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PL-12-1504• < . Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 nspection Number: INSP - 181643 Permit Number: PL -8 -12 -1504 Inspection Date: November 15, 2012 Inspector: Hernandez, Rafael Owner: FRANKLIN, TRACY Job Address: 77 NE 100 Street Miami Shores, FL 33138- Project: <NONE> Contractor: ELITE GAS CONTRACTOR INC Permit Type: Plumbing - Residential Inspection Type: Final Work Classification: Gas Phone Number (917)826 -6492 Parcel Number 1132060131430 Phone: (786)333 -0679 Building Department Comments INSTALL 250 GAL PROPANE TANK AND GAS LINE TO 2 TANK LESS WATER HEATERS BBQ RANGE AND DRYER Infractlo Passed Comments INSPECTOR COMMENTS False Passed Inspector Comments CREATED AS REINSPECTION Ot REINSPECTION FOR INSP- 181420. CREATED AS F R INSP- 177118. not ready Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled re- inspection fee is paid. until November 15, 2012 For Inspections please call: (305)762 -4949 Page 1 of 1 Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305) 762.4949 Dap BLTILbING M PERMIT APPLICATION Permit Type: PLUMBING JOB ADDRESS: 77 /' /D© J7 RECEIVED AUG 0 ?, FBC 201 Permit No. 12— ISCA Master Permit No. City: Miami Shores County: Folio/Parcel #: 3)-0(0 - 0/ - /Y30 Miami Dade Is the Building Historically Designated: Yes NO f C Flood Zone: OWNER: Name (Fee Simple Titleholder): 41 44-Z-466- Phone#: Address: i A444— /00 Jf City: Ai% ,,0 ,/ State: Zip: Tenant/Lessee Name: Phone#: Email: Phone #: 71b 333 0677 CONTRACTOR: Company' 1' Name: %� Pz X7 4 -/� Address: ! X � t 3J /i City: / 1 _? L1 State: Y7( Qualifier Name: zip: 33 0 Phone #: 7/6-333-D67; State Certification or Registration #: 4 e01/. 2- Certificate of Competency #: Contact Phone#: 7d 6 333 Ott 27 Email Address: / € l e.6I1CC -.d / co-A- DESIGNER: Architect/Engineer: Phone#: Value of Work for this Permit: $ 025r S , Square/Linear Footage of Work: Type of Work: ❑Address 9afteration " ❑New ❑Repair/Replace Description of Work: /9/9M ire • id& i k! %1///11 ,% _ l! ice✓ f, / fc Mo Aleve ❑Demolition ****** *** * ************** *********+x *****Fees******* * * ** **** *+ x****+x** **** * * * *** * * * **** ** Submittal Fee $ -T IP. , AN Permit Fee $ l5- ■ Scanning Fee $ Radon Fee $ Notary $ Training/Education Fee $ Double Fee $ Structural Review $ CCF $ CO /CC $ DBPR $ Bond $ Technology Fee $ TOTAL FEE NOW DUE $ ��L • b-, OrindiIg Compr any'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 AI'F11)AVIT: 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 co : ment must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issue In t - absence of such posted notice, the inspection will not be q)Qproved and a reinspection fee will be charged. Signature Signature 0 e or Agent Contractor The foregoing instrument was acknowledged befor The forego, rg instrument was acknowledged before me -�+ ,�- day of 11'20 ��—by %l ��� who is personally known to me or who has produced As identification and who did take an oath. NOTARY PUBLIC: �a�s�® ®19000 ®�oo ae. adda TAMMY B. VALDES 4117411,;/4 Comm# DD0804506 . 46'1 Sign: Expires 9/5/2012 e;ari•'Fa ".34„ ,, Florida Notary Assn., Inc Print: 0019. 0e.o..9.P9919.......1919.......1919. My Commission Expires: day of ; T' , 20/z, by who is personally known to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: Sign: Print: TAMMY B. VALDES gam �R4, Comm# DD0804506 s Y Expiiab 9/5/2012 x® ` Florida Notary Assn_ Inc My Commission Expires: + N*M+ N**+ N********.b****** ***** MMNW *+ N**+ k+ N*M ***+ N********* * *******+1•*****+PM*+ Ads****+ N*N. *******+ hga*************B**+ *** APPROVED BY kb, 2-R-12- Plans Examiner Structural Review (Revised3 /12/2012)(Revised 07 /10 /07)(Revised 06 /10 /2009)(Revised 3/15/09) Zoning Clerk Elite AS CONTRAEiTOFI /NC, Nt z 4. S c� ova subtcrbecl before me this day by TAMMY�wB...V�kpLOEESe �/�� Wmm#DWV04506 07, Stres 9152012 &RSS Florida Wary Assn., Inc nay S. 1 o N 41 1■1 ''S 4 K - w� w AP PRO\iED ZONING DEPT [ DC. DEPT BY DATE fet 'ECT iO CC, !NICE 'Ad PH ALL FEDERAL ECEUVE AUG 0 7 k #' Elite GAS CONTAACiTOA INC. 3,// h76', to Dnd iubbabed Wore me this day °day d��.�7_ by TAMMY B. *WEB ComODD0804506 • s s 915n012 a1 IJoteuyAssn.,Ina