PL-07-632Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Date: 04/20/2007
Inspector: Levrock, James
Owner: ARTUNDUAGA, GUSTAVO
Job Address: 1250 96 Street NE
Miami Shores Village, FL
Project: <NONE>
Block:
Contractor: SUNSHINE GAS SERVICE, INC.
Permit Type: Plumbing - Residential
Inspection Type: Final
Work Classification: Gas
Phone Number (305)757 -0735
Parcel Number 1132060143900
Lot:
Phone: 954- 389 -1289
Building Department Comments
UNDERGROUND GAS PIPELINE
4 "44--
'-.) , 1
APR 232007
Passed
Inspe tor Comments
Failed
Correction
Needed
Re- Inspection
Fee
($75)
No Additional Inspections can be scheduled
re- inspection fee is paid.
until
Thursday, April 19, 2007
Page 2 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
RECEIVED
MAR 3 0 1007 M
limktsk
Permit No. PL - c32
aster Permit No.
Owner's Name (Fee Simple` Titleholder) lilrb�t�' CPU Phone # (3) 51-4464
Owner's Address k�t 1 E. ekt `j�
City , �1'IS State T Zip 2' Nis
Tenant/Lessee Name kill
E -MAIL:
Job Address (where the work is being done) t)I1Q, en abaft
Phone #
City Miami Shores Village County Miami -Dade Zip
FOLIO / PARCEL #
Is Building Historically Designated YES NO 17 .
Contractor's Company Name 1VNQ C�uj 3)C, Phone #
Contractor's Address ' -11 SLt, Z1 ST
City 1ztJK
c54-crv-T 5
State
Zip 33 023
Qualifier Name Cch+t05 'R&t,Vetb Phone #
State Certificate or Registration No. Certificate of Competency No.
E -MAIL:
Architect /Engineer's Name (if applicable) Phone #
Value of Work For this Permit $
t21360.00
Square / Linear Footage Of Work:
Type of Work: ['Addition [Alteration ['New ❑ Repair/Replace
❑Demolition
Describe Work: U )Ad(I)WIDOW)
********** * * * * * * * * * * * * * * * * * * * * * * * * *,9v�** Fees************* * ** ***** **** * * ******* ***** ** ***
Submittal Fee $ Permit Fee $ / ?o CCF $ [ ( CO /CC
Notary $ Training /Education Fee $ ;
Scanning $ 27 Radon $ DPBR $ Zoning $
Technology Fee $ 4 -2.5
$ Code Enforcement $ Double Fee $
Structural Review. $ Total Fee Now Due $ n q . n
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 Signature
Owner or Agent Contractor
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
day of , 20 , by , day of , 20 _, by
who is personally known to me or who has produced who is personally 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: NOTARY PUBLIC:
Sign: Sign:
Print: Print:
My Commission Expires: My Commission Expires:
**
* * * * * * * * * * * * * * * * * * * * * * * * * * * * ** * * ** *: ****************************** * * * * * * * * * *** * * * * ** * * * * * * * * * * * **
APPLICATION APPROVED BY:
(Revised 02/08/06)
Plans Examiner
Engineer
Zoning
-.179 1040
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01,400. 011144 0•15".-1
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eNte, MARLENE LILT COLLADO
AizIr MY COMMISSION # DDS44876
EXPIRES: Apr. 25, 2010
395-0153 Florida Notary
/2 .5-1; 41. 6""
fICALIS:
AFPROVED BY:
OATE : 3 /1.-0 7
Sunsbine Gas %M�, las
Prl nos 840006-
Pembroke Pines, FL 33084
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DRAWN BY
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REVISED
DRAWING G NUMBER
/
Miami Shores Village
Building Department
100 50 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
BUILDING Permit No. PL 1' (;,•Y
PERMIT APPLICATION Master Permit No.
FBC 2001
Permit Type (circle): Building j/ Electrical '' umb• , Mechanical Roofing
Owner's Name (Fee Simple Titleholder) 'F< 1 m b e- r le e5f O Phone # 75) -751- (40. Co co
Owner's Address IA5Q pJ l 016 s
City if' ;A t-t E Slry;re State rL• Zip 3a 33
Tenant/Lessee Name Phone #
Job Address (where the work is being done) IA S 6 N e- 01 b ST�C E
City Miami Shores Village County Miami -Dade Zip . 3 I ,g'
Is Building Historically Designated YES NO
Contractor's Company Name cSU kS H 1.0 6 AS S UC e Phone # q 5"t' - 81- -73.36
Contractor's Address S ' 17 S L 021 5'T
City ark- state zip 3a C 2
Qualifier °ACK— .-(i6 p,(,i l0eiLD -
Architect/Engineer's Name (if applicable)
Phone #
$ Value of Work For this Permit d /60
Type of Work: ❑Addition ['Alteration [New
Describe Work: nz.) c/
Square Footage Of Work:
0 Repair/Replace ❑ Demolition
Submittal Fee $ Permit Fee $ 1e) CCF $
Notary $ Training/Education Fee $ Technology Fee $
Scanning $ Radon $ Bond $
Code Enforcement $ Structural Plan Review. $
Total Fee Now Due $
(Continued on opposite 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 Ste Zip
Application is hereby made to obtain a permit to do the work and installations as indicanvi 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 tins jurisdiction. 1 understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS,
WELLS, POOLS, FURNACES, 13011.ERS, HEATERS, TANKS and AIR CONDITIONERS, ETC.... .
OWNER'S AFFIDAVIT: I certify that all the foregoing information is emirate ,,,t1 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 el a building permit with an estimated value exceeding $2500, the applicant must
gcod faith that a copy of the notice of commencentent and construction lien law brochure will be delivered to the person
fF 'T'''f7Chflient. Also, a certified copy of the recorded notice of commencement nuts: be posted at the job site
frx- the fir. pi-..in WhiCh VCVUT5 (7) dap afts.!r the Irni,nng permit is iszaed. In the•qbsenf.:e Antr& posted rolice the
-.41! .17 ?"..,q,LF,pt•f.'ql.7t,:.,.f.::' "!-!,17,1
Owner or Agent
The foregoing instrument was
day ofMefe6, 20 ()"7, by
who is personally known to me or who has produced
As identification and who did take an oath.
Signalise
The foregoing instrument was aelmowiedged before me thisa2a-fr*
day of p. &;4#% , 20 7, by j:01,Leej,j2CAllaCk,
who is personally known to me or who has produced
t cation an C an
44, MARLENE LILI COLLADO
MY C!.. MI N # D 544876
NOTARY PUBLIC:
Sign:
Print:
My Commission xp ' My.Commission Expires:
(Certificate of Competency Holder)
State Certificate or Registration No. j Certificate ofeompetency No.
*****************************
APPLICATION APPROVED BY:
Chc 10/14/03
***Itc************************************
Plans Examiner
Engineer
Zoning