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RC-08-2179 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Scheduled Inspection Date: February 10, 2009 Permit Type: Residential Construction Inspector: Bruhn, Norman Inspection Type: Final Building Owner: WILLIAMS, MARIE Work Classification: Alteration Job Address: 297 NE 97 Street Miami Shores, FL 33138- Phone Number Parcel Number 113206013429 Project: <NONE> Contractor: OCHA CONTRACTOR INC Phone: (305)592 -9771 Building Department Comments y Inspector Comments Passed � cc Failed Correction Needed Re- Inspection ❑ Fee No Additional Inspections can be scheduled until re- inspection fee is paid. February 09, 2009 Page 3 of 16 Inspection Worksheet I ff Miami Shores Village 10060 N.E. 2nd Avenue Miami Shores, FL R Phone: (305)795-2204 Fax: (306)756-8972 ­-----------­----- -------------------------------------- ..... . ............. ­- - ----------- .............. - ------------- .............. . - - - -------------- ....... ............................................................... ... �W. Inspection Date: January 21, 2009 Permit Type: Residential Construction Inspector: Bruhn, Norman Inspection Type: Drywall Screw Owner: WILLIAMS, MARIE Work Classification: Alteration Job Address: 297 NE 97 Street NE Miami Shores, FL 33138- Phone Number Parcel Number 1132060134290 Project: <NONE> Contractor: OCHA CONTRACTOR INC Phone: (306)692-9771 Building Department Comments tip Inspector Comments Passed Failed Correction Needed Re-inspection ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is paid. January 16, 2009 Page 1 of 1 Inspection Worksheet Miami Shores Village 10060 N.E. 2nd Avenue Miami Shores, FL Phone: (306)796-2204 Fax: (306)756-8972 ------------------------------------- ............................................. ----------- - - - ------------------------------------------------------ - ----------------- .................................................. ............................... WIN Inspection Date: January 21, 2009 Permit Type: Residential Construction Inspector: Bruhn, Norman Inspection Type: Insulation Owner: WILLIAMS, MARIE Work Classification: Alteration Job Address: 297 NE 97 Street NE Miami Shores, FL 33138- Phone Number Parcel Number 1132060134290 Project: <NONE> Contractor: OCHA CONTRACTOR INC Phone: (305)592-9771 B uilding Department Comments Inspector Comments Passed Ar- Failed El Correction Needed Re-inspection ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is paid. January 16, 2009 Page 1 of 1 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 4 G Inspection Date: January 14, 2009 Permit Type: Residential Construction Inspector: Bruhn, Norman Inspection Type: Framing Owner: WILLIAMS, MARIE Work Classification: Alteration Job Address: 297 NE 97 Street NE Miami Shores, FL 33138- Phone Number Parcel Number 113206013429 Project: <NONE> Contractor: OCHA CONTRACTOR INC Phone: (305)592 -9771 BuIlding Department Comments Inspector Comments Passed CREATED AS REINSPECTION FOR INSP- 102491. CC Plumbing topout required. NB Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. January 13, 2009 Page 1 of 1 rte' Inspection Worksheet Miami Shores Village L� 10050 N.E. 2nd Avenue Miami Shores, FL R Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Date: January 12, 2009 Permit Type: Residential Construction Inspector: Bruhn, Norman Inspection Type: Framing Owner: WILLIAMS, MARIE Work Classification: Alteration Job Address: 297 NE 97 Street NE Miami Shores, FL 33138- Phone Number Parcel Number 1132060134290 Project: <NONE> Contractor: OCHA CONTRACTOR INC Phone: (305)592 -9771 Building Department Comments Inspector Comments Passed cc Failed Correction Needed Re- Inspection a Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Thursday, January 8, 2009 Page 1 of 1 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 h max' _ a MA , Inspection Date: February 05 2009 Permit Type: Electrical - Residential Inspector: Devaney, Michael Inspection Type: Final Owner: WILLIAMS, MARIE Work Classification: Addition /Alteration Job Address: 297 NE 97 Street Miami Shores, FL 33138- Phone Number Project: <NONE> Parcel Number 1132060134290 Contractor: INDUSTRIAL ELECTRICAL SYSTEM C ORP Phone: 3061228 -1384 BuIlding Department Comments Inspector Comments Passed E� Failed Correction Needed Re- Inspection ❑ Fee No Additional Inspections can be scheduled until re- inspection fee is paid. February 04, 2009 Page 1 of 1 Inspection Worksheet Miami Shores Village pf! Nlt . 10050 N.E. 2nd Avenue Miami Shores, F R Phone: (305)795 -2204 Fax: (305)756 -8972 Gfr - �� - 1 Inspection Date: February 05, 2009 Permit Type: Plumbing - Residential Inspector: Levrock, James Inspection Type: Final Owner: WILLIAMS, MARIE Work Classification: Addition/Alteration Job Address: 297 NE 97 Street Miami Shores, FL 33138- — Phone Number Project: <NONE> Parcel Number 1132060134290 Contractor: MASTER PLUMBING GROUP INC Building Department Comments ,16spe o Co m is Passed CC R Failed El Correction Needed Re- Inspection ❑ Fee No Additional Inspections can be scheduled until re- inspection fee is paid. February 04, 2009 Page 1 of 1 ..° Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL R Phone: (305)795 -2204 Fax: (305)756 -8972 • Inspection Date: January 07 2009 Permit Type: Plumbing - Residential Inspector: Levrock, James Inspection Type: Underground Rough Owner: WILLIAMS, MARIE Work Classification: Addition /Alteration Job Address: 297 NE 97 Street NE Miami Shores, FL 33138- Phone Number 'Parcel Number 1132060134290 Project: <NONE> Contractor: MASTER PLUMBING GROUP INC Building Department Comments q F G In t C ments Passed c Failed Correction Needed Re- Inspection ❑ Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Tuesday, January 6, 2009 Page 1 of 1 Inspection Worksheet Miami Shores Village L 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 ' s 20 Inspection Date: January 07, 2009 Permit Type: Electrical - Residential Inspector: Devaney, Michael Inspection Type: Underground Rough Owner: WILLIAMS, MARIE Work Classification: Addition/Alteration Job Address: 297 NE 97 Street NE Miami Shores, FL 33138- Phone Number Parcel Number 1132060134290 Project: <NONE> Contractor: INDUSTRIAL ELECTRICAL SYSTEM C ORP Phone: 3051228 -1384 Building Department Comments Inspector Comments Passed EEr cc Failed Correction Needed Re- Inspection ❑ Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Tuesday, January 6, 2009 Page 1 of 1 *` Miami Shores Village �eS�l �l"lt�t7r111„ 10050 N.E. 2nd Avenue q �' ` `' Miami Shores, FL 33138-0000 / Phone: (305)795 -220A nu Expiration: 0612712009 Project Address Parcel Number Applicant 297 NE 97 Street 1132060134290 Miami Shores, FL 33138- Block: Lot: MARIE WILLIAMS Owner Information Address Phone Cell MARIE WILLIAMS 297 97 Street MIAMI SHORES FL 33138- Contractor(s) Phone Cell Phone $ 2,500.00 Valuation: OCHA CONTRACTOR INC (305)592 -9771 (305)986 -5811 Total Sq Feet: 0 Approved: In Review Available Inspections: Comments: Inspection Type Date Approved:: In Review Final PE Certification Date Denied: Shutter Final Type of Construction: BATHROOM REMODEL Occupancy: Wi Door Attachment Stories: Exterior. re Be am Front Setback: Rear Setback: S lab Left Setback: Right Setback: Termit Letter Bedrooms: Bathrooms: Framing Insulation Plans Submitted: Certificate Status: Drywall Screw Certificate Date: Additional Info: Shutter Attachment Bond Return : Classification: Residential Window and Door Buck Gelling Grid Fees Due Amount Total Amt Paid Amt Due Fill Cells Columns CCF $1.80 Education Surcharge $0.60 $ 0.00 $ 0.00 j�-:00: Permit Fee - Additions/Alterations $150.00 Scanning Fee $3.00 Payment Type: Submittal Fee ($50.00) Technology Fee $3.75 Total: $109.15 ? DEC, 29 2008 ILIA b`'1 I H® ES VILLAGE In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL, PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work. OWNERS AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Futhermore, 1 authorize the above-named contractor to do the work stated. December 29, 2008 Authorized Signature: Owner / Applicant / Contractor / Agent Date Building Department Copy Monday, December 29, 2008 1 7 T 7 2 10050 NX20d Avenue, Miami Shot s oric 8 Tel: (305) 795.2204 Fa*. (30} ) ? f� 7 -- ----- -- BUILDING in .. PERMIT "PLIC.ATION FBC 2004 Permit Type (circle):.. Building itj In Owner's Name (Fee Simple Titleholder ... 1 A ""--, Owner's Address "Y'L City &V- U 1 State F , TenanVUssee Job Address (where the work is being done) " 1 f �` City Miami Shorec pillage County IViiaizu -Dgde FOLIO / PARCEL # Is Building Historically. 000$n . YFS . No Contractor's Co an f .. :.. mp Y Name . �'� ����' � _ Flio�ie # :� .�� • �.�� 1 Contractor's Address 1 1 City �!?? State . *' Vai fier Name �� ' ♦/Ifs ' 1'lione # ` Qn 1 "o j Certificate Uf teitC N fl , ArchitectlEngineer's Name (if applicable) Phone # "" VaWe of Work For this Permit $ t ncaur Eooe tf Warr: { T"Af Work; ❑Addit ©n Alteration . New R D Work• VBM eparteglace( Demolition s� ,fit SabLl Fee $- : Permit Fee $ C. Notaq _$ Tiiniag/Cdocation:ie $ Teeiixai og fee$ - $ Radon DPBR $ Z_ontng Bo Code $ Dc►ubl�s. �+`+ee $ Review: $ �-- Total: Fee low Due See "Reverse side E n fsi Bonding Company's Address C State zip Mortgage Lender's Name (if applicable) Mortgage Lender's Address City Statep 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, TANXS 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 alt. 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 erson whose property is subject to attachment Also, a certified copy of the recorded notice of commence nt must be posted at t jo site for the first inspection which occurs seven (7) days after the building permit is issued. to a se smac posted tic the inspection will not be. approved and a reinspection fee will he charg 3 ed yyi Signature Si -� . ry``` Co Owner or Agent ntractor The fore oing iflstriiient'as acl ° wtt;dged bef re me this The foregong tyn5�eigient wluloed befo thi day of lk, 20 M, by t day tzf e °.. x..:•20 b Jq� who is personally known to me or who.has produced who is pe rsanaliy known to me or who has produced - As identification and who did' take an oath. as identification and who did take an oath. NOT gaoa�a NOTARY P ® a .....a.... m ` tltltltltltltletla eaatleraaaaaasanu . .• +� , ® a ►�:' 7 CAM" 0 EXpttas �� Sign: E=km Sign: a Print Print ,r w ® ,Paamoana ®.tli.aaas0aaa8rsoaaa . Q M Commission Ekpires: t►� , . a y„Cotmissr�ou P,FeS� APPLICATION "PROVED BY: Plans Examiner Engineer Zoning (Revised 07 /10/07) h PERMIT #: B co CI.. Miami Shores Villa e j•. � I`�J �° r 1 ^ APPROVED BY DATE �'� a C0 B � ZONlNG DEPT BLDG DEPT' O AV ca SUSJECTTO COMPLIANCE WTH ALL FEDERAL STATE AND COUNTY RULES AND RbitNJ4T14 . . X ! t "2 � a f) y -- �TnmMdV+rf B Q � V 'e a. r ol ROL r 74 1 '7 .......... 4 f , sees y � Miami Shores Village Pty 10050 N.E. 2nd Avenue Miami Shores, FL 3313 8-0000 y Phone: (305)795 -2204 r �`2t3 Expiration: 0612712 Project Address Parcel Number Applicant 297 NE 97 Street 1132060134290 MARIE WILLIAMS Miami Shores, FL 33138- Block: Lot: Owner Information Address Phone cell MARIE WILLIAMS 297 97 Street MIAMI SHORES FL 33138 - Contractor(s) Phone Cell Phone Valuation: $ 150.00 INDUSTRIAL ELECTRICAL SYSTEM C 3051228 -1384 Total Sq Feet: 0 Type of Work: ELECTRICAL Available Inspections: Additional Info: BATHROOM REMODEL Inspection T yp e : Classification: Residential Underground Rough Final Meter Box Alteration Relocation Fire Alarm Service Change W. W. Fees Due Amount Total Amt Paid Amt Due CCF $0 Education Surcharge $0.20 $ 0.00 $ 0.00 $ 0.00 Permit Fee - Additions/Alterations $150.00 Scanning Fee $3.00 Payment Type: Technology Fee $3.75 Total: $157.55 EC 2 9 2908 AA CC W91 M SHORES VILLAGE 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 December 29, 2008 Authorized Signature: Owner / Applicant / Contractor I Agent Date Building Department Copy Monday, December 29, 2008 1 `71� .LmLai 11 anurCS V in age J L-1 11 Building Department' 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 BY - - - - -- --- Tel: (305) 795.2204 Fax: (305) 755.8972 BUILDING IN - 1 1 Permit No.' C PERMIT APPLICATION Master Permit No. — t49 FBC 2004 Permit Type: Electrical Owner's Name (Fee Simple Titleholder) �L _t e, ! L D & Phone # Owner's Address City Q 4e State P TenantlLessee Name Done # E -MAIL: U3 Job Address (where the work is being done) Zq _ — 93 "'-Y1 !S+ City Miami Shores Village County - Miami -Dade _Zip FOLIO / PARCEL # Is Building Historically Designated YES NO Contractor's Company Name �st � 2 Phone # eo,5 t /-3 O Contractor' Address / City[. State L zip Z 3 / 7 A Qualifier Name Phon 2 Z State Certificate or Registratio No 6e 1�CO.)19 z Certificate of Competency No. E- MAIL• QS h'J lll�4.r l Architect/Engincer's Name (if applicable) Phone # o° Value of Work For this Permit $ Square i Linear Footage Of Work: Type of Work: [lAddition ❑Alteration ONew 14 Repair/Replace r Demolition Describe Work: Submittal Fee $ Permit Fee $ tale � CCF $ CO /CC Notary $ Training/Education Fee $ Technology Fee $ Scanning $ Radon $ DPBR $ Zoning $ Bond $ Code Enforcement $ Double Fee $ Structural Review. $ Total Fee Now Due $ See Reverse side —> DEC 2 2008 W A D ORO Bonding Company's Name (if applicable) Bonding Company's Address State Zip City Mortgage Lender's Name (if applicable) Mortgage Lender's Address City Stater 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 acxuiate and that all work will be done in compliance with all applicable laws regulating constriction and zoning. "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR O UR IMPRO OR AN YO UR PR BEFORE RINTE RDING YOUR NOTICE FINAN OF CONSULT WITH 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 Signauff signature Owner or Agent Contractor The foregoing instrument was ac wledgei before me this A The foregoing instrument was admowledged before me this- day f DW'' , 20 � by riff l�l ��i r i day of 2 200 by y who is p who is =g y laiown t o me or who has produced personally known to me or who has produced � As identification and who did take an oath as identification and who did take an oath. NOTARY P LIC: NOTARY PUBL C• a „ .. ..............................w �..•,a'Vol °jp FRANCIS. P. MORALES 1 TA M F�EREZ DO 491732 3 a °4 �"• �' t � ,� 11.17 -200 i`OMM# OD080288 ,.= Sign: a m Sign: ' • ■ Print: p r Print eegtae.nwum.mm� My Commission Expirer /7 My Co>i►'ltElt�"acpires: APPLICATION APPROVED BY/ - 1ans Examiner Engineer Zoning (Revised 02108/06) Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 � Inspection Date: January 13, 2009 Permit Type: Plumbing - Residential Inspector: Levrock, James Inspection Type: Top Out Owner: WILLIAMS, MARIE Work Classification: Addition /Alteration Job Address: 297 NE 97 Street NE Miami Shores, FL 33138- Phone Number Parcel Number 1132060134290 Project: <NONE> Contractor: MASTER PLUMBING GROUP INC Building Department Comments 1 spe to ants Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Monday, January 12, 2009 Page 1 of 1 -- Miami S .> a hores Village e !�•w > d q 1005 0 N.E. 2nd A •. � venue •. a»x i• t V. - ml 1 ' Shores FL 33138-0000 '� '���'�'�'�'�'�:;. ;: -• ::: '� •.� ���. :::=::::::>::> �:::?:::>:::>::::::>:::>:::::::>:::::> �::>:::::':>;:::: :: >�:::«:: >:::::::::: > <.:: >: >:> Miami S i - . r:.::::::..: :. ......::::.:.::.::............. o. Phone: .� . e. 3 OS 795- 2204 Sf 41�` r - p Project Address Parcel Number Applicant . ....... ......... ......... .... ,, ....... 297 NE 97 Street 1132060134290 Miami Shores, FL 33138 Block: Lot: MARIE WILLIAMS .., - gym ✓. w...::::.: .. ..... s✓i�.:':� ..::::.�:.�:.. _ , :.�:y ::... :: : : :..., :v. :. :. : :x :. : :.. ✓. -• --- ..::vy .:::::.�✓✓:: :.. �e.:..:fi SS... Owner Information Address Phone Cell MARIE WILLIAMS 297 97 Street E MIAMI SHORES FL33138- ............•... ✓..•.•.• ..... ✓..•✓,:• •.•.•.•.•.•.•.•.•.•.•.•.•.•.•. ..v. ✓:. .:. ✓ .• :• i:•:{•:{ rv:•:•:•:•:.:.:•:•:.:.:.:.:•:•'•.❖:•:•: 4:.:.:•:•'•: ivw.....•.•.•.••...- nv.•.•.•.•.•..vvvv.•.•.•.v.••.• ....: ................•✓ ........e..:..........•:.....s. ✓..s.::4 Fn!y:•%G:.q {. •...! n........................ �.......,..... x.. �.. A:.: rL.)!.•,.• i;.• r,.:.! d:.• �..•:.> Y. vAi;{ rf,✓, i::•.''•' T >.!hM'nn:k•:•%?..,.,.,.,.:2. }!. i.;.•.•..!. Contractor(s) Phone Cell Phone ...:._ Valuation: $600.00 MASTER PLUMBING GROUP INC ..................................................................................................................................... ............... ................ :Total Sq Feet: 0 Type of Work: PLUMBING Available Inspections: Type of Piping: BATHROOM REMODEL Inspection Type: Additional Info: Top out Bond Return : Re Pipe Classification: Residential Main Drain Underground Rough Heater Water Service Final Water Main Lavatory Fees Due Amount Total Amt Paid Amt Due CCF $0.60 . ....... ........ Education Surcharge $0.20 $ 0.00 $ 0.00 $ 0.00 Permit Fee - Additions/Alterations $180.00 Scanning Fee $3.00 Payment Type: Technology Fee $4 Total: $188.30 V 9 271 C CIAD6 M IAMI SHORS VILLAGE 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. December 29, 2008 Authorized Signature: Owner / Applicant / Contractor / Agent Date Building Department Copy Monday, December 29, 2008 1 e f Miami Shores Village �IE ILI, 1 8 2 2 1 0 6 Building Department BY f0050 N.E.2nd Avenue Miami Shores Florida 33138 --- '- Tel: (305) 795.2204 Fax: (305) 756.8972 BUILDIN Permit No. ~' `44 PERMIT APPLICATION Master Permit No. 1 G FBC 2004 Permit Type Plumbing `l el r 7 � Owner's Name (Fee Simple Tit�le /older) ��� � ��� � Phone # ��y — `7 �� ' � 4 Owner's Ad ess, / City /`�/ )1 j'`A ,,1 l State Zip 3 J 3 g Tenant/Lessee Name Phone # E -MAIL: �� � titGJ a 2 M 6 1, � Job Address (where the work is being done) Z q A � -) 7 d °/ City Miami Shores Village County Miami -Dade Zip FOLIO / PARCEL # Is Building Historically Designated YES NO Contractor's Company Name CiS e A Phone # Gz Contractor's Address 9 0 54 Arl ; cf City C State Zip Qualifier Name a Phone # (?-0b State Certificate or Registration No. 0 Certificate of Competency No. E -MAIL: Architect/Engineer's Name (if applicable) Phone # Value of Work For this Permit $ C " • S ua Linear Footage Of Work: 4 Type of Work: ElAddition ElAlteration QNew Ea ❑ Demolition Describe Work: ����yl�i Submittal Fee $ Permit Fee $ J` CCF $ CO /CC Notary $ Training/Education Fee $ Technology Fee $ Scanning $ Radon $ r DPBR $ Zoning $ Bond $ E Double Fee $ Structural Review. $ Total Fee Now Due $ DEC 2 99 2000 See Reverse side -� ef Jf X M IAMI SHORES ILLAGE Bonding Company's Name (if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name (if applicable) Mortgage Lender's Address City Sta 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. v Signature -/ d �� z �� ✓�� Signature Owner or Agent Contractor 6 A The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this day of 31� , 20 �P , by �)J /litr �r day of � 20d, by who is personally kn�n to me or who has produced who is perso nally know to me or who has produced As identification and who did take an oath. as identification and who did take an oath. m�� vouvuvsuvvvvu vevu + ® 1 e N0TAPV* 0h OVVV °avmaaavvvmovavas�i uuhn, DD080'2683 RITA M PEREZ Explraeif2S1 = DD0802883 Sign: rs 7/28/2092 4 1 . 9 ., nvuvv P�e�tt. Print: vv bu v vsv vvvevvvvv v ®va vev ® ®vvsvv vvsevvsv evvvve My Commissi Expires: My Commission Expires: APPLICATION APPROVED B G , Plans Examiner Engineer Zoning (Revised 02/08/06)