PL-09-406Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Scheduled Inspection Date: March 30, 2009
Inspector: Levrock, James
Owner: HELLER, DAVID & JUDE
Job Address: 1300 NE 94 Street
Miami Shores, FL 33138-
Project: <NONE>
Contractor: ALEMAN SPRINKLER SYSTEMS
WTI
Permit Type: Plumbing - Residential
Inspection Type: Final
Work Classification: Sprinkler System
temp Phone Number 3305 - 757 -8142
Parcel Number 1132050100120
Building Department Comments
Passed
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
March 27, 2009
Page 8 of 21
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33 138
TeL (305) 795.2204 Fax: (305) 756,8972
BUILDING
PERMIT APPLICATION
FBC 20
Permit Type: PLUMBING _
Owner's Name (Fee Simple Titleholder) i Phone #
Orair
NMCIEEVIE`Th
MAR 17 2009
BY:
Permit No. ilect ACCT
Master Permit No.
Own 's ddress
City , �►: �li.�, i
Tenant/Lessee Name
Email
State
Zip
Phone #
Job Address (where the work is being done) 13 00 Imo , q GJ
City Miami Shores Village County Miami -Dade Zip L 3 /;
FOLIO / PARCEL #
Is Building Historically Designated YES NO Flood Zone
Contractor's Company Name A I. N A.N`S S i2QZI A" M • LF1LS Phone #
Contractor's Address /' 7 5.. G!J / 3' G r
City / 7)Afa•/ — IJO State r4/{ Zip ,3✓ s'z
Qualifier Name i, $ E ALE >-t ALA, Phone #
State Certificate or Registration Nom/ Certificate of Competency No. (`� 0 00 1 3 S. .�' 6.
Contact Phone G r L L �l p G- a,10 i mail
:05_3-72'- / TS "5'
Architect/Engineer's Name (if applicable) Phone #
Value of Work For this Permit $ 3, $4j, O'
Square / Linear Footage Of Work:
Type of Work: ❑Addition ❑Alteration dew ❑ Repair/Replace
Describe Work: L � w S �12 / A/74/1.-0/Z.
f1 /
❑ Demolition
C
MAR 1 7 PAS
Submittal Fee $ VlJ' C
***** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Fees************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
CCF $ Dl
Technology Fee $
Notary $
Scanning $ Y'?. O - Radon $
Permit Fee $
Training/Education Fee $
o
DPBR $
Bond $ Code Enforcement$ Double Fee $
Structural Review. $
CO /CC
4.50
Zoning $
Total Fee Now Due-$ 1 44rt - " e •
See Reverse side ->
Boding Company's Name (if applicable)
Bonding Company's Address
City ;fate 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 a proved and a reinspection fee will be charged. 0
-Lis
Signat
Owner or Agent
The foregoing instrument was acknowledged before me this
�
day of 200- t , by 0-40 rFc�i -t
who is personally known to me o wh has roduced
+1.41=x343 de icatio u
s identification and who did take an oath.
OTARY PUBLIC
Print: K TAB €C. d�
My Commission Expires:
04,0
Notary Public State of Florida
jero ette X Jackson
Ms Corn. ;: ion 0D651348
Eras ► •/"1/2009
**** *** * * * ** * ******** ** **:
Signature
The foregoing instrument was acknowledged before me this/
6
1
day of / , 20 U1, by Sc'"-14'[.e`ttfM/
who is personally known to me or wh
ds-identification and who did take an oath.
Sig _
Print: zJ *IJ& `rE K • 4GtCSv1,‘
cJkceefe-1A.
My Commission E
Notary Public te of Florida
Jeanette K Jackson
My Commission DD651348
Expires 06/21/2009
* * * * * * * * * * * * * * ** * ** ** ******************* * * * * * * * * * * * * * ** * * *k** * * * * * * * * **
t E miner
APPLICATION APPROVE
(Revised 07/1-0/07)
Engineer
Zoning
Clerk checked