PL-13-2593 Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-209288 Permit Number: PL-11-13-2593
Scheduled Inspection Date: April 23,2014 Permit Type: Plumbing - Residential
Inspector: Diaz, Osvaldo Inspection Type: Final
Owner: DAVIDSON,JENNIFER Work Classification: Addition/Alteration
Job Address:75 NE 101 Street
Miami Shores, FL 33138- Phone Number
Parcel Number 1132060131550
Project: <NONE>
Contractor: BILT GREEN CONSTRUCTION SERVICES LLC Phone: (954)826-8988
Building Department Comments
REPLACE EXISITNG KITCHEN SINK, DISHWASHER AND Infractio Passed Comments
2 BATHROOM INSPECTOR COMMENTS False
Inspector Comments
Passed CREATED AS REINSPECTION FOR INSP-208890. connection at sink shall
have approved fittings
Failed
❑ 2-
Correction ❑
Needed
Re-Inspection ❑
Fee
No Additional Inspections can be scheduled until
re-inspection fee is paid.
April 22,2014 For Inspections please call: (305)762-4949
Page 14 of 37
Miami Shores Village
Building Department �jjp ilw V13
90050 N.E.2nd Avenue,Miami Shores,Florida 33138
Tel:(305)795.2204 Fax:(305)756.8972 ?,Y:
INSPECTION'S PHONE NUMBER:(305)762.4949
FBC 201
BUILDING Permit No. ���
PERMIT APPLICATION Master Permit No. �`�
Permit Type: PLUMBING
JOB ADDRESS:3 5 NE 101 5�:dr elt*
City: Miami Shores County: Miami Dade Zip:3)J 13
Folio/Parcel#: %1 — 7) CO I 0
Is the Building Historically Designated:Yes NO ` Flood Zone:
OWNER:Name(Fee Simple Titleholder): n n i nPp lr J ,o yi d SoY)— Phone#:_3015-9 17
Address: -7-5 N_'E )()I S-Af e r__*
City: M;4nM,j stmtas State: V-- L. Zip:
Tenant/Lessee Name: N -1 Phone#:
Email:
CONTRACTOR:Compan Name: 1 LT- GlAr- `�'Vi P`hho#:
Address: Pzl �, RLL
City: S � Zip:
Qualifier Name: L _ L%1A 12C' Phone#: ° P
State Certification or Registration#: C Certificate of Competency#:
Contact Phone#: Email Address:
DESIGNER:Architect/Engineer: Phone#:
Value of Work for this Permit:$ Qy. 15 d. 00 Square/Linear Footage of Work:
Type of Work: ❑Addres/s� ❑Alteration ❑Ne(w �epair/Replace ❑Demolition
Description of Work: R Q @X i i �,il �;4 C i) , sink,, dijb W 0.S A er
Rdt%1aCI 4ZY.V�inR eaS� bi
a° ;,--0M :SMn n_�w.}
hep/acc @c►S>ti�a W¢l�- bg���oa,n sink� �ine� ���8� ♦ b��ti,�b
��x�x��:����x��xxx�x����xxx����x�xa�uxxxxFeesxxx��xx+xxxxxxx��x�x�xxx�xxxxx���x�x�x:xx�xxx�
Submittal Fee$ Permit Fee$ 2-2,S,✓ CCF$ CO/CC$
Scanning Fee$ Radon Fee$ DBPR$ Bond$
Notary$ Training/Education Fee$ Technology Fee$
Double Fee$ Structural Review$ 4n Iq a4
TOTAL FEE NOW DUE$ `
i• %
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 posfq at the job site
for the first inspection which occurs seven (7) days after the building permit is issued. In the ce uch os d notice, the
inspection will not be approved and a reinspection fee will be charged.
Signature Signature
Owner or Agent �owledge
The foregoing instrument was acknowledged before me this ' The for16.L�oing instrument
twc e s L3
day of ,20��,by�l'L�t lllyl Fel. I9,AMc2� day of20� by e / atr�-
who is personally known to me or who has produced ''t r7 who is personally known t me Rr,l,;,o as pr
`PRY
As identification and who did take an oath. as id � 'QdydlPdt iI �S�tfltbglflorida
• .•:My Comm. Expires Feb 23,2017
NOTARY PUBLIC: NOTA PLyBL Com, Commission#EE 870470
a\e` 111111111/1 %°IJ��'� Bonded Through National Notary Assn.
Sign: .>'�''� Sign:
Print: Print: /71'7i1')QYl�1�/
My Commission Expires: _ O�'���oJ J
d My Commission Expires: Z I�3/ ,
co
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APPROVED BY Plans Examiner Zoning
Structural Review Clerk
(Revised3/12/2012)(Revised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09)