PL-16-203 Inspection Worksheet
Miami Shores Village
10050 N.E.2nd Avenue Miami Shores,FL
Phone:(305)795-2204 Fax:(305)7 -8972
Inspection Number INSP-251593 Permit Number. PL-1-16-203
Scheduled Inspection Date: May 25,2016 Permit Type: Plumbing-Residential
Inspector Hernandez,Rafael Inspection Type: Final
Owner: ROSSETTI,JOHN Work Classification: Pool-Private
Job Address:549 NE 95 Street
Miami Shores,FL Phone Number
Parcel Number 1132060140740
Project <NONE>
Contractor. PARKWOOD POOLS INC Phone:(954)583-3355
Building Department Comments
POOL PIPING Intractio ments
INSPECTOR COMMENTS False
Inspector Comments
Passed
Failed
Correction
Needed
Re-Inspection
Fee
No Additional Inspections can be scheduled until
re-Inspection fee Is pale.
Miami Shores Village � � _ .
10050 N.E.2nd Avenue NE
Miami Shores,FL 33138-0000 ` r e m £.
R Phone: (305)795-2204 f F '
Expiration: 0912412016
Project Address Parcel Number Applicant
549 NE 95 Street 1132060140740
Miami Shores, FL Block: Lot: JOHN ROSSETTI
Owner Information Address Phone Cell
JOHN ROSSETTI 549 NE 95 ST
MIAMI FL 33138-2731
Contractor(s) Phone Cell Phone Valuation: $ 1,300.00
PARKWOOD POOLS INC (954)583-3355
��-�- Total Sq Feet: 0
Type of Work:POOL PIPING Available Inspections:
Type of Piping:
Inspection Type:
Additional Info: Main Drain
Bond Retum: Final
Classification:Residential Scanning:1 Rough
Review Plumbing
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due
CCF $1.20 Invoice# PL-1-16-58446
DBPR Fee $3.38 03/28/2016 Check M 2240 $412.96 $50.00
DCA Fee $3.38
Education Surcharge $0.40 01/26/2016 Check*1141 $50.00 $0.00
Permit Fee $225.00
Scanning Fee $3.00
Technology Fee $1.60
Work without Permit Fee $225.00
Total: $462.96
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 the fOg�'ig n information is accurate and that all work will be done in compliance with all applicable laws regulating
construction and zoning. Futhermo a I� hoc�Lr�sjy(��e bove-named contractor to do the work stated.
March 28,2016
Authorized Signature: er / Applicant / Contractor / (Agen!j Date
Building Department Copy
March 28,2016 1
Miami Shores Village c ET ?---
Building Department JAN 34 2016
10050 N.E.2nd Avenue,Miami Shores,Florida 33138 BY
Tel:(305)795-2204 Fax:(305)756-8972
INSPECTION LINE PHONE NUMBER:(305)762-4949 5411
FBc 2o`y
BUILDING Master Permit No. &� (6- WZ
PERMIT APPLICATION Sub Permit No. L %& - %W3
❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
[PLUMBING ❑ MECHANICAL [:]PUBLICWORKS ❑ CHANGE OF ❑CANCELLATION [:] SHOP
T ® p CONTRACTOR DRAWINGS
JOB ADDRESS:( AJ 7 S�
City: Miami Shores County: Miami Dade Zip: 3 3M
Folio/Parcel#: If -33 06 OI y-0-74?10 Is the Building Historically Designated:Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER:Name(Fee Simple Titleholder): o h YL -V OSSeg&, Phone#: J s6- -7-)55-
Address: 54(4 4)Ic Cl51 St
City: f,,ewe.: S'� State: ilw— Zip: 3313V
Tenant/Lessee Name: /UIp Phone#:
Email: Jok►n d ; ^}Asie C�ale�ih5 .Lir►-, ff
CONTRACTOR:Company Name: (?0—1 . o 96,0 l_S Phone#:: R� sapl-
Address: 4-76t W.
City: e-:�f ho i 14 State: R- Zip: -5031-3
Qualifier Name: v;S) Phone#:
State Certification or Registration#: Certificate of Competency#:
DESIGNER:Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit:$ 1 g 300.— Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition
Description of Work: ( ri Di"
Specify color of color thru tile:
Submittal Fee$ Permit Fee$ v1- CCF$ I �� CO/CC$
Scanning Fee$ �3' Radon Fee$ vP DBPR$ Notary$
Technology Fee$ i �0 Training/Education Fee$ ® () Double Fee$
Structural Reviews$ 10 Bond$
TOTAL FEE NOW DUE$
(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. 1 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$2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also,a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
Signa Signature[.tom
OWNER or AGENT CONTRACTOR
The for oing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
day of 20 (to ,by ol$ day of 201(a .by
who is personally known to who is personally known to
me or who has produced V"k 11Q —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:
Sign Sign•
Print: Pr t, A o
Seal: ;:20`-, `e4; HERYL MORGAN Seal: ;2otYP�e�c: CHERYL MORGAN
MY COMMISSION#FF008874 =* MY COMMISSION "FF008874
""".0 op ` EXPIRES June 28,2017
OF°` 'soFFlop EXPIRES June 28.2017
*a�*x�e�x / nix*s�x�+x***����x* ��'9 !!'P5'�'�*+►�`t��`�` �`s' enr�`ce�`co�n�ex�� �xx�������*��e�a*
APPROVED BY —r Plans Examiner Zoning
Structural Review Clerk
(Revlsedo2/24/2014)