PL-15-2790 a 6 /5
Inspection Worksheet
Miami Shores Village
10050 N.E.2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-247064 PermitNumber: PL-11-15-2790
Scheduled Inspection Date: January 20,2016 Permit Type: Plumbing - Residential
Inspector: Diaz, Osvaldo
Inspection Type: Final
Owner: PREDRAG STARCEVIC, KAREN BLAIR Work Classification: Addition/Alteration
Job Address:1225 NE 92 Street
Miami Shores, FL 33138-2936 Phone Number (305)751-9333
Parcel Number 1132050270300
Project: <NONE>
Contractor: A-B REMODELING INC(PLUMBING) Phone: (305)613-9881
Building Department Comments
REMOVE EXISTING SHOWER PAN AND INSTALL NEW Infractio Passed comments
SHOWER PAN INSPECTOR COMMENTS False
Inspector Comments
Passed Ee 6 1(
Failed
Ib
Correction ❑ � � �
�
Needed
Re-Inspection ❑
Fee
No Additional Inspections can be scheduled until
re-inspection fee is paid
January 19,2016 For Inspections please call: (305)762-4949 Page 17 of 56
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Miami Shores Village ,,,f �t
Pe�?T ! O� fR #(t1 ,« B (d� °
10050 N.E.2nd Avenue NE
a lr�+ rkla a +� Acidltlai> 1aton
'•" '" Miami Shores,FL 33138-0000 rM z
` � Phone: (305)7952204 NPD
Expiration: 06/06/2016
Project Address Parcel Number Applicant
1225 NE 92 Street 1132050270300
Miami Shores, FL 33138-2936 Block: Lot: KAREN BLAIR PREDRAG START
Owner Information Address Phone Cell
KAREN BLAIR PREDRAG STARCEVIC 1225 NE 92 Street (305)751-9333
MIAMI SHORES FL 33138-2936
1225 NE 92 Street
MIAMI SHORES FL 33138-2936
Contractor(s) Phone Cell Phone $ 800.00
A-13 REMODELING,INC.(PLUMBING) (305)613-9881 Valuation:
W.: _.. .__, ,. .._.._. ......_ . ... Total Sq Feet: 00
Type of Work:REMOVE EXISTING SHOWER PAN AND INST Available Inspections:
Type of Piping: Inspection Type:
Additional Info: Top Out
Bond Return: Final
Classification:Residential Scanning:3 Review Plumbing
Underground
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due
CCF $0.60
DBPR Fee Invoice# PL-11-15-57637
$2.25 11/02/2015 Credit Card $50.00 $115.10
DCA Fee $2,25
Education Surcharge $0.20 12/09/2015 Credit Card $ 115.10 $0.00
Permit Fee $150.00
Scanning Fee $9.00
Technology Fee $0.80
Total: $165.10
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, m7y agent, servants, or employes. I understand that separate permits are
required for ELECTRICAL,PLUMBING,MECHANICAL,WINDOWS,DOORS7th
nd SW ING POOL work.
OWNERS AFFIDAVIT: I certify that all the foregoing inform n is cc ork wi be done in compliance with all applicable laws regulating
construction and zoning. Futhermore,I authorize the abov amed ntract0 rk stat
December 09, 2015
Authorized Signature:Owner / Applicant r A e t Date
Building Department Copy
December 09,2015 1
Miami Shores Village
Building Department 2015
10050 N.E.2nd Avenue,Miami Shores,Florida 33138 ,
Tel:(305)795-2204 Fax:(305)756-8972
INSPECTION LINE PHONE NUMBER:(305)762-4949
FBC20)9 °-_5- 1b
BUILDING Master Permit No. 1 ° 1 1 5 " 2•t*?V
PERMIT APPLICATION Sub Permit NO-P L I s IL96
❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
rV)PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
�}, n CONTRACTOR DRAWINGS
JOB ADDRESS: 12,Z '/ 6N/J SnE ff
City: Miami Shores County: 4 1— Miami Dade Zip:
Folio/Parcel#: 37o 0 7-?'®, Is the Building Historically Designated:Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER:Name(Fee Simple Titleholder): 2tZ 0 STAQ Cr,V 1 C Phone#: 3gi '16Y &2
Address: I ZZ� N� ZO S�/fz�"'/
City: A44 A-M I -sal®fie( State: zip: 1-3-31 3K
Tenant/Lessee Name: Phone#:
Email: / �(
CONTRACTOR:Company Name: 2 4.4 Cs Phone#: n
Address: _4W07 W I)—C-?—
City: L�Y• , i- State: r Zip: i
Qualifier Name: LUIS 0— 'ate 2*kf Phone#:
State Certification or Registration#: C 35 7 Certificate of Competency#:
DESIGNER:Architect/Engineer: Phone#:
Address: City: State: Zip:
i�Value of Work for this Permit:$ Do ASauare/Linear Footage of Work: I q0 fir_
Type of Work: ❑ Addition ❑ Alteration9 ❑ New Repair/Replace ❑ Demolition
Description of Work: cue JL v, S�o ,w i `�
Specify color of color thru tile:
Submittal Fee$ Permit Fee$ F� $ CO/CC$
Scanning Fee$ Radon Fee$ DBPR$ Notary$
Technology Fee$ Training/Education Fee$ Double Fee$
Structural Reviews S Bond S
1
� : ) ) 5 .
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 certiTted 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.
Signature Signature
It OWNER or AGENT CONTRACTOR
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
2,'�� day of O C11 0 _ ,20 (f . by day of Q CT O C'5'1 ,20 1by
,�(Zc D`Q AC1 S�QrQ IC ,who is personally known to1t7N2e`Z_ ,who is personally known to
me or who has produced-3.6 S 361 X604; ?25g'(Is me or who has produced Q-1 SZA S7-K a30 s
identification and who did take an oath. identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
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Sign: Sign:
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Print: '?°• +`�: Notary Public-State of Flora Print:
yComm. xpires Sep 15,2018
Notary Public-State of Florida
Seat: fF`Op�;=` commission#FF 159996 Seal: My Comm.Expires Sep 15,2018
BaMedthrough ialionalNotaryA Commission#FF 159996
Sonrad through National Notary Assn.
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