PL-12-190Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL '
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-169558 Permit Number: PL -2-12-190
Scheduled Inspection Date: June 06, 2012 Permit Type: Plumbing - Residential
Inspector. Hernandez, Rafael
Inspection Type: Final
Owner: LIBONATTI, ALEXANDRA Work Classification: Pool - Private
Job Address: 10343 NE 6 Avenue
Miami Shores, FL
Project: <NONE>
Phone Number
Parcel Number
1122310120210
Contractor: GENIE POOLS Phone: 305-260-9555-
liunaing uepanment comments
NEW SWIMMING POOL PIPING
Inspector Comments
Passed
Failed
J
Correction ❑
Needed
Re -Inspection ❑
Fee
No Additional Inspections can be scheduled until
re -inspection fee is paid.
June 05, 2012 For Inspections please call: (305)762-4949 Page 2 of 17
'4
Miami 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 No.V1
PERMIT APPLICATION Master Permit No.
FBC 20
Permit Type: PLUMBING
OWNER: Name (Fee Simple Titleholder): o g u n 0 L1 b®nci+6 Phone#: 30511 i' 5013 6
Address:_ _ ` 03q'3 N 1r W Ave) n U Q
City: Miami S ho K &'S State: r101Z 1 d &1 Zip:
Tenant/Lessee Name: N / A Phone#:
Email:
JOB ADDRESS: 102)4-2) NF, (p Avon u,&
City: Miami Shores County: Miami Dade Zip: 12
Folio/Parcel#: 11 'LZ 31 P ®1-L — 021 C)
Is the Building Historically Designated: Yes NO Flood Zone:
CONTRACTOR: Company Name: (14410 f2 l'"- Phone#: '305 i 2 -on .')5G5
Address: i -mu c i w 0 2b sr t 2®1
City: M ICA hn ` State: El zip: 3 318 (O
Qualifier Name: L12- i'1(1 . (j u a rd i G Phone#: 305 % 2d0®. 9 _65SC3
State Certification or Registration #: G 2 G1 t 510 Certificate of Competency #:
Contact Phone#:3 O 5 0� 00 - q� �1� Email Address: n u a 1'd 1 a a zii11 G
DESIGNER: Architect/Engineer:
J
-16to/ -366-1_7' 9
Value of Work for this Permit: $
1100
Square/Linear Footage of Work:
20 5f (- pz )
Type of Work: ❑Address
❑Alteration
34New ❑Repair/Replace
❑Demolition
Description of Work:
Now s W 1 m
t Yl i n Cg 1200L 121 b i n 67
Submittal Fee $ Permit Fee $ �Z
Scanning Fee $
Radon Fee $
Notary $ Training/Education Fee $
Double Fee $ Structural Review $
CCF $ CO/CC $
DBPR $ Bond $_
Technology Fee $
TOTAL FEE NOW DUE $ ��
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
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 properly 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 areinspection fee will be charged. _ ,,
Signature Signature
`tea- By ent Contractor
The foregoing instrument was acknowledged before me this
day of anQ-1201`x, by D900 Ll b®i1Oij!
who ' ers o me or who has produced
As identification and who did take an ath.
NOT:71119-In
IC:""
o."aVA6e�y,� GABRIELE. UARDIA
Notary Public - tate of Florida
a� • Q• M es ul 4, 2013
o.
Sign: jkL
Print:
My Commission Expires:
APPROVED BY
The foregoing instrument was acknowledged before me this —?I
day of n<JLlf20 02by H2 M -6104YdI G�
who 'ersonally knt me or who has produced
-2- ® 2-3-11 Plans Examiner
Structural Review
(Revised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09)
identification and who did take an
NOTARY
Sign: C 4i
%, OFF ,Cpr�prjrf 'PW 00 903043
Print: ltdd ��77 �I C�dfl 1 �/�
My Commission Expires:
Zoning
Clerk