PL-14-2487Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-226068 Permit Number: PL -11-14-2487
Scheduled Inspection Date: January 08, 2015 Permit Type: Plumbing - Residential
Inspector: Diaz, Osvaldo Inspection Type: Final
Owner: , Work Classification: Addition/Alteration
Job Address: 490 NE 91 Street
Miami Shores, FL 33138- Phone Number (305)596-0111
Parcel Number 1132060190010
Project: <NONE>
Contractor: ACA CONSTRUCTION INC Phone: (305)788-8914
Building Department Comments
KITCHEN REPLACEMENT - PLUMBING RECONNECTION.
Infractio Passed Comments
INSPECTOR COMMENTS False
Inspector Comments
Passed
ET
CREATED AS REINSPECTION FOR INSP-225572. CREATED AS
REINSPECTION FOR INSP-223281. NOT READY
NO ONE HOME
Failed
Correction
Needed
Re -Inspection
❑
Fee
No Additional Inspections can
be scheduled until
re -inspection fee is paid.
January 07, 2015
For Inspections please call: (305)762-4949 Page 25 of 34
Type of Work: ❑ Addition ❑ Ittrati n
Description of Work: tQ
T1611 —
Specify color of color thru tile:.
q g
ewRepair/Replace ❑
4E�rAj7-
Submittal Fee $ Permit Fee $ �a• CCF $ 0 bV CO/CC $
Scanning Fee $ 7F> G. Radon Fee $ DBPR $ W Notary!"—
Technology Fee $ V Training/Education Fee $ (�� Double Fee $
Structural Reviews $ Bond $
TOTAL FEE NOW DUE $ v
(Revised02/24/2014)
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
FBC 20
BUILDING
l"
Master Permit No.
PERMIT APPLICATION
Sub Permit NoT 1`
❑ BUILDING ❑ ELECTRIC
❑ ROOFING ❑ REVISION ❑ EXTENSION ❑ RENEWAL
PLUMBING MECHANICAL
PUBLIC WORKS CHANGE OF CANCELLATION SHOP
CONTRACTOR DRAWINGS
I `s �z
JOB ADDRESS: ► On,u
City: Miami Shores
County: Miami Dade Zip:
Folio/Parcel#:
Is the Building Historically Designated: Yes NO
Occupancy Type: Load:
Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder):
/ H"S%/AI C? C,5'/*7 One#:
Address: 2-,
A -
-
City: iW� �
State: Zip:
Tenant/Lessee Name:
Phone#:
Email:
��ff
CONTRACTOR: Company Name: /9t �i \ <✓/'l��J / 0.+�, �Y� Phone#: �30<j �80 ' 99/�
Address: /0
vlel—
City: _ 4aM
Stater zip:
Qualifier Name: / j- ,ti°
n?z/S Phone#:
State Certification or Registration #:
/I »o? 7iee 3✓r Certificate of Competency #:
DESIGNER: Architect/Engineer:
Phone#:
Address:
City: State: Zip:
Value of Work for this Permit• $
S mre/Linear Foo a of Work•
Type of Work: ❑ Addition ❑ Ittrati n
Description of Work: tQ
T1611 —
Specify color of color thru tile:.
q g
ewRepair/Replace ❑
4E�rAj7-
Submittal Fee $ Permit Fee $ �a• CCF $ 0 bV CO/CC $
Scanning Fee $ 7F> G. Radon Fee $ DBPR $ W Notary!"—
Technology Fee $ V Training/Education Fee $ (�� Double Fee $
Structural Reviews $ Bond $
TOTAL FEE NOW DUE $ v
(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
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 roved and a r nspection fee will be charged.
�f
f
Signature Signature
OWNER or AGENT C NTRACTOR
The forf cling instrument was acknowledged before m this The�fof going instrum�en/t' was acknowledged before me his
27 day of f �! tv ( 20 1 by /'' day of k/O V 20 by
y . , who is personally known to �S who is personally known to
me or who has produced as me or who has produced as
identification and who did take an oath. identification and who did take arloa .
NOTARY PUBL I NOTARY PUBLI
Sign: Sign:
y
Print: „1, Print: ��_° • . �=
GUILLERMO M. DIAZ
« r My Comm. Expires Apr 26, 2015
�dtP �e<yi ' s a
Seal: Notary Public -State of Florida Seal: �'- Commission # EE 87672
y My Comm. Expires Apr 26, 2015 ';oF F��.'
%.-OFF S � Commission # EE 87672
APPROVED BY //omits/ y Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)