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PL-16-1001 Inspection Worksheet pp Miami Shores Village tee 9 10050 N.E.2nd Avenue Miami Shores,FL Phone:(305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-256906 Permit Number: PL-4-16-1001 Scheduled Inspection Date:June 29,2016 Permit Type: Plumbing- Residential Inspector: Hernandez, Rafael Inspection Type: Final Owner: PUENTES,ANDRES Work Classification: Pool- Private Job Address:354 NE 91 Street Miami Shores,FL 33138-3130 Phone Number (786)606-9930 Parcel Number 1132060190220 Project <NONE> Contractor. ROSMEL POOL INC Phone: (305)592-7900 Building Department Comments I cdo Passed Comments POOL PIPING INSPECTOR COMMENTS False Inspector Comments Passed Failed Correction ❑ Needed Re-Inspection Fee No Additional Inspections can be scheduled until reinspection fee is paid r N Miami Shores Village 10050 N.E.2nd Avenue NE Miami Shores,FL 33138 0000 Phone: (305)795-2204 � � Expiration: 11/05/2016 Project Address Parcel Number Applicant 354 NE 91 Street 1132060190220 Miami Shores, FL 33138-3130 Block: Lot: ANDRES PUENTES Owner Information Address Phone Cell ANDRES PUENTES 354 NE 91 Street (786)606-9930 MIAMI SHORES FL 33138- 354 NE 91 Street MIAMI SHORES FL 33138- Contractor(s) Phone Cell Phone Valuation: $ 2,000.00 ROSMEL POOL INC (305)592-7900 Total Sq Feet: 0 Type of Work:POOL PIPING 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 $1.20 Invoice# PL-4-16-59408 DBPR Fee $3.38 05/09/2016 Credit Card $ 187.96 $50.00 DCA Fee $3.38 Education Surcharge $0.40 04/14/2016 Check#:13343 $50.00 $0.00 Permit Fee $225.00 Scanning Fee $3.00 Technology Fee $1.60 Total: $237.96 In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans,drawings,statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL,PLUMBING,MECHANICAL,WINDOWS,DOORS,ROOFING and SWIMMING POOL work. OWNERS AFFIDAVIT: I certify that all the foregoinginfo acc ate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Futhermore,I authorize the a e-n a roto do the work stated. 1 May 09,2016 Authorized Signature:Owner / ApplicaCractont / Agent Date Building Department Copnt May 09,2016 1 Miami Shores Village � _; -- -- Building Department APR 14 2016 10050 N.E.2nd Avenue,Miami Shores,Florida 33138I Tei: 305 795-2204 Fax:(305)756-8972 i14y1 -----.---- INSPECTION LINE PHONE NUMBER:(305)762-4949 TJX F C 20N BUILDING Master Permit No.bi?f t(O — ctqq PERMIT APPLICATION Sub Permit No. L 4 C01 F-�BUiLDING F-� ELECTRIC r-1 ROOFING ❑ REVISION ❑ EXTENSIONRENEWAL w(PLUMBiNG ❑ MECHANICAL 7PUBLIC WORKS 7 CHANGE OF ❑ CANCELLATION [] SHOP CONTRACTOR DRAWINGS 10B ADDRESS: J,54 IJ E 11 St• City: Miami Shores County: Miami Dade zip: Folio/Parcel#: ! ! •,320(0 Q tat - 0 Z W Is the Building Historically Designated:Yes -NO Occupancy Type: Load: Construction Type: Flood Zone: SFE: FFE: OWNER:Name(Fee Simple Titleholder): -fq-yArL-� --?UCA0Aie4S Phone#: `75 -60[o-99,30 Address: 3SH tj� A 1 S-f City: M.1AV-ni 51-xmS State: EL Zip: 3313 Tenant/Lessee Name: N!A Phone#: Email: CONTRACTOR:Company Name: jpA Phane#: .�rJ1Qa1'1Q0� Address: 060uS Nvi 3t4 St• -J;E 51-10 City: �or'a� State: — Zip:_,?4 1�(0l0 Qualifier Name: 1✓11 r-t� l_/ayPla. _ Phone#:, 3C�$•S•R 2•"1ei0O State Certification or Registration#: CJ'�IL45Lg%Ck+ Certificate of Competency#: DESIGNER:Architect/Engineer: :Cnr7 i V%ooA0 0 rL-114 t�.F. LA/2541 Phone#: -1%.0 Address: 7171 City:�f=41,ter=:- State: rL Zip: Value of Work for this Permit:$ Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition Description of Work: O I pip"cg Specify color of color tl ru tile: Submittal Fee$ Permit Fee$ CCF$ �® CO/CC3. CRJ $ Scanning Fee$ Radon Fee$ 5 DBPR$ .� ` �� Notary'$ fA Technology Fee$ Training/Education Fee$ 0 Double Fee$ Structural Reviews$ � Bond$ TOTAL FEE NOW DUE$ (Revised02/24/2014) Bonding Company's Name(if applicable) tg Bonding Company's Address IBJ City State Zip Mortgage Lender's Name(if applicable) 1� Mortgage Lender's Address City State Zip Application is hereby made to obtain a permit to do the work and installations as indicated. 1 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$2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also,a certified copy of the recorded notice of commencement must be posted at the Job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature Signature OWNER or AGENT CONTRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this JL4 _day of -AL"11S"f ,20 15 by Y 4 day of - S AyS* 20_15_,by Aje(1k:t�,who i ersonaily known o M Ivi t_- V Aj1e rA who is ersonaliy know to me or who has produced as me or who has produced as identification and who did take an oath, identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Sign: Sign: Print: e-q-, Print: aga MARCOS A.MARTINEZ �g1`" �• MARCOS A MAR TINEZ Seal: "t Lit c MY COMMISSION#FF 008989 Seal: MY COMMISSION#FF 008989 EXPIRES:May 15 2017 <�._- EXP May 15,2017 "''•' q Bonded Thru Notary Public Underwriters Pq4. Bonded Thru Notary Public underwrite, F••�•p`°' r �,°°' SF k�+hEk$aY+k�sk sk k�Rt rp�ey e#%ciF�ege atb k&$�+k aka##��F�sk+#$#okeh��###tksFsk+k+k h k�k k+kak:kmak�F+k�+kk xcxe#ak�AR�de=k]eek tla$k�&k#A'+de��k dd�+4�Ac uk�h ak��%ek�+�k�+k�k k>k APPROVED BY a- ` Pians Examiner zoning Structural Review Clerk (Revised02/24/2014)