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PL-08-1784Project Address 1287 NE 100 Street Miami Shores, FL 33138- Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138-0000 Phone: (305)795 -2204 Expiration: 04/06/2009 Parcel Number 1132050080070 Block: Lot: Applicant Owner Information Address Contractor(s) Phone Cell Phone WOLFE & BOBOS PLUMBING (954)981 -1496 Fees Due CCF Education Surcharge Permit Fee - Additions/Alterations Scanning Fee Technology Fee Total: Amount $0.60 $0.20 $180.00 $3.00 $4.50 $188.30 Authorized Signature: Owner / Applicant / Contractor / Agent Building Department Copy Phone Type of Work: PLUMBING Type of Piping: GAS LINE Additional Info: Bond Retum : Classification: Residential ELAINE GOLL ELAINE GOLL 1287 NE 100 ST MIAMI SHORES 38 FL 33138 -2603 Valuation: Total Sq Feet: $ 100.00 1000 Available Inspections : Cell Inspection Type: ROW Final Press Test 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. October 08, 2008 Date Wednesday, October 8, 2008 1 BUILDING PERMIT APPLICATION FBC 2004 Permit Type: Plumbing Owner's Name (Fee Simple Titleholder) Owner's Address la 3"/ City iniaid.jigge"____ Tenant/Lessee Name E-MAIL: City Miami Shores Village FOLIO / PARCEL # Is Building Historically Designated YES Contractor's Address City State Qualifier Name L L. C r State Certificate or Registration No. C 0 L td. Lig E-MAIL: Architect/Engineer's Name (if applicable) Value of Work For this Permit $ Type of Work: Describe Work: DAddition State Notary $ Training/Education Fee $ Scanning $ Radon $ Miami Shores Village Building Department /0050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 FLoc`v-e_ aot( )r50 6t Pa. Job Address (where the work is being done) lag A) E. t 00 Contractor's Company Name 43o fe_. -86tos P6%6 13 DAlteration ct, 1.J v1/402.— County Miami-Dade NO *************************************** ees ******************************************** Submittal Fee $ Permit Fee $ CCF $ CO/CC DPBR $ Bond $ Code Enforcement $ Structural Revicw. zip 3 3) 3r Phone # Certificate of Competency No. Square / Linear Footage Of Work: ONew EI'pair/Replace Double Fee $ Permit No.V1 - )16 4- Master Permit No. Phone # Zip Phone # Phone # Total F Po Now one zip 3 31 3r Phone # 9 91 q 33330 ?sly -4 1P1 - 101- D Demolition tboiCgsz— Technology Fee $ Zoning $ IMCIEVELTI I OCT 0.6 2008 BY: 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 fe vj4l be charged Signature day of 047 , 20 p8', by iriatlf Gn Ly who is personally known to me or who has produced Ai L t L As identification and who did take an oath. �.� .. .. ... .p s.. o�Y Pia, JOSEPH LEBLANC 140 �� Notary Public - State of Florida • _ P ly Commission Expires Feb 19. 2010 •�: Commission # D0495514 Bonded By National Notary Assn. NOTARY PUBLIC: (Revised 02/08/06) Owner or Agent Sign: Print: ,.‘" rAig AV My Commission Expires: * * * * * * * * * * * * * * * * * * * * ** * / * / APPLICATION APPROVED �•.�.► - .. — — — • Pri Signature cis i.t,C 16 ry.t'ir,� Contractor The foregoing instrument was acknowledged before me this 140 The foregoing instrument was acknowledged before me this_340 day of G C 7 , 20 or by 4A'S /10 v41A4 who i NOTARY PUB Sign: me or who has produced as i ' did takean�at�1 ;;r� p,,,�� JOSEPH LEBLANC � 4p • : Notary Pubs - State of Florida • Uty Commission Expires Feb 19, 2010 Commission # DD495514 sled By National NotaryAssn. t>� p o 4e39 9' , As'esv /O My- Commission Expires: q/ q o, O *.*******,****** *****_ ***.�,�,�** ***. * ****** * ** *'a.S�,�.�*** *. ** ** - e7 Plans Examiner Engineer Zoning • El4i‘‘h G1o ! a 8 7 N E f iGv ■ 5h.are,5 q. 33)38 IMCIERWMT IR OCT 0 v 248 v BY: I/ Oci M b tze.10� PI i "1,2 5yr 6 $` - #0 S 7 Ceofze C x'14 . 3 333 0 E14N‘vne Giot 5hbre.5 V-10- 33)38 OCT 0 2008 LP BY: ••• •• • • •• • •••• • • Miami Shores Villa e oolcetzow' P /ow.biA,g Svc_ 67 sPam 4 r -0 a27 GO Pc,, 3 333 © REPLACE OLD GAS LINE Passed ns c r Comments Failed Correction Needed Re- Inspection Fee ($75) No Additional Inspections can be scheduled re- inspection fee is paid . until Inspection Date: 10/10/2008 Inspector: Levrock, James Owner: GOLL, ELAINE Job Address: 1287 100 Street NE Miami Shores, FL 33138- Project: <NONE> Contractor: WOLFE & BOBS PLUMBING Building Department Comments Thursday, October 9, 2008 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 ;hilt 9 13 Block: Permit Type: Plumbing - Residential Inspection Type: Rough Work Classification: Gas Phone Number Parcel Number 1132050080070 Lot: Phone: (954)981 -1496 Page 2 of 2