PL-06-2132Issue Date: 8/14/2006
Owner's Name: NEIL HART
Permit Type: Plumbing - Residential
Work Classification: Gas
Job Address: 295 GRAND CONCORSE
Miami Shores Village, FL 33138-
Contractor(s) Phone
TECO PEOPLES GAS SYSTEM (305)957 - 3857
Primary Contractor
Yes
Comments:
NEW 3/4" PLASTIC GAS SERVICE FROM GAS MAIN LOCATED ON SOUTH R/W
NE 94TH
Additional Information
Type of Work: GAS
Additional Info:
Classification: Residential
Type of Piping:
Bond Return :
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 Amount
CCF $1.20
Education Surcharge $0.40
Permit Fee - New Construction $160.00
Scanning Fee $9.00
Technology Fee $4.00
Total: $174.60
Building Department File Copy
Applicant Signature
Miami Shores Village
10050 N.E. 2nd Avenue
Miami Shores, FL 33138 -0000
Phone: (305)795 -2204 Fax: (305)756 -8972
Permit
Expires: 02/10/2007
Invoice Number
PL - 8 - 06 - 25901
Total:
Permit Status: APPROVED
Permit Number: PL -8 -06 -2132
Phone: (305)962 -4547
Parcel #: 1132060133600
Block: Lot:
Section: PB:
Total Square Feet: 0
Total Valuation: $ 2,000.00
uired Ins,ections
Re
Press Test
ROW
Final
Amt Due
$174.60
$
AUG 2 1 PAID
Amt Paid
1
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.
Date
Payment Type
Monday, August 21, 2006
08/21/2006 Check
Receipt
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000
Phone: (305)795 -2204 Fax: (305)756 -8972
Permit Number: PL -8 -06 -2132
Invoice Number: PL -8 -06 -25901
Applicant: NEIL HART
Company Name:
Owner Address:
295 GRAND CONCOURSE
MIAMI SHORES, FL 33138
Job Address:
295 GRAND CONCORSE
Miami Shores Village, FL 33138-
Check Number
5025
Amount
$174.60
Change
$0.00
Total Payment: $174.60
Page 1 of 1
Permit Type (circle): Building Q ec rica umbing Mechanical Roofing
Owner's Name (Fee i le T leholder) + QJ \ P . Phone #
Owner's Address
BUILDING
PERMIT APPLICATION
FBC 2004
Tenant/Lessee Name
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 7952204 Fag: (305) 756.8972
Job Address ('Miere the work is being done) a9E G by\(..0.)(Se
City
FOLIO / PARCEL # I ( 6 \0_ 013 ( 360°
Is Building Historically Designated YES NO
Miami Shores Village County Miami -Dade
Permit No. Pi_ -lt2-
Master Permit No.
Zip
Contractor's Company Name C6 ( ( Phone #
Contractor's Address L 7 2 l k) L) (•C tc-
Cit N' /1n, ° 4- 1 State Zip L) 16 0 1
S Us
Qualifier Name
State Certificate or Registration No. Jvot.- Certificate of Competency No. 6 OP
Architect/Engineer's Name (if applicable) Phone #
Square
Value of Work oft s ,�,
-11 Alteration fNe
Type of Work: k
Describe Work: C y. 2An/
Phone # 3 or- C(7{) / 78?
j ear,fo4tage Of Work:
Repair/Replace ❑ Demolition
Submittal Fee $
Notary $ Training/Education Fee $ Technology Fee $
Scanning $ Radon $ DPBR $ Zoning $
Bond $ Code Enforcement $ Double Fee $
Structural Review. $
Permit Fee $
CCF$
Total Fee Now Due $
CO /CC
See Reverse side --
CkZ5
Ale 2 1 NUB
Bonding Company's Name (if applicable)
f
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
Owner or Agent
The foregoing trument was acknowledged before me this
day of �'U 2006 by I v°Q t L I A a 4?4
who is pers k mown to me or who has produced
NOTARY PUBLIC: .` v,
APPLICATION APPROVED BY:
(Revised 02108106)
L\A
As identification and who did take an oath.
LUIS MONTERO
Notary Public - Stte of Florida
My Commission Expo Feb 2, 2010
Commission # DD 513850
Sign: , "P , j'' 'v National No Assn.
mar-
Print~
My Commission Expires:
Signature c l)(1 0 Alj
ntractor
The foregoing instrument was acknowledged before me this
day of P iCLA S /— ,20 by S "
who is _ perso nall y ow ne or who has produced
NOT
Sign:
Print:
— — unifjentification and jt+hg, did take an oath
My Commission Expires:
LUIS MONTERO
'Notary Public - State of Florida
•PAy Commission Expires Feb Commission # DD 513850
Bonded By National Notary Assn.
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CONSRUCTION NOTES:
SWALE GRASS
MEDIAN
6" PLASTIC GAS MAIN
SWALE GRASS
SIDEWALK
S.R/W
f. ALL CAS PIPELINE CONSTRUCTION TO FOLLOW TECO PEOPLES GAS STANDARDS.
2. TRAFFIC CONTROL SHOULD BE MAINTAINED AND COORDINATED WITH THE
APPROR/ATE GOVERNMENTAL AGENCY.
3. ALL DISTRUBED ASPHALT /CONCRETE /SOD AREAS TO BE RESTORED TO PRIOR
CONDITION, UNLESS OTHERWISE SPECIFIED.
NE 94TH STREET
48 HOURS BEFORE
CALL SUNSHINE 1 -8
NEW 3/4" PLASTIC GAS SERVICE
295 GRAND CONCOURSE. MIAMI SHORES
N
NEW RISER
C.)
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WALL Lb (295)
[ �
M I
1 I N,R/W
a SIDEWALK
)ICGINC
00- 432 -4770
DATE:
8/8/06
SHEET:
1/1
JO: