PL-14-2402 Inspection Worksheet
Miami Shores Village
10050 N.E.2nd Avenue Miami Shores,FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-222685 PermitNumber: PL-10-14-2402
Scheduled Inspection Date: November 13,2015 Permit Type: Plumbing - Residential
Inspector: Diaz,Osvaldo
Inspection Type: Final
Owner: RICE, CORRIE Work Classification: New
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
new swimming pool piping Infractio Passed Comments
INSPECTOR COMMENTS False
Inspector Comments
Passed �(
h i
Failed 33 S
Correction
Needed
Re-inspection
a
Fee
No Additional Inspections can be scheduled until
re-inspection fee is paid.
November 12,2015 For Inspections please call: (305)762-4949 Page 2 of 44
Miami Shores Village
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 26
BUILDING Master Permit No. �LfO
PERMIT APPLICATION Sub Permit N4 '�-
F-IBUILDING ® ELECTRIC r-1 ROOFING Q REVISION QEXTENSION RENEWAL
PLUMBING EJMECHANICAL ]PUBLIC WORKS F-1 CHANGE OF CANCELLATION SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: -it A/iv
City: Miami Shores County: Miami Dade zip: -3-3150
FoW/Parcel#. 11 -it% Jig- 005- t>(41 f., Is the Building Historically Designated:Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER:Name(Fee Simple Titleholder): Phone#:
Address: k-ki 11 s-r-
City: t vi I*Iq I 1.t State: Zip: 1'5 cl
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR:Company Name: 1-b A
rOC Phone#:AVL6/.?55 -31 -S
Address: -1 of�':>U S w t 6 L Z F
City: AA I A:t& State: F--L- Zip: 3 3 j,&4.
Qualifier Name: Jb} & Phone#:
State Certification or Registration#: Certificate of Competency
DESIGNER:Architect/Engineer: Phone#:
Address: -jo -7
', �p tQ i.� %Li Lj��j-j C _5 City: M!#M State: r-1 Zip:3-3 t
Value of Work for this Permit-$
;Z600 " Square/Linear Footage of Work:
Type of Work- El Addition 0 Alteration ED New F� Repair/Replace E3Demolition
Description of Work:
Specify color of color thru tile:
Submittal Fee k
'Ql ,0(�) 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 ro
(RevisedG2/24/2014)
Bonding Company's Name(if applicable) A,
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. 1 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.
X Signature Signature
OWNER or AGENT CONTRACTOR
The foregoing instrument was acknowledged before me this The foregoing' strumen-t was
/acknowledged before me this
2 day of 20 ,by e
/ day of �,�C�?Yl 20 by
`e , J
e' who is personally known to V AJ pleb& ,who is personally known to
me or who has produced 93 =6 -7457 me or who has produced_ as
identification and who did take an oath. identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
Sign: Sign:
aoZ No is rida � �� h/ ARIIYNSCHWRZER
P ^
ommission FF 082753 i WIRES:Am"10,2016
Seal: ar Expires 01/12/2018 Seal: SoniM 1Wv NftyPv*ftowher ;
APPROVED BY 6�/f�3-/'�/ Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)