PL-08-150•
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
...............
Inspection Date: 02/06/2008
Inspector: Levrock, James
Owner: SELZER, ALEXANDRA
Job Address: 271 101 Street NE
Miami Shores, FL 33138-
Project: <NONE>
Contractor: LASSETER PLUMBING CO INC
Permit Type: Plumbing - Residential
Inspection Type: Final
Work Classification: Addition /Alteration
Nom
Phone Number 305/446 -0500
Block:
Parcel Number 1132060134810
Lot:
Phone: 305 -893 -7180
Building Department Comments
REPIPE SEWER LINE UNDER HOUSE TO SOUTH EAST
CORNER. TIE TO NEW SEPTIC
?Et ®1 2000
ct�r
Comments
Passed
Failed
Correction
Needed
Re- Inspection
Fee
($75)
No Additional Inspections can be scheduled until
re- inspection fee is paid .
Tuesday, February 5, 2008
Page 2 of 2
tvidem 4/01.
't., 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
10,111
JAN h.4 208
Permit No. R■DC— 130
Master Permit No.
Permit Type: Plumbing
Owner's Name (Fee Simple Titleholder) Le) lila cS� Z2 Phone # % /3‘71 "' :(, — 36).56
Owner's Address 7/ o /0 / `
City - S/T' 1 State /—L Zip 33/< jr
Tenant/Lessee Name
E -MAIL:
Phone #
Job Address (where the work is being done)
City Miami Shores Village
FOLIO / PARCEL #
:27r 244 /c /Jt
County Miami -Dade
Zip 3/ 3 ,f/
Is Building Historically Designated YES ('
Contractor's Company Name 2 } f L 7t7(' »L1)/')/ Phone # 3es 4/3 1 /JZ
Contractor's Address 16 : f )V& /36 -
City ,/ 1)2(i - State - Zip 33/ C / ^ d
Qualifier Name � �) �� �`JeL � � � T� Phone # „y) S �' , cue !/
State Certificate or Registration No.C- 6 / 5'6 Certificate of Competency No.
E -MAIL:
Architect/Engineer's Name (if applicable)
Value of Work For this Permit $ 2 366. 6'+3'
Phone #
Square / Linear Footage Of Work:
Type of Work: ['Addition ['Alteration ❑New 124epair /Replace
Describe Work: Fe p t p 5gc.0 1.1A.16 E R -
® 5- t e �R , Tt l a /V r—'® /% sEp E eC.
El Demolition
17®
******************* * * *aYaY4eoea'e************Fees*
Permit Fee $ / ® CCF $ 1 • ^ //C--��O /CC
Training /Education Fee $ 0.(0,0 Technology Fee $ 4 S V
Radon $ DPBR $ Zoning $
Code Enforcement $ Double Fee $
Structural Review. $ Total Fee Now Due $ 1612•10
See Reverse side -+
Submittal Fee $
Notary $
Scanning $ Cp .W
Bond $
*** rx xzxxxx *xx *xx *xxxxxxxxxxzxx * * * * **
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 whic'h occurs seven (7) days after the building permit is issue In the absence of such posted notice, the
inspection will not be ap roved and a reinspection fee will be charged.
al7 )..-.r
�, Owner orz gent j r� Contractor
The foregoing instrument was acknowledged before,me this .70. ' The foregoing instrument was acknowledged before me this--11Z4 �
day of 442 b L- se---4-z'&'
�� �k day of
Signature
, 20 �/i by aiii-) c =ie
who is onally known me or who has produced who is sr onally noun -fo me or who has produced
As identification and who did take an oath. as identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
My Commission Expires:
x* *x**xxx*it** xxxx*
owtw
APPLICATION APPROVED BY:
(Revised 02/08/06)
IRO All
v I 7r.
xxx
NOTARY PUBLIC:
Sign:
Print:
My Commi
•r
pieMlY COMMISSION # DD 391258
os yy ..��E.X�,�PPI�,R�.j,(E.S: May yyy3.}}��0, 2009 yn
Xtalletl1NOfa T(6RIG IOx
xxx
gPlans Examiner
Engineer
Zoning
&hop ipor
T gar p 'Lh .
4x3
cep? ga dai
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