PL-2004-233A
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Inspection Date: 12/18/2007
Inspector: Levrock, James
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Sho res, FL
Phone: (305)795 -2204 Fax: (305)75 6-8972
Owner: SYMES, ALEXIS & STEPHEN
Job Address: 313 92 Street NE
Miami Shores Village, FL
Project: <NONE>
Contractor:
Building Department Comments
ZI1_'
Permit Type: Plumbing - Residential
Inspection Type: Final
Work Classification: Addition /Alteration
Block:
Phone Number
Parcel Number 1132060136360
Lot:
WORK FOR REMODELING FIXTURES AND UPGRADE
xt ,
Qst19'101
Passed
Insp
to Comments
Failed
Correction
Needed
Re- Inspection
Fee
($75)
No Additional Inspections can be scheduled
re- inspection fee is paid .
until
Monday, December 17, 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
BUILDING
PERMIT APPLICATION
FBC 2001
Master Permit No.
So7
Permit Type (circle): Building Electrical Plumbing Mechanical Roofing
Owner's Name (Fee Simple Titleholder) I
Owner's Address -- G
CityP 1 S(4 State
Tenant/Lessee Name
a(a
Zip
Phone #
324 9? 3
Job Address (where the work is being done)
City Miami Shores Village County Miami -Dade Zip
Is Building Historically Designated YES NO
Contractor's Company Name
Contractor's Address
.-o
City
Qualifier
Phone # 7 0 5--).- 6 >_(e/./
A(
ir
State Certificate or Registration No. /'/4 / < / O Certificate of Competency No.
Architect/Engineer's Name (if applicable) Phone #
$ Value of Work For this Permit
Type of Work: ❑ tion
Describe Work:
/1
i 1�
cO
C] Alteration ON
Square Footage Of Work:
Repair/Replac j ❑ Demolition
* * * * * * * * * * * * * ** * * * * * * * * * * ** *Fees * * * * * * * * * * * * ** * * * * * * * * * * * * * **
Submittal Fee $ c�O .00 Permit Fee $ 9'39"' CCF $3. 0 0 CO /CC
Notary $ .5 0 0 Training/Education Fee $ 1 . 0 0 Technology Fee $ l 0, t &
Scanning $
Code Enforcement $ Structural Plan Review. $
Radon $
Zoning,
Total Fee Now Due $ 3 1 7 t S
(Continued on opposite side)
�c
ApR 12 PAID
Bond $
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 y- 'ttachment. Also, a certified copy f the recorded notice of cowmen ement must be posted at the job site
for the first inspection wh' occurs seven (7 'ays after t building permit is issued. 1 e absence of such posted notice, the
inspection will not be app / ed and a reinsp n fee will , harged.
Signature 14101
Owner or Agent
The foregoing in ent was acknowledged before me this
day of , 2 , by
who is personally • •; who has produced
_ 1111.10,17'n . d who did take an oath.
Signa
Contractor
The foregoing instrument was acknowledged before me this
day of ,20_,by
who is personally known to me or who has produced
as identification and who did take an oath.
NOT ' Y PUBLIC: NOTARY PUBLIC:
Sign: Sign:
Print: Print:
My Commission Expires:
My Commission Expires:
***************************************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** ****-# * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** *** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
E
APPLICATION APPROVED BY i en,L' , - ' '' I Plans Examiner
Engineer
Zoning
Chc 05/13/03
Issue Date: 12/22/2005
Owner's Name: ALEXIS POWELL
Permit Type: Plumbing - Residential
Work Classification: Addition /Alteration
Miami Shores Village
10050 N.E. 2nd Avenue
Miami Shores, FL 33138 -0000
Phone: (305)795 -2204 Fax: (305)756 -8972
Permit
Expires: 05/17/2005
Job Address: 313 92 Street NE
Miami Shores Village, FL
Contractor(s)
Phone
Primary Contractor
Comments:
WORK FOR REMODELING FIXTURES AND UPGRADE
Additional Information
Type of Work: REMODELING
Additional Info:
Type of Piping:
Bond Return :
In consideration of the issuance to me of this permit, I agree to perform the work
covered hereunder in compliance with all ordinances and regulations pertaining
thereto and in strict conformity with the plans, drawings, statements or specifications
submitted to the proper authorities of Miami Shores Village. In accepting this permit I
assume responsibility for all work done by either myself, my agent, servants, or
employes. I understand that separate permits are required for ELECTRICAL,
PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING
POOL work.
OWNERS 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. Futhermore, I authorize the above -named contractor to do the work
stated.
Fees Due
CCF
Education Surcharge
Miscellaneous Fee
Notary Fee
Permit Fee - Additions /Alterations
Scanning Fee
Technology Fee
Work without Permit Fee
Total:
Amount
$3.00
$1.00
$80.00
$5.00
$175.00
$3.00
$10.75
$175.00
$452.75
Building Departme
ile Copy
Parcel #:
Block:
Section:
Permit Status: APPROVED
Permit Number: PL2004 -233
Phone:
1132060136360
Lot:
PB:
Total Square Feet:
Total Valuation:
Required Inspections
0
$ 5,000.00
Underground Rough
Water Main
Top Out
Main Drain
Lavatory
Water Service
Re Pipe
Heater
Final
Invoice Number
PL -12 -05 -23210
Total:
Amt Due
$452.75
APR R1 2 PAID
Amt Paid
NOTICE: In addition to the requirements of this permit, there may be
additional restrictions applicable to this property that may be found in the
public records of this county.
AND THERE MAY BE ADDITIONAL PERMITS REQUIRED FROM OTHER
GOVERNMENTAL ENTITIES SUCH AS WATER MANAGEMENT
DISTRICTS, STATE AGENCIES, OR FEDERAL AGENCIES.
r �
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Date: 06/06/2006
Inspector: Levrack, James
Owner: POWELL, ALEXIS
Job Address: 313 92 Street NE
Miami Shores Village, FL
Project: <NONE>
Contractor:
Permit Type: Plumbing - Residential
Inspection Type: Plumbing
Work Classification: Addition /Alteration
Block:
Phone Number
Parcel Number 1132060136360
Lot:
Building Department Comments
SHOWER PAN'
C� ' /
Passed
spe to
A omments
Failed
Correction
Needed
Re- Inspection
Fee
($75)
No Additional Inspections can be scheduled
re- inspection fee is paid.
until
Tuesday, June 6, 2006
Page 2 of 2