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PL-15-3058 .� RC LIC) -Z_ Inspection Worksheet Miami Shores Village 10050 N.E.2nd Avenue Miami Shores,FL Phone: (305)795-2204 Fax:(305)756-8972 Inspection Number: INSP-252868 Permit Number. PL-12-15-3058 Scheduled Inspection Date: February 17,2016 Permit Type: Plumbing - Residential Inspector. Hernandez, Rafael Inspection Type: Final Owner. ROY,WILLIAIs Work Classification: Addition/Alteration Job Address:1280 NE 101 Street Miami Shores,FL Phone Number Project: <NONE> Parcel Number 1132050210010 Contractor. EH WHITSON PLUMBING Phone:954929-3599 Building Department Comments INSTALL NAT GAS TANK LESS HWH GAS EXISTING, Infracuo Passed meft ELECTRICAL EXISTING. INSPECTOR COMMENTS False Inspector Comments Passed CREATED AS REINSPECTION FOR INSP-252178.CREATED AS REINSPECTION FOR INSP 249088. PROVIDE DROP TEST FOR FINAL PROVIDE SLEEVES AT ALL PENETRATIONS No access Failed Correction Needed Re-Inspection ❑ Fee No Additional Inspections can be scheduled unto reinspection The Is paid February 16,2016 For Inspections please call: (305)7624849 Page 28 of 40 00 Miami Shores Village '' fie_ ri 10050 N.E.2nd Avenue NE ... /Alteratlt n Miami Shores,FL 33138-0000 � u h � 3 `2 orb Phone: (305)795-2204 e (., , tAPPROVED �`Q71� 3i': Ex iration: 6/26/2016 DO _ P Project Address Parcel Number Applicant 1280 NE 101 Street 1132050210010 Miami Shores, FL Block: Lot: WILLIAM ROY Owner Information Address Phone cell WILLIAM ROY 1280 NE 101 Street (305)793-5050 MIAMI SHORES FL 33138- 1280 NE 101 Street MIAMI SHORES FL 33138- Contractor(s) Phone Cell Phone $ 900.00 Valuation: EH WHITSON PLUMBING 954-929-3599 _.. m _._: ..... _.., Total Sq Feet: 0 Type of Work:INSTALL NAT GAS TANK LESS HWH GAS E Available Inspections: Type of Piping: Inspection Type: Additional Info: Final Bond Return: Press Test Classification:Residential Scanning:1 Review Plumbing Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $0.60 Invoice# PL-12-15-58008 DBPR Fee $2.25 DCA Fee $2.25 12!29!2015 Check#:3246 $ 109.10 $50.00 Education Surcharge $0.20 12/10/2015 Check#:3224 $50.00 $0.00 Permit Fee $150.00 Scanning Fee $3.00 Technology Fee $0.80 Total: $159.10 In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans,drawings,statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL,PLUMBING,MECHANICAL,WINDOWS,DOORS,ROOFING and SWIMMING POOL work. OWNERS AFFIDAVIT: I i that all th fore ing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. utheYrmore,I au rize he bove-named contractor to do the work stated. r December 29, 2015 Authorized Signature:Owp6r A icant / Contractor / Agent Date Building Department Copy December 29,2015 1 Miami Shores Villa e g Building Department D C 10 2015 10050 N.E.2nd Avenue,Miami Shores,Florida33138 Tel:(305)795-2204 Fax:(305)756-8972`" INSPECTION LINE PHONE NUMBER:(305)762-4949 12�23�i5 - PLACO`- FBC 20(4 BUILDING Master Permit No. "Z i PERMIT APPLICATION Sub Permit No °J " ❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL PLUMBING ❑MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP v� CONTRACTOR DRAWINGS JOB/AADDRESS: CifiM.k i Shores County alb Miami Dade Zip: Folio/Parcel#: 1'� ®�l"�®/� Is the Building Historically Designated:Yes NO Occupancy Type: Construction Type: Flood Zone: BFE: FFE: OWNER:Name(Fee Simple Titleholder): j f Phone#: el Address: f City: fflia ��SS State: Zip: 3,3/ 3® Tenant/Lessee Name: Phone#: Email: / C� CONTRACTOR*Com any Name: ' f'L Phone #�� Address: City: State: Zip: �f�° Qualifier Name: ��^^ Phone#: State Certification or Registration#: /—/ Z.�7' M Certificate of Competency#: DESIGNER:Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit:$ �• Square/Linear Footage of Work: Type of Work: ❑ Addition W Alteration ❑ New ❑ Repair/Replace ❑ Demolition Description of Work: �WrQ ,�f- ! Specify color of color thru tile: Submittal Fee$ c3N Permit Fee$ ffA CCF$ CO/CC$ Mo)Scanning Fee$ Radon Fee$ DBPR$ Notary$ Technology Fee$ Training/Education Fee$ Double Fee$ Structural Reviews$ en Bond$ IV � TOTAL FEE NOW DUE$ 10 / 1 V (Revised02/24/2014) s Bon11ng ODmpand❑Name(if applicable) Bon EIng Compand❑Am e® City State Zp Mortgage Len❑er'[]Name(if applicable) Mor[gage Lente'❑Am enn Clty 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 ELEGRC; PLUMSNQ SGN$ POOL RJR MACI34 BIXLl3;rA HEATER$TANIQ AIROONDITION6FC4 ETC.... O❑NERSAFRDAVIT. I certify that all the foregoing information is accurate and that all work will be done in compliance withal applicable laws regulating construction and zoning "❑ARNI NG TO O❑ NES YOUR FAILURE TO WOORD A NOTICE OF OOM M ENCEVI ENT MAY FESJLT IN YOUR PAYI NG TWICE FOR I M PROVEVI ENTS TO YOUR PROPERLY. IF YOU INTEND TO OBTAIN RNANGNQ OONSULT WITH YOUR LENDER ORAN ATR)MEYBEFOFE SING YOUR NOTICE OF OOM M ENCM ENT" Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding$250,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 son whose property is subject to attachment. Also,a certified copy of the recorded notice of commencement must be post th site for the first inspection which occurs seven (7) days after the building permit is i In ea of ch eel ice, the inspection will not be approved and a reinspection fee will be charged. 9 ature �� .� / 91 9gnatur OMERor AGENT #V The foregoing instrument was acknowledged before me this The foreffgoi strumentt was acknowledged before me this day of 20 /� .by s day of 4?-C,- 20 ,.�5',by �� ► Ct,Jl1 CJ who is personally known to Aah/l . �n1�1�},who i meson ly n to M4;t11111111111 j,f me or who has produced � N SAFFA 11, as me or who has produced as identification and who did talMIss1oN'�.90 ot rS �Ni'�''. INOT ification and who did t`a�� S�o°��90% NC>1'ARY WFMW i a".r *0 01•i ' i.* $ 199`'�:a'lBOj"ded thr'c+�`;m°'OQe ? ' AFF 65398;1 J�� 9h: g } 8gn: �o : .o- �irSO1Z.�a.' " 0 \\\\° ,9 •.oig ondedtY� fi�.•O`� Ifint: JJ P/11r1�111111N°t Writ ter- I'rc� `��r nom•.•, \�\ Seal: Ste: APPFOV®BY �6 v 0 S Rans 6carniner Zoning Structural Faview Oerk (PeAsed02/24/2014)