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PLC-07-319i . - ,5'°Rs,r Inspection Worksheet Miami Shores Village �BBOB II�_ BB /BIB 10050 N.E. 2nd Avenue Miami Shores, FL '��oRivA Phone: (305)795 -2204 Fax: (305)756 -8972 � Inspection Date: 10/11/2007 Inspector: Levrock, James Owner: , JIFFY LUBE Job Address: 8787 BISCAYNE Boulevard Miami Shores Village, FL Project: <NONE> Contractor: FELIX FERA PLUMBING Buildina Denartment Comments Permit Type: Plumbing - Commercial Inspection Type: Final Work Classification: Septic umw� Phone Number Parcel Number Block: Lot: 1132060280450 Phone: 954 -981 -3016 ABNADON SEPTIC TANK ®C1 15 X001 In , pe or mments Passed Failed E]_ Correction Needed Re- Inspection Fee ($75) No Additional Inspections can be scheduled until re- inspection fee is paid. Wednesday, October 10, 2007 Page 2 of 2 Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Fax: (305)756 -8972 Permit Permit Status: APPROVED Issue Date: 318/2007 Expires: 09104/2007 Permit Number: PLC -2 -07 -319 Owner's Name: JIFFY LUBE one: Permit Type: Plumbing - Commercial Work Classification: Septic Job Address: 8787 BISCAYNE Boulevard Miami Shores Village, FL Contractor(s) Phone Primary Contractor FELIX FERA PLUMBING 954- 981 -3016 Yes Additional Information 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 Amount CCF $0.60 Education Surcharge $0.20 Permit Fee - Additions /Alterations $175.00 Scanning Fee $3.00 Technology Fee $4.37 Total: $183.17 Building Department File Copy Applicant Signature Parcel #: 1132060280450 Block: Lot: Section: PB: Total Square Feet: 0 Total Valuation: $ 1,000.00 Invoice Number Amt Due Amt Paid PLC -3 -07 -27778 $183.17 Total: 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. - 'ADDENDUM TO BUILDING PERMIT APPLICATION AN APPLICATION FOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. IF A MASTER PERMIT HAS BEEN OBTAINED, THE OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS. �q PLEASE CIRCLE O DISCIPLINE APPLIED FOR: PERMIT # LUMBING ELECTRICAL MECHANICAL ITEM UNIT FEE ITEM UNIT FEE ITEM UNIT FEE BATH TUB SWITCH OUTLETS SPACE HEATERS DISHWASHER LIGHT OUTLETS CENTRAL HEATING DISPOSAL RECEPTACLES A/C (WIND) FLOOR DRAIN ISERVICE TEMPORARY A/C (CENTRAL) GREASE TRAP ISERVICE SIZE IN AMPS DUCT WORK INTERCEPTOR ISERVICE REPAIRIMETER CHANGE REFRIGERATION LAVATORY JAPPLIANCE OUTLETS PROCESS AND PRESS PIPING LAUNDRY TRAY RANGE TOP UNDERGROUND TANKS CLOTHES WASHER JOVEN ABOVE GROUND TANKS SHOWER IWATER HEATER U.F. PRESSURE VESSELS SINK. POT /3 COMP. IMOTORS 0 -1 HP STEAM BOILERS SINK, RESIDENCE. MOTORS OVER 1 -3 HP HOT WATER BOILERS SINK, SLOP. IMOTORS OVER 3 -5 HP IMECHANICAL VENTILATION TEMPORARY WATER CLOSET MOTORS OVER 5-8 HP ITRANSPORTING ASSEMBLIES URINAL MOTORS OVER 8-10 HP ELEVATORS/ESCALATORS WATER CLOSET MOTORS OVER 10 -25 HP I FIRE SPRINKLER SYSTEMS INDIRECT WASTES IMOTORS OVER 25 -100 HP ICOOLING TOWERS WATER SUPPLY TO: IMOTORS OVER 100 HP IVIOLATION A/C UNIT JAIC WINDOW IREINSPECTION FIRE SPRINKLER JAIR CONDITIONERS HEATER -NEW INST. ISTRIP HEATER HEATER - REPLACE IGENERATORS TRANSFORMERS LAWN SPRINKLER -WELL IGENERATORS TRANSFORMERS SWIMMING POOL IGENERATORS TRANSFORMERS WATER SERVICE ISPECIAL PURPOSE. SEWER CONNECTIONS OUTLETS COMMERCIAL UTILITY -SEWER SIGN TUBES UTILITY -WATER SIGN TRANSFORMERS EPTIC TANK SIGN TIME CLOCK RELAY FIXTURES FAINFIELD, 4" TILEIRES. JANTENNA PUMP & ABANDON SEPTIC TANK ITELEVISION OUTLETS SOAKAGE PIT CU. FT. VIOLATION CATCH BASIN IREINSPECTION DISCHARGE WELL DOMESTIC WELL AREA DRAIN ROOF INLET SOLAR WATER HEATER FIRE STANDPIPE POOL PIPING LAWN SPRINKLER SYSTEM GAS RANGE METER SET (GAS) GAS PIPING Receipt Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Fax: (305)756 -8972 Permit Number: PLC -2 -07 -319 Owner Address: Invoice Number: PLC -3 -07 -27778 PO BOX 2967 Applicant: JIFFY LUBE HOUSTON, TX 77252 Company Name: COMMERCE PARTNERSHIP #1124 % JIFFY LUBE iniri nc nen Job Address: 8787 BISCAYNE Boulevard Miami Shores Village, FL Date Payment Type Check Number Amount Change Monday, March 12, 2007 03/12/2007 Check 2828 $183.17 $0.00 Total Payment: $183.17 Page 1 of 1 Miami Shores Village Buildin g Department artment C107M 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 FEB 21 tool Tel: (305) 795.2204 Fax: (305) 756.8972 19 ........ BUILDING 03ja /0 ' Permit No. kc PERMIT APPLICATION C-10 � Master Permit No.� FBC 2001 Permit Type (circle): Building Electrical Plumbing Mechanical Roofing Owner's Name (Fee Simple Titleholder) J r T T� V q Phone # Owner's Address �• &,7 • 0 Z City / -Y s O h State Zip Tenant/Lessee Name Phone # Job Address (where the work is being done) r 7 8 % : f a Q y 7 c° i31c. -4 City Miami Shores Village County Miami -Dade Zip Is Building Historically Designated YES NO i+Q v fD.,r� qs ^V��A� 9y Contractor's Company Name I'� �i`�1 f C'' C! /' �� M� ��k y Phone #�� Contractor's Address tf /y,E f �f C/ S ✓e p City 4'1,P,-f4 A: "t'i i LL State F L Zip 513 Qualifier 4 f 14 o a y Ga T A,d4 4 n Architect/Engineer's Name (if applicable) Phone # 00 $ Value of Work For this Permit /OOo "� Square Footage Of Work: Type of Work: ❑Addition ❑Alteration [--]New ❑ Repair/Replace ❑ Demolition Describe Work: A 44-Ar ela r . f d,- c. Id-Alt Submittal Fee $ Permit Fee $ 1 //19 CCF $ i ko-u - CO /CC Notary $ Training/Education Fee $ Technology Fee $ 413 Scanning $ — Radon_ $ Zoning Bond $ Code Enforcement $ Structural Plan Review. $ Total Fee Now Due $ A;� 1 (Continued on opposite side) Bonding Company's Name (if applicable) Bonding Company's Address City State Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State Zip Zip_ I I . - 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 and a reinspection e charged. Signature Signature Owner or Agent Contractor The foregoing instrument was acknowledged before me this �Y day of rr h 20,97 , by !Midi e %�S S who is personally known to me or who has produced As NOTARY PUBLIC: Sign: Print: My Commission Expires: I who did take an oath. Gary Kilgore Expires April 8, 2010 Banded Trey Pan • Mewer a, Inc. I&M The foregoing instrument was acknowledged before me this p day of Fe , 200) by Xlt �� y �Q pdstO who is personally known to me or who has produced as identification and who did take an oath. ARY PUBLIC: -- 7 Sign: G ilgore Print: �` Expires April 8, 2010 ray sM : MIly -0, Ind, AD4Qd6 7019 My Commission Expires: (Certificate of Competency Holder) State Certificate or Registration No. f C Certificate of Competency No. APPLICATION APPROVED BY: Mans Examiner Engineer Zoning Chc 12/15/03