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PL-16-616 Inspection Worksheet Miami Shores Village 10050 N.E.2nd Avenue Miami Shores,FL Phone:(305)795-2204 Fax: (305)756-8872 Inspection Number: INSP-254206 Permit Number. PL-3-16-616 Scheduled Inspection Date:April 05,2016 Permit Type: Plumbing -Residential Inspector. Hernandez,Rafael Inspection Type: Final Owner. NORA LANGE,KENNETH LANGE Work Classification: Drainfieid Job Address:70 NE 96 Street Miami Shores,FL 33138- Phone Number Parol Number 1132060130620 Project <NONE> Contractor MR C'S PLUMBING&SEPTIC INC Phone:{305}651-7859 Building Department Comments DRAIN FIELD PaSsed comments INSPECTOR COMMENTS False Inspector Comments Passed HRS APPROVAL IN FILE Failed Correction Needed Re-inspection Fee No Additional Inspections can be scheduled until re-inspection fee is paid I:nr inarummlewna massa a-aw!UM7A9..dddQ 1 °al Miami Shores Village ;! 10050 N.E.2nd Avenue NE •'^ Miami Shores,FL 33138-0000 Phone: (305)795-2204 ! �� Expiration: 09/06/2016 Project Address Parcel Number Applicant 70 NE 96 Street 1132060130620 Miami Shores, FL 33138- Block: Lot: KENNETH LANGE NORA LANGE Owner Information Address Phone Cell KENNETH LANGE NORA LANGE 70 NE 96 Street MIAMI SHORES FL 33138- 70 NE 96 Street MIAMI SHORES FL 33138- Contractor(s) Phone Cell Phone Valuation: $ 3,660.00 MR C'S PLUMBING&SEPTIC INC (305)651-7859 Total Sq Feet: 300 Type of Work: Available Inspections: Type of Piping: Inspection Type: Additional Info: HRS Approval Bond Retum: Final Classification:Residential Scanning:3 Review Plumbing Fees Due Amount Pay Date Pay Type Amt Paid Amt Due Bond Type-Owners Bond $500.00 Invoice# PL-3-16-58947 CCF $2'40 03/10/2016 Credit Card $63.40 $550.00 DBPR Fee $2.00 DCA Fee $2,00 03/08/2016 Credit Card $50.00 $500.00 Education Surcharge $0.80 03/10/2016 Credit Card $500.00 $0.00 Permit Fee $100.00 Bond#:3011 Scanning Fee $3.00 Technology Fee $3.20 Total: $613.40 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 ace nd that all work will be done in compliance with all applicable laws regulating construction and zoning. Futhennore,I authorize the above-named to do the work stated. March 10,2016 Authorized Signature:Owner / Applicant • Contractor / Agent Date Building Department Copy March 10,2016 1 Miami Shores Village 7MAR C D Building Department 08 2016 1wso N.E.2nd Avenue,Miami Shores,Florida 33238 j Tei:(305)795-2204 Fax:(305)756-8972LSi�7 INSPECTION UNE PHONE NUMBER:(305)762-4949 FBC 20ILL a BUILDING Mester Permit No-91 u I PERMIT APPLICATION Sub Permit No. MBUILDING ❑ELECTRIC ❑ ROOFING ❑ REVISION M EXTENSION ❑RENEWAL ®PLUMBING ❑MECHANICAL ®PUBLIC WORKS [] CHANGE OF CANCELLATION ❑SHOP � CONTRACTOR DRAWINGS 108 : -70 �& ".� S 1,y,, City: Mlami Shores �1`r County 9 Miami Dade by: 3 3 t 3 Fa1io/Parcel6: JL--3�b a(L--t/6 0 is the BuiWit Historically Designated:Yes NO --• Occupancy Type: Load: Construction Tweet) Flood Zone: SFE: FFE: OWNER:Name(Fee Simple Titleholder): /V1�Zi L.�1s��® Phone#36gi 2V kf�d- Add _- City: 1,..,; state: /fG 21p: Tenant/Lessee Name: Phone# Email: CONTRACTOR:Company Name: Mr C's Plumbing and Septic Phone#: 305 6517859 Address: 19932 NW 2 Ave City: Miami state: FL. 4p.._33169 QualN3er Name: Kemble Mick Phone#: 305 6517859 State Certification or Registration#: SR061536 Cer#aiicate of Competency#: CEsGNER:Architect/Englneer: Phone# Address: _-State: Zip: i Value of Work for this Permit:$ .!/E_Square/Linear Footage of Work: _ 3 Type of Work: [:1 Addition ❑ Alteration ff❑ New Repair/Replace ❑ Demolition 9 omwipffion of Woric f d i a 4wdfy color of color thru tile: WW.Va Fee 5 Permit Fee S l3(j CCF Co/CC 5 Sca�ng Pae$ ` Radon Fee 5 Z•-�d DBPR$ �� ' Notarl►$ Technology Fee 5 j- TrainlrWEducation Fee$ Double Fee Structural Reviews Bond S TOTAL FEE NOW DUE$ - (REy /24/ 14) S1 3. V 4' _ooding Company's Name(if applicable) i w Bonding Company's Address city State Zip Mortgage Lender's Name(if applicable) t Mortgage tender's address s city State ZIP. 4( Application is hereby made to obtain a permit to do the work and installations as indicated. t 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 AFFIDAYR: 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. I "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 F YOUR NOTICE OF COMMENCEMENT," Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding$25170,the applicant must i 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. i 4 a Signature � Signature } � OWNER or AGENT CONTRACTOR The foregoing Instrument was acknowledged before me this The foregoing Instrument was acknowledged before me this 7 day of 4 .20 lA ,byday of ,,� .20 L� ,by a � � � �� h F - .who is personally known to j� ,who Is persona to me or who has produced. as �e or who has produced as Identification and who did take an oath. identification and who did take an oath. NOTARY PUBLIC NOTARY PUBLIC P tl Sign: Sign: KEMBLE ED55;3 +. ,,�OtPtiY P�j@,4 Print Print. PublicFlorida "Y' •,,, SNERVL A MWES .• My Comm.ExpireSeal: ,;,�;`� Notary Pn -Stye of Florida PO Seal; �`' Commission# £My Comm.Exm Oct 23,2018 Bonded Throe h 'J'" Q`9 � � '9, �.. Comnriasion#r FF 136597 Bonded aryAssn. #####!#+►#######+t#!di##i�#############+R+MAt�M####fs#ai+�##+R#####i#######f###i # !t#�#Ac##+i�Ri APPROVED BY Plans Examiner Zoning is i' Structural Review Clerk (Revue&W24/2014) 3/8/2016 1 IMG_0081.JPG y mruw r Irl pm . M I1*k7 e 4 r-s EiA 0 F D on ;5� F A, €�tFti ' tK ' 'AN .s , � � 7}t t�tk✓ WIT CA R im-T'zp. D FOR D-VEWPvel4T a PD AS . _ j...GAUCiNS u.'SIVN TASK CAPACITY °�u',S�'�' PEP. 24 �.r.,a g�,;ullso TYPE SYST'M CI `. Cr. 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