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DEMO-15-2101 Lanz) Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-241694 Permit Number: DEMO-8-15-2101 Scheduled Inspection Date: September 01, 2015 Permit Type: Demolition Inspector: Diaz, Osvaldo Inspection Type: Final Owner: DUQUE, CHRISTOPHER Work Classification: Plumbing Job Address:361 NE 101 Street Miami Shores, FL 33138-2424 Phone Number Parcel Number 1132060135220 Project: <NONE> Contractor: UNIVERSAL PLUMBING CORP Phone: (305)887-3131 Building Department Comments DEMOLITION 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. August 31, 2015 For Inspections please call: (305)762-4949 Page 23 of 37 sO1s L Miami Shores Village 10050 N.E.2nd Avenue NE e � � �>tt1113Lt •�•' Miami Shores,FL 33138-0000 tiF Phone: (305)795-2204 �8tltsiyl� ..r '..: 81 Expiration: 02123/2016 11 Project Address Parcel Number Applicant 361 NE 101 Street 1132060135220 CHRISTOPHER DUQUE Miami Shores, FL 33138-2424 Block: Lot: Owner Information Address Phone Cell CHRISTOPHER DUQUE 361 NE 101 Street MIAMI SHORES FL 33138- 361 NE 101 Street MIAMI SHORES FL 33138- Contractor(s) Phone Cell Phone Valuation: $ 4,000.00 UNIVERSAL PLUMBING CORP (305)887-3131 Total Sq Feet: 0 Type of Demo:Plumbing Available Inspections: Additional Info:DEMOLITION Inspection Type: Classification:Residential Final Scanning: 1 Review Plumbing Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $2.40 Invoice# DEMO-8-15-56766 DBPR Fee $2.00 DCA Fee $2.00 08/19/2015 Credit Card $50.00 $63.40 Education Surcharge $0.80 08/27/2015 Check#:375 $63.40 $0.00 Permit Fee $100.00 Scanning Fee $3.00 Technology Fee $3.20 Total: $113.40 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 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. Fu th horize the above-named contractor to do the work stated. August 27, 2015 Authorized S' re:Owner / Applicant / Contractor / Agent Date Build' g Department Copy August 27,2015 1 Miami Shores Village Building Department A U(J4 12015 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel:(305)795-2204 Fax: (305)756-8972 -- INSPECTION LINE PHONE NUMBER:(305)762-4949 S(11 FBC 20 r BUILDING Master Permit No.,� U PERMIT APPLICATION Sub Permit No., - 15 -- 2-103- ❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL PLUMBING ❑ MECHANICAL [:]PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP C, CONTRACTOR DRAWINGS JOB ADDRESS: N� �� .S1 IN001V City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: Is the Building Historically Designated:Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: `` FFE:,c OWNER: Name(Fee Simple Titleholder): 0)i(,C� )n -0-hu Phone#: �S 0 3 Address: 40UuNC' `3►d 11 f l 6— 1 _ City: 1'"Y)f m ) State: Zip: Tenant/Lessee Name: Phone#: Email: / Z � I r� CONTRACTOR:Company Name: 041-tve "46 �lv�b%�� -B�Gr Phone#: "<,, Address: � 61l 6- 4 ',057_ �- City: ' l C/li'(f{ State: _'Cp/(� �i� Zip: 3�Or3 Qualifier Name: �ezGr¢ylrJYa Phone#: �rx State Certification or Registration#: �`'L �C�.+� �r Certificate of Competency#: DESIGNER:Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit:$ !Y600 Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace EQ Demolition Description of Work: h �� o <<'. 7 ©n 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$ ' (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$2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature X ( Signature OWNER or AGENT CONTRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument gwas acknnowledged before me this day of J� �-� ,20 by day of 4nt �GJ 20.1 by UMGA�Ifl 7k tQl. who is personally known to `/d who is personally known to me or who has produced � Vl � IvS� as me or who has produced as identification and who did take an oath. identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBL ��""� LOURDES MARIN ,1',iI�aIQN#FF009167 17,2017 Sign: Nnlnr Sdrvite.0M Print: Print: `D61101' e✓ople-lel-I Seal: io`°"YP Notary Public State of Florida Seal: Sindia Alvarez ' ��a My commission FF 156750 of Expires 09/03/2018 ************************************** * *************************************************************** APPROVED BY �$—Z�-!$ Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014)