PL-05-226 �,S�'{tac tssr Jit
Miami Shores Village Plumbing Permit fall�'
NMI"
10050 NE 2nd Avenue ---r
Permit Number: PL2006-226
Phone: 305-795-2204 �'toRtvp'
Printed:7/26/2005 Page 1 of 1
Applicant: LOUISE PALMATIER
Owner: PALMATIER LOUISE
JOB ADDRESS: 540 NE 103 ST
Contractor CONSUMER GAS PLUMBING CORP. Contractor's Address: 4510 SW 154 PLACE
Local Phone: 305-608-5400
Parcel # 1132060170900 Legal Description: MIAMI SHORES SEC 4 AMD PLAT PB 15-14 LOTS 7 &8 BLK 93
Fees: Description Amount
FEE2005-10164 Building Fee $150.00 Total Fees:$157.55
FEE2005-10165 CCF $0.60
FEE2005-10166 Training and Education Fee $0.20 Total Receipts: $0.00
FEE2005-10167 Technology Fee $3.75
FEE2005-10168 Scanning Fee $3.00
Total Fees: $157.55
Permit Status: APPROVED Permit Expiration: 1/17/2006 Construction Value: $430.00
Work: NATURAL GAS LINE TO GENERATOR
26PAID
6 -t-
Signed: (INSPECTOR)
In consideration of the issuance to me of this permit,I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict
conformity with the plans,drawings,statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responisibility for all work
done by either myself,my agent,servants or employes.
Signed: (Contractor or Builder) BY:
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305-795-2204
Building Inspection Request
Date-
Type Insp'n Fld`a(k\
Permit No. TL LW �7 -k
Name L w i�,(I -RA mJ(x,
Address 5+0 tj E io j C
Company CO ASVAUV ' -(2qs��l`� C�✓�
Phone# ,�
Inspection Date
Approved
Correction ❑
Re-Insp'n Fee ❑
Miami Shores Village
Building Department
10050 N.E.2nd Avenue,Miami Shores,Florida 33138
Tel:(305)795.2204 Fag. (305)756.8972
BUILDING RE . qED
Permit No.
PERMIT APPLICATION JULr Permit No.
FBC 2001 Permit Type(circle): Building Electricl Mechanical Roofing
Owner's Name(Fee Simple Titleholder) ® C e\R. ( A-L.PA-Tt P(,.Phone#
Owner's
Add7��"_5_State
��(� � � � � a:) 1
City A - Zip
Tenant/Lessee Name Phone#
Job Address(where the work is being done) C> 0 d
City Miami Shores Village County Miami-Dade Zip
Is Building Historically Designated YES NO
Contractor's Company Name C ®y, Sy m-eL_ r�) bi_S Phone# ®� ®
Contractor's Address 4s) ® S„.) /SA-A ?L .
CiState Zip 1
ty
Qualifier CQ-_Q-2—
Architect/Engineer's
Architect/Engineer's Name(if appli le) Phone#
S Value of Work For this Permit Square Footage Of Work:
Type of Work: ❑Addition ❑Alteration [-]New ❑ Repair/Replace ❑Demolition
Describe Work:
Aja- ti\_ "N—O�
Submittal Fee$ Permit Fee S _jCCF$
Notary$ Training/Education Fee$ Technology Fee$ -1:34 s
Scanning$ J' -W Radon$ Bond$
Code Enforcement$ Structural Plan Review.$
Total Fee Now Due$ IS-7 , 55
(Continued on opposite side)
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 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 ch posted notice, the
inspection will not be approved and a reinspection fee will be charged.
Signature Signature
r or A ent � Contra or
The foregoing instrument was ac wledged"e me this� The foregoing instrument was acknowledged before me this
day of �J�. 20 6 2,by C e \a-�M�`�� day of v 20 0.S by ,
who is personalIknown to me or who has produced_ who is perso known to me or who has produced
As identification and who did take an oath. as identification and who did take an oath.
NOTARXPUBLIC: NOTARY P •
SlgnC r Si c, 7 ;-Z=
P MY COMMISSION C6lNM1SSiUN 8
8=dedThn•SWar 'Voi+r t ."W tae . . !
My Commission Expires. _ r 2 My Commission Exp _ 'k'i�' "1 1
m /
(Certificate of Competency Holder)
State Certificate or Registration No. certificate of Competency No.
APPLICATION APPROVED BY: Plans Examiner
Engineer
ov A:: 7J, --,06! Zoning
Chc 10/14103
JUL-18-05 MDM 15:14 •- •'�"` r o� -
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CLIENT INFORMATION: COMPANY
CONSUMER GAS PLUMBING CORP. INFORMATION:
Name:ROGER PALMATIER Folio:
540 NE 103 ST Total Gas Load:250 OOOBTUH
MIAMI SHORES
Total Developed Length:47' 4510 SW 154PL TABLE:402(6)
Phone 1:305 754-OM MIAMI FL 33185
305 608-5400
1"GALV SCH 40
11` \ STRAPPED TO THE WALL
1"QALV SCH 40 1 29' ,
STRAPPED TO THE WALL 1 `
10' I
GENERATOR 250 000 BTUH
I 11"GALV SCH 40
SOV 3/4" , '4 1 STRAPPED TO
1 THE WALL
181
1
i
I
1
ONATURAL GAS METER
PRESSURE 1 PSI
••• • • • ••• •
• •• •• • • • •• ••
'MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305-795-2204
Building Inspection Request
Date 6#&0'5 I
Type Insp'n GAS " LX44u% �C4 50C'
Permit No. 2( S —ZZ
—�
Name
Address 5 -s7
Company COSUA&/ �14 'Rom jm (0)
Phone# S/ Lb-1 61 OS T
Inspection Date 0 1 ! l(J
Approved
Correction ❑
Re-Insp'n Fee ❑
II I