PL-07-1263It
Inspection Date: 09/06/2007
Inspector: Levrock, James
Owner: BLACK, BRIAN
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Job Address: 1294 96 Street NE
Miami Shores Village, FL
Project: <NONE>
Contractor: HOME OWNER
Permit Type: Plumbing - Residential
Inspection Type: Final
Work Classification: Sprinkler System
Block:
Phone Number (678)986 -2032
Parcel Number 1132060143840
Lot:
Building Department Comments
sprinklers system
7
- • ctor
m`
J'
omments
Passed
Failed
Correction
Needed
(
Re- Inspection
Fee
($75)
No Additional Inspections can be scheduled until
re- inspection fee is paid .
Wednesday, September 5, 2007
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
Me/ErVin
JUN 15 2007 LI
BY. _. N......__
BUILDING CSI l)n,i; Permit No.�-0.1— !JV
PERMIT APPLICATION Laf l�Sj - Master Permit No.
FBC 2004
Permit Type: Plumbing nn ,^ , (�
Owner's Name (Fee Simple J
��mple Titleholder) r 'CZ.. ' Phone # Li 0 3 b. 5
Owner's Address 1 ( 0`--) E l,(4) S\NCee_.k
City U\ lc.. 'AJ. S E3State
L
Zip
Tenant/Lessee Name C \ e a + ,�� er Phone # j 7 5 - (a�p pD
E -MAIL: V `lc,\C. NOS,1` J *' t' CID LOYYl
Job Address (where the work is being drone) 1(, q & L-)E cl Cc, JVa_` -
City Miami Shores Village
County Miami -Dade
FOLIO /PARCEL# t \- 3a-a(0 3 -�j O
Is Building Historically Designated YES NO
Zip `jj�3�
Contractor's Company Name II u/0 ri^ Phone #
Contractor's Address
City lQ m l State 1 Zip
Qualifier Name
Phone #
State Certificate or Registration No. Certificate of Competency No.
E -MAIL:
Phone #
Architect /Engineer's Name (if applicable)
Value of Work For this Permit $ 400 Square / Linear Footage Of Work:
Type of Work: [Addition Alteration QNew n Repair/Replace D Demolition
Describe Work: Svb j ce_ \.i% Ss\C-/ yI
* * * * * * * * * * * * * * * * * * * ** * * * * * * * * * * * * * * Fees********************************************
Submittal Fee $ Permit Fee $ /60! CCF $ , CO /CC
Notary $ Training /Education Fee $ • C,0 Technology Fee $ 400
Scanning $ '3 00 Radon $ DPBR $ Zoning $
Bond $ Code Enforcement $ Double Fee $
Structural Review. $ Total Fee Now Due $ 167 -6
See Reverse side -->
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.
Signature
Owner or Agent 2
Signature
Contractor
,The hhe ores ..,►�_''' trument was acknowledged before me this The foregoing instrument was acknowledged before me this
Li day o ii�i�ti , 0 Jby thee- l �' • %% L- day of , > , by
who is personally known to me or who has produced who is personally known to me or who has produced
61/20,07015080As identification and who did take an oath. as identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
My Commission Ex
Sign:
Print:
My Commission Expires:
APPLICATION APPROVED BY:
(Revised 02/08/06)
U D Plans Examiner
Engineer
Zoning