PL-10-1679 Miami Shores Village -- -
Building Department kAUG 0 9 2007
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305)795.2204 Fax:(305) 756.8972 BY:__0�_________-
BUILDING ff -
Permit No. l.� ,�
PERMIT APPLICATION Master Permit No. .
FBC 2004
Permit Type: Plumbing
Owner's Name(Fee Simple Titleholder) -6-a c),gh _e,,, Phone# 065-- '-7) 3( oE2 J
Owner's Address_?S-1 p S-
City110M)' e _State f`'1 Zip
Tenant/Lessee Name Ilin
I Phone#
E-MAIL: V1 v City l�"�-e. 0, Gt S C
Job Address(where the is being done)
City Miami Shores Village County Miami-Dade Zip
FOLIO/PARCEL# J) 2-2 3
Is Building Historically Designated YES NO
Contractor's Company Name Phone# 3 b 37� q41 C/ G 29P-
Contractor's Address T T-0
N ) 17 S/—
City 13 1'S e A-yQj YJ A >z/L State /- Zip_ -33 )(01
Qualifier Name INft Phone#
State Certificate or Registration No. L LEUCompetencyNo.
E-MAIL:
Architect/Engineer's Name(if applicable) Phone#
Value of Work For this Permit$ Square/Linear Footage Of Work:
Type of Work: ❑Addition ❑Alteration ❑New [ Repair/Replace
y— ❑ Demolition
Describe Work: n 10 (A J (a,l l I()_?�1r Q4 1,64 gq=ie �' y� �e
ld�
p�
Submittal Fee$ Permit Fee$ CCF$ CO/CC
Notary$ 5.QQ Training/Education Fee$ �-�� Technology Fee$
Scanning$ Radon$ DPBR$ Zoning$
Bogd„$ Code Enforcement$ Double Fee$
Struoura(Revi Total Fee Now Due$ t q f9 L D
See Reverse side-MG 13 PAID
('dS�
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 orinstallation 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,fee will be charged /
Signature
,�=— Signature
Owner or Agent C ntractor
The foregoing instrument was acknowledged befo_rq%f t is, f re oing in rument was acknowledged bef e me this
day of t,'S 1 ,20 �,by V
D_ f by
20 ,
who is personally known to me or who has produced who is pe sonally�kknown to me or who has produced Y11 jl(✓
As identification and who did take an oath. i I b as identification and who did take an oath.
NOTARY UBLIC: NOTARY PUBLIC:
Sign: Sign: 1;
�912
Print: Y -6 ORIDA Print:
tuict L. J
My Commission Expires: ocommfssiorl#DD�47480 M
y Commission Expires. '_oz
BondedThruA cWa g G k4#*****************
APPLICATION APPROVED BY: 72 1Plans Examiner
Engineer
Zoning
(Revised 02/08/06)
LIED
CAME
5N°Rs4 Inspection Worksheet
... ..�+
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
FXOR IDp'
Phone: (305)795-2204 Fax: (305)756-8972
� r
Inspection Date: 08/21/2007 Permit Type: Plumbing - Residential
Inspector: Levrock,James
Inspection Type: Water Main
Owner: ENGEL,JERRY Work Classification: New
Job Address: 351 105 Street NE
Miami Shores Village, FL 33138- Phone Number
Parcel Number 1122310130290
Project: <NONE>
Block: Lot:
Contractor: EDDIE ROJAS PLUMBING INC Phone: 305-944-6788
Building Department Comments
REPIPE HOLE HOUSE
/i�v7 //(j'W C�
9) A.,S ®1
Inspector Comments
Passed E:I_
Failed
Correction
Needed
Re-inspection
Fee
($75)
No Additional Inspections can be scheduled until
re-inspection fee is paid.
Monday,August 20, 2007 Page 2 of 2
Receipt
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL 33138-0000
Phone: (305)795-2204 Fax: (305)756-8972
Permit Number: PL-8-07-1679 Owner Address:
Invoice Number: PL-8-07-29443 351 N. E. 105 ST.
Applicant: JERRY ENGEL
Company Name:
Job Address:
351 105 Street NE
Miami Shores Village, FL 33138-
Date Payment Type Check Number Amount Change
Monday, August 13, 2007
08/13/2007 Cash $194.90 $0.00
Total Payment: $194.90
Page 1 of 1
IUB P'L4-0?-1679
Sd�RryS � Miami Shores Village 'iy r T?�Btai1 >Typ+�' Ul l� R"NOW
s.,
10050 N.E.2nd Avenue
Miami Shores,FL 33138-0000
c
Phone: (305)795-2204 i�lT1fI $taE#S,AIPROVED
�t:ORIOP'
,,; Expiration: 02106/2008
r
77,
Project Address Parcel Number Applicant
351 NE 105 Street 1122310130290
....j
L.
Miami Shores Village, FL 33138- Block: Lot: JERRY ENGEL
Owner Information Address Phone Cell
JERRY ENGEL 351 N. E. 105 ST.
.j
Contractor(s) Phone Cell Phone Valuation: $ 2,500.00
EDDIE ROJAS PLUMBING INC 305-944-6788
Total Sq Feet: 0
Type of Work: RE-PIPE HOUSE Available Inspections:
Type of Piping: PLUMBING Inspection Type:
Additional Info:WATER LINE
Re Pipe
Bond Return: Main Drain
Classification:Residential Heater
Underground Rough
Final
Top Out
Water Service
Water Main
Lavatory
Fees Due Amount Total Amt Paid Amt Due
CCF $1.80
Education Surcharge $0.60 $0.00 $0.00 $ 0.00
Notary Fee $5.00
Permit Fee-Additions/Alterations $180.00 Payment Type: ^��)'
Scanning Fee $3.00 /lam' fL'
Technology Fee $4.50
Total: $194.90 �'U( �.� PAID
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.
August 10, 2007
Authorized Signature:Owner / Applicant / Contractor / Agent Date
Building Department Copy
Friday,August 10, 2007 1
.r
Inspection Worksheet
Miami Shores Village
_=rv � 10050 N.E. 2nd Avenue Miami Shores, FL
�'�QsaitPhone: (305)795-2204 Fax: (305)756-8972
•�
.... ..::::: ::::::::::::::.::::::.::::::::::::::::::::::::::::.:::::.:::::::::::::::::::::::.. .. ... . . :. ::::
..........:....:::::::::::::::::.::::::.:::::::............................................:..::::::.......... :::::::::::::.:::::.::.:::::.............................................Psi
Inspection Date: 09/1�12007 Permit Type: Plumbing - Residential
Inspector: Levrock, James
Inspection Type. final
Owner: ENGEL,JERRY Work lassification: (dew j
Job Address: 351 105 Street NE
Miami Shores Village, FL 33138- Phone Number
Parcel Number 1122310130290
Project: <NONE>
Block: Lot:
Contractor: EDDIE ROJAS PLUMBING INC Phone: 305-944-6788
Buildina Department Comments
REPIPE HOLE HOUSE
n
{nsfector Comments
Passed
Failed El
Correction
Needed a
Re-Inspection
Fee
($75)
No Additional Inspections can be scheduled until
re-inspection fee is paid .
ptember 13, 2007 Page 2 of 2
I