PL-03-301Miami Shores Village
10050 NE 2nd Avenue
Phone: 305 - 795 -2204
Printed: 11/12/2003
Applicant: EDDIE
Owner: LEWIS
JOB ADDRESS: 9490 NW
Contractor GONZALEZ PLUMBING
Local Phone: 305 - 266 -8126
Parcel # 1131010330600
1
Signed: (INSPECTOR)
Plumbing Permit
Permit Number: PL2003 -301
LEWIS
EDDIE
AVE
Contractor's Address: 1500 SW 86 CT
Legal Description: MIAMI SHORES SEC 6 PB 10 -39 LOTS 1 & 2
Fees:
FEE2003 -7061
FEE2003 -7062
FEE2003 -7063
FEE2003 -7064
FEE2003 -7065
Description
Building Fee
CCF
Notary Fee
Training and Education Fee
Technology Fee
Total Fees:
Amount
$120.00
$1.80
$5.00
$0.60
$3.00
$130.40
Total Fees: $13040 f &c
Total Receipts: $0.00
$ 0, `l -0
Permit Status: APPROVED Permit Expiration: 5/8/2004 Construction Value: $2,400.00
Work: HOT WATER PIPING
Page 1 of 1
BLK 132 LOT SIZE
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:
BUILDING
Owner's Address 9',/ % /-/
City /4" 5/04A f State 1
Tenant/Lessee Name
Job Address (where the work is being done) ems'® Az e4° /
$ Value of Work For this Permit
Type of Work: ❑Addition DAAlteration
Describe Work: !a / - it/1;E �-
Submittal Fee $ 50 , . Permit Fee $
Total Fee Now Due $ S °_O
(Continued on opposite side)
iami Shores Village
uilding Department
0 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
Permit No. e 12O(B 30'
Master Permit No.
PERMIT APPLICATION
FBC 2001
Permit Type (circle): Building Electrical Plumbing " Mechanical Roofing
.�, � ' � � # �'
Owner's Name (Fee Simple Titleholder) 1 "Y. g•.," - �v /'hone �/�°
Zip
Phone #
City Miami Shores Village County Nfiami Dade Zip
Is Building Historically Designated YES NO
Contractor's Company Name el 7 a0
/ 7 ' fi ii � Phone # 3.P/�° IC: 6 ` S le e
Contractor's Address /5 d _5 eel R C 6_
City 7 '- -.---- State-
Zip .,./..p /
Qualifier z719 IL el, v 7
Architect/Engineer's Name (if applicable) Phone #
3r
* * * * * * * * * * * * * * * * * * * * * * * * * * * *F
J4®
Notary $ , . 0 C) Training/Education Fee $ 0
Scanning $ Radon $
Code Enforcement $ Structural Plan Review. $
Square Footage Of Work:
DNew Repair/Replace ❑ Demolition
* * * * * * * * * * * * * * * * * * * * * * * * * * * * **
CCFS ,(C0
Technology Fee $ 3 0 0
Bond $
Bonding Company's Name (if applicable)
Bonding Company's n
g pony'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 CONDrFIONERS, 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 will not b e ed and a reinspection fee will be charged • T such posted notice, the
Signature
The
day o
who is
Owne or Agent Contractor
oregoing instrument was acknondged b fore me this t _ The foregoing instrument was acknowledged before me this 1 1
�`rn110 2U ��5, \ /
, day of tO , 200 ` by � tf", " """" e
y known to me or who has roduced known to me _(__11 _ has produced
rs
�. W ' ion #� ' ''.;1 Y„ a an oath. •
NOT • . ° Expires: Jul 13, f 7
� � • 1 1 l�i�pppy . c• a :, _ , 2
NOTARY P
Sign: e, ,
4 • I 1O 1 S
Print:
My Commission Expires:
My Commission
(Certificate of Competency Holder)
Certificate of Competency No.
State Certificate or Registration No.
:hc 10/14/03
Signatur
Print
as iden
I Ir oath.
Commission #DD231984
xpires: u113, 2007
******** * * * * * * * * * * * * * * * * * * * * * * * * * * *. -,* *, ** *: **************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
��
APPLICATION APPROVED BY: I e',
Plans Examiner
Engineer
Zoning
Y
i TUB
UNIT
FEE
ITEM
SWITCH OUTLETS
UNIT
FEE
ITEM
SPACE HEATERS
UNIT
FEE •
ET
LIGHT OUTLETS
CENTRAL HEATING
:MASHER
RECEPTACLES
A/C (WIND)
SAL
SERVICE TEhWORARY
A/C (CENTRAL)
NKING FOUNTAIN
SERVICE SIZE IN AWS
DUCT YORK
ifR DRAIN
SERVICE REPAIR/METER CHANGE
REFRIGERATION
:ASE TRAP
APPLIANCE CUTLETS
PROCESS AND PRESS PIPING
•ERCEPTCR
RANGE TOP
UNDERGROUND TANKS
'ATORY
OVEN
ABOVE GROUND TANKS
kORY TRAY
WATER HEATER
U.F. PRESSURE VESSELS
)THES WASHER
MOTORS 0- 1 HP
STEAM BOILERS
OWER •
MOTORS OVER 1- 3 HP
HOT WATER BOILERS
.
NX, POT/3 COW.
MOTORS OVER 3- 5 HP
MECHANICAL VENTILATION
•
•11(, RESIDENCE
MOTORS OVER 5- 8 HP
TRANSPORTING ASSEMBLIES
NX, SLOP
MOTORS OVER 8- 10 FP
+�PORARY WATER CLOSET
MOTORS OVER 10- 25 HP
_
FIRE SPRINKLER SYSTEMS•
INAL
MOTORS OVER 25-100 HP
COOLING TOWERS
TER CLOSET
MOTORS OVER 100 HP
VIOLATION
3IRECT-WASTES
A/C WINDOW
REINSPECTION
TER SUPPLY TO:
AIR CONDITIONERS
A/C UNIT
STRIP HEATER
FIRE SPRINKLER
GENERATORS TRANSFORMERS
•
HEATER -NEW INST.
GENERATORS TRANSFORMERS
f
HEATER- REPLACE
GENERATORS TRANSFORMERS
LAWN SPRINKLER -WELL
_
SPECIAL PURPOSE
.
•
SWIM+IING POOL
OUTLETS COMMERCIAL
-
WATER SERVICE
SIGN TUBES
NER CONNECTIONS
SIGN TRANSFORMERS
•
ILITY -SEWER
SIGN TIME CLOCK
ILITY -WATER
FIXTLRES
PTIC TANK
ANTENNA
LAY
TELEVISION OUTLETS
AINFIEI.O, 4' TILE/RES.
VIOLATION
VP & ABANDON SEPTIC TANK
REINSPECTION
.
AKAGE PIT CU. FT.
TCH BASIN
SCHARGE WELL
'MESTIC WELL
;EA DRAIN
)OF INLET 1
)LAR WATER HEATER
.
:RE STANDPIPE
a PIPING
knN SPRINKLER SYSTEM
LS RANGE
•
:TER SET (GAS)
f h
1 APPLICATION FOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. IF A MASTER PERMIT HAS B.
STAINED, THE OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.)
PLUMBING
ADDENDUM TO BUILDING PERMIT APPLICATION
ELECTRICAL
MECHANICAL