PL-13-2653Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number INSP-217906 Permit Number: PL -11-13-2663
Scheduled Inspection Date: August 19, 2014 Permit Type: Plumbing - Residential
Inspector: Diaz. Osvaldo
Owner: ,
Job Address: 101 NE 110 Street
Miami Shores, FL 33161-7045
Project <NONE>
Contractor. ACA CONSTRUCTION INC
Comments
Inspection Type: Final
Work Classification: Addition/Alteration
Phone Number
Parcel Number 1121360040230
Phone: (305)788-8914
UPDATE PLUMBING IN TWO BATHS INCLUDING 1F11VdUUV rases %.ommenzs
CHANGE TOILETS VALVES AND SHOWER HEADS INSPECTOR COMMENTS False
UPDATE KITCHEN
Inspector Comments
Passed. G
Failed
Correction ❑
Needed
Re -Inspection ❑
Fee
No Additional Inspections can be scheduled until •- _ �p
re -Inspection fee Is paid. I
August 18, 2014 For inspections please call: (305)762-4949 Page 17 of 27
Miami Shores Village
R Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fag: (305) 756.8972
INSPECTION'S PHONE NUMBER: (305) 762.4949
BUILDING
PERMIT APPLICATION
Permit Type: PLUMBING
FBC 20
Permit No.
Nov 2 2'2013
Master Permit No.1? 1 13 --2— 6 c�
JOB ADDRESS: 1 C) I 1''' ( I C) d_� .
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#: I I"_ � 3 Ce - Oc 4- 0 D 3
Is the Building Historically Designated: Yes
NO
Zone:
f ' — LLG.
OWNER: Name (Fee Simple Titleholder): % �L 1...
Address: P~ =L Ar -e
City: State: FL_ Zip:�' �'"7.
Tenant/Lessee Name: Phone#: ---
Email:
CONTRACTOR: Company Name: _/�r—.Q &E C�f� , Phone#: 2,5>5 -,p- 64 3 q
Address: t 0 -i::x s SW S
City: CYn i G"_1 i State: FF L_ Zip: � :�3l
Qualifier Name: A Phone#:
State Certification or Registration #: C.1=' C 14 —r 3 S' Certificate of Competency #:
Contact Phone#: 3o S' -,a l!j - 3 44 P) Email Address: Ck 0
Value of Work for this'P
+]
—
��itn4�
z...
;s7fitt�"
Type of Work: ❑Address OAlteration =� ,F,, _,14,4 +r '; <(ir/Replace ODemolition
Description of Work: U 1 L P✓-�r� h �o^►� t r" --�r� �C-�1`
Submittal Fee $ Permit Fee $
Scanning Fee $
Radon Fee $
Notary $ Training/Education Fee $
Double Fee $ Structural Review $
CCF $ CO/CC $
DBPR $ Bond $_
Technology Fee $
TOTAL FEE NOW DUE $ 116, ���
Bonding Coxnp4ny'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
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. i ,
Signature Signature
wn or A ent Contractor
The foregoing instrument �wasacknowledged before me this The foregoing instrument was acknowledged before me thi§-Z<D
day of t,/ , 20 1'� by r -v -N 6 i 20 La, byJ'
who is pi sonally known . e or who has produced who' perso y kno to me or who has produced
As identification and who did take an oath.
NOTARY PUBLIC:
Nom► Pd* - SW N FWW
My Comm. b0ft Feb 24, 2011
Sign:
Banded
My Commission Expires:
APPROVED BY
Plans Examiner
Structural Review
(Revised3/12/2012)(Revised 07/10/07XRevised 06/10/2009)(Revised 3/15/09)
as identification and who did take an oath.
NOTARY PUBLIC: A``"�' "••.. JOSE M. SANTANA
Notary Public - State of Rotbla
• : • My Comm Expires Feb 24, 2017
Si o;+�f ;QP Commission # EE 877443
T Nut ry Assn.
Print:St -
My Commission Expires:
Zoning
Clerk
MS
Oki
-sit
.�_ S9Q# L152'61710
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