PL-10-721.4
Inspection Number: INSP - 141734 Permit Number: PL -4 -10 -721
Scheduled Inspection Date: May 07, 2010
Inspector: Hernandez, Rafael
Owner: , CAV HOLDINGS, LLC
Job Address: 58 NW 104 Street
Miami Shores, FL 33150-
Project: <NONE>
Contractor: JUPITER FARMS PLUMBING & IRRIGATION INC
Building Department Comments
May 06, 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
Q 00 k ummoo• Phone Number
Parcel Number 1121360131060
Phone: (305)662 -7979
RELOCATION OF WATER HEATER FROM OUTSIDE TO
INSIDE REAR STORAGE ROOM
Passed
IT
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Inspector Comments
,te s*/
Page 7 of 11
Protect Address
Miami Shores Village
10050 N.E. 2nd Avenue
Miami Shores, FL 33138-0000
Phone: (305)795 -2204
Parcel Number
58 NW 104 Street
Miami Shores, FL 33150-
1121360131060
Block: Lot:
CAV HOLDINGS, LLC
Owner Information
Address
Contractor(s) Phone
JUPITER FARMS PLUMBING & IRRIGI (305)662 -7979
Cell Phone
Fees Due
CCF
Education Surcharge
Permit Fee - Additions/Alterations
Scanning Fee
Technology Fee
Total:
Amount
$0.60
$0.20
$150.00
$3.00
$0.80
$154.60
Authorized Signature: Owner / Applicant / Contractor / Agent
Building Department Copy
Type of Work: PLUMBING
Type of Piping: WATER HEATER RELOCATION
Additional Info:
Bond Retum :
Classification: Residential
May 05, 2010
Expiration: 11/01/2010
Phone
Pay Date Pay Type
Invoice # PL -4-10 -37699
05/05/2010 Credit Card
Amt Paid Amt Due
$ 154.60 $ 0.00
Applicant
Cell
Valuation:
Total Sq Feet:
$ 1,000.00
0
Available Inspections:
Inspection Type:
Top Out
Re Pipe
Main Drain
Heater
Water Service
Final
Water Main
Lavatory
Underground
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.
May 05, 2010
Date
1
BUILDING
PERMIT APPLICATION
FBC 20
Permit Type: PLUMBING em at
Owner's Name (Fee Simple T'tleholder)
Owner's Address � � O ✓ 1ZA=
Architect/Engineer's Name (if applicable)
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
City 4 / U 44'
1, State R Zip 33) 3
Tenant/Lessee Name ) Phone #
Email c v L I ` /J / ` U
Job Address (where the work is being done / v ! -6
City Miami Shores Villa e
FOLIO / PARCEL #
Is Building Historically Designated YESJ NO Flood Zone
Contractor's Company Name cJ V� l thS P t4�d& Phone # Cr& /' . 1"e -33 6
Contractor's Addre 1 cite'--, l-01 vim.
City State Zip r� ` C�
Qualifier Name . �. to i�I. ld 4 i-e" Phone # "772 - 26 3
State Certificate or Registration No. (re- l Lj Z ( S Z Certificate of Competency No.
Contact Phone ) " 7 2- 2' .3 - 3 lo 3 E -mail J Gel sots vie
LLe�
County Miami -Dade
Master Permit No.
Phone # ZZ 4
Phone #
rim � + 1, ` 9
^ u1 Lr� C�T� fi1
APR, 2 7 2010 l
BY:.._o.__- ---- ...
Permit No. f i 10
Zip
Value of Work For this Permit $ Q �O "�, Square / Linear Footage Of Work:
Type of Work: ['Addition ► i Alteration [New ❑ Repair/Replace ❑ Demolition
De,c Work:
- &iit /44.4I/14 14L6 me , •
* * * ** * * * * * * * * * * * * * * * * * * * * ** * *** ** * * * ** F * * * * * * * * **** * * * * * * * * * * * * * * * * * **
Submittal Fee $ Permit Fee $ /00 CCF $
Notary $ Training/Education Fee $ GAO Technology Fee $ 0 'KD
Scanning $ V` �l , Radon $ DPBR $ Bond $
CO /CC $
Double Fee $ Violation date: r
Structural Review. $ Total Fee Now Due $ 1 L 4 COO
See Reverse side ->
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) clays after the building permit is iss . In .t the abse c of such posted notice, the
inspection will not bprp" ed and a rnspec 'on fee will be charged
Signature
The for
day of
Sign:
Print:
goin instrument was a
, 20 10 by
My Commission Expires:
Owner or Agent
who is personally known to me or who has produced
As identification and who did take an oath.
NOTARY P : LIC:
* * * ********** * * * * ** **** * * ** % ********************************************* ** ******** ** * ** ****** * **** *****
APPROVED BY Z ' if # • Plans Examiner Zoning
(Revised 07 /10 /07)(Revised 06/10/2009)
nn°� Contractor
wledge s0� I The fore oing instrument was acknowledged before me this —
1 tX�C 0 , day o f 1 ( , 20 ID, by �� c a. V / 1'fr'
who is personally known to me or who has produced
as identification and who did take an oath.
NOTARY PUBLIC:
,
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4111 ;aaa s ��7e 11'1V�O�ry
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Sign:
tv ti'lARY PUBLIE A
Signature
•
qu ug4 AMO 'Commission #DD6 5 Expires:
Expires: MAY ! 2011
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Engineer Clerk checked