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PL-13-1762z Inspection Number: INSP - 196581 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Scheduled Inspection Date: November 07, 2013 Inspector: Diaz, Osvaldo Owner: PETERSON, DIRK & ELIZABETH Job Address: 1350 NE 101 Street Miami Shores, FL Project: <NONE> Permit Number: PL -8 -13 -1762 Permit Type: Plumbing - Residential Inspection Type: Final Work Classification: Gas Phone Number Parcel Number 1132050230020 Contractor: CAPITAL GENERAL CONTRACTORS & DEVELOPERS INC Phone: (305)827 -6211 Isunamg uepanment comments GAS CONNECTION TO WATER HEATER AND POOL Infractio Passed Comments HEATER I INSPECTOR COMMENTS False Inspector Comments Passed Di b .f-1 r-� 1 Failed Correction Needed Re- Inspection ❑ Fee No Additional Inspections can be scheduled until re- inspection fee is paid. 3 November 06, 2013 For Inspections please call: (305)762 -4949 Page 10 of 40 GENERAL CONTRACTORS & DEVELOPERS, INC. CGC 1504082 - CMC 1250161 - CFC 1428436 Carlos Bello President 480 West 84th St. Suite B -106 Office: 305 - 827 -6211 Hialeah, FL 33014 Fax: 305 - 827 -6411 Email: cgc@capkalgeneralcontractors.com Toll Free: 866 - 501 -4172 INVOICE / WORK ORDER Prepared By: L:H /G�W � � Date R1�� - U4 s' Approval: Date Promised: AWPM Name yl i6� W�s t DCN C C- , Account # Js 1(� S 1 S%J S Service Address: City 'A ISM i Si QIZL- 5state Zip Day Phone ( ) Work Phone Pager Other Phone Billing Address: City State Zip Terms: ❑ COD ❑ CHARGE $ Index: Meter#: Current Reading .'revious Reading / Date / INSTALLATION/TYPE: INSTRUCTIONS: 13 New Installation El Temporary Off El Final ❑ Appliance CJ COMMERCIAL RESIDENTIAL ❑ Turn On ❑ Restore ❑ PUE (Pick -Up) Service MERCHANDISE % APPLIANCE INFORMATION: INSTRUCTIONS: New Meter # New Reading: WORK PERFORMED: DR©D i+rSST 6V— I*-3C� ,_ ❑ REWRITTEN DATE WORK ORDER # CUSTOMER: I HAVE WITNESSED THE MANOMETER TEST OPERATING WC, i C LOCKUP WC, TEST AT , w TESTED 15 I� MINUTES. I HAVE ALSO BEEN INTT SAFE USE OF APPLIANCES AND RELATED GAS EQUIPMENT PLUS I HAV ODOR AND CAN READILY DISTINGUISH ITS ODOR. I HEREBY ACCEPT ABOV VICE AND CHARGES AS BEING SATISFACTORY AND ACKNOWLEDGE THAT E N LEFT IN GOOD CONDITION. CUSTOMER I U f) 3 SIGNATURE: - - -- ��:� - - - - -- DATE: SERVICEMAN: AQL- t--- - - - - -- DATE: II ®� ) TIME IN ff 1,041591 "1 OFFICE USE ONLY Amount collected: Check Number. Cash Amount $: Money accepted by: Service: Office: BUILDING Miami Shores Village g AUG o 5 2013 Building Department 90050 N.E.2nd Avenue, Miami Shores, Florida 33138 — Tel: (305) 795.2204 Fag: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305) 762.4949 FBC 20� Permit No. PERMIT APPLICATION Permit Type: PLUMBING JOB ADDRESS: 1350 NE 101 ST Master Permit No. RC -10 -12 -1984 City: Miami Shores County: Miami Dade 4p. 33138 Folio/Parcel #: 1132050230020 Is the Building Historically Designated: Yes NO X Flood Zone: OWNER: Name (Fee Simple Titleholder): Dirk & Elizabeth Peterson Phone#:305- 333 -9955 1350 NE 101 ST City: Miami Shores Tenant/Lessee Name: Email: State: FL Zip: 33138 CONTRACTOR: Company Name: Capital General Contractors Phone#: 305 - 827 -6211 Address: 480 West 84 ST B -106 City Hialeah State: FL Zit): 33014 Qualifier Name: Carlos Bello Phone#: 305 -827 -6211 State Certification or Registration #: CFC 1428436 Certificate of Competency #: Contact Phone#: 305 -827 -6211 Email Address: CGC @capitalgeneralcontractors.com DESIGNER: Architect/Engineer: Victor Bruce - AI- Associates Phone#: 305 - 310 -5030 Value of Work for this Permit: $2,400.00 Square/Linear Footage of Work: 0 Type of Work: DAddress ❑Alteration DNew DRepair/Replace ❑Demolition Description of Work: GAS CONNECTION TO WATER HEATER/POOL HEATER (refer to master permit) Submittal Fee $ Permit Fee $ / `��' i CCF $ CO /CC $ Scanning Fee $ Radon Fee $ Notary $ Training/Education Fee $ Double Fee $ Structural Review $ DBPR $ Bond Technology Fee $ TOTAL FEE NOW DUE $ CJ Bonding Company's Name (if applicable) N/A Bonding Company's Address City State Mortgage Lender's Name (if applicable) N/A Mortgage Lender's Address city State zip 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 which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved areinspection fee will be charged. -q � 14u— Signature 101-1211-1--r •• • The foregoing instrument was acknowledged before me this -57q day of Ag U51 .20)3 , by 1C'41865111 FETM--,Qh/ , who is personally known to me or who has produced As identification and who did take an oath. NOTARY PUBLIC: Sign: // Prmt: O/ °s W CAWSSION # FF 02$437 My Commission Expires: 9/� EXPIRES: September 23, 2017 • ;q t Bonded Thm NotmY Pubk Undeav tm APPROVED BY The foregoing instrument was acknowledged before me this �Llv day of AV4,IS:iT 20 l3 , by &P-(05 who is personally known to me or who has produced as identification and who did take an oath. " L ^ l :5 Plans Examiner Structural Review (Revised3 /12/2012)(Revised 07 /10 /07)(Revised 06 /10/2009)(Revised 3/15/09) NOTARY PUBLIC: Sign: I, Print: ©1a_ My Commission Expires: OMLCRUZ W COMMISSION # FF 028437 EXPIRES: September 23, 2017 Zoning Clerk