PLC-12-1684Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972 ^
Inspection Number: INS P-187315
Scheduled Inspection Date: March 13, 2013
Inspector: Hernandez, Rafael
Owner: , LEOCAVA LLC
Job Address: 9534 NE 2 Avenue
Miami Shores, FL 33138 -
Project: <NONE>
Contractor:
DALE PLUMBING
Building Department Comments
CAP 2" DRAIN LINE IN MIDDLE FLOOR
Passed
Failed
Correction
Needed
Re -Inspection
Fee
No Additional Inspections can be scheduled until
re -inspection fee is paid.
Permit Number: PLC -9-12-1684
Permit Type: Plumbing - Commercial
Inspection Type: Final
Work Classification: Addition/Alteration
Phone Number
Parcel Number 1132060132630
Phone: (786)663-1804
INSPECTOR COMMENTS False
Inspector Comments
CREATED AS REINSPECTION FOR INSP-178316. no access
CSF'
March 12, 2013 For Inspections please call: (305)762-4949 Page 38 of 43
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Miami Shores Village
Building Department
10050 NX.2nd Avenue, Miami Shores, Florins 33138
• Tel: (305) 795.2204 Fax: (305) 756.8972
INSPECTION'S PHONE NUMBER: (305) 762:4949
BUILDING
PERMIT APPLICATION
"C 20
Permit Type PLUMBING
-
SEP 10 2012
�r
Perm1tN0.9IG)2---)(,oU
Master Permit No.
OWNER: Name (Fee Simple Titleholder); L C -c-:, t, L\1 Phone#
Address- 115210
City: V�ek' ,,A state: % Zip:
Tenant/i,essee Name:
hg8e#
Email:
JOB ADDRESS:
City:
-
County: Miami Dade Zap;
Folio/Parcel#: - � .
Is the Baihling Histerleally Designated: Yes NO Flood `Lone:
CONTRACTOR: Company Name: P k U H b / iJ f Phoae#: -?f-6
Address: l f- A)9 %
City: ! ®r10 S /0 State: - -.
2 / �
Qualifier Name: �- ` �% ° .D4 W k i t&I„ S' Phone#i
State Certification 'brkogistration 4l C e e �' �? Certificate of Coro tencj► #:
Contact Phone#: ee ���7®�Tnail Address:
DESIGNER: Archtect/fingineerc Phone#:
Value of Work for this Permit: $ �®
Squarefl inear Footage of Work:
Type of Work: OAddress (3AlterationONevg ORepair/Replace ODemolition
Description of Work: �ff �9 7-) sq
H,
Submittal Fee $ Permit Fee $ CCF $ CO/CC $
Sauming Fee $ Radon Fee $ DBPR $ Bond $
Notary $ Training/Educatfon Fee $ Technology Fee $
Double Fee $ Structural Review $
TOTAL FEE NOW DUE 0
Bonding Company's Name (if applicable)
Bonding Company's Address
City State zip
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
City State Zip
4
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 ELECTRI Z4L� WORK PILUMBI1)[G, 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.
16WARNJNG TO. OWNER: YOUR FAILURE TO RECORD A NOTICE , OF
CON[MENCEMENT 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 hich occurs even (7) days after the building permit is issued. In the absence of such posted notice, the
inspection will clot be Prov nd reinspection fee will be charged.
Si Cli
Signature Signature
Owner or Agent Contractor
The foregoing ins went was acknowledged before me this
day of , 20 J:,) by I
who is onally known/ or who has produced
Alsfderitification and who did take an oath.
The Two ' g instrumpfit was ackn wl ed bef
day of 201, by +�
who ' Wally known or who has produced
as identification and who did take an oath.
NOTARY PL*LI¢V s` NOTARY PUBLIC:, ' - 'I ;0,\ n
APPROVED BY
;C1 C&MMISBION # EE+7rM
MUM: Merh 27.2015
F1. Ndw Dhow Anon. Ca
(Revised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09)
Sign: of -.
9 «o My omm. Expires Sep 23, 2015
Bonded Through National Notary Assn,
My Commis
Plans Examiner Zoning
Structural Review Clerk