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PL-05-1077Issue Date: 12/6/2005 Owner's Name: ANNEMETTE SODBERG Permit Type: Plumbing - Residential Work Classification: Gas Job Address: 1143 98 Street NE Additional Information Miami Shores Village, FL 33138- Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Fax: (305)756 -8972 Permit Expires: 12/02/2006 Contractor(s) Phone HOME GAS CORPORATION/ MEDLE Primary Contractor Yes Type of Work: LP LINE FOR RANGE Type of Piping: Additional Info: 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. Fees Due CCF Education Surcharge Permit Fee - Additions /Alterations Plan Review Fee (Engineer) Scanning Fee Technology Fee Total: Amount $0.60 $0.20 $100.00 $60.00 $3.00 $4.00 $167.80 Building Depp.!tment Fi Applicant Signat re Permit Status: APPROVED Permit Number: PL -12 -05 -1077 Phone: 305 - 394 -9445 Parcel #: 1132050180270 Block: Lot: Section: PB: Total Square Feet: 0 Total Valuation: $ 425.00 Reauired Inspections Press Test ROW Final Invoice Number Amt Due PL - 12 - 05 - 22909 $1 7.80 Total: DEA B PAID Amt Paid $167.80 $167.80 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. ty i 6 ` I spect « �" Passed Failed Correction Needed Re- Inspection Fee ($75) No Additional Inspections can be scheduled until re- inspection fee is paid. r � Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Date: 04/28/2006 Inspector: Levrack, James Owner: SODBERG, ANNEMETTE Job Address: 1143 98 Street NE Miami Shores Village, FL 33138- Project: <NONE> Contractor: HOME GAS CORPORATION/ MEDLEY GAS COMPANY Building Department Comments Thursday, April 27, 2006 Block: Permit Type: Plumbing - Residential Inspection Type: Press Test Work Classification: Gas Phone Number 305 - 394 -9445 Parcel Number 1132050180270 Lot: Page 2 of 2 • • • • .... ••• • • • • • • PIPING DIAGRAM CONTRACTOR LICENSE # 1616 • 1 • • • • •• • • • • • • • • • • • .•• • • • PIPE SIZE: TOTALIITUS • REG.TYPE TOTAL-BB/5 ii 11 11 =Ill I= MI 11=1.imills•lil aim PIPE Vey SIZE PIPE SIZE: RE-G. TYPE TOTAL BTU'S 1060 SW 27 AVE - MtAM( FL 33135 (305) 643 -1511) Fax (305) G43 -1516 SIZE TYPE AL,tmrS GEST RUN t PREsst LONGEST RUN (Lowt1axs) CONTRACTOR SIGNATURE Swum to and sukscnbed bc(ota me - • this day day of , 2002 dry (SEAL) • (LONGEST RUN LONGEST RUN (ow ra sst (Lowmess) NAME: /97(//9 S� ® fir ADDRESS: 1/ 3AA6T Ve or DATE: s'e"r- CITY /STATE A? 7 3 3/ 3 FS OM-AMR F I` AI • •.. • • • ... .... ... .. •••• . . • • •••• • .... • .••• ••••• • • •• • .. • • •••• . . • •• • .. . ... . • • • • • • • • • • • •• • • • • BUILDING PERMIT APPLICATIO FBC 2001 Job Address (where the work is being done) City Miami Shores Village Is Building Historically Designated Contractor's Company Name Contractor's s City t O. lat Qualifier ��'� ®2_ Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: 305 7 5.22_ _ . • - ) 756.8972 BE 2'335 YES Permit Type (circle): Building Electri Plumbin Mechanical Roofing Owner's Name (Fee Simp }e Titleholder) Owner's Address 1l41 6 g City /V\ ` g Q S. State Tenant/Lessee Name Phone # Zip )14 3& 9% County Miami -Dade 2 0 6 "'\° N )- 7(YG- Zip NO Phone J 41 ° i j Architect/Engineer's Name (if appli ble) Phone # $ Value of Work For this Permit .A/2).. op Square Footage Of Work: Type of Work: ❑Addition teration ❑New ❑ Repair/Replace ❑ Demolition Describe Work: Permit No. P Z 0-1 1 Master Permit No. ( ****************************F * ** Fees *, * * * ** * **** *** * * * * * * * * * * * * * ** Submittal Fee $ Permit Fee $ i ( CCF $ CD . 6CD CO /CC Notary $ Training/Education Fee $ C). c) C.) Technology Fee $ 4 - CD Scanning $ v °C) Radon $ Zoning Bond $ Code Enforcement $ Structural Plan Review. $ Total Fee Now Due $ I � ---1 . C EEC 0 8 PAID (Continued on opposite side) cif, 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 bf 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 . bject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first insp ction which occurs seven (7) days after the building permit is .issued In the absence of such posted notice, the inspection will 1st be approved and a reinspection fee will be charged. Si owledged before me thi Owner or The foregoing tument was ac d a y of 'ON ,20 of, by who is personally known to me or who has produced As identification:andwhp did an oath. C pp��''qq ``' R y OS ° '� RE : Iai © ARY PUBLIC: EXPIRES AP-RR. NOTARY PUBLIC: Si PrintC My Commission Expires: fdLe * * * * * * * * * * * * * * * * * * * * * * * * * * * *. * ** * * * * * ** APPLICATION APPROVED BY: Cho 12/15/03 Signatur Con The foregoing ' ent was acknowl + b: fore me this d a y of 20O', by l PUI> L, , who is personally known to me or who has produced as identification and who did take an oath: Si Print: My Commission Expires: 4 / ertificate of Competency Holder) State Certificate or Registration No. Certificate of Competency No. *************** * *** * * * **** * * * * * * * ** *** ** ** * * ** * *******/*****.*********************************************** II' Plans Examiner Engineer Zoning