PL-14-259Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number INSP 207007 Permit Number PL -2-14-259
Scheduled Inspection Date: May 20, 2014 Permit Type: Plumbing - Residential
Inspector. Diaz, Osvaldo
Inspection Type: Final
Owner: DENNIS LEYVA, CLARK REYNOLDS Work Classification: Pool - Private
Job Address: 69 NE 102 Street
Miami Shores, FL 33138- Phone Number
Parcel Number 1132060131680
Project <NONE>
Contractor. ROSMEL POOL INC Phone: (305)592-7900
awidmg uepartment comments
POOL PIPING Infractio Passed Comments
INSPECTOR COMMENTS False
Inspector Comments
Passed
C-)�
Failed
Correction
Needed
Re -Inspection
Fee
No Additional Inspections can
be scheduled until
re -inspection fee is paid
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 �'BC L�Z_ 14
Permit No.
PERMIT APPLICATION Master Permit No D q — S-7
Permit Type: PLUMBING
JOB ADDRESS: 61 ,tU E 1 O -z- s-"
City: Miami Shores County: Miami Dade Zip: 3 3 13 $
Folio/Parcel#: - 3 2 C> - 13 j fo 8 O
Is the Building Historically Designated: Yes NO Flood Zone:
OWNER: Name (Feee Simple Titleholder): C L.d1C12e.jr1.nlJ5 - inn; s Ja.y va Phone#:
Address: Or= 102 --ST
City: State: Zip: S 3 3 8
Tenant/Lessee Name: _ /J 1 A Phone#:
Email:
CONTRACTOR: Company Name: T-,_*0s.+ieJ js , ?�.e . Phone#:
Address:
City: _Q:;1 IC4 State• -Tc Zip: 3-B) L 4 -
Qualifier Name: I'T t4" VQ elz. Phone#: 100
State Certification or Registration #: "C- 145-6904 Certificate of Competency #:
Contact Phone#: `7 $ (o -545 - 615 5 Email Address: rn� �eoS �c9� Pas rne� o��s. corn
DESIGNER: Architect/tnneer:474e—.o - P. C. 6 Z S 31 Phone#: 3 4>s3os s e-3 I
Value of Work for this Permit: $.-2, S Square/Linear Footage of Work: 536
Type of Work: ❑Address DAlteration 3Kew ❑Repair/ReplaceODemolition
Description,of_ Work:. -P.—(
- - .g�L�,
Submittal Fee $ Permit Fee .$-
Scanning Fee $ Radon Fee $
Notary $ Training/Education Fee $
Double Fee $ Structural Review $
CCF $ - CO/c"
DBPR $ Bond $
Technology Fee $
TOTAL FEE NOW DUE $
Bonding Company's Name (if applicable) 4 fm
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 note approvfAand a reinpection fee will be charged.
0 Oper or Agent
The foregoing instrument was ackn ledged before me this 44
day of�i�, 20 /`X, by OJCM J<
all
who is personally known tee or who has produced
As identification and who did take an oath.
NOTARY PUBLIC:
a �.—Lviiir�
oe
Signature
Contractor
The foregoing instrument was acknow g beforee s
day of ���, 20, by t�
who is personally known to me or who has produced
as identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
MARC0S A. MARTINEZ My Commissio MARCOS A. MARTINEZ
MY COMMISSION # FF 008989 MY COMMISSION 9 FF 008989
EXPIRES: May 15, 2017. " . ry P
Banded ThEXPIRES: May 15, 2017
ru t+lateublic Unde�riters li;� ' ,.•` Borcled Thnr Notary Pu6Ge ORderts
APPROVED BY 4 Plans Examiner
,J l i •s ✓-, ..
Zoning
Structural Review GTerk
(Revised3/1 =01 2)(Revised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09)