PL-13-1317LEI
Ine-pootfon Wo.r-k-s-heet
Miami Shores Village
100$0 N.E. 2nd Avenue Miami Shores, FL
Phone,- (3,06)796-2204 Fax: (106656,8972
Inspection Number. HTP -1-9330"- PL -6-134317
Permit, Num, ber;
Scheduled Inspection Date: April Permit Types PlUmbin - Residential
Inspector: nspector: Diaz, Osvaldo ype _a
Irl.tPdtfidh TY -PO: FIND
Owner: A&LANA MIRANDA, PAUL. ADAN
Job Address .500 WE 97. Street
NaMilhores, FL33130-
Projorlt, <NONE>
Work ClefsSification'. AdOitiolVAlteration
Phone Number
Pareet-Nurriber 110080171,040
Contractor: FOREVER POOLS Phone. (306)448-1517
PLUMBING POR SWIMMING POOL,
FAWL-
April 09, 2014 For Inspections please call., 006042-40 Page 3 o1'90
Inspector Comments
Passed
Failed El
Correction
Needed
Re -Inspection
Fee
NO.Ackfifional Inspop6ons can be s4ohoduled until
re-inspedoft WA p6l8.
April 09, 2014 For Inspections please call., 006042-40 Page 3 o1'90
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 Tv4e: PLUMBING
JOB ADDRESS:
JUN 2013
FBC 20 10
Permit No. fl, 14 —131---4—
Master
131---4—Master Permit No. �Prp l; —131
City: Miami Shores �*County: Miami Dade Zip:
Folio/Parcel#: ��" � 06 --too '✓� '
Is the Building Historically Designated: Yes NO Flood Zone:
OWNER: Name (Fee Simple der
��; Phone#: ®c .33,E -17j i
Address: �
cIS—_ l-lto
City: /G/ 1771 ����5 State: �� Zip:
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR:: C�ompan N
� �ov ame;
Address: /
City: U -C
Qualifier Name:
U
Q
�J Phone#:
State Certification or Registration #: /i L0 4 P :�®® 9'Certificate
Contact Phone#: ��� �/�— �/� Email Address
DESIGNER: Architect/Engineer:
Zip: 93i_31 `O'
Phone#: 'W4P'.0e)
Value of Work for this Permit: $ /0? Square/Linear Footage of Work:
Type of Work: OAddress DAlteration ❑Repair/Replace
Deccrintion of Work:2,�w
�
if �_:3S492
Submittal Fee $ Permit Fee $ 50-7'0c". CCF $ CO/CC $
Scanning Fee $
Radon Fee $
Notary $ Training/Education Fee $
Double Fee $ Structural Review $
DBPR $ Bond
Technology Fee $
TOTAL FEE NOW DUE $ 6
ODemolition
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
P
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 absence of such posted notice, the
inspection will not be approved a a reinspection fee will be charged.
Sign Signature
Owner or Agent Contractor
The foregoi instrument was ac led d 07
or me E s
day of , 20 4� , by ®��1 ,
who is perso ally known to me or who has produc /tel:
Z�/I/I� As identification and who did take an oath.
NOTARY
Sign:
Print:
My
&RE:: May 13, 2016
Ctor w p, Notary Puw unaerw dw
The foregoin nstrument was acknowl d bore me this
day of , 20 L3, by Z?"
fn t+/
who is per11 sonal known to me or who has produced
4i as identification and who did take an oath.
NOTARY
Sign:
Print:
My Conunission Expires:
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APPROVED BY /3 Plans Examiner
Structural Review
(Revised 3/12/2012)(Revised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09)
MAREIA BPff0SJW MOS
pdy(MNNIS,SION # EE 197797
EXPIRES: May 13, 2016
Ba�dedThNNo�YPubliCUmier:�+:,er; �
Zoning
Clerk