PL-14-675Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-219819 Permit Number: PL -4-14-675
Scheduled Inspection Date: October 21, 2014 Permit Type: Plumbing - Residential
Inspector: Diaz, Osvaldo
Inspection Type: Final
Owner: MENGE, ROBERT Work Classification: Addition/Alteration
Job Address: 1102 NE 105 Street
Miami Shores, FL Phone Number (305)778-9835
Parcel Number 1122320280110
Project: <NONE>
Contractor: HOME OWNER
6unaing uepartment comments
REPLACE SHOWER, TOILET, AND SINK
INSPECTOR COMMENTS False
Inspector Comments
Passed CREATED AS REINSPECTION FOR INSP-210269. provide proper trap on
I I lavatory
caulk shower valve
Failed '
Correction C,
Needed
Re -Inspection ❑
Fee
No Additional Inspections can be scheduled until
re -inspection fee is paid.
October 20, 2014 For Inspections please call: (305)762-4949 Page 20 of 48
Miami Shores Village
Building Department APR 0 2014
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
#4L mel: (305) 795.2204 Fax: (305) 756.8972
INSPECTION'S PHONE NUMBER: (305) 762.4949
BUILDING
PERMIT APPLICATION
Permit Type: PLUMBING
JOB ADDRESS:
CP
) L
Pery.mto
Master Permit No.
City: Miami Shores County: Miami Dade
Folio/Parcel#:
Is the Building Historically Designated: Yes NO
OWNER: Name (Fee Simple Titleholder): Phone#.
Address:
City:
State: zip:
Tenant/Lessee Name:
Email:
CONTRACTOR: Company Name:
Address:
V, �00
%W20
POW W , S-
W.W..
City: State:
Z4 --zip: Z 3
Qualifier Name:
Phone#:
State Certification or Registration #: Certificate of Competency #:
.6 �,
Contact Phone#: - Email Address:
DESIGNER: Architect/Engineer: ZI-1 Phone#:
V
Value of Work for this Permit:
_ / o' �) , �') -- Square/Linear Footape"of Work:
Type of Work: QAddress UAlteration UNew epair/Replace UDemolition
Description of Work: 2
Submittal Fee $ PermitFee$- CCF$ CO/CC $
Scanning Fee $
Notary $
Radon Fee $
Training/Education Fee $
DBPR $ Bond $
Technology Fee $
Double Fee $ Structural Review $
ze7 �5
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
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.
Signature ; Signature
Owner or Went Contr for
The foregoing instrument was acknowledged before me this 1 u
c�
day of t�\ , 20 14 by Q3& -r% mi/1�J —
who issonall own to me or who has produced
As identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print: Crlsta Steanick
,� � Gsiotl#F
My Commission Expires.
g 03,2018
"s;;Pj .ark AARM140TnRY=n
•.E
The foregoing instrument was acknowledged before me this 3
day of }1tOQ1 , 20 1 , by 5�gOQ 4wf5 ,
who is personally known to me or who has produced
APPROVED BY Plans Examiner
Structural Review
(Revised3/12/2012)(Revised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09)
as identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
My Co Crista _Crista Stefanick
a' #FF085515
i�,�►¢ E)Ores: FEB. 03, 2018
„..r W '.AAMNNOTA".=n
Zoning
Clerk
Miami shores Voillage
Building Department
`0050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
ate: L4- ? _
Permit No: f L _ f -�f, � -�5
�-P rIr) r rpt
Csvaldo "Ozzie" Diaz
Chief plumbing Inspector
-t% I LA—
2A� CY`2M cT .
plan review is not complete, when all items above are corrected, we will do a complete
ppPan review.
f any sheets are voided, remove them from the plans and replace with new revised
sheets and include one set of voided sheets in the re -submittal drawings.