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PL-10-1400BUILDING PERMIT APPLICATION FBC 20 Permit Type: PLUMBING Owner's Name (Fee Simple Titleholder) Owner's Address City 1& ( ‘ *W) State Tenant/Lessee Name Email Job Address (where the work is being done) City Miami Shores Villag FOLIO / PARCEL # 1 1 - 3 1 Is Building Historically Designated YES Architect/Engineer's Name (if applicable) Value of Work For this P "' Describe Work: \ers Submittal Fee $ Permit Fee $ Notary $ Scanning $ Radon $ Double Fee $ Structural Review. $ Miarii Shores Village 1n Build De artment 003RW 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305) 762.4949 BYt !. trte«cefoeo ermit $ ,, Type of Work: ['Addition ❑Alteratioi County Miami -Dad Zip �O - (00©0 NO Permit Nof L t O 1 10 Master Permit No. N Phone # ea,wZ Contractor's Company Name t G 4l VAG Phone # V ° • `- (-- Contractor's Address jn Q-S X0 `■t 1 City 1`kY t000 Stag - 2AD1X Zip 3 ' O 2_ f Qualifier Name I MCkW1- Phone # .- -get. - ti-to State Certificate or Registration No. (' `w. C 0 2141,0 Certificate of Competency No. Contact Phone E -mail Zip 1,S( Phone # Phone # Square / Linear Foota Of Work: T Fee $ DPBR $ Vio ration date: Total Fee Now Due $ New [ Repair/Replace _ Flood Zoneca 3' ,[D '4�2 * * * * * ** * * * ** * * * * * * * * * * * * * * * * . 4* * * * * * F ees***** ** * ,;e* * *** * * * * ** * ;* * * * * *** * * * * * ** ** * ** * se /lb CCF $ . CO /CC $ Technology Fee $ Bond $ . 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) 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 i s,�� Signature f Signature Contractor The foregoin instrument was acknowled ed before me this 2. ( The foregoing instrument was acknowledged before me this day of , 20 ICI by day of `1, , 20 VD, by i tc ik L Jotnekto who is personally known to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: who is personally known to me or who has produced As identification and who did take an oath. NOTARY PUBLIC• My Commission Ex • Owner or Agent APPROVED BY 9-94'/0 Plans Examiner (Revised 07 /10 /07)(Revised 06/10/2009) Engineer Sign Print: My Co Zoning Clerk checked Inspection Number: INSP - 149694 Scheduled Inspection Date: September 10, 2010 Inspector: Hernandez, Rafael Owner: ARFELD, MARTA Job Address: 55 NW 102 Street Project: Contractor: Miami Shores, FL <NONE> 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 For Inspections please call: (305)762 -4949 \ (s/ut.0 Permit Number: PL -8 -10 -1400 Permit Type: Plumbing - Residential Inspection Type: Final Work Classification: Addition /Alteration Phone Number Parcel Number 1131010180090 CORRECTIONS OF PLUMBING WORK IN PROFESSIONAL MATTERS ACCORD TO PLUMBING CODE. REMODELING KITCHEN Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments Page 9 of 14 WOW t\ 5 m1) log c 14-,u/ R 33/5D 10 6 r Kckeu MACAI tzsiCOM f2o1 �Y Y 55 r j l0 2 S eLl-Ato eA- c la,L,74‘,A 2)A k-\ .--p80AL>ectQA19k., PERMIT #: MIAMI SHORES VILLAGE APPROVED BY DATE ZONING STRUCTURAL ELECTRICAL /0 PLUMBING g_y MECHANICAL L BLDG. SUBJECT TO COMPLIANCE WITH ALL FEDERAL STATE AND COUNTY RULES AND REGULATIONS