PL-05-170450 NOV 2005
MIAMI SHOS VILLAGE
BUILDING DEPARTMENT
305-795-2204
Building Inspection Request
Date 1 l I Z (C1S
Type Insp'n
Permit No. PLC6 - 170 •
Name Qw
Address sLE-G- t ^ " ST'
Compan
Phone #
\j LMAZ fVIVIY?I t'L
(c) 41Z
Inspection Date I
Approved
Correction
Re-Insp'n Fee
Miami Shores Village
10050 NE 2nd Avenue
Phone: 305-795-2204 Permit Number: PL2005-170
Printed: 8/18/2005
Applicant: CORY GITTNER
Owner: GITTNER CORY
JOB ADDRESS: 551 NE 102 ST
Contractor NELMAR PLUMBING INC
Local Phone: (305) 261-3942
Parcel # 1132060170980
Contractor's Address: 4954 SW 75 AVE
Legal Description: MIAMI SHORES SEC 4 AMD PLAT
Plumbing Permit
Page 1 of 1
PB 15-14 LOT 19 & W1/2 LOT 20
Fees: Description Amount
FEE2005-7740 Scanning Fee $3.00
FEE2005-11392 Building Fee $168.00
FEE2005-11393 CCF $3.00
FEE2005-11394 Technology Fee $4.20
FEE2005-11395 Training and Education Fee $1.00
Total Fees: $179.20
Total Fees: $179.20
Total Receipts: $0.00
Permit Status: APPROVED Permit Expiration: 11/23/2005 Construction Value: $515.00
Work: PLUMBING WORK FOR
Signed:
(INSPECTOR)
AUG 18 PAID
- r.< -14 11/�3
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 responisibility for all work
done by either myself, my agent, servants or employes.
Signed: (Contractor or Builder) BY:
y1 2 6 2825
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
BUILDING
PERMIT APPLICATION
FBC 2001
PlOS—I` 0
Permit No.
Master Permit No.
Permit Type (circle): Building Electrical [Plumbing) Mechanical �RR000fing
Owner's Name (Fee Simple Titleholder) 6-/T' 7J /21 =f/.e y Phone # C- c) Y T 7` 9e() -
Owner's Address 6-�/ O. E. /602 .
d
//
City �r/<4 // / aIdeece:cS State Zip , /,5 d
Tenant/Lessee Name
Phone #
Job Address (where the work is being done) "---� X.,) . E. //%, e"il
City Miami Shores Village County Miami -Dade Zip 3 3/3 g'
Is Building historically Designated YES NO }I
r
Contractor's Company Name �L L r 1n'ni -k. PL I il Phone # 3 o r - 2 G / - 3 l V L
45S-( se-7r19-121
City, t Vj L ( State f1_ Zip <.i IT
Qualifier L / n 5 (�-f1,o- I:9 ,,t,--2
Contractor's Address
Architect/Engineer's Name (if applicable) 1 4 • 005 "V'l k 7/ Phone #
$ Value of Work For this Permit
Square Footage Of Work:
Type of Work: [Addition ❑Alteration ❑New Repair/Replace ❑ Demolition
Describe Work:
4.
****************************Fees******************************
Submittal Fee $ Permit Fee $ /12 ¶i% CCF $
Notary $ Training/Education Fee $ Technology Fee $
Scanning $ Radon $ Zoning Bond $
CO/CC
Code Enforcement $ Structural Plan Review. $
Total Fee Now Due $
(Continued on opposite side)
Chc 12/15/03
Print: Prin gE.
My Commission Expires: My g ,• , Bonded
# DD194890
By National Nota Assn.
****************************************************************
Bonding Company's Name (if applicable)✓✓�,
Bonding Company's Address N /A
City State Zip
Mortgage Lender's Name (if applicable) // ,/y
Mortgage Lender's Address /0- /A
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 $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 0 Signa
Owner or Agent onttractor
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this 2-
day of , 20 _, by day of /114/ , 20 0 c, by
who is personally known to me or who has produced who is personally known to me or who has produced
As identification and who did take an oath. as identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUB
Sign: Sign —.
:"et, _ otary Public - State of Florida
**********
(Certificate of Competency Holder)
State Certificate or Registration No. Certificate of Competency No.
APPLICATION APPROVED BY: Plans Examiner
Engineer
Zoning
Inspection Worksheet
Miami Shores Village
050
10050 N.E. 2nd-Avenue Miami Shores, F
Phone: (305)795-2204 I Fax: (305)756-8972
In fechon: um
Inspection Date: 02/01/2007
Inspector: Levr®ck, James
Owner: OBREGON, DAVID AND DORIS
Job Address: 551 102 Street NE
Miami Shores Village, FL 33138-
Project: <NONE>
Block:
Contractor: NELMAR PLUMBING INC
Permit Type: Imported Permit
Inspection Type: Final
Work Classification: Plumbing
Phone Number (305)868-6419
Parcel Number 1132060170980
Lot:
Phone: (305) 261-3942
Building Department Comments
PLUMBING WORK FOR
FEB 0 1 2001
Passed
Failed
Correction
Needed
Re -Inspection
Fee
($75)
No Additional Inspections can be scheduled until
re -inspection fee is paid .
Wednesday, January 31, 2007
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