PL-14-294Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-207287 Permit Number: PL -2-14-294
Scheduled Inspection Date: June 25, 2014 Permit Type: Plumbing - Residential
Inspector: Diaz, Osvaldo Inspection Type: Final
Owner: BECERRA, JACQUELINE Work Classification: Addition/Alteration
Job Address: 401 NE 94 Street
Miami Shores, FL 33138 -
Phone Number
Parcel Number 1132060140480
Project: <NONE>
Contractor: TWIN BROTHER Phone: (305)332-1969
tsuiming Department comments
BATH ROOM REMODEL
INSPECTOR COMMENTS False
Inspector Comments
Passed
Failed
Correction ❑
Needed
Re -Inspection ❑
Fee
No Additional Inspections can be scheduled until
re -inspection fee is paid.
June 24, 2014 For Inspections please call: (305)762-4949 Page 7 of 35
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
� 4
Q rD t i1
®a-- -- ---,-
FBC 2010L_/ t opt q q
Permit No.
Master Permit No. c - 1� —
JOB ADDRESS: _ A{®i ME3 qA.4 S Tee:�
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#: Ll - -92o(Q - njS � <{
Is the Building Historically Designated: Yes NO Flood Zone:
OWNER: Name (Fee Simple Titleholder): I�1a�� r� Phone#:
Address: ''-to% q&_4
City: (:�xrosio �1/l�f c State:-t�rrc�� Zip:'-, &1
Tenant/Ussee Name: Phone#:
Email:
CONTRACTOR: Company Name: l U e� e Phone#: :305 313 t T Ce
Address: -0"°'5%�s/
City: State: �- Zip: Pow
Qualifier Name: sAIhAffa Phone#:
State Certification or Registration #: G -FC. 0-07 // Certificate of Competency #:
C
Contact Phone#: '40V '3gL /96i Email Address:
DESIGNER: Architect/Engineer: Phone#:
Value of Work for this,Permit,
��U ` Square/Linear Footage of Work:
e o;�Vtfi'k DAddtess DAlteration ONew ljair/Replace;Y.
T� w ❑Demolition
Submittal Fee $ Permit Fee $ isd CCF $ CO/CC $
Scanning Fee $
Notary $
Radon Fee $
DBPR $ Bond $
Training/Education Fee $ Technology Fee $
Double Fee $ Structural Review $
TOTAL FEE NOW DUE $
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
IlVIPROVEMENTS 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 subje t nt. Also, a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspectio which occ rs s en (7) days aft the building permit is issued. In the absence of such posted notice, the
inspection will not be pprov a a rpection fee wile charged.
or
The for�oing instrumen as acknowledged before me this
day o , 20 , by iC jyf ohs CPI(A—
who is perso al known to me who has produced
As identification and who did take an oath.
Signature
i
ntractor
The foregoing instrument was acknowledged before me this,
day of , 20 �, by ��n ku L�_
who is personall known to me or who has produced
4>� Qe as identification and who did take an oath.
NOTARY
Print:
My Commission
MY COMMISSION # EEVM4
APPROVED BY 2, " ��+" <Y Plans Examiner Zoning
Structural Review Clerk
(Revised 3/12/2012)(Revised 07/10/07)(Revised 06/10/2009)(Revised 3/15/04)