PL-13-2266 Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-200630 Permit Number: PL-10-13-2266
Scheduled Inspection Date: January 28, 2015 Permit Type: Plumbing - Residential
Inspector: Diaz, Osvaldo
Inspection Type: Final
Owner: MOWERS,JEFFREY Work Classification: Addition/Alteration
Job Address: 1175 NE 101 Street
Miami Shores, FL 33138- Phone Number
Parcel Number 1132050190230
Project: <NONE>
Contractor: ARFA PLUMBING CORP Phone: 305-552-8410
Building Department Comments
BATHROOM REMODEL Infractio Passed Comments
INSPECTOR COMMENTS False
Inspector Comments
Passed
Failed
Correction
Needed
Re-Inspection ❑
Fee
No Additional Inspections can be scheduled until
re-inspection fee is paid.
January 27, 2015 For Inspections please call: (305)762-4949 Page 2 of 34
Miami Shores Village
Building Department `g"` ' �r =D
10050 N.E.2nd Avenue,Miami Shores,Florida 33138 ��( � 7 2013
Tel: (305)795.2204 Fax: (305)756.8972
INSPECTION'S PHONE NUMBER: (305)762.4949 PY:
FBC 20
BUILDING Permit No. P f l 3 � 6,6
PERMIT APPLICATION Master Permit No. RC_ (a"t 3-'1361
Permit Type: PLUMBING
JOB ADDRESS: 1175 Al,_4 lot S
City: Miami Shores County: Miami Dade Zip: 313
Folio/Parcel#: 11" 3205" 01q- 023v
Is the Building Historically Designated: Yes NO ,X Flood Zone:
OWNER:Name(Fee Simple Titleholder): J Cyq**e- . kciAer-47t Aloyee(i Phone#:
Address: 117 S AIX 101 ST
City: M 1:4m; S i s State: FL. Zip: 13 3/3 r—
Tenant/Lessee Name: /V/A Phone#:
Email:
CONTRACTOR:Company Name: L PL L/d"? Phone#:7,k,
Address:
City: 6 State: r- Zip: .331CJ
Qualifier Name: 0 '^/ 6L ! r Phone#: e-
State Certification orRegistration C`�f , 7��z- Certificate of Competency#:
Contact Phone#: 9 (aL`5 .-�('ZY Email Address:
DESIGNER:Architect/Engineer: Phone#:
Value of Work for this Permit:$ �5:ce-x_) Square/Linear Footage of Work:
Type of Work: ❑AddressIter��attion ❑New ❑Repair/Replace ❑Demolition
Description of Work: 77/+/ if`"'7 /J`e4-e le ,.
Submittal Fee$ Permit Fee$Azzs CCF$ CO/CC$
Scanning Fee$ Radon Fee$ DBPR$ Bond$
Notary$ Training/Education Fee$ Technology Fee$
Double Fee$ Structural Review$
TOTAL FEE NOW DUE$
l q s �6
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,1 U A tS,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 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•builil ng per;Ait 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. - N Signatur ,:��:—�—
4er or Agent Contractor
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this 3
day o 20 f�by P/G/�t /L' w ! : day of L 2013 by PVD4�S I t04R C QV- ,
who ' personally known o me or who has produced who is personallyown tome r Sho has produced
As identification and who did take an oath. as identification and who did take an oath.
NOTARY PUBLIC: NOT C:
Sign: .000.
Si -
No Public State of Florida
Print: � on lis Print:
My Co �pi�ro12/0612015 Commission 1478n My Commissi '"Y p` OMMIS ION#E EZ
_*; , MY COMMISSION#EE 066039
ZZ
EXPIRES:February 20,2015
•.., F
,F Bonded Thru Notary Public Underwriters
APPROVED BY �i t-/ %S Plans Examiner Zoning
Structural Review Clerk
(Revised3/12/2012)(Revised 07/10/07)(Revised 06/10/2009)(Revised.3/15/09)