PL-14-1487Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-215692 Permit Number: PL -7-14-1487
Scheduled Inspection Date: October 30, 2014
Inspector: Diaz, Osvaldo
Owner: JORDAN, JENNIFER
Job Address: 1700 NE 105 Street 202
Miami Shores, FL
Project: <NONE>
Contractor:
TWIN BROTHER
Building Department Comments
REMOVE AND REPLACE KITCHEN SINK
Permit Type: Plumbing - Residential
Inspection Type: Final
Work Classification: Addition/Alteration
Phone Number (386)986-9440
Parcel Number 1122300500210
INSPECTOR COMMENTS False
Phone: (305)332-1969
October 29, 2014 For Inspections please call: (305)762-4949 Page 7 of 36
Inspector Comments
Passed
Failed
Correction
Needed
❑
Re -Inspection ❑
Fee
No Additional Inspections can
be scheduled until
re -inspection fee is paid.
October 29, 2014 For Inspections please call: (305)762-4949 Page 7 of 36
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
JUL 112014
FBC 20
Permit No.
Master Permit Nog " "e ���
JOB ADDRESS: 1100 L06 S yee�- 7* 202
City: Miami Shores County: Miami Dade Zip: SV S9
Folio/Parcel#: 1 I - 22 • G50 • [�%
Is the Building Historically Designated: Yes NO Flood Zone:
OWNER: Name (Fee Simple Titleholder): t M y� tnaw-io Phone#: 505 W% M&N I
Address: 0100 N E 1cS5 S�e+ 2
city: A yam i SW'ete& state: F 14f i dk& zip: 33N-,jx
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR: Company Name: ��''� �leoTfFr S' P -[d3 Phone#: *09* 1 9(fy
Address: Vvi(a 64y 6;;1"W /V
City: ' State: /��- Zip:
Qualifier Name: 6 z Phone#:�
State Certification or Registration #: G G ��� Certificate of Competency #:
Contact Phone#: -4-vg V3 -.A e116 -P, Email Address: � A e 'J ot+t/ • Cs
DESIGNER: Architect/Engineer: Phone#:
Value of Work for this Permit: Square/Linear Footage of Work: Ifi�l�
Type of Work: ❑Address ❑Alteration ❑New T<Repair/Replace ❑Demolition
Description of Work: _V_j
Submittal Fee $ Permit Fee $ Of 10" — CCF $ CO/CC $
Scanning Fee $
Radon Fee $
Notary $ Training/Education Fee $
Double Fee $ Structural Review $
DBPR $ Bond $
Technology Fee $
TOTAL FEE NOW DUE $ t !7f) ° t
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
IlVIPROVEMENTS 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 gvplicant 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 Agent
Contractor
The foregoing instrument was acknowledged before me this 21 The foregoing instrument was acknowledged before me this
day of !�pr%j 201J-, by A !Fnlerd day of 201 , by'25enik-b RkVg<-e2 ,
who is personally known to me or who has produced 7EL IN who is personally known to me or who has produced—b1=4
.41.6-666-1+634' As identification and who did take an oath. 0.0 ire. as identification and who did take an oath.
NOTARY PUBLIC:
Sign:
My Commission Expires:
APPROVED BY
!REB!ECA M. PASTRANA
ISSIONlEES72624: N-My07, 2D17
R�kzlssk�k�kak�k�kak�kskasgaik�9k�k��kHa�ss1�8a8ask?
Plans Examiner
Structural Review
(Revised 3/12/2012)(Revised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09)
NOTARY PUBLIC:
Print: M. A_
My Commission Expires:W%Wf
REBECA M. PASTRANA
My comMISSION N OX 16724
EXPO ES: �Y
Zoning
Clerk