PL-12-1967Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP- 189766 Permit Number: PL -10 -12 -1967
Scheduled Inspection Date: April 25, 2013
Inspector: Hernandez, Rafael
Owner: BORENSTEIN, NICOLE
Job Address: 441 GRAND CONCOURSE
Miami Shores, FL
Project: <NONE>
Contractor: JAVIER SPRINKLER SYSTEM
Permit Type: Plumbing - Residential
Inspection Type: Final
Work Classification: Sprinkler System
Phone Number (786)258 -2484
Parcel Number 1132060170310
Phone: (786)218 -6468
Building Department Comments
LAWN SPRINKLERS
Infractlo Passed Comments
INSPECTOR COMMENTS
False
Passed
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Inspector Comments
CREATED AS REINSPECTION FO INSP-180274. permit fee not paid
April 25, 2013
For Inspections please call: (305)762 -4949
Page 20 of 49
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
INSPECTION'S PHONE NUMBER: (305) 762.4949
B�TIbIL�INGrt2
PERMIT APPLICATION
Permit Type: PLUMBING
4df/ C!a$del evo✓d,/ir.r.e
JOB ADDRESS:
City:
Folio/Parcel #:
FBC 20
Permit No.
Master Permit No. FIX2----19V+
Miami Shores
County:
Is the Building Historically Designated: Yes
Miami Dade Zip:
NO Flood Zone: '✓
OWNER: Name (Fee Simple Titleholder): %l EPIC ( Ptt.S fen Phone #: ? 8T -� 'J -� d `' /i; 7
Address: y 4 r 4 (j��e
City: M!, Sin4lP.5 State: FL..
Tenant/Lessee Name: Phone #:
Email:
zip: 3,13fr
CONTRACTOR: Company Name:
Address:
City:,rA /• State:
Qualifier Name:
State Certification or Registration #:
Contact Phone #: % �(p�' el6 g Email Address:
DESIGNER: Architect/Engineer:
/'s' Phone #: ?04. G ( b b 961
Zip: 3 3 f ?/
,..402.0:0 Phone #: � � 6 4( 7,
Certificate of Competency #: Q(P1i(0
4Df. C?d,
Value of Work for this Permit: $ /1-00 % Square/Linear Footage of Work:
Type of Work: Address DAlterationn
Description of Work: pG ( j
outz
New fR�epair/Replace
UDemolition
******** * * * * * ** * * * * * ** ** * * * * * * * **** * * ** Fees************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
S.
Submittal Fee $ Permit Fee $ 1 CCF $ CO /CC $
Scanning Fee $ Radon Fee $ DBPR $ Bond $
Notary $ Training/Education Fee $ Technology Fee $
Double Fee $ Structural Review $
TOTAL FEE NOW DUE $
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 ELECTRICAL WORK, PLUMBING, SIGNS,
WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and 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 42500, 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 th ab ence of uch posted notice, the
inspection will not be approved and a reinspection fee will be charged.
Signa
Owner or Agent
The foregoing instrument was acknowledged before me this l The foregoing ins wledged before me this
day of OL , 26(2, by N lC c) --0-. O J-7(1.,rc) day of 0(.--.' ' , 20)Z_ ;by ' -A\.i 1(lAaUAX
who is personally known to me or who has produced 1 (-- A 0 who is personally known to me or who has produ \ \\� II�i1P� r� ' ( i
Tr1 U11/
ufl
As identification and who did take an oath. - as identification and * d ak
§ " e an oath,
NOTARY PUBLIC: .o''•'; • ti -9
NOTARY PUBLIC:
Sign:
Print:
011n1111/w,,,
/
cco �d0
Sign:
.„ •
S 07 • n E
1,��i�U n u11S�P
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My Commission Expires:
Print:
My Commission Expires:
Crs
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APPROVED BY pl.— Plans Examiner Zoning
t�
Structural Review Clerk
(Revised3 /12/2012XRevised 07 /10 /07XRevised 06 /10 /2009)(Revised 3/15/09)
ci J
THIS IS NOT A BILL- DO NOT PAY
RECEIPT NO. 30- 4407441 CC NO: 00P000050
BUSINESS NAME / LOCATION
JAVIERS SPRINKLERS INC
9120 FONTAINEBLEAU BLVD
OWNER :JAVIERS SPRINKLERS INC
SEE BACK OF RECEIPT FOR
A LIST OF NON-PARTICIPATING
MUNICIPALITIES
Receipt holder must
register in the city
where work is to be
done.
PAYMENT RECEIVED
MIAMI•DADE COUNTY TAX
mur712772012
02260012001
000175.00
FIRST -CLASS
U.S. POSTAGE I
PAID
MIAMI, FL
PERMIT NO. 231
RECEIPT HOLDER MAY DO
BUSINESS AS A CONTRACTOR
AS SPECIFIED HEREON.
SPECIALTY PLUMBING CONTRACTOR
DO NOT FORWARD
JAVIERS SPRINKLERS INC
JAVIER AGUAYO PRES
9120 FONTAINEBLEAU BLVD #109
MIAMI FL 33172
11il itt£ 1l£££} 1Ittll l£}!£i£ IIII} £tl£££171i{£I££IS'l}£II£Il£}411
13 FIRST -CLASS
U.S. POSTAGE I
MIAMI, FL
PERMIT NO.231
- DO NOT PAY RENEWAL 440744'1
RECEIPT NO.
CC # 00P440050
109
THIS IS NOT A BILL
422031-5 3
BUSINESS NAME / LOCATION
JAVIERS SPRINKLERS INC
33172 UNINADADELCOUNTYVD
OWNER
JAVIERS SPRINKLERS INC
Sec. Type o
ties } IT
Does ENOT PERMIT THE
HOLDER TO VIOLATE ANY
EXISTING REGULATORY OR
ZONING COUNTY OR CITIES. NOR
DOES IT LAWS
EXEMPT THE
PERMIT FROM O LICENSE
REQUIRED BY LAW. THIS IS
NOT E HOLDER'S QUALIFICA-
TIONS.
PAYMENT MIAM D E COUP TAX
COLLECTOR.
07/10/2012
60140001213
000075.00
SEE OTHER SIDE
JA CONTRACTOR
f Business
TH s /2� A §aCIALTY PLUMBING
RECEIPT
WORKED S
DO NOT FORWARD
JAVIERS SPRINKLERS INC #109
JAVIER AGUAYO PRES
9120 FONTAINEBLEAU BLVD
ISlliflfll} }lit1 !!ii}i!!1l�i! }££7£i}} !££i}£i!}tFt7Iili54