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PL-09-1621BUILDING PERMIT APPLICATI FBC 20 Permit Type: PLUMBING Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 INSPECTION'S PHON BER: (305) 762.4949 Owner's Name (Fee Simple Titleholder) 7!. -art ,SGn / one # Owner's ddress /Z( , V / 73 / 5/ City % � A r ' Of e5 State L Zip 33/3 Tenant/Lessee Name Phone # Email Architect/Engineer's Nanie (if applicable) Phone # Permit No.ctj ID bat Master Permit NoQ.0 —1 0 (AS Job Address (where the work is being done) /2-60 4 £ f3, City Miami Shores Village County Miami -Dade Zip 3Z/ 3, FOLIO / PARCEL # Is Building Historically Designated YES, NO 1 Flood Zone Contractor's Company Name ( e y ('a 9/.1,4. 1,4. rt ./. Phone # 7 "47/' 5'95 Contractor's Address /t/ff go ,4,4' U cit f/ i L" f 4 state Pe-- Zip 3 1/a 3 Qualifier Name )4944- 4-C Yilh Phone # 7 8dv - 4( -L State Certificate or Registration No. tee- j t . 6 4 (O Certificate of Competency No. Contact Phone AI■,wr - - W 8 I , - 50- 69 i.4 E -mail 4 L /` 6 t ' 49 © * 4 DD. 4 Vii► Value of Work For this Permit $ OD ( Square / Linear Footage Of Work: 11 Type of Work: EAddition Alteration / ENe / w ❑ Repair/Replace Describe Work: pte/yl4 /,M /NI I / y 6 'A6$ I Dill 1 �l <� //W /AY, fho,vo.e) (10 1 p i`//I)/' ******* * * *** * * * * ** * * * *** *** * * * * * * * * *** *Fe * ************************************** Submittal Fee $ Permit Fee $ / ( CCF $ l• 0-0 CO /CC $ Notary $ Training'/Education Fee $ 0 Technology Fee $ 1 • tQ ( J Scanning $ 3.60 Radon $ =: DPBR $ Bond $ Double Fee $ Violation date: Structural Review. $ Total Fee Now Due $ See Reverse side --> Demolition 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 m Zip Application is hereby made to obtain a pe o do the work and installations as_indiiated. 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) A after the building permit is issued. In the absence of such posted notice, the inspection will not be a''roved and a r- 'nspe`, , ee will be charged. 0 trument was ac , 20Caby lly known to me or who has produced Q identification and who did take an oath. NOT Y PUBLIC: Signature The fore day of who is Sign: Print: My Commission Expires: * * * * * * * * * * * *t * * * ** APPROVE (Revised 07 /10 /07)(Revised 06/10/2009) 1 X1 p�1 IV Wit Plans Examiner Engineer Signature Sign: Print: ontractor The foregoing instrument was acknowledged before me this Zc� of .�f �h^�3G by AZ A, l 4_014 — o is personally known to me or who has produced P . FALd ® ��0 t �7 ®s identification and who did take an oath. 14 NOTARY PUBLIC: My Commission E LIC -STATE OF FLORIDA Milena Paparnni I Commission #DD685086 D685086 Expires: JUNE 13, 2011 pip U ATLANTIC BONDING CO., INC. Zoning Clerk checked Inspection Number: INSP- 142291 Permit Number: PL -10 -09 -1621 Scheduled Inspection Date: May 26, 2010 Inspector: Hernandez, Rafael Owner: HERNANDEZ, FRANCISCO Job Address: 126 NE 93 Street Miami Shores, FL 33138- Project: <NONE> Contractor: LEYVA PLUMBING SERVICES INC. Building Department Comments Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 ( <C- 10 ©9 CL Permit Type: Plumbing - Residential Inspection Type: Final Work Classification: New Phone Number (786)282 -9014 Parcel Number 1132060133130 Phone: 786- 316 -0631 Remodeling- washing machine, bath,toilet, shower, sink. Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments CREATED AS REINSPECTION FOR INSP- 126019. May 25, 2010 For Inspections please call: (305)762 - 4949 Page 5of21