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PL-07-204Issue Date: 2/13/2007 Owner's Name: SANDRA ALICE SOUTHMAYD Permit Type: Plumbing - Residential Work Classification: New Job Address: 10538 3 Court NE Contractor(s) TECO PEOPLES GAS SYSTEM Phone (305)957 -3857 Primary Contractor Yes Additional Information Miami Shores Village, FL Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Fax: (305)756 -8972 Permit Expires: 08/12/2007 Type of Work: GAS Additional Info: Classification: Residential Type of Piping: Bond Retum : 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, 1 authorize the above -named contractor to do the work stated. Building Department File Copy Applicant Signature Parcel #: Block: Section: Permit Status: APPROVED Permit Number: PL -2 -07 -204 Phone: 1122310130310 Lot: PB: Total Square Feet Total Valuation: Re ' uired Ins ' ections Underground Rough Water Main Top Out Main Drain Lavatory Water Service Re Pipe Heater Final 0 $ 2,500.00 Fees Due CCF Education Surcharge Permit Fee - Additions /Alterations Scanning Fee Technology Fee Total: Amount $1.80 $0.60 $160.00 $3.00 $4.00 $169.40 Invoice Number PL - 2 - 07 - 27507 Total: eeitAr�� Amt Due $169.40 Amt Paid FRS 1 5 P 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. :teturn to: Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Bill To SANDRA ALICE SOUTHMAYD 10538 NE 3 CT MIAMI SHORES, FL 33138 -2010 Date Fee Name 02/11/2009 Expired Permit Renewal Fee Wednesday, February 11, 2009 Invoice Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Fax: (305)756 -8972 Invoice Number: PL -2 -09 -33941 Invoice Date: February 11, 2009 Permit Number: PL -2 -07 -204 Bond Number: Comments: Fee Type Calculated Total Fees Due: Fee Amount $160.00 $160.00 Payments Date Pay Type 02/11/2009 Check Check Number Amount Paid 1115 $160.00 Change $0.00 Total Paid: $160.00 Total Due: $0.00 II BUILDING PERMIT APPLICATION y. FBC 2004 Permit Type (circle): Building Electrical Plumbing Mechanical 5ANDI .COU # '36 75 Owner's Name (Fee Simple Titleholder) Owner's Address City State Zip Tenant/Lessee Name Phone # Job Address (where the work is being done) / 05 3 /�/ e 3 J . City Miami Shores Village County FOLIO / PARCEL # Is Building Historically Designated YES Contractor's Company Name Contractor's Address City Nk Qualifier Name Architect/Engineer's Name (if applicable) Notary $ Scanning $ 3' Bond $ 0.24 Miami Shores Village � )51oi Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 BC c ' 7o( ? State Certificate or Registration No. Certificate of Competency No. T / ypetiQ Wok` g X 1 1 IftlifilA r S!!P i! t.°c a �f f( ;•7 r. [] .ddition � r AA' . Phone # +i Wo quark Miaat:� )botage O>�.�4for4: � '_ -*AO ,S W � e9140.6 LEA' r-,3 9 ` f * Ne v Repairfll epla Alteration Submittal Fee $ Permit Fee $ I 0 5) 756.8972 FEB 0 2 200 Permit No. O — ZL' Master Permit No. G4 IC Wg-1CS Miami -Dade Training/Education Fee $ s �DU Code Enforcement $ Structural Review. $ Phone # �� J £ 77) / 70- Zip s11 Phone # Radon $ DPBR $ Roofing Zip ** * * *** •< ** *•* ** ** * *•* * *** * * ** * *** * * *•* F ees * *•*, *•* * * * *, *** * * * * ** * *** * * *** * *•* * * * ** ** ** * ** CCF $ 1 .80 CO /C Technology Fee $ 4-- Zoning $ Double Fee $ Total Fee Now Due $ I . See Reverse side t-> 0 Demolition 0 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 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 NOTARY PUBLIC: Owner or Agent The foregoing instrument was acknowledged before me day of AAA - i 1? who is personally known to me or w has produced s identification and who did take an oath. as identification and who did take an oath. Sign: Print: My Commission Expires: (Revised 02 /08/06) APPLICATION APPROVED BY: Sign: Print: My Commissi ontractor The foregoing instrument was acknowledged before me this`2 day of 2, 0 C , by ( S who is personally known to n4 or who has produced NOTARY, PUBLIC: ******************************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Plans Examiner Engineer Zoning Public Works Permit Application FBC 2004 Type of Woric Describe Work Miami Shores Village Public Works Department City Miami Shores Vi@ape 10050 N.E. 2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 7952204 Fax (305) 756.8972 G/IS Permtt Type: Public Works WATER Owners Name (Fee Simple Titleholder) p! L MVP OwrneaAddtess i � 5 33 At c� City State Tenant/Lessee Nance / Phone County le Building Her Designated: YES Contractor's Company Name \- G4F? y- 1 , � ConuactorsAddress l 7 ) T "V Y Q City r ' FC Ar hitectlErtghieer's Name (if applicable) Phone S: $ Vairre of Work For this Permit Lineal Footage Of work Submittal Fee $ Fame Fee $ Notary $ Scanning t Code Enforcement $ Total Fee Now Due $ (Continued on opposite side) Training/Education Fee $ Ram $ Structnar Plan Review $ Phone 0: Pendt No. Miami Dade Zip Phone#: cc $ Technology Fee $ Zoning Bond $ ziP 2 Bonding Company's Name (ff applicable) Bonding.Company's Address (P ( N/A City - State Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State Application is hereby made to obtain a penn0 to do the work and installations as indicated. I =Iffy 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 pemrit 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 condit ion to this issuance of a Public Works permit with an estimated value exceeding $2500, the applicant must promise in good fah that a copy of the note of cammencement and axistruction lien law brochure will be delIvemd to the person whose property is subject to attachment Also, a certified copy of the recorded notice of commencement rust be posted at theme ale 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 refnspecdon fee Will be charged Signature CiArl AfiA NOTARY PUB 'C Sign: Print: My Commission 11/17/2005 Owner or Agent as identification and who did take an oath. • t 1 - ,,° Notary Pic - Stated FIbdd 1 • Commission if 0D 513850 ,,, °� �'••- Bonded By National Notary Assn. Signature N/A ZIP '1'\ rrtrtor Co The foregoing instrument was acknowledged before me this The foregoing instrument was admowledged before me this -� 2007 by �J.11aJ� V � U who is personally known to me or wh has produced Who is personally know to me or produced day of_ ,20 by Cam' J° 0 ' - ` SUU kayof as idenbic ation and who did take an oath. 09k10 7 Public Works Director or his designee. . A • NOTES CONSTRUCTION 17 LocAtE AND . PROTECT. ALL UTILITIES IN AREA OF CONSTRUCTION. SUNSHINE # 1-800-432-4770 / 2. RESTORE ALL AREAS TO PRIOR CONDITIONS 3. ALL CONSTRUCTION TO FOLLOW JURISDICTIONAL GOVERNMENT .AND TPG STANDARDS. 15 . 12 9 PER COFTL 4.NO 5. NQ WM., Al-R PROFILES. 6. NQ DRAINAGE, NO APPLI0A11ONS SOON:PIED .. • 6. DEWATERINO ABOVE W TABLE 7. TRAFFIC STRIPS o LOOPS. LEGEND R/W RIGHT .CI‘F WAY - P/L PROPERTY LINE /T TAPPING TEE EFV EXCESS FLOW VALVE SVC SERVICE LINE SP STEEL PLASTIC .COAT PE POLYETHELENE 3 MAX SOD RESTORATION DETAIL SCALE: NOT TO SCALE PROP 3/4 PE BORE 0--- NE 3RQ COURT CROSS SECTION SCALE NOV - TO SCALE WArEft VAN 'W F T- MINIMUM •••■•••••••■••••••■,•••.. PROPOSED 3• 1 14F P DRIVE WAY tipRNAROUND tar 4 L co< 12 LOT 3 BLOCK 12 LOT 2 MOP( 12 • LOT 1 BLOCK .12 END _ LOT 14 LOT 13 BLOCK 11 LOT1 BLOCK 11 DRIVE WAY / TUFOIAREtOND N P/L LOT V/116 LOOK 11 s LOT. LOCK II- , • 10MI • . - . _ .4 • • • • • • - •• • • • • • • • • - • • • • • • •• • • .• • • • • • ••-• • • •• • • • • • FEB 0 2 sNifmv , • -6 Y: n_ 1.1 GAF SERVICE COU - NT • • • • • • • • • •• • • • • • • • • • • • • • • • • • • • • • • -••• • s • • • • • • 0" • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • 0.•• • ' • •• • . • irs • •0 A Do • • • • • • • • • • • - PROPOSED Am FlAsnc.. pAg MAIN 00 +, 0 Ca pre 0 p 00 + 02 • • 3 • .3"1 TECO / PEOPLES - N,ASNINVE16,4 --..