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PL-06-738 ........... Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Date: 07/25/2006 Permit Type: Plumbing - Residential Inspector: Levrack,James QA1.1 Inspection Type: Final Owner: HANSON, JAMES Work Classification: New Job Address: 9730 5 RD NL 2 6 RTO Miami Shores Village, FL Phone Number (305)751-43" Parcel Number 1132060171470 Project <NONE> Block: Lot: Contractor: PIPELINE PLUMBING INC Phone: 954-680-4415 Building Department C9mments Is e r Comments Passed E Failed Correction Needed Re-inspection Fee ($75) No Additional Inspections can be scheduled until re-inspection fee is paid Monday, July 24, 2006 Page 1 of 2 Inspection Worksheet Miami Shores Village z 10050 N.E. 2nd Avenue Miami Shores, FL fitD83�✓'<y Phone: (305)795-2204 Fax: (305)756-8972 1� tip...N. •. ..:.... ...... ... . ..::.. . .::: Inspection Date: 07/25/2006 Permit Type: Plumbing - Residential Inspector: Levrack,James RECD JUL 2 6 Inspection Type: Underground Rough Owner: HANSON, JAMES Work Classification: New Job Address: 9730 5 RD Miami Shores Village, FL Phone Number (305)751-4344 Parcel Number 1132060171470 Project: <NONE> Block: Lot: Contractor: PIPELINE PLUMBING INC Phone: 954-680-4415 Building Department Comments Ins i o Comments Passed E�' Failed El Correction Needed Re-Inspection Fee ($75) No Additional Inspections can be scheduled until re-inspection fee is paid . Monday, July 24, 2006 Page 1 of 2 Miami Shores Village 10050 N.E.2nd Avenue Miami Shores, FL 33138-0000 > w0 Phone: (305)795-2204 Fax: (305)756-8972 FGvn Permit Permit Status:APPROVED Issue Date: 3/23/2006 Expires: 03/22/2007 Permit Number: PL-3-06-738 Owner's Name: JAMES HANSON one: (305_)751-4344 Permit Type: Plumbing- Residential Parcel#: 1132060171470 Work Classification: New Block: Lot: Job Address: 97305 AVP- Rci . NE Section: PB: Miami Shores Village, FL Contractor(s) Phone Primary Contractor Total Square Feet: 0 PIPELINE PLUMBING INC 954-680-4415 Yes Total Valuation: $ 2,000.00 Comments: Required Inspections INSTALL GAS WATER AND GENERATOR HOOK UP Underground Rough Water Main Top Out Main Drain Additional Information Lavatory Water Service Type of Work:GAS LINE Type of Piping: Re pipe Additional Info: Bond Retum: Heater Classification:Residential Final 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 Invoice Number Amt Due Amt Paid CCF $1.20 PL-3-06-24217 $199.35 Education Surcharge $0.40 Total: Permit Fee-Additions/Alterations $190.00 PAID Scanning Fee $3.00 ,7 Technology Fee $4.75 Total: $199.35 Building Department File Copy 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. Applicant Signature Miami Shores Village Building Department e's5.A►r'G; 10050 N.F.2nd Avenue,Miami Shores,Florida 33138 ,-3 I jb P. +7 ph Te�:( �p mag:(305)756.8972 BUILDING MAR 2 g2 p05 Permit No� 0(0p — PERMIT APPLICATIO - m m m _ Master Permit No. FBC 2001 ®` Permit Type(circle): Building Electrical l Plumbing Mechanical Roofing a Owner's Name(Fee Simple Titleholder) z Owner's Address ?-2,30 //(p ,�5 `'`i //r; gA ' City %T,_> �/��(i .�; —State zip-- Tenant/Lessee Zip _ j� S( Tenant/Lessee Name Phone# Job Address(where the work is being done) 9_230 AJL-- IS _7A V ' City Miami Shores Village County Miami-Dade Zip Is Building Historically Designated YES NO �I Contractor's Company Name G' 4✓e LA, ! �11 �Cl Phone Contractor's Address 0 - /IFIOX S a/ City /11/A^7 1/ State F(_ Qualifier_ State Certificate or Registration No. C rC- L's- 4�5Certificate of Competency No. Architect/Engineer's Name(if applicable) Phone# $Value of Work For this Permit C?CD C', Ca 0 Square Footage Of Work- Type of Work: ❑Addition ❑Alteration UNew ❑ Repair/Replace ❑Demolition Describe Work: Submittal Fee$ Permit Fee$ ��la CCF$ •20 CO/CC. Notary$ Training/Education Fee$__ An Technology Fee$ Scanning 43.0 Radon$ Zoning Bond Code Enforcement$ Structural Plan Review.$ Total Fee Now Due$ (Continued on opposite side) Bonding Company's Name(if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name(if applicable) Mortgage Lender's Address F 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 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 ContractoNIJ The foregoing instrument was acknowledged beforyye��me this /g The foregoing instrument was acknowledged before me this day of ,209 by 3P, -5 Q Ntg�vt�©� day of 20�by who is personally known to me or who has produced who is personally known to me or who has produced As identification and who did take an oath. as identification and who did take an oath. NOTARY PUBLIC: A / NOTARY PUBLIC: r Sign:Sign: `' � Print: A,4,h / -44o rL,L-- Print: dL4e tf 44 «, My Commission Expires: 3/Z7 2� �' My Commission Expires: Robes M.COMMA •`T MY Cm n b9m DD2727®2 • MY Ccm&Wm WVV62 APPLICATION APPROVED BY: ,' � �/� Plans Examiner Engineer Chc 05/13/03 Zoning