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PL-18-2239Miami Shores Village 10050 N.E. 2nd Avenue NE Miami Shores, FL 33138-0000 Phone: (305)795-2204 Project Address Parcel Number Issue Permit NO. PL-8-18-2239 Permit Type: Plumbing - Residential Work Classification: Gas Permit Status: APPROVED te: 8/2412018 Expiration: 02/20/2019 Applicant 1421 NE 103 Street Miami Shores, FL 33138-2625 1132050310150 Block: Lot: VILMA QUINTANA Owner Information Address Phone Cell VILMA QUINTANA 1421 NE 103 Street MIAMI SHORES FL 33138- (305)527-3904 1421 NE 103 Street MIAMI SHORES FL 33138- Contractor(s) CORAL REEF PLUMBING INC Phone CeII Phone (305)361-6769 (786)298-6853 Valuation: Total Sq Feet: $ 3,500.00 0 • Type of Work: GAS LINE, STOVE, LAUNDRY, WATER HEA Type of Piping: Additional Info: GAS LINE, STOVE, LAUNDRY, WATER HEA Bond Return : Classification: Residential Scanning: 3 Fees Due CCF DBPR Fee DCA Fee Education Surcharge Permit Fee Scanning Fee Technology Fee Total: Amount $2.40 $2.63 $2.00 $0.80 $175.00 $9.00 $3.20 $195.03 Pay Date Pay Type Invoice # PL-8-18-68634 08/22/2018 Check #: 1347 $ 50.00 $ 145.03 08/24/2018 Check #: 1348 $ 145.03 $ 0.00 Amt Paid Amt Due Available Inspections: Inspection Type: Final Press Test Review Plumbing 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 AFFIDA IT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating constru and -. ing. Futhermore - . . ' - he above -named contractor to do the work stated. August 24, 2018 Agent Date Building Department Copy August 24, 2018 1 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Ave, Miami Shores, Florida 33138 Tel: 305-795-2204 Fax: 305-756-8972 Inspection Number: INSP-001144-2018 Permit Number: PL-8-18-2239 Scheduled Inspection Date: October 29, 2018 Inspector: 1 Massanet, Maykel Owner: VILMA QUINTANA Address: Project: 1421 NE 103 ST Miami Shores, FL 331382625 Contractor: CORAL REEF PLUMBING INC OSVALDO JAVIER LEON Permit Type: Plumbing - Residential Inspection Type: Plumbing -Final) Work Classification: Gass Phone Number: 3055273904 Parcel Number: 1132050310150 Phone Number: 3053616769 Building Department Comments GAS LINE, STOVE, LAUNDRY, WATER HEATER Checklist Item General Comments Passed False Comments Inspector Comments Passed Hr Failed Correction Needed Re -Inspection Fee No Additional Inspections can be scheduled until re -inspection fee is paid. October 26, 2018 For Inspections please call: 305-762-4949 Page 6 of 27 DROP TEST CERTIFICATION FORM SD CONSTRUCTION LLC 328 CRANDON BLVD SUITE 226 KEY BISCAYNE, FL 33149 ,JOB SITE ADDRESS: 1421 NE 103th ST MIAMI SHORES, FL.33138 Permit # PL-18-2239 Type of installation: New Rough Description of Work: Performed drop test and proves negative. System Pressure from Meter: 0.5 PSI If hybrid system, branch pressure: Appliances present at the time of installation: W/H X Dryer X BBQ_ Pool Heater . Cooktop X Range _Oven Grill Fryer C. Cooker Boiler Space heater Steam table Hood Rice cooker Others: GENERATOR Water Column: 8.2" Test Duration: 30 minutes Date of Test: 10/22/2018 Technician's name: Osvaldo Javier Leon Technician Signature: Dated: 10/22/2018 STATE OF FLORIDA COUNTY OF DADE Sworn to end subscribe before Me this 1022/2018, by OSVALDO JAVIER LEON (X) Personally known ( ) Produce identification Signature o Print Name PO BOX 524677 MIAMI, FL 33152 i PH: 305-361-6769 i FAX: 305-629-9815 I CFC# 1426671 I LP 35932 Email: Estimator@coralreefolumbing.com ❑ New BUILDING Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795-2204 Fax: (305) 756-8972 INSPECTION LINE PHONE NUMBER: (305) 762-4949 RECEIVED AUG 222018 co h FFnBC 20(� Master Permit No. IL C_ 1 S ' i q PERMIT APPLICATION Sub Permit No. P \ ❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL LUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: \`'\ L\ 1 v� \O J � City: Miami Shores County: Miami Dade Zip: 3 \� F7 Folio/Parcel#: \\ - 37_..n- (3\ - \. ° Is the Building Historically Designated: Yes NO Occupancy Type: Load: \ Construction Type: Flood Zone: BFE: FFE: V OWNER: Name (Fee Simple Titleholder): �\ma Q.6\ !\" \ (\ Chi Phone#: Address: City: 147.\ 1D2)��' s- . \8'M\ 6Vo Q - State: ��-- Zip:33136 Tenant/Lessee Name: Phone#: Email: CONTRACTOR: Company Name: N ( \ VSLQ---C\ ?\'3iv AS, Address: -PC) 30.)4- Zt'\(7 Phone#: City: /v\\ 2'M \ State: -VL-- Zip: --1D-7- \ 5 Qualifier Name: a Qs:3\6\Q .\-) \ C c /l- e cDr\ Phone#: /� State Certification or Registration #: l C. \ L\ L (SI lS?�Certificate of Competency #: DESIGNER: Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit: $ 3S0Q Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration Description of Work: 6-lag Sy'a v LAp., z jL/ / w ❑ Repair/Replace ❑ Demolition Specify color of color thru tile: Submittal Fee $ Permit Fee $ / 7 S ` c. CCF $ CO/CC $ Scanning Fee $ Radon Fee $ Z • C-C3 DBPR $ Z ' 3 Notary $ Technology Fee $ Training/Education Fee $ Double Fee $ Structural Reviews $ Bond $ TOTAL FEE NOW DUE $ S • C 3 (Revised02/24/2014) #Bondii 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 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 approved 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 CCL , 20 , by ay of )4 ^G rc,\-- , 20 ` , , by VV\INi Wi1/4,‘- , who ' \f ds0U\ _ c L , w s personally known to me or who has pro uced identi ica ion and who did take an oath. NOTARY PUBLI : Sign: Print: Seal: ;.i MY COMMISSION # GO 121819 o has produced as identification and who did take an oat NOTARY PUBLI Sign: Print: Seal: APPROVED BY 1/1/? Plans Examiner Zoning Structural Review (Revised02/24/2014) Clerk