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PL-15-3043 Inspection Worksheet Miami Shores Village 10050 N.E.2nd Avenue Miami Shores,FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: Permit Number: PL-12-15-3043 Scheduled Inspection Date: December 10,2015 Permit Type: Plumbing - Residential Inspector: Diaz, Osvaldo Inspection Type: Final Owner: RANDLE,JULIA Work Classification: Pool - Private Job Address:285 NE 103 Street Miami Shores, FL 33138-2430 Phone Number Parcel Number 1121360130440 Project: <NONE> Contractor: G.E POOLS CONSTRUCTION INC Phone: (786)355-3382 Building Department Comments REPLACE MAIN DRAIN COVER Infractio Passed Comments INSPECTOR COMMENTS False Inspector Comments Passed [Ell 0 V, Failed ��- �v Correction ❑ Needed Re-Inspection Fee No Additional Inspections can be scheduled until re-inspection fee is paid December 09,2015 For Inspections please call: (305)762-4949 Page 30 of 44 Miami Shores Villages 10050 N.E.2nd Avenue NE Miami Shores,FL 33138-0000 �q Al Phone: (305)795-2204 rMr • "Ise ueli� 12912015 Expiration: 1 Project Address Parcel Number Applicant 285 NE 103 Street 1121360130440 Miami Shores, FL 33138-2430 Block: Lot: JULIA RANDLE Owner Information Address Phone Cell JULIA RANDLE 285 NE 103 ST MIAMI SHORES FL 33138-2430 Contractor(s) Phone Cell Phone Valuation: $ 100.00 G.E POOLS CONSTRUCTION INC (786)355-3382 Total Sq Feet: 0 Type of Work:REPLACE MAIN DRAIN COVER Available Inspections: Type of Piping: Inspection Type: Additional Info: I, Main Drain Bond Retum: Final Classification:Residential Scanning:1 Rough Review Plumbing Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $0.80 DBPR Fee $2.0o Invoice# PL-12-15-57985 DCA Fee $2.00 12/09/2015 Check#: 1289 $58.60 $50.00 Education Surcharge $0.20 12/08/2015 Check* 1285 $50.00 $0.00 Permit Fee $100.00 Scanning Fee $3.00 Technology Fee $0.80 Total: $108.60 In considei8tion of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining hereto 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 fpr 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 constructl_or1 and zoning. Futhermore,I authorize the above-named contractor to do the work stated. December 09, 2015 Authorized Signature:Owner / Applicant / Contractor / Agent Date Building Department Copy 4. Decerrfher 09,2015 1 ©� Miami Shores Village g p Building Department _ + 0 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 =-.-- � J Tel: 305 795-2204 Fax: 305 756-8972 INSPECTION LINE PHONE NUMBER:(305)762-4949 FBC 2W4 f BUILDING Master Permit No. - �- 15- //29 � `f � PERMIT APPLICATION sub Permit No. � ❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS ST JOB ADDRESS: aK 5 Nr_ 73 City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: Is the Building Historically Designated:Yes NO Occupancy Type: Load: Construction Type: II Flood Zone: BFE: FFEE: OWNER:Name(Fee Simple Titleholder): Ty b � �fl-nj � -P ' Phone#: '375-V 6 5- 'sS 3 Address: Z95 N C 2. "C City: M l Vlm% 5keyepS - State: '( Zip: Tenant/Lessee Name: Phone#: Email: CONTRACTOR:Company Name:_ (E PwL5 /onS- -U [ 0'V1 �c_ Phone#: M3S533 F-2 , Address: g2_2_0 S(-J 9,`1 P(., e1 City: l A MiCa � (a State: r Zip: Qualifier Nam e: VUo We(1Y)Q e 5rD0 I J PL Phone#: State Certification or Registration#:PC )q 5 eq.SJ' Certificate of Competency M DESIGNER:Architect/Engineer: Phone#: Address: City: State: Zip: cc Value of Work for this Permit:$ 100, Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ❑ New Repair/Replace ❑ Demolition Description of Work: RePLo)o_L= D�a,,Q C®JeV- Specify color of color thru tile: " �S Submittal Fee$ G6° 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$ (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. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. 0 Signatur :�RSignature OWNER or AGENT rCC T ACTOR The instrument was acknowledged before me this The foregoing instrument was acknowledged before me this �P day of 1�eG 120 15 ,by day of J),ec_. 020 )1 ,by / who is personally known to (��iUPr -,)-O cO c who is personally known to me or who has produced as 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: 1 Print: Apue,. �pEa�Rn Print: � `` o AMAPEQUERO zMY COMMISSION#FF 16� 5513 Seal: Seal: * EXPIRES:October 5.2018 FW * * EXPIRES:October 5,2018 °yq R�Op Bonded Thnu Budget Notary Sens X0''40'J% Bonded Thtu Budget Notary BMW APPROVED BY l Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014)