PL-15-1035 — J 110
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-233778 Permit Number: PL-4-15-1035
Scheduled Inspection Date: June 03, 2015 Permit Type: Plumbing - Residential
Inspector: Diaz, Osvaldo
Inspection Type: Final
Owner: BERRY, NICKOLAS Work Classification: Addition/Alteration
Job Address: 295 NE 91 Street
Miami Shores, FL
Phone Number
Parcel Number 1132060133470
Project: <NONE>
Contractor: ARMANDO PENA Phone: (786)255-5474
Building Department Comments
REPLACE KITCHEN SINK AND RELOCATE WATER LINE Infractio Passed Comments
FOR REFRIGERATOR INSPECTOR COMMENTS False
TO CLOSE PERMIT#PL-14-970
Inspector Comments
Passed
c
Failed
Correction
Needed
Re-Inspection ❑
Fee
No Additional Inspections can be scheduled until
re-inspection fee is paid.
June 02, 2015 For Inspections please call: (305)762-4949 Page 7 of 28
Pert,Wt
�5`aO s y Miami Shores VillagePem�tt Tye Plumbing Residential
10050 N.E.2nd Avenue NE ;l lttlC usssmgf aaon_ A ion
Miami Shores, FL 33138-0000 Pefniit Status APPROVED
Phone: (305)795-2204
•N ®,.
FLORIDA =x> �.
115 Expiration: 11/2912015
Project Address Parcel Number Applicant
295 NE 91 Street 1132060133470
Miami Shores, FL Block: Lot: NICKOLAS BERRY
Owner Information Address - Cell
NICKOLAS BERRY 295 NE 91 ST .... ��W � �.�- m,�
MIAMI SHORES FL 33138-3127
Contractor(s) Phone Cell Phone Valuation: $ 1,300.00
ARMANDO PENA (786)255-5474
Total Sq Feet: 0
Type of Work:REPLACE KITCHEN SINK AND RELOCATE W Available Inspections:
Type of Piping: Inspection Type:
Additional Info: Top Out
Bond Return: Final
Classification:Residential Scanning: 1 Review Plumbing
Underground
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due
CCF $1.20
DBPR Fee Invoice# PL-4-15-55394
$225 06/02/2015 Credit Card $ 160.70 $0.00
DCA Fee $2.25
Education Surcharge $0.40
Permit Fee $150.00
Scanning Fee $3.00
Technology Fee $1.60
Total: $160.70
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 ELECTRICWert'
BING, MECHANICAL,WINDOWS,DOORS, ROOFING and SWIMMING POOL work.
OWNERS AFFIDAVI . hat all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
construction and zo gore, I authorize the above-named contractor to do the work stated.
June 02, 2015
Authori ed Si ture:Owner / Applicant / Contractor / Agent Date
Building Department Copy
June 02,2015 1
Miami Shores Villagec�T—v—�l
Building Department 3 X IS
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel:(305)795-2204 Fax:(305)756-8972 L4APR
-
INSPECTION LINE PHONE NUMBER:(305)762-4949
FBC 20 r,
BUILDING Master Permit No.
PERMIT APPLICATION Sub Permit NoFL:-�15 — 103
BUILDING F-] ELECTRIC ROOFING REVISION F-] EXTENSION �ENEWAL
E�XLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS:2 / v e Q��
City: Miami Shores I / County: Miami Dade Zia: 3--2)13,?
Folio/Parcel#: i _�J D�D d 13 �'17 Is the Building Historically Designated:Yes NO_
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: cc��
OWNER: Name(Fee Simple Titleholder):IV C LLka I(, ye-&C,yc, �2f'r✓-1 Phone#:�c�S'
Address: S– /V ( s T/Q'
City: M i CA yn) S r P S State: F L Zip: 37? I ��
Tenant/Lessee Name: Phone#:
Email: V G► \Oerr ti G h, (6 Yh
CONTRACTOR:Company Name: (1r-mG;161C) Yah Ci � I V MA Phone#:
Address: ILP V qt) A W 44(o 14U en J e
City:_Mj'u!dj �/f 0 a r rl kn/S State:_ F L Zip: �v3y aSS�
Qualifier Name: Y?Y�.,,, a^da a /'Q h,, Phone#:
State Certification or Registration#: C ]a. (25D6)�9 Certificate of Competency#:
DESIGNER:Architect/Engineer: Phone#:
Address: //,,.---�� City: State: Zip:
Value of Work for this Permit:$ W Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace
l ❑ Demolition
Description of Work: eP4pW<G Ijn i- el oyt . b do c �Q� rvl I r L—
Specify color of color thru tile:
Submittal Fee$ Permit Fee$ ' CCF$ CO/CC$
Scanning Fee$ Radon Fee$ DBPR$ Notary$
Technology Fee$ Training/Education Fee$ Double Fee$
Structural Reviews$ Bond$
TOTAL FEE NOW DUE$ '10
(Revised02/24/2014)
Bonding Company's Name(if applicable)
Bonding Company's Address _
City State Zip
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 a probed and a reinspection fee will be charged.
Signature Signature
OWNER or AGENT CONTRACTOR
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
day of 6P n'
120 /G by '/ 1-/day off Apr 1 20 , by
C 1V GL. t l�1��1 who is personally known to Y1Yh�,,4 do %Fh� ,who is personally known to
me or who has produced U►'ll1�°.(S Q66n(_C— as me or who has produced Q�J(/�fs U(_�,/7�G as
identification and who did take an oath. identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
Sign: Sign:
Print: 1 Print: /
Seal: MY COMMISSION#EE843691 Seal: "I�ColkAMISSION#EE843691
EXPIRES October 15,2016 ?: :October 15,2016
1407)39"153 FWdsNot9rySwvice.com H0711-:' a oaWotaryServla.00m
************************************************************************************************************
APPROVED BY 3c7 Plans Examiner Zoning
Structural Review Clerk
IRevised02/24/2014)