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PL-09-278Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Scheduled Inspection Date: March 19, 2009 Inspector: Levrock, James Owner: HELLER, DAVID & JUDE Job Address: 1300 NE 94 Street Miami Shores, FL 33138- Project: <NONE> :eft Permit Type: Plumbing - Residential Inspection Type: Final Work Classification: Gas Phone Number 3305-757-8142 Parcel Number 1132050100120 Contractor: AMERIGAS PROPANE AND SUBSIDIARIES Phone: 305-883-8600 Building Department Comments Passed \\C ti/ Failed Correction Needed Re-Inspection Fee No Additional Inspections can be scheduled until re-inspection fee is paid. 0 March 18, 2009 Page 9 of 29 k?L. Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 BUILDING' PERMIT APPLICATI FBC 2004 Permit Type: Plumbing P Permit No. TUYI- Master Permit No. Owner's Name (Fee Simple Titleholder) - 164-eCR Phone # &O '' 7 02 4, .Z Owner's Address G ' 49 f� AJ' 9V City ,- -[..L� L t ..re- Zip 3-6 i. Tenant /Lessee Name Phone # E -MAIL: Job Address (where the work is being done) /goo /'J 5 Z- 1 City Miami Shores Village County Miami -Dade Zip FOLIO / PARCEL # Is Building Historically Designated YES Contractor's Company Name Contractor's Address City Qualifier Name NO State State Certificate or Registration No. Z-C6. 06:90,:n / E -MAIL: Architect /Engineer's Name (if applicable) Value of Work For this Permit $ Type of Work: Describe Work: 9 p (o Phone # r r7 ij5 Oe) Certificate of Competency No. /sac `;'.1 Phone # Square / Linear Footage Of Work: ❑Addition ❑Alteration ❑New —/2 0 ❑ Repair /Re I ce ❑ Demolitio G� at**** * * * * * ** ** ***** *** *** * ** * * * * **** * Fees**** ** ** * ** * ** * ** *** * * * * * * * * * * * **** * Submit al Fee $ )' Permit Fee $ CC $ L20 CO/CC Notary $ . ff,,,, Training /Education Fee $ 0 , 10 Technology Fee $ 1. 25 Scanning $ W Radon $ DPBR $ Zoning $ Bond $ Code Enforcement $ Double Fee $ Structural Review. $ Total Fee Now Due $ j 5 e g5 See Reverse side 0 & PAID C,kt$'4 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. Owner or Agent The foregoing insti i ment was acknowledged before me this / day of 5,6 , 207'9 , by 1/4i r0r #4 - /!_c= 'e who is personally known to me or who has produced DL.t& 14 .4 ,c ) L33 ) ? / —Q As identification and who did take an oath. NOTA P IILIC: Sign: Print: My Commission Expires: APPLICATION APPROVED BY: (Revised 02/08/06) Signature Contractor The foregoing instrument was acknowledged before me this% day of F f , 20''?, by 6 fr,: =' who is personally known to me or who has produced s identification and who did take an oath. NO ARY P BLIC: Sign: Print: My Coms ss 2( d' `"Z- / Plans Examiner Engineer Zoning ZCI--e 79 I VI. SNOLLV1fD3a ONV S3l118.l INn 3'•NV•31V1S '�9a33 iM H•LUM 3OAVfldW•0 011D3rans Ida] Ja e 1d3a ONIN a]no11d7' is Flak NA1P . DETERMINE NORTH . abeIIV1 SGJOL !we 'n • • • • • •• • • • • • • • .• • •• •. • • • • . • • • •• ••• • • •••• • • •••• •. • • .. • •• .... • • •••• • • •• ••.. D kti-C 4) ac2' arj-rfig.4441,7 j`- .- Gt-•k to' ratryn -tiesovol 4,d`m "a�Y AmeriGast EPIC- 00899 1.0052 flIN $!Ave., Medley, FI`33•t78" Tel. 305 - 388 -8600 Fax 305 - 884 - 589.1 JOB: .J t. t30c) N gilt- DATE: SCALE:- • c APPROVED BY: REVISED: DRAWN BY: ( AFFIDAVIT: This ktstaln shall comply NFPA 54, NFPA 58, aswell as all state & local codes and regulations. GENERAL SITE PLAN Page.} of ire of Qualm PRINT NAMIE �6 .c Akk t so i1/4) Quaver #. a8gt;CI Sworn to and subscribed bye me this day of • , 20 by (SEAL) Personally known: or Produced Identification: a Type of lion Produced: • • ••• • • • 44• • •• ._._. • • • •• ' • • • • •• • • •• * • • •• • • • • 1 T:L -RIGGS 3081 SHIPPING AVE. MIAMI, FL 33133 -1305) 448 -9032 . 725 Z i. ^'Ces SURVEYOR ri' I STAYS OFft • ••• • ' • • • • • • • • • • • •• • • • 'jT: • . • • • • • • • r . tj & is • • • i • • F . . • * '• -4 •S• •,. • /of •10, • • • • vR • • • • • � • •••• - • - .w • �i • • • • • • •it doil•Illi • • • NI • • • • ` . 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'%le: /. ,f Li s f a. f 4/4 /af c:o /-. er - 47.0v, L Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Scheduled Inspection Date: March 04, 2009 Inspector: Levrock, James Owner: HELLER, DAVID & JUDE Job Address: 1300 NE 94 Street Miami Shores, FL 33138- Project: <NONE> Contractor: AMERIGAS PROPANE AND SUBSIDIARIES Nu Permit Type: Plumbing - Residential Inspection Type: Press Test Work Classification: Gas Phone Number 3305 - 757 -8142 Parcel Number 1132050100120 Phone: 305 - 883 -8600 Building Department Comments -2/ oo-f° Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. March 03, 2009 Page 4 of 20