PL-13-2555 Inspection Worksheet
Miami Shores Village
10050 N.E.2nd Avenue Miami Shores, FL � 2_3�
Phone: (305)795-2204 Fax: (305)756-8972 iar\
Inspection Number: INSP-217079 Permit Number: PL-11-13-2555
Scheduled Inspection Date: August 13, 2014 Permit Type: Plumbing - Residential
Inspector: Diaz, Osvaldo
Inspection Type: Final
Owner: CHEF-AWAI, CAMILLE Work Classification: Addition/Alteration
Job Address: 1370 NE 103 Street
Miami Shores, FL Phone Number (305)710-3331
Parcel Number 1132050300080
Project: <NONE>
Contractor: UNIVERSAL PLUMBING CORP Phone: (305)887-3131
Building Department Comments
PLUMBING WORK TO REDO ALL 3 1/2 BATHROOMS ANC Infractio Passed Comments
KITCHEN INSPECTOR COMMENTS False
Inspector Comments
Passed CREATED AS REINSPECTION FOR INSP-202945.
Failed
Correction
Needed
Re-Inspection ❑
Fee
No Additional Inspections can be scheduled until
re-inspection fee is paid.
August 12, 2014 For Inspections please call: (305)762-4949 Page 14 of 32
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-218167 Permit Number: PL-11-13-2555
Scheduled Inspection Date: August 20,2014 Permit Type: Plumbing - Residential
Inspector: Diaz, Osvaldo Inspection Type: Final
Owner: CHEE-AWAI, CAMILLE Work Classification: Addition/Alteration
Job Address: 1370 NE 103 Street
Miami Shores, FL Phone Number (305)710-3331
Parcel Number 1132050300080
Project: <NONE>
Contractor: UNIVERSAL PLUMBING CORP Phone: (305)887-3131
Building Department Comments
PLUMBING WORK TO REDO ALL 3 1/2 BATHROOMS ANC Infractio Passed Comments
KITCHEN INSPECTOR COMMENTS False
Inspector Comments
Passed r
Failed
Correction ❑
Needed
Re-Inspection ❑
Fee
No Additional Inspections can be scheduled until
re-inspection fee is paid.
August 19,2014 For Inspections please call: (305)762-4949 Page 23 of 26
Miami Shores Village --
Building Department wo 0 N9'i'6
10050 N.E.2nd Avenue,Miami Shores,Florida 33138 F
Tel: (305)795.2204 Fax:(305)756.8972
INSPECTION'S PHONE NUMBER:(305)762.4949
FBC 20
BUILDING Permit No. R-A ASS S
PERMIT APPLICATION Master Permit No. Q e—
Permit Type: PLUMBING
JOB ADDRESS: V 3--ko 0 i I oZ —
City: Miami Shores County: Miami Dade Zip: 33► 3A
Folio/Parcel#: I I Z 22 05-0 ® 190
Is the Building Historically Designated:Yes NO '� Flood Zone:
OWNER:Name(Fee Simple Titleholder):-4:14 W 1 L_L G Nk'�-� Phone#: 3 o�C-
Address: 1.1 tL-)2'� --
City: K4 r 02� sH-ares State: Zip; 33 1 -%a
Tenant/Lessee Name: Phone#:
Email �.a-w. 91 l c 1 o c o
CONTRA �t�iO2i2S1 �7(��l��h �eZ/�
CONTRACTOR:Company Name: � ( � Phone#:
Address: /6z All/ 5 ��-
;City: leo State: G Zip:
Qualifier Name: CG?G �i f�G Phone#: IYO e t
State Certification or Registration#: of -Z/-Certificate=.Certificate of Competency#•
Contact Phone#: ZI3/ 3Email Address y �¢.
DESIGNER:Ar hitect/Engmeer: Phone#:
Value of Work for this Permit:$ !D, Ce / + Square/Linear Footage of Work:
Type of Work: OAddress (Alteration AkNew ORepair/Replace ODemolition
Description of Work: PLU Ai R,k. 7,6- RST l R
4•+,� Ott , 3 ` z
Submittal Fee$ 0"UJ Permit Fee$ CCF$ CO/CC$
Scanning Fee$ Radon Fee$ DBPR$ Bond$
Notary$ Training/Education Fee$ Technology Fee$
Double Fee$ Structural Review$
TOTAL FEE NOW DUE$ 0
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,FURNACES,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 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 Signature
./_oe
Owner or Agent Contractor
The fo10V
ing instrument was acknowled ed before me this The foregoing instrument was acknowledged before me this'
day of ,20 L,by 0tSIM u` WArl day of MW 20 a by
who is personally known to me or who has produced__1PV_L _ who is personallyknown to me or who hag produced
0000-!tO•Gf- 7 n'(As identification and who did take an oath. as identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
Sign Sign:
Print: ^/ S �c��'/'� Print: 'e '`Vp
ao��?!°�evc, "RIB GOttE2 moo`;.":: % ELZIRIS(�MEZ
My Commission Expires: My Commission Expires:
**,.,d4e*
YY COMAdISS�NI!EE 8183 � MY COMMISSION 9 EE 838183
EXPIRES:January 25,2017 EXPIRES:January 25,2017
BEmThruSu*Noteysvvicee "'�OFaro��op BondedThruBudgatNotarySeneitss
************************************************************************************************************
APPROVED BY y // L(r�� Plans Examiner Zoning
Structural Review Clerk
(Reviwd3/12/2012)(Revised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09)