PL-07-505Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP -43 0514
Permit Number: PL-3-07-505
Inspection Date: 07/24/2007
Inspector: Grande, Claudio
Owner:
Job Address:
MATEO, RAYMOND
1140 100 Street NE
Miami Shores Village, FL
Project: <NONE>
Block:
Contractor: TECO PEOPLES GAS SYSTEM
Permit Type: Plumbing - Residential
Inspection Type: Final
Work Classification: Gas
Phone Number
Parcel Number 1132050190430
Lot:
Phone: (305)957 -3857
Building Department Comments
Tuesday, July 24, 2007
Page 2 of 2
JUL l2 6 21117
Passed
romments
Failed
Correction
Needed
Re- Inspection
Fee
($75)
No Additional Inspections can be scheduled
re- inspection fee is paid.
until
Tuesday, July 24, 2007
Page 2 of 2
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
BUILDING 0311
•
Permit No.
PERMIT APPLICATION
j Lt-t
MAR 1 4 20 o 7
BY:
FBC 2004
Master Permit No.
Puif6kulves
Permit Type (circle): Building Electrical lumbing Mechanical Roofing
# 37 F eeg
Owner's Name (Fee Simple Titleholder) kaAnnietrOS Phone
Owner's Address 1 14,(0 I 00
State PL- Zip
City (X/
Tenant/Lessee Name Phone #
Job Address (where the work is being done) ') Lit 0 e (00 gt
City Miami Shores Village County Miami-Dade
FOLIO / PARCEL # tk-e2s otq LAS-o
Zip
Is Building Historically Designated YES
Contractor's Company Name
Contractor's Address ll_s7 12 »i td-\d'3
City /J (IA v6reAtetA state Ft
I\J
Qualifier Name
State Certificate or Registration No.
Architect/Engineer's Name (if applicable)
Value of Work For this 'e.
'OAddition
Type of
Describe
Phone #
Zip
Phone #
I 723 3
Certificate of Competency No. 1;31463
ark:
Squa mewl- op or :
P4 tLe- ,, fi,, 6.; -a 1_4194,
-‚-
Alteration galsrew tKr' ' 'El Repair/Replace ---' '
1 7_, AL AtiktiotALL
all, ■ Alb. 11■011■1, A—A.1
VREVAMIIIIIIErMirlirl-
Phone #
LC ‘P
Demolition
Submittal Fee $ Permit Fee $
Notary $ Training/Education Fee $ 0'49-0
Scanning $
Radon $
DPBR $
CCF $ 0 -GO CO/CC
Technology Fee $ 4.CC
Zoning $
Bond $ Code Enforcement $ Double Fee $
Structural Review. $
Total Fee Now Due $ I(d7.1cj
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 $2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued In the absence of such posted notice, the
inspection will not be approved and a reinspection fee will be charged
Signature
Owner or Agent
The foregoing instrument was acknowledged before e this ti 0
e or who has produced
As identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
-a C
`./ ,, ,,\t�YUj,,,,, LUIS MONTERO
a �8��. Notary Public - State of Fiaida
'•MWy Commission Expires Feb 2, 2010
Commission # DD 513850
Bonded By Nas i Notary Assn.
Signature )%2J) cY'
Con for
The foregoing instrument was acknowledged before me this l' )
das. _I A. (' 2001, by tt VeG�
who is personally kno to m- ; r who has produced
as identification and who did take an oath.
NOTARY PUB
My Commission Expires:
Sign:
Print:
My
;;. PUB "i
Commission # DD 513850
Bonded By National Notary Assn.
APPLICATION APPROVED BY:
(Revised 02/08(06)
Plans Examiner
Engineer
Zoning
• ••• • • • •••
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SWALE GRASS 40'
limummorafistrim
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SWALE GRASS 40'
NEW 3/4" PLASTIC
NEW RISER
• 1. ION NO
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1. 4 L CAS PIP$tIn FOLLOW TECO PEOPLES GAS STANDARDS,
*A1'PIQ CQN7ADt aLA 1,R APAUNTAINED AND COORDINATED WITH 7715
APPROI{IAT'E' SIWENiJWi .jV'A,IL ASSNeri
41E7771177W0 ASPNALTj/CONQ1WTE /SOD AREAS .PO DE RESTORED TO PRIOR
OONINTION. DNIOS 7TSi VS'E FDECI71IE5,
48 HOURS BEFORE DICCINC
CALL SUNSHINE 1 -$00- 422 -4770
NEW 3/4" PLASTIC GAS SERVICE
1140 NE 100TH STREET. MIAMI SHORT'
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