PL-13-1384Miami 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
JUN 18 2913
FBC 2013
Permit No. IV U,� , 3
Master Permit No. jLA 3 — � 3 9-3
JOB ADDRESS: %U U.) Z
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#:
Is the Building Historically Designated: Yes
NO
Zone:
01
OWNER: Name (Fee Simple Titleholder): "C, C0Phone#:
Address:,
a
City: L\A:A o, iM l l�1_-5 State: —ZL— Zip:�� p�,
Tenant/Lessee Name: Phone#: `fs-7 cicav
Email:
CONTRACTOR: Company Name: d�l(�z�,fG �V_JgSoN\G , INC Phone#: ®� 4-A S
Address: 4 Q F) ZQ Ss_go '2jo 0'- � f
City:
Qualifier Name:
P
State Certification or Registration
Regiestration #: tCIPC _ l 2 QF) )- Certificate of Competency #: _
Contact Phone#: `! CJ' -91 SL7 —�0 Email Address:
DESIGNER: Architect/Engineer: Phone#:
Value of Work for this Permit: $ � 15 50 ,0._O� Square/Linear Footage of Work:
Type of Work: ❑Address ❑Alteration ❑New ❑Repair/Replace CJDemolition
Description of Work: o a \ �� 1i11 Q �( . n 5 -P--2J
Submittal Fee $ Permit Fee $ ���� CCF $ CO/CC $
Scanning Fee $ Radon Fee $ DBPR $ Bond $
Notary $ Training/Education Fee $ Technology Fee $
Double Fee $ Structural Review $
TOTAL FEE NOW DUE $ '
3
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 $2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also, a certified copy of the recorded notice of comnAncement must be posted at the job site
for the first inspection which occurs seven 7 ing permit is issued. Kt ae absence of such posted notice, the
inspection will not be appro remspection fee wiltke;vharge
Signature %• / Signature
Owner or Agent Contractor
Th oregoing instrument was acknowledged before me this �� The foregoing instrument was acknowledged before me this
day of , 20 L, by 916it., 6-4-h eA irLday of , 20 , by !2- k0& r �► t;��
who is person wn to me or who has produced w o is personall own to me or who has produced
As identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
My C
[\Q!U:Z911/010e3d
�p� P�d� NolaI
ublic Sta4e f Florida
A Godoymission EE 84764
eo ou Expires 06/30/2015
as identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
o a Notary Public State of Flory
My Comm p�e$►edro A Godoy
4 My Commission EE084764
ov ati Expires 018/3012015
Plans Examiner Zoning
Structural Review Clerk
(Revised3/12/2012)(dtevised 07/]0/07)(Revised 06/10/2009)(Revised 3/15/09)
08-14-'13 06:48 FROM -
T -659 P0002/0013 F-877
Inspection Worksheet (Y)AAs3"16-�
Miami Shores Village 1
10050 N.E. 2nd Avenue Miami Shores, IFIL I
Phone: (305)795.2204 Fax: (305)756-8972
Inspection Number: INSP-'I 96999 Permi[ Number;' a MMM.-
�
��_---�-- ---
Scheduled Inspection Date: August 13, 2013 Permit Type: Residential Construction
Inspector: Diaz, Osvaldo
Owner: E:THEART, ELSIE AND BERNARDO
Job Address: 9337 NW 2 Court
Miami Shores, FL
Project: <NONE>
Inspection 'type: Final
Work Classification: Alteration
Phone Number
Parcel Number 1131010150370
Contractor: AG STAR CONSTRUCTION INC Phone: (305)457-9970
Building Department Comments
RENOVATE MASTE=R BATHROOM. NEW TOILET &
SHOWER STALL, NEW CABINETS & FIXTURES
bounce check #11658 to be paid. 7/1/13
INSPECTOR COMMENTS False
Passed
Inspector Comments
Failed
Correction
Needed
Re -Inspection
Fee
No Additional Inspections can be scheduled until
re -inspection fee is paid.
August 12, 2013 For Inspections please cell: (305)762-4+349
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