MC-14-2526 Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-223481 Permit Number: MC-11-14-2526
Scheduled Inspection Date: November 18,2015 Permit Type: Mechanical - Residential
Inspector: Perez,JanPierre Inspection Type: Final
Owner: I RICE, CORRIE Work Classification: Pool Heater
Job Address:41 NW 105 Street
Miami Shores, FL 33150- Phone Number (305)799-5785
Parcel Number 1121360050290
Project: <NONE>
Contractor: CUSTOM POOLS Phone: (305)255-5315
Building Department Comments
HEAT PUMP Infractio Passed Comments
INSPECTOR COMMENTS False
Inspector Comments
Passed PERMIT HANGING BACK PATIO'S DOOR
Failed
Correction ❑
Needed
Re-Inspection a
Fee
No Additional Inspections can be scheduled until
re-inspection fee is paid.
November 17,2015 For Inspections please call: (305)762-4949
Page 1 of 33
S
Miami Shores Village` 17 2014
Building Department
10050 N.E.2nd Avenue,Miami Shores,Florida 33138
Tel:(305)795-2204 Fax:(305)756-8972
INSPECTION LINE PHONE NUMBER:(305)762-4949
FBC 2016
BUILDING Master Permit No."RP P iQ .-.I+- �Zq0
PERMIT APPLICATION sub Permit No.LL )F-IBUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION EXTENSION F-]RENEWAL
❑PLUMBING ®`MECHANICAL PUBLIC WORKS ❑ CHANGE OF CANCELLATION [:] SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: y/ Al IA) /05 S 7-
City:
City: Miami Shores County: Miami Dade Zip: 3.3/50
Folio/Parcel#: I t" 2134-COG -0250 Is the Building Historically Designated:Yes NO
Occupancy Type: Load: (Construction Type: Flood Zone: BFE: FIFE:
OWNER:Name(Fee Simple Titleholder): two Z V-Lie=M yC.e. Phone#:
Address: Li I N W I V 5 5.T-
City:
. -City: k Ior tm I no hl oQ E5 State: Ft- Zip: 3-4/56
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR:Company Name: �tiC S f'oM A9 0 t-S - Phone#: 301; 2555315
Address: 13;250 s u1 13 L s'T tl !V-D
City: r4//I`YI,1 ; State: F(-- Zip: 3 PF 4
Qualifier Name: J r)k' PiegD Phone#: 30 5 x55.5 315
State Certification or Registration#: CPC 0 5 /i 3 Certificate of Competency#:
DESIGNER:Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit:$ e" " Square/Linear Footage of Work:
Type of Work: ❑ Addition,,(( ❑ Alteration New ❑ Repair/Replace El Demolition
b1
Description of Work: p c)r- ,&M n --r-71V%-�. Lc,4 t o^�
Specify color of color thru tile:
Submittal Fee$ Permit fee$ L CCF$ CO/CC$
Scanning Fee$ Radon Fee$ DBPR$ Notary$
Technology Fee$ Training/Education Fee$ Double Fee$
Structural Reviews$ Bond$_
TOTAL FEE NOW DUE$ Q)
(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. 1n the absence of such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
Signature Signature �
OWNER or AGENT CONTRACTOR
The foregoing instrument was acknowledged befor me this The foo go g instrument was acknowledged before me this
_ day of toy 20 0T by 7 day / ✓SWF� 20 �� by
CC .�j�j ✓ who is personally known to VAid d/lC���-0 who is personally knownto
me or who has produced as me or who has produced as
identification and who did take an oath.\\\\\\\ �!tnl,!!! identification and who did take an oath.
NOTARY PUBLIC: \�����\ C0 i/i/� NOTARY PUBLIC:
Sign; _ •o° ®- Sign;
Print: �
n � '� `�., � Print: i
My r
/ COMMISSION R EE 129
/ JB6
Seal;. �i \\\\ Seal: „a Via;: EXPIRES:January 10,2016
Bonded?hruNotary Public undenvrlters ..
i
APPROVED BY Plans Examiner Zoning
Structural Review Clerk
10-4-40717ahm M