PL-06-391Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Date: 05/11/2006
Inspector: Levrack, James
Owner: LONGMAN, THOMAS
Job Address: 1200 95 Street NE
Miami Shores Village, FL
Project: <NONE>
Block:
Contractor: TECO PEOPLES GAS SYSTEM
Permit Type: Plumbing - Residential
Inspection Type: ROW
Work Classification: Gas
Phone Number 305)892 -8598
Parcel Number 1132060144110
Lot:
Phone: (305)957 -3857
Building Department Comments
\ I
6.5-0.1
Passed
In
or
ents
Failed
Correction
Needed
Re- Inspection
Fee
($75)
No Additional Inspections can be scheduled
re- inspection fee is paid.
until
Thursday, May 11, 2006
Page 1 of 2
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972.
Permit No.
BUILDING
PERMIT APPLICATIO
FBC 2001
FEB ECEIVED
1 y �ppg
aster Permit No.
- 1v.\
Permit Type (circle): Building Electrical
Owner's Name (Fee Simple Titleholder) /71-- LOA)
` 1209 A 'Kg � s f
City f ( -S am 4 State -
Owner's Address
Mechanical Roofing
Phone #
Zip
Tenant/Lessee Name Q c Phone # 3- 7i 5 --
"1..7
Job Address (where the work is being done)
City Miami Shores Villa • e
Is Building Historically Designated YES
County Jiami -Dade Zip
Contractor's Company Name
(9; 61-3 Phone # L �0 /7
Contractor's Address l Z -7 �(O p rC
city
h' / State Zip
lifter (� ��-
Qualifier
State Certificate or Registration No. Certificate of Competency No. G '�
Name (if applicable)
$ Value of Work For this Permit
Phone #
4-0d
Sgt u;e Footage Of Work:
194,6 LLC t° ri
Type of Work: ❑Addition DAlteration ['New
Describe Work:
❑ Repair/Replace ❑ Demolition
elvezt) 1,44.111/ (01V 12 747-v
°lam 12 ' Y.OM zotirk,, e op l)
Its,. "D151
Submittal Fee $ Permit Fee $ 1 CCF $ 2 CO /CC.
Notary $ Training/Education Fee $ CD. 20 Technology Fee $ 4,00
Scanning $ 3 . CD Radon $ Zoning
Code Enforcement $ Structural Plan Review. $
Total Fee Now Due $ 1 tz,n . .
(Continued on opposite side)
Bond $
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 - ro ed and a reinspection fee will be charged
Signature
The foregoing ins
gent
Signature
was acknowledged before me this2- The foregoing instrument was acknowledged before me this-2
200 a� by r
day of NV. , 20 G 6, by T itJ N f LONG 11.19-0
who is personally known to
or who has produced
_
1ificationAnd vthgtcfiglAke an
Notary Public - State of Florida
My Comrntsaion Egiea Jan 27, 2008
Commission 3D084905
dcd F. j 'Jational (Notary
NOTARY
Sign:
Print:
My Commission Expires:
pth.
********************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
*** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
APPLICATION APPROVED BY:
Cho 05/13/03
*
who is personally known t me or who has produced
as identification and who did take an oath.
NOTARY P L (�
Sign: 1:
Print
My Commiss
fit • Sanded By National Notary Assn.
****************** ***** * * * ** ** ** *** *** ** *** *ir *;t *'lr*
****************)***** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
, / 0 "O2___Plans Examiner
Engineer
Zoning
NORTH
PROP OPEN CUT WORK AREA
T /T, T /F, E /M, EFV
RESTORE SWALE
• ••
• • •
• • 0000 • ••
• • •
• • 0000 • •
• •
0:00410 0000 • •
• • • •
• •
• :041••
• •
•
•4
• •
•:04141•
•
•
0000
•
0000
•• ••
• •
• 0000
• •
• • 4100•
•
•• •
• • •
• ••
0000
• •
41.410
•
• • • • 142OP 2• PREFAB RISER
• ••
• • •
• •
A
1200
LOT 17
BLK 85
PROP. TAP TO EXISTING 4"
GAS STEEL GAS MAIN
GAS STEEL GAS MAIN
NOTES
CONSTRUCTION
1. LOCATE AND PROTECT ALL UTILITIES IN AREA OF
CONSTRUCTION. SUNSHINE # 1- 800 - 432 -4770
2. RESTORE ALL AREAS TO PRIOR CONDITIONS
3. ALL CONSTRUCTION TO FOLLOW , U'ISDICTIONAL
GOVERNMENT AND TPG S DS.
PER COFTL
4. NO S. FM.
5. NO WM PROFILES.
NO APPLICATIONS SUBMITTE
6. DEWATERING ( ABOVE W T
7. TRAFFIC STRIPS OR LOOP
8. MOT (WORK IN ALLEY)
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
15
- -12
3' MAX
500 RESTORATION DETAIL
NE 95TH STREET
6
CROSS SECTION
NTS
PROP ill" PE SVC BORE
�iiiEE1 pry,��
t•G QOt OYI M
YF =r0.I 940
G5 2313
034: 010170
AFE: 010170
PROP 4' PE MAIN
& r SERVICE •
1200 NE 95TH STREET
MPS: M-2
1311083
SHEET: 1 OF 1
SCALE: NTS
MIN EN: WC
DATE 01 -28 -06