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PL-10-914Project Address 500 NE 92 Street Miami Shores, FL 1132060141200 Block: Lot: CATULO PALAU 1 Owner Information Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Fees Due CCF Education Surcharge Permit Fee - Additions/Alterations Scanning Fee Technology Fee Total: Amount $1.80 $0.60 $150.00 $3.00 $2.40 $157.80 Building Department Copy Address Parcel Number Contractor(s) Phone Cell Phone THE NEW MIAMI SHORES PLUMBING (305)751 -2446 (786)553 -5424 Authorized Signature: Owner / Applicant / Contractor / Agent Phone Type of Work: WATER REPIPE Type of Piping: REPIPE Additional Info: Bond Retum : Classification: Residential Pay Date Pay Type Invoice # PL -5-10 -37965 06/01/2010 Check #: 5036 05/25/2010 Check #: 4998 Amt Paid Amt Due $ 107.80 $ 50.00 $ 50.00 $ 0.00 Applicant June 01, 2010 Date Expiration: 11/29/2010 Cell CARMEN PALAU 500 NE 92 ST MIAMI SHORES FL 33138 -3157 Valuation: Total Sq Feet: $ 2,200.00 0 Available Inspections: Inspection Type: Final 1 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 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. Futhermore, I authorize the above -named contractor to do the work stated. June 01, 2010 1 Inspection Number: INSP - 144103 Scheduled Inspection Date: June 02, 2010 Inspector: Hernandez, Rafael Owner: PALAU, CARMEN Job Address: 500 NE 92 Street Project: <NONE> Contractor: THE NEW MIAMI SHORES PLUMBING Building Department Comments June 01, 2010 Miami Shores, FL Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 For Inspections please call: (305)762 -4949 Permit Number: PL -5 -10 -914 Permit Type: Plumbing - Residential Inspection Type: Final Work Classification: Repair Phone Number Parcel Number 1132060141200 Phone: (305)751 -2446 Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments /04/ Page 11 of 18 BUILDING PERMIT APPLICATION FBC 2004 Permit Type: Plumbing {� 1 Owner's Name (Fee Simple Titleholder) Ca \ O 1'G1 `a V Phone # ( ) 15 9 - - 1(f)2.4 Owner's Address Soo N q z co k �. City Mtam I Shores state 1 k zip 33138 Tenant/Lessee Name Phone # E -MAIL: Job Address (where the work is being done) Soo N E Az_ '3T City Miami Shores Village County Miami -Dade Zip 33138. FOLIO / PARCEL # 1 32 b(o - 014 - 120C) Is Building Historically Designated YES NO Contractor's Company NamelVie I e W 14 k %Urn 1 s kro re3 P (o t # 005-75 (44 6 Contractor's Address q00 NU) 144 ST City M [c m I state F Qualifier Name Q n n `S G LA V \ t o n Phone # State Certificate or Registration No. CSC q zQ S Certificate of Competency No. E- MAIL: Type of Work: DAddition DAl ion DNew Describe Work: U) c& ( P� Miami Shores Village TO II d IE Building Department /0050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 BY Master Permit No. Perini No. [ 0 - c11 4 Zip 331 c0 8 Architect/Engineer's Name (if applicable) Phone # Value of Work For this Permit $ 9 o2 00.00 Square/ Linear Footage Of Work: Repair/Replace 0 Demolition Submittal Fee $ Ci Permit Fee $ A5 — CCF $ I Ar CO /CC al Notary $ T' raining/Education Fee $ 0 • (Q C7 Technology Fee $ 2 . lb Scanning $ 3_ o 0 Radon $ DPBR $ Zoning $ Bond $ Code Enforcement $ Double Fee $ Structural Review. $ Total Fee Now Due $ t 0 -1 -O See Reverse side -+ 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 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 if/AO Owner or Agent The foregoing instrument was acknowledged before me this ZS day of h 0 , 20 %0 , by C.c g i' l (`' Pc1 I ci ti , who is oersonall y know to me or who has produced As identification and who did take an oath. NOTARY PUBLIC: Sign: Print: My Commission APPLICATION APPROVED BY: (Revised 02108106) Signature Contractor The foregoing instrument was acknowledged before me this Z d a y of - L 2010 , by �Q vt vl I S )) cLt t uut 0 c t` who is personally known to me or who has produced as identification and who did take an oath. My Commission Expires: 03- I C. -12 ** ** ** ** *****,r, * ** **** ***** ter****, , **** * ,t **** *** * *a*,urn**** tit** **** * * ****,s**,u* era *** * ** * *ar,t Plans Examiner / Engineer Zoning ITEM UNIT FEE ITEM UNIT FEE ITEM UNIT FEE BATH TUB SWITCH OUTLETS SPACE HEATERS DISHWASHER LIGHT OUTLETS CENTRAL HEATING DISPOSAL RECEPTACLES NC (WIND) FLOOR DRAIN SERVICE TEMPORARY A/C (CENTRAL) GREASE TRAP SERVICE SIZE IN AMPS DUCT WORK INTERCEPTOR SERVICE REPAIR/METER CHANGE. REFRIGERATION LAVATORY APPLIANCE OUTLETS PROCESS AND PRESS PIPING LAUNDRY TRAY RANGE TOP UNDERGROUND TANKS CLOTHES WASHER OVEN ABOVE GROUND TANKS SHOWER WATER HEATER U.F. PRESSURE VESSELS SINK. POT /3 COMP. MOTORS 0-1 HP STEAM BOILERS SINK, RESIDENCE. MOTORS OVER 1 -3 HP HOT WATER BOILERS SINK, SLOP. MOTORS OVER 3-5 HP MECHANICAL VENTILATION TEMPORARY WATER CLOSET MOTORS OVER 5-8 HP TRANSPORTING ASSEMBLIES URINAL MOTORS OVER 8-10 HP ELEVATORS/ESCALATORS WATER CLOSET MOTORS OVER 10-25 HP FIRE SPRINKLER SYSTEMS INDIRECT WASTES MOTORS OVER 25-100 HP COOLING TOWERS WATER SUPPLY TO: ge ? le. S MOTORS OVER 100 HP VIOLATION A/C UNIT A/C WINDOW REINSPECTION FIRE SPRINKLER AIR CONDITIONERS HEATER -NEW INST. STRIP HEATER HEATER- REPLACE GENERATORS TRANSFORMERS LAWN SPRINKLER -WELL GENERATORS TRANSFORMERS SWIMMING POOL GENERATORS TRANSFORMERS WATER SERVICE SPECIAL PURPOSE SEWER CONNECTIONS OUTLETS COMMERCIAL UTILITY -SEWER SIGN TUBES UTILITY WATER SIGN TRANSFORMERS SEPTIC TANK SIGN TIME CLOCK RELAY FIXTURES FAINFIELD, 4" TILE/RES. ANTENNA PUMP & ABANDON SEPTIC TANK TELEVISION OUTLETS SOAKAGE PIT CU. FT. VIOLATION CATCH BASIN , REINSPECTION DISCHARGE WELL DOMESTIC WELL AREA DRAIN ROOF INLET SOLAR WATER HEATER FIRE STANDPIPE , POOL PIPING LAWN SPRINKLER SYSTEM GAS RANGE METER SET (GAS) GAS PIPING PLUMBING ADDENDUM TO BUILDING PERMIT APPLICATION AN APPLICATION FOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. IF A MASTER PERMIT HAS BEEN OBTAINED. THE OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS. PLEASE CIRCLE 0 DISCIPLINE APPLIED FOR: ELECTRICAL PERMIT # MECHANICAL