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PL-16-900 Inspection Worksheet Miami Shores Village 10050 N.E.2nd Avenue Miami Shores,FL Phone: (305)795-2204 Fax: (305)756-8972 C ( 60 - 3 Inspection Number. INSP-256223 Permit Number: PL-4-16-900 Scheduled Inspection Date:August 29,2016 Permit Type: Plumbing -Residential Inspector: Hernandez,Rafael Inspection Type: Final Owner. NETKIN,ROBERT AND MELISSA Work Classification: Addition/Alteration Job Address:1266 NE 94 Street Miami Shores,FL 33138- Phone Number (305)965-5110 Parcel Number 1132050100170 Project <NONE> Contractor: ACA CONSTRUCTION INC Phone: (305)788-8914 Building Department Comments CHANGE OLD SINK FOR NEW AND RELOCATE WATER Inftactlo Passed Comments LINE FOR THE REFRIGIRATOR INSPECTOR COMMENTS False Inspector Comments Passed Failed Correction ❑ Needed Re-Inspection Fee No Additional Inspections can be scheduled until re-inspection fee is paid. 2 0 1porik yo as s y Miami Shores Village !?tt 11r � iia t 10050 N.E.2nd Avenue NE IN ASBeb�Aci �[vl �trtit '° "• Miami Shores,FL 33138-0000 3 Phone: (305)795-2204 rtt7l Sfatr,:APPROVED, Issue" 411 Expiration: 10/11/2016 Project Address Parcel Number Applicant 1266 NE 94 Street 1132050100170 ROBERT AND MELISSA NETKIN Miami Shores, FL 33138- Block: Lot: Owner Information Address Phone Cell ROBERT AND MELISSA NETKIN 1266 NE 94 Street (305)965-5110 MIAMI SHORES FL 33138-2947 Contractor(s) Phone Cell Phone Valuation: $ 400.00 ACA CONSTRUCTION INC (305)788-8914 w. __.:. _....r:: ... ._... .. .. _... _._ Total Sq Feet: 1000 Type of Work:CHANGE OLD SINK FOR NEW AND RELOCAT Available Inspections: Type of Piping: Inspection Type: Additional Info: Top Out Bond Return: Final Classification:Residential Scanning:1 Review Plumbing Underground Fees Due Am]$2.25 Pay Date Pay Type Amt Paid Amt Due CCF DBPR FeeInvoice# PL-4-16-59275 04/04/2016 Check#:10232 $50.00 $109.10 DCA Fee Education Surcharge 04/14/2016 Check#: 10234 $ 109.10 $0.00 Permit Fee $Scanning Fee Technology Fee Total: $15 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 rate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Futhermore,I authorize the above-n a or to do the work stated. April 14, 2016 Authorized Signature:Owner / Applicantractor / Agent Date Building Department Copy April 14,2016 1 Miami Shores Villager ► Building Department7APR4 2010 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 FBC 20{ BUILDING Master Permit No. 9- PERMIT APPLICATION Sub Permit No. _ '�®Z) ❑BUILDING ❑ELECTRIC ❑ ROOFING REVISION ❑ EXTENSION ❑RENEWAL PLUMBING ❑MECHANICAL PUBLIC WORKS ❑ CHANGE OF ❑CANCELLATION ❑ SHOP / A� CONTRACTOR DRAWINGS JOB ADDRESS: ,/ 2ICJ XJ '" J/ tOU + City: Miami Shores County: Miami Dade Zip: 33 !3 S Folio/Parcel#: &_ 3 20 s 0)() - 0)-10 Is the Building Historically Designated:Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FF�E: OWNER:Name(Fee Simple Titleholder): A06EILT rJ i- 9 J� Phon4l 3 00 6 ' —13 80 Address: 2 q Sir't Q It�,/ ��- City: /%s� � State: f a 331 � Zip: � Tenant/Lessee Name: Phone#: `-------- Email: CONTRACTOR:Company Name: `�!� ®�S//y�1/byl, �e�� Phone#: �D�✓ �� Address:. /1 > -5&)- 57 City: te: �'� Zip: Qualifier Name: Aie-'e' Phone#: -:5&57^ 99— State Certification or Registration#:/�/ �e /�c��Certificate of Competency#: �'/i_ DESIGNER:Architect/Engineer: / tRl)�/'g J® __ 301 C/`7(— Address: JLl) / S7yt�r City: RIAM/ State: ' h Zip: Value of Work for this Permit:$ % Square/Linear Footage of Work: ✓�®©� Type of Work: ❑ Addition ❑ AlteratioPrn ❑ New ElRepair/Replace ❑ Demolition Description of Work: U .-V fZt LO CAI! (1) Oty-k, " Specify color of color thru tile: Submittal Fee$ ✓G- a Permit Fee$ �,�� CCF$ .6(!) CO/CC$ Scanning Fee$ '3�cz Radon Fee$ a- �� DBPR$ v�-s Notary$ y Technology Fee$ ' Training/Education Fee$ Double Fee$ Structural Reviews$ Bond$ 4[/ TOTAL FEE NOW DUE$ 109. I (Revised02/24/2014) W 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 an a reinspection fee will be charged. Signature Signature OWNER rAGENT �ONTRACTOR The foregoing instrum t was ac k owledged before me his The foregoing instrument was acknowl dged before me this 11 // day of �. 20-- by 0 day of V 20 4 b.by ,who is personally known to � �"lam �� ,who is personally known 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 P NOTARY PUBLIC: auuu„ -Foo too •d YPy�p� o f �4te 0t Sig »er Sign: MR Admm- 110f naa�0• o y ot8 b1iC $t Print: �m "' Print:�� 15 7 o. • Commission#FF 195 Seal: Seal: APPROVED BY -KOJ �' — Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014)