PW-16-55 Inspection Worksheet
Miami Shores Village
10050 N.E.2nd Avenue Miami Shores, FL
Phone.(305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-250624 Permit Number: PW-1-16-55
Scheduled Inspection Date:January 27,2016 Permit Type: Public Works
Inspector. Diaz,Osvaldo
Inspection Type: Final
Owner: MORALES,ANNE&NESTOR Work Classification: Public Works
Job Address:474 NE 95 Street
Miami Shores,FL 33138- Phone Number (305)283-7233
Parcel Number 1132060140440
Project: <NONE>
Contractor: TECO PEOPLES GAS SYSTEM Phone: (305)957,3857
Building Department Comments
INSTALLING A NEW GAS SERVICE LINE BY lnfractio Passed Comments
DIRECTIONAL DRILLING INSPECTOR COMMENTS False
TO CLOSE PERMIT#PW15-740
inspector Comments
Passed
Failed
Correction ❑
Needed
Re-Inspection a
Fee
No Additional Inspections can be scheduled until
re-inspection fee is paid
January 26,2016 For Inspections please call:(305)762.4949 page 26 of 62
Permit NO. PW-1-16-55
Miami Shores VillagePermit Type:Public Works
10050 N.E.2nd Avenue NE Permi't
Work Classification:Public Works
•• Miami Shores,FL 3313&0000 Permit Status:APPROVED
Phone: (305)795-2204
04/13/2016Issue Date: 1/14/2016F—Expiration:
Project Address Parcel Number Applicant
474 NE 96 Street 1132060140440 ANNE 8 NESTOR MORALES
Miami Shores, FL 33138- Block: Lot:
Owner Information Address Phone Cell
ANNE&NESTOR MORALES 474 NE 95 Street (305)283-7233 (305)733-6534
MIAMI SHORES FL 33138-
Contractor(s) Phone Cell Phone Valuation: $ 2,000.00
TECO PEOPLES GAS SYSTEM (305)957-3857 (305)970-1783
- Total Sq Feet: 0
Scanning:3 Available Inspections:
Inspection Type:
Final
Excavation
Review Building
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due
CCF $1.20 Invoice# PW-1-16-58278
DBPR Fee $2.00 01/14/2016 Check#:6069 $ 116.20 $0.00
DCA Fee $2.00
Education Surcharge $0.40
Permit Fee $100.00
Scanning Fee $9.00
Technology Fee $1.60
Total: $116.20
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 AF IDA IT: I certify that all the foregoin information is acc to and that all work will be done in compliance with all applicable laws regulating
construction a z nin . Futhermore,I authoriz a ve- a e con or to do the work stated.
Com- January 14,2016
Authorized Signature:Owner / A lira / Contractor / Agent Date
Building Department
January 14,2016 1
i
Miami Shores Village
Building Department JA 2016
10050 N.E.2nd Avenue,Miami Shores,Florida 33138 __ r4°A JO`
Tel:(305)795-2204 Fax:(305)756-8972 V
INSPECTION LINE PHONE NUMBER:(305)762-4949
FBC 20 ("A�
BUILDING Master Permit No._
PERMIT APPLICATION Sub Permit No.
BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION RENEWAL
❑PLUMBING [:] MECHANICAL 0 PUBLIC WORKS ❑ CHANGE OF ❑CANCELLATION M SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: +14 �.E• qg*-- o)T—
City: Miami Shores County: Miami Dade Zia:
Folio/Parcel#: Is the Building Historically Designated:Yes NO X
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER:Name(Fee Simple Titleholder):RIGHT-OF-WAY Phone#:
Address:
City: State: Zip:
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR:Company Name: TECO PEOPLES GAS Phone#: 954-453-0811
Address: 5101 N.W. 21 AVE., SUITE 460
City: FT. LAUDERDALE State: FL Zip: 33309
Qualifier Name: JESUS VEGA, JR. Phone#: 945-453-0811
State Certification or Registration#: E1608 Certificate of Competency#:
DESIGNER:Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit:$2000 Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration 0 New ❑ Repair/Replace ❑ Demolition
Description of Work: 71t IT(I
Specify color of color thru tile:
Submittal Fee Q Permit Fee$ CCF$ CO/CC$
Scanning Fee$ Radon Fee$ DBPR$ Notary$ 0
Technology Fee$ Training/Education Fee$ Double Fee$ %'
Structural Reviews$ Bond$ 2
TOTAL FEE NOW DUE$ I G ` 12-0
(Revised02/24/2014)
A L
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 ELECTRIC, PLUMBING, SIGNS, POOLS,
FURNACES,BOILERS,HEATERS,TANKS,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.
c-
Signature Signature
OWNER or AGENT CONTRACTOR
The foregoing instrument was acknowledged before me this The foregoing instrumen was acknowledged before me this
day of 0 20 by T day of 20 4 by
who is personally known to r who i rsonally know o
me or who has produced as me or who has produced as
identification and who did take an oath. identification d wh di t e n atq�
NOTARY PUBLIC: NOTARY P B C: PRY°Gy' HUBERT NUNEZ
�.) Notary Public-State of Florida
= My Comm. Expires Sep 11,2017
Commission #FF 043679
Si F k,
Sign: sn.,
Print: Print:
Seal: Seal:
APPROVED BY Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)