PL-08-503Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspectioi
Inspection Date: 04/03/2008
Inspector: Levrock, James
Owner: ROBERTS, MICHAEL & TERESA
Job Address: 279 96 Street NE
Miami Shores, FL 33138-
Project: <NONE>
Contractor: ALL FLORIDA KINGS IRRIGATION SYSTEMS INC
Permit Type: Plumbing - Residential
Inspection Type: Final
Work Classification: Sprinkler System
0•••••••• Phone Number
Block:
Parcel Number 1132060134120
Lot:
Phone: (305)283 -3330
ilding Department Comments
intalled sprinklers system. replace existing pump
C
%
- .'- ctor Comments
Passed
Failed
Correction
Needed
Re- Inspection
Fee
($75)
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Wednesday, April 2, 2008
Page 1 of 2
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
BUILDING
PERMIT APPLICATION
FBC 2004
Permit Type: Plumbing
Owner's Narne (Fee Simple Titlehdlder)
1 Owner's Address
City Ml SI■oteS State
k
1
2.-0ME7F-Si
MAR 2 1 2008
BY- 4--2—'
Permit No. RIJL76
- ADZ
Master Permit No.
24QJ2f tl M .eobe o44 Phone # 3 0 r' 7s8- 6 b 08
0,19 N- E -9Gs-i
Tenant /Lessee Name
F t- Zip 33 13 8
Phone # 3e s- 7.r9- 9iag
2
E- MAIL: N,-,4 -
Job Address (where the work is being done)
City Miami Shores Village County Miami -Dade Zip
FOLIO / PARCEL # L, 10ZD £f#sT /Z. o L r /9' lv /c'J( 30 � f //�tvasSkor�,r $ c4 -1Arnb
Is Building Historically Designated YES NO ��pO� �°i `^ P1�9''fs °° K l o� (,'? Pob (
7q 6. !6 s r ,17/4 - s.{are,>^,�
Contractor's Company Name ,4)/ P/62, z /, ., a j 707(®„,phone # ` od-- 433 233 a
Contractor's Address / 3 %' /. k/{ $- ,S
City /Yf/ H°7
Qualifier Name —1 D/26i
State
State Certificate or Registration No.
E -MAIL:
Architect /Engineer's Name (if applicable)
Zip 33 ,/ 8 3
Phone # 3 o,s- 4 �* a .?'C
Certificate of Competency No. O0 e20,0' 33 0
Value of Work For this Permit $ / 5 s' . rj 0
Type of Work: ['Addition ['Alteration
Describe Work:
/.25 T " /��ed s e s
Phone #
ee„ r r r ! IiII
q .0 stai/
Square / Ljieootage f)'k)Q.rk:
ooa rt4
„V 017 nMl •,s
[';epalr /Replace ❑ Demolition
❑New
**************************************.*F
Submittal Fee $ Permit Fee $
Notary $ ' Training /Education Fee $ 0
a
Scanning $ 3.CD Radon $
Bond $ Code Enforcement $
Structural Review. $
DPBR $
CCF $ 1.Z-0 co /cc
Technology Fee $. 4 Sb
Zoning $
Double Pee $
Total Fee Now Due $
r
1614.10
See Reverse side
Bonding Company's Name (if applicable)
Bonding Company's Address
City State
\ 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: t 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."
Zip
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. n the .bsence of such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
1 Signature
Owner or Agent
hth
Signature
The foregoing instrument was ackk wled d b ore me th• The for
day of f / ,;2008, by ` /C / /Ci.P� /.G O t`�. -tr. day
Y
who ispers`b ally known to me or who has produced
As identification and who did take an oath.
NOTARY PUBLIC: ■•��� R F,
Sign:
Print:
Contractor
trument was ackn wledged before me this
20AP, b
known to me or who has produced
as identification and who did take anl� n�
liiEttrilllftit� 1... G r .
NOTAR
My Commission Expires:
* * * *** * ** * ** * * * * * ** **** * ** * **
APPLICATION APPROVED BY
(Revised 02/08/06)
Sign:
Print:
UBLIC:
My Commi ion Expires:
:******** * * * ** * ** *** * * * * ** * * *** * ** * * ** *, ** * ** * *** ** * ** ** **** *** ***
Plans Examiner
Engineer
Zoning
9‘ t.
•
4.10 11V A4,67-- 9 S
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