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PL-16-1692 Inspection Worksheet Miami Shores Village r I L 10050 N.E.2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-261216 Permit Number: PL-6-16-1692 Scheduled Inspection Date: September 15, 2016 Permit Type: Plumbing - Residential Inspector: Hernandez, Rafael Inspection Type: Final Owner: GRIMBERT, DAVID AND MEGHAN Work Classification: Addition/Alteration Job Address:824 NE 100 Street Miami Shores, FL Phone Number (305)323-7700 Parcel Number 1132060340050 Project: <NONE> Contractor: REGOSA ENGINEERING SERVICES INC Phone: (786)262-2964 Building Department Comments INSTALLATION OF 3 TOILETS 3 SINKS 1 KITCHEN 1 Infractio Passed Comments BATHRUB, 1 SHOWER NEW TILE INSPECTOR COMMENTS False Inspector Comments Passed Failed Correction ❑ Needed Re-inspection ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is paid. September 14,2016 For Inspections please call: (305)762-4949 Page 5 of 23 AROUNDTHE Around The Clock Gas Service, Corp. 13117 NW sol Ave unit 17 Hialeah Gardens, FL.33018 (N�GZS SERVICE Phone: 305-231-3632 ext 301 Fax: 305-231-418o STATE LIC# LPG17356 CLASS# 803 DROP TEST CERTIFICATION August 25, 2016 To: Whom It May Concern in the City Of Miami Shores Plumbing Department. This is to certify that Around the Clock Gas Service Corp. has performed a drop test at the following site and tested all the appliance connections. The gas line has been checked to the standards of the 2014 Florida building code, SECTION 406 (IFGS)INSPECTION, TESTING AND PURGING 406.1 GENERAL and properly tested to meet the standards of NFPA 54. The work was performed for. David Grimber 824 NE 100 ST Miami Shores Fl,33138 Test Pressure: 8.0 Lock up pressure: 11.2 Operating pressure:11.0 Test time: 10 Minutes Test Results:Negative/No Drop If you should have any questions regarding this matter please do not hesitate to call us. Sincerely, Amaury Gonzalez STATE OF FLORIDA COUNTY OFMLAMI DADS,SWORN TO& CEO SUBSCRIBED BEFORE ME THIS a r DAY OF (-)06jjt 20 Around The Clock Gas Service Corp. AMAURYGONZALEZ,PERSONALLYKNOWN TOME �•n".�oADML SILVER A4t—t�I75 TURE OFNOTARY PUBLIC EXPIRES January 22,2017 (407j 398 015 Flcriaallotery�prvk�per, Miami Shores Village f7?? type Plumbing,rResi0onti 10050 N.E.2nd Avenue NE ..., .�, Work CfasOcahblir AdditioNAlEal�lti(M Miami Shores,FL 33138-0000 Phone: (305)795-2204 ��s � �4$ `AM � ' Expiration: 1/ 2/ 017 3 Project Address Parcel Number Applicant 824 NE 100 Street 1132060340050 DAVID AND MEGHAN GRIMBER' Miami Shores, FL Block: Lot: Owner Information Address Phone Cell DAVID AND MEGHAN GRIMBERT 253 NE 92 Street (305)323-7700 (305)505-7750 MIAMI SHORES FL 33138- 253 NE 92 Street MIAMI SHORES FL 33138- Contractor(s) Phone Cell Phone Valuation: $ 8,500.00 REGOSA ENGINEERING SERVICES Ih (786)262-2964 (786)344-8720 Total Sq Feet: 295 Type of Work:INSTALLATION OF 3 TOILETS 3 SINKS 1 Available Inspections: Type of Piping: Inspection Type: Additional Info: Top Out Bond Return: Final Classification:Residential Scanning:1 Review Plumbing Underground Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $5.40 Invoice# PL-6-76-60239 DBPR Fee $4.50 07/26/2016 Credit Card $331.40 $0.00 DCA Fee $4.50 Education Surcharge $1.80 Notary Fee $5.00 Permit Fee $300.00 Scanning Fee $3.00 Technology Fee $7.20 Total: $331.40 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 AFFIDAy�T: I rli all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction an zq mg. e, thorize the above-named contractor to do the work stated. i July 26, 2016 Auth riz i net e:Owner / Applicant / Contractor / Agent Date Buildingdepartment Copy pY July 26,2016 1 Miami Shores Village �, �� Building Department JUN 10050 N.E.2nd Avenue, Miami Shores,Florida 33138 Tel:(305)795-2204 Fax:(305)756-8972 BY: INSPECTION LINE PHONE NUMBER:(305)762-4949 FBC 201' � BUILDING Master Permit No. �� _ l PERMIT APPLICATION Sub Permit No. ❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑■ PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 824 NE 100 STREET City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: 11-3206-034-0050 Is the Building Historically Designated:Yes NO X Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name(Fee Simple Titleholder):GRI MBERT DAVID Phone#: Address:252 NE 92 STREET City: MIAMI SHORES State: FL Zip: 33138 Tenant/Lessee Name: Phone#: Email: CONTRACTOR:Company Name: REGOSA ENGINEERING SERVICES, INC Phone#: 786-262-2964 Address: 15700 NE 2 AVE City: MIAMI State: FL 33162 Qualifier Name: GUSTAVO VELEZ Phone#: 786-262-2964 State Certification or Registration#: CFC-1427292 Certificate of Competency#: DESIGNER:Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit:$ Square/Linear Footage of Work: 19 Type of Work: ❑ Addition ❑ Alteration ❑ New 0 Repair/Replace ❑ Demolition Description of Work: ®�� 1`l /�� a %r®�G F,7�B 51N,& s 0+9,rNp , Specify color of color thru tile: Submittal Fee$ Permit Fee$ a � �•® CCF$ • � CO/CC$ Scanning Fee$ Radon Fee$ `r DBPR$ � Notary$ '00 Technology Fee$ 0 Training/Education Fee$ 1 Double Fee$ Structural Reviews$ Bond$ TOTAL FEE NOW DUE$ 1 0 (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 valuexc eding$2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law br chu a will be delivered to the person whose property is subject to attachment. Also,a certified copy of the recorded notice of comme cem �t must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. /n t e ab ence of such posted notice, the inspection will not be aper ed a a reinspection fee will be charged. i Signature Signature O NER or AGENTC NTRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this 11 day of )(1►\t ,20 1 (o .by 28 day of MAY 20 16 by w hc-,\ Crr n-10-4—— who is ersonal y kno GUSTAVO VELEZ wh ersonally know o 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: 111111111///z Sign: tltlION //i Sign: ii o Print: _ /� ._ �y Print: �(+��; �� • = ►"�°4'• LUZ EDITH GIRALDO Seal: , a F o:33— Seal: _ : f, MY COMMISSION#FF203458 fco '•1,E�F oQ`i` EXPIRES MarCh 22,2019 g„u.0 g:3 Fwrrcfallota•y5ervtce cm "7I�I ty?'`a fir d97. APPROVED BY f Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014)