PL-07-1346Miami Shores Village
10050 N.E. 2nd Avenue
Miami Shores, FL 33138 -0000
Phone: (305)795 -2204
Project Address
1234 NE 101 Street
Miami Shores Village, FL
1132050080030
Block: Lot
JANN RUFENER
Owner Information
JANN RUFENER
1234 NE 101 ST
MIAMI SHORES FL 33138 -2609
Valuation:
Total Sq Feet
$ 600.00
0
Contractor(s)
TECO PEOPLES GAS SYSTEM (305)957 -3857
Phone CeII Phone
Type of Work: PLUMBING
Type of Piping: GAS LINE
Additional Info:
Bond Retum :
Classification: Residential
Fees Due
CCF
Education Surcharge
Permit Fee - Additions/Alterations
Scanning Fee
Technology Fee
Total:
Amount
$0.60
$0.20
$100.00
$3.00
$2.50
$106.30
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.
Authorized Signature: Owner / Applicant / Contractor / Agent
Building Department Copy
Address
Parcel Number
Phone
Applicant
Available Inspections :
Inspection Type:
Press Test
Final
ROW
1
August 07, 2007
Date
Cell
Tuesday, August 7, 2007 1
CV
vonfvo • -
Public Works
Permit Application
FBC 2004
Permit Type: Public Works WATER
Owner's Name (Fee Simple Titleholder)
Owner's Address 2-))
City 714.
Temmt/Lessee Name
a JUN 2 7 2007 IN
Ma
BY: I JUNhav2007
IMMEEV'
Miami. Shores Village B 42- - --
Public Works Department °J1 TA I r/1 ,
10050 N.E. 2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
Job Address (where the work is being done) N-Q I 01 sl
City Miami Shores Village
Is Building Historicany Designated:
166 • 2)0
Total Fee Now Due $
(Continued on opposite side)
14AJ FP. E Phone ft: 3 75'9- Wa
/cy sit At
stab, zi p - 3 3?3
Phone d:
Contractor% company Name 7— 0 Phone fi:5C6 *4 am
Contractors Address /9 7 .? NA) /7 H Lik)c Ay7- 910. rrct3
City state 6)2_
PermftNo
Architect/Engineets Name (If applitable) Phone 8:
$ Value of Work For this Permit 6 0o
Radon $
Structund Plan Review $
Zoning
Lineal Footage Of Work:
Type of Work 0 Addition JM.era1Ian New
'z - , - - 1-..-_ - __ - z.e.,...ar.....4. , ...- -, - - i,..-: ..,....,...--;,' • . , ! - D Repair/Replace
DetXribi i '..) .',
w e-vt 9/it Fi G _
6 etoN1 In :osk: .,":,-' , :4 0)
,
Submittal Fee $ . Permit P° CCF $ 0-60 CO/CC
Notary $ Training/Education Fee $ 0 1.20 Teelmelogy Fee $
Scanning $ 5.0C)-
Code Enforcement $
101-f.Y■ NWAVAIVVIAVAIIIIIMALIRACII/
0 Demolition
Bond
Bonding Company's Name (if applicable)
Bonding Cwinpanyrs Address NIA
City State Zip
Mortgage Lenders Name (if applicable)
Mortgage Lender's Address
City State
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 this issuance of a Public Works 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 cerffled copy of the recorded notice of commencement must be posted at the job site for the gust
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 reinspeciion fee will be charged.
11/17/2005
The foregoing Instrument was acknowledged before me this°R) The foregoing instrument was acknowledged before me this 2
day of 1. , 202 by TNV N Vl/fr4 day of , P, 20 by Fire 5 S
NOTARY
Sign:
Print
My Commission
LUIS MONTERO
Notary Public - State of Florkla
duly Commisslan Expires Feb 2, 2010
V Commission tt DD 513850
Bonded By National Notary Assn.
•
APPLICATION APPROVED BY:
to me or who has produced
as identification and who did take an oath.
Signature
Print .
N/A
Who is personally know to ; or has produced
as identification and who did take an oath.
" KTi'Tj:L� ,i
•G
Sign: , 10,
My Commission Expires:
Public Works Director or
his designee.
u
. LUIS MONTERO
?+�j � i Notary Public = State of Florida
Feb 2,2010
Commission # DD 513850
uondad 8 National No Assn.