PL-10-14991
Scheduled Inspection Date: September 10, 2010
Inspector: Hernandez, Rafael
Owner: STOCKS, THOMAS
Job Address: 26 NW 108 Street
Miami Shores, FL 33168 -4311
Project: <NONE>
Contractor: DOUGLAS ORR PLUMBING INC
Building Department Comments
September 09, 2010
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Phone Number
Inspection Number: INSP- 150265 Permit Number: PL -8 -10 -1499
For Inspections please call: (305)762 -4949
(0
Permit Type: Plumbing - Residential
Inspection Type: Final
Work Classification: Gas
Parcel Number 1121360110110
Phone: 305/887 -1687
INSPECT GAS FLUE AND MAKE ANY NECESSARY
REPAIRS TO BRING TO CODE
Passed
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Inspector Comments
Page 11 of 14
91 I 1"F 3 i ,, Miami Shores V 1 , llage
I lsft .,
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
I3UILDING
ERMIT APPLICATION
BC 20
Permit Type: PLUMBING
Owner's Name (Fee Simple Titleholder) THOr nas M • *b G6(s ',I Phone #
Owner's Address Z (O N 1.J In$ Sfi
C ity M11 Q rYl l S(iTOY es State t='L . Zip .ti. 1_(.7,F2 T!
Fenant/Lessee Name Phone #
mail
ob Address (where the work is being done) 2. (p lU KJ 108 .S (—
City Miami Shores Villa e County
FOLIO / PARCEL # ( ( — 213(0 — v` I — O I I 0
$s Building Historically Designated YES I NO X
Contractor's Company Name r)0U5ICIS Dr( ! l ldm,.i , I }1e
Contractor's Address 3O! t 91 br ; V $.
City M j & not S�"! S J State FL
Qualifier Name vv al h -L. AA. Orr
!tate Certificate or Registration No. C F t✓ OS 2. (4)( 04
Contact Phone 30S - sai - 1( l
Miami-Dade Zip 3 (08
Zip. I (Q(p
Phone # , ,Q 5 - $ $1 -1(p g 1
Certificate of Competency No
-mail 1\-4O..r I G l Orr iv( tu 1 r150 . c tyn
Architect/Engineer's Name (if applicable) 1.11 Phone #
Square / Linear Footage Of Work:
Type of Work: ['Addition EAlteration ['New ❑ Repair/Replace ❑ Demolition
[ 2C+ -
:scribe Work: .S � U e.
r•ep a i r s
Value of Work For this Permit $ j p( . 00
Submittal Fee $
N otary $
S canning $
Double Fee $
******** * * * * * * * * * * * * * * * * * * * * * * * * * * *,* ** F * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
CCF $ CO /CC $
Radon $
Permit Fee $
Training/Education yee $
DPBR $
Permit No. PI 10 14 1
Master Permit No. R F 900 / 3 WV
PPhone #
Violation date:
Structural Review. $ Total Fee Now Due $ 54
30S- 1sq - slgN
Flood Zone
3c-A-E3R`7 - dk91
Technology Fee $
Bond $
AUG jpaRRVEIM
z 0 2010 gij
BY:
See Reverse side -+
Bonding Company's Name 'Of applicable) hl IA-
Bonding Company's Address
City State Zip
Mortgage Lender's Name (if applicable) NI IFS
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 fee will be charged.
Signature ,
Owner or Agent
The foregoing instrument was acknowledged before me this 1 %
day of /41)(v , by ° r4oty s /`(_ .roc ,c5
F AL
who is personally known to me or who has produced
As identification and who did take an oath.
NOTARY PUBLIC:
os
: My Commission Expires Feb 26, 2012
r��soc Commission # DD 730824
eS`?�a °� + ;g ° p • �� Bonded Though National Notary Assn.
Sign: --1-1 / ( 7'�.-
Print: ., ` -
My Commission Ex
,c0
is
(Revised 07 /10 /07)(Revised 06/10/2009)
MARIA V. LLANES
Engineer
Signature
Contractor
The foregoing ii trument was acknowledged before me this i
day of , 2011 =, by ( wa rt. O /2 ,
w ho is personally known to e r who has produced
as identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
My Commis
4. ..�
MARIA V. LLANES
, � Commission # DD 730824
• n •Pi - : Bonded Through National Notary Assn.
****** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** * * ** ********************************* * * * * * * * * * * * * * * * * * * * * * * * * * * * ** **
APPROVED BY 2 Plans Examiner Zoning
Clerk checked