BPP-15-865 Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-232362 Permit Number: BPP-4-15-865
Scheduled Inspection Date: August 03, 2015 Permit Type: Pools/Whirlpools/Hot Tubs
Inspector: Rodriguez,Jorge
Inspection Type: Final
Owner: LONGMAN, PATRICK Work Classification: Addition/Alteration
Job Address: 1499 NE 104 Street
Miami Shores, FL Phone Number (305)677-3046
Parcel Number 1122320320110
Project: <NONE>
Contractor: CHAMPION CONCRETE Phone: (305)252-8055
Building Department Comments
POOL DECK AND POOL RESURFACING 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.
July 31,2015 For Inspections please call: (305)762-4949 Page 5 of 28
Ir 06M -44 6-865
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j°' s ey Miami Shores Village1W.F" IS)Hot, 7tti
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10050 N.E.2nd Avenue NEfl>f�10*0 3Oft
Miami Shores,FL 33138-0000 rM It
> mit t8t P?ROVED
"�. Phone: (305)795-2204 .
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3 Expiration: 12/0112015
Project Address Parcel Number Applicant
1499 NE 104 Street 1122320320110
PATRICK LONGMAN
Miami Shores, FL Block: Lot:
Owner Information Address Phone Cell
PATRICK LONGMAN 1499 NE 104 ST (305)677-3046
l MIAMI FL 33138-2663
Contractor(s) Phone Cell Phone $ 11,200.00
Valuation:
CHAMPION CONCRETE (305)252-8055 (786)402-4802
Total Sq Feet: 900
Approved:In Review Available Inspections:
Comments:
Inspection Type:
Date Approved: : In Review Pool Deck
Date Denied: Wall Steel
Type of Work:Swimming Pool Occupancy:Private Fence
Additional Info: Bond Return : Final
Classification: Residential Scanning:3 Review Plumbing
Review Electrical
Review Electrical
Review Planning
Review Planning
Review Planning
Review Building
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due Review Building
CCF $7 20Review Building
Invoice# BPP-4-15-55187
DBPR Fee $5.04 04/14/2015 Cash $50.00 $324.28
DCA Fee $5.04
Education Surcharge $2.40 06/04/2015 Check#: 1926 $324.28 $0.00
Permit Fee $336.00
Scanning Fee $9.00
Technology Fee $9.60
Total: $374.28
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% h the plans,drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In
accepting this permit I assume responsiVity for all work done by either myself, my agent, servants, or employes. I understand that separate permits are
required for ELECTRICAL,PLUMBING,7the
HANICAL,WINDOWS,DOORS, ROOFING and SWIMMING POOL work.
OWNERS AFFIDAVIT: I ce that foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
construction and zonin er I authorize the above-named contractor to do the work stated.
June 04, 2015
Authorized Si ature:Owner / Applicant / Contractor / Agent Date
Building Department Copy
June 04, 2015 1
'►� � �� Miami Shores Villa �.FrF
6 Village APR � 2015
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138 �__--
1� Tel: (305)795-2204 Fax: (305) 756-8972
INSPECTION LINE PHONE NUMBER:(305)762-4949
FBC M 0
BUILDING Master Permit No'e--FF—t5-RGA
PERMIT APPLICATION sub Permit No.
E�IUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION [:]RENEWAL
❑PLUMBING ❑ MECHANICAL [:]PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
i CONTRACTOR DRAWINGS
JOB ADDRESS: ! 4 441 0/4;
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#: 11-72-'L— Ozi 2-- 0110 Is the Building Historically Designated:Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name(Fee Simple Titleholder): P*-71Lta4- L M&A0 4..; Phone#:
Address: i q 4 ty A-5- /0115;r
City: 1,46"; 3,17,0ite3 State: t-- Zip: 7 ;14-Y'
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR:Company Name: Phone#:
Address: d ey 1 Ir-3 `jam X17"t f�
City: ydf State: - Zip:,�1)2X
Qualifier Name: .JA�/�� '7�y��''r.� Phone#: 7!2j`4((Z OA-Z
State Certification or Registration#: Certificate of Competency J'-5'0ytyS
DESIGNER:Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit:$_ Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition
Description of Work:
��
Specify color ofrlcolor
�thru-tile:
Submittal Fee$ U Permit Fee$ CCF$ CO/CC$
Scanning Fee$ Radon Fee$ DBPR$ Notary$
Technology Fee$ Training/Education Fee$ Double Fee$
Structural Reviews$ Bond$ t:>(J V `-"'
TOTAL FEE NOW DUE$ L-U
(Revised02/24/2014) �''4
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 mus a posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued. In the absence such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
• w
Signature i �! Signature
OWNER or AGENT ONTRACTOR
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
Z day of /Lk 20 1 S by day of "%,-a 120 / by
4 016✓1 who is personally known to oi✓y)-7c 6/j-5i/,V who is personally known to
me or who has produced .DL L-SZS-67Y-66-IM-42 me or who has produced S:�ru1� as
identification and who did take an oath. identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
r•
SignSign:
Print: K Print:
nu I ri LUX WA�
Seal: Y MY COMMISSION FF 172019 Seal: _�' + MY COMMISSION#FF 172019
EXPIRES:January i8,2019 =s' EXPIRES:January 18,2019
ti Bonded Thru Notary Public UnderwritersR 1 Bonded Thru Notary Pubic Undo writers
**************************** ************************************************************************
APPROVED BY Plans Examiner ( � Zoning
Structural Review Clerk
(Revised02/24/2014)
(-I hA ut-
APR 2015
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