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PL-07-620 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-190128 Permit Number: PL-3-07-620 Scheduled Inspection Date: April 29, 2013 Permit Type: Plumbing - Residential Inspector: Hernandez, Rafael Inspection Type: Final Owner:Owne PEREZ-CONTRERAS YENI E Work Classification: New Job Address:54 NE 106 Street Miami Shores, FL 33138-2035 Phone Number Parcel Number 1121360060040 Project: <NONE> Contractor: HOME OWNER Building Department Comments BATHROOM REMODEL Infractio Passed Comments INSPECTOR COMMENTS False Inspector Comments Passed CREATED AS REINSPECTION FOR INSP44574. Failed Correction Needed Re-Inspection ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is paid. April 26,2013 For Inspections please call: (305)762-4949 Page 44 of 50 Permit No. hL-3-07-620 .R °ter Miami Shores Village M Permit Type:Plumbing-Residential 10Shores,FL 33138-0000 N.E.2nd Avenue Miami Per 1NorfcCtassi�rcafion:New S a� Phone: (305)795-2204 Permit Status:APPROVED �ZORYD�" Issue Date:3/30/2007 Expiration: 09/26/2007 Project Address Parcel Number Applicant . .......... ... .............. .................. ......_............... .. ........... ...... .................. ....... ...... ............. ... ............. .. 541106 Street 1121360060040 MARIA DEL ORTIZ Miami Shores Village, FL Block: Lot: Owner_Information _._Address..__ ......_...... _. Phone . ........ Cell MARIA DEL ORTIZ 54 N.E.106 ST. Contractor(s) Phone Cell Phone Valuation: $ 700.00 HOME OWNER Total Sq Feet: 0 Type of Work:BATHROOM Available Inspections: Type of Piping: Inspection Type: Additional Info: Lavatory Bond Retum: Top our Classification:Residential Re Pipe Water Main Underground Rough Water Service Final Main Drain Heater Fees Due Amount Total Amt Paid Amt Due CCF $0.60 Education Surcharge $0.20 $0.00 $0.00 $ 0.00 Notary Fee $5.00 Permit Fee-Additions/Alterations $160.55 Payment Type: Scanning Fee $3.00 Technology Fee $4.01 Total: $173.36 G �o In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans,drawings,statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL,PLUMBING,MECHANICAL,WINDOWS,DOORS,ROOFING and SWIMMING POOL work. OWNERS AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Futhermore,I authorize the above-named contractor to do the work stated. March 30,2007 Authorized Signature:Owner / Applicant / Contractor / Agent Date Building Department Copy Friday,March 30,2007 1 Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305)795.2204 Fax:(305)756.8972 BUILDING N I�° Permit No. PERMIT APPLICATION MAS zoo? Master Permit No. FBC 2004 Permit Type: Plumbing Owner's Name(Fee Simple Titleholder),G?&K/ A 012-71- Z . Phone# 30S-742-676Z h76Z Owner's Address :5- x/(F 10 (0 S7 CiState P L Zip �j� Tenant/Lessee Name Phone# E-MAIL: (� Job Address(wherethe worlds being done) a (,� --- City Miami Shores Villaee County . Miami-Dade Zip FOLIO/PARCEL# Is Building Historically Designated YES NO Contractor's Company Name ®�it//U�� Phone# Contractor's Address City State Zip Qualifier Name Phone# State Certificate or Registration No. Certificate of Competency No. E-MAIL: Arch itect/Engineer's Name(if applicable) Phone# Value of Work For this Permit$—77 V Square/Linear Footage Of Work: Type of Work: ❑Addition ❑Alteration E]New Repair/Replace l El Demolition Describe Work: 4A J(:/ 9r+kxxeF�Y at�lr#4exaY e4 d:oY oY�:9e de dextkaY oYxdr de$rear&u� d¢tY k of Feesx�Yxst•ko:�d:ek okxdcxxxeF�irx9cxx&xxxsir'xxxxxd:xxxxxx4cx�a:�e Submittal Fee$ Permit Fee$ CCF$ CO/CC Notary$ Training/Education Fee$ Technology Fee$ 0 ' Scanning$ Radon$ DPBR$ Zoning$ Bond$ Code Enforcement$ Double Fee$ Structural Review.$ Total Fee Now Due$ 1 1� See Reverse side-+ Bonding Company's Name(if applicable) Bonding Company's Address City State Zip Mortgage Lender's blame- if - ( a.pplicable}-- - --- Mortgage Lender's Address City State Zip Application is hereby made to obtain a permit to do the work and installations as indicated. l certify that no work or installation has commenced prior to the issuance of a permit,and that all work will be performed to- t the -standards of all laws regulating construction in this jurisdiction- d-,unde-rstand#ht-a separate permit-must be secured or CTRTCAL—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. Signatu- Signature Owner r Ta _ Contractor The foregoing instrument was ack wledged before me this C__%_-J The foregoing instrument was acknowledged before me this day of ar ,20aby n f�2- , day of ,20_,by who is personally known to me or who has produced who is personally known to me or who has produced As identification and who did take an oath. as identification and who did take an oath. NOTARY P LIC NOTARY PUBLIC: ryl �l Sign: Yp�'� 1 e1 Sign: Print: y: _Commis n , _.ilk Print: M Com fission Expires: porde Thrc Y Y p titieel RC . Itic My Commission Expires: xxdcxxde�it aY dexueent e4xde dr oexnF it aY scxxx�xxxxak eYxxde�cxxxxde tY i:xxde Y Bex aYr'e eexxae er nY�'xxxxxxaYxx�aC sexYlexsYuYxYaexx�e aY 4e�aYxxeY a't eY nY eY4e or eY oY t 4rxxxxx APPLICATION APPROVED BY: �� r2 Plans Examiner Engineer Zoning (Revised 02/08/06)