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PL-09-1822 Inspection Worksheet Miami Shores Village Clow 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: I NSP- 128580 Permit Number: PL -11 -09 -1822 Scheduled Inspection Date: April 09, 2010 Permit Type: Plumbing - Residential Inspector: Hernandez, Rafael Inspection Type: Final Owner: YEHEZBEL, HAIM Work Classification: Drainfield Job Address: 9806 NE 2 Avenue Miami Shores, FL Phone Number Parcel Number 1132060132241 Project: <NONE> Contractor: NATIONWIDE PLUMBING Phone: (305)822 -8002 Building Department Comments DRAINFIELD REPLACEMENT Inspector Comments Passed ZZ Failed Correction Needed Re- Inspection ❑ Fee No Additional Inspections can be scheduled until re- inspection fee is paid. April 08, 2010 For Inspections please call: (305)762 -4949 Page 2 of 10 Miami Shores Village Type� 10050 N.E. 2nd Avenue Dralnfieltd Miami Shores, FL 33138 -0000 r� "r Phone: (305)795-2204 APPR �"lORtDp Expiration: 051041201 Pr oject A ddress Parcel Number Applicant 9806 2 Avenue 1132060132241 HAIM YEHEZBEL Miami Shores, FL Block: Lot: Owner Information Address Phone Cell HAIM YEHEZBEL 210 71 ST. #309 MIAMI BEACh fl Contractor(s) Phone Cell Phone Valuation: $ 2,200.00 NATIONWIDE PLUMBING (305)822 -8002 Total Sq Feet: 400 Type of Work: PLUMBING For Inspections please call: Type of Piping: DRAINFIELD (305)762 -4949 Additional Info: Available Inspections: Bond Return : Inspection Type: Classification: Residential Final Rough Landscaping Fees Due Amount Invoice # Total Amt Paid Amt Due CCF $1.80 PL -11 -09 -36305 $ 182.80 $ 182.80 $ 0.00 Education Surcharge $0.60 Permit Fee - Additions /Alterations $175.00 Scanning Fee $3.00 Technology Fee $2.40 Total: $182.80 x F-+ F F-+ t --t �n 4 7 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 pertainingRereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In acceptingc.8is permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required fbrELECTRICAL, PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work. OWNER,VFFIDAVIT: 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 -named contractor to do the work stated. November 13, 2009 "horized Signature: Owner / Applicant / Contractor / Agent Date co BuilldUng Department Copy November 13, 2009 1 JaSr� �Cj� 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 rl BUILDING RECE ED Permit No. L J U PERMIT APPLICATION NOV Q 4 1 9 aster Permit No. FBC 20 _ _ _ _ _ p __ — _ Q, 5 3CXj Permit Type: PLUMBING Q{ _ ,Q e2� , j � Owner's Name (Fee Siniple Phone # Owner's Address / V 2� 19 V City State Zip Tenant/Lessee Name Phone # Email Job Address (where the work is being done) S't�cJ 6 City Miami Shores Villaee County Miami -Dade Zip FOLIO / PARCEL Is Building Historically Designated YES NO r/ Flood Zone Contractor's Company Name A14 - PJt , C., Phone #(�� Contractor's Address 12 S? Cie S' ;�;— City �� q2 rit/a State L Zip Qualifier Name ��4Y /�U Phone # 6!3 y 1 1 23 O y State Certificate or Registration No. C /`� a Sy 6 Certificate of Competency No. J Contact Phot( S�/),< 3 �'- Z 3 ©0 E -mail /� 1�O y CU /r7 ' Architect /En ineers Name if applicable) g� ( pp ) Phone # Value of Work For this Permit $ ' °�� CCU Square / Linear Footage Of Work: ©� Type of Work: ❑Addition ❑Alteration []New [J-** /Replace ❑ Demolition Describe Work: Submittal Fee $ Permit Fee $ Notary $ Training /Education Fee $04d Technology Fee $ 2•y Scanning $ Radon $ DPBR $ Bond $ Double Fee $ Violation date: Structural Review. $ Total Fee Now Due $ !'X2 See Reverse side Bonding Company's Name (if applicable) 1,0 Bonding Company's Address City State Zip Mortgage Lender's Name (if applicable) /C_IA Mortgage Lender's Address City State Zip Application is hereby made to obtain a permit to do the work- ; and,.xn$.MY),ations.: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 '' l Signature g g Owner or Agent Contractor The foregoing instrument was acknowledged before me this L f The foreg ing instrument was acknowledged before this day of 2001, by v� �-el/U A day of ! , 20 0 by a who is personally known to me or who has produced who i ersonally know me or who has produced A rlm— ' G� L As identification and who did take an oath. as identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Sign. Sign: Print:. 0 6 •NI II _ My Commiss rr Not y ubiic State of Florida q"ft [ AGALYGONCE My omm. Expires Apr 3, 2013 EXPIRESi May t5 Yi ' MISSION # DD 672293 missMn �► DD 8A282A r�i '` BondedThruNot"P IKES: May 15, 2011 �;r 6o Through National Notary Sn, Notary Pubho underwriters r APPROV D BY Plans Examiner Zoning IV67? Engineer Clerk checked (Revised 07 /10 /07)(Revised 06/10/2009) �: w slow fWE AMISCAPL BUILDING DEPARTMENT BNZM1142 11/03/2009 ADD MISCELLANEOUS APPLICATION PAGE 1 09:13 :44 YALI22 APPLfCATION DATE 11/03/2009 PROCESS NO. X2010011766 OTHER DEBT APPLICATION # OR BLDG DEPT. PERMIT # /ADDRESS: AP941247 CONTACT NAME NATIONWIDE PLUMBING SUB TOTAL $200.00 ADDRESS 1257 W 62 ST CITY HIAL EAH STATE FL ZIP 33012 PHONE COUNTY AGENCY SALES FEE UNIT USER PAID TYPE CODE UNITS DESC FEE DESCRIPTION ID FEE IND DOH H015 1 EACH IRRIGATION WELL YALI22 200.00 PF1 = UPDATE PF9 = MOD MISC APL NEXT SCREEN NEXT KEY MISC APPLICATION CCEPTED...ENTER NEXT KEY