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PL-12-1100Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP - 174862 Permit Number: PL -6 -12 -1100 Scheduled Inspection Date: June 27, 2012 Inspector: Hernandez, Rafael Owner: MONTERO, ANGELICA Job Address: 9338 NW 2 Avenue Miami Shores, FL 33150- Project: <NONE> Contractor: AROUND THE CLOCK GAS SERVICE Permit Type: Plumbing - Residential Inspection Type: Final Work Classification: New Phone Number Parcel Number 1131010150280 Phone: 305 - 231 -3632 Building Department Comments NEW GAS LINE FOR A COOKTOP AND FUTURE DRYER Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments June 26, 2012 For Inspections please call: (305)762 -4949 Page 20 of 36 Around The Clock Gas Service, Corp. 13117 NW 107 Ave unit 17 Hialeah Gardens, FL. 33018 Phone: 305- 231-3632 Fax: 305- 231 -4180 June 25, 2012 To: Whom It May Concern in the City Of Miami Shores Plumbing Department. This is to certify that Around the Clock Gas Service Corp. an authorized Advantage Dealer of Peoples Gas and Florida City Gas, has performed a drop test at the following site and tested all the appliance connections. The gas line has been checked to the standards of the 2010 Florida building code and properly tested to meet the standards of NFPA 54. The work was performed for Luz Lera 9338 NW 2 AVF Miami Fl, 33150. Test Pressure: 8.0 Lock up pressure: 14.2 Operating pressure: 14.0 Test time: 10 Minutes State Lic# LPG017356 Class # 803 If you should have any questions regarding this matter please do not hesitate to call us. Amaury Gonzalez President Around The Clock Gas Service Corp. °y�G^ Notary Public State of Flonda � Edwin L Sore ® My Comma5ior L 4 Expires 03/2o/201 3 Miami Shores Village RECEIVED Building Department JUN 14 2012 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 BYaO Tel: (305) 795.2204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305) 762.4949 BUILDING PERMIT APPLICATION Permit Type: PLUMBING JOB ADDRESS: 9 3 /1" 1 FBC 2010 (� Permit No. i' 12. " 1100 Master Permit No. City: Miami Shores County: Miami Dade Zip: 3 S /5C) Folio/Parcel #: / / " 3/ d l ' C9 / S ` C92 ' Is the Building Historically Designated: Yes NO Flood Zone: OWNER: Name (Fee Simple Titleholder): 4 'G /ems / 7c 7' /-' Phone #: 3 © S 577YZS Address: 7 3 3 57 't. -c/ Z B% (/ City: 4 .09- 1/ /i1c State: zip: 3 3 /SO Tenant/Lessee Name: Phone #: Email: CONTRACTOR: Company Name: Atccl- i9%`t%t__ doc-I 66'5 5e-r-(i /re Phone #: 3C)S Z /'36" 3Z Address: i 3/ k' 41/ vim' /7` / City: flm(e .¢h' C 12 5 State: Zip: Qualifier Name: /i/fri 4 f/f7 cP Z Phone#: 3c°) 5 3,:o') <7.52 State Certification or Registration #: 3.56 Certificate of Competency #: Contact Phone#: 362 S 3(90 '60 ' Email Address: L� z�9/`t�� 1,?i�'v,V & x / �� DESIGNER: Architect/Engineer: Phone #: Value of Work for this Permit: $ / 5 g4--/: • Square/Linear Footage of Work: Type of Work: DAddress UAlteration »New URepair/Replace Demolition Description of Work: _j /CCU S G 41--A-P _ c 7 f1- c'd e.:7 1, 7 ******** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** gees************* * * * * * * * * * * * * * * * * * * * * * * * * ** * * * ** Submittal Fee $ X • Oa Permit Fee $ /5 CCF $ CO /CC $ Scanning Fee $ PA- jD Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ TOTAL FEE NOW DUE $ 1 1 �^ 7� 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 FT ECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILF,RS, 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 a.sence of :uch 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 me this 11 The foregoing instrument was acknowledged before me this f3 day of 3`4"`� , 2012 —., , day of ✓� , 20 (L, by /Atv' d who is personally known to me or who has produced w is person known to me or who has produced identification and who did take an oath. as identification and who did take an oath. NOTARY PUB IC• Signature tractor Sign: Print: My Commission Expires: G Notary Public State of Florida Edwin L Silver y F¢ '�57 My Commission nnra <,ac, o xpires 03/20/2013 NOTARY Sign: Print: �2F•� .- w v My Commission Expires: 2 t7 61/40"' f'tto Notary fir ublic State of Florida = • Edwin y Commission DD854954 * * * * ** * * * * **** ** * * * * * * * * *** *** ********************************************** * * * * * ******* * *** ** * ** * * ** ** **** APPROVED BY Plans Examiner Structural Review (Revised3 /12/2012)(Revised 07 /10 /07)(Revised 06 /10 /2009)(Revised 3/15/09) Zoning Clerk 06114/2012 09:59 3056668014 max. THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR AL'T'ER THE COVERAGE AFFORDED EY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING 'NEURONS), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: if the certificate holder is an ADDITIONAL INSURED, the polley(los) must be endorsed. 111 SUBROGATION IS WANED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder In Ilea of such endoroementis). PRODUCER Mccertney Insurance Agency,lnc 8739 Bird Road Miami, FL 33156 -3705 Don MsCartneyy MCCARTNEYINS CERTIFICATE OF LIABILITY INSURANCE PAGE 01/01 Or ID: AM DATE (MMIDf1YYYY) 0611412 INSURED Around the Clock Geis Service Corp. 13117 NW 107 Ave. Unit 17 Hialeah Gardens„ FL 33018 COVERAGES 305666 -4444 cQNTA� 03 L. - gDDRESS -- RODU06R AROI�N -.1 c &ipMrtP, INSUR@ AFFORDING COVPRA0E INSURER A : Scottsdale Insurance Company _ INSURER n : Ailtierican Home Assurance Co. INSuRERC °Progressive Insurance Co. 10193 SURER D INSURER E; NSURERF: CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD IN )iCATEb. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDFITON OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED 13Y THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, P D F F 1'oLpD(1 +' LIMITS I TYPE OF INSU1rANGE pd4k 1GLV�1 POLICY NUMBER t1�AA M,bDIYYYYl 1, Ito) NAIL # GENERAL LIABILITY EACH OcCuRRENCE $ 02/11/12 02M1113 PREMISEStEeoawrrg l 50,000 IVIED EXP {Anyone Pcnsen).- -- $ 6,000 PERSONAL & ADV INJURY S 1,000,00!1 GENERAL AGGREGATE $ 2,000,000 PRODUCTS • COMP /OP AGO $ 1,000,000 1,000,000 A X COMMERCIAL GENERAL LIABILITY CLAIMS•MADE ! 1 OCCUR GEN'L AGGREGATE UM T APPLIES PER: POLICY El . I I LOC AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS C X SCHEDULED AUTOS X HIRED AUTOS X NON -OWNED AUTOS CP$1545326 $ CA01519906 -6 02111112 02/11/13 COMBINED SINOLC LIMIT . $ (Es WARM BODILY INJURY (Per pert*/$ $ BODILY INJURY (Per aceldent) $ 1,000,000 PROPERTY DAMAGE (P�seddent) UMBRELLA LIAR EXCESS LAB OCCUR CLAIMS•MADE B DEDUCTIBLE RETENTION WORKRRD COMPENSATION AND EMPLOYERS' LIABILITY N ANY PROPRIETORIPARTNERIEXECLMVE Yt 1 OFFICERAIIEMBBR EXCLUDED? (MAtplatory in NN) I yyeea deawIbe und+ar DESLRiPT,ION (P OPgRA11QNS bettaw NIA WC003 -63 -9248 09/11/11 EACH OCCURRENCE AGGREGATE Excluded Excluded Excluded Excluded WC $TATU- II OTH- max i IiM1YR I FB _ 09/11/12 EL EACH ACCIDENT EL, DISEASE - EA EMPLOYEE $ ELL DISEASE • PO ICY LIMIT S 1,000,00 1,000,00 1,000,00 DESCRIPTION OF OPERATIONS 1 LOCATIONS! VEHICLES IMO ADCRD 101, AddlUonsl Romeo $sl:gdula M mero apses Is required) _... •.. ...e... _ _ CITY OF MIAMI SHORES 10050 N.E. 2ND AVENUE MIAMI SHORES„ FL 33138 CITYMIS SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DA'Z'E THEREOF, NOTICE WILL BB DELIVERED IN ACCOORDANCE WITH THE POLICY PROVISIONS. — AUTHORIZE) REPResral7rATtve Don McCartney 1 0y-t (1' e ACORD 25 (2009109) ®1988 -2008 ACt7RD CORPORATION. AI reserved. The ACORD name and Logo are registered marks of ACORD 484274 -7 THIS I8 NOT A BILL — DO NOT PAY RENEWAL NAPE H LOCATION 41 RAT NO. 505458 - 0 ARO ND THE CLOCK GAS SERVICE CORP 13117 NW 107 AVE 33018 HIALEAH GARDENS FT•CLASS U.S. POSTAGE PAID FL PERMIT NO. 231 17 OWNER AROUND THE CLOCK GAS SERVICE COR See. 05 Type LPG Business INNSTALLER THIS EI ONLY A LOCAL SIAMESE TAX RECEIPT. IT DOES NOT MINT ME NOLOER TO VIOLATE ANY E EEMMII REOIIIATORY OR SHINE COUNTY Ric . NOR DOES IT SSW TIE HOWER ANY OTHER P FOR LICENSE REQUIRED NOT A C6IYIIPICAT� OF THE MITERS COALIPiCA- PAYMENT RAYED ERAIBITADE COUNTY TAX 09/06/2011 60010000439 000060.00 SEE OTHER SIDE 00 NOT FORWARD AROUND THE CLOCK GAS SERVICE CORP AMAURY GONZALEZ PRES 13117 NW 107 AVE 17 HIALEAH GARDENS FL 33018 11111111110111111111M11111110111$0111111)1111111111111131411 Fl Nu ; ber. 17 eiBi : A re a Consumer Sew Bureau r, s .. , n a; Petroleum Gas Bn :.., ,;on P.O. Box 6720 Tallahassee, Florida 323996720 THE C c. r «w; GAS SERV&CE 1E417 WW1 AVE STE 17 �rl tKk:u', e. 11 non Add AROUND THE CLOCK GAS SERVICE CORP. 13117 NW 107TH AVE STE 17 HIALEAH, FL 33013.1164 ONLY t,. >r the yea; 'y located 8 p ?;.r see must be !at biters tics "if• 1"ffaF�'. 7111S pliegigss LQCA • N. This license remainder of the c wrerit Knee r upon written License :' must be approved by the department. Ali a transfer Pee of m ; . ;,. may. To splay for a ) 921 -1800. Uwe return PORTION Fi r.a!!de De '!r ',F.rau A" cult . ,a and Consumer Semi Bureau of L Petroleum Gas in P.0. x 6720 Tallahassee, Florida 32399 -6720 Crud Hese State of Florida of Standards Ur4 . ° Petroleum Gas ins (850)921 -1 , Florida address Liquefied Petroleum Gas License LP GAS INST ER • • • FOR ONE LOCATION ONLY ANY CHAUCES OF OWNERSHIP OR SALM OF RENDINS THIS LICENSE INVALID 11808 ij Section 537 t0: AROU k r THE CLOCK GAS SERVICE CORP. 13117 >' 10 AVE 17 HIA . , FL 33018 -1164 ADAM H. COMMISSIONER OF AGRICULTURE Property Information Map My Home Miami -Dade County, Florida Page 1 of 1 Property Information Map Aerial Photography - 2009 0 111 ft This map was created on 6/13/2012 11:59:53 AM for reference purposes only. Web Site © 2002 Miami -Dade County. All rights reserved. Summary Details: Folio No.: 11 -3101- 015 -0280 Property: 9338 NW 2 AVE Mailing Address: ANGELICA MONTERO 9338 NW 2ND AVE MIAMI SHORES FL 33150- Property Information: Primary Zone: 0800 SINGLE FAMILY RESIDENCE CLUC: 0001 RESIDENTIAL - SINGLE FAMILY Beds /Baths: 2/1 Floors: 1 Living Units: 1 Adj Sq Footage: 1,358 Lot Size: 7,500 SQ FT Year Built: 1940 Legal Description: ODELL MANORS PB 41- 57 LOT 4 BLK 3 LOT SIZE 75.000 X 100 OR 12000 -1818 1283 1 COC 26144 -1682 11 2007 3 OR 26881 -4790 0509 12 Assessment Information: Year: 2011 2010 Land Value: $60,066 $60,066 Building Value: $103,074 $75,734 Market Value: $163,140 $135,800 Assessed Value: $137,837 $135,800 Exemption Information: Year: 2011 2010 Homestead: $25,000 $25,000 2nd Homestead: YES YES Taxable Value Information: Year: 2011 2010 Taxing Authority: Applied Exemption/ Taxable Value: Applied Exemption/ Taxable Value: Regional: $50,000/ $87,837 $50,000/ $85,800 County: $50,000/ $87,837 $50,000/ $85,800 City: $50,000/ $87,837 $50,000/ $85,800 School Board: $25,000/ $112,837 $25,000/ $110,800 Sale Information: Sale Date: 5/2009 Sale Amount: $73,000 Sale O /R: 26881 -4790 Sales Qualification Description: Deeds to or from financial institutions View Additional Sales http: / /gisims2 .miamidade.gov /myhome /printmap. asp? mapurl = http: / /gisims2.miamidade. go... 6/13/2012 Longest Run: 47 Feet Total Load: 77,000 BTU's Type of Gas: Natural Gas Materials: Galvanized Pipe CSST Tubing New Outlet (S) 2 New Connection (S) 1 m< Future Dryer (30 ") 22,000 BTU's 1/2" Outlet 1/2" Shut Of Valve & Capped New 1/2" Galvanized Pipe Thru the floor 15' New Cook Top (30 ") 50,000 BTU's 1/2" Outlet 1/2" Shut Of Valve New 1/2" - CSST Tubing (18 -EHD) strapped to a beam thru the crawl space Florida Building Code FUEL GAS 2010 Chart #402.4 (2) (Galvanized Pipe) Chart # 402.4 (13) (CSST Tubing) 1/2 - PSI to 7" W.C. Gas System Please see attachments New Meter For Equipment New Outlet 3/4" 1/2 - PSI to 7" W.C. Gas System 28' New 3/4" - CSST Tubing (25 -EHD) strapped to a beam thru the crawl space Around The Clock Gas Services LPG017356 / CCN 02P000359 13117 N.W. 107th Ave Unit # 17 Hialeah Gardens, Florida 33018 Phone:(305) 231 -3632 / Fax:(305) 231 -4180 New 3/ ' Galy- ..!zed-Pipe strapped to the wall Installation done in accordanc - ith FB 1 G v w� Notary Public State of Florida NFPA 54 58 regulations as 11 as all oc Inc 'g y eMCommission DD854954 6/13/2012 12:53 Expires 0 3/2 012 01 3 Amaury Gonzalez Job Address: 9338 N 1 2nd Ave (Isometric) • Florida Building Code - FUEL GAS 2010 Chart # 402.4 (2) (Galvanized Pipe) Chart # 402.4 (13) (CSST Tubing) 1/2 - PSI to 7" W.C. Gas System Please see attachments, North Future Dryer (30 ") 22,000 BTU's 1/2" Outlet 1/2" Shut Of Valve & Capped New Meter For Equipment New Outlet 3/4" 1/2 - PSI to 7" W.C. Gas System N iami Shores Village APPROVED BY `NING DEPT BLDG DEPT DATE SUBJECT TO COMPLIANCE >klI If tl ALL FEDERAL STATE AND COENTY RULES AND REGULATIONS New Cook Top (30 ") 50.000 BTU's 1/2" Outlet 1/2" Shut Of Valve Front of House Around The Clock Gas Services LPG017356 / CCN 02P000359 13117 N.W. 107th Ave Unit # 17 Hialeah Gardens, Florida 33018 Phone:(305) 231 -3632 / Fax:0051 231 -41 80 Installation done in accordance , NFPA 54 & 58 regulations as w, 6/13/2012 12:53 Amaury Gonzalez Job Address: 9338 arr2nd Ave ® Notary Public State of Florida desdwin L Silver ® My Commission DD854 Expires 03/20/ (Floor Plan)