PL-15-1186 f3 p 2
Inspection Worksheet
Miami Shores Village
10050 N.E.2nd Avenue Miami Shores,FL
Phone: (305)795-2204 Fax: (305)7564972
Inspection Number: INSP-234981 Permit Number: PL-5-15-1186
Scheduled Inspection Date:June 07,2016 Permit Type: Plumbing- Residential
Inspector. Hernandez,Rafael Inspection Type: Final
Owner: TOVAR,JONATHAN&ANDREA Work Classification: Pool- Private
Job Address:464 NE 92 Street
Miami Shores, FL
Phone Number (786)375-5533
Parcel Number 1132060140030
Project: <NONE>
Contractor: DEL RIO&SON PLUMBING CORP Phone: (786)295-0098
Building Department Comments
RELOCATE POOL PUMP Infractlo Passed Comments
INSPECTOR COMMENTS False
Inspector Comments
Passed
Failed
Correction ❑
Needed
Re-Inspection
Fee
No Additional Inspections can be scheduled until
re-inspection fee is paid
3
Miami Shores Village �X7? 7-fie' I�i�,fnl�in .
g-,144iidobtii� r
g 10050 N.E.2nd Avenue NE
nri� dt ,7 #L' LCtF? VCf Private
Miami Shores,FL 33138-0000A.
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41 Phone: (305)795-2204
'Sta .
Expiration: 11/17/2015
Project Address Parcel Number Applicant
464 NE 92 Street 1132060140030
Miami Shores, FL Block: Lot: JONATHAN&ANDREA TOVAR
Owner Information Address Phone Cell
JONATHAN&ANDREA TOVAR 464 NE 92 Street (786)375-5533 (305)610-0914
Miami Shores FL 33138-
464 NE 92 Street
Miami Shores FL 33138-
Contractor(s) Phone Cell Phone Valuation: $ 900.00
DEL RIO&SON PLUMBING CORP (786)295-0098
_,. ..... _.. _... Total Sq Feet: 0
Type of Work:RELOCATE POOL PUMP 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 $0.60
DBPR Fee $3.38 InVOICe# PL-5-1x55619
DCA Fee $3.38 05/19/2015 Credit Card $50.00 $186.36
Education Surcharge $0.20 05/21/2015 Credit Card $ 186.36 $0.00
Permit Fee $225.00
Scanning Fee $3.00
Technology Fee $0.80
Total: $236.36
In consideration of the ' suance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations
pertaining thereto and' s ict conformity with the plans,drawings,statements or specifications submitted to the proper authorities of Miami Shores Village. In
accepting this permit I ass me onsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are
required for ELECTRIC L4ify
MBI G,MECHANICAL,WINDOWS,DOORS,ROOFING and SWIMMING POOL work.
OWNERS AFFIDAVIT: I that II the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
construction and zoning. ermore, authorize the above-named contractor to do the work stated.
May 21, 2015
Authorized Sign ure:Owner / Applicant / Contractor / Agent Tate
Building Dep rtment Copy
May 21,2015 1
Miami Shores Village
Building Department
10050 N.E.2nd Avenue,Miami Shores,Florida 33138 MAY 9 2015
Tel:(305)795-2204 Fax:(305)756-8972
INSPECTION LINE PHONE NUMBER:(305)762-4949 BY:
FBC 20
BUILDING Master Permit No. ��' Q-q
PERMIT APPLICATION Sub Permit No. l - 6— �_ (9
❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
�
' CONTRACTOR DRAWINGS
JOB ADDRESS: `E�n 4 /^V2 ST
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#: Is the Building Historically Designated:Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name(Fee Simple Titleholder): ��/�A�� `®�� Phone#:
Address: �A62L( IVE "n[ZST-
City: I l�4-/l//( �.J HCD F s State: exe l D//-4 Zip: 1-:5-0
Tenant/Lessee Name: Phone#:
Email: :1o'DTV
CONTRACTOR:Company Name: L Va-t Phone#:C7 '9 2 q_To o q c2
Address: �E)Ckq o S
City: rt
State: a Zip: 110
Qualifier Name: -��d J- o Phone#: (T670) 2 S q L
State Certification or Registration#: 'I E5 qC6 Certificate of Competency#:
DESIGNER:Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit:$ crigd `0 0 Square/Linear Foota of Work:
Type of Work: ❑ Addition El Alteration El New Repair/Replace ❑ Demolition
Description of Work: R \�o PO�� �e
Specify color of color thru tile:
Submittal Fee$ j 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 7-
(Revised02/24/2014) E?r o_316 4� - ea
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 th a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subj ct to attachment. Also,a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspection whi ccurs even (7) days after the building permit is issued. In the absence of such posted notice, the
inspection will not be a pr d and a r inspection fee will be charged.
Signature Signature
O ER or AGENT CONTRACTOR
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
day ofd J��L? ,20 ( ,by ��day of �Y 20 1 � ,by
-IINPj�f�1 IU\/i c ,who is personally known to �-� DC7 ��L Q who is personally known to
me or who has produce e as me or who has produced ` -�---VT21 VU-1 WT as
identification and who did take an oath. identification an who did take an oath.
NOTARY PU LI NOTARY PUBLIC
Sign: Sign:
Print: Print:
Seal: ° Notary Public State of Florida Seal: °
a� Notary Public State of Florida
Sindia Alvarez
My Commission FF 156750 f Sindia Alvarez
p, Expires 09/0312018 +� My Commission FF 156750
�, Expires 09/03/2018
APPROVED BY Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)
S�ORs
ltiC.Aja
into ..,..v" Miami shores Village
=B � Building Department
��OIRIUp� 10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
CONTRACTORS' REGISTRATION
IF CONTRACTOR IS A FLORIDA STATE CERTIFIED CONTRACTOR:
A. COPY OF QUALIFIER'S STATE LICENCES
B. COPY OF LOCAL BUSINESS TAX RECEIPT
C. COPY OF LIABILITY INSURANCE*
D. COPY OF WORKERS COMPENSATION INSURANCE*
(Workers Compensation EXEMPTION must have NOTICE TO OWNER form and Contractor Affidavit)
IF CONTRACTOR HAS A MIAMI DADE COUNTY CERTIFICATE OF COMPETENCY:
A. COPY OF CERTIFICATE OF COMPETENCY OF QUALIFIER
B. COPY OF LOCAL BUSINESS TAX RECEIPT
C. COPY OF STATE REGISTERED CONTRACTOR LICENSE OR MIAMI DADE COUNTY MUNICIPAL
CONTRACTOR'S TAX RECEIPT.
D. COPY OF LIABILITY INSURACE*
E. COPY OF WORKERS COMPENSATION INSURANCE*
(Workers Compensation EXEMPTION must have NOTICE TO OWNER form and Contractor Affidavit)
*YOUR INSURANCE COMPANY MUST ISSUE A CERTIFICATE AS FOLLOW:
Certificate Holder:
MIAMI SHORES VILLAGE BLDG DEPT
10050 NE 2ND AVE
MIAMI SHORES, FL 33138
Certificate must specify the description of operations or contractor license number.
BUSINESS NAME:
BUSINESS ADDRESS: CITY STATE ZIP
BUSINESS PHONE: FAX NUMBER( )
CELL PHONE ( QUALIFIER'S NAME:
QUALIFIER'S LIC NUMBER:
Del Rio & Son Plumbing Corp.
State Licensed Plumbing Contractor
State Licensed Gas Contractor
Phone: 786:.295.0098
Fax. 786.362.5426
8990 SW 24 Street#213
Miami, FL, 33165
1�
MANOMETER REPORT
Job Address: z Jt . . �.
Permit# t 1 _
4
Date:
This report serves as acknowledgement the gas system \111-Nat.
or LP is
leak free.
Test report duration for ! C Minutes.
Positive test Negative test
Soap test Negative Positive.
Meter# L s s :;f.. 1 f
Regulator#
Equipment 9 .
Valid only for equipment fuel type and accessories instaJ14t time f original
inspection and submitted.
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