PW-16-59 Inspection Worksheet
Miami Shores Village
10050 N.E.2nd Avenue Miami Shores,FL
Phone: (305)795-2204 Fax:(305)756-8972
Inspection Number: INSP-250638 Permit Number: PW-1-16-59
Scheduled Inspection Date:January 27,2016 Permit Type: Public Works
Inspector. Diaz,Osvaldo
Inspection Type: Final
Owner: MOORE,JOHN AND KELLY Work Classification: Public Works
Job Address:450 NE 94 Street
Miami Shores, FL 33138- Phone Number
Parcel Number 1132060140320
Project <NONE>
Contractor. TECO PEOPLES GAS SYSTEM Phone:(305)957-3857
Building Department Comments
INSTALLING A NEW GAS SERVICE LINE BY Infra°ti° Passed Comments
DIRECTIONAL DRILLING INSPECTOR COMMENTS False
TO CLOSE PERMIT#PW15-2348
Inspector Comments
Passed �C
Failed
1
Correction ❑
Needed
Re-Inspection
Fee
No Additional Inspections can be scheduled until
re-inspection fee is paid
January 26,2016 For Inspections please call:(305)762-4949 page 28 of 62
Permit NO. PW-1-16-59
s�!01 y Miami Shores Village Permit Type:Public Works
c 10050 N.E.2nd Avenue NE Perm 'It Work Classification:Public Works
Miami Shores,FL 33138.0000 Permit Status:APPROVED
Phone: (305)795-2204
Issue Date: 1/14/2016 Expiration: 04/13/2016
Project Address Parcel Number Applicant
450 NE 94 Street 1132060140320
JOHN AND KELLY MOORE
Miami Shores, FL 33138- Block: Lot:
Owner Information Address Phone Cell
JOHN AND KELLY MOORE 450 NE 94 Street
MIAMI SHORES FL 33138-2924
450 NE 94 Street
MIAMI SHORES FL 33138-2924
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.zo Invoice# PW-1-16-58282
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.
OWNER0andz
IT I certify that all the foreg 'ng information is accurate and that all work will be done in compliance with all applicable laws regulating
construct Futhermore,I auth aove-na d co ractor to do the work stated.
January 14,2016
Authorized Signature:Owner / p licant / Contractor / Agent Date
Building Department Copy
January 14,2016 1
• i
Miami Shores Village
JAN 11 2016
Building Department
10050 N.E.2nd Avenue,Miami Shores,Florida 33138
Tel:(305)795-2204 Fax:(305)756-8972
INSPECTION LINE PHONE NUMBER:(305)762-4949 ---
FBC201 �
BUILDING Master Permit No.
PERMIT APPLICATION Sub Permit No.
❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
F-1 PLUMBING ❑ MECHANICAL OPUBLIC WORKS ❑ CHANGE OF ❑CANCELLATION [:] SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: 460 - L�• �� _61
City Miami Shores County Miami Dade Zip:
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:$2000 Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration N New ❑ Repair/Replace ❑ Demolition
Description of Work: 42 rK
Specify color of color thru tile:
Submittal Fee$ Permit Fee$ CCF$ CO/CC$
Scanning Fee$ Radon Fee$ DBPR$ Notary$
Technology Fee$ Training/Education Fee$ Double Fee$
Structural Reviews$ Bond$
TOTAL FEE NOW DUE$
(Revised02/24/2014)
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.
Signature Signature
OWNER or AGENT CONTRACTOR
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
day of ,20 ,by �_day of 20 / -�— by
,who is personally known to ��s s Y��,¢s <t�p:e:rs®r��
me or who has produced as me or who has produced as
identification and who did take an oath. identifica •on and o did take an oath.
NOTARY PUBLIC: NOTAR PUBLIC:
pu1o„ HUBERT NUNEZ
Ozpay PVBC'1i
* a o, Notary Public-State of Florida
Sign _.°�* Comm.Expires Sep 11,2017
commisslon #FF 0 79
Print: Print: dotaryAssn.
Seal: Seal:
********************************* ***** 1*****************************************************************
APPROVED BY G� Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)