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PL-10-1998REPAIR SEWER LINE Passed Inspector Comments - Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled re- inspection fee is paid. until nspection Number: INSP- 153235 Permit Number: PL -11 -10 -1998 Inspection Date: November 17, 2010 Inspector: Hernandez, Rafael Owner: REMONVIL, PHILOMENE Job Address: 142 NW 94 Street Project: <NONE> Miami Shores, FL Contractor: THE NEW MIAMI SHORES PLUMBING Building Department Comments November 17, 2010 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 Type: Plumbing - Residential Inspection Type: Final Work Classification: Addition /Alteration Phone Number Parcel Number 1131010330770 Phone: (305)751 -2446 Page 1 of 1 BUILDING PERMIT APPLICATION FBC 20 Permit Type: PLUMBING i l 1� OWNER: Name (Fee Simple Titleholder): v 1 C tC ev/1tnU i\ - w Address: kV- 3101- 033-0'770 / 142 N UO cl City: 1' \o rrl I 5 v\O re S State: F Phone#: Email: JOB ADDRESS: 14 2 N \iv cl 4 3+ Tenant/Lessee Name: City: Miami Shores Folio/Parcel #: 11— 3 101— 03? — 0'7'70 Is the Building Historically Designated: Yes NO Flood Zone: CONTRACTOR: Company Name:The N ew tUhh) SklOVeS . Address: q00 Wco X44 S� M \Arr11 State: F I City: Qualifier Name: 042 r 1 IS 1' I la U State Certification or Registration #: CF C 0 Contact Phone #: 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 County: Miami Dade Zip: 3 S. Phone #: Certificate of Competency #: MS? ovn-alrn ©a01 .CO r'1 DESIGNER: Architect/Engineer: Phone #: Tot 205 Email Address: Type of Work: ❑Address ❑Alteration UNew Description of Work: 1v_. $ J r ✓l!� Submittal Fee Permit Fee $ / 6 Scanning Fee $ Radon Fee $ Notary $ Training/Education Fee $ Double Fee $ Structural Review $ Pit TOTAL FEE NOW DUE $ Permit No. ?LAO — t C1 t3 Master Permit No. 1 I o inert- e_24: �J Phone #: t ®� CN 4 s+ Zip: 39 IS 0 Zip: ( ( : ) Phone #: 305 751 2 9 4 6. Value of Work for this Permit: $ 2 1 CO Square/Linear Footage of Work: Repair/Replace ❑Demolition sksk&** sksk sksk* aksksk agx sksksk ':s$.:<t >:sxsksksksksksk*>k* ask: d*** F skaesk> ksaaa****. kv,.:> kx>; e>: sk> a****xx;:'•> ;:::^•:g:}:v::Y -x;::a****xa$3e. * CCF $ CO /CC $ DBPR $ Bond $ Technology Fee $ 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 trust 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. Print: Owner or Agent Contractor The foregoing instrument was acknowledged before me this / l The fore oing instrument was acknowledged before me this IC -It,. day ofMuet+ 420 by F11 -e Ffrlt , day of ak f ,2010 °,by)Qfn 1` 1 who is personally known to me or who has produced who is p rsonally known to me or who has produced As identification and who did take an oath. as identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Sign: My Commi $n pfrM iY COMMISSION # DD753565 EXPIRES March 16, 2012 (407)390 -ft 53 Floridallotsorv'r9,ico.com ,h**** *xd.::It*:k*>ks' ** * ***** kak*xsa,c 9cxa:.exa::<:eYSxx9:gc: APPROVED BY Structural Review (Revised 07 /10 /07)(Revised 06 /10 /2009)(Revised 3/15/09) 1 .-40'1 Plans Examiner Signature Sign: rw.) cN 7 C g-1(. -e (2-1 Print: re/ rip �., CARMEN A. RNERA My Comm go �;' p, res: MY COMMISSION # DD753565 �,. EXPIRES March 16, 2012 (407) 398 -0153 FlorldallotaryServicg.com sga ****** N�9+ �k>�2aN=:kXssgye:�** **x$>gxxok> *** %•q. -- -, .4 ...x.. ` - 'seoh Zoning Clerk