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PL-15-3199 (2) Inspection Worksheet Miami Shores Village 10050 N.E.2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-250135 Permit Number: PL-12-15-3199 Scheduled Inspection Date: May 03,2016 Permit Type: Plumbing - Residential Inspector: Hernandez, Rafael Inspection Type: Final Owner: PERAGALLO, DINO&IRENE Work Classification: Pool - Private Job Address:55 NE 97 Street Miami Shores, FL 33138- Phone Number (305)995-5224 Parcel Number 1132060130990 Project: <NONE> Contractor: ROSMEL POOL INC Phone: (305)592-7900 Building Department Comments NEW POOL PIPING Infractio Passed Comments INSPECTOR COMMENTS False Inspector Comments Passed �- Failed Correction ❑ Needed Re-Inspection ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is paid May 02,2016 For Inspections please call: (305)762-4949 Page 3 of 33 Miami Shores Village P €in urrtbir� tisi',. 10050 N.E.2nd Avenue NE E Miami Shores,FL 33138.0000 `ties, Phone: (305)795-2204 � f8 Expiration: 08/01/2016 Project Address Parcel Number Applicant 55 NE 97 Street 1132060130990 DING 8,IRENE PERAGALLO Miami Shores, FL 33138- Block: Lot: Owner Information Address Phone Cell DINO&IRENE PERAGALLO 55 NE 97 Street (305)995-5224 MIAMI SHORES FL 33138- 55 NE 97 Street MIAMI SHORES FL 33138- Contractor(s) Phone Cell Phone Valuation: $ 2,000.00 ROSMEL POOL INC (305)592 7900 Total Sq Feet: 00 Type of Work:NEW POOL PIPING Available Inspections: Type of Piping: Inspection Type: Additional Info: Main Drain Bond Return: Final Classification:Residential Scanning:1 Rough Review Plumbing Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $1.20 Invoice# PL-12-15-58181 DBPR Fee $3.38 02/03/2016 Check#:13299 $ 187.96 $50.00 DCA Fee $3.38 Education Surcharge $0.40 12/29/2015 Check#:13229 $50.00 $0.00 Permit Fee $225.00 Scanning Fee $3.00 Technology Fee $1.60 Total: $237.96 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 red contractor to do the work stated. �' , - a,_) February 03, 2016 Authorized Signature:Owner / Applicant / Contractor / Agent Date Building Department Copy February 03,2016 1 Miami ShoresVillage Building Department W292M 10050 N.E.2nd Avenue, Miami Shores,Florida 33138 .4 Tel:(305)795-2204 Fax:(305)756-8472 - INSPECTION LINE PHONE NUMBER:(305)762-4949 BUILDING Master Permit Na.�� PERMIT APPLICATION Sub Permit No.��/� []BUILDING ❑ ELECTRIC F-1ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL [PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: City: Miami Shores Count- Miami Dade Zio Folio/Farrell#:_ 1 1 -�.®���®1A- 4 0%Rc1 Is tine Building Historically Designated:Yes -NO OccupancyType: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name(Fee Simple Titleholder): _ il_ .�© ,r --�.�� Phone#: Address:_ City: t✓1'�aw,� Nv.��.S State:_ FL Zip: 33135 Tenant/Lessee Name: Phone#: Email: ti9 CONTRACTOR:Company Name: Phone#• �c�,. .t)eta-1Iq®c3 Address: _ �13�U 1 03 -- City:�- �B�c< State: _FL -- Zip: Qualifier Name: Phone#: State Certification or Registration#:_ �17C' 1?► �A ' Certificate of Competency#: DESIGNER:Architect/Engineer: 7F 3 Address: Phone#: � � � , City:�i.�c�.orv►r State:�_Zip• :�31�`-.1 Value of Work for this Permit.. $ j Val Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ /Re lace Re air P P F] Demolition Description of Work; 0CA Specify color of color thru tile, Submittal Fee$— Perrrtit Fee$�22� ;� CCF co/cc� Scanning Fee$ Radon Fee$ DBPR$ Notary$ Technology Fee$ Training/Education Fee$ Double Fee$ Structural Reviews$_ Bond$ (Revi5ed02/2412014) TOTAL FEE NOW DUE$_( / 9 G I Bonding Company's Name(if applicable) Bonding Company's Address State Zip city Mortgage Lender's Name(if applicable) Mortgage Lender's Address City State Zip permit to do the work and Installations as indicated. i certify that no work or installation has Application is hereby made to obtain a 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, FOOLS, 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 REC®R® A NOTICE �F COMMENCEMENT YOUR oYOU iN EN® RESULT iN YOUR PAYING TWICE FOR IMPROVEIVd ®��� ATTORNEY BEFORE RECORDING TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER YOUR NOTICE OF COMMENCEMENT." Notice to Applicant: As a condition to the issuance of a building permit_with an estimated value exceeding$2500, the applicant must promise in good faith that a copy m the notice of commencement andco rded notice/ien low brochure will of commencement must be posted at the job site whose property is subject e delivered to the person to attachment. Also,a. r fled copy of there for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. n Signature SignatureJ� ►'°'`� CONTRACTOR OWNER or AGENT The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this day of by _day of 2X �.�V•-���, =�n.11y � 20e by who 1 personally known it-A r� i,. LV�,iz�• o ownto vas me or who has produced as me or who has produced_ identification and who did take an oath. identification and who did take an oath.. NOTARY PUBLIC: NOTARY PUBLIC: Sign: Sign: Gi C® Le n1�2r Z Print: Print: ARCS A MARTINEZ epgs~" Seal: Seal' =*: *`_ MY COMMISSION#FF 008989 ;oi' :Pv MARCOSA.MARi1NEZ y'• EXPIRES:May 15,20-17 = ' __ MY COMMISSION#FF 008989 Bonded Thru Notary Public Underwrtm c EXPIRES:May 15,2017 yF ...q.' *�d> TA� �i ��' a:tl+xti+kd +k3arkak 7stc�.kAz�ktieAk&�shdsnkAt�iskxkx`•ak�9+kdiisda$c+kM��ea�axdFata7es'f�#kkaN+Rdd dadkakokda�FtaoIId+kak�&�#sk2#p+xokd . .Zoning APPROVED BY zC``fL Plans Examiner Clerk Structural Review (Revised02/24/2014)