PL-10-1445Scheduled Inspection Date: September 20, 2010
Inspector: Hernandez, Rafael
Owner: KRIVAK, BRIAN
Job Address: 102 NE 102 Street
Miami Shores, FL 33138-
Project: <NONE>
Contractor: GOBIE PLUMBING INC
Building Department Comments
September 17, 2010
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP- 149978 Permit Number: PL -8 -10 -1445
For Inspections please call: (305)762 -4949
Permit Type: Plumbing - Residential
Inspection Type: Final
Work Classification: Addition /Alteration
Phone Number (917)533 -4477
Parcel Number 1132060131900
Phone: (305)235 -3523
PLUMBING REPIPE
Passed
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Inspector Comments
Page 9 of 26
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
BUILDING Permit No.
PERMIT APPLICATION Master Permit No.
FBC 20
Permit Type: PLUMBING
OWNER: Name (Fee Simple Titleholder): or V Cl Phone#'
Address: 1 O ruE straa =+
Cit (th i G M ,Sh at G S state:
Floc r' Ql - Zip: 33
Tenants Name: ' I
Email: Kri 1�Gi I<G7t.r.S ;9 els ®g✓y-tQ: t . Go/✓'1
JOB ADDRESS: Jam ry 10.• Sr
County:
CONTRACTOR: Company Name:
Phone#: R I -.33 -y ?77
City: Miami Shores
Folio/Parcel#:
Is the Building Historically Designated: Yes
Value of Work for this Permit: $ 4300 r 00
Type of Work: Address OAlteration
Description of Work:
NO
u
Address: 75--a t U � .5w i37
City: Pa I m t' r � - 16a'1 State: lc 1-.. Z '
Qualifier Name t t. .) t - t r
c�
State Certification or Registration #: d-O� 333 Certificate of Competency #:
Contact Phone#: Email Address: / �� LA
DESIGNER: Architect/Engineer: Phone#:
lu t�s- �o9pe
Miami Dade
Flood Zone:
PL'8 -lilt
Zip: 331 3 f
Monet ? a3s
ip: 331 s t L�
Phone: OS- if 9 P " .4 7 /
Square/Linear Footage of Work:
ONew depair/Replace GlDemolition
*** * ****** * * * ** a***** *** *4 nrmaas**** **F e*stw**** ****se +Raw*w **eeas®a *******aoM+*
Submittal Fee $ 5 O u Permit Fee $ ,2/4 c " .
P�tD Radon Fee $
Sunning Fee $ .
Notary $ Training/Education Fee $
Double Fee $ Structural Review $
CCF $ CO /CC $
DBPR $ Bond $
Technology Fee $
TOTAL FEE NOW DUE $
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, BEATERS, TANKS and AIR CONI)mONERS, 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 $2.500, 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.
Signatu%e
Owner or Agent `J�
instrument was acknowledged before me this Iv
by 1 'VQt
e or who has produced
cation and who did take an oath.
Si
The fo
day
who is
NOT
Contractor
befo
My Commi
`•'• AU ••
*********************************** 11� ******lpgAtN**** **r
Structural Review Clerk
(Revised 07n0N7)(Revised 06/10J2009)(Revised 3/15!09)
r