PL-09-1073Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
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Inspection Number: INSP - 165362 Permit Number: PL -6 -09 -1073
Scheduled Inspection Date: October 26, 2011
Inspector: Hernandez, Rafael
Owner: LEE, PATRICK
Job Address: 1122 NE 97 Street
Miami Shores, FL 33138-
Project: <NONE>
Contractor: DIAL PLUMBING CORP
Permit Type: Plumbing - Residential
Inspection Type: Final
Work Classification: Gas
Phone Number
Parcel Number 1132050170170
Phone: (305)221 -8569
Building Department Comments
GAS PIPING TO WATER HEATERS AND STOVE
Passed
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Inspector Comments
CREATED AS REINSPECTION FOR INSP- 117871. not ready for final
October 25, 2011
For Inspections please call: (305)762 -4949
Page 16 of 33
Miami+thores Village
Building Department
>0050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 7952204 Fax: (305) 756.8972
BUILDING
PERMIT APPLICATION
FBC 2004
Permit Type: Plumbing
Owner's Name (Fee Simple Titleholder)
Owner's Address JI27.
City 4,04i, 4, de* State
Tenant/Lessee Name
E -lawn:
JUN 2 5 2009
BY: __h_vm____ m__ese
Permit No. V 0+ I 013
Master Permit Na. RC O' t
697-m Sr.
Zip 3313R.
Phone #
Phone # 6,6 7s7— 61fGr
P4.12- 2 7 ea.r 477044 .11-N
Job Address (where the work is being done)
City Miami Shores Village
FOLIO / PARCEL #
Is Building Historically Designated YES NO
County
Miami -Dade
Zip
Contractor's Company Name
Contractor's Address 4l VD i#J £
City i'/UttA4 State Pt
Qualifier Name
State Certifi
E -MAIL:
Phone #
72,z,p e 3-61
zip 33 -/4, 4'
Phone# ger 7ili/ 8,S-b-`3
Certificate of Competency No. O 0 4 0 / . // 3 /4"
Archftect/Engineer's Name (if applicable) Phone #
Value of Work For this Permit $ 1,70
Type of Work: ['Addition
Describe Work:
Square / Linear Footage Of Work:
dew ❑ Repair/Replace ❑
��- Demolition
el
Submittal Fee $
Permit Fee $
*
Notary $ . Training/Education Fee $
Scanning $&'3 '00 Radon $ DPBR $
** * * ** *** * ***
CCF $
Technology Fee $
CO /CC
Zoning $
Bond $ Code Enforcement $ Double Fee $
Structural Review. $ Total Fee Now Due $ r S®` 30
See Reverse side -�
,
Cli State 711)
Mortgage Lender's Name (if applicable)
City State Zip
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wueuiencea 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 mist be secured for ELECTRICAL WORK, PLUMBING, SIGNS,
WET .S FOOT ,S FITRNACFS Rt)TT.FRS HEATERS TANKS and AIR C ONI)TTIONRRS FTC
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.
._.. .... A..•
rsor uin, rwn;E MR 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
•
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Jor one first inspection whic
inspection will not be
s seven (7)
and a reinspec
Owner or Agent
The f reanini' instnument was ae:knn
ee will be charged
•
after the building permit is issued In the absence of such posted notice, the
Pell before me this
day of i19�� , 20 0, dry T 474 C - Lift
who is personally known to me or who has produced
NOTARY PUBLIC:
Print:
PATRICIA ELENA CEPERO
Commission. Dn 734374
:41f Expires November 14, 2011
Contractor pp
The form-inn instnmient was anknnwlee1Pe d hefnre me this U
day of .bane 200, by P/a�� /9 /0/2/66k2?
who is personally known to me or who has produced
,......w.....w...vaa caul. Wtttr wu Iaz c WI UWli.
NOTARY PUBLIC:
My Commission F.xnwes' Mc C ommission F _ -
.,it... : *n ssKrres**rs*:a*aaa 481 Qaae
a/L Ail-IC.-.1 Sse *er *sa•. Nas * * * * ** ***ea * *.•em.* :/a, te / / �s t.�il ans Examiner *s*Mt
' ircr —
il Engineer
Zonm
(Reviatd 02 08 06)
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