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PL-15-2716 Inspection Worksheet Miami Shores Village (S`® (c)q 10050 N.E.2nd Avenue Miami Shores,FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-246504 Permit Number: PL-10-15-2716 Scheduled Inspection Date:April 13,2016 Permit Type: Plumbing -Residential Inspector: Hernandez, Rafael Inspection Type: Final Owner: SOVEN,ALAN&KAREN Work Classification: Addition/Alteration Job Address:1215 NE 95 Street Miami Shores,FL 33138- Phone Number (305)297-9357 Parcel Number 1132060143980 Project <NONE> Contractor: UNIVERSAL PLUMBING CORP Phone: (305)887-3131 Building Department Comments SINK AND FRIDGE FOR KITCHEN ALTERATION. Infractio Passed ments INSPECTOR COMMENTS False Inspector Comments Passed Failed Correction Needed Re-Inspection ❑ Fee No Additional Inspections can be scheduled until reinspection fee is paid. MIN Miami Shores Village y� P"€;)7 luRpe 141<[i 11 .r ertt �a 10050 N.E.2nd Avenue NE I �C1a5s Addti©rid inn .✓ Miami Shores,FL 3313130000 E m ( �� E 1 tid�r�po Phone: (305)795-2204 �1181Ci1 Expiration: 0511 /216 Project Address Parcel Number Applicant 1215 NE 95 Street 1132060143980 ALAN&KAREN SOVEN Miami Shores, FL 33138- Block: Lot: Owner Information Address Phone Cell ALAN&KAREN SOVEN 1215 NE 95 Street (305)297-9357 (561)346-5533 MIAMI SHORES FL 33138-2549 Contractor(s) Phone Cell Phone Valuation: $ 1,800.00 UNIVERSAL PLUMBING CORP (305)887-3131 __ __.... _..... _. Total Sq Feet: 0 Type of Work:SINK AND FRIDGE FOR KITCHEN ALTERAT Available Inspections: Type of Piping: Inspection Type: Additional Info: Bond Return Top OutFinal Classification:Residential Scanning: 1 Review Plumbing Underground Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $1.20 DBPR Fee InVO1Ce# PL-10-15-57548 $2.25 10/23/2015 Credit Card $50.00 $110.70 DCA Fee $2.25 Education Surcharge $0.40 11/16/2015 Credit Card $ 110.70 $0.00 Permit Fee $150.00 Scanning Fee $3.00 Technology Fee $1.60 Total: $160.70 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,�larned ontractor to the work stated. (�(�_ (� November 16, 2015 Authorized Signature:Owner / Applicant / Contractor / Agent Date Building Department Copy November 16,2015 1 Miami Shores Village Building Department ; OCT 3 2015 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(1-4 BUILDING Master Permit No. Rof,-- 5'—I�-- /® y'F PERMIT AP, LIACALON sub Permit No. 5—��Ifo ❑BUILDING ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL =PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: ISI}-- �� 0 � Cit : 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): ��/��1 Phone#: 9� Address: 12_ )T NT City: t::� 1 Cj i/y/) i State: �— Zip: l J Tenant/Lessee Name: Phone#: Email: ,4I(41 Gln lll/1.`Y7►/ 1 �:I�/l CONTRACTOR:Company Name: &/!,,(/e/L t 1j2/y4*W&1,,;ey rg 6' F2(� Phone#-5 f q Address: la 4g�p_cp City: Zj`,4 ��'A� State: Zip: Qualifier Name:/z`C�o'efK / Phone#:, State Certification or Registration#: ��"C ! C!��'2 Certificate of Competency#: DESIGNER:Architect/Engineer:��- V L,-) t I r Phone ., �J Address: City: State: Zip: Value of Work for this Permit:$ Square/Linear Footage of Work: Type of Work: ❑ "K Addition ElAlteration ❑ [:1Eltion New Repair/Replace Demolition Description of Work: ,/�ioSir, k �s. �-� `� -v ;e o -�S— Specify color of color thru tile: Submittal Fee$ U ' Permit Fee$ z' CCF$ CO/CC$ .^ Scanning Fee$ Radon Fee$ DBPR$ Notary$ Technology Fee$ Training/Education Fee$ Double Fee$ Structural Reviews$ Bond$ TOTAL FEE NOW DUE$ U �� (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 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 re* spection fee will be charged. Signature Signature OWNER or AGENT 0 CONTRACTOR The foregoing instrument was acknowledged before a this The foregoing instrument was acknowledged before me this day of Jfrf A4 by f 7"_ ,20 t5' ,by AW S# ,who ispers�onall known to who is personally known to me or who h�ced �as me o has produced 72 as identification and who did take an oath. identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: r<►+'"P.�s• +o-•-•• •�,� LOURDES MARIN * f MY COMMISSION#FF008167 EXPIRES April 17,2017 Sign: Sign: Ins PlarmaN mgnadw=m Print: Print• �D e✓`' ��` Seal: 8TEPHAME CARDONA Seal: MANOTARY PUBLIC STATE OF FLOR113A. ComW FF11150 APPROVED BY Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014)