PL-13-1115 07-26-'13 06:40 FROM- T-615 P0009/0010 F-783
Inspection Worksheet
Miami Shores Village
10060 N.E. 2nd Avenue Miami Shores, FIL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-191855 Permit Number: PL-5-13-1115
Scheduled Inspection Date:July 25,2013 Permit Type: Plumbing - Residential
Inspector: Diaz,Osvaldo
Inspection Type: Final
Owner: MINSKI,JOEL &ANDREA Work Classification: Addition/Alteration
Job Address:9969 NE 4 Avenue Road
Miami Shores, FL 33138- Phone Number (306)510-0916
Project: <NONE> Parcel Number 1132060171230
Contractor: REGENCY POOL&SPA OF FLA INC Phone: 954424-0134
Building Department Comments
POOL PIPING FOR POOL. REMODEL ISPEC Passed comments
INNSPECTOR COMMENTS False
Inspector Comments
Passed
Failed
Correction
Needed
Re-Inspection ❑
Fee
No Additional Inspections can be scheduled until
re-inspection fee is paid.
July 25,2013 For Inspections please call: (305)762-4949
Page 10 of 33
Miami Shores Village
Building Department I MAY 212013
10050 Iv.E.2nd Avenue,Miami Shores,Florida 33138
v�---->
Tel:(305)795.2204 Fax:(305)756.8972
INSPECTION'S PHONE NUMBER:(305)762.4949
FBC 20 � l
BUILDING Permit No. t
PERMIT APPLICATION Master Permit No. &T15� 1 1
Permit Type: PLUMBING
JOB ADDRESS: 9959 NE 4 Ave. Rd.
City: Miami Shores Comity: Miami Dade Zip: 33138
Folio/Parcel#: 11-3206-017-1230
Is the Building Historically Designated: Yes ILIO Flood Zone:
OWNER:Name(Fee Simple Titleholder):Joel Minski/Andrea Minski Phone#:
Address:9969 NW 13 Ct.
City: Miami Shores State: FL 33138
Tenantl.essee Name: phone#:
Email:
CONTRACTOR:Company Name: Regency Pool and Spa of Florida, Inc. phol,e4t. 954-583-7373
Address: 6507 NW 13 Ct.
City: Plantation State: FL Lip: 33313
Qualifier Name: Rafael A. Imbert phone#: 305-684-3804
State Certification or Registration#: CPC056811 Certificate of Competency#:
Contact Phone#: 954-583-73 73 Email Address: miriam@regeneypool.eom
DESIGNER: Architect/Engineer: �'�� �/r.�¢4-4,1 •F W 31 D Phone#:
Value of Work for this Permit:$ _Square/Linear Footage of Work:
Type of Work: LJ Address Alteration ❑New ❑Repair/Replace ❑IDeemolition
Description of Work: 7-4
i:k#*l:L•a=�=�:x�:;:,;;�::t-�a«x:e,;.�..��ra+: ag:4� •"zti�: -.�:e
Submittal Fee$ Permit Fee$ CCF$ CO/CC$
Sea nixing Fee$ Radon Fee$ DBPR$ Bond$
Notary$ Training/Education Fee$ Technology Fee$
Double Fee$ Structural Review$
TOTAL FFE NOW DUE$ •S_
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 ELECTRICAL WORK,PLUMBING,SIGNS,
WELLS,POOLS,FURNACE,-,,BOILERS,HEATERS,TANKS and 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 con.,truction and zoning.
"WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF
COMMENCEMENIP 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 withan estimated value exceeding$2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure ia,ill be delivered to the person
whore properly,is subject to attachment. Also, a certified copy of the recorded notice of conttnencement must be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is i sited. In the absence of such posted notice, the
inspection will not be approved and a reinspection fee will be charged. � — I
A `t•
Signature Signatt e
Owner or Agent ^� pntractor
The foregoing instrumentwas,rc owledged before me this { The fore ii instmmen aasppacknowledg 1 bef re me thirV
day of7peerly
20 1,by � �J'^� day of 20 Z5.by W r
who is nown to me or who has produce who is personallvknow�to me or who has produced
A i en?ification and who did take tui oath. as identification and who did take an oath_
NOTAR UBL : NOTARY PUBLIC:
oto�PUQVo1DARID
Sign: a : M`ICAMM PE
Sign: aEt NO
Print: * urluu
®�„ �u&doHM. Print: =. •' MY Comm.Expires Jul 21,2016
m Sion#t EE 2113
My Commission Expires: My Co. kpirem o n.
APPROVED BY Plans Examiner Zoning
Structural Review Clerk
(Revised 3/12/2012)(Revised 07/10/0T(Revised 06/10/2009)(Revised 3/15/09)