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PL-09-2108500 NE 102 Street Miami Shores, FL 33138- 1132060171070 Block: Lot: JOHN BUTLER 1 Protect Address Owner Information Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Contractor(s) Phone Cell Phone THE NEW MIAMI SHORES PLUMBING (305)751 -2446 (786)553 -5424 Fees Due CCF Education Surcharge Permit Fee 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 Address f I111i I X : APPRO Expiration: 0/110/2011 Parcel Number Phone JOHN BUTLER 500 NE 102 Street MIAMI SHORES FL 33138 -2455 1 Type of Work: NEW GAS LINE Type of Piping: Additional Info: Bond Retum : Classification: Residential Scanning: 1 Pay Date Pay Type Amt Paid Amt Due Invoice # PL -12 -09 -36709 07/14/2010 Credit Card $ 154.60 $ 0.00 Applicant Cell Valuation: Total Sq Feet: $ 800.00 10 1 Available Inspections: Inspection Type: Final Press Test ROW 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. July 14, 2010 Date July 14, 2010 1 Inspection Number: INSP - 132190 Scheduled Inspection Date: July 16, 2010 Inspector: Hernandez, Rafael Owner: BUTLER, JOHN Job Address: 500 NE 102 Street Miami Shores, FL 33138- Project: <NONE> Contractor: THE NEW MIAMI SHORES PLUMBING Building Department Comments July 15, 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 Number: PL -12 -09 -2108 Permit Type: Plumbing - Residential Inspection Type: Final Work Classification: Gas Phone Number Parcel Number 1132060171070 Phone: (305)751 -2446 RUN NEW GAS LINE TO NEW GAS WATER HEATER AND GAS STOVE. Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments Page 3 of 11 Miami Shores Village Building Department BUILDING PERMIT APPLICATION FBC 2004 Value of Work For this Permit $ elft. 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Permit No.R— IC 2 Master Permit No. Permit Type: Plumbing Owner's Name (Fee Simple Titleholder) C-^ `S 11 / 44 00 , rcA1C,t Phone # (o) c 9 I 1 Owner's Address SOO Ni a '. 02 ' City kOW11 Silo res State F, Zip 33138- Tenant/Lessee Name Phone # E -MAIL: Job Address (where the work is being done) 60 C) N E- 1 O S4 ' City Miami Shores Village County Miami -Dade FOLIO / PARCEL # ,1 I 320G2 C)1 - ® 7 0 Is Building Historically Designated YES NO Contractor's Company Name e. t w) 'kcw►1 SrtO12°S PI W►Phone # 3t 5 / 12 � 4 ( 1 i#. Contractor's Address COO I v u_) 144 City \t✓11M 1 State FA Zip 31(0 • Qualifier Name De n n t S c' Lai c t Y\ • Phone # State Certificate or Registration No. CPC01A205 Certificate of Competency No. E -MAIL: Architect/Engineer's Name (if applicable) Phone # Square / Linear Footage Of Work: Zip ho -Pf Type of Work: ❑Addition ❑Alteration ['New ` ❑ Repair /Replace ❑ Demolition Describe Work: Pe\ re . J cctS ` . n 2 - n•ec.0 wcOe( VQ4 r ln6 . gct S S+ Q ****'Y'F'' ** ***x xxxxxx'tx'Y'ti'Y**** xxxx'r x''e'Y***Feeww *xxx xx* xxxxxxrxxxxxxx *x* *****xxrx *xxxxx Submittal Fee $ — Permit Fee $ / CCF $ 0`t0c Notary $ Training/Education Fee $ 0•a,0 Technology Fee $ 0• Scanning $ 5'O Radon $ Bond $ Code Enforcement $ Double Fee $ Structural Review. $ Total Fee Now Due $ 1 _r"r' See Reverse side - DPBR $ CO /CC Zoning $ 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 Zi 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 inspects ill not be a roved and a reinspection fee will be charged. Signatu Sig Print: (Revised 02/08/06) ner or Agent The foregoing instrument was acknowledged before me this ____ zgick- day of I AX C t 20 cwt , by C((S4 X (cAA,ac.irl %c& , who is personally known to me or who has produced As identification and who did take an oath. NOTARY PUBLIC: 1 Y & My Commiss u) X1 1 53: * **** **************; APPLICATION APP Contractor The foregoing instrument was acknowledged before me this 23' day of �JeCtw∎ier , 20 by ' rr i --kc Lew eit4k who is personally known to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: Sign. Print: My Comm' i ires:CARMEN A. RIVERA EXPIRES March 16, 2012 8-0153 FloridallotaryService.com Plans Examiner Engineer Zoning ITEM UNIT FEE ITEM UNIT FEE ITEM UNIT FEE BATH TUB SWITCH OUTLETS SPACE HEATERS DISHWASHER LIGHT OUTLETS CENTRAL HEATING DISPOSAL RECEPTACLES NC (WIND) FLOOR DRAIN SERVICE TEMPORARY NC (CENTRAL) GREASE TRAP SERVICE SIZE IN AMPS DUCT WORK INTERCEPTOR SERVICE REPAIR/METER CHANGE REFRIGERATION LAVATORY APPLIANCE OUTLETS PROCESS AND PRESS PIPING LAUNDRY TRAY RANGE TOP UNDERGROUND TANKS CLOTHES WASHER OVEN ABOVE GROUND TANKS SHOWER WATER HEATER U.F. PRESSURE VESSELS SINK. POT/3 COMP. MOTORS 0-1 HP STEAM BOILERS SINK, RESIDENCE. MOTORS OVER 1 -3 HP HOT WATER BOILERS SINK, SLOP. MOTORS OVER 3-5 HP MECHANICAL VENTILATION TEMPORARY WATER CLOSET MOTORS OVER 5-8 HP TRANSPORTING ASSEMBUES URINAL MOTORS OVER 8-10 HP ELEVATORS/ESCALATORS WATER CLOSET MOTORS OVER 10-25 HP FIRE SPRINKLER SYSTEMS INDIRECT WASTES MOTORS OVER 25-100 HP COOUNG TOWERS WATER SUPPLY TO: MOTORS OVER 100 HP VIOLATION NC UNIT • NC WINDOW REINSPECTION FIRE SPRINKLER AIR CONDITIONERS HEATER -NEW INST. X STRIP HEATER HEATER - REPLACE GENERATORS TRANSFORMERS LAWN SPRINKLER-WELL GENERATORS TRANSFORMERS SWIMMING POOL GENERATORS TRANSFORMERS WATER SERVICE SPECIAL PURPOSE SEWER CONNECTIONS OUTLETS COMMERCIAL UTILITY -SEWER SIGN TUBES UTILITY WATER SIGN TRANSFORMERS SEPTIC TANK SIGN TIME CLOCK RELAY FIXTURES FAINFIELD, 4" TILE/RES. ANTENNA PUMP & ABANDON SEPTIC TANK • TELEVISION OUTLETS SOAKAGE PIT CU. FT. VIOLATION CATCH BASIN REINSPECTION • DISCHARGE WELL DOMESTIC WELL AREA DRAIN ROOF INLET SOLAR WATER HEATER FIRE STANDPIPE POOL PIPING LAWN SPRINKLER SYSTEM GAS RANGE - METER SET (GAS) GAS PIPING K PLUMBING ADDENDUM TO BUILDING PERMIT APPLICATION AN APPLICATION FOR BUILDINo PERMIT MUST ACCOMPANY THIS ADDENDUM. IF A MASTER PERMIT HAS BEEN OBTAINED, THE OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS. PLEASE CIRCLE 0 DISCIPLINE APPLIED FOR: ELECTRICAL 1. PERMIT # MECHANICAL