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PL-07-122
Job Address: 418 105 Street NE 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 Issue Date: 1/29/2007 Expires: 07/28/2007 Owner's Name: ST ROSE OF LIMA CATHOLIC CHURCH Permit Type: Plumbing - Residential Work Classification: Gas Contractor(s) TECO PEOPLES GAS SYSTEM Phone (305)957 -3857 Primary Contractor Yes Type of Work: GAS LINE 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, I 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 -1 -07 -122 Phone: (305)758 -0539 1122310150060 Lot: PB: Total Square Feet: 0 Total Valuation: $ 600.00 Reauired Inspections Press Test ROW Final Fees Due CCF Education Surcharge Permit Fee - New Construction Scanning Fee Technology Fee Total: Amount $0.36 $0.12 $160.00 $3.00 $4.00 $167.48 Invoice Number Amt Due PL -1 -07 -27337 $167.48 Total: 6 s1 FEB 0 2PIiL Amt Paid 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. 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 BUILDING Permit No. PERMIT APPLICATION -. Master Permit No. FBC 2004 Permit Type (circle): Building Owner's Name (Fee Simple Titleholder) Owner's Addres �� (i ' e City M Tenant/Lessee Name Job Address (where the work is being done) City Miami Shores Village County Miami -Dade I - 2231 ®LC 06'0 FOLIO / PARCEL # Is Building Historically Designated YES N� Contractor's Company Name "Tea) C Phone # 3DJ q7O Contractor's Address _15)___2_2 — H L k.t State Zip City 1 AA t_ ' A Qualifier Name . c State Certificate or Registration No. CM_ Architect/Engineer's Name (if applicable) s : Phone # " orl,, gyp; ,ip:',grmt shoon to ElifilP '+. OteS ,S d91 itqb ` r f 'I Ilil Addition RI MA �(2Evr.i1 d Valu Type Desc Submittal Fee $ Notary $ Scanning $ <((tii . tate L CCF $ ©° ( CO /CC Training/Education Fee $ 0 12- Technology Fee $ 400 Radon $ DPBR $ Zoning $ Permit Fee $ Bond $ • Code Enforcement $ Miami Shores Village Building Department u131cc ulKO Electrical Plumbing Mechanical Li (3 fP LAS S /6 a 0 Zip t3 Phon -#- Certificate of Competency No. Double Fee $ Phone # Zip JAN 2 3 2007 B Y: 1\0 Ilt 2 3 i Roofing Phone # o 0 (7 Square /`Lineal- Footage Of Work ve" t't3 ` _ Re Lii1Replace molition , _ � ,+ t1?6f: tl E OAF- 011e0H (Ai Structural Review. $ Total Fee Now Due $ I C/ - See Reverse side -- 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 (Revised 02/08/06) 40144.„ LUIS MONTERO 4 `. Notary Public - State of Florida �� • Ny Commission Expires Feb 2, 2010 Sign: Print My Commission Expires: APPLICATION APPROVED BY: Signature Sign Print•. M Co Owner r Agent Contrac or The foregoing instrument was acknowledged before me this 17 The foregoing instrument was acknowledged before me this p day of 20 L 7 by o /� �-Q R bel6 ■j '2-.. day of 20Q7 , by `Pc U S €o is personally known to i tt who has produced who is personally known to me or who has produced As identification and who did take an oath. as identification and who did take an oath. NOTARY PUBLIC: onded By National Notary Assn. Expires: * * * * * * * * * * * * * * * * * * *_ * * * * * * * * * * * ** Plans Examiner Engineer Zoning Public Works Permit Application FBC 2004 city n,'/a al Job Address (where the work is being done) City Contractors Company Name Contractors Address City Describe Work Code Eel $ Total Fee Now Due $ (Continued on opposite Vie) Miami Shores Village Public Works Department 10050 N.E. 2nd Avenue, Miami Shores, Florida 33138 ' Tel: (305) 7952204 Fax (305) 756.8972 Paine Type: Public Works WATER Owners Name (Fes Simple Titleholder) ld Titlehoer) Phoned: d ed V7 0 ' / ?L Owners Address ' /Q /1 ' �� /0y Tenant/Lessee Name Phoned: V8 A 6 /d Miami Shores Village County Wand Dade Zip .22f .3e Is Building Historic* Designated: YES co R "/- X46 /s? 79 0)• may A/. ,tit• Av9-c14- state G Fear Pwndt No. PL State Phoned: Jar rip 3 sneers Name (if applicable) Phone S: $ Value of Work For this Penrtit F l� ° �4 () Lineal Footage Of Work Type of Work ❑ Addition ❑ Alteration ❑ New ❑ RepaidReplace ❑ Demolition Submittal Fee $ Permit Fee $ CCF $ CO/CC Notary $ TrandnglEducation Fee $ Technology Fee $ Scanning $ Radon $ Zoning Bond $ Structural Plan Review $ Bonding Company's Name (if applicable) Bonding Company's Address N/A City ,: ' State Z� Mortgage Lenders Name (if applicable) Mortgage Lender's Address City N/A 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 .... OWNERS AFFiDAVIT: I certify that all the foregoing information is accurate and that all work wdl be done in compliance with all appficab 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 mud promise in good faith that a copy of the notice of commencement and construction lien law brodture 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 sae for the fast 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 Signature Owner or Agent Contractor The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this day of , 20 , by day of , 20,__, by who is personally known to me or who has produced Who is personally know to me or has produced as identification and who did take an oath. as iderdifrcation and who did take an oath. NOTARY PUBLIC: Sign: Pmt Print My Commission Expires: APPLICATION APPROVED BY: 11/17/2005 NOTARY PUBLIC: Sign: My Commission Expires: Public Works Director or his designee. N N E 4TH A V E N U 75' E A TLA S M 24 R/W 1 M.77719 Lit ��14 2 3 ." 'ti!T C3 Y: BSE GAS MAIN PARKWAY -40 PROPOSED 3/4" PL STIC NE RISER L... 2' ..i 64 .. .. • • • .. .. • • • • • • • • • • • • • • • .. • • • • .... • • • • .... • • • .. • • ... .... • • • • • • • • • . .. • • • • ... • • • • • .... • . ••0 • • • • • • • • .. .. • • • •• •l IE.O.P 1. ALL CAS PIPELINE CONSTRUCTION TO FOLLOW TECO PEOPLES CAS STANDARDS. 2. TRAFFIC CONTROL SHOULD BE MAINTAINED AND COORDINATED WITH 7118 APPRORIATE GOVERNMENTAL AGENCY. 3. ALL DISTRUBED ASPHALT /CONCRETE /SOD AREAS TO BE RESTORED TO PRIOR CONDITION, UNLESS OTHERWISE SPECIFIED. PARKWAY SWALE CRASS Iv (SOD) TECO PEOPL SIDEWALK N, R/W NEW 3/4" PLASTIC CAS SERVICE DRAWN BY: LM 418 NE 105 STREET. MIAMI SHORES, FL NE 105TH STREET R/W SIDEWALK S. 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