PL-07-189Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756 -8972
Inspection Date: 06/19/2007
Inspector: Levrock, James
Owner: JEROME, MATHURIN
Job Address: 445 96 Street NE
Miami Shores Village, FL
Project: <NONE>
Contractor: E.H WHITSON PLUMBING
Block:
Permit Type: Plumbing - Residential
Inspection Type: Final
Work Classification: Gas
Phone Number (305)757 -2147
Parcel Number 1132060170110
Lot:
Phone: 954 - 929 -3599
Building Department Comments
RUN GAS TO WITH FUTURE RANGE FUTURE DRYER
FUTURE GENERATOR 1rt.
f:5
jug2021
- c • 'omments
Passed
Failed
Correction
Needed
Re- Inspection
Fee
($75)
No Additional Inspections can be scheduled until
re- inspection fee is paid .
Monday, June 18, 2007
Page 1 of 2
Miami Shores Village
IMMEEVin
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138 ig JAN 3 1 20U1
BY: ..........
BUILDING bOlat Permit No. g-' 01- 1
PERMIT APPLICATION
FBC 2001
Tel: (305) 795.2204 Fax: (305) 756.8972
Master Perinit No.
Permit Type (circle): Building EIectrical lumbin u_ Mechanical Roofing
Owner's Name (Fee Simple Titleholder) HAM L ■1f na. Phone #,
Owner's Address 44- ,N€ q
Gig's in / S State
Tenant/Lessee Name 10146.
Zip ,3/30
Phone #
Job Address (where the work is being done) 205 t 9
City Nfiami Shores Village County Miami -Dade Zip 3/,-3
Is Building Historically Designated YES NO
Contractor's Company Name C F�j(� P A' O Phone # 6204 -g q 9
Contractor's Address 20 1 So UTh cg
41
city 41 WO 0 State Zip 330,40
Qualifier �� L Pwia
State Certificate or Registration No. 6
Certificate of Competency No. () +0509
Architect/Engineer's Name (if applicable) Phone #
$ Value of Work For this Permit
AI*
go
Type of Work: ❑Addition ['Alteration
Describe Work: Ali., ) 0 1
Puy-
Square Footage Of Work:
:New ❑ Repair/Replace ❑Demolition
Wf Qi ur -2
*** * * * ** ** ** ** ** ** ** ,y,**Fees, * * *** **t * ***** ** * * * * * **
Submittal Fee $ Permit Fee $
Notary $ Training/Education Fee $
Scanning $ t. 00 Radon $ Zoning Bond $
Code Enforcement $
04
CCF $ I• 9-0 CO /CC
Technology Fee $ 4.Q
Total Fee Now Due $ 'r -to
(Continued on opposite side)
Structural Plan Review. $
0 VAC
Bonding Company's Name (if applicable)
Bonding Company's Address
City State Zip
6
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address tr
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 exceedin
promise in good faith that a copy of the notice of commencement and construction lien law b . c re
whose property is subject to attachment. Also, a certified copy of the recorded notice of co
for the first inspection which occurs seven (7) days after the building permit is issued
inspection will not b _ ;.,.,r.r• d a reinspec ee will be charged.
2500, the applicant ust
eliv' ° d to t 'r on
be '. ted at site
ce, the
ent
The foregoing in ►:� -, a acknowledged before me this 30
day ofe5o > ,20CF:'', by ftl Uii0�
who is personally known to me or who has produced
1), m a As identification and who did take an oath.
NOTAR UBLIC:
Sign.
Print:
Contractor
The foregoing instrument was acknowledged before me this
dayo ,, 1.1 PVA
who is personally known to me or who has produced
as identification and who did take an oath.
NOTARY PUBLIC-
My Commission Expires
* * * * * * * * * * * * * * * * * * **
**** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** *,rig, **
APPLICATION APPROVED BY:
Chc 05/13/03
Print:
My Commission E
* * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
* * *, *************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
- Plans Examiner
Engineer
Zoning
E.H. Whitson Plumbing
421 South 21st Avenue
Hollywood, FL 33020
CFC1425789
Survey Sheets / Plans
Customer Name: /1M1?
Address: ®e° P# 4 "
City, State, Zip:
Phone #: 30
All Work to Comply With N.F.P.A. Code #: ° ' nrc -'`
MIEWRI
B ILL
Estimated Job Cost: ® ®r iV
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E.H. Whitson Plumbing
421 South 21st Avenue
Hollywood, FL 33020
CFC1425789
Survey Sheets / Plans.
Customer Name:
Address:
City, State, Zip:
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yys �� 96 �f
Phone #: t 30,'5 — IL34
All Work to Comply With N.F.P.A. Code #: 0 ?f
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75):•e(--z � ti it 5
Estimated Job Cost:
Description of Work:
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