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PL-15-1167 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 1 Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-240696 Permit Number: PL-5-15-1167 Scheduled Inspection Date: August 06,2015 Permit Type: Plumbing - Residential Inspector: Diaz, Osvaldo Inspection Type: Final Owner: NEGREVERGNE,JULIA Work Classification: Pool - Private Job Address:429 NE 99 Street Miami Shores, FL 33138-2461 Phone Number Parcel Number 1132060170400 Project: <NONE> Contractor: CUSTOM POOLS Phone: (305)255-5315 Building Department Comments Infractio Passed Comments POOL PIPING INSPECTOR COMMENTS False Inspector Comments Passed CREATED AS REINSPECTION FOR INSP-234913. NO ACCESS N PLANS/PERMIT Failed �V Correction `! Needed Re-Inspection ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is paid. August 05,2015 For Inspections please call: (305)762-4949 Page 23 of 33 Aarmit NP, 'L- -15 -1167 �aoREs°4 Miami Shores Villages -T yam:P)LifEi ?(tt ,w38tit; l 10050 N.E.2nd Avenue NE War*0buffkatf n:Pooi p V to Miami Shores,FL 33138-0000 '' �sae Phone: (305)795-2204etss. P� � f4OR1°� Expiration: 11/29/2 1 Issue late;612/204 Project Address Parcel Number Applicant 429 NE 99 Street 1132060170400 Miami Shores, FL 33138-2461 Block: Lot: JULIA NEGREVERGNE Owner Information Address Phone Cell JULIA NEGREVERGNE 429 NE 99 Avenue 4 MIAMI SHORES FL 33138- C 429 NE 99 Avenue ij MIAMI SHORES FL 33138- Contractor(s) Phone Cell Phone Valuation: $ 3,000.00 CUSTOM POOLS (305)255-5315 (305)218-3861 ... 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:3 Rough Review Plumbing Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $1.80 Invoice# PL-5-15-55595 DBPR Fee $3.38 05/18/2015 Credit Card $50.00 $ 195.56 DCA Fee $3.38 Education Surcharge $0.60 06/02/2015 Credit Card $ 195.56 $0.00 Permit Fee $225.00 Scanning Fee $9.00 Technology Fee $2.40 Total: $245.56 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-nam d cont for to do the work stated. June 02, 2015 Authorized Signature:Owner / Applican ontractor gent Date Building Department Copy June 02,2015 1 Miami Shores Village coo Building Department �� 10050 N.E.2nd Avenue,Miami Shores, Florida 33138 Tel:(305)795-2204 Fax:(305)756-8972 INSPECTION LINE PHONE NUMBER:(305)762-4949 FBC 20 6 BUILDING Master Permit No.:Off— F—�1 PERMIT APPLICATION sub Permit No. FL f L'-) 16--) BUILDING ❑ ELECTRIC ❑ ROOFING REVISION ❑ EXTENSION ❑RENEWAL PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: ' Q2 AJC' ST City: Miami Shores County: Miami Dade Zip: .33/3 9- Folio/Parcel#: 11 -.3AQ fa —®17-®`fib O Is the Building Historically Designated:Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name(Fee Simple Titleholder): Ul i R 1J e a reJe�Q n e Phone#: Address: ga 9 N I=- q q 57` City: A-4I A-U I S1toQt:5 State: FL Zip: 3 1.3 9 Tenant/Lessee Name: Phone#: Email: n (� CONTRACTOR:Company Name: l.U. STi7M POOLS L S Phone#: 3051,9-65 -5j/,6 Address: oasO SLA) 131 S?' * too / City: (��flr�/ State: l�GoR//��4 Zip: 33le6 Qualifier Name: �. 6) M Pi e.klo Phone#-305IR65 5315 State Certification or Registration#: (2_Pe D 5 6 q 3+ 9- Certificate of Competency#: DESIGNER:Architect/Engineer: Ke k) P��\I 4 e(� Phone#: 786 a35 -2/35 Address: City: AM/ State:rt- Zip:3 3/S-9 Value of Work for this Permit:$ 30D0 Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition Description of Work: 2[�!©OL. 1:;?t nG Specify color of color thru tile: Submittal Fee$C5Permit Fee$ / .oma CCF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Notary$ Technology Fee$ Training/Education Fee$ Double Fee$ Structural Reviews$ Bond$ tt TOTAL FEE NOW DUE$ 1�S (Revised02/24/2014) Bonding Company's Name(if applicable) 411� 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 reinspection fee will be charged. Signature Signature / OWNER or AGENT CONTRACTOR The foregoing instrument was acknowledged before me this The foregoing' strument was acknowledged before me this / `ST day of /1!L 20 lS— , by / day of 20 lSP by who is personally known to ez "�� 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: r Sign: ' -tn4 Sign: Print: ® Print: *: MY COMMISSION#EE 129586 � ': MARILYN SCHVIAIZER Seal: •. ;�s EXPIRES:January 10,2016 Seal: "? *= MY COMMISSION#EE 129566 EXPIRES:January RyP��,QS` Bonded Thru Notary Public Underwriters ?t•...;a ' ry 10,2016 RP„fb•'` Bended Thru Notary Public undenmters APPROVED BY Lis Plans Examiner Zoning Structural Review Clerk (RevisedO2/24/2014)