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PL-10-244Inspection Number: INSP - 135832 Permit Number: PL -2 -10 -244 Scheduled Inspection Date: March 12, 2010 Inspector: Hernandez, Rafael Owner: HOLDINGS, LLC, CAV Job Address: 289 NW 111 Terrace Miami Shores, FL 33168- Project: <NONE> Contractor: JUPITER FARMS PLUMBING & IRRIGATION INC Building Department Comments March 11, 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: Repair Phone Number Parcel Number 1121360010380 Phone: (305)662 -7979 plumbing work for water heater and kitchen remodel Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments Page 7 of 17 Project Address 289 111 Terrace Miami Shores, FL 33168- 1121360010380 Block: Lot: CAV HOLDINGS, LLC Owner Information CAV HOLDINGS, LLC Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Address Valuation: Total Sq Feet: Contractor(s) Phone CeII Phone JUPITER FARMS PLUMBING & IRRIGI (305)662 -7979 Type of Work: plumbing Type of Piping: Water heater & Kitchen Remodel Additional Info: Bond Retum : Classification: Residential Fees Due CCF Education Surcharge Permit Fee - Additions/Alterations Scanning Fee Technology Fee Total: Amount $0.60 $0.20 $100.00 $3.00 $0.80 $104.60 Building Department Copy March 02, 2010 ROV Expiration: 08/2312010 Parcel Number 801 UNIVERSITY Drive PLANTATION FL 33324- Phone Invoice # PL -2 -10 -37069 Invoice Total Amt Paid Amt Due $104.60 $104.60 $0.00 Applicant CeII For Inspections please call: (305)762 -4949 Available Inspections: Inspection Type: Final 2 BUILDING PERMIT APPLICATION FBC 20 Permit Type: PLUMBING ' Ail N- afredA-- d Phone # ) s ail Owner's Name (Fee Simple Titleholde Owner's Address City 111 6 MJk, Tenant/LesseeNa Email d V -LW G Q r Job Address (where the work is being done) 5 Ni (i City Miami Shores Village County FOLIO / PARCEL # Is Building Historically Designated YES NO Contractor's Company Name '• 3 t4 t 6, t'il't -s s (7 2 Pil L- er-,n Value of Work For this Permit $ 900 CO- Type of Work: ❑Addition ❑Alteration Describe Work: Double Fee $ 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 Permit No. P■ Zip Miami -Dade Master Permit No. Phone # Architect/Engineer's Name (if applicable) Phone # [New ❑ Repair/Replace Violation date: Structural Review. $ Total Fee Now Due $ 104 `0 FEB 1 8 2010 gli - R Zip Flood Zone ei { � � - b`? Contractor's Ad City ` , State Pt Zip 33t-1 g / a Qualifier Name rd ill- lil ciel Phone # 5 3 3 to 7 State Certificate or Registration No. CFC 04/05'72- Certificate of Competency No. Contact Phone 772-h 2b 3 - 2ve ®3 E -mail Square / Linear Footage Of Work: See Reverse side -* ❑ Demolition ******** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** F * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Submittal Fee $ Permit Fee $ //4M 'CCF $ 0.J (00 Notary $ Training/Education Fee $ Q Scanning $ )' Q Radon $ DPBR $ CO /CC $ Technology Fee $ ®K Bond $ 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 In the abse of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature Signature Owner or Agent Contractor The foregoing instrument was acknowledged before me this _S The foregoing instrument was acknowledged before me this day of .W; , 20 to , by CAS \J 1 A , day of A d , 20 /61 by vt c4 , : / �� ,_ who is personally known to me or who has produced PLI o who is personally known to me or who has produced fC Ord As identification and who did take an oath. entification and who did take an oath. NOTARY ' L / NOT : LIC: s S itt ►t► r b • ' S • � �J ``�• 0 ", Q ' /1 'S I,c2is Examiner Print: My Commissi;;n Expires: APPROVED BY (Revised 07 /10 /07)(Revised 06/10/2009) Engineer Sig Print: My Commissio ,UIn , ,.o :Y /4 SEAN R. MCLAUGHLIN FAY COMMISSION # DD 889290 fX ? ES May 12, 2013 Boni ed "no U Nouy Public Underwriters ** Zoning Clerk checked