PL-09-229Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Scheduled Inspection Date: March 02, 2009
Inspector: Levrock, James
Owner: RAMIREZ, DIANE
Job Address: 760 NE 96 Street
Miami Shores, FL 33138-
Project: <NONE>
Contractor: LUIS QUALITY PLUMBING
Permit Type: Plumbing - Residential
Inspection Type: Final
Work Classification: Addition/Alteration
Phone Number
rcel Number 1132060142080
Phone: 305- 553 -7155
Building Department Comments
Passed
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
ctor Comments
February 27, 2009
Page 8 of 22
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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 Name (Fee Simple Titleholder) v3,P
Owner's Address
OpECEVE:
r31, Nu
BY:--- ------ - --
Permit No. PI 01-90,C1
Master Permit No.
Phone # 7 3-7 S
City , >'A tt S{rtrrVe SState 4L-�
Tenant /Lessee Name
Zip 33,7,k
Phone #
E -MAIL: VOL l re 2., c( €'2 COM C'(r s 4. 1' t
Job Address (where the work is being done)
City Miami Shores Village
FOLIO / PARCEL #
fl1g- 014
Is Building Historically Designated YES
1,o %v (--_ 676, si
County Miami -Dade
Zip 33
NO
\Orr')
Contractor's Company Name 6 Phon e #
Contractor's Address—In .3 Ls) L -t's + I
City "l i State___
Qualifier Name misl-
3
- -0.5 15,s
Zip 33 1 C_o C._v
Phone #3C-----1)3(‘,---
State Certificate or Registration No. Certificate of Competency No.
E -MAIL:
Architect /Engineer's Name (if applicable)
Value of Work For this Permit $
Type of Work: ❑Addition ElAlteration
Describe Work V‘-C.„
Phone #
Square / Linear Footage Of Work:
[New
Repair /Replaice
❑ Demolition
Submittal Fee $ Permit Fee $
Notary $ Training /Education Fee $ 0 •10
Scanning $ 3400
forn
/
ccF $ 1•090 CO/CC
Technology Fee $ v • LA
Radon $ DPBR $ Zoning $
Bond $ Code Enforcement $
Structural Review. $
Double Fee $
Total Fee Now Due $
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
Zip
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 absenc _ of such posted notice the
inspection will not be approved and a reinspection, fee will be charged.
Signature
Owner or Agent
day of
(
The fore oing instrumen
, 2(
cknowledge= before
h by
pj Iltt
ne this 13
who is personally known to me or who has produced
As identification and who did take an oath.
NOT Y PUBLIC:
Sign
Print.
Signatur
The fore
day of
who is nersonally known to me or who has produced
as identification and who did take an oath.
instrument wa
ontract
ckno
ledged be
me this'
My Commission Expires:
* * * * * * * * * * * * * * * * * * * ** **
ii******* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *`
NOTA' PUBLIC:
lfrfifii,„,
i LS it_'' d
hll t Iiir.w.r.. f
Sign:
Print
My Commission Expires:
* **
APPLICATION APPROVED B
(Revised 02/08/06)
* * * * * * * **
Plans Examiner
Engineer
Zoning