PL-14-1632Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-218202
Scheduled Inspection Date: August 21, 2014
Inspector: Diaz, Osvaldo
Owner: CRANE, AMY
Job Address: 9015 NE 4 Avenue Road
Miami Shores, FL
Project: <NONE>
Contractor: QUINTERO GENERAL CONSTRUCTION
tsunaing uepartment comments
INSTALL SINK AND DISHWASHER.
Permit Number: PL -7-14-1632
Permit Type: Plumbing - Residential
Inspection Type;g
Work ClassificatioRepair
11571,4.� G
Phone Number
Parcel Number 1132060460080
INSPECTOR COMMENTS False
Inspector Comments
Passed E2,
�cL
Failed
Correction ❑
Needed
Re -Inspection ❑
Fee
No Additional Inspections can be scheduled until
re -inspection fee is paid.
Phone: (786)487-5738
August 20, 2014 For Inspections please call: (305)762-4949 Page 24 of 27
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: (30S) 762-4949
FBC 20
BUILDING Master Permit No �� U
PERMIT APPLICATION Sub Permit N01�'
❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION [—]RENEWAL
09 PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: 'i®®.�r #JG- ZI- Y A'19, 12D
City: Miami Shores / County: Miami Dade zip:
Folio/Parcel#: t / ` &� 6 6 " 0 � v 0 a g 0 Is the Building Historically Designated: Yes NO
Occupancy Type: Load:
OWNER: Name (Fee Simple Titleholder):
Construction Type: Flood Zone: BFE: FFE:
305 -733 8-702
Address: 1;00 NC—
100 _j
I �
City: I' 1 I C� i
Sk�-S
�r
State: I—L
Zip: -3313 p O
Tenant/Lessee Name:
Phone#:
Email: IM+ 0,
,D
�CYIG C, lMC'.
,
CONTRACTOR: Company Name: Q,1A J - . 6F-N�� 6DPI-01
Phone#: 'il�b-963 '�-O lt,6 3
Address: &901
pl\�s 11 Z rt ao
iA
City: 4t
& PA -z_-
State: -FL—
33101
Zip:3
Qualifier Name: BFK2_
NAIIZ��
tti3z"x=-�-�,
7
Phone#: �T - 43-�' 5332
State Certification or Registration
t ����Certificate of Competency #:
DESIGNER: Architect/Engineer: la 5 2. -?z,I o,\.I(J AR4- ) 31 -76 Phone#: 305- -710 S -7 r�
Address: of �/ `G ii <5-i- City: State: , // �Lt Zip: 3 c�
Value of Work for this Permit: $ 00 Square/Linear Footage of Work: V �1
Type of Work: ❑ Addition ❑ Alteration ❑ New Repair/Replace ❑ Demolition
Description of Work: `r1.5 t c j \_
Specify color of color thru tile:
Submittal Fee $ b 3 - �� Permit Fee $ IBJ o ➢`7 CCF $ CO/CC $
Scanning Fee $
Radon Fee $
Technology Fee $ Training/Education Fee $
Structural Reviews $
(Revised02/24/2014)
DBPR $ Notary
Double Fee $
Bond $
TOTAL FEE NOW DUE $ I
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 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 l�f�
OWNER or AGENT
The foregoing instrument was acknowledged before me this
Q�l day of 20 by
ez- U/ who is personally known to
me or o has produced ft- DV t I"�a LLC as
identification and who did take an oath.
NOTARY PUBLIC:
Signature
CONTRACTOR
The foregoing instrument was acknowledged before me this
day of IQ 201_, by
� //who is personally known to
me or who has produced L -0L as
identification and who did take an oath.
NOTARY PUBLIC:
Sign: C
Sign-
1°
Print:
aLL'
Print:a ' Z�
Seal: '•
s ' =
BAFOMAESTEP
W COMMISSION y FF 073975
k Seal:;
�„�,,, ELCIDACEBALLOS
,o;�Y'�a�c,, Notary Pubic -State of Florida
�
EXPIRES: March 29, 2018
_; 2015
- '_ My Comm. Expires Jun 1
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IIYGY � IW udc ,IYO,A'IYWO
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Commission At EE 61875
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a Through National Notary Assn.
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APPROVED BY
�o y
Plans Examiner
Zoning
Structural Review
Clerk
(Revised02/24/2014)