PW-09-337Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP- 107869
Scheduled Inspection Date: July 09, 2009
Inspector: Levrock, James
Owner: O'DONNELL, EDWARD & JACQUELINE
Job Address: 1215 NE 94 Street
Miami Shores, FL 33138 -0000
Project: ' <NONE>
Contractor: TECO PEOPLES GAS SYSTEM
Permit Number: PW -3 -09 -337
Permit Type: Plumbing - Residential
Inspection Type: Final
Work Classification: New
Phone Number
Parcel Number
11- 3205 -010 -0025
Phone: (305)957 -3857
Building Department Comments
NEW 3/4" PLASTIC GAS SERVICE FROM GAS MAIN
LOCATED IN THE S.R/W OF NE 94 ST
Passed
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
or Comments
July 08, 2009
For Inspections please call: (305)762 -4949
Page 4 of 28
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Miami. Shores Village
Public Works Department
10050 N.E. 2nd Avenue, 'Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
Public Works
Permit Application
FBC 2004 i IG T tit A\ Vet@
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Public works WATER
Owners Name (Fee Simple Titleholder)
Owners Address
Permit Type:
City
Permit No.
09-557
`Dees pL644Dert- 3 42 )'5e,
Pilate #: �� 57") �'/ 621-6
Tenant/Lessee Name
zip / 3?
Phone
Job Address (where the work Is being done)
City Miami Shores Village
is Building Historically Designated:
YES
County
Miami Dade
NO
Architect/Engineers Name (it apptbable)
$ Value of Work For this Permit
'S 004
b lei iu oQAT
Type of work ❑ MdWon ❑ Atteratlon ❑ New
Describe Work
Submittal Fee $
Notary $
Scanning $
Zip
Phone it
Lineal Footage Of Work:
❑ RepaMReptace,
/ yd r
/D/- i/�fi'�►T�J�1�Z�� ��ri
Ale if Fen
I CO r
Permit Fee $ CCF $ ® •
m4
Training/Education Fee $ Or 1' Technology Feed 2.5D
Code Enforcement $
Total Fee Now Due $ 0 lZ
(Continued on opposite side)
Radon $ Zoning Bond $
Structural Plan Review S
Tm
MAC 9'8 21109
MIAMI SHORES VILLAGE
Bonding Company's Name (if applicable)
Bonding Ccrinpany's Address
City
N/A
State
Mortgage Lenders Name (if applicable)
Mortgage Lenders Address
City State
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 core strudion 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 wIh'an esffmated value exceeding $2800, the applicant must
promise in good faith that a copy of the notice of commencement and Construction lien law brochure will be de#vered to the person whore
property is subject b attachment Also, a certified copy of the recorded notice of commencement must be poked at the Job site 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 reinspecffon lee will be charged
Signature
Owner or Agent
Signature
The foregoing instrument was acknowledged before me this 0 The foregoing In
day of
20 by m day of 4I � C..
who Is personally known to me} . r who has produced
NOTARY ' U -,
WV
Sign:
Print:
as identification and who did take an oath.
LUIS MONTERO
`A? Notary 'u• c - • •a
•vly Commissio Expires Feb 2, 2010
mmissi # DD 513850
%° ,, Bo d =,• By N`. , '1 Notary Assn.
My Commission Exp1
ment was adcnowledged before me this
20(22, by - .0s S Ve ) 44-
Who Is personally know to me . has produced
as identification and who did take an oath.
Sign:
Print: .
4
My Commission
C:
a _ h•fig
.111,,,%ls, , LUIS MONTERO
!� : Notary Public - State of Florida
fiMy Commission Expires Feb 2, 2010
Commission # DD 513850
Bonded By National Notary Assn.
O' r w r v .► - s® v
APPLICATION APPROVED BY:
11/17/2005
Public Works Director or
his designee,
1
12T
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N
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CONSRUCTION NOTES:
N,R /W
E.O.P
E.O.P
X
DOOR
(1215)
SWALE GRASS
2" BSE GAS MAIN
S. R/W
SWALE GRASS
GAS MAIN 3" N. OF S /RW
NE 94%'% ST
1. ALL GAS PIPELINE CONSTRUCTION TO FOLLOW TRCO PEOPLES GAS STANDARDS.
2. TRAFFIC CONTROL SHOULD BE MAINTAINED AND COORDINATED PITH THE
APPROAVATE GOVERNMENTAL AGENCY.
3. ALL DISTRUBED ASPHALT /CONCRETE /SOD AREAS TO BE RESTORED TO PRIOR
CONDITION, UNLESS OTHERWISE SPECIFIED.
E
48 HOURS BEFORE DIGGING
CALL SUNSHINE 1- 800 - 432 -4770
ATLAS
M2
SCALE:
NTS
DRAWN BY:
LM
c
NEW 3/4" PLASTIC GAS SERVICE
1215 NE 94TH STREET. M SHORES
DATE:
2/27/09
SHEET:
1/1
JO:
22451
12T
A
V
N
E
N, R/W
E. 0_ P
E.O.P
S.R/W
CONSRUCTION NOTES:
i
1
1
DOOR
(1215)
SWALE GRASS
1 2"
BSE GAS MAIN
"1 SWALE GRASS
V--
GAS MAIN 3" N. OF S /RW
E :!4 /l' ST
1
9. ALL GAS PIPELINE CONSTRUCTION TO FOLLOW TECO PEOPLE'S GAS STANDARDS.
2. TRAFFIC CONTROL SHOULD BE MAINTAINED AND COORDINATED WITH THE
APPRORIATE GOVERNMENTAL AGENCY.
3. ALL DISTRUBED ASPHALT /CONCRETE /SOD AREAS TO BE RESTORED TO PRIOR
CONDITION, UNLESS OTHERWISE SPECIFIED.
•
T
48 HOURS BEFORE DIGGING
CALL SUNSHINE 1-800-432--4770
ATLAS
M 2
SCALE:
NTS
DRAWN BY:
LM
T
FL..
NEW 3/4" PLASTIC GAS SERVICE
1215 NE 94TH STREET. M SHORES
DATE:
2/27/09
SHEET:
1/1
JO:
22451