PL-06-723Inspection 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: BENJAMIN, PAUL
Job Address: 1441 101 Street NE
Miami Shores Village, FL 33138-
Project: <NONE>
Contractor: TECO PEOPLES GAS SYSTEM
Permit Type: Plumbing - Residential
Inspection Type: Final
Work Classification: Gas
Block:
Phone Number (305)757 -5351
Parcel Number 1132050240270
Lot:
Phone: (305)957 -3857
Building pepartment Comments
NEW NATURAL GAS SERVICE FROM GAS MAIN
LOCATED IN THE SOUTH RAN OF NE 101 ST SOUTH
WARS TO# 1441 NE 101 ST
Passed
I
tor Comments
Failed
Correction
Needed
Re- Inspection
Fee
($75)
No Additional Inspections can be scheduled
re- inspection fee is paid .
until
Friday, March 28, 2008
Page 1 of 2
Miami Shores Village
Building Department
10050 ,�1 Rr ■res, Florida 33138
18 4!^'1 �� Jc*, . set (a o� 305)756.8972
BUILDING
PERMIT APPLICATIO
FBC 2001
Permit Type (circle): Building
Owner's Name (Fee S plc Titleholder) /
Owner's Address `� I 4
City S State
Tenant/Lessee Name
2 0 MOMS
vi'3 le t)
Electrical
10 (St
PC-- Zip
Permit No. P LO 6 2-3
Master Permit No.
Plumbing Ai Mechanical Roofing
30' 7S-7
&Nei r
Phone
Phone #
Job Address (where the work is being done)
City Miami Shores Village County Miami -Dade
Is Building Historically Designated YES NO
% 47` l e /O/ S'(
Contractor's Company Name
Zip
Phone #
Contractor's Address /S- -2 7 l01/ l `r
City ti 4 State r— ---
Qualifier V 026,1 1"1,
Zip��G�_ -
State Certificate or Registration No. //' of Competency No. t OY
Architect/Engineer's Name (if applicable)
Phone #
tr■PVt 00h1
tee eF1 +its A170-3 a tiC1
Yp 9F ' Addition .z_
OA All
Stt-i Footages Of Work:
CV:.; t', P. *ti ;r wr !h "
va. t iEbs�>. �g aniReplace
Demolition
**********************,****Fees****** ** * * * * * ** ** * * * * * * * * * **
Submittal Fee $ Permit Fee $ 9 6 0
Notary $ Training/Education Fee $
Scanning $ Radon $ Zoning
Code Enforcement $
Total Fee Now Due $
Structural Plan Review. $
(Continued on opposite side)
CCF $
CO /CC.
Technology Fee $
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 $2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued In the absence of such posted notice, the
inspection will not be approved and a reinspection fee will be charged
P\
Signature Signature
Si afore
Owner or Agent 4 19- Nd.��1 t/ Contractor /�
The forego instrument was acknowledged before me this � The foregoing Instrument was acknowledged before' me this 9b
day of � t'� , 20 0C,, by 4 '($ .�q s �- / day of r � , 20 ®0 by T,) S G� ki kW 1 ,
who is personally known to me or who has produced who is personally known to me or who has produced
l.+at; tl
-�'a°46n�;`�' i Notary Publk,` - State of Raids
•y+ Commission Eames Feb 2, 2010
Le Commission # DO 513850
e .
3 •I °F F`�" Bonded B National
jam,.
My Commission Expires:
as identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print
My Commission Expires:
Commission # DO 513850
Bonded By National NotayAAssn,
4I
*********** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** ** * *: ******************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
APPLICATION APPROVED BY:
chc 05 /13/03
Plans Examiner
Engineer
Zoning
NE 14TH AVENUE
1
� t'V`
ram 61. I
�I
- � N,R/W
Fr
c/) I
M I SWALE GRASS
Q E.O.P
M f NE 101 STREET
d 1 2" SP GAS MAIN
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CONSRUCTION NOTES:
1. ALL GAS PIPELINE CONSTRUCTION TO FOLLOW TECO PEOPLES CAS 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.
E. 0. P
SWALE GRASS
S. R/w
48 HOURS BEFORE DIGGING
CALL SUNSHINE 1- 800 - 432 -4770
ATLAS:
N 112
SCALE:
NTS
NEW 3/4" PLASTIC
DRAWN BY:
LM I 1441 NE 101 STREET. M. SHORES, FL
SHEET:
1/1
JO:
13129