PL-14-2664 266
n! 3
Inspection Worksheet
Miami Shores Village
10050 N.E.2nd Avenue Miami Shores,FL
Phone:(305)795-2204 Fax:(305)756-8972
Inspection Number: INSP-224654 Permit Number. PL-12-142664
Scheduled Inspection Date:April 07,2015 Permit Type: Plumbing- Residential
Inspector: Diaz,Osvaldo Inspection Type: Final
Owner: CATHERINE HABERMANN,GLENN Work Classification: New
cnon
Job Address:164 NE 105 Street
Miami Shores,FL 33138-2033 Phone Number
Parcel Number 1121360130660
Project: <NONE>
Contractor: STAR-LITE POOLS Phone:(954)747-3377
Building Department Comments
PLUMBING FOR NEW CONSTRUCTION POOL. Infractio Passed Comment;
INSPECTOR COMMENTS False
Inspector Comments
Passed
Failed L
Correction ❑ '
Needed
Re-Inspection
Fee
No Additional Inspections can be scheduled until
re-inspection fee Is paid
Aprll 06,2015 For Inspections please call:(305)762-4949
Page 10 of 63
Miami Shores village f -
I
Building Department DEC 0 8 2014
90050 N.E.2nd Avenue,Miami Shores,Florida 33138 BY:
Tel:(305)795.2204 Fax:(305)756.8972
INSPECTION'S PHONE NUMBER:(305)762.4949
FBC 20(0
BUILDING Permit No. 1��= ~ �.
PERMIT APPLICATION baster Permit No:7E�pp- `Y `I_)(-G5
Permit Type:PLUMBING
JOB ADDRESS: 164 NE 105 STREET
City:_ Miami Shores County: Miami Dade gyp. 33138
Folio/Parcel#: 11-2136-013-0660
Is the Building Historically Designated:Yes NO X Flood Zone:
OWNER:Name(Fee Simple Titleholder)•GLEN FORD AND CATHERINE HABERMANN phone# 305-505-7104
Address.164 NE 105 STREET
City: MIAMI SHORES Ste: FL Tap: 33138
TenantOJessee Name: NA Phone#
Email: NA
CONTRACTOR:Company Name: STAR-LITE POOL BUILDERS phone#. 954747-3377
Address: 10875 NW 52 STREET SUITE 8
City. SUNRISE State. FL Tap: 33351
Qualifier Name. L w(- s� Phone#. 954747-3377
State Certification or Registration#: CPC.VA 5?5 0 Certificate of Competency#:
Contact Phone#. 954747-3377 Email Ate: STARLITEPOOLBLDRS@HOTMAIL.COM
DESIGNER:Architect/Engineer. DAVID FAERMAN Phone# 561-445-1787
Value of Work for this Permit:$1000- SquardLinear Footage of Work:
Type of Work: DAddress (]Alteration ANew ORepnWReplace ODemolition
Description of Work; PLUMBING FOR NEW CONSTRUCTION POOL
* e * we�ea� �a�eF�*s teea�s���ss �� �es� s
Submittal Fee$9(3' 00 Permit Fee$ ie 2 Z CCF$ CO/CC$
Scanning Fee$ Radon Fee$ DBPR$ Bond$
Notary$ Training/Education Fee$ Technology Fee$
Dmtble Fee$ Stractaral Review$
TOTAL FEE NOW DUE$
NA
B4niiupgCompany's Name(if applicable)
NA
Bonding Company's Address
City NA State NA zip NA
Mortgage Lender's Name(if applicable) NA
Mortgage Lender's Address NA
City NA State NA Zip NA
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 m this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK,PLUMBING,SIGNS,
WELLS,POOLS,FURNACES,BOILERS,HEATERS,TANKS and 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 wristruction ami zoning.
"WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF
COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR
EMPROVEMENTS 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$25M. the applicant must
promise in good faith that a copy the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attar Also,a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspection which oc s seven (7) days after the Building permit is issued In the absence of such posted notice, the
inspection will not be approved a reinspection fee will be charged
Signature- Signature A/
Owner or gent Contractor
The - instrument was acknowledged before me this� The foregoing instrument was acknowledged before me thiss
day of 20),by day of �.�.,` 20 1q.,by
who is personally known to me�orho has produced_,.,E— who' personally known to me r who has produced
LAI As identification and who did take an oath. as identification and who did take an oath.
NOTARY UBLIQ NOTARY Q
6
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Sign: Sgt: DA-1-
MY
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Print: - Print: ` r� 1'LDA- -
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My ". � DALE .E My _ n Ct .nn EE 09128
Cu ;ssion#I:E+199428 ''=_
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saes*s is t te *s*
APPROVED BY o Plans Examiner Zoning
Structural Review Clerk
WwiseM2/2012)Wr4ised 0711WIXRrAsed 06nW2W9XR"ised 3115M)