PL-13-2564Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-202982 Permit Number: PL -11-13-2564
Scheduled Inspection Date: August 06, 2014
Inspector: Diaz, Osvaldo
Owner: FREDERICK SUTHERLAND, VERONICA
een' tAJA
Job Address: 555 NE 93 Street
Miami Shores, FL
Project: <NONE>
Contractor: MARLIN PLUMBING OF MIAMI INC
i3mialing Department comments
REMOVE AND REPLACE BATHROOM FIXTURES AND
ROUGH SET REPLACE SANITARY DRAIN LINE TO PVC
NEW INSTALLATION OF KITCHEN SINK AND ICE MAKER
NEW WATER LINE FROM WATER METER TO
RESIDENCE
Permit Type: Plumbing - Residential
Inspection Type: Final
Work Classification: Addition/Alteration
Phone Number (786)260-4901
Parcel Number 1132060141020
INSPECTOR COMMENTS False
Inspector Comments
Passed
Failed'
Correction ❑
Needed
Re -Inspection ❑
Fee
No Additional Inspections can be scheduled until
re -inspection fee is paid.
Phone: 305-652-6108
August 05, 2014 For Inspections please call: (305)762-4949 Page 3 of 37
Miami Shores Village Nov i
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 Typei]PLUMR NG_ -
FBC 20 1
Permit No.R.I. 1 a, � D
v
Master Permit No.Vje _ I � — 02 Ll 5
JOB ADDRESS: 5 SS'AZ E+ 9 3 rd A 2
City: Miami Shores County: Miami Dade Zip: 33 *
Folio/Parcel#: I I �) 1® G ON— / Q
Is the Building Historically Designated: Yes _
NO Flood Zone:
OWNER: Name (Fee Simple Titleholder): ! 1d n I•C& !{D1.A�a � Phone#: / 9c .2 w — �fo
Address:9 & S Al,E ��t,
City: 't'j.; State: 3E 1 Zip: 3313`
Tenant/Ussee Name:
Email:Ci'fl!'I i
CONTRACTOR: Company Name: �A"i Iz V& P�w Phone#:
Address: 2611/1r e E & FL
City: # M n State: _ F
Qualifier Name: E I.JfiLd ,l 1 �� l L w
State Certification or Registration #: EQ, ® Y 52-1 �L
Contact Phone#: e3DT7 C T,;-34,3Email Address:
DESIGNER: Architect/Engineer: � Phone#:
Value of Work for this Permit: $
Type of Work: ❑Address_
of Work:
Submittal Fee $ • Ue) Permit Fee $
Scanning Fee $
Radon Fee $
_Square/Linear 7ep:/Replace
f Work:
ONew
ODemolition
6&4,b mn,.,L T
.. Se-"> -
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 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 willn t be approved and a reinspection fee will be rged.
e
Signature Cdg;L )4Signature
Oypefor Agerl' ' C;dpfractor
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
day of , 201 , by [Aeoa" 4A day of f Ar" , 20./x' , by _ &:;hNJAei(d
who is gVAQually=known to me or who has produced who is personally known to me or who has produced
As identification and who did take an oath.
NOTARY PUBLIC:
Sign: JHWA
Print:
My Commission
IZ-&-l3
THERESA MOCREERY
W WMMISSION # DD 943806
WLAES: December 6.2013
APPROVED BY �0 ®� / 3 -/7 Plans Examiner
Structural Review
(Revised3/12/2012)(Revised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09)
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
My Commission E ' "...ifli' ,, SAMOCREMY
- M) G SSION # DO 943806
/�-G-N
RES: December 6, 2013
Bonded Tfw Notary Public Underwriters
Zoning
Clerk
(616919_46124043_Standard )
Cbl.31-de
L4-;la4t- a
. Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138���
Tel: (305) 795.2204 Fag: (305) 756.8972
INSPECTION'S PHONE NUMBER: (305) 762.4949 RV•
FBC 20
BUILDING•t No. /P/
P s <
PERMIT APPLICATIO �s ¢ F :p s Mir •t No. —
Permit Type: PLUMBING
JOB ADDRESS: 555 NE cis S'1"
City: Miami Shores County: Miami Dade Zip: 53138
Folio/Parcel#:
Is the Building Historically Designated: Yes
NO
Zone:
OWNER: Name (Fee Simple Titleholder): N 1 .A �-ir0 �- �'t! Phone#:
Address: 555 NE 43 5"r
City: _KJI ANSI 1121> f e"'s State: -*F
Tenantlessee Name: Phone#:
*Email: VP-V'O Ki CA-ino N Kq (9 ni e. C -O M
CONTRACTOR:
Address: shy %
Name: _Av
"Q
3 'to f 3 tg
City: A) A State: FI Zip:
Qualifier Name: Fj waej_ �_ _ruaa j� Phone#: 3C2 g " �•�c� "' y 3 j
State Certification or Registration #: l � � Q 7 Vag_eertif=tc
r y #: (Z,:F C!
Contact Phone#: Email Address: or".1
DESIGNER: Architect/Engineer: bon #:
Value of Work for this Permit: $ I `� —S Mork:
quare/Linear Footage o
Type of Work: ❑Addre s Iteration ❑New C�9e r/Replace ❑Demolition
Description of Work: 4Q — Cl, — c✓
1V I S1 Ono A fdatv S
Submittal Fee $ Permit Fee $ CCF $ CO/CC $
4OScanning Fee $ Radon Fee $ DBPR $ Bond $ .
Notary $ Training/Education Fee $ Technology Fee $
Double Fee $ Structural Review $
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
Zip
City State Zip
-0
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, th�
inspection will not be approved and a reinspection fee will be charged.
Signature VX W,n� Signature
&��A,,�M 1,1*A1& A -
1.1k % 4--.qf.
Own rAge Contractor
The foregoing instrument was acknowledged before me this , The foregoing instrument was acknowledged before me this
day of 01 , 20 X16 V by RnanJ tci* YY10 LU day of I WQFY , 20 L, by
who is s orally kno me or who has produced who is personally known to me or who has produced
As identification and who did take an oath. as identification and who did take an oath.
NOTARY PUBLIC:
My Commission Expires:
0wuuunU
APPROVED BY t .. L ® / Se Plans Examiner Zoning
Structural Review
(Revised3/12/2012)(Revised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09)
Clerk •