PL-14-2267N
U ,
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Number: INSP-221662 Permit Number: PLA
Inspection Date: May 20, 2015
Inspector: Diaz, Osvaldo
Owner: ATASH, KARIM & METIS CORINA
Job Address: 1195 NE 100 Street
Miami Shores, FL
Project: <NONE>
Type:Permit PlumbingResidential
Inspection Type:
Work Class"ftafig
Phone Number (306)790-5561
Parcel Number 1132050190360
Contractor: A&C PORTELA PLUMBING INC Phone: (786)5474611
Building Department Comments
NEW FIXTURES IN GUEST BATHROOM, ADDING HALF
BATH, RELOCATING ONE BATHROOM, TANK LESS
WATER HEATER, RELOCATING PLUMBING IN EXISTING
KITCHEN CONNECTING TO SEPTIC TANK.
In ractlo Passed Comments
INSPECTOR COMMENTS False
Inspector Comments
Passed EV
Failed El
Correction
Needed
Re -inspection
Fee
No Additional Inspections can be scheduled until
re -inspection fee is paid:
For Inspections please call: (305)762-4949
May 20, 2015 Page 1 of 1
W
a
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
0c 5
FBC 20 CO
BUILDING Master Permit No. %K ®�r
PERMIT APPLICATION Sub Permit No? 1 a-`� C--�
F-1 BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION []RENEWAL
APLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF [:]CANCELLATION ❑SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: 119 �5 N E t W SA -
City: Miami Shores County Miami Dade Zip: 2>131'319
Folio/Parcel#: Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (FeeSimpleTitleholder): Phone#:
Address:
City: l 233'.41 Z v S - State: 1 Zip:
Tenant/Lessee Name: Phone#:
Email: �K4 4 "12 1/il ('Ozin
CONTRACTOR: Company Name: N It G _(' o)te_- ec-k a nq Phone#: `30G '9 6F'(5715
Address: 21055 S 1.A) S-3 ftv F
City: KA -1 t riI state: F L Zip: S�3135
Qualifier Name: T)OL.0 i C�L 71P01+_r�_ (o�, Phone#: 150 G • 9 U_G - hi l 5
State Certification or Registration M (a Cl Certificate of Competency #:
DESIGNER: Architect/Engineer: Phone#:
Value of Work for this Permit:
Type of Work: ❑ Addition
Description of Work:
CL
lbs
tl
City: State: Zip:
J1
Square/Linear Footage of Work: t' . .0') .
❑ Alteration ❑ New
Specify color of color thru tile:.
W
❑ Demolition
I /`
Qj %*ial
Submittal Fee $ Permit Fee $ 300,_ `CCF $ CO/CC $
Scanning Fee $ Radon Fee $
Technology Fee $ Training/Education Fee $
Structural Reviews $
(RevisedO2/24/2014)
DBPR $
Notary $
Double Fee $
Bond $
TOTAL FEE NOW DUE $ C9
-7� - So—
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 $2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued. in the absence of such posted notice, the
inspection will not be approved and a reinspection feeill be charged.
Signature 'y Signature
OWNER or AGENT
The foregoing instrument was acknowledged before me this
6 day of f 20 by
�F �tM "h , who i personally known
me or who has produced as
CONTRACTOR
The foregoing instrument was acknowledged before me this
B day of , 20 14 ' by
Iba,il(::--b)tc�10l , who is rsonally kno n to
me or who has produced as
identification and who did take an oath. identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
ilgn: K)(1� QA L Sign:
Print P r r -~C ' Ma of (
Seal: ; ,;!a` �' NOM
A`FAL9� LARji Seal: Cep +i EE slog
MY COMMISSION d EE124530 ft" won rte,
EXPIRES Sept®111Dmber S0, 2015
33 F.IarirS®NWe erviea,cty�
kk$*�K4RMMW kkkRN*k+kNMskNi+PkkNkk�kffiMR*k4Mkl+F+kKkk34ffik#kNM6Nk4+RMRkYKANkRbR#fMk
APPROVED BY Z 'S- t� Plans Examiner Zoning
Structural Review
(Revised02/24/2014)
Clerk