PL-15-1383 T
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-240379 Permit Number: PL-6-15-1383
Inspection Date: January 01, 2999 Permit Type: Plumbing - Residential
Inspector: Diaz, Osvaldo
Inspection Type: Final
Owner: MARINO, STEPHEN Work Classification: Gas
Job Address: 1066 NE 94 Street
Miami Shores, FL 33138- Phone Number 305-812-0629
Parcel Number 1132050120120
Project: <NONE>
Contractor: JT MECHANICAL SERVICES LLC Phone: (954)367-3463
Building Department Comments
RELOCATING GAS LINE INTO WALL IN KTICHEN Infractio Passed Comments
INSPECTOR COMMENTS False
nspector Comments
Passed CREATED AS REINSPECTION FOR INSP-238190. BRING IN DROP TEST
FOR FINAL APPROVAL
Failed
Correction ❑ ��� ,` �
Needed
Re-Inspection ❑
Fee
No Additional Inspections can be scheduled until
re-inspection fee is paid.
For Inspections please call: (305)762-4949
August 06,2015 Page 1 of 1
vi�i«ii�iibfil
Residential P Commercial Air Cond,tioning Specialists
"Taking Quality to the Highest Level" 5901 SW 21 s' Street
West Park, FL 33023
Ph: 954.367.3463
GAS PIPING TESTS AFFIDAVIT
Homeowner(PLEASE PRINT) Mr. Marino
Address 1066 NE 94`6 Street
City Miami,Florida
Manufacturer of home(if known)
Serial number of home(if known)
I, Jimmy Galvez,am authorized to certify on behalf
(Print Name)of_JT Mechanical Services, that on July 30,2015 the gas piping
system was tested as follows:
1. Before all appliances were connected,at three(3) PSI for a period of not less than
ten (10)minutes without showing any drop in pressure; and
2.After the appliances were connected and the system was pressurized to not less
than ten(10) inches nor more than fo " n(14)inches water column and the
appliance connections w e leakage with soapy water or bubble solution,
no leaks were obsery %
Signature of teste
Other witness signature s) ien ailable]: Homeowner
Gas Company
L&I Inspector
The original of this affidavit must be available for the inspector when the inspection
is made.
f (�� Miami Shores Villagea _ -�
Building Department JUN 08 2015
10050 N.E.2nd Avenue,Miami Shores,Florida 33138
Tel:(305)795-2204 Fax:(305)756-8972
INSPECTION LINE PHONE NUMBER:(305)762-4949
F BC 20 1®cu
BUILDING Master Permit No< pa
PERMIT APPLICATION Sub Permit No. F ---I
❑BUI DING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION E]RENEWAL
PLUMBING ❑ MECHANICAL [-]PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS:_I D LQ LP K � q
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#: Is the Building Historically Designated:Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER:Name(Fee Simple Titleholder): r fil�'�'� /'�l Gi/l��i U Phone#:
Address: 10 Gb A9 E b
City: AA,,4A+1, 40,)6o, f4 State: FZip:
Tenant/Lessee Name: Phone#:
Email: d
CONTRACTOR:Company Name: n 9 Phone#:q 3o ' Pll�i�
Address: 5 D I _
City: P / Sate Zip: ��
a
Qualifier Name: ' Phone#:
State Certification or Registration#: Certificate of Competency#:
DESIGNER:Architect/Engineer: Phone#:
Address: / City: State: Zip:
Value of Work for this Permit:$ Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ teration ❑ New ❑ Repair/Replace ❑ Demolition //
Description of Work: O / t/1cA-ell
Specify color of color thru tile:
Submittal Fee$SC•OZ) Permit Fee$ 160v CCF$ CO/CC$
Scanning Fee S Radon Fee$ DBPR$ Notary$
Technology Fee$ Training/Education Fee$ Double Fee$
Structural Reviews$ Bond$
TOTAL FEE NOW DUE$OCI
(Revised02/24/2014)
I '
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$2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also,a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
Signature Signature
OWNE or AGENT RACTOR
The foregoing
egoing instrument was acknowledged before me this The fore ing instru ent was acknowledged before me this
day t,1 of ,,, 20 �� , by W,day of 20 `�� by
21, 1��
1- Y"C- 1.who is personally known to 2l who is personally known to
me or who has produced V'-( ` as me or who has produced as
identification and who did take an oath. identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
Sign: ` / Sign: y1tts'Q'&
Print. ass( C; V=vow -a— Print: C� a
Seal: JESSIMMIARIAVARCA Seal:
MYCOMMISSION EE848717 �.it "4 Notary Public State of Florida
EXPIRES:March 2,2017 � Nancy Milan
Af;;(t•' Bonded Tinu Notary PW*Undetwrhrs0! •$ My Commission EE 843210
as w�' Expires 10/1412016
s+�*�x*ens*s*a**erase*ea�a�a�**a* *a�w�e**eswrs�a�sassa�sa�ma�asa e��ra��sa��seea�x�
APPROVED BY ��� /� Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)
Permit No.,Pl:. -` -'1=38
Miami Shores Village PO 'ttt'Type.Plumb"-Residential
s 10050 N.E.2nd Avenue NE
Wot1t 0as16Tc�rtron;Gas
Miami Shores,FL 33138-0000 Peft-
_n_
mss Phone: (305)795 2204 PF3tX?7 ;StettS.'AIaF` VE1
FtORtDp'
Issue lte:6117120, Expiration: 12/14/2015
Project Address Parcel Number Applicant
1066 NE 94 Street 1132050120120
Miami Shores, FL 33138- Block: Lot: STEPHEN MARINO
Owner Information Address Phone Cell
� STEPHEN MARINO 1249 NE 97 ST 305-812-0629
1
Miami Shores FL 33138
Contractor(s) Phone Cell Phone Valuation: $ 150.00
JT MECHANICAL SERVICES LLC (954)367-3463
Total Sq Feet 0
Type of Work:RELOCATING GAS LINE INTO WALL IN KT Available Inspections:
Type of Piping: Inspection Type:
Additional Info:
Bond Return: Top OutFinal
Classification:Residential Scanning:1 Review Plumbing
Underground
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due
CCF $0.60
DBPR Fee Invoice# PL-6-15-55883
$2.25 06/08/2015 Credit Card $50.00 $109.10
DCA Fee $2.25
Education Surcharge $0.20 06/17/2015 Credit Card $ 109.10 $0.00
Permit Fee $150.00
Scanning Fee $3.00
Technology Fee $0.80
Total: $159.10
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 AFFIDAV I certi hat all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
construction an ning. F rmor ,a authorize the above-named contractor to do the work stated.
June 17, 2015
Authorized Signature:Owner / Applicant / Contractor / Agent Date
Building Department Copy
June 17,2015 1