PL-14-18467
Li
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-218409 Permit Number: PL -8-14-1846
Scheduled Inspection Date: December 22, 2014 Permit Type: Plumbing - Residential
Inspector. Diaz, Osvaldo
Inspection Type: Final
Owner: KIMBERLY KRAUSE, JACK EFROMSON Work Classification: Repair
Job Address: 290 NE 100 Street
Miami Shores, FL Phone Number
Project: <NONE> Parcel Number 1132060134440
Contractor: G&L PLUMBING SERVICE Phone: 305-551-5090
ksuiIamg impartment comments
BATHROOM REMODELING
INSPECTOR COMMENTS False
,Wspector Comments
Passed
Failed
Correction ❑
Needed
Re -Inspection ❑
Fee
No Additional Inspections can be scheduled until
re -inspection fee is paid.
December 19, 2014 For Inspections please call: (305)762-4949 Page 8 of 38
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
BUILDING
PERMIT APPLICATION
❑BUILDING ❑ ELECTRIC ❑ ROOFING
A442.5 2014
°�FBC 20 _
Master Permit No. 1�`i— 14_
Sub Permit No _ 1�34C
❑ REVISION ❑ EXTENSION ❑RENEWAL
r_1 PLUMBING ❑ MECHANICAL r-1 PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
//�� / CONTRACTOR DRAWINGS.
JOB ADDRESS: �_ -G (� � � ` D®'�
City: Miami Shores County: Miami Dade Zip: 331/13
Folio/Parcel#: Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Sim le Titleholder): Rack- e 1'R 0 K" ' � Phone#:
Address: �a-µ"� O 0—p—
City:
State:
Tenant/Lessee Name: Phone#:
Email
p:
CONTRACTOR: Company Name: Phone#: .305 3411
Address: ►
City: ew, , A State: Zip:
Qualifier Name: � `e7
one#:
State Certification or Registration M �� Certificate of Competency #:
DESIGNER: Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit: $ Square/Linear Footage of Work: �S
Type of Work: ❑ Addition ❑ Alteration ❑ New Repair/Replace El Demolition
Description of Work:
V
Specify color of` color thru tile:
Submittal Fee $ �f� - 00 Permit Fee $ rem® r`� CCF $l&CO/CC $
Scanning Fee $ Radon Fee $ e ✓ DBPR $ Notary $
Technology Fee $ _ Training/Education Fee $ ® Double Fee $
Structural Reviews $ Bond $ pp
TOTAL FEE NOW DUE $ A R l
(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
Application is hereby made to obtain a permit to do the work an
commenced prior to the issuance of a permit and that all wo
construction in this jurisdiction. I understand that a separate
FURNACES, BOILERS, HEATERS, TANKS, AIR CONDITIONERS, ETC.....
Zip
Zip
d installations as indicated. I certify that no work or installation has
rk will be performed to meet the standards of all laws regulating
permit must be secured for ELECTRIC, PLUMBING, SIGNS, POOLS,
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
WNER AGENT
The foregoing instrument was acknowledged before me this
V day/off t 20 by
who is personally known to
me or who has produced
identification and who did take an oath.
NOTARY PUBLIC:
Sign: „,AVkAA UPM
•;:: Commission # FF 006305
Print: *_
:bxrtetl Sew lmY Fein lnawanee 800-X5419
Seal:
Signature
CONTRACTOR
The foregoing instrument was acknowledged before me this
12-- day of /(r6 20 % . by
who is personally known to
as me or who has produced
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print: • ' Expires April 9, 2017
� n roy am - 019
Seal:
as
APPROVED BY ( -z:)(9-Z5 7?�Y Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)
e