PL-07-1967MOMEIMI
SEP 192007
BY:
BUILDING
PERMIT APPLICATION
FBC 2004
Permit Type: Plumbing
Owner's Name (Fee Simple Titlehdlder)
Owner's Address
Tenant/Lessee Name
E -MAIL:
Job Address (where the work is being done)
City Miami Shores Village
FOLIO / PARCEL #
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
Is Building Historically Designated YES NO 71
Permit No. R-
Master Permit No.
O l•binie #
City State Zip
Phone #
County Miami -Dade Zip
a
Contractor's Company Name .�/ "l � b / N (b (7 11 '
Contractor's Address a7 C) C7 A/ IA" 1'24 5 f •
City ,(/ State '` Zip . 3 —7- 7r‘ rr
Qualifier Name a 7 5 , ' �� t.----5 Phone # s
L
State Certificate or Registration N Certificate of Competency No.
E -MAIL: — 0 i — 5 "2- 'p �--
Architect/Engineer's Name (if applicable)
Type of Work: ['Addition ['Alteration
Describe Work: ?1��
��
Notary $ 5,00 Training /Education Fee $ l.✓'
Scanning $ Radon $
Bond $ Code Enforcement $ Double Fee $
Submittal Fee $ Permit Fee $
['
DPBR $
Phone #
Phone #
Value of Work For this Permit $ r.20 Square / Linear Footage Of Work:
Repair /Replace ❑ Demolition
•-1
******* ** * * * * * ** * * * * * * * ** * ** ** * ** * * *** *F *, *x, ******* ,*** * * * ** ** ** * * **** *** * * **** ***
CCF $ 0 •"-�L/ G CO /CC
Technology Fee $. 4 , 50
Zoning $
Structural Review. $ Total Fee Now Due $ 1 4 13 .EC
See Reverse side -
Bonding Company's Name (if applicable)
Bonding Company's Address
City State
Signature
Owner or Agent
Sign:
Print:
My Commission Expires:
APPLICATION APPROVED B
(Revised 02/08/06)
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: [ 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
Contractor
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me his a
day of 20 by �/
y day of y( , 20 01 , by G 57c�s IftoTo 5
who is personally known to me or who has produced who is personally known to me or who has produced ft 'ivi lc
As identification and who did take an oath. as identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
Sign:
Print:
My Commission Exp
* ** ** * ** * ** * * * *** ** * * * * ** ** * * * ** ** ** 3. ********* * * * * * **** * * * ** *** * * * ** * * * * *****
Of J
/
� �
Plans Examiner
Engineer
Zoning
I
Scheduled Inspection Date: August 27, 2010
Inspector: Hernandez, Rafael
Owner: GORDON, JACK
Job Address: 863 NE 92 Street
Project: <NONE>
Building Department Comments
August 26, 2010
Miami Shores, FL 33138-
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP -62154 Permit Number: PL -9 -07 -1967
Contractor: ALADDIN PLUMBING & CONSTRUCTION CORP
PLUMBING WORK FOR BATHROOM
Passed
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Inspector Comments
(d/ er/77A
For Inspections please call: (305)762 -4949 ti
Permit Type: Plumbing - Residential
Inspection Type: Final
Work Classification: Addition /Alteration
Phone Number
Parcel Number 1132060050040
Page 14 of 14
Inspection Number: INSP -62154 Permit Number: PL -9 -07 -1967
Scheduled Inspection Date: August 27, 2010
Inspector: Hernandez, Rafael
Owner: GORDON, JACK
Job Address: 863 NE 92 Street
Project: <NONE>
Miami Shores, FL 33138-
Contractor: ALADDIN PLUMBING & CONSTRUCTION CORP
Building Department Comments
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Phone Number
Permit Type: Plumbing - Residential
Inspection Type: Final
Work Classification: Addition /Alteration
Parcel Number 1132060050040
PLUMBING WORK FOR BATHROOM
Passed
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Inspector Comments
9'
August 26, 2010
For Inspections please call: (305)762 -4949
Page 14 of 14