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PL-15-2745 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-246773 Permit Number: PL-10-15-2745 Scheduled Inspection Date: November 17, 2015 Permit Type: Plumbing - Residential Inspector: Diaz, Osvaldo Inspection Type: Final Owner: MOORE,JOHN AND KELLY Work Classification: Gas Job Address:450 NE 94 Street Miami Shores, FL 33138- Phone Number Parcel Number 1132060140320 Project: <NONE> Contractor: EH WHITSON PLUMBING Phone: 954-929-3599 Building Department Comments RUN NATURAL GAS LINE TO TANKLESS W/H ELEC. Infractio Passed Comments EXISTING INSPECTOR COMMENTS False Inspector Comments Passed Ed Failed '� � f� Correction Needed Re-Inspection Fee No Additional Inspections can be scheduled until re-inspection fee is paid. November 16, 2015 For Inspections please call: (305)762-4949 Page 16 of 38 E.H. WHITSON PLUMBING 421 S 21 AVENUE HOLLYWOOD,FL 33020 (954)929-3599 STATE LICENSE 4CFC1425789 DROP TEST CERTIFICATION OWNERS INFORMATION: NAME: ADDRESS:- CITY: STATE:,� � -`'P STATE: TYPE OF INSTALLATION: NEW -rUPGRADE — DESCRIPTION OF WORK: C27A7 S9 4 4 SYSTEM PRESSURE FROM METER: d,, ! IF YBRID SYSTEM, BRANCH PRESSURE z WATER COLUMN: �l ' TEST DURATION: _ DATE OF TEST: IP CO CT6R (QUALIFIER) SIGNATURE DATE vz PRINT-NAME State of florida County of 121UOU-MkO , °; •••'' sworn to and subscribed before me this day of 20 (personally known( )produced identification-type of identification n ew k f *°R Miami Shores Villagei' ff � Rol 10050 N.E.2nd Avenue NE ti w� Miami Shores, FL 33138-0000 Phone: (305)795-2204 z � tona[�' lssu t3ate,::'�' Expiration: 103/2016 Project Address Parcel Number Applicant 450 NE 94 Street 1132050140320.._�.__�, ..��...�. .,.��.... .�._�.�....�...�..��.�_.._.__�..._�.�. Miami Shores, FL 33138- Block: Lot: JOHN AND KELLY MOORE Owner Information Address Phone Cell JOHN AND KELLY MOORE 450 NE 94 Street MIAMI SHORES FL 33138-2924 450 NE 94 Street MIAMI SHORES FL 33138-2924 Contractor(s) Phone Cell Phone Valuation: $ 2,000.00 EH WHITSON PLUMBING 954-929-3599 .._.. ,... _. Total Sq Feet: 0 Type of Work:RUN NATURAL GAS LINE TO TANKLESS W/ Available Inspections: Type of Piping: Inspection Type: Additional Info: Final Bond Return : Press Test Classification:Residential Scanning:3 Review Plumbing Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $1.20 Invoice# PL-10-15-57580 DBPR Fee $2.25 11/05/2015 Check#:3176 $ 116.70 $ 50.00 DCA Fee $2.25 Education Surcharge $0.40 10/28/2015 Check#:3188 $50.00 $0.00 Permit Fee $150.00 Scanning Fee $9.00 Technology Fee $1.60 Total: $166.70 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 certi t all the re ing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Futh -mth ore, I aur the above-named contractor to do the work stated. November 05, 2015 Authorized Signature: ner / pIicant / Contractor / Agent Date Building Department Copy November 05,2015 1 Miami Shores Village Building Department Oce z 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 2011 BUILDING Master Permit No.?L 2-7qS PERMIT APPLICATION Sub Permit No. ❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP y ` CONTRACTOR DRAWINGSCo� AA JOB ADDRESS: 1 �� 1 v ' S� 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): Phone#: -3 6 - -21 S O �So C el-1 i) V' ' Address:__ City: e S State: t- Zip: '331S S Tenant/Lessee Name: Phone#: Email: C,r e\ C CONTRACTOR:Company Name: —7 H Phond �:.. r . Address: City: State: Zip: (�% 1 Qualifier Name: Phone#: State Certification or Registration#: Cr�"C- � "1 ` p�2S � 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: ❑ Additionteration ❑'nNe/w Ej Repair/R�ep�lace f�❑ Demolition Description of Work: 6/n ( /�-r m� IA l.� -It), -��" \,t�.�f 6p W)-d Specify color of color thru tile: Submittal Fee$ 410 Permit Fee$ �0. '�L Y CCF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$_ Notary$ Technology Fee$ Training/Education Fee$ Double Fee$ Structural Reviews$ Bond$ ` TOTAL FEE NOW DUE$ 1T (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$2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also,a certified copy of the recorded notice of comm ment m e posted at thsoAsite for the first inspection which occurs seven (7) days after the building permit is issued. n the se of h p ed tice, the inspection will not be approved and a reinspection fee will be charged. Signature 4 (—4�� Signature OWNER or AGENT /ONT AC R The foregoing instrument was acknowledged before me this The foregoing' strum nt was ackno edged before me this L day of G"C-��`j e ' ,20 I S by day of 20 , by r YN b C1 who is personally known towho is personally known to MP.or who has produced as me or who has produced as identification and who did take an oath. identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: uuSign, E3'w Y-1 :.��. v� "i"LC 2 i 3 Sign: Print: 1.. r x- �C`. Print: SOttS� ;�Z l rI olt� �FFRdn��/ii. Seal: "P"" 5 SIO �S/�i�i ;�-' -; LE�I(Mf�SES Seal: �� :'��'s NF••.s'i% :»: r MY COMMISSKNV#EE 193887 4 Vp�obe(5, EXPIRES:April 29,2016 Bonded Ttn Notary Public Underwriters 2 i�j••. ,y Bondad��cs`�. •�� APPROVED BY �, w,L 5 Plans Examiner ��i9/p":ryWbrw��,7 `c Structural Review Clerk (Revised02/24/2014) • u � ¢ • L.II. !x'1!1 ! so N- , a 421 SOUTI 1 21 AN"E..114['1,. 110t.1-NA 'OOD, F LOI.t)A 33020' (954) 929 -3599 I PLANS CUSTONIEll CITY: :1I.(, 1V( RIt "1 (l \.I�.1'/Al ('01)L# 1 S OCT 2 2015 0 see SAFF.. ,.. �. •. �� 5 .......• N9 , ��,•.�MISSlO,y•. Os a, Q�VO er5,2F�•.� • • • • • • • • • .wcn•*� •i • • • • • • • • FF 053983 7= ICU •�bia nded ihN ism. O • • • • • w • • w •• •• • • • •• •• L E.H. Whitson Plumbing 421 South 21st Avenue - Hollywood, FL 33020 CFC1425789 S �v fiba2ft taw Cust+t er Name: City. State, zip: All Work to Comoy With N.F.P.A. Code #b EOnuVad Job Cost: DescripMn oil Work: 15�4�f - a • Y i •�i i i i•i •. °°i��84gt$A�FF��f`�®// •• wpfi i Isro `.�.. y.. • .• • • • • • • OF 053983 :^� 99•';spa BOndedthN fi��OQe ••• i • w ••• i i�.__ _._ �. • �Q��,�STAB 1��,°°° —_