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PLC-07-1838` Inspection Worksheet ®SHC ®! `° � Miami Shores Village ease � teams Contractor: PETROLEUM AND CONSTRUCTION SERVICES INC Phone: (954)942 -1117 10050 N.E. 2nd Avenue Miami Shores, FL x " ►� Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Date: 10/19/2007 Permit Type: Plumbing - Commercial Inspector: G Yee Inspection Type: Final Owner: , JIFFY LUBE Work Classification: Addition /Alteration Job Address: 8787 BISCAYNE Q4t000* Miami Shores Village, FL Phone Number Parcel Number 1132060280450 Project: <NONE> Block: Lot: Contractor: PETROLEUM AND CONSTRUCTION SERVICES INC Phone: (954)942 -1117 Building Department Comments Public works permit to get authorization to removed asphalt and concrete for sewer connection. �Q1 Inspector Comments Passed my PUBLIC WORKS Failed Correction Needed Re- Inspection Fee ($75) No Additional Inspections can be scheduled until re- inspection fee is paid. Thursday, October 18, 2007 Page 1 of 2 Miami Shores Village 10050 N.E. 2nd Avenue e!. Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Project Address Parcel Number Applicant 8787 BISCAYNE 1132060280450 COMMERCE PARTNERSHIP Miami Shores Village, FL Block: Lot: .. .... ......... . ....QWn9t. ny.9.11.171 9n ........................... ............................... Address ........................................................... ............................... ...................................................... ............................... Phone Cell COMMERCE PARTNERSHI P #1124 % PO BOX 2967 HOUSTON TX 77252 Contractor(s) Phone Cell Phone PETROLEUM AND CONSTRUCTION S (954)942 -1117 Type of Work: remove asphalt and concrete Type of Piping: Additional Info: to run sewer line Classification: Commercial Fees Due CCF Education Surcharge Permit Fee - Additions/Alterations Scanning Fee Technology Fee Total: Amount $0.60 $0.20 $100.00 $3.00 $106.30 ........................................................ ............................... Valuation: $ 1,000.00 € :# Total Sq Feet: 0 Available Inspections: Inspection Type: Water Service Re Pipe Main Drain Heater Water Main Lavatory Top Out Underground Rough I Total I Amt Paid I Amt Due I $ 0.00 00 Payment' l 7 SE g2� 5 7 qq p MIAMI SHORES VILLA7 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 . September 04, 2007 Authorized Signature: Owner / Applicant / Contractor / Agent Date Building Department Copy Tuesday, September 4, 2007 1 1 � Miami Shores Village r� � 1 �. a 6d AUG 2 9 2007 BYsi000000 Public Works Department 10050 N.E. 2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 7952204 Fax (305) 756 8972 Public Works Permit Application FBC 2004 ..�,,, R%. 1— W X10 O 0-1-�I�Co . Pemdt Type: Pubrta Waft WATER "'` OwrdWs Name (Fee Simple Tl Wwklw) ✓�i f- 1-d 4e Ptmne S 7� / D 1 b owrrers Address 0. /.4 ®oe L q 6 7 citye�! TermuNU ssee Name SIale T.t, zip Poona s: Job Address ere 8 % % 'eif e' e Rld- Wwm work Is being dare) O &'f city nnlemi shrores vie county www Daft Zip Is Building Historically Designated: YES NO contractor's cmnpw1y Nonre • Pi o / ✓p�, atvZ 4o-yf haeel kl'% Ph-.,w it�� �T L 1117 contractors Address 2-17.? / /Q %'`; IY ✓.'R O o - -0 _ CRY /9r 0� �l /' State !� C— Zip 01 3 2 7 O, ArdriteWEngineers Name Of apPkW*) Phone B: $ Vakre of wank For this Permit !00 d t ineel Foote of Wwk: Type or Work: ❑ Additim EBIAftefion ❑ New ❑ Repaaee ❑ ommon b Deafie Work i .r 1/ � 'r&610"' ae jr Fan submittal Fee $ Pemdt Fee $ v =F$ t ftwY $ TmWWg1E&.*#. Fee $ e h <' TadmakW Fee i 1 scanning Rain $ BOWS Code Enforcernant $ 'Sirvehwal Plan Review $ Tot Fee Nov Due $ (Cent toed on opposite side) F.^'1 I y 5EP 0 5 W - MIAMI SHORES, VILLAGE Bonding Company's Name (if applicable) Bonding Cc 4gw y's Address NIA City �- State Zip Mortgage Lender's Name (if applicable) WA Mortgage Lender's Address City State Zito �! .?ISO, to obtain a permit to do the work and installations as mdicated,1 cerlily that no work or installation has OnEen5cid, prio r a issuance of a permit and that all work will be performed to most 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 a Lion 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 this Issuance of a Public Works permit with An estimated value exceeding $255, the appEcent must promise in good #WM got a copy of the notice of commencement and construcUan lion. law brochure wffl be delivered to the perm whose property is submit to attachment Also, a certified copy of the recorded nok a ofcormrmrxxhmerd must be posted at the, fob We far on rffm inspection which occurs seven (7) days after the buc7dtng permit is owed In Un absence of such posted notice, the mWedim wftl not be approved and a reinspecron fee will be charged. Owner or Agent Contractor The fo L r The foregoing instrument was adaiowledged Before me this ae regatng iristrumerrt was acknowledged Before�Jme day of . 200 , by �/� �i� B 5� V A- day of �, 2t} % by �•`G w&0'c`l'7 who Is personally known to me or who has produced Who Is personally know to me or has produced as identiftcsdion and who did take an oath. NOTARY PUBLIC: NOTARY as Menh7cation and who dial talcs an oath. nV ff C—r-oA—aIJ-Y* mission # DD518327 Print 2010 My Commission Expires: WAIN TW Ra^' lftpjgmo tra ON07019 My commission APPLICATION APPROVED BY: &CO E 'pA/c4 4301 19-1 11/17!2005 P * Commission # DD518327 ate' �ttey��"010 Ff ®fib& im. &iot9 Public works Director or his designee. Receipt Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Fax: (305)756 -8972 Permit Number: PLC -8 -07 -1838 Owner Address: Invoice Number: PLC -9 -07 -29684 PO BOX 2967 Applicant: JIFFY LUBE HOUSTON, TX 77252 Company Name: COMMERCE PARTNERSHIP #1124 % JIFFY LUBE inrri r%C nen Job Address: 8787 BISCAYNE Miami Shores Village, FL Date Payment Type Check Number Amount Change Wednesday, September 5, 2007 09/05/2007 Check 3030 $106.30 $0.00 Total Payment: $106.30 FLORIDA CRACKER CONSUtTW PERMIT {* NC. Gary Gary Kilgore office. . 954 -475 -8113 954-045-3099 _ , -Fox: 954 - 475 -8983 122 Via L 333 25 Terrace Emil: IdlgoM @belhcu&net Davie, FL 333 Page 1 of 1