PL-08-748Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Date: 04/25/2008
Inspector: Levrock, James
Owner: ALDERMAN, JASON
Job Address: 357 97 Street NE
Miami Shores Village, FL
Project: <NONE>
Contractor: THE NEW MIAMI SHORES PLUMBING
Permit Type: Plumbing - Residential
Inspection Type: Final
Work Classification: Addition /Alteration
Usiosso. Phone Number (305)539 -7249
Block:
Parcel Number 1132060135750
Lot:
Phone: (305)751 -2446
Buildinu Department Comments
install (2) two way clean out
tv
Iri
P or Comments
Passed
Failed
Correction
Needed
Re- Inspection
Fee
($75)
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Thursday, April 24, 2008
Page 2 of 2
417_4101 )TP0
--1j00
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
1,R!, tJ
1it ;PR 2 3 2308
BY: CL`---
Permit No.l Q 1
Master Permit No.
Permit Type: Plumbing I.r : Jok5150rl
Owner's Name (Fee Simple Titleholder) I (,y�Se�°1 A� dQv'm can 46 Phone #
Owner's Address 3 5 7 N EJ t7 54
City 1CA in\ 9/(6 State r I Zip 5513B.
Tenant/Lessee Name
E -MAIL:
Job Address (where the work is being done) 651 '4' 1iS
City Miami Shores Village County Miami -Dade
FOLIO / PARCEL # Ike 32 OCo ° 0 13- 575 0°
Phone #
ti
Zip
Is Building Historically Designated YES NO
Contractor's Company Name Ike RN.) i` \ c rr t Store) T IUvost{9inq Phone # 305 75 I Z-44
(�.
Contractor's Address C100 NUJ ii 44 51- J
City iv\tam 1 , A State F I Zip 3 -31 (r�'
Qualifier Name De''lrl tSQ LC,tC� h1 �1 Phone #
State Certificate or Registration No. C F LO 2.0 5 .- Certificate of Competency No.
E -MAIL:
Architect/Engineer's Name (if applicable)
Value of Work For this Permit $ 6100
Phone #
Square / Linear Footage Of Work:
Type of Work : . IAddition.. ,Utiferi4ion ONew .,Repair /Replace ❑ Demolition
3
Describe Work: ' 1109+c1-111 tt. - Cfj0 tA) CC a l
iii, .�
xxxxx *xx *xxxxxxxxxx * * * * *x x x x xxxxxxx * * * *W****w xx * x*xxxxxrxxxxxxxxxxxxxxxrxxxxk
Submittal Fee $ Permit Fee $
Notary $ Training /Education Fee $
Scanning $ *-6 "OD
Bond $
Radon $
I0n�
0.0-0
DPBR $
CCF $ 0 •(Q0 CO /CC
Technology Fee $ 3-15
Zoning $
Code Enforcement $ Double Fee $
Structural Review. $ Total Fee Now Due $ C.m 0 •��
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. 1 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 ftrst inspection which ocHrs se, - cn (7) days after the building permit is issued. In the absence of such posted notice, the
inspection will not be approved an. r inspection fee will be charged.
Signature
Owner or Agent
The foregoing instrument was acknowledged before me this 9 3
day of 4r:4 , 20 0� , by Kr o 5 ) O t () 5O )
who is personally known to me or who has produced
As identification and who did take an oath.
NOTARY PUBLIC:
Sign:
P nt:
My Co
10 MARTINEZ JR.
o ry ' ub c • tate of Florida
"" ' Commission Expires :an 3, 2011
�> p COs ppmmisstop PO 6 tiVI
Inr
APPLICATION APPROVED B
(Revised 02/08/06)
r
xxxxxxrxx
Signature
Contractor
The foregoing instrument was acknowledged before me this2,3
day of \V ,20C'P,by
who ispersonally known to me or who has produced
as identification and who did take an oath.
NOTARY PUBLIC:
Sign:
My C
1/1
=r °'c+�N�otary Pubpc - State of Florida
=y�
1111 r rorlunIssion Expires . an 3, 2011
°o xx>e#6xx
„,," Bonded Through National Notary Assn.
a�'
Plans Examiner
Engineer
Zoning
:r.