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PL-15-3155 Inspection Worksheet Miami Shores Village 10050 N.E.2nd Avenue Miami Shores,FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-251843 Permit Number: PL-12-15-3155 Scheduled Inspection Date: February 01,2016 Permit Type: Plumbing -Residential Inspector: Diaz,Osvaldo Inspection Type: Owner: SOUTHWELL,DAVID Work Classification: Addition/Alteration Job Address:560 NE 103 Street F7 Miami Shores,FL 33138-2458 Phone Number (305)822-8161 Parcel Number 1132060170890 Project <NONE> Contractor. STAR PLUMBING Phone:3051949-9749 Building Department Comments REPLACE SINK&FAUCET ON KITCHEN CABINETS AND Inrractio Passed Comments CONNECT DISHWASHER INSPECTOR COMMENTS False Inspector Comments Passed p J� r Failed Correction Needed Re-Inspection ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is paid January 29,2016 For Inspections please call: (305)762-4949 Page 26 of 36 Pem•+it nro `L_ 2-"11- � ': Miami Shores Village } Plu*bing-Residential �a 10050 N.E.2nd Avenue NE r Ad ciftion/1lteraton Miami Shores,FL 33138-0000 / V D 2 � Phone: (305)795-2204 a� " F Me" ., lite t ate;IM312016 Expiration: 07111/2016 Project Address Parcel Number Applicant 560 NE 103 Street 1132060170890 TRUST ADVISORS CORPORATII Miami Shores, FL 33138-2458 Block: Lot: Owner Information Address Phone Cell TRUST ADVISORS CORPORATION 5781-B NW 151 Street (305)822-8161 MIAMI LAKES FL 33014- Contractor(s) Phone Cell Phone Valuation: $ 500.00 STAR PLUMBING 305/949-9749 ,..._ _. .. """....... Total Sq Feet: 160 Type of Work:REPLACE SINK&FAUCET ON KITCHEN CA Available Inspections: Type of Piping: Inspection Type: Additional Info: Top Out Bond Return: Final Classification:Residential Scanning:1 Review Plumbing Underground Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $o.so Invoice# PL-12-15-58129 DBPR Fee $2.25 12/22/2015 Check#:2552 $50.00 $109.10 DCA Fee $2.25 Education Surcharge $0.20 01/13/2016 Credit Card $ 109.10 $0.00 Permit Fee $150.00 Scanning Fee $3.00 Technology Fee $0.80 Total: $159.10 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, 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 informati c ate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Futhermore,I authorize the above-n e o ctor to do the work stated. January 13, 2016 Authorized Signature:Owner / Applicant / ntra / Agent Date Building Department Copy January 13,2016 1 Miami Shores Village Building Department DEC 2 9 2015 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 Tel:(305)795-2204 Fax:(305)756-8972 ------ INSPECTION -INSPECTION LINE PHONE NUMBER:(305)762-4949 S�,h FBC 20 '`� BUILDING Master Permit No. PERMIT APPLICATION Sub Permit No. `L[ 5 —3155 +UILDING ❑ ELECTRIC ❑ ROOFING REVISION EXTENSION RENEWAL PLUMBING ❑ MECHANICAL PUBLIC WORKS ❑ CHANGE OF ❑CANCELLATION [__1 SHOP f CONTRACTOR DRAWINGS JOB ADDRESS: S�� (02; City: Miami Shores County: Miami Dade Zia: Folio/Parcel#: i t 3 Zo6 - ®I ®fig c V Is the Building Historically Designated:Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER:Name(Fee Simple Titleholder): _ -��, y�p�c0-s; - 6�ret�� Phon#: 130,T_ BZZ- 191(11( Addresgs,•_,S-n I r � Om j 16T City: I' /-1 r-�'. [t-)tL Z"> State: FL Zip: -33c)[4 . Tenant/Lessee Name: QA . Phone#: Email:_ 14 C CONTRACTOR:Company Name: ('P" ItS*e a9 c JU C Phone#: 47 2-3), t:_ Address: 1!�tif Z`Z &_�C Z f ,Ar�C City: 0 iZm, "Orr1-, r(State: �� Zip: Qualifier Name: Cg_-aa Leaj�o._iA Phone#: State Certification or Registration M C- �C l fo(3 Z Certificate of Competency#: DESIGNER:Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit:$ 3ro® Square/Linear Footage of Work: /� Type of Work: ❑ Addition r��j ❑ Alteration ❑ New epair��?/Replace ID Demolition Description of Work: 1za•l�CAcc_ �;p.3 IL 170.,'C'A 'Q' . K.1 c l�`� C t c� s ed 0 A .Specify color of color thru tile: Submittal Fee$ Permit Fee$ ,rISO, CCF$ CO/CC$ P Scanning Fee$ Radon Fee$ - z;,� DBPR$ Q ` - Notary$ Technology Fee$ Training/Education Fee$ <Y ® Double Fee$ 0 Structural Reviews$ Bond$ 2 TOTAL FEE NOW DUE$ 1P; (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 su to attac ent. Also,a certified copy of the recorded notice of commence ent must be posted at the job site for the first insp tion which occ rs seven 7) days after the building permit is issued. In the sence f such posted notice, the inspection wil at be approved a rnspe ' nee will be charged. SignatureSignature OWNER or AGENT dONTRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this s day of h Gems'*-c 6C-IL ,20 IS— ,by Z i day of �4 ca-l-A�0AL 20 IS- by b411 AL who is personally known to Cc QfE!F P Ord.Na who is personally known to mor 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 �aA VAZ Sign: ,� B� Sign: ®� Print: ('4m, �i� ��Y1�� Print: f-/ ""✓� Seal: ;� LORELI MENDEZ Seal: ,f:a' LORELI MENDEZ Commission N FF 20521 1 _ ,_ Commission q FF 20521 1 My Commission Expires My Commission Expires '�`�� rt°pPy r,, , March 02, 2019 March 02, 2019 APPROVED BY Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014)