PL-13-1894Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-197687
Scheduled Inspection Date: March 12, 2014
Inspector: Diaz, Osvaldo
Owner: , B&L REALTY HOLDINGS LLC
Job Address: 973 NE 96 Street
Miami Shores, FL 33138 -
Project: <NONE>
Permit Number: PL -8-13-1894
Permit Type: Plumbing - Residential
Inspection Type: Final
Work Classification: Addition/Alteration
Phone Number
Parcel Number 1132060143230
Contractor: ACA CONSTRUCTION INC Phone: (305)788-8914
comments
KITCHEN AND BATH REMODEL
INSPECTOR COMMENTS False
--� ' Inspector Comments
Passed
M
Failed
Correction ❑
Needed
Re -Inspection y
Fee f
No Additional Inspections can be scheduled until l i
re -inspection fee is paid. @@@@
l�
March 11, 2014 For Inspections please call: (305)762-4949 Page 5 of 34
Miami Shores Village
Building Department Aug zN
90050 N.E.2nd Avenue, Miami Shores, Florida 33138 6;2—
Tel: (305) 795.2204 Fax: (305) 756.8972
INSPECTION'S PHONE NUMBER: (305) 762.4949
FBC 2�0 L 0,
BUILDING Permit No. T
PERMIT APPLICATION Master Permit No.q-c43 Z
Permit Type: PLUMBING
JOB ADDRESS: q-1 2) �� q Cn 14-
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#: ( I - 3a CY,, <::-t 4- C) ` l
Is the Building Historically Designated: Yes NO Flood Zone:
OWNER: Name (Fee Simple Titleholder): IS L *Q� O=L 4,J CJ i nFline#: ` 3 OS S g 4?
Address: ISPOt >b ^-X.,/
City:
Tenant/l essee Name:
Email:
r G•-Y"� i
State: *:7L-
CONTRACTOR: Company Name: e0%C- )N% _ Phone#: _�S ®'� ' %9. 3%-I �-Q.
Address: I O -l_--- S T1n/ C's �,� r,�
City: ,/—g -'sI G + State: E L Zip: 3
Qualifier Name: L --_C-1 LAJ• Phone#: 6C;P S - =k- ICY " 3448
State Certification or Registration #: t., it C.. 14-:1'7 6 35 Certificate of Competency #:
Contact Phone# 3®$°. 4mail Address: f'Y> C.►/ CGQ Ui'7�s'Y�c
DESIGNER: Architect/Engineer: �- Phone#:
Value of Work for this Permit: $ aC® ® C) Square/Linear F�oo�e of Work:
Type of Work: ❑Address ❑Alteration ❑New 3Repair/Replace ❑Demolition
Description of Work: x rQU C�'�' ��j���� n, --,e �
G
el A
Submittal Fee $ �`� • Permit Fee $ u� CCF j CO/CC $
Scanning Fee $ Radon Fee $ �a Dg�BPR $ - Bond
$
Notary $ Training/Education Fee $ o �U Technology Fee $ 1.60
Double Fee $ Structural Review $ �y /y
TOTAL FEE NOW DUE $ I a %o '7 A °
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.
Signatureux�Signature
er or Agent Contra or
The foregoing instrument was acknowledged before me this �G The foregoing instrument was acknowledged before me this% C/,
day of , 20 , by PO ( cJ�_VCs. �,\ y of C , 20 1 by>�1 �C��'�I L �P
who is p s nally k o me or who has produced who is rsonally kn v to me or who has produced f
As identification and who did take an oath. as identification and who did take an oath.
NOTARY UBLIC: NOTARY PUBLIC:
Sign: Sig .
Print: �fl C_ on I(11 1ra� Print:
My Commis My Commission Ex
RANNI A BLANK RONNI A BLANK
"c MY COMMISSION # EE000573 *: MY COMMISSION # EE000573
(407) 3'88-01 3 FloridallotmySerwee.cam 7)39"153 FlorWallotarySennce.com
APPROVED BY ZC: -/ 7 Plans Examiner Zoning
Structural Review Clerk
(Revised3/12/2012)(Revised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09)