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PL-05-221Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Printed: 7/20/2005 Applicant: LAURA NATIRBOFF Owner: NATIRBOFF LAURA JOB ADDRESS: 9317 NE 9 AVE Contractor TECO PEOPLES GAS SYSTEM Contractor's Address: 1218 NE 101 ST Local Phone: 957 -3857 X7383 Parcel # 1132060010070 Signed: (INSPECTOR) Plumbing Permit Permit Number: PL2005 -221 Page 1 of 1 Legal Description: MARILYN HGTS PB 41-8 LOT 7 LOT SIZE 75.000 X 128 OR 19489 -4807 02 Fees: Description Amount FEE2005 -9961 Building Fee $120.00 FEE2005 -9962 CCF $0.60 FEE2005 -9963 Training and Education Fee $0.20 FEE2005 - 9964 Technology Fee $3.00 FEE2005 -9965 Scanning Fee $3.00 Total Fees: $126.80 Total Fees: $126.80 Total Receipts: $0.00 Permit Status: APPROVED Permit Expiration: 1/14/2006 Construction Value: $600.00 Work: NEW GAS SERVICE 42" PLASTIC FROM GAS MAIN JUL 2 5 PAID ma c. .4#- 1303 In consideration of the issuance to me of this permit, 1 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 1 assume responisibility for all work done by either myself, my agent, servants or employes. Signed: (Contractor or Builder) BY: 4155 MIAMI SHORES VILLAG1 O BUILDING DEPA 0�O o OS Building Inspection Request Date cf l z /o5 Type Insp'n G Ct 5 0/ 111 CL Permit No. ?1 2 00 5 - 111 f aun Mat y1.33FF q3r t JE ceti kJ Name Address Company T( 'j ' ork, c I.5 3861 Phone # 305 ( ? -3 Zs 57 E T 7 4 37 Inspection Date 9 / 3o1J 5 Approved ❑ Correction Re- Insp'n Fee BUILDING PERMIT APPLICATI FBC 2001 jj / t Roofing Owner's Name (Fee Simple Titleholder) PA.AJIi 1 A/ / Phone # 305 71 9 3 3 Owner's Address 4 11 C r P / V` S YC 6 S z Cit mit ° &kit "7 4>s State Zip j aj �y Permit Type (circle): Building ec rice Tenant/Lessee Name Job Address (where the work is being done) 13 (7 ft e V City Miami Shores Village Is Building Historically Designated YES Contractor's Company Name `L' Co -ei vo S C Phone # r � 3 () ,� ''7 01723 ` Contractor's Address is '.) P 1 t 1 ?J (4, I /�I, 6 l l� /" 1 City Q V c ege( V State . Zip t3 J - -2 Qualifier 6es los V G _/ State Certificate or Registration No. Certificate of Competency No. ' /t Architect/Engineer's Name (if applicable) Phone # $ Value of Work For this Permit Type of Work: ❑Addition ['Alteration Describe Work; Submittal Fee $ Notary $ Scanning $ 3 • 00 Total Fee Now Due $ (Continued on opposite side) 12i= . ED Miami Shores Village Building Dep artment 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 05) 756.8972 County Miami -Dade Permit Fee $ Training/Education Fee $ ©• Z,® Phone # Master Permit No. Permit No. - Q ' 2 . 2 . 1 Mechani Si‘/1/ /ot. pipitv 4i Le - r : e ic; C: oxio, Zip ' 3 K Square Footage Of Work: al ° 1 N ***** * * * * * ** * ** * ** ** * * ** * *** Fees * c * ** * * * * * * * ** * * * * ,* * * * * * * * ❑ Repair/Replace ❑ Demolition CCF $ 0 • 4.. coicc Technology Fee $ 3 - C Radon $ Zoning Bond $ Code Enforcement $ Structural Plan Review. $ 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 issue, absence of such posted notice, the inspectio proved and a reinspection fee will be charged Signature Owner or Agent /WD KN 1 /fg; The foregoing instrument was acknowledged before me this /6 day of v , 20 b by 12 RA RA.M 1 o is personally known to f�a or who has produced As identification and who did take an oath. NOTARY ' 1: LIC: `', at a' Sign: Print: chc 05/13/03 Signature Contractor — Y ,, e6 Qrecci , The foregoing instrument was acknowledged before me this // day of � � , 20 61 , by. €:'S cl C Ve6 4 to me or who has produced -- as identification and who did take an oath. I -env ,,,,, lres: LUIS MONTERO ti My Co nmi �`, icn mps A Commission d DD054905 . %4, ,a, Bonded B; Netionai Notary Assn * 0 . „ LUIS MONTERO • • l iN , 1'"PtSHc 9tbs ef*6loddak • tit •; My Canmess+on EXPires Jan 27, 2 � Commission 8 00084905 r:Iri By National Notary Assn. ., * pad} * ** * * * * * * * * * * * * ** My Commis * * * * * * * * * ** * * * * * * * * ** APPLICATION APPROVED BY: NOTARY PUB Sign: Print: My Comm' * * * * * * * * * * * * * * * * * * * * * * * * ** * * * * * * * * * * * * * * * * * ** 7 - / 9- 6 5 Plans Examiner Engineer Zoning *** * N. t CONSRUCTION NOTES: ATLAS: M 3 SCALE: NTS DRAWN BY: LM N TIE IN TO GAS MAIN. SET 1 EXC SS FLOW VALVE. • II lb 50' R/W 15' 50' R/W 1. ALL GAS PIPELINE CONSTRUCTION TO FOLLOW TECO PEOPLES GAS STANDARDS. 2. TRAFFIC CONTROL SHOULD BE MAINTAINED AND COORDINATED WITH THE APPRORIATE GOVERNMENTAL AGENCY. 3. ALL DISTRUBED ASPHALT /CONCRETE /SOD AREAS TO BE RESTORED TO PRIOR CONDITION. UNLESS OTHERWISE SPECIFIED. NEW 1/2" PLASTIC GAS SERVICE N tat g N, R/W C.D s. pd, N.E, 93RD STREET S. R/W 9317 NE 9TH AVENUE. MIAMI SHIORES, FL PROPOSED RISER 48 HOURS BEFORE DIGGING CALL SUNSHINE 1 -500- 432 -4770 DATE: 7/16/05 SHEET: 1/1 JO: 10491 :z/ •