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PL-06-1677Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Fax: (305)756 -8972 Permit Permit Status: APPROVED Issue Date: 6/22/2006 Expires: 12/19/2006 Permit Number: PL -6-06 -1677 Owner's Name: GLENWOOD AND JEANNE EKLUND hone: (305)758 -909§ Permit Type: Plumbing - Residential Work Classification: Gas Job Address: 1460 102 Street NE Miami Shores Village, FL 33138- Contractor(s) Phone Primary Contractor TECO PEOPLES GAS SYSTEM (305)957 -3857 Yes Comments: NEW NATURAL GAS SERVICE FROM GAS MAIN LOCATED ON THE SOUTH R/W OF NE 102 ST Additional Information Type of Work Type of Piping Additional—Info Bond_Retum_ Classification 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 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 Parcel #: 1132050240250 Block: Lot: Section: PB: Total Square Feet: E Total Valuation: $ 600.00 Press Test ROW Final Invoice Number Amt Due Amt Paid PL -6 -06 -25308 $167.80 Total: IJUN 2 7 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. It Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Nov 0 6 2006 Job Address: 1460102 Street NE Miami Shores Village, FL 33138- Phone Number (305)75&9095 Parcel Number 1132050240250 Project: <NONE> Block: Lot: Contractor: TECO PEOPLES GAS SYSTEM Phone: (305)957 -3857 Building Department Cemmentc Thursday, November 2, 2006 Page 2 of 2 Inspector Comments Passed Failed E:1_9 Correction Needed Re- Inspection Fee ($75) No Additional Inspections can be scheduled until re- inspection fee is paid. Thursday, November 2, 2006 Page 2 of 2 BUILDING PERMIT A %'BC 2001 Permit Type (cir Owner's Name (Fee Owner's Address City S Tenant/Lessee Name Job Address (where the City Miami S Is Building Historically Contractor's Company Contractor's Address _ City. Qualifier I I, Miami Shores Village4 ]Building Department JUN 21 zoos 100$0 X .2nd Avenue, Miatni Shores, Florida 33138 I is A� Tel: (305) 795.2204 Faa : (30S) 756.8972 Permit No. pL 06 —1 6 CATION Master Permit No. Building Electrical Title�tolder & N i )e c � U g� � State l — -~ is being done) , ), q 60 N -e abing Mechanical Roofmg UPh a 305 75 170 ?� Zip Phone # s res Village County Miami Dade Zip lesignated IYES NO I i erne Q Phone # 3 a State1i-- Zip % 7i S—� \1(26A:A& I State Certificate or Regis 'on No. � � (� Certificate of Competency Architect/Enginoees Name (if applicable). Phone E' Phone # dhwI l 6 quareAW"i'd W-i � L� � f j �° c �) � ►,�x�,a1 : �' ^� z -. p11fj�'. � 'yD � �a_' ' s y< ,! .' toy's e�pewkAd 'on Alteration [dam ! epa eplace �eRA�ct:^ �t M � � . Submittal Fee $ Notary $ Scanning $_ Code Enforcement $� Total Fee Now Due $ {Continued on opposite ; 1111 OAF �G C' Demolition, Permit Fee $_ CCF $ " �J� CO /CC. 'raining/Education Fee $ CD - Technology Fee $ �� _ Radon $ ,Zonin Bond $ Structural Plan Review. $ le) Bonding Company's Name (if applicable) Bonding Company's Address City State Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State Zip 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 — Signature Owner or .Agent c&6ctor The foregoing instrument was acknowledged before me this l� day of `� 2WZ6, by` y4P -N42 rz IV n) is personally known to NOTARY Sign: Print: My Commission Expires: has produced Notary► Pubf c - SM of Florida f COmmLg M EXON ft $ 20 The foregoing instrument was acknowledged before me this day of . 2WK , by Je S 1,' Cho personally known to mm who has produced as identification ap4jwbp id IiAt o NOTARY P ,�.�, $,,, LUIS Moto RQ NO" Pubk . Statb of FW& Sign: ' • CommMW DO* Feb 2.2016 Print: r'•:o a�°: o n 9 100 513M Bonded H Nitfonai No Assn. My Commission Expires: APPLICATION APPROVED BY: PIans Examiner Engineer chc 05/13/03 ' Zoning 1 Miami Shores Village Public Works Department 10050 N.E. 2nd Avenue, Miami Shores, Florida 33138 Tel: (305 ) 7952204 Fax: (305) 756.8972 Public Works P km Permit Application FBC 2W4 PemW T"w Padmft WATER Owner s Name (Fee / �)) �9 &rU Phate NI* Owner's Cft 1� NIA ate_ Fl Tetnad/LesseeNeme /v A Phone# �, 33 X38 .bh Address (whm #0 work is burrs date) c as C yt City Miami Shores VE298 Cotmty Mom a -OP Is b9ft Mft*:* „RtEd No X comer s Compaty Nerve Carbatdofs Address AtS Cft Phones: °005 J qjo 1 suft R MP 33161. mss: Lind FOOMW Or Work: ❑ ROP9&fflePWw 13 Dmaww Gera 1 nrl hm 5i� f/ w S1 Fee $ P Fea $ CCF S on" $ _ — T Fee $ TeehnoWW► Fee Seatuting S ___. Code Emit S Toil Fee Now ate $ (Continued on opposite awe) Rattan $ Band S Stns Plan Retrma►S Bonding Company's Name (if applicable) Bonding ComWWS Address WA CRY a state 751) Mortgage Lender's Name Cd applicable) WA Mortgage Lenders Address city State zip Application is hereby made to obtain a pemtfi to do the work and installations as indicated. l caadiry 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. l understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, FOOLS, FURNACES, BOILERS, BEATERS, TANKS and AIR CONDITIONERS, ETC .... OWINEWS AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable kras regulating cornsWcdion 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 Apphcent: As a condition to this immince of a PubW Works permit with an estimated value exc $2500 the appfcant rmust pronise in good fafib OW a copy of the notice of cxm mencenwd and construction ken law irnx*we wX be defnAered to the person whose property is subject to altecmtnent Also, a certMect copy of the recorded neew ofcommencement nud be posted at ftjob sift for the Srsf Inspection which errs seven (7) days after the iwrldfng permit is issued M the absence of such posted notice, the inspection wifl not be approved and a tWnspection flee wfp be charged Signature Owner or Agent Signature Contractor The foregoing instrument was acknowledged before me this The foregoing instrument was admowledged before me this day of 20_, by day of .20-_, by who is personally known to me or who has produced Who is personalty know to me or has produced as identification and who did take an oath. NOTARY PUBLIC: Sign: Print My Commission Expires: 11117/20(}5 Sign: Print: as klentilication and who did take an oath NOTARY PUBLIC. My Commission Expires: *,OA^ 6ric46 _ Public Works Director or his designee. i I I I I I �I 1W1� `}L0 CIO &, i SWALE CRASS NE 102ND STREET -�, CV SWALE CRASS - - -S-.R-1- 7 - - - - - NEW 3/4" PL I44 (1460) - NEW RISER CONSRUCTION NOTES: f. ALL GAS PIPELINE CONSTRUCTION TO FOLLOW TECO PEOPLES GAS STANDARDS. 2. TRAFFIC CONTROL SHOULD DE MAINTAINED AND COORDINATED WITH THE APPRORIATE GOVERNdlENTAl AGENCY 48 HOURS BEFORE DIGGING 3. ALL DISTRUBED ASPHALT /CONCRETE /SOD AREAS TO BE RESTORED TO PRIOR CALL SUNSHINE 1- 800 - 432 -4770 CONDITION, UNLESS OTHERWISE SPECIFIED. ATLASm DAT M 1 1 M 1 1 �E SCALE: PEOPLE AS SHEET: NTS NEW 3/4" PLASTIC 1 RLM BY: 1460 NE 102ND STREE. M SHORES, FL �o: 1461.1 LM