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PL-14-2357Of ICJ Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 nspection Number: INSP-226140 Permit Number: PL -10-14-2357 Inspection Date: January 08, 2015 Permit Type: Plumbing - Residential Inspector: Diaz, Osvaldo Inspection Type: Final Owner: , B&L REALTY HOLDINGS LLC Work Classification: Addition/Alteration Job Address: 170 NW 97 Street Miami Shores, FL 33150 - Phone Number Parcel Number 1131010250030 Project <NONE> Contractor: ACA CONSTRUCTION INC Phone: (305)788-8914 Buildina Department Comments CHANGE VANITIES, TOILETS, AND FAUCETS IN TOW infractlo Passed Comments INSPECTOR COMMENTS False BATHS, REPLACE BATHTUB AND SHOWER PAN REPLACE KITCHEN SINK DISHWASHER AND DISPOSER. ADD WATER LINE FOR REFRIGERATOR. Passed Inspector Comments r Failed Correction Needed Re -Inspection ❑ Fee No Additional Inspections can be scheduled until ' re -inspection fee is paid. For Inspections please call: (305)762-4949 January 07, 2015 Page 1 of 1 M Miami Shores Village BuildingDepartment `' � pmen4 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 OCT 2 Zo Tel: (305) 795-2204 Fax: (305) 756-8972 INSPECTION LINE PHONE NUMBER: (305) 762-4949 I:BC_z BUILDING Master Permit No. I �f_'j?'5(0 � PERMIT APPLICATION Sub Permit No. kL� 5� ❑ BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑ RENEWAL LUMBING ❑ MECHANICAL ❑PUBLIC WORKS [:]CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: � '? 0. LW 9 J 4-. City: Miami Shores County: Miami Dade Zip: -39 1SZ), Folio/Parcel#: is the Building Historically Designated: Yes NO '_� Occupancy Type:P, �. Load: Construction Type: Flood Zone: BFE: FFE: _` LLC, OWNER: Name (Fee Simple Titleholder): i' L t�� I C..1 f 4�QP�Flone#: C/(o� Address: 3c� © (D 7-1 W _ City: , a State: t- 1- _ Zip: Tenant/Lessee Name: Email: CONTRACTOR: Company Name: k Vii, CAD',.S'� ,i -LA C -,-+-)'Q -Z Phone# 0 3 Address: 1®'-1 S S P b®B 1 City: State: �_ Zip: Qualifier Name:._ A'��.C.A,-'ff',J L t_ -4S. Phone#: -a C)5 V; 3 State Certification or Registration #: Certificate of Competency #: DESIGNER: Architect/Engineer: !— Phone#: Address: City: _ State• Zip: Value of Work for this Permit: $ cc ® 0 Square/Unearr F0000tage of -Work: Type of Work: ❑ Addition ❑ Alteration ❑ New Repair/Replace,' ❑ Demolition Description of Work: C I'%Ge-)<iC ��!ir_i�i"S� �C✓1i,AC�-�S� of _ v -c' Icxce bc4thh b Ofnej lh®"Ire� 42ge—). �Q'ffiolnc'E i .S, c'r_ r. A d d %nin. - I j ---i e Fo,-- e -e! i%r-1 «�ca-ham Specify color of color thru tile: Submittal Fee $ C96 _ 0(�) Permit Fee $ X2-5- �Zj CCF $ CO/CC $ Scanning Fee $ Radon Fee $ DBPR $ Notary $ Technology Fee $ �J Training/Education Fee $ Double Fee $ Structural Reviews $ Bond $ TOTAL FEE NOW DUE $ a � (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 e. t 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 $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature OVMER or AGENT The foregoing instrument was acknowledged before me this 0 COQ day of Q C,��JnrV - . 20 )-4-, by 1 cr)(5e- 1 62) • C2no o is rsonall n to me or who has produced as identification and who did NOTARY PUBLIC: 39&o1 Signature lLI, I ONTRACTOR The foregoing instrument was acknowledged before me this D-Of—"l day of C)C40 -f- % , 20 1 +-. . by e��es LO -r -y ---,CA- , who is rsonally knb�n to me or who has produced as RONNI ANN BILA tification and who did t `'"rte' RONNI ANN BLANK +�, IP MY COMMISSION #FFi580t4 MY COMMISSION #FF1581NC ARY PUBLIC: �e elf EXPIRES October 1, 2018 air EXPIRES October 1, 2018 dallot Serve Print:1� 1 ^tom Sign: t g`S' cecom Print:�L7nv�� Seal: Seal: APPROVED BY <:D 're) Plans Examiner Zoning Structural Review Clerk (Revised(32/24/2014) Nv � !. NV VCI[IYVR STATE OF FLORIVA CFC142705 The RLUMlkN- G-00lMMAC Named lbwr tS CERTIFIED - Under the proviftM Of ChWsr489. Expiration daft: AUG -31 i 20'6 LE9i M ANDRES ACA CON'RCpN 1 O,7Z5�{} S�11f MAW, an�7p c� r MIAW, _ .. ISSUM WMSM14 D160LAYA$ R€QUiRE[3 BY LAW sEo a L14wimm2w.