PL-14-1706Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-217307 Permit Number: PL -8-14-1706
Scheduled Inspection Date: December 16, 2014 Permit Type•. Plumbing - Residential
Inspector: Diaz, Osvaldo Inspection Type: Final
Owner: GONZALEZ, RICARDO Work Classification: Repair
Job Address: 150 NW 101 Street
Miami Shores, FL 33138 -
Phone Number
Parcel Number 1131010230210
Project: <NONE>
Contractor: PSG PLUMBING SERVICES, INC Phone: (305)796-7304
rsunamg uepanment comments
BATHROOM FROM POOL HOUSE RENOVATION Infractlo Passed Comments
INSPECTOR COMMENTS False
December 15, 2014 For Inspections please call: (305)762-4949 Page 7 of 51
Inspector Comments
Passed'
6(1
Failed
EZ'
Correction
Needed
❑
Re -Inspection
Fee
No Additional Inspections can be scheduled until
reinspection fee is paid.
December 15, 2014 For Inspections please call: (305)762-4949 Page 7 of 51
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
BUILDING
PERMIT APPLICATION
F-1 BUILDING ❑ ELECTRIC ❑ ROOFING
AUG 062014
FBCpp20 [0
Master Permit No: `4` t��
Sub Permit No.-PL7
❑ REVISION ❑ EXTENSION [—]RENEWAL
PLUMBING r-1 MECHANICAL F-1 PUBLIC WORKS ❑CHANGE OF
CONTRACTOR
JOB ADDRESS: 150 NW 101 STREET
❑ CANCELLATION ❑ SHOP
DRAWINGS
City Miami Shores County Miami Dade Zip:
Folio/Parcel#: 11-3101 -023-0210 Is the Building Historically Designated: Yes NO X
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): Ricardo Gonzalez Phone#: 786.715.0071
Address: 150 NW 101 STREET
City: Miami Shores State: Florida Zip: 33150
Tenant/Lessee Name:
Email: rgonzalez@basingen.com
CONTRACTOR: Company Name: PSG Plumbing Services, INC Phone#: 305.796.7304
Address: 3892 NW 125st Court
Cit,. Opa Locka State: Florida Zip: 33054
Qualifier Name: Pedro Guzman Phone#:
State Certification or Registration #: CFC1426257 Certificate of Competency M
DESIGNER: Architect/Engineer: Jose Ruben Jimenez Phone#: 305.582.2836
Address: 7950 nw 53 Street, Suite 337 city: Miami State:,, FL Zip: 33166
Value of Work for this Permit: $ k0,000 Square/Linear Footage of Work: M
Type of Work: ElAddition ElAlteration ElNew Q Repair/Replace El Demolition
Description of Work: 6 at N eoo'vs'% F• ?oo` (Ab U_ -i.
Specify color of color thru the:
Submittal Fee $ Permit Fee $ 3®CCF $ CO/CC $j
Scanning Fee $ Radon Fee $�4 _ DBPR $ Notary $ `6
Technology Fee $ S - Training/Education Fee $ 2-. 00 Double Fee $
Structural Reviews $ Bond $ ("
ni
TOTAL FEE NOW DUE $ n�
(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 $25W, 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 approv nd a reinspection fee will be charged.
Signature Signature
OWN4 o GENT CO CTOR
The foregoing instrument was acknowledged before me this
6 day of 20 Iq . by
ifAM2MV7Who is personally known to
me or who has produced as
identification a�-vstt�p did taken;�oath.
Sign:_
Print:
Seal:
IES A. CI
OMMIISSION # F
EXPIRES: J=09,
The foregoing instrument was acknowledged before me this
day of 20 t`1 by
�)2ft who is personally known to
rile or who
Sign:_
Print:
Seal:
APPROVED BY Plans Examiner
Structural Review
(Revised02/24/2014)
did take
)URDES A. CROG
'COMMISSION # FF094767
EXPIRES: JM 09, 2018
as
Zoning
Clerk