PL-16-987 Inspection Worksheet
Miami Shores Village
10050 N.E.2nd Avenue Miami Shores, FL 9--1C l�14
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-268069 Permit Number: PL-4-16-987
Scheduled Inspection Date: September 28,2016 Permit Type: Plumbing - Residential
Inspector: Hernandez, Rafael
Inspection Type: Final
Owner: SAKI, ROBERT Work Classification: Addition/Alteration
Job Address:5 NE 102 Street
Miami Shores,FL Phone Number
Parcel Number 1132060131640
Project: <NONE>
Contractor: FERA PLUMBING INC Phone: (954)658-8086
Building Department Comments
CHANGE OLD CAST IRON TO SCHEDULE 40 PVC AND infractio Passed Comments
CHANGE COPPER LINES. INSPECTOR COMMENTS False
Inspector Comments
Passed CREATED AS REINSPECTION FOR INSP-266282. not ready
Failed
Correction ❑
Needed
Re-Inspection ❑
Fee
No Additional Inspections can be scheduled until
re-inspection fee is paid
September 27,2016 For Inspections please call: (305)762-4949 Page 37 of 39
Jermrttc� P �4-1r- "
Miami Shores Village
10050 N.E.2nd Avenue NE /ry� j
� 1.! h � fii����1�1�1t�,�'�ratton
Miami Shores,FL 33138 0000
h"t�oe Phone: (305)795-2204
1$12 � Expiration: 10/23/2016
Project Address Parcel Number Applicant
5 NE 102 Street 1132060131640
Miami Shores, FL Block: Lot: ROBERT SAKZ
Owner Information Address Phone Cell
ROBERT SAKZ 5 NE 102 ST
MIAMI SHORES FL 33138-2322
Contractor(s) Phone Cell Phone $ 3,500.00
FERA PLUMBING INC (954)658-8086 Valuation:
_.._._,... . - Total Sq Feet: 0
Type of Work:CHANGE OLD CAST IRON TO SCHEDULE 40 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 $2.40 Invoice# PL-4-16-59391
DBPR Fee $4.50 04/26/2016 Credit Card $268.40 $50.00
DCA Fee $4.50
Education Surcharge $0.80 04/12/2016 Credit Card $50.00 $0.00
Permit Fee $300.00
Scanning Fee $3.00
Technology Fee $3.20
Total: $318.40
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 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-n d contr to do the work stated.
April 26, 2016
Authorized Signature:Owner / Applicant , / Y
ra or / Agent Date
Building Department Copy
April 26,2016 1
Miami Shores Village
Building Department a i 2 2o�s
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.� b
o'
PERMIT APPLICATION sub Permit No.PLKb
BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION EXTENSION RENEWAL
PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑CANCELLATION ❑ SHOP
X70 1 CONTRACTOR DRAWINGS
JOB ADDRESS:
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#: Is the Building Historically Designated:Yes NO
Occupancy Type: Load: CgpiVtruction Type: Flood Zone: BFE: �FFE:
OWNER:Name(Fee Simple Titleholder): Phone#:��L ,7� '��`7/
Address: � i j
City: /U'�h State: Zip: �,��LJ
Tenant/Lessee Name: ��I�yYs�� / ���5 Phone#: � Q wz
CONTRACTOR:Company Name: Gr Cl G o m�l�Q Phone#:.1,5 K!�-D �d
Address: 196-0 0G/ ALZZ
City: Afe=nj i>'7CS State: �L Zip:
Qualifier Name: LUi/l ia.-, M &&el Phone#:
State Certification or Registration#: R r Certificate of Competency#:
DESIGNER:Architect/Engineer: l�➢!4r Phone#: 3E)5- 6s— 78
Address: y [� ' C(� A/2 , City: k4ygState: Zip: 536
It I
Value of Work for this Permit:$ ���/� l� 2 Square/Linear Footage of Work:
Type of Work: El Addition I� Alteration ❑ New ❑ Repair/Replace ❑ Demolition ,g
Description of Work: f��' �L7 I�— U C— % i�f 1'b �G� 470,0 /O!!
AA 13 A9 ems' --A&3 ,o
Specify color of color thru tile:
Submittal Fee$ Qa `'ems Permit Fee$ 30 CCF$ k4 0 CO/CC$
Scanning Fee$ `' Radon Fee$ (`1 ' E'0 DBPR$ ® Notary$
Technology Fee$ S ` U Q Training/Education Fee$ 0 Double Fee$
Structural Reviews$ Bond$
TOTAL FEE NOW DUE$ cam° �`✓
(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 reinspection fee will be charged.
Signature Signature �%i`'� /'����i�v �r' ✓!/� —
OWNER or AGENT CONTRACTOR
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
day of G�j ,20 by (1 day of 20J by
Z who is personally known to who is personally known to
me or who has produced as me or who has produced ki as
identification and who did take an oath. identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
Sign •'U-P—i 64?— Sign: `b
Print: � �, ®�r1 W '`b Print:
Seal: "'""�• Seal: Notary Public State of Florida
ti CARMEN WANDA FIGUEROA C Rodriguez
MY CONAIISSION 9 FF 138720 a My Commission EE 861704
EXPIRES:September 7,2018 i�,c+rwodi' Expires 12130/2016
Thru Public Undembrs
e�..x* **ae�x* �xae�xa�x�xr*r* *x*wx�* �xx�
APPROVED BY Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)