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PL-06-5171 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: 305)795 -2204 Fax: (305)756 -8972 Inspection Date: 05/10/2006 Inspector: Levrack, James Owner: BOLTON, JOHN AND JENNIFER Job Address: 1202 101 Street NE Miami Shores Village, FL 33138 -2304 Project: <NONE> Block: Contractor: TECO PEOPLES GAS SYSTEM Permit Type: Plumbing - Residential Inspection Type: ROW Work Classification: Gas Phone Number (305)754 -2136 Parcel Number 1132050210030 Lot: Phone: (305)957 -3857 Building Department Comments I) ) d Passed nspeet r Comments Failed Correction Needed Re- Inspection Fee ($75) No Additional Inspections can be scheduled re- inspection fee is paid. until Tuesday, May 9, 2006 Page 1 of 2 Mcsge 4 :zgprn 312 of Miami Shores Village Building Department 10050 N.E.2 a, , �— _ Y— orida 33138 Tel: (305E VOW / 5n.8972 „R 12006 BUILDING PERMIT APPLICATION FBC 2001 Permit Type (circle): Building Electrical ioq Permit No. .P - —1 ster Permit No. I Plumbing Mechanical Roofing Owner's Name (Fee Simple Titleholder) 0/kJ Phone # 3%5 �` 243 Owner's Address I a. 6-2- f\- 101 S State "T't_ City Tenant/Lessee Name Phone # Job Address (where the work is being done) 1a 6 NQ / D 1 County Miami -Dade City Miami Shores Villa • e Is Building Historically Designated YES Contractor's Company Name Contractor's Address City Qualifier NO t.S77 Zip 73') t. To Cro° Phone # 3 05 9 V 11\D \ State State Certificate or Registration No. Architect/Engineer's Name (if applicable) aloe of iV r`k Fgr,this,Permii F..�'t d 1 - -- Sp T of Work:. [ Describe Work: ]Addition_ Certificate of Competency No. �� -2 � Phone # AVailftegistalkai Square } Qo�ta ,Of •ork.. ilta S. 40 art-40 "itiFP 30 A, rr, t .,ter ❑News - IV Repair/Replace I Al t��L 1. i S? Iteration LI Demolition Submittal Fee $ * * * * * * * * * * * * * * *** * ** * *Fees ****************************** CCF $ ©' EC - CO /CC. Permit Fee $ Notary $ Training/Education Fee $ C). z0 Scanning $3 • DO Radon $ Zoning Code Enforcement $ Structural Plan Review. $ Total Fee Now Due $ 7 (Continued on opposite side) Technology Fee $ 4 - C 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 afier 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 yr- Vi Owner or Agen The foregoing instrument was acknowledged before me this - day of tm ,20cX , by ' . ciI who is personally known to me or who has produced A NOT Sign: Print: My Commission Expires: 01114;,,, LUIS MONTERO ..+° `'= Notary Put t - State of Florida 3 • " • fury Commies Expires 2.2010 ,iii 'Y C. ,.% &b.I 1 '- 61 �• •'°^,,,,, Bonded By National Notary Assn, Contractor The foregoin instrument was acknowledged before me thi day of " 206 is , by 3 who is personally known to me or who has produced as enxtn P� 4, on ana NOTARY P Sign: Print: **** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** APPLICATION APPROVED BY: cic 05/13/03 Co�6B4 A t ' , Notary Punk - State of Fi a • Y+1y Commission Expires Feb 2, 2010 -;k ' oP�; Commission 1t DD 513850 •'' ,n•' Bonded By National Notary Assn • My Commission Expires: *************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** ****************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Plans Examiner Engineer Zoning 35 /5*-357 90./9' B •• • •• •• 9s' 8s' • • • • • •••• • • • ••• • • • •••• • •• • • . •••• • •• • • • • •••• • • • • • (1) /0-.3 34 3/ .57 37 /39.7' • •••••• • • •••• • • •••• • •�s33e� • •••• • •••• •• •• • •,• 75' 1 •••• • • •••• ••••• ••:33 • •• • • • • • 75. 3 /8-358 /y /e5r -3re.o 9 /e'i -3W /8-361" 734Z' 80' j0. /61:F44 /83'4 (/2¢7) /2' ad.. mot 94 .35!04 32 /6-41/ h 7S' - .06/38-0 1. a -Avai-a. 9 33Fo 0 <i• 677.' /2i5r /06.08' /79.33' F"e',47 7'29 -G9 .a1' 99.60' . /oo' 404. 4. 3 /0-42- 'coca ' /446 32 /8 -4zo so' 4/4 ' /ifo) 4Z 452 4S4 ( /2Sz • N /e70 ,S'T 7/ /8�q 'B 43Z /8•443 /.5' /8 -4.x14 44a 4So 433 2 4, 5 7s' 75' /./e3.9/' 77 $i' 1 -4/E 99 - T 9 7B /2 7.4 /3 472 /4 470 /✓5 /6 46 6 N C NE 101 STREET 12TH AVENUE 1 • • • • • • • • • • ••1 • • • • • • • • • • • N,R .W SIDEPY- • • ••• ••• • • • • ••• Mk R 0 1 2006 • •• • • • • i °FaP •—• —jam ••� ( 6 • 2" SP GAS MAIN' E.O. P SWALE GRASS SIDEWALK S.R/W PROPOSED RISE CONSRUCTION NOTES: 1. ALL GAS PIPELINE CONSTRUCTION TO FOLLOW TECO PEOPLES GAS STANDARDS. 2. TRAFFIC CONTROL SHOULD BR MAINTAINED AND COORDINATED WITH THE -APPRORIATE GOVERNMENTAL AGENCY. 3. ALL DISTRUBED ASPHALT /CONCRETE /SOD AREAS TO BE RESTORED TO PRIOR CONDITION, UNLESS OTHERWISE SPECIFIED. ATLAS: M 12 48 HOURS BEFORE DIGGING CALL SUNSHINE 1- 800 - 432 -4770 SCALE: NTS DRAWN BY: LM NEW 3/4" PLASTIC 1202 NE 101 STREET. MIAMI SHORES, FL DATE: 2/19/06 SHEET: 1/1 JO: 12851 Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Fax: (305)756 -8972 Permit Issue Date: 3/2/2006 Expires: 03/01/2007 Owner's Name: JOHN AND JENNIFER BOLTON Permit Type: Plumbing - Residential Work Classification: Gas Job Address: 1202 101 Street NE Miami Shores Village, FL 33138 -2304 Contractor(s) Phone TECO PEOPLES GAS SYSTEM (305)957 -3857 Primary Contractor Yes Comments: NEW NATURAL GAS SERVICE FROM GAS MAIN LOCATED ON THE SOUTH RAN OF NE 101 ST Additional Information Type of Work: GAS LINE Additional Info: Classification: Residential Type of Piping: 3/4" PLASTIC Bond Retum : 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. Permit Status: APPROVED Permit Number: PL -3 -06 -517 Phone: (305)754 -2136 Parcel #: 1132050210030 Block: Lot: Section: PB: Total Square Feet: 0 Total Valuation: $ 600.00 Required Inspections Press Test ROW Final Fees Due Amount CCF $0.60 Education Surcharge $0.20 Permit Fee - Additions /Alterations $160.00 Scanning Fee $3.00 Technology Fee $4.00 Total: $167.80 Building Department File Copy Applicant Signature Invoice Number PL -3-06 -23994 Total: MAR 0 3 pill() Amt Due $167.80 Amt Paid 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.