RC-14-2466Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-223421 Permit Number: RC -11-14-2466
Scheduled Inspection Date: November 17, 2014
Inspector: Rodriguez, Jorge
Owner: LEROY, PIERRE
Job Address: 9301 NW 2 Court
Miami Shores, FL 33150 -
Project: <NONE>
Contractor: HOME OWNER
rsunamg uepanment comments
RENEWAL OF EXPIRED PERMIT RC 07-1321 FOR A
BATHROOM TILE REPLACEMENT
Permit Type: Residential Construction
Inspection Type: Final Building
Work Classification: Alteration
Phone Number
Parcel Number
INSPECTOR COMMENTS False
1131010150400
November 14, 2014 For Inspections please call: (305)762-4949 Page 26 of 31
Inspector Comments
Passed
TO CLOSE PERM IT#RC-1 4-2466
Failed
Correction
Needed ❑
Re -Inspection ❑
Fee
No Additional Inspections can be scheduled until
re -inspection fee is paid.
November 14, 2014 For Inspections please call: (305)762-4949 Page 26 of 31
(Ifiqhb)4
BUILDING
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
WED
NOV 10 2014
CBY:
FBC 2010
Master Permit Now_ h " o9 yh&
PERMIT APPLICATION Sub Permit No.' i 03- 1 ?U ) .
BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION )6ENEWAL
F-1 PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
/)� J CONTRACTOR DRAWINGS
JOB ADDRESS: ��/�//itJ ���GJ/
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#: Is the Building Historically Designated: Yes NO V
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): Phone#:
Address: �,v _/A 4:V
City: 'i i xy/ State: Ali Zip:
Tenant/Lessee. Name: Phone#:
Email:
CONTRACTOR: Company Name: Phone#:
Address:
City: State:
Qualifier Name:
State Certification or Registration #:
DESIGNER: Architect/Engineer:
of Competency #:
Address: City: State:
Value of Work for this Permit: $ Square/Linear Footage of Work:
Type of Work: ❑ Addition
Description of Work:
Zip:
❑ Alteration ❑ New U Repair/Replace ❑ Demolition
Specify color of color thru tile:
Submittal Fee $ Permit -Fee $ �'� CCF $ G -(20 CO/CC $
Scanning Fee $ s Radon Fee $ DBPR $ ` Notary $
Technology Fee $ Training/Education Fee $ Double Fee $
Structural Reviews $ Bond $
TOTAL FEE NOW DUE $ C 1
(Revised02/24/2014)
Bonding Company's Name (if applicable)
Bonding Company's Address
City
State
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
City State
i"
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 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
OWNER or AGEN
The foregoing instrument was acknowledged before me this
1
—day of / 2k2� /I.t��' 20 �/ ,by
4--1wV , who is personally known to
me or who has produced as
identification and who did take an oath.
NOTARY PUBLIC:
Signature
CONTRACTOR
The foregoing instrument was acknowledged before me this
day of , 20 by
who is personally known to
me or who has produced as
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print: Print:
Seal: my Pfjs Notary Public State of Florida Seal:
a� °; Joanna M Feliciano
My Commission FF 082753
�vPvao� Rxpires0ll1212018
APPROVED BY l° , L /V Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)