PL-13-1172Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-192221
Scheduled Inspection Date: August 28, 2014
Inspector: Diaz, Osvaldo
Owner: ANDREOPOULOS, FOTIOS
Job Address: 118 NW 101 Street
Miami Shores, FL
Project: <NONE>
Contractor: PSG PLUMBING SERVICES, INC
Building Department Comments
BATH ADDITION AND KTICHEN REMODEL
Permit Number: PL -5-13-1172
Permit Type: Plumbing - Residential
Inspection Type: Final
Work Classification: Addition/Alteration
Phone Number (305)301-7828
Parcel Number 1131010220200
Phone: (305)796-7304
Infractio Passed Comments
INSPECTOR COMMENTS False
Inspector Comments
Passed
Failed
Correction ❑
Needed
Re -Inspection ❑
Fee
No Additional Inspections can be scheduled until
re -inspection fee is paid.
August 27, 2014 For Inspections please call: (305)762-4949 Pagel of 27
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 APPLICATION
Permit Type: PLUMBING
JOB ADDRESS: 119 kN) -101 5+ *felt
MAY 2 8 2013
=-C3�
FBC 24 l-3
Permit No. U �3
Master Permit No. JZ -C 13 ` 1 -7 0
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#: // • 3/'D/ • 0.2 • 0200
Is the Building Historically Designated: Yes NO V1, Flood Zone: _
OWNER: Name (F Simple Titleholder): (��IUS Phone#:
Address: U v st ee +
t ??
City: m1ww bh(reb State: L/ Zip: �J 1 50
Tenant/UName: Phone#:
Email: fwcvi &Aos 0 ml� l.%
CONTRACTOR: Company Name: _ PS 7 1,le fAb Gna Phone#:
Address: 3 1 qa V IAf S'T
city: Cal 40tka State: I Zip: _ „` _
Qualifier Name:
State Certification or Registration #: C'�"t= I !J�L 6 ),S7 Certificate of Competency #:
Contact Phone#: 7 L 'S 15" 7 % %5- Email Address:
DESIGNER: Architect/Engineer: Phone#:
Value of Work for this.Permit: $, 3"= Square/Linear Footage of Work:
Type;of Work: DAddress DAlteration ONew ORepair/Replace
Description of Work: t+h e fi, -4— k t iR.i,C'
CIO 'V1 P%
Submittal Fee $ Permit Fee $ CCF $ CO/CC $
Scanning Fee $
Radon Fee $
Notary $ Training/Education Fee $
Double Fee $ Structural Review $
DBPR $ Bond $
Technology Fee $
TOTAL FEE NOW DUE $
Wool
Bonding Company's Name (if applicable)
Bonding Company's Address
City State
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
Zip
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 $2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted no ' , the
inspection will not be approved and a reinspection fee will be charged A ,
Signature v
Owner or Agent
The foregoing instrument was acknowledged before me this
day of0, 20 �, by iFW S J�7?�lLP.�� —L ,
who is personally known to me or who has produced 0- AL '*
A%-253 & 9l9 & V As identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print: �
`'�r ° �•'%
My C �UEL A. SCARBt)ROU$p
Public - State of FlOft
g� �= My Comm. Expires Oct 18, 201
'••�;,g
its, �� , Ceanmission # EE 13231'9
The foregoing"mstrumentasw acknowledged before me this 1
day of r 201Z, by —ilk -r, Z .t .
who is personally known to me or who has produced
as identification and who did take an oath.
APPROVED BY® --21r /ll Plans Examiner
Structural Review
(ReAsed3/1=012)(Revised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09)
NOTARY PUBLIC:
"
My Commissi?n L s: Expos 07/13=15
Zoning
Clerk