PL-14-1440W
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-215378 Permit Number: PL -7-14-1440
Scheduled Inspection Date: October 15, 2014 Permit Type: Plumbing - Residential
Inspector: Diaz, Osvaldo
Owner: ,
Job Address: 144 NW 105 Street
Miami Shores, FL 33150 -
Project: <NONE>
Contractor: ACA CONSTRUCTION INC
OTSI i iTi iIa 11 �:
REMODEL KITCHEN AND 2 BATHS
Inspection Type. Final
Work Classification: Addition/Alteration
Phone Number
Parcel Number 1121360131320
INSPECTOR COMMENTS False
Phone: (305)788-8914
Passed
E2�
Inspector Comments
G •
Failed
/C3-��'r�
Correction
Needed
❑
Re -Inspection ❑
Fee
No Additional Inspections can be scheduled until
re -inspection fee is paid.
October 14, 2014 For Inspections please call: (305)762-4949 Page 8 of 40
BUILDING
PERMIT APPLICATION
❑ BUILDING
R(PLUMBING
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795-2204 Fax: (305) 756-8972
INSPECTION LINE PHONE NUMBER: (305) 762-4949
❑ ELECTRIC ❑ ROOFING
P�Ec
.JUL 0 3 2014
FBC 20 .1'D
Master Permit No.'Rc�',` _j_ j "-_1(
Sub Permit No.
❑ REVISION ❑ EXTENSION ❑ RENEWAL
❑ MECHANICAL F-1 PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: l t4_4 L( D'!5 S�
City: Miami Shores County Miami Dade Zip•�i��' ®,
Folio/Parcel#: Is the Building Historically Designated: Yes NO
Occupancy Type QDE9. Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): r L_.. '<,--i�ione#: '�6 ®S 'S — !6q(
Address
City: i G State: �C_ , Zip: �•a 1 _-7
Tenant/Lessee Name:
Email:
e#:
CONTRACTOR: Company Name: Ate_ .. , rte-,' e—,, Phone#: jf>N=-b— Ql-\c9'
Address: �Z�1 Z� .Sind 5-F&
City: State: = l_ Zip:
Qualifier Name: Phone#: 3 C \�— X141-1
State Certification or Registration #: G �PC_ I ('s 'S S Certificate of Competency #:
DESIGNER: Architect/Engineer:
State: Zip:
Value of Work for this Permit: $ a�®x>c) Square/Linear Foota a of Work:
Type of Work: El Addition ❑ Alteration ❑ New Repair/Replace
❑ Demolition
Description of Work: e��jpi c"t V + % 't= -S r'7 Z �' 'I-� Y •�C r-P� 1QC
i��� (� � i j�l �,�•�� .rl . � � !° � � e� �" : /� \tel �i/^�a�,r�
Specify color of color thru tile:
Submittal Fee $ Permit Fee $ CCF $ CO/CC $
Scanning Fee $
Technology Fee
Structural Reviews $
(Revised02/24/2014)
Radon Fee $
Training/Education Fee $
DBPR $
Notary $
Double Fee $
Bond $ L.�
TOTAL FEE NOW DUE $ � v
Bonding Company's Name (if applicable)
Bonding Company's Address
City
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
City
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 ELECTRIC, PLUMBING, SIGNS, POOLS,
FURNACES, BOILERS, HEATERS, TANKS, 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 —44
OW ER o AGENT
Signature, --Z==
CONTRACTOR
The foregoing instrument was acknowledged before me this The for ing instrument was acknowledged before me this
AA
J- day of �c.�, . 20 by day of J U 20 14-. . by
CE(a-04 who i ono y n to 'Pq%d4--e—� uer—o i ersonal known
me or who has produced
identification and who did take an oath.
NOTARY PUBLIC:
as me or who has produced
identification and who did take an oath.
NOTARY PUBLIC:
as
Sign. ign• /JCS L-1.
Print: :;PPY°•°e% 573 rint:
:_ a, q , gym RO NI L NK
Seal: �' @�0`,' EXPIRES October 01, 2014 S al:
. RjlY Ct?PJitdIISSION # EE000573
(407) 398-0153 F10nd3N04arySennce.c0m °o ° °
ky°c4s y;, ?IRGmS October 01, 2014
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APPROVED BY V�'ti —/V Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)