: MITO PLUMBING CORP
Inspection Types
Work Classification: Addition/ Iteration
Phone Number 7"86!277 -9756
Parcel Number 1132060420530
Phone: (786)553 -5003
Building Department Comments
CONNECT SINK AND DISH WASHER EXISTING
Infractio Passed Comments
INSPECTOR COMMENTS
False
Passed
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Inspector Comments
PLEASE CALL ALAIN GONZALEZ
786 - 277 -9756 FOR ACCESS TO CONDO UNIT.
June 17, 2014
For Inspections please call: (305)762 -4949
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