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PW-15-2973 Inspection Worksheet Miami Shores Village 10050 N.E.2nd Avenue Miami Shores,FL Phone.(305)795-2204 Fax:(305)7564972 Inspection Number: INSP-248454 Permit Number: PW-1'1-15-2973 Scheduled Inspection Date: February 23,2016 Permit Type: Public Works Inspector. Hernandez, Rafael Inspection Type: Final Owner: , Work Classification: Public Works Job Address:9306 NE 9 Avenue Miami Shores,FL Phone Number (305)989-7418 Parcel Number 1132060020070 Project <NONE> Contractor. TECO PEOPLES GAS SYSTEM Phone: (305)957-3857 Building Department Comments infractlo Passed Comments INSTALL A NEW 3/4"PLASTIC GAS SERVICE LINE BY INSPECTOR COMMENTS False LINE BY DIRECTIONAL DRILLING Inspector Comments Passed Failed / /.i�i Correction D Needed Re-inspection Fee No Additional Inspections can be scheduled until re-inspection fee is paid Permit IVO. M-1-15-2975 Miami Shores Village PBtr17t!`T,y)!e;put) Work s 10050 N.E.2nd Avenue NE t 6*Clessific;>affon:Public Works Miami Shores,FL 33138-0000 � m Permit Status:,APPROVED @ a Phone: (305)795 2204 �GORLDp' ' _ .• Expiration: 03/08/2016 l�;ia tla�:'I�1S1201 ! P Project Address Parcel Number Applicant 534 NE 95 Street 1132060140820 Miami Shores, FL Block: Lot: MIRYAM ROJAS Owner Information Address Phone Cell 534 NE 95 Street _ !M1RYAM ROJAS (305)498-1227 MIAMI SHORES FL 33136- . Contractors) Phone Cell Phone I Valuation: $ 1,000.00 TECO PEOPLES GAS SYSTEM (305)957-3857 (305)970-1783 Total Sq Feet: 00 4 Scanning:3 Available Inspections: Inspection Type: Final Excavation Review Building ff1 fl Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $0.60 DBPR Fee $2.00 InVO1Ce# PW-11-15-57882 DCA Fee $2.00 12/09/2015 Credit Card $64.60 $50.00 Education Surcharge $0.20 11/25/2015 Check#:5959 $50.00 $0.00 Permit Fee $100.00 Scanning Fee $9.00 Technology Fee $0.80 Total: $114.60 In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compli ince with all ordinances and regulations pertaining thereto and in strict conformity with the plans,drawings,statements or specifications submitted to the prof ar authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, senan's, er amp!oyes I understand that separate permits are required for ELECTR PLUMBING,MECHANICA'_,WINDOWS,DOORS,ROOFING and SWIMMING POOL wore OWNERS AFFIDA IT: I rti hat all the for ping information is accurate and that all work will be done in com fliance with all applicable laws regulating construction a zonin F t o , I uth .z t e above-named contractor to do the work stated. Decer fiber 09, 2015 Authorize gnatur O er ! pp'cant / Contractor / Agent late Building ®ep ent Cope December 09,2015 1 e f �V) Miami Shores Village -� Building Department artment 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 13y: Tel:(305)795-2204 Fax:(305)756-8972 INSPECTION LINE PHONE NUMBER:(305)762-4949 FBC 20I�Y—d/—' BUILDING Master Permit Nopi PERMIT APPLICATION Sub Permit No. ❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING ❑ MECHANICAL Q PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 9306 NE 9th AVE. 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#: 954-453-0806 Address: 5101 NW 21 AVE. STE. 460 city: FT. LAUDERDALE State: FL Zip: 33309 Qualifier Name: JESUS VEGA Phone#: 954-453-0806 State Certification or Registration#: E1608 Certificate of Competency#: DESIGNER:Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit:$ 1000 Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration Q New ❑ Repair/Replace ❑ Demolition Description of Work: INSTALL A NEW 3/4" PLASTIC GAS SERVICE LINE LINE BY DIRECTIONAL DRILLING Specify color of color thru tile: � Submittal Fee$ Permit Fee$ CCF$ CO/CC$ Scanning Fee$ Radon Fee$ i DBPR$ Notary$ Technology Fee$ Training/Education Fee$ Double Fee$ Structural Reviews$ Bond$ TOTAL FEE NOW DUE$ &4 (ReAsed02/24/2014) 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 ZJ day of /V 0 V 20 by who is personally known to is personally kno to me or who has produced as me or who has ed as identification and who did take an oath. identificati and who did take an oath. NOTARY PUBLIC: NOTARY UB IC.. HUBERT NUNEZ Notary Public-State ol11020�7 My Comm.Expires Sep Sign: Si s,r# ° Commission#FF 043675 ° Bonded Througl Nalloflhl Print: Print Seal: Seal: APPROVED BY r r Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) 1 � I I a $@ O s $ W W S W d I I I i b L-L a / IL k, Av I � � •Eiji � e �� 5 .�� ® I 6.1„ •a 1b•e4 '� l' _ Baa 3° � ^'� W m'� $ • • OEsis a ,y �+i4 av�'w• Vgl $n yg@. �� ®U d w N@lSPA3� g —fl .1 • 0 •.• r • • • • • • • • • � � � � � • •• • • • •• •• • • • • • • • • • • • • • • • • • • • •• •• • • • •• •• WHIN. S it � TTT999 m � som 1® S5 3 �a=o�D • •••• W (AD • a x • DzOzmP � om morin vamz . .. ZG5 �8mozz me ••.• 2�r68a • —I �D C prZ L/ImD3.9 �D •.••. �Om>mN 0- 0 G/9 7e �.y yypp 1I�e11 eyeky (D m s i•.. �`D`7p� 2�Liwn1+1� • z O ••.•9S ZmZ D •-i��aZo •. 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