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PL-16-888 .a 4 ' Inspection Worksheet Miami Shores Village 10050 N.E.2nd Avenue Miami Shores,FL Phone:(305)7952204 Fax: (305)75&8972 Inspection Number: INSP-266337 Permit Number. PL-4-16-888 Scheduled Inspection Date:August 312016 Permit Type: Plumbing -Residential Inspector. Hernandez,Rafael Inspection Type: Final Owner. SCOTT JR,GEORGE M Work Classification:Addition/Alteration Job Address:480 NE 103 Street Miami Shores,FL 33138- Phone Number . .(813)36249488 Parcel Number 1132060170710 Project: <NONE> Contractor. EH WHITSON PLUMBING Phone.954929-3599 Building Department Comments INSTALLATION OF 1 RINNAI TANKLESS WATER Inftmo0 omments HEATER INSPECTOR COMMENTS False Inspector Comments Passed Failed Correction Needed Re-inspection Fee No Fddltlonai inspections can be scheduled until re-Inspection fee Is paid e E.H. WHITSON PLUMBING 421 S 21 AVENUE HOLLYWOOD,FL 33020 (954)929-3599 STATE LICENSE#CFC1425799 DROP TEST CERTEFICATION OWNERS INFORMATION: NAME: ,�'c:n tf ADDRESS:_ oid CITY:- tv--4O, L . / A .--zSTATE:. TYPE OF INSTALLATION: NEW r UPGRADE DESCRIPTION OF WORK: 'T �',�746 ,/-e=SC SYSTEM PRESSURE FROM METER: a Zee' 9 YBRID SYS72W;BRANCH PRESSURE: - WATER COLUMN: 1 4 TEST DURATION: �> DATE OF TEST: r8 {)4d CO (QUALII+9")SIGNATURE DATE PRINT-NAME State offtorida County of eml° G' ko sworn to and subscribed before uz this day of 20 Vptsondly known()podwed idodfic ion—type of identification 3 t. Miami Shores Village (_ 10050 N.E.2nd Avenue NE £ 3 Miami Shores,FL 33138-0000 Phone: (305)795-2204 r. " Expiration: 1010412016 Project Address Parcel Number Applicant 480 NE 103 Street 1132060170710 Miami Shores, FL 33138- Block: Lot: GEORGE M SCOTT JR Owner Information Address Phone Cell GEORGE M SCOTT JR 480 NE 103 Street (813)362-9468 MIAMI SHORES FL 33138-2457 480 NE 103 Street MIAMI SHORES FL 33138-2457 Contractor(s) Phone Cell Phone Valuation: $ 2,000.00 EH WHITSON PLUMBING 954929-3599 Total Sq Feet: 0 Type of Work:INSTALLATION OF TANKLESS WATER HEAT Available Inspections: Type of Piping: Inspection Type: Additional Info: Top Out Bond Retum: Final Classification:Residential Scanning:3 Review Plumbing Underground Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $1.20 Invoice# PL-416-59261 DBPR Fee $2.25 04/07/2016 Check*3332 $116.70 $50.00 DCA Fee $2.25 Education Surcharge $0.40 04/01/2016 Check#:3327 $50.00 $0.00 Permit F 1 $150.00 Scanning 9 $9.00 Techno1Q1 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%breto and in strict conformity with the plans,drawings,statements or spec cations 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 6*-LECTRICAL,PLUMBING,MECHANICAL,WINDOWS,DOORS,ROOFING and SWIMMING POOL work. OWNERS IDAVIT: I cert th all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating constructi&n' nd zoning. Futh o , authorize the above-named contractor to do the work stated. Y April 07,2016 Autho Si to er / Applicant / Contractor / Agent Date BuildIng Department Copy April 07,2016 1 tv�icic; �P` Miami Shores Village � Buildin Department ` � � g 10050 AIPRO � �s N.E.2nd Avenue,Miami Shores,Florida 33138 I Tel:(305)795-2204 Fax:(305)756-8972 Y: INSPECTION LINE PHONE NUMBER:(30S)762-4949 FBC 201q BUILDING Master Permit No. Cc Cv PERMIT APPLICATION Sub Permit No. ❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL 'PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS [] CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: ® City: Miami Shores County Miami Dade Zip Folio/Parcel#: If` 3 D Q 60 " Q y - G-7 10 Is the Building Historically Designated:Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER:Name(Fee Simple Titleholder: P�r ��'C cz± Phone#:_ Address. n �� P 16,3 City:-1 Vl lCn--Sr CCCS Stater Zip: Tenant/Lesseee�N•�a.,me: Phone#: g 13 Email:__-�-�-1��.5'C.e��f-�-� CONTRACTOR:Company Name: — w ir1 Phone#: ,(16`I~7?- -3 %19 Address: City:_ L 111 `aJrc d State: F1 Zip: n Qualifier 12 Phone#: State Certification or Registration#: P-4 41S'-7r 'C-1 Certificate of Competency#: DESIGNER:Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit:$ _LD Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration New ❑ Repair/Replace ❑ Demolition Description of Work: Specify color of color thru tile: Submittal Fee$ CO Permit Fee$ !�C�— CCF$ •-00 CO/CC$ Scanning Fee$ Radon Fee$ ` DBPR$ a ` Notary Technology Fee$ Training/Education Fee$ %46 Double Fee$ Structural Reviews$ Bond$ (Revtse02/24/2014) f TOTAL FEE NOW DUE$ t � 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 ah job site for the,list inspection which occurs seven (7) days after the building permit is iss In th obs ce of ch po d n e, the Inspection w7Signat be approved and r coon fee will be charged. Signature OWNER or AGENT NT OR The foregoing instrument was a knowledged before me this The foreg ng instrument was acknowledged befo a me this day of 20�,,byay of 20 by who is ersonally wn to :7 �, 4� y all known to me or who has produce as me or who has produced as identification and who did take an oath.\`\\\ONIS1 °// identification and who did take an oath\�o�\\\5�N SAFFi�°°°i�� NOTARY �O 5 �....,...��r,9 y� �� •......,••Rqy •.•iMtssloN�c•;.�O �� NOTARY PUBLIc: 40- �� P:• MMISS/o'••9 Sign: = _ • _ Sign. Print :• eatfau :Qaa e " " �•'Q� Print y C ' '2bpe ••� Seal: y°°°°hi%lli t!N��\\\a\ Seal: °i°°i C STATED �lrlllfNlRlltlt\\ APPROVED BY Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) 7APR 0 1 4UP11 E-11. WHITSON PLUMB 421 SOUTH 21 AVENUEHOLLYWOOD. FLORIDA 33021) •... •.... ...... . . . . 054) 929--3599 �•••• PLANS CUSTOMER sJMER -NAMK: ALL %IVOit i 1'() (-ON IPLY WITII 'v .P/.1/ nE:S(*R1#'7'1(). ()F WORK: Miami Shores Village APPROVED BY DATE ZONING DF SAFFAgN�!i�// ;.n cTTc� %7111 iniac i w11•11 Nf E �)i icnL \\\�G�•� •.....• 9O// 40F v i 4 E.H. Whitson Plumbing .0.00 • • • 0000 ••••s• 421 South 21st Avenue 0 • 0.00 Hollywood,, 33020 ...... • 000• •0000 .... 000• ....4 q� • • .0000• ....- a Plans 00 00 . 00.00• ARr •00•00 .� • • • . . • CXmtww Name: � '� � /� • � .0 .....• :0000: . � . . 00• 0000 • Address: re cftyt State, Zito a %.BGG!�i�'/r Phone1 • •mar-,•— a.•u.r..�. - r.r r r.a wi++w..�.s All Work to Corer with N.F.P,A4 Code EsUmated 3ob Com: Work:Desciption of ,.,7 / Ae*oe-- SNFFRA i�, _ xv� 51 Z� •\0= Auk i� 0000•• o � ,,y�1101f1friiNl 00