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PL-11-1410
Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP- 163749 Permit Number: PL -8 -11 -1410 Scheduled Inspection Date: August 26, 2011 Inspector: Hernandez, Rafael Owner: ALVAREZ, LAZARO Job Address: 372 NE 98 Street Miami Shores, FL 33138- Project: <NONE> Contractor: MIAMI GAS CORP Permit Type: Plumbing - Residential Inspection Type: Final Work Classification: Gas Phone Number Parcel Number 1132060135680 Phone: (305)634 -6646 Building Department Comments LP GAS INSTALL FOR GAS RANGE. ONE TANK ABOUVE GROUND ONE OUTLET Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments August 25, 2011 For Inspections please call: (305)762 -4949 Page 8 of 9 Monometer Leak Check Form Customer Number K.-4R- (I i i Customer: Address -sr-- • Name IAA 41._v System leak Test (Inches W.C.) Single Stage 0- Start Pressure / 6 End Pressure / 0 Time Held O Leaks N Flow Pressure Flow pressure Starting pressure Ending pressure Time held HRS_Leaks Two Stage 1 ST (PSIG) Two Stage 2nd(Inches W.C.) Flow Pressure Starting Pressure Ending Pressure Time held Leaks Lock Up Test 1st Stage 2nd Stage Single Stage Leaks Comments: p S Dal k foe l Sniff test: Customer given safety instructions? .� Appliances present at the time of installation: W/H Drier BBQ Pool heater Oven Grill Fryer C.Cooker Boiler Space Heater Steam Table Hood Stove '� Others Equipment Check performed? a/ Fire System present? Make Up Air present? tit Miami Gas Corporation Rep. Name: g Ei - Signature: Title: Date: 60,1, �'c✓a tstlaci 2l °5 /1/ Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305) 762.4949 BUILDING PERMIT APPLICATION FBC 20 ZCZEVED AUG 0 1 .2011 Permit No.0 II l— )4)Q Master Permit No. Permit Type: PLUMBING , R �} `, Mr OWNER: Name (Fee Simple Titleholder): LA-P t&0 f\ t_\' �Z' Phone #: Address: 3'12 06. qt• City: MIAS% State: Tenant/Lessee Name: t� 6 Email: LAtt.1.1 ,ic k Aov UNA JOB ADDRESS: 3 r� O S 4f zip: 3,155 Phone #: City: Miami Shores County: Miami Dade Zip: 331 ?i$ Folio/Parcel #: Is the Building Historically Designated: Yes NO '' Flood Zone: CONTRACTOR: Company Name: 11 i 1#iwvtI 61 fAs. COV Phone #: Address: '6 (e)-■ ` 6 is.) . (LAD C `\ City: YY\ \ vt, " State: C� A Qualifier Name: A-i/y ( L - - ,r M '.d -e°t, State Certification or Registration #: %05�"J Certificate of Competency #: Contact Phone #: j °*54 °I I ) Email Address: ,i0 s g 1 ,‘co DESIGNER: Architect/Engineer: Phone #: Zip: r `6tq C� , Phone#: _S3V—&C Value of Work for this Permit: $ 6 Square/Linear Footage of Work: Type of Work: ❑Address 4Alteration /Gp�3p`M�. W"�► y k` J P ❑New URepair/Replace air/Replace Description of Work: L. ets 4— 410,9 /r y«A 40,4- 22_ ❑Demolition ******* ** * * * ** ** * * *** * ** ** * **** * * * ** ** *Fees* ********** * * ******** **** ********** *** ** ** Submittal Fee $ Permit Fee $ Scanning Fee $ Radon Fee $ Notary $ Training/Education Fee $ Double Fee $ Structural Review $ OP® CCF $ CO /CC $ DBPR $ Bond $ Technology Fee $ TOTAL FEE NOW DUE $ Q fo 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 0 The foregoing instrume was acknowledged before me this day of ,20_,by who is personally known to me or who has produced As identification and who did take an oath. NOTARY PUBLIC: Sign: Print: My Co ' ission Expires: APPROVED BY MARTHA MAN1ANILLA MY COMMISSION # DD947571 EXPIRES: February 10, 2014 100.3- NOTARY °P R. Notary DP coam Assoc. Co. * ** * * ** * * * * * * * * * * * * ** Contractor The foregoing instrument was acknowledged before me this day of , 20 _, by who is personally known to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: My Commission Expires N MARTHA MANZAN1LLA MY COMMISSION # DD947571 tbt 1 EXPIRES: February 10, 2014 1400-3-µUl'ART R-B F.wont Assoc. C9t * * * * * * * * * * * * ** * * * * * * * * * * * * * *** !,.,;,'sIi *:k * * * * * * * ** Plans Examiner Zoning Structural Review Clerk (Revised 07 /10 /07)(Revised 06 /10 /2009)(Revised 3/15/09) �.. CERTIFICATE OF LIABILITY INSURANCE PRODUCER Ptuumg(�y T ( ) .'W -0600 Fak main T31 -M DONOVAN INSURANCE INC PO SOX 24380 JACKSONVILLE FL 311241 -4960 INSURED MIAMI GAS CORP 3235 NW 41 STREET MIAMI I L. 231.42 COVERAGES AoaaylJ # L044812 DATE (MMMIi D/YYTYI cERTIFICJTE IS ISSUED As A MATTER OF INFORMATION I9�OV2010 ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. MIS CERTIFICATE DOES NOT IWENG, EXTEND OR ALT THE.00VERAGE AFFORejn 3Y.THEPpUC(SS BELOW._ INSURERS AFFORDING COVERAGE INSURER A: TRAVELERS IND CO OF AMER tNSVRER B. TRAVELERS PROP OAS OF AMERICA INSURER C: Chards NAIL 8 25688 INSURER a INSURER THE POLICIES OF' INS ELF ® HA D TO INSURED "PNANI:D ABOVE FI H THE POLICY PER: D INDICATED, i STANDING ANY REQUIREMENT, TERM OR CONDITION Of ANY CONTRACT CR OTHER DOCUMENT WITH Reare r TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED ay THE POLICIES OaSCR18ED HEREIN IS SUBJECT TO ALL 111E TERNS, EXCLU5ION5 AND COMMONS OF OUCH POLICIES. AGGREGATE LINTS SHOWN MAY HAVE SEEN REDUCED BY PAID CLAIMS. 4 R I If URANCE MUD', NUkIGER EFFECTIVE POLICY paplgaY N dTY 63857381.517 X ' COMMERCIAL GENERAL LIAB1l1TY CLAIMS MACa © occuu �GEN'L AGGREGATE LIMIT LIMIT APPLIES PER: PRO- ^ I POLICY 17 ��• • Loa AUTOMOBILE LIABILITY X ANYAUTO ALL OWNED AUTOS _ SCHEDULED AUTOS X HIRED ALITDs X NON-OWNED AUTOS GARAGE LIA841TY ANY AUTO BAS73OL039 05122/10 08122/11 EACH OCCURRENCE NCE POE TO RF,NTEE uauitoCO MED. 6%P (Any Leers Dm Fermin) PERSONAL aADV INJURY GENERAL AGGREGATE PRODUCTS -COMP/OP AGO 08122114 08122/11 COM51NE0 SINGLE LIMIT (Ea accroanll 5 s 100,000 5,000 5 1,000,000 5 2,000,500 $ 2,000,000 3 1,000,000 BODILY INJURY 1P r Wean) 5 S0DLY INJURY (Pergcadenl) 3 PROPERTY DANIAGe (Pet eaCidenO ��w EWE881 UMBRELLA LIABILITY OCCUR ❑ CLAIMS MADE REThwfl0p �1'�'IVT'ION S 11I081(ERa COIIIPENSATION AND EmPLOYERW Leus rrY C ANY PROPRIETommo TNERIE�menvE o1FRcSitmar DER EYCI.uDFAF EituullEtoly Ir aNuM , SPECIAL PROVISIONS eau OTHER WC00744100T Y!N 0 10/30/10 AUTO ONLY - EA ACCIDENT' 5 OTHER THAN EA ACC AUTO ONLY $ AGG EACI•HOCCURRENCE S AGGREGATE 5 S 3 10130/11 X T uwyTS 5 OTHER Si. EACH ACCIDENT 5 100.000 E.L DISEASE-EA EMPLOYEE 6 100,000 E.L DISEASE- POLICY LIMIT 5 DESCRIPTION OF OPERATIONSILOCATIONSNEHICLEElEXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS CERTIFICATE HOLDER 500,000 M Miami Shores Vivass Building Department 10050 NE 2nd Avenue Miami Shams FL 93138 Attended: ACARf 2R tenf91IAd ■ vesm.. •_a.til{ 1 ills SHOULD ANY OF THE ABOVE DESCAR:1EL! POLICIES SE CANCELLED 8EFORE THE EXPIRATION DATE THEREOF. THE ISSUING INSURER WILL ENDEAvOR TO NWL 10 DAYS WRITTEN NOTICE TO yea CERTIFIUAIE HOLDER NAMED TO THE LEFT. OUT FAILLIRETO DO W SHALL IMPOSE NO OELIGATION OR LlABILrTy OF ANY IOW ur'ON THE INSURER. IDS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE t0 /t0 3EVd ®rtticate 20626 1988 -2009 ACt)RD CORPOR�LTION. A I rights teserye�j. The ACORD name and logo are registered marks of ACORD SV9 IWtI N Z17179VE950E IO :Ot ITOZ /Ot /80 0 "•—?Ds. E cpL 11--)4- 0 • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • Miami Shores Village APPROVED BY DATE ZONING DEPT BLDG DEPT eAze SUF3,JECT TO COMPLIANCE WITH ALL FEDERAL STATE AND COUNTY RULES AND REGULATIONS cs-v°01r`A-' A 'he/ 9z-ro,94 47r "e. rA\ o t5b00 A A ecimtt, MARTHA MANZANILLA MY COMMISSION # DD947571 ty.4, EXPIRES: February 10, 2014 cveg) 14004-140ThaY P1. NoWY Moomot Assoc. Co. • • • • • • • • • • .. 0 37a M.�t.... w2z) rN' ..•. • • • • •••• • • • • •• • • • • • • • • • • .... • • • •••• •••• 0 • • •• •• •••• • • • • • • • • • • • • ®lV / 6v`tA • •••• • • • • • • • • • L O) o00 ,r7J-0:23CL-is Lk-NA \'e t;te ,rta L Nt, MARTHA MANZANILLA MY COMMISSION # DD94757I EXPIRES: February 10, 2014 1-W0- TAAY F7. No my D'rawunt Assoc. Co. • ANSI 2223.1 -49 PIPE 6.3(f) Semi -Rigid Copper Tubing. Nominal. 8 1 1% ••. • • .•'• AQ2: 1% 1% Oatside: Inside:` 0.375 0.500 -0.6250 575 M 1.125 1.375 0.305 0.402 '0.745 0.995 1.245 • •_ • • •• • •••• • •.w• • • 1.481 2.125 • Length (ft) tea:' onsands of Btu per Hour • • • • • •• • • • L98i••• • • • 10 20 50 60 70 80 90 100 45 31 25 21 19 17 16 15 14 13 93 64 51 44 39 35 32 30. 28 27 125 150 175 200 250 300 350 400 450 500 550 600 650 700 750 11 10 NA NA NA NA NA NA NA NA NA NA NA NA NA 24 21, 20 18. - -- 16 15 14 13 12 11� 11 10 NA NA.. NA 84 76 70 65 58 52 48 45 42 40 38 36 34 33 32 467 321 258 220 195 997 685 550 471 417 1,800 1,230 991 848 752 2,830 1,950 1,560 1,340 1,180 .yy-• • 5!890 4,050 3,250 2,780 2,470 177 163 152 142 134 119 108 99 • 92 82 74 68 63 60 56 53 51 49 47 45 378 348 324 SO4 287 254 230 212 197 175 158 146 136 127 120 114 109 104 100 96 681 626 583 547 517 458 415 382 355 315 285 262 244 229 216 205 196 188 180 174 • 1,070 988 919 862 814 722 654 602 560 496 449 414 385 361 341 324 309 296 284 274 2,240 2,060 1,910 1,800 1,700 1,500 1,360 1,250 1,170 1,030 936 861 801 752 710 674 643 616 592 570 800 850 900 950 1,000 NA NA NA NA NA NA NA NA NA NA ;18 ,17 X17 16 ;,, .16 31 30 29 28 27 44 42 41 40 39 93 90 87 85 83 168 162 157 153 149 264 256 248 241 234 551 533 517 502 488 1,100 1,200 1,300 1,400 1,500 NA NA NA NA NA NA NA NA NA NA 15 14 14 -13 13 26 25 24 23 22 37 35 34 32 31 78 75 72 69 66 141 135 129 124 119 223 212 203 195 188 464 442 423 _.407 392 1,600 1,700 1,800 1,900 2,000 NA NA NA NA NA NA NA NA NA NA 12 12 11 11 11 21 20 20 19 19 30 29 28 27 27 64 62 60 58 57 115 112 108 105.... 102 182 176 170 166 161 378 366 355 345 335 NA means a flow of less than 10,000 Btu /hr. Note: All table entries are rounded to 3 significant digits. "Table capacities are based on Type K copper tubing inside diameter (shown), which has the smallest inside diameter of the copper tubing products. 2006 Edition • ••• • 08/1012011 10:15 3056346442 MIAMI GAS rs• Florida .Departrnent :of Agriculture 'and ConsurrierServices• Bureau'of Liquefied Petroleum' Gas. rrpection PO: B'ox'6720 • • • • Tallahassee, Florida 32399 -6720 • 'License Number: 05528 • Business.Mailing,Address • ` t.icensed''focation Address • -'; • iVi1Aleir GYCSCORPORATION 3235 NW4:1ST'ST . • MIAMI, FL;331424303 . MIAMI •GAS•CORPORATION • • 3235 NW: 41•S• ST • MIAMI, FL 33142 -4303 The'llquefied• :petroleum► gas•license at the'•bottom of this form is valid ONLY °for the c npany:Ioaated.etthe •• .: address •un •the''Jicerise.. Each buslness� location •vf a company must.be licensed: Ali LP Gas'tic er'1sss'rniist• be' • •renewed einnuall�:: Any license.alkakred••to expire shall become inoperative;l eceuse,of. fairure to renew: ,.The.` ' fee • foe. res'toraticfi•.af a licensecta equal to the original:Iiaans�?�fee and must•i a paid beforre the licensee may • : • ; ; • resume'oper°ations. . IiV •T� :h1 tT;OF ' J�N.�OWNNERSHIP CHAN:GE.AT'THIS SUSiNES:S•LOCATION:. Thi'S Iict se ybe •, traray,.' fened,' to:• abypalton, firniorcerporation .for•the•remainderrofthe; current, lipenise ':yeeruponw.titten•request :.. . to='the dep rt�inenrt'by�'the original license holder. License transfers, Must be approved by the: department: ,•All,. • . iicensing requirements must be m'et:by the transferee and a transfer fee of $50 will apply, To apply for a ' transfer; contact the Bureau of LP Gas inspections at 850/921- 8001'.. • • • ' • Part to'Chapter 527, plerlda Statutes; 'LP Gas licensees 'must present proof of Iloensure •#o any consumer , ouieruOrend user u pon request :When :engaged in' the business of servicing, repairing; or' 1 in aliin�LP Gas Systems and /or ulpment. . . • Forfuly.re•crrespondence; please Make any needed corrections or changes to• your business mailing address end/ot. your licensed• lecationaddress and, return the U'P. ER PORTION With corredtions.to: FloridaDeparthrtent of AAricirlture and Consumer. Services Bureautof LiquefeeI p troleum as Inspection •.' . P: i;Box 6.720 Tallahassee, ...16ricIa'32399;-6720 & Cut Here PAGE 01/04 . State •'of• floride Department of Ag'ricu$ ure'and.:Consprne-r SONii os • . Division Gi tandards • ' Bureau of Liquefied; Petroleum Gas :Inspection '' Expiration to August•41; 2011 (850)921-8001' ' . • Date :oflssue6..Septertber t;.2D10. Tallahassee, Florida ► icense Fee; '$425.00 '. •• Ltq•TYpe end'Crasd: 0601 u'efied P ttole.um Gas License' • „ CATEGO'R,1, :11P: GAS: DEALER . • • coca F',.. ONE LOcATION'ONLY ANY CHANCE OF 'OWNERSHIP OR SALL'OF THiS• BUSINESS RENDERS TFiiS LICENSE INVAun • " This Ileac ice Is issued.undsr authorriy of Bacion• 527..02, FIoeida.Statutes, to; MIAMi•.GAS CORPORATION' 3235 N'W *4't Sri' .ST MIANII,'i 1: 33142-4303 H'• Ri15s H. [BONS• • COMMISSIONER OF, a1GRICCILTURE