PL-16-2848 Inspection Worksheet
Miami Shores Village II
10050 N.E.2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-269328 Permit Number: PL-10-16-2848
Scheduled Inspection Date: December 19,2016 Permit Type: Plumbing - Residential
Inspector: Hernandez, Rafael Inspection Type: Final
Owner: WARD, DAVID Work Classification: Addition/Alteration
Job Address:9120 NE 8 Avenue 1 G
Miami Shores, FL
Phone Number (305)903-4927
Parcel Number 1132060440230
Project: <NONE>
Contractor: QUINTERO GENERAL CONSTRUCTION Phone: (786)487-5738
Building Department Comments
REPAIR AND REPLACE IN KITCHEN AND BATHROOM Infractio Passed Comments
REMOVE AND REPLACE BATHTUB INSPECTOR COMMENTS False
Inspector Comments
Passed
Failed
Correction ❑
Needed
Re-Inspection ❑
Fee
No Additional Inspections can be scheduled until
re-inspection fee is paid.
December 16,2016 For Inspections please call: (305)762-4949 Page 19 of 60
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Miami Shores Village � robing-Fuld n�
10050 N.E.2nd Avenue NE
a ', .= Wart Jac t��1! dJtiQndAftr*ion._,
••• ""'� Miami Shores,FL 33138-0000
Phone: (305)795-2204
11171201" Expiration: 05/06/2017
Project Address Parcel Number Applicant
9120 NE 8 Avenue Number: 1G 1132060440230
IRA SERVICES TRUST COMPAN
Miami Shores, FL Block: Lot:
Owner Information Address Phone Cell
IRA SERVICES TRUST COMPANY CFBOFL (305)903-4927
Contractor(s) Phone Cell Phone Valuation: $ 3,200.00
QUINTERO GENERAL CONSTRUCTIO (786)487-5738
Total Sq Feet: 0
Type of Work:REPAIR AND REPLACE IN KITCHEN AND B Available Inspections:
Type of Piping:
Additional Info: Inspection Type:
Top Out
Bond Return: Final
Classification:Residential Scanning: 1 Review Plumbing
Underground
L]
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due
CCF $2.40 Invoice# PL-10-16-61716
DBPR Fee $2.25 10/19/2016 Credit Card $50.00 $118.90
DCA Fee $2.25
Education Surcharge $0.80 11/07/2016 Credit Card $ 118.90 $0.00
Notary Fee $5.00
Permit Fee $150.00
Scanning Fee $3.00
Technology Fee $3.20
Total: $168.90
In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations
pertaining thereto and in strict conformity with the plans,drawings,statements or specifications submitted to the proper authorities of Miami Shores Village. In
accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are
required for ELECTRICAL,PLUMBING,MECHANICAL,WINDOWS,DOORS,ROOFING and SWIMMING POOL work.
OWNERS AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
construction and zoning. Futhermore,I authorize the above-namedr to do the work stated.
November 07, 2016
Authorized Signature:Owner / Applicant / ontractor / Agent Date
Building Department Copy
November 07,2016 1
Miami Shores Village
ti`s` • Building Department OCT s 201
10050 N.E.2nd Avenue,Miami Shores, Florida 33138
�® L/ Tel:(305)795-2204 Fax:(305)756-8972
INSPECTION LINE PHONE NUMBER:(305)762-4949 �[�,,
FBC 20)�i
BUILDING Master Permit No. tc'(0
PERMIT APPLICATION Sub Permit No. (v Z.$LI$
❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
E(PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: I/Z® ILIAC y7h ^ye- /40�_ !C,
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#: Is the Building Historically Designated:Yes NO
Occupancy Type: Load: Construction Type:
+ -/' Flood Zone: BFE: FFE:
OWNER:Name(Fee Simple Titleholder): 194 �t?.VACQS ("J 60—OFFS 4 �ne#: .10S
Address: &/JV8 AA9 6-A Sr
City: State: Ice Zip: 3-
Tenant/Lessee Name: Phone#:
Email: / /� /'� 01
CONTRACTOR:Company Name: DCVI ki (a ^e- aa' agrii4• N 42Ae Phone#: � yo`` 57L34y
Address: 'flo l Aj i j tfo21"A__7
City: � 4A 60-4&77 State: Zip: 3�l
Qualifier Name: A8,e, j,,x og t / Phone#: 7'rw/
State Certification or Registration#: C;q,- /5PJU43 Certificate of Competency M
DESIGNER:Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit:$ fes® - 0 Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration //❑ New &T Repair/Replacee� ❑ Demolition
Description of Work: �e .�� i4,�� G� AnJ01
�� Cv
Specify color of color thru tile: h
Submittal Fee$S�•C� Permit Fee$ .� CCF$ 2• LA CO/CC$
Scanning Fee$ Radon Fee$ Z • Z.5 DBPR$^ 2 , �. Notary$
Technology Fee$ �• ® Training/Education Fee$ ® �® Double Fee$
Structural Reviews$ Bond$
TOTAL FEE NOW DUE$
(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
M
0
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 appro d and a reinspection fee will be charged.
Signature Signature
OWNER or AGENT CONTRACTOR
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
/ day of 0C ,20 by day of OCM 4 -P42- ,20 1 ro by
�"�A ,who is personally known to—F&EgNA ��Ro is personally known to
me or who has produced as me or who has producedfv,-
identification and who did take an oath. identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
Sign: Sign:
Print: X.' Print: f�Seal: Seal: Public state os Florida
,`ppT vL4 Notary
MARIJAIR RAVEL]Florlda
$ �f; Sindia Alvarez
Notary Publ(c-State of a My COmrnission FF 156750
iCCommission#FF 20 �OfI� ' Exaireaosro312o+sBonded Oral No
APPRO Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)