PL-14-584t
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number. INSP-209630 Permit Number: PL -3-14-584
Scheduled Inspection Date: July 24, 2014 Permit Type: Plumbing - Residential
Inspector. Diaz, Osvaldo
Owner:
Job Address: 957 NE 99 Street
Miami Shores, FL 33138 -
Project <NONE>
Inspection Type: Final
Work Classification: Addition/Alteration
Phone Number
Parcel Number 1132060340260
Contractor. ACA CONSTRUCTION INC Phone: (305)788-8914
ttuutling Department comment;
UPDATE THREE BATHROOMS
Passed
INSPECTOR COMMENTS False
Comments
Correction
Needed
Re -inspection
Fee
No Additional Inspections can be scheduled until
re -inspection fee is paid.
July 23, 2014 For Inspections please call: (305)762-4949 Page s of 34
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
FBC 20 c�
Permit No. P(—
Master Permit No. c' y
JOB ADDRESS: ®; 'Fb -) f-� (= i n m
City: Miami Shores County: Miami Dade Zip: -.-.x,:`
Folio/Parcel#:
Is the Building Historically Designated: Yes
NO l«� Flood Zone:
OWNER: Name (Fee Simple Titleholder): +a ' L_- a c� "-,-J 4 1 a � �® 1 Phone#: � - -
Address: �_ k� vv- �' � -
City: VnC2' ^C_
Tenant/Lessee Name:
Email:
State L- Zip: A 12-77
CONTRACTOR: Company Name: ^C_ Phone#: -3� =) -. Vzi- _ 4
Address: a ®-1 =h- 5 S-' �� ���✓.
City: State: 1� L _ Zip: -3 -!S
Qualifier Name: Phone#: 30!-� - _0L Y'S - 'a,}4 -b,
State Certification or Registration #: Certificate of Competency #: C IF (
Contact Phone#: Email Address:
DESIGNER: Architect/Engineer: Phone#:
Value of Work for this Permit: $,�� 00c) Square/Linear Footage of of Work: 6200 _� r ,
Type of Work: DAddress DAlteration ONew R%CRta�air/Replace ODemolition
Description of Work: (a j�:`��-t� �'I�i C►-iM`���r�. P
Submittal Fee
Scanning Fee $
Permit Fee $ 3 ()aL___ CCF $ CO/CC $
Radon Fee $
DBPR $ Bond $
Notary $ Training/Education Fee $ Technology Fee $
Double Fee $ Structural Review $
TOTAL FEE NOW DUE $ 2�`
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
• • .
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 $2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
Signature Signature V-1
01
err gent Contractor
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this moi''
day of 20 LA,:, -by o - 6 of20 _J!!!�,by
who ' onally kno to me or who has produced o r who is 1102o kno to me or who has produced
As identification and who did
NOTARY PUBLIC:
Sign:
Print: �' a
My Commission Expires:
o$A1h� 9'
as identification and who did tak
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NOTARY PUBLIC: z
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Sign:
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Print: 4L i s
My Commission Expires:
APPROVED BY ("� Plans Examiner
Structural Review
(Revised3/12/2012XRevised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09)
Zoning
Clerk