PL-14-1532 • b /
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL 14— G3 I
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-249979 Permit Number: PL-7-14-1532
Scheduled Inspection Date: April 28,2016 Permit Type: Plumbing - Residential
Inspector: Hernandez, Rafael
Inspection Type: Final
Owner: FABLE, ELISE Work Classification: Addition/Alteration
Job Address:941 NE 91 Terrace
Miami Shores, FL 33138-3219 Phone Number
Parcel Number 1132060030050
Project: <NONE>
Contractor: LONCUS PLUMBING CONTRACTORS INC Phone: (305)218-1004
Building Department Comments
NEW 2 BATHROOM, LEGALIZATION 1 BATH AND Infractio Passed comments
KITCHEN. INSPECTOR COMMENTS False
Inspector Comments
Passed CREATED AS REINSPECTION FOR INSP-216044. fix p-traps at kitchen
and lavatory drains
Failed
Correction ❑
Needed
Re-Inspection ❑
Fee
No Additional Inspections can be scheduled until
re-inspection fee is paid
April 27,2016 For Inspections please call: (305)762-4949 Page 8 of 47
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�s►°Rs ar, Miami Shores Village
10050 N.E.2nd Avenue NE �� + ##C311 { Qtl-q
Miami Shores,FL 33138-0000Per
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W Phone: (305)795-2204
Expiration: 01/03/2016
Project Address Parcel Number Applicant
941 NE 91 Terrace 1132060030050
MONTANA 13 HOLDINGS III LLC
Miami Shores, FL 33138-3219 Block: Lot:
Owner Information Address Phone Cell
MONTANA 13 HOLDINGS III LLC 970 SOUTH SHORE Drive
MIAMI BEACH FL 33141-
970 SOUTH SHORE Drive
MIAMI BEACH FL 33141-
Contractor(s) Phone Cell Phone Valuation: $ 1,800.00
LONCUS PLUMBING CONTRACTORS (305)218-1004
------- Total Sq Feet: 0
Type of Work:NEW 2 BATHROOM,LEGALIZATION 1 BATH Available Inspections:
Type of Piping: Inspection Type:
Additional Info: Top Out
Bond Return: Final
Classification:Residential Scanning:3 Underground
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due
CCF $1.20 Invoice# PL-7-14-52301
DBPR Fee $4.50 07/07/2015 Check#: 1051 $615.20 $0.00
DCA Fee $4.50
Education Surcharge $0.40
Permit Fee $300.00
Scanning Fee $3.00
Technology Fee $1.60
Work without Permit Fee $300.00
Total: $615.20
In consideration of the issuance to me of this permit, I agree to pert r the work covered hereunder in compliance with all ordinances and regulations
pertaining thereto and in strict conformity with the plans,drawings,stat ment or specifications submitted to the proper authorities of Miami Shores Village. In
accepting this permit I assume responsibility for all work done b eith r rr elf, my agent, servants, or employes. I understand that separate permits are
required for ELECTRICAL,PLUMBING,MECHANICAL,WIND ,DO RS ROOFING and SWIMMING POOL work.
OWNERS AFFIDAVIT: I certify that all the foregoing jinfoatios accur a and that all work will be done in compliance with all applicable laws regulating
construction and zoning. Futhermore,I authorize the acon to to do the work stated.
` July 07, 2015
Authorized Signature:Owner / Applicant / Contractor / Agent Date
Building Department Copy
July 07,2015 1
Miami Shores Village �' �
Building Department :BY:
UL 10 2014
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 2016
BUILDING Master Permit No. - i ,-] `
PERMIT APPLICATION Sub Permit No.�� —( 2-
❑BUILDING ❑ELECTRIC ❑ ROOFING ❑ REVISION ❑EXTENSION ❑RENEWAL
PLUMBING ❑MECHANICAL ❑PUBLIC WORKS ❑CHANGE OF ❑CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: q`/1 AIC 5'/
City: Miami Shores County Miami Dade Zip:
Folio/Parcel#: Is the Building Historically Designated:Yes NO
Occupancy Type: Load: Construction Type:r� �� �� Flood Zane: BFE: FFE:
OWNER:Name(Fee Simple Titleholder): 1, 3r �flV:L- Phone# t q:+,9 >
Address: I IV12 cy
City: v I c ��(� _ mate:
Tenant/Lessee Name p�e#.-
Email•
CONTRACTOR:Company Name: o�����f �'�•''� r� Phone#:(.TOS)o22/F/DO
Address:
City: 14! X-iii! State: ��® .cold Zjp. 33/ ySO.
Qualifier Name: � � b Phone#: (00s)-i f8 loov.
State Certification or Registration#: off- f'A.)'fO <o. Certificate of Competency#:
DESIGNER:Architect/Engineer: Phone#:
Address: City: State: Zip:
Value o r hJe"' ft, &00 Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition
Description of Work:
�r/E�.v � ��-/�i.rim� • oL.���/�z�>f 7',-, / �'��,
Specify color of color thru We:
Submittal Fee$ Permit Fee$ CCF$®• co/cc$
Scanning Fee$ Radon Fee$ DBPR$ Notary$
Technology Fee$ Training/Education Fee$ Double Fee$
Structural Reviews$ Bond$
TOTAL FEE NOW DUE$ 0
(Revisedoz/za/2014)
Bonding Company's Name(if applicable)
Bonding Company's Address
city State Tip
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,o'certified copy of the recorded notice of commencement must be posted at-the Job site
for the flrst inspection which o ev (7) days after the building permit is issued. in the Bence of such posted notice, the
inspection will not be app d and a re' ection fee will be charged.
10
Si
Signature
OWNERo NT CO TRACTOR
The foregoing instru ent was acknowledged before a this The foregoing instrument was acknowledged before me this
day of 20 1L by 1_day of �� J 20 d `}� ,by
(� �Fgbwho*rsonally nown to fluLgAzg who is6ersonally known�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:
Sign: Sign:
Print Print cif}��s9 h
Seal: ��` 4� YANELLE ALM pe►pu., Notary Public State of Florida
Seal: Za(da Tamayo
MY COMMISSION#FF0637?8 v bAy Commission EE 157381
EXPIRES October 16.2017 �p Expires 01/05/2018
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APPROVED BY 7'S_ � � Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)