PL-16-2870 �FY
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Miami Shores Village Pexrtt 7� It� eti�
10050 N.E.2nd Avenue NE `
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•' Miami Shores,FL 33138-0000 f a
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Phone: (305)795-2204 3
Expiration: 05/0712017
Project Address Parcel Number Applicant
987 NE 96 Street 1132060143240
Miami Shores, FL Block: Lot: ROBERT HACH
Owner Information Address Phone Cell
ROBERT HACH 987 NE 96 Street
MIAMI SHORES FL 33138-2523
Contractor(s) Phone Cell Phone Valuation: $ 2,495.00
ALL SOLAR SOLUTIONS DBA DISCOI (954)475-6160
Total Sq Feet: 32
Type of Work:DHW SOLAR WATER HEATER Available Inspections:
Type of Piping: Inspection Type:
Additional Info: Final
Bond Return: Rough
Classification:Residential Scanning: 1 Review Plumbing
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due
CCF $1.80 Invoice# PL-10-16-61742
DBPR Fee $2.25 10/20/2016 Check#:011 $50.00 $262.30
DCA Fee $2.25
Education Surcharge $0.60 11/08/2016 Check#:012 $262.30 $0.00
Permit Fee $150.00
Scanning Fee $3.00
Technology Fee $2.40
Work without Permit Fee $150.00
Total: $312.30
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-named contractor to do the work stated.
November 08, 2016
Authorized Signature:Owner / Applicant / Contractor / Agent Date
Building Department Copy
November 08,2016 1
Inspection Worksheet
Miami Shores Village
10050 N.E.2nd Avenue Miami Shores,FL
Phone: (305)795-2204 Fax:(305)756-8972 C `�
Inspection Number: INSP-269458 Permit Number: PL-10-16-2870
Scheduled Inspection Date: December 14,2016 Permit Type: Plumbing - Residential
Inspector. Hernandez, Rafael
Inspection Type: Final
Owner: HACH,ROBERT Work Classification: Solar
Job Address:987 NE 96 Street
Miami Shores,FL Phone Number
Parcel Number 1132060143240
Project: <NONE>
Contractor: ALL SOLAR SOLUTIONS DBA DISCOUNT POOL HEATING Phone: (954)475.6160
Building Department Comments
DHW SOLAR WATER HEATER Infractio Passed Comments
INSPECTOR COMMENTS False
TO REPLACE PERMIT#PL-5-10-826
Inspector Comments
Passed
Failed
Correction D
Needed
Re-inspection
Fee
No Additional Inspections can be scheduled until
re-inspection fee is paid.
December 13,2016 For Inspections please call: (305)762-4949 Page 14 of 40
Miami Shores Village
Building Department OCT i 2o1s
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" �r
BUILDING Master Permit No.Q C
PERMIT APPLICATION Sub Permit No. � ��'� C�
❑BUILDING ❑ ELECTRIC ❑ ROOFING REVISION ❑ EXTENSION [:]RENEWAL
PLUMBING ❑ MECHANICAL [:]PUBLICWORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
,/ CONTRACTOR DRAWINGS
JOB ADDRESS: d l 1-7 ,v -140 4 k i
City: Miami Shores County: Miami Dade Zip: '�✓)��
Folio/Parcel#: ll ino& 014 "3a*0 Is the Building Historically Designated:Yes NO V
Occupancy Type: Load: Construction Type: Flood Zone: 10 BFE: FFE:
OWNER:Name(Fee Simple Titleholder): �liZ yJ�°fV! K HaA L '1'112 t PK'5t Phone#: 766 5
Address: j eb-7 Ale__ cfl%0
City: t/ O'vll` 6wy"t" State: Zip:
Tenant/Lessee Name: Phone#:
Email:
moo\ .� 1,; 063 -
CONTRACTOR:Company Name: P�`Tw1 Phone#:�.0)U( Lt-75
�l
Address: �``"� '�w
City: C-'-t y(J4"/ J -State: g� Zip:
Qualifier Name: 0 d Phone#:`SLS (�`�D LJ S
State Certification or Registration#: I Certificate of Competency#:
DESIGNER:Architect/Engineer: Phone#:
Address: ¢� City: State: Zip:
Value of Work for this Permit:$ 2 Square/Linear Footage of Work: -j-'7 5!t. r
Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition
Description of Work: 17HV/ '51,016LIA W0dW Pleo&4
Specify color of color thru tile: .
i
Submittal Fee$ ' Permit Fee$ A CCF$ /• �® CO/CC$
Scanning Fee$ Radon Fee$ 'Z-5 DBPR$ 2 •25 Notary$
Technology Fee$ 2 • Training/Education Fee$ Double Fee$ / S
Structural Reviews$ Bond$ �—
TOTAL FEE NOW DUE$
�C,�Z • �®
(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 absenc of such posted notice, the
inspection will notim approved and a reinspection fee will be charged.
Signature P Signature LZ Y W
OWNER or AGENT CONTR R
The ore oing instrument was acknowledged before a this T foregoing instru nt was acknowledged before me this
day of C � 20 by day of � /�'Y 2d�g ,by
o4 personally known to A`
wl� r"�✓I?etfWjd who is personally known to
me or who has produced ` as me or who has produced �i12as
identification d ake an oath. identification and who did take an oath.
NOTARY P LI NOTARY PUBLIC:
h•
Sign: Sign:
Print: • L Print:
n9FF961477
Seal. EghsFebruary 17,2020 Seal:
��oR ' Bonded TMu Troy fain Insurance 800.385-7019
APPROVED BY �[�� Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)