PL-07-1820Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Date: 10/25/2007
Inspector: Levrock, James
Owner: SANDLER, ALAN
Job Address: 1090 96 Street NE
Miami Shores Village, FL
Project: <NONE>
Contractor: EH WHITSON PLUMBING
Permit Type: Plumbing - Residential
Inspection Type: Final
Work Classification: Gas
Block:
Phone Number
Parcel Number 1132060143470
Lot:
Phone: 954 - 929 -3599
Building Department Comments
INSTALL GAS LINE FOR CUSTOMER SUPPLIED
I
RANGE
Passed,
-
tor Comments
Failed
Correction
Needed
Re- Inspection
Fee
($75)
No Additional Inspections can be scheduled
re- inspection fee is paid.
until
Wednesday, October 24, 2007
Page 2 of 2
ti g11 c�
C1iII
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 (,LLi%X
Owner's Name (Fee Simple Titleholder) F 5 t/l (1 1 l
Owner's,Address ) \D ^�o �1Y . to 6?
City' Oi\l.1 .5‘\--)0(-0,s lQ(()5 State IC
pMCME'VIE1
ilit AUG 2:7 2007. BB
BY: ......... . ....
Permit No. 'tV t - 1 2-D
Master Permit No.
Tenant/Lessee Name
E -MAIL:
Phone # -'131 5 -i O Lf
Zip 3 3 ∎ 5O
Phone #
Job Address (where the work is being done) (.i ( 0 41 C
Q(0 Let
City Miami Shores Village / County Miami -Dade
FOLIO /PARCEL# `l ' 3�V (7- OIt4 3`l` ' J0
Zip 3'3 ► 3 O
Is Building Historically Designated YES NO
Contractor's Company Name
Contract rs Address I
(\City I yija1C1
Qualifier Name itANT) S- LI g9vC
Phone # 9 -5V - ctfi.33cict
,-;21 l+1
State
State Certificat r gist rati° No.�� L . �� Certificate of Competency No.
E -MAIL: f1 ' �� �n1 P 1-5(7i) , C C) rr')
Architect /Engineer's Name (if applicable) 4) A Phone #
Zip 53090
Phone # 9 75. y °
Value of Work For this Permit $ I) 6)1,00 Square / Linear Footage Of Work:
Type of Work: ['Addition 'Alteration ['New ❑ Repair/Replace
❑Demolition
Describe Work: rytafccti oas to--). C Costiorns2r . Supptoed renngc. `I-
* * * * * * ** * * **xxxxx * * **** * **** * * *** ** ** Fees************* **** ** ***** * * **** ***** * *** ** * **
Submittal Fee $
Notary $
Scanning $ 0 -CO
Bond $
Permit Fee $
1f'o
Training /Education Fee $ .40
Radon $ DPBR $
Code Enforcement $ Double Fee $
CCF $ I'Z�) CO /CC
Technology Fee $ 4-�
Zoning $
Structural Review. $ Total Fee Now Due $ 1 - .
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: [ 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 appl
promise in good faith that a copy of the notice of commencement and construction lien law brochur vill .e del''er
whose property is subject to attachment. Also, a certified copy of the recorded notice of om enc
for the first inspection which occurs seven (7) days after the building permit is iss ed l
inspection will not i e approved and a rein . ction fee will be charged.
Owner or Agent -41111 '411* 4111
Signature
Signature
'int must
edhe person
at t job site
.oste notice, the
Alcill Asi10/
i
The foregoing instrument was acknowledged before me this � The fore oi instrument was a
day of gL 2( J , by t .t.lai \ (\ VACS t.er- day of r' +1 , 2001 , b
Cwho is personally known to e or who has produced who is perso ly known to me or who has produced
As identification and who did take an oath. as identification and who did take an oath.
NOTARY PUBLIC:
Contracto
o e.ged before me this
0 ' h
Sign:
Print:
My Commission E
NOTARY PUBLIC:
APPLICATION APPROVED BY:
(Revised 02/08/06)
���6'2 Plans Examiner
Engineer
Zoning
H.,. Whitson Plumbing
1 South 21st Avenue
llollywood, FL 33020
CFC1425789
•40
Survey Sheets / Plans
Customer Name:
Address:
City, State, Zip: e/%09//7,,'
Phone #:
All Work to Comply With N.F.P.A. Code #: e,
01E01071E1
IE AUG 2 7 207 JJ
L.513Y:JL ..........
#05,-//21„5•gZe-i< • • • •
• •
• • •
• •
/e) 90 /1,/; 7' • •
• 0 •
• • •
Estimated Job Cost:
Description of Work:
777),:z /47e
1517e
/ . c M .tf*. ,c-49
2-p
• • • •
• •
• •
• • • •
• •
• • • •
• • • •
• •
• •
• •
•
• •
•
• •
• CYNTHIA L. MARTIN
Notary Public - State of F
0, My Commission Expires Apr 8,
Commission # DO 308790
CE WITH ALL FEDERAL
1)1
EH. Whitsm Plumbing
,e121 South 2Ist Avenue
Hollywood,'FL 3.3020
CFC1425789
Surygya_Ieets / Plans
044/4//9-42)
customer Name:,
• •
• ••••
• •
• • •• •
• • •
••••
•• •
•
••lic •• •
••••
• •
••••
• •
•• ••
Address: 11 //e;,- 1,57,4 • • •
• • •
• •• •
••••
••••
• • • •
•• • ••• •
City, Slate, Zip: _A201/ 7y1L-,'"Cleg____---- i ••
• •
•• •
• •
• ••
••• •
• •
••
•
Phone #:
All Work to Comply With N.F.„P.A. Cod itt'l
Estimated Job Cost:
Description of Work:
Piping IS()
tJ
CYNTHIA L. MARTIN
.• s Notary Public - State of Florik
ss ff.! My Commission Expires Apr 8.2008
N;t8rAp.' Commission # DD 308790
11111.1'. .11111, "Mr ■••■ 'Mr mr Nor-- 11W
VY ,