PL-14-2261 Inspection Worksheet
Miami Shores Village
10050 N.E.2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-241307 Permit Number: PL-10-14-2261
Scheduled Inspection Date: August 25,2015 Permit Type: Plumbing - Residential
Inspector: Diaz, Osvaldo
Inspection Type: Final
Owner: KURLANDSKI, GUY&SELIN Work Classification: Gas
Job Address:9301 N BAYSHORE Drive
Miami Shores, FL Phone Number
Parcel Number 1132050270560
Project: <NONE>
Contractor: LEYVA PLUMBING SERVICES INC. Phone: (772)871-5893
Building Department Comments
GAS WATER HEATER AND RANGE INSTALLATION Infractio Passed Comments
INSPECTOR COMMENTS False
Inspector Comments
Passed CREATED AS REINSPECTION FOR INSP-241197. PROVIDE DROP TEST
:2/ FOR FINAL
PROVI E ACCESSIBLE SHUT OFF FOR STOVE
Failed
,Z
Correction
❑ r/f
Needed .
Re-Inspection ❑
Fee
No Additional Inspections can be scheduled until
re-inspection fee is paid.
August 24,2015 For Inspections please call: (305)762-4949 Page 18 of 33
rrrlt No. P -'f 0-'14-226'I
Miami Shores Village - Permit Type Pi ng-Reside0f JO - ,
„ 10050 N.E.2nd Avenue N WOrltCloSstt<dx lnr7
- Miami Shores, FL 33138-0000 :,
Phone: (305)795 2204 ' Peririt jus" D
FLORIDA a
; 131t Expiration: 0113012016
Project Address Parcel Number Applicant
9301 N BAYSHORE Drive _ 1132050270560 �-��- I
Miami Shores, FL Block: Lot: GUY&SELIN KURLANDSKI
Owner Information Address Phone Cell
GUY&SELIN KURLANDSKI 9301 N BAYSHORE Drive
s MIAMI SHORES FL 33138-
15811 COLLINS Avenue
SUNNY ISLES FL 33160-
Contractor(s) Phone Cell Phone $ 3,000.00
Valuation:
LEYVA PLUMBING SERVICES INC. (772)871-5893 (772)672-3673
Total Sq Feet: 0
i
Type of Work:GAS WATER HEATER AND RANGE INSTALLA Available Inspections:
Type of Piping: Inspection Type:
Additional Info: Top Out
Bond Return: Final
Classification:Residential Scanning:3 Underground
Review Plumbing
Review Plumbing
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due
CCF $1.80 Invoice# PL-10-14-53278
DBPR Fee $2.25 08/03/2015 Credit Card $ 168.30 $0.00
DCA Fee $2.25
Education Surcharge $0.60
Permit Fee $150.00
Scanning Fee $9.00
Technology Fee $2.40
Total: $168.30
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.
1
OWNERS AFFIDAVI t'ce ify hat all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
construction and zonin Fut r ore, I authoriz he above-named contractor to do the work stated.
-- '' - August 03, 2015
Authorized Signature:Owner / Applicant / Contractor / Agent Date
Building Department Copy
August 03, 2015 1
..
y PRESTIGE GAS SERVICES CORP.
1511 SW 71 CT MIAMI FL 33144
PHONE: 305-300-0608
FAX: 305-356-4332
DATE AUGUST 17, 2015
TO: WHOM IT MAY CONCERN IN THE CITY OF MIAMI SHORES PLUMBING DEPARTMENT.
THIS LETTER IS TO CERTIFY THAT PRESTIGE GAS SERVICES CORP HAS PERFORMED A DROP TEST AT
THE FOLLOWING SITE AND TESTED ALL THE APPLIANCE CONNECTIONS. THE GAS L NE HAS BEEN
CHECKED To THE STANDARDS OF THE 2010 FLORIDA BuEDING CODE AND PROPERLY TESTED TO MEET
THE STANDARDS OF NFPA 54. THE WORK WAS PERFORMED FOR M2 DEVELOPMENT GROUP AT 9301
N BAY SHORE DR, MIAs SHoREs, FL 33138
TEST PRESSURE: 8.0
LocK up PRESSURE: 14.2
OPERATING PRESSURE: 14.0
TEST TDm 30 MINUTES
STATE LICENSE No: LPG 32634
TYPE AND CLASS: 0803
IF YOU SHOULD HAVE ANY QUESTIONS REGARDING THE MATTER PLEASE DO NOT HESITATE To CALL us.
SINCERELY,
j =o'pA YESENIA A UILAR
r [ MY COMMI 10 #FF051322
LAZARO �AZ 9E �EXP14ita`( ptember 4,2017
or v .;
CEO 37i 392-0153 Florid allotaryService.com
PRESTIGE GAS SERVICE CORP.
01� Miami Shores Village r�r� -cFED
Buildin De artment ocr 2014
g p � g
M 10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305)795-2204 Fax:(305)756-8972
INSPECTION LINE PHONE NUMBER:(305)762-4949
FBC 2016
BUILDING Master Permit No. RC 14 - 689
PERMIT APPLICATION Sub Permit No. FW j-- 2?-L.=,
❑BUILDING ❑ ELECTRIC ❑ ROOFING REVISION ❑ EXTENSION ❑RENEWAL
❑■ PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: 9301 N BAYSHORE DR
City: Miami Shores County: Miami Dade Zip:33138
1132050270560 X
Folio/Parcel#: Is the Building Historically Designated:Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name(Fee Simple Titleholder):GUY KURLANDSKI Phone#:305.297.0803
Address:9301 N BAYSHORE DR
City:
MIAMI SHORES State: FL Zip: 33138
Tenant/Lessee Name: Phone#:
Email:
GUYKURLANDSKI@HOTMAIL.COM
CONTRACTOR:Company Name:
LEYVA PLUMBING SERVICES Phone#: 786.263.1941
Address: 1502 SW MERIDIAN AVE
City:
PORT ST LUCIE State: FL Zip: 34953
Qualifier Name: ABNER LEYVA Phone#:
State Certification or Registration#: CFC 1425666 Certificate of competency#:
DESIGNER:Architect/Engineer: MARK CAMPBELL Phone#: 305.528.3037
Address:
373 NE 92 ST City: MIAMI SHORE;State: FL Zip: 33138
Value of Work for this Permit:$ �, �a Square/Linear Footage of Work:
Type of Work: ❑ Addition Alteration ❑ New ❑ Repair/Replace ❑ Demolition
Description of Work: GAS WATER HEATER AND RANGE INSTALLATION
Specify color of color thru tile:
Submittal Fee$ Permit Fee$ SU• ;2y CCF$ �')b CO/CC$
Scanning Fee$ Radon Fee$ c7-a�' DBPR$ oZ, 'aG Notary$ _
Technology Fee$ 2 �_Training/Education Fee$ U (40O Double Fee$
Structural Reviews$ ( Bond$ALJ
TOTAL FEE NOW DUE$
(Revised02/24/2014)
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 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 ELECTRIC, PLUMBING, SIGNS, POOLS,
FURNACES,BOILERS, HEATERS,TANKS,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.
� o
Signature
—JAa
WNER or AGENT CONTRACTOR
a o '- v
ff��Feg ng instrument was acknowledged before me this The fore/g[oing inTument w a�nkno�wI dged before me this
c N day of `-C- �P�� 20 by 7 day of Ci ! 20 ! -/ by
awy Li
�sS r t who is personally known to Lc–'/Y4 who is pn II known to
m#or wh has produced as me or who has produced s
Z �
kdeptifica n and who did take an oath. identification and wh id t e an o
ro,
BLIC: NOTARY PUBLIC:
E�
Sign. 6Sign: * AI Min -
a
Print: Print:
.e 1 iia-off; M
Seal: Seal: / :GB LIG .
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OFFLORA
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############################################################################################################
APPROVED BY �lcrL3'-/`Dr Plans Examiner Zoning
I
Structural Review Clerk
(Revised02/24/2014)
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