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PL-06-1298Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Date: 03/31/2008 Inspector: Levrock, James Owner: LEVASSER PHILIP Job Address: 1218 95 Street NE Miami Shores Village, FL 33138 - Project: <NONE> Block: Contractor: TECO PEOPLES GAS SYSTEM Permit Type: Plumbing - Residential Inspection Type: Final Work Classification: Gas Phone Number (305)756 -6214 Parcel Number 1132060144090 Lot: Phone: (305)957 -3857 Building Department Comments NEW MAIN EXTENSION AND SERVICE FROM GAS MAIN LOCATED ON NE 12 AVE TO # 1218 NE 95 ST Comments Passed Failed Correction Needed Re- Inspection Fee ($75) No Additional Inspections can be scheduled until re- inspection fee is paid . Friday, March 28, 2008 Page 1 of 2 Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 5) pi 10(0 4_ Tel: (305) 7952204 Fax: (305) 756.8972 BUILDING mcmrem PERMIT APPLICATIO y 1 8 200 FBC 2001 g Permit No.PL- I YJ Master Permit No. p-ue3 (cc DNoeK'..r Permit Type (circle): Building lec cal Plumbing Mechanical Roofing Owner's Name (Fee Simple Titleholder) P H-C 11 1 cp Le Phone # Owner's Address 12 j fv E cr 5 s f City State L Tenant/Lessee Name Zip -3? l d Phone # • Job Address (where the work is being done) City Miami Shores Villa e County Miami -Dade Is Building Historically Designated YES NO_ [ 2 ($' I'VE cjS s'f Contractor's Company Name I e co ( Contractor's Address 1 9 7 7 tdu `� City t� i State Qualifier Zip Phone # Zip (3 3 & State Certificate or Registration No. Certificate of Competency No. / 0 -8 Architect/Engineer's Name (if applicable) --°° Phone # $ Value of Work For this Permit eCO CID Square Footage Of Work: Type f Work: DAddition Describe Work: e °e A T r , f c'vir 71/G) Submittal Fee $ Permit Fee $ CCF $ CO /CC. ai Notary $ Training/Education Fee $ 0. s - . Technology Fee $ � Scanning $ ) - Radon $ Zoning Bond $ Code Enforcement $ Structural Plan Review. $ Total Fee Now Due $ (Continued on opposite 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 , pprov pection fee will be charged Sign . ;,r = l/ffil�i�OP" r� r Owner or Agent The foregoing instrument was acknowledged before me this 3 day of 20 6 by khilte who is personally known to me or who has produced NOTARY Sign: Print: As identification and who did take an oath. My Commission Expires. * * * * * * * * * * * * * * * * * ** •=My Commiss on 3 Tt o`er Commission # DD 513850 * A4 . _ a... w National Notary Assn:. ****** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** APPLICATION APPROVED BY: chc 05/13/03 * * ** Signature Contractor The foregoing instrument was acknowledged before me this d a y of /. , 2O ' , by who is personally known to me or who has produced as identification and who did take an oath. NOTARY PUBL Sign: Print: My Commis UIS MONTERO =o`er Notary Pit TAI He: Cory I' ; Bonded ri 00 513850 Nm.bw Assn. :x * *7 * * * * * * ** * * * * * * * * * * * * * ** Plans Examiner Engineer Zoning PFOPLES GAS Nam 1-� 1 e L.1 p LE\he ER, 2lAddress $ Nt Q5iN c (1 ►► GO Name Mailing Address Contact Name Gas Service Agreement 361308 Evening Phone Other Phone City tit 5 City Limits Yes/ No ❑ FL t '5138 h1urit- DA-DC City Zip Day Phone Other Phone Federal ID/Social Security # Field Contact Name Tax Exempt Yes ❑ No Date Service Line Required Date Gas Service Requited Alt. Phone lONS /RLMARK Tlftca •l f tsD to AftZ it.oN6) KbP C 5 c OF Etc te.w4,4%5N ,L?o5a RC SPic-coati 7,04.1■+ cri FEE S5.0 e0 0 L 3eflACE U N e Main on ❑ Off er New 9' Added Load ❑ Conversion: Propane Company *71)7141.. cosi t [ llt 1 V.I V' III IU\tS' 'i4 )) ( j PRhSL F tDI)I1[O Reactivate ❑ Restart ❑ Ress) Com ❑ Indus ❑ Rate Class ❑ 2.45 Map # �)RYIA1 IO\s WH Billing Program ❑ Aid to Construction (Non- Refundable) Conversion Billing ❑ Construction Deposit Required ❑ Other (Details in Remarks) Prepayment Balance Due $5919 , ©O' Other [a LACER Dealer Name Dealer Phone Alt Phone Services to be provided by Dealer TOTAL Meter Size System Pressure Remarks Regulator Size Delivery Pressure Rt/Cycl Account # wos # ?L9 E A• L c (A) 10- 11 t,J•EE (3 Psi) CO0SraWCtot3 1�( Buyer/ 5101 Nt) /UST PNE 5T LILO PT, L ND FL:745'2(ff I have read all of the terms and conditions on revs side and agree to them. t.4 LeOoiss -e,- Ikc Lua ,LN Printed Name / Sales Rep Printed Name /W / S -06 Buyer/Owner Signature Date Sales Rep ID #. Sales Rep Signature Date PGS CONTACT DURING INSTALLATION OF GAS SERVICE: DIVISION PHONE # PGS 5 Rev 05/02 • • • • • • • 5' SIDEWALK •••• • • • • •••• • • • • •••• • • •••• • • • •• • BORE UNDER DRIVEWAY (- i PROP 2" PL GAS LINE 5' SIDEWALK LEGEND R/W RIGHT OF WAY P/L PROPERTY LINE EOP EDGE OF PAVEMENT P/T PRESSURE TEST T/T TAPPING TEE SVC SERVICE LINE SK STEEL PROP. TAP TO 2" GAS PL GAS MAIN SOD RESTORATION DETAIL NOTES CONSTRUCTION 1. LOCATE AND PROT CT ALL UTILITIES IN AREA OF CONSTRUCTION. S NSHINE l 1- 800 - 432 -4770 2. RESTORE ALL AR TO PRIOR CONDITIONS 3. ALL CONSTRUCTIO TO FOLLOW JURISDICTIONAL GOVERNMENT AND TPG STANDARDS. PER COFTL 4. NO S, FM. PROP 2' PREFAB RISER ..., ED FOR: • 11 W TABLE). 0 00PS. csrc O Ome uE: o+oim mus: M-2 PROP 2" PE MAD LOT:77 BUM &3 /4 "> r:ioFi SCALE: wrs 1218 t8 08TH STREET ova+ at sic WOE: ai -20-06 aci6 inummaigumedon csrc O Ome uE: o+oim mus: M-2 PROP 2" PE MAD LOT:77 BUM &3 /4 "> r:ioFi SCALE: wrs 1218 t8 08TH STREET ova+ at sic WOE: ai -20-06 aci6