PL-15-1087 v 3
sK° 6A&IV
Miami Shores Village Ph7? 7'y?e Piut> I ;Resi�et�tiil
10050 N.E.2nd Avenue NE Ill/titf OISSS �� IRD 41Y
Miami Shores,FL 33138-0000 „ Y
t' Phone: (305)795-2204 „ Mp,v 1M E t ECS
6/11261& Expiration: 1
Project Address Parcel Number Applicant
290 NE 98 Street 1132060134150
Giselle Kovac
Miami Shores, FL 33138- Block: Lot:
Owner Information Address Phone Cell
Liselle Kovac 290 NE 98 street 828 230-5395
Miami Shores FL 33138
Contractor(s) Phone Cell Phone $ 2,000.00
Valuation:
ROSMEL POOL INC (305)592-7900
®-- - - Total Sq Feet: 0
Type of Work:POOL PIPING Available Inspections:
Type of Piping:
Inspection Type:
Additional Info:
Main Drain
Bond Return
Final
Classification:Residential Scanning:1 Rough
Review Plumbing
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due
CCF $1.20 Invoice# PL-5-15-55464
DBPR Fee $3.38 05/07/2015 Credit Card $50.00 $187.96
DCA Fee $3.38
Education Surcharge $0.40 06/01/2015 Check* 12796 $ 187.96 $0.00
Permit Fee $225.00
Scanning Fee $3.00
Technology Fee $1.60
Total: $237.96
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 ccurate and that all work will be done in compliance with all applicable laws regulating
construction and zoni g. Futherm re authorize the above-named is
to do the work stated.
1,0&Q S��_ � June 01, 2015
Authorized Signature:Owner / Applicant / ontractor / Agent Date
Building Department Copy
June 01,2015 1
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores,FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number. INSP-245278 Permit Number: PL-5-15-1087
Scheduled Inspection Date: October 13,2015 Permit Type: Plumbing - Residential
Inspector: Diaz,Osvaldo
Inspection Type: Final
Owner: Kovac, Giselle Work Classification: Pool- Private
Job Address:290 NE 98 Street
Miami Shores,FL 33138- Phone Number 828 230-5395
Project: <NONE> Parcel Number 1132060134150
Contractor: ROSMEL POOL INC Phone: (305)592-7900
Building Department Comments
POOL PIPING Infractlo Passed Comments
INSPECTOR COMMENTS False
Inspector Comments
Passed E2/
Failed
Correction ❑
Needed
Re-Inspection ❑
Fee
No Additional Inspections can be scheduled until
re-inspection fee is paid.
October 09,2015 For Inspections please call:(305)762-4949 Page 21 of 41
Miami Shores Village
Building Department MAY 0 7 2015
10050 N.E.2nd Avenue,Miami Shores,Florida 33138
Tel:(305)795.2204 Fax:(305)756.8972 -
INSPECTION'S PHONE NUMBER:(3057 762.4949
BUILDING FBC 20�F, +�_ I O
Permyt No.
PERMIT APPLICATION Master Permit No. ' 67- t Q
Permit Type: PLUMBING
JOB ADDRESS:_ °ZqC°+ V`-J Gj S
City: Miami Shores County: Miami Dade Zip: 313
Folio/Parcel#: 1 I ° a,W n
Is the Building Historically Designated:Yes NO Flood Zone:
OWNER:Name(Fee Simple Titleholder): IAC Dom'ea C- Phone#.
Address: ZCi® K)F— �T FS Srt _
City: State: �L zip: 3313�S
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR:Company Name: ��Eune, Vcxnjf�, 1 QC. . Phone#: 'may
Address: `c>C 4S I,,l1 �)(e^ S S 1AC 54 C)
City:_ ��r 1 State: 1— zip:
Qualifier Name: tL 1G �Jo.v-���, Phone#:
State Certification or Registration#: CPC-1�4-,Q S L-Li Certificate of Competency#:
Contact Phone#: Email Address:
DESIGNER:Architect/Engineer: ru uD (Dot e-e. ' _ CAP30 I Phone#• `7 b L&'
Value of Work for this Permit: Square/Linear Footage of Work:
Type of Work: OAddress OAlteration ONew ORepair/Replace ODemolition
Description of Work:. ..
Submittal Fee$ Permit Fee$ fy CCF$ CO/CC$
Scanning Fee$ Radon Fee$ DBPR$ Bond$
Notary$ Training/Education Fee$ Technology Fee$
Double Fee$ Structural Review$
TOTAL FEE NOW DUE$ L
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 appro einspection fee will be charged.
Signature
Signature
Ow or Agent Contractor
The foregoing instrument was acknowledged before me this I The foregoing instrument,was acknowledged before me this
day of �"e4 20 6,by Jh KOJ C day of I.Ra�c ,201 ,by 1� ,�r ►�cy i����C,
who i ersonall know o me or who has produced who is sonally know o me or who has produced
As identification and who did take an oath. as identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
¢•,,
A MARTINEZ
Sign: + AFF y�• ,,,
TMu Pbte �
Sign: 4)a'
Print: Print: '� 1
My Commission Expires: My Commis
r
APPROVED BY �• ans Examiner `s Zoning
Structural Review Clerk
(Revised3/12/2012XRevised 07/10/07)(Revised 06/1012M)(Revised 3/15/09)