PL-15-1555Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-237478 Permit Number: PL -6-15-1555
Inspection Date: June 30, 2015 Permit Type: Plumbing - Residential
Inspector: Diaz, Osvaldo
Inspection Type: Final
Owner: HUTCHESON, LYDIA Work Classification: Repair
Job Address: 220 NW 112 Terrace
Miami Shores, FL 33168-3332
Project: <NONE>
Contractor: MARLIN PLUMBING OF MIAMI INC
Buildina Danartmant Cnmmpnts
Phone Number
Parcel Number 1121360010310
Phone: 305-652-6108
RE -PIPE 3" SEWER LINE
Infractio Passed Comments
INSPECTOR COMMENTS False
Inspector Comments
Passed
G1
Failed
E:1
��'`
Correction
Needed ❑
Re -Inspection ❑
Fee
No Additional Inspections can be scheduled until
re -inspection fee is paid.
For Inspections please call: (305)762-4949
June 29, 2015 Page 1 of 1
Project Address Parcel Number Applicant
220 NW 112 Terrace 1121360010310 LYDIA HUTCHESON
Miami Shores, FL 33168-3332 Block: Lot:
Owner Information Address Phone Cell
LYDIA HUTCHESON 220 NW 112 Terrace
MIAMI SHORES FL 33168-3332
Contractor(s) Phone Cell Phone
MARLIN PLUMBING OF MIAMI INC 305-652-6108
Type of Work: RE -PIPE 3" SEWER LINE
Type of Piping:
Additional Info:
Bond Retum :
Classification: Residential Scanning: 3
Fees Due
Miami Shores Village
CCF
10050 N.E. 2nd Avenue NW
DBPR Fee
Miami Shores, FL 33138-0000
DCA Fee
Phone: (305)795-2204
Project Address Parcel Number Applicant
220 NW 112 Terrace 1121360010310 LYDIA HUTCHESON
Miami Shores, FL 33168-3332 Block: Lot:
Owner Information Address Phone Cell
LYDIA HUTCHESON 220 NW 112 Terrace
MIAMI SHORES FL 33168-3332
Contractor(s) Phone Cell Phone
MARLIN PLUMBING OF MIAMI INC 305-652-6108
Type of Work: RE -PIPE 3" SEWER LINE
Type of Piping:
Additional Info:
Bond Retum :
Classification: Residential Scanning: 3
Fees Due
Amount
CCF
$2.40
DBPR Fee
$2.25
DCA Fee
$2.25
Education Surcharge
$0.80
Permit Fee
$150.00
Scanning Fee
$9.00
Technology Fee
$3.20
Total:
$169.90
Valuation: $ 3,980.00
Total Sq Feet: 0
Pay Date Pay Type Amt Paid Amt Due
Invoice # PL -6-15-56077
06/23/2015 Check #: 2327 $ 50.00 $ 119.90
06/24/2015 Check #: 2328 $ 119.90 $ 0.00
Available Inspections:
Inspection Type:
Final
Review Plumbing
In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations
pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In
accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are
required for ELECTRICAL, PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work.
OWNERS AFFIDAVITcertify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
construction and zonjffg. Futhermore, I,authorixe the above-named contractor to do the work stated.
June 24, 2015
Authorized Slgna!�O: Owner / Applicant / Contractor / Agent
Building Department Copy
June 24, 2015
k
BUILDING
PERMIT APPLICATION
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
F-IBUILDING ❑ ELECTRIC ❑ ROOFING
J�1N � g 2015
FBC 20 tO
Master Permit No. P-1 5-® �'s5
Sub Permit N
❑ REVISION ❑ EXTENSION ❑RENEWAL
OPLUMBING ❑ MECHANICAL ❑PUBLIC WORKS [-]CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: 220 NW 112 TERRACE
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#: 11 -2136-001 -0310 Is the Building Historically Designated: Yes NO
Occupancy Type: RESIDENCE Load: Construction Type: PLUMBING Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): LYDIA HUTCHENSON Phone#: 786-553-1307
Address: 220 NW 112 TERRACE
City. MIAMI SHORES State: FL Zip: 33168
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR: Company Name: MARLIN PLUMBING OF MIAMI, INC Phone#: 305-652-3031
Address: 20145 NE 16 PLACE
City: NORTH MIAMI BEACH State: FL Zip: 33179
Qualifier Name: EDWARD J WALKER Phone#: 305-652-3031
State Certification or Registration #: CFC048292 Certificate of Competency #:
DESIGNER: Architect/Engineer: Phone#:
Address City: State: Zip:
Value of Work for this Permit: $ 3,980.00 Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration ❑ New ❑■ Repair/Replace ❑ Demolition
Description of Work: REPIPE 3" SEWER LINE
Specify color of color thru tile:
Submittal Fee $ Permit Fee $ • �`� CCF $ CO/CC $
Scanning Fee $
Technology Fee $
Structural Reviews $
(Revised02/24/2014)
Radon Fee $
Training/Education Fee $
DBPR $
Notary
Double Fee $
Bond $
TOTAL FEE NOW DUE $ `� 1
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
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
OWNER orAGENT
The foregoing instrument was acknowledged before me this
dayof 74—im" 20 L5 by
i, 4U6L,& ► ,Vho is personally known to
me or who has produced as
identification and who did take an oath.
NOTARY PUBLIC:
N
Print:
THERESA MCCREERY
Notary Public - State of Florida
My Comm. Expires Doc 6, 2017
APPROVED BY
(Revised02/24/2014)
Signature 967,1/7/
COCTOR
The foregoing instrument was acknowledged before me this
2.Z day of n�.� e 201S by
ed"'I,✓� L� V.tho is personally known to
me or who has produced
identification and who did take an oath.
NOTARY PUBLIC:
as
Sign: r
Print.
__ �� cee r -LJ
Se
�•�4Y PI'6fi �� THERESA MCCREERY
Notary Public - State of Florida
%f��t••..•` Commiss on # FF 070897
Plans Examiner - Zoning
Structural Review
Clerk