RC-14-788 (2)Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-216103
Scheduled Inspection Date: July 18, 2014
Inspector: Rodriguez, Jorge
Owner: DAVIS, KARIN AND TIMOTHY
Job Address: 80 NE 94 Street
Miami Shores, FL 33138 -
Project: <NONE>
Contractor: VEROTEX CONSTRUCTION INC
Building Department Comments
BATHROOM RENOVATION: DEMO RELOCATE DOOR,
INSTALL NEW TUB, TOILET, SINK INSTALL 38 LF OF
SEWER CONNECTION LINE TO EXISTING SEPTIC TANK
. ELECTRICAL, PLUMBING, TILE, AND INSULATION
WORK TO BE DONE
Permit Number: RC -4-14-788
Permit Type: Residential Construction
Inspection Type: Final Building
Work Classification: Alteration
Phone Number
Parcel Number 1132060130300
INSPECTOR COMMENTS False
Phone: (305)261-8777
July 17, 2014 For Inspections please call: (305)762-4949 Page 12 of 13
Inspector Comments
Passed or
Failed
Correction
Needed ❑
Re -Inspection ❑
Fee
No Additional Inspections can be scheduled until
re -inspection fee is paid.
July 17, 2014 For Inspections please call: (305)762-4949 Page 12 of 13
Miami Shores Village
Building Department APR 1820%
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795-2204 Fax: (305) 756-8972 $
INSPECTION LINE PHONE NUMBER: (305) 762-4949
FBC 20
BUILDING Master Permit No. 9-11. �� 2
PERM APPLICATION Sub Permit No.
ILDING
❑ ELECTRIC
❑ ROOFING
❑ REVISION
❑ EXTENSION
[-]RENEWAL
PLUMBING
❑ MECHANICAL
❑PUBLICWORKS
[:]CHANGE
CONTRACTOR
❑ CANCELLATION
❑ SHOP
DRAWINGS
JOB ADDRESS:=� 4
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#: 11 --'novo ® r; - 0 Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
�--
OWNER: Name (Fee Simple Titleholder): � �e �/ t IT 1 �✓ • �/ �� Phone#:3D5 s10s 41T5
Address: ® V�Ei ou#N ssh-
City: "Omx S) State: Zip:
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR: Company Name: 16 �'7't� �- Phone#: J1D5'Z6a -,k-"j
Address: & 0 LU
city: 1. -r State: Zip: '�35 1 S5
Qualifier Name: Cr(O Phone#: 30 -451 -26t -i-1-11
State Certification or Registration #: (.,es�l9 rat '(� Certificate of Competency #:
DESIGNER: Architect/Engineer: I 0fz0?_CA=) Phone#:1%-11� �IZS
Address: if (" -2' W 14.:'L City: it( A4l I State: sFLL Zip: Z tq
Value of Work for this Permit: $ Square/Linear Footage of Work: [in
peofs 1:1Addition Alteration 1:1New ❑ Repair/Replace ❑Demolition
Description of Work:` T l '� 1� iK51J !i �iD►"(l 9 D f nt [� c
4ty TO
�td'�tr►.cC�c�—. '�t�s�t,�ittJts� � �iul`t,�►�- E r�l,�� , tnJc�r�� �' k��. '��%1,-� �y�nc��1Sy
Specify color of. color thru tile:
Submittal Fee $ fb Permit Fee $ CCF $ CO/CC $ y r
Scanning Fee $
Notary
Radon Fee $
Training/Education Fee $
Double Fee $ Structural Review $
DBPR $ Bond $
Technology Fee $
TOTAL FEE NOW DUE $ _'�Iv LE�
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 inspectjv;.,Which occurs seven (7) days after the building permit is issued. Innthe absence of such posted notice, the
inspection will rf t e TPIT
d and a reinspection fee will be charged.
Signature ( I Signature
Owner or Agent
Contractor
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me
this day ofd 20 by / �tcftyi S day of 20 ui by
who is personally known to me or who has produced p /dD who is personally known to me or who has produced
�.3 As identification and who did take an oath. identification and who did take an oath.
NOTARY PUBLIC:
NOTARY PUBLIC:
Sign:
My Commission Expires: My Commission Expire
n
EqPubl
Notary Public state Of Florida
Joanna M Fe#dano
NSt spy Commiaaion FF 082753
*d * ee ��MLoorpiP E018 082753
APPROV Plans Examiner Zoning
Structural Review
(Revised02/24/2014)(Revised 5/2/2012)(Revised 3/12/2012) )(Revised 06/10/2009)(Revised 3/15/09)(Revised 7/10/2007)
Clerk