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PL-11-443Inspection Number: INSP - 157163 Permit Number: PL -3 -11 -443 Scheduled Inspection Date: March 25, 2011 Inspector: Hernandez, Rafael Owner: DUBRIN, JOSEPH Job Address: 420 GRAND CONCOURSE Miami Shores, FL 33138- Project: <NONE> Contractor: THE NEW MIAMI SHORES PLUMBING Building Department Comments REPLACE EXISTING ELECTRIC WATER HEATER Passed Failed Correction Needed Re- Inspection Fee March 24, 2011 No Additional Inspections can be scheduled until re- inspection fee is paid. Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspector Comments For Inspections please call: (305)762 -4949 Permit Type: Plumbing - Residential Inspection Type: Final Work Classification: Addition /Alteration Phone Number Parcel Number 1132060170080 Phone: (305)751 -2446 Page 8 of 8 BUILDING PERMIT APPLICATION FBC 20 Permit Type: PLUMBING OWNER: Na e (Fee Simple Titleholder):�� t� City: Folio/Parcel #: Address: City: n [ ° ll! 14) State: Tenant/Lessee Name: Phone #: Email: JOB ADDRESS: A20 Is the Building Historically Designated: Yes NO CONTRACTOR: Company Name: ��( J r ut��'tJ Phone #:i�c'7'c? —2(p4-h, Address: 9 oo r...( L (JJ4 Cit C ( r State: Zip: Qualifier Name: ( )6 )6 5 I f � �°- LL-7 Phone #: State Certification or Registration -1:::: #: C -1:::: 6 ( 26:6 Certificate of Competency #: Contact Phone #: tL'j (...*t '.,/ Email Address: DESIGNER: ArchitectlEng neer: Phone #:4US 7V-W-4.., Type of Work: Address Description of Work: Miami Shores 1 -32 oI v ; 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 County: Value of Work for this Permit: $ / G 66 Square/Linear Foota T ❑Alteration UNew Permit MAR 1 0 2011 BY:..,.: ::. N. (LA 1 LT> Master Permit No. Phone #: Miami Dade Flood Zone: Work: epair/Replace :Demolition 2 Submittal Fee $ 6, Permit Fee $ /676) CCF $ CO /CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ TOTAL FEE NOW DUE $ J� • �� 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. The foregoing in day of who is personally known to me or who has produced Print: My Com Owner or Agent trument was acknowledged before me this The foregoing in trument was acknowledged before me this 20/L, by , day of WI , 20 I , by As identification and who did take an oath. e. - Contractor who is personally known to me or who has produced as identification and who did take an oath. Y PUBLIC: Print: CARIVIEfJ M. AVERA My Commi ;snrr esli, COMMISSION # DD753565 s ., E.XP1RES March 16, 2012 ( 407)398 -0153.._...* FloridaNctt7SeN ^c2.com_,_ APPROVED BY ,,,AR A. RWERA E.:tpiFVF:COMM SSION # DD753565 EXPIRES Marc 1(3, 2012 (Revised 07 /10 /07)(Revised 06 /10 /2009)(Revised 3/15/09) Plans Examiner Structural Review Zoning Clerk ITEM UNIT FEE ITEM UNIT FEE ITEM UNIT FEE BATH TUB SWITCH OUTLETS SPACE HEATERS DISHWASHER LIGHT OUTLETS CENTRAL HEATING DISPOSAL RECEPTACLES A/C (WIND) FLOOR DRAIN SERVICE TEMPORARY A/C (CENTRAL) GREASE TRAP SERVICE SIZE IN AMPS DUCT WORK INTERCEPTOR SERVICE REPAIR/METER CHANGE REFRIGERATION LAVATORY ESS �. LAUNDRY TRAY III RANGE TOPOUTLETS ■� UNDERGROUND TANKS ( PING 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 ASSEMBLIES 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 COOLING TOWERS -. WATER SUPPLY TO: - MOTORS OVER 100 HP VIOLATION A/C UNIT NC WINDOW REINSPECTION FIRE SPRINKLER AIR CONDITIONERS HEATER -NEW INST. _ 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 SEPTIC TANK -- SIGN TRANSFORMERS 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 -� -� WELL AREA AREA DRAIN DRAIN -- -- ROOF INLET SOLAR WATER HEATER FIRE STANDPIPE �- -- POOL PIPING LAWN SPRINKLER SYSTEM -- -- GAS RANGE -! -- � METER SET (GAS) GAS PIPING -- -- ADDENDUM TO BUILDING PERMIT APPLICATION AN APPLICATION FOR BUILDING 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: PLUMBING ELECTRICAL PERMIT # MECHANICAL