PL-15-230 Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-227549 Permit Number: PL-2-15-230
Scheduled Inspection Date: July 02, 2015 Permit Type: Plumbing - Residential
Inspector: Diaz, Osvaldo
Inspection Type: Final
Owner: FALERO,ANGEL Work Classification: Addition/Alteration
Job Address: 1700 NE 105 Street 202
Miami Shores, FL Phone Number (305)898-8841
Parcel Number 1122300500210
Project: <NONE>
Contractor: THE NEW MIAMI SHORES PLUMBING Phone: (305)751-2446
Building Department Comments
INSTALL CUSTOMER PROVIDED 20 GALLON WATER Infractio Passed Comments
HEATER INSPECTOR COMMENTS False
Inspector Comments
Passed
Failed � ����"
Correction ❑
Needed
Re-inspection
Fee
No Additional Inspections can be scheduled until
re-inspection fee is paid.
July 01,2015 For Inspections please call: (305)762-4949 Page 9 of 47
Miami Shores Village
Building Department FEB p 2 ZOiS
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel:(305)795-2204 Fax: (305)756-8972
INSPECTION LINE PHONE NUMBER:(305)762-4949
FBC 20 10
BUILDING Master Permit No j2I Z,! —30
PERMIT APPLICATION Sub Permit No.
❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION [:]RENEWAL
10`PLUM�l NG ❑ MECHANICAL E]PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: I r700 Ne I C)Cj7 2-0 2 1
City: Miami Shores T1 County: Miami Dade Zip:
Folio/Parcel#: �a3 O'a 'lJ� O Is the Building Historically Designated:Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE:: pFFE: pQ
OWNER: Name(FeeSimple Titleholder): A �I u�//�V Phone#: 05- ��b . m
Address: 170C) NE 106 5 fc1
City: M14mi USS State: Zip: 3�3 t 5 S
Tenant/Lessee Name: Phone#:
Email: �p � �� �'
CONTRACTOR:Company�Na\me: I s )C � [\'i i��( 5 r65 TlawbiPhone#:
{�
Address:: / oc �w C`4
City: / State:- Zip: '35
Qualifier Name: 5 ► (IIn Phone#:
State Certification or Registration#: O Co gn 15 Certificate of Competency#:
DESIGNER:Architect/Engineer: Phone#:
Address: City: State: Zip:
to
Value of Work for this Permit:$ �a� ,`- Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑
Alteration ❑ New
Repair/Replace Demolition
Description of Work: f aI SatUv, VyyId6Q (O Gq' c -e6 �
Specifyc or.af color thru tile:' . .�
Submittal Fe ermit Fee$ �'� CCF$ CO/CC$
Scanning Fee$ Radon Fee$ DBPR$ Notary$
Technology Fee$ Training/Education Fee$ Double Fee$
Structural Reviews$ Bond$
TOTAL FEE NIOW DUE$
(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 approved and a reinspection fee will be charged.
Signature _ Signatu
�c c
OWNER or AGENT CONTRACTOR
The foregoing instrument was acknowledged before me this The foregoing instrument was
acknowledged before me this
day of 20 by T day of I~' "I 20 15 by
��' 1(tel e� who is personally known to JJ � 5 - 1�(1i7,who is personally known to
�� G
me or who has produced O .L- `i 6 d 'Oo C',,y+GSc s+ 1 me or who has produced as
identification and who diatoath. i e tification and who d' n oath.
N ARY PUBLIC: , r NO RY PUBLIC:
Sig r
Si
�. CAR EN A.RIVERA
Print. :'�aY Po••., Print:
.r ' • My Comm.Expires Mar 16,2016 `¢ Notary Public-State of FlJ
Seal: 154640 Seal: My Comm.Expires Mar 16,
Commission#EE
'••`%EOi" Bonded Through National Notary Assn.
:'� Commission I EE 1546
•"'""• �"10Z; Bonded Throw National t�tary
************************************************************************************************************
APPROVED BY a--fPlans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)