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PL-10-11 Miami Shores Villages Y P(1lriRb �Wa 10050 N.E. 2nd Avenue W - Miami Shores, FL 33138-0000 Phone: (305)795- 2204�'� x Expiration: 0 7107/201 0 Project Address Parcel Number Applicant 113 101 Street 1132060131910 Miami Shores, FL 33138- stock: Lot: GIL & DEANNA GREEN Owner Information Address Phone Cell GIL & DEANNA GREEN 113 101 Street MIAMI SHORES FL 33138 -2320 Contractor(s) Phone Cell Phone Valuation: $ 1,200.00 SUBURBAN PROPANE 305 -891 -8393 Total Sq Feet: 0 Type of Work: GAS LINE For Inspections please call: Type of Piping: PLUMBING (305)762 -4949 Additional Info: Available Inspections: Bond Return: Inspection Type: Classification: Residential Final Press Test ROW El Fees Due Amount Invoice # Total Amt Paid Amt Due CCF $1.20 PL -1 -10 -36737 $ 189.20 $ 139.20 Education Surcharge $0.40 ._.i.,, .__..w Permit Fee Additions/Alterations $180.00 PL - 1 - 10 - 36737 $ 189.20 $ 189.20 $ 0,00 Scanning Fee $6.00 Submittal Fee $50.00 Submittal Reversal Fee ($50.00) Technology Fee $1.60 Total: $189.20 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. January 08, 2010 Authorized Signature: Owner / Applicant / Contractor / Agent Date Building Department Copy January 08, 2010 1 pt IT lin TV a I • I. ,4��:A en ` �,�45t11N. A enue, Miami Shor s, orida 33 I Tel: M 795.2204 Fax:; (305), 5.8972 BUIL G fi I�!'fl i� a f9l. 'erMit No. j! jf PERMIT AP�`T.I ;CT I aster Perimit No. FBC 2004 f Fe mgt' 'y ►e. V Plu �bi �,� ;, �. ; -Ih i Owner's f ame ee Simple Titleholde,01 it Phone #k r3 Owners Address cit ! ty Af I. i w II T en an see Na N � �� t/I.es e hone # {i E-MAIL: � , II Job Add r ssi(wh" re the WI4 is bof � � I ) �� + � I, , b,�✓I : �I �ty am Sho Vil �e'�`' My iaan'-Dad r3' / k II • p FOLIO / PARC L # Is Buildin Dist o -fealty lgna ed � , ('�FS Contractor's Co peaty Name U � Phone # -V5 6- $'3 1 91T u Contractor's Ad& ss / 7 mil I I I I I city /tats, UCL!'lo — 3 3 Q ualitier ante Phone # v0s P S ,� State Certificate q' Re is o nN g t� o. I Ce 'fi rtt Com R -MAIL; gin pe g to c y No. Architect�n is 1V (ap I �{ I I` Rhone li .a f o u , Value Work th is P 0. r emit u Y I w , I Square / Li ootage Of Work: i Type of Work: [ � Addition Itet'ation {�! , ONow kepatir/Replace [:1 Demolition Describe Work.. V e I ! II r i it ,,i '� T �� . 4R ?k i bk eeS &4rdnY,t�xar &dr'�nk �, de$ eIroYir�YaYsdeb�rs At� ubmittal Fee S F I I el Notary S Traini�ig /Cd time'F ' ecpnolo' Fee Scanning $ Radon S �' 1 DPRR.S Zoning $ Bond S Doubt .Structure R taN ee Now D ue 1 evie .$ f T S —�—- ,I See Reverse side --> a ; t k 1- i Bonding Company's Name if applicable) (, pP ) ;I Bonding Company's Address City State �. Zip I I Mo I Le Lender's Name (if applicable) Mortgage Lender's Address 1, City State Zi 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 issuince 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 i 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 C ONSULT WITH YOUR LENDER OW. AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.' lip a' I Notice'to Applicant. As a condition to the issuance ce o a building permit w' . .f with an estimated value g P exceeding 00 the he 8' � 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 fp r the', first inspection which occurs seven (7J 'days after the building permit is issued. In the .! , g' P absence of such posted notice, the ;. j inspection will not be approved and a reinspection fee will be charged I V Signature Signature I Ow r or Agent Contractor The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before is day of C- , 20 , by ,V/!yA eitop-b day of 0 by GUJJIV r ho is personally kn wn to me or who has produced w k nown �me r who has produced I' 4i As identification and who did take an oath. as identification and who did take an oath. Ii NOTARY PUBLIC: NOTARY P LIC: oUEVEDO " � P�lia • �� of FiD1� Sign:'' Sign: P 'nt: Colon • 00 1 �' �— �. Print: .• .. Notary ublto - State d My Co mmi s� xp e . M Commis *' tMyCommtseiOnExD* .�m1li.oil Y ,9 Commission � pp 6 , a��t rt Ye�x�Yx BcxaYx &'+Y'+Fde�dr� &dt,at 9ieYaYx 9txoY 1 dr do aatr of 4edr de ok aYeYdede da oYd:s4 &Yxtiede�r eY a4 &x8e deoY sYa4 ek�$e xeYa� �c aYsY 1 PPL q APPLICATION AT[ A C ON APPROVE D Y: Plans Examiner er I i Engineer ! Zonin (Ri vised 02/08/06) I i I (( ;I p21 .� 001, e q '� �Zi6 va e1E' L TAP Loa L JA '00 LP CP* fob P G� e /- too Suburban Propane rjLjk �� 1491 N. E. 130th Street P N. Miami, FL 33161 3 05-891-8393 Qualifier Job Address 1 13 /!L /6>/ 9f- to (0 ��, Longest Run (0 7 �cf Total BTU's 6 96c4) I - � � � �•�.�� vw COBS �' �- tj PC , F suburban Propane 1491 N. E. 130th Street N. Miami, FL 33161 305- 891 -8393 Qualifier Job Address 11 Al /a/ S/ jw //7/"/ .SAO" Longest Run 3 3 �-e- - Total BTU's f da1210i.i `S3a0HS INVIN NO,IdISl3S3O IWOM 133HIS 1S l0 L '3N £ l L VIVO CHINOZ , NV O 3MS 30NMIS38 N33110 NV,d NOM 91 1 0 � I . I I I Q V) I ' II � � I ,I Io I I Suburban Propane 1491 N. E. 130th Street N. Miami, FL 33161 F= I � 305 - 891 -8393 *Is Qualifier y flog, 11a � sr Call ll Job Address 13 Iv /ti p Lon Run' �rcef 33 f.,� P_ Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP- 132582 Permit Number: PL- 1 -10 -11 Scheduled Inspection Date: March 08, 2010 Permit Type: Plumbing - Residential Inspector: Hernandez, Rafael Inspection Type: Final Owner: GREEN, GIL & DEANNA Work Classification: Gas Job Address: 113 NE 101 Street Miami Shores, FL 33138 - Phone Number Parcel Number 113206013191 Project: <NONE> Contractor: SUBURBAN PROPANE Phone: 305 -891 -8393 Building Department Comments Inspector Comments Passed Failed Correction ❑ Needed Re- Inspection ❑ Fee No Additional Inspections can be scheduled until re- inspection fee is paid. March 05, 2010 For Inspections please call: (305)762 -4949 Page 8 of 30 a ,oi)'iJ'K' -bA N PROPANE 1491 NE 130 ST NO MiAMI, FL 305 -891 -8393 CIA DROP TEST WC M IN 0 SIG NATUR i � "ni r4` r*, c `�• ^• i' ?f— iJ 01 x,Ftl i i w y 71 i 9. a .3 x,J at 3 _ r y . V t "ri� rr:Y I i E'•` :2 Inspection Worksheet Miami Shores Village 10050 N:E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP- 134417 Permit Number: EL -1 -10 - 138 Scheduled Inspection Date: March 16, 2010 Permit Type Electrical - Residential Inspector: Devaney, Michael Inspection Type: Final Owner: GREEN, GIL & DEANNA Work Classification: Addition /Alteration Job Address: 113 NE 101 Street Miami Shores, FL 33138 - Phone Number Parcel Number 1132060131910 Project: <NONE> Contractor: TIRONE ELECTRIC, INC. Phone: 954- 989 -7162 Building Department Comments installation of a 120 v ignitor for gas water heater Inspector Comments Passed Failed Correction Needed ❑ �� G� �°� Re- Inspection 13 y Fee No Additional Inspections can be scheduled until re- inspection fee is paid. March 15, 2010 For Inspections please call (305)762 -4949 Page 10 of 23 . Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 cj L Inspection Number: INSP - 138168 Permit Number: EL -1 -10 -138 Scheduled Inspection Date: March 31, 2010 Permit Type: Electrical - Residential Inspector: Devaney, Michael Inspection Type: Final Owner: GREEN, GIL & DEANNA Work Classification: Addition /Alteration Job Address: 113 NE 101 Street Miami Shores, FL 33138- Phone Number Parcel Number 1132060131910 Project: <NONE> Contractor: TIRONE ELECTRIC, INC. Phone: 954- 989 -7162 Building Department Comments installation of a 120 v ignitor for gas water heater Inspector Comments Passed - CREATED AS REINSPECTION FOR INSP - 134417. Seal openings in 1900 boxes in garage. Sprap P. V. C. conduit & replace cover on receptacle by water heater. Failed Correction Needed Re- Inspection ❑ Fee No Additional Inspections can be scheduled until re- inspection fee is paid. March 30, 2010 For Inspections please call: (305)762 -4949 Page 10 of 23