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PL-16-1652 Inspection Worksheet Miami Shores Village 10050 N.E.2nd Avenue Miami Shores,FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-268047 Permit Number: PL-6-16-1652 Scheduled Inspection Date: October 05,2016 Permit Type: Plumbing - Residential Inspector: Hernandez, Rafael Inspection Type: Final Owner: GRIMBERT, DAVID AND MEGHAN Work Classification: Gas Job Address:824 NE 100 Street Miami Shores,FL Phone Number (305)323-7700 Parcel Number 1132060340050 Project: <NONE> Contractor. AROUND THE CLOCK GAS SERVICE Phone: 305-231-3632 Building Department Comments GAS LINE FROM PROPANE TANK TO A RANGE Infractio Passed Comments INSPECTOR COMMENTS False Inspector Comments Passed CREATED AS REINSPECTION FOR INSP-260946. NO ACCESS MM Failed Correction Needed Re-Inspection Fee No Additional Inspections can be scheduled until re-inspection fee is paid. 3 k` pore l 'L "-'i 6 1 5 Miami Shores Village T Prn �•- edW1 10050 N.E.2nd Avenue NE l��sia5catx was it Miami Shores,FL 33138-0000 Phone: (305)795-2204 Per Mit St'&tf�1�"APIPROVE1:3 F�ORT�1� Expiration: 1 1312 1 Project Address Parcel Number Applicant 824 NE 100 Street 1132060340050 DAVID AND MEGHAN GRIMBER Miami Shores, FL Block: Lot: i Owner Information Address Phone Cell DAVID AND MEGHAN GRIMBERT 253 NE 92 Street MIAMI SHORES FL 33138- 253 NE 92 Street MIAMI SHORES FL 33138- Contractor(s) Phone Cell Phone $ 1,900.00 Valuation: AROUND THE CLOCK GAS SERVICE 305-231-3632 _.. ....._ Total Sq Feet: 0 Type of Work:GAS LINE FROM PROPANE TANK TO A RAN Available Inspections: Type of Piping: Inspection Type: Additional Info: Final Bond Return: Press Test Classification:Residential Scanning:3 Review Plumbing Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $1.20 Invoice# PL-6-16-60188 DBPR Fee $2.25 06/14/2016 Credit Card $50.00 $121.70 DCA Fee $2.25 Education Surcharge $0.40 06/16/2016 Credit Card $ 121.70 $0.00 Notary Fee $5.00 Permit Fee $150.00 Scanning Fee $9.00 Technology Fee $1.60 Total: $171.70 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 zo F the ore,I authorize the above-named contractor to do the work stated. June 16,2016 Authorized Signature:Owner / Applicant / Contractor / Agent Date Building Department Copy June 16,2016 1 001565 Local Business-Tax�114eceipt Miami-Dade County, State of Florida -THIS IS NOT A BILL - DO NOT PAY 4842747 IN.-LBTI) BUSINESS NAME/LOCATION RECEIPT NO. EXPIRES AROUND THE CLOCK GAS SERVICE CORP RENEWAL SEPTEMBER 30, 2076 13117 NW 107 AVE 17 - 5004580 Must be displayed at place of business HIALEAH GARDENS FL 33018 Pursuant to County Code Chapter SA-Art 9&10 OWNER SEC.TYPE OF BUSINESS PAYMENT RECEIVED AROUND THE CLOCK GAS SERVICE 205 LPG INSTALLER BY TAX COLLECTOR CORP LPGO17366 $60.00 08/06/2015 FPPU09-15-005456 This Local Business Tax Receipt o*confirms paymentof tba Local Business Tax The Receipt is nota license, permit or a certification of the holder'squalficadons,to do business. Hold with any govemmental or nongovernmental regulatory lavas and requiremaats whicb apply to the businass. The RECEIPT N0.above must be displayed on all commercial vehicles-MIEW-Dade Code Sec Iia-276. For more information,visit www.miamidada wyAw collacter Florida Department of Agriculture`and Consumer Services P.O.BOX 6700 Tallahassee,.RoMa.3230"700 License Number: 173$6 Business Mailing Address Irk n Lotion-Addie AROUND THE CLOCK GAS SERVICE CORP. AfiOUNDTKC4� 13117 SFW 107TH AVE Sf E 17 131,171W OM- W 11"M,17 r HWX-M GARDENS.FL 33018-1184 The liquet petroieun S t€ /tie b Yil` r `. on the lkxm e. Each business fi;,# a C it tlsEd.'AD Lo On fici31hSe9 tthu�t�i�isN�+red annually. Any license allowed to expire shag bac orne inopesetiwe because Of faWte to renew. lhihiO W remmtjonof a Gi ense is equal to the ordinal license fase,ah trust be paid before the tio� operations. IN-TME EVENT OF AN ERSMP CHANGE THISSS JSINI S9 I 0-CAT-� ' This ilcer+�a y be transferred to any person,firm or corporation for the remainder of the ourrent year i tti the department by the original kanse bolder. Liceme trarAht"dust requirements must be met by"trarta�ee ands tranderlai of$5 ivAlapply To for a�. � Bureau of LP Gas Inspe6tioris at(8 0)921-16M. Pursuant t*Chapter 527,Florida Statutes,LP Gw fine ns must p0fi6f.i "to taa�imlts fir, owner,or end user upon request when engaged in the busitress cif , salts or 'installing LP Gas systerrssand/or equipMert For future correspondence.please make any needed cotnecaions or t#h I+ '0twowrrig"", and/or your licensed location address and return ft UPPER PORTION rx►1'rD4 ens to: Florida Department of AgngWWre and Consumer S+ +i s 0.0 BoX 6700 Taliattassee,Flofiida'32399-6700 , �IYI'iiQ lGr,':. Stiff offlorW Depa(tent of AgrieUkUre and CatIOuit"0 49ntis" Division of Consumer Services teenais, ;17 Bureau of Ligtsef i atrcileurn Gas inion x'31,2016 (050)921.1:600 1,2(113 . .eta ea POSTS Tallahassee,'..��aT{ :• nytpp�n�d :paw CONSPICUOUSLY LP GAS I STA ,� `` Gaon FoR ONE WCATM MY ,earn cHawM OF cn NSPSMP OR sage Of rrft SUMNIESS T1im : This ftwW is inter au#+oft of 827 2,- to: AROUND tHE CLOCK GAS SERVICE060. 13117 NW 4Q"7I AVE-.STE 1.7 HIALEAHA ►EIKt8,, f AC 0� AROUN-1 OP ID-AN CERTIFICATE OF LIABILITY INSURANCE I DATE(MMMDNrif) 06/16/2016 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER TFfS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTENT] OR ALTER THE COVERAGE AFFORDED BY THE POLICI$S BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER{S), AUTHORIZ*D REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the pollcy(ies)must be endorsed. If SUBROGATION 13 WAIVED,subjectito the terms and conditions of the policy,certain policies may require an endorsement A statament on this certificate does not confer rights to the Martificate holder in lieu of such endorsement(s). PRODUCER N�MEA Annmarie McCartney MDW Insurance Group Inc PHONE 362 Minorca Ave Are Nc 305-44Q.2324 Arc No;305-444-4880 Coral Gables,FL 33134 aoo IREss:almccartne mdwlnsurance.com Donald W McCartney INSURNWIM AFFORDINGCOVERAGE NAIC# INSURER A:Endurance American Special 41718 INSURsa Around the Clock Gas Service Corp INSURER8;Pro Progressive Insurance Co. 10193 13117 NW 107 Ave Unit 17 INSURERC;Granite State Insurance Co. 23809 Hialeah Gardens,FL 33018 INSURER D,Nautilus Insurance Com an 47370 INSURER E: INSURER F; COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: TF11S iS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTAN13ING ANY REQUIREMENT, T15RM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED OY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE SEEN REDUCED BY PAID CLAIMS. LTE TYPE OF INSURANCE !3 POLIO POLI POLICYNU6IBEIZ MM/DD MMIDDUMrTS A X 'COMMERCIAL GENERAL LIABILITY CLAIM&MADE OOCCUR C6C20001094300 02111/2016 02[11/2017 EACH OCCURRENCE $ 4,000,00 PREMI Ea oocurran $ 100,00 MED EXP{Any ane rson) $ 66,00 PERSONAL&ADV INJURY $ 1,000,00 OEML AGGREGATE LIMIT APPLIES PER GENERALAGGRpGATE. POLICY E]JEC M LOC OTHER: PRODUCT$-COMP/OP ACG $ 2,000,00 $ AUTOMOBILE LIABILITY COMBINED INGLE LIMIT $ 1,000,00C H ANYAUTOLOWNE 01599908 0211112016 02/11/2017 BODILYINJURY(perpetson) $ ' ALLOWNED SCHEDULED i AUTOS X Np AUTOS BODILY INJURY(Per awdent) $ i X HIREDAUTOS X WN —ARVERTY DAMA a UMBRELLA LIAR X ocOU>: $ I MADE AN026684 EACH OCCURRENCE $ 3,000,00 D X EXCESS LIAB CLAIMS- 02[1112016 02/41/2017 AGGREGATE DED $ 3,000,00 RETENTION$ WORKERS COMPENSATION $ ' AND EMPLOYERS'LIABILITY X R El C PR YIN Y/N 0003638248 091111x015 09/11/2048TATUTE ER OFF[ EMBER EXCLUDSW N/A E.L.EEACH ACCIDENT $ 1,000,00 (M4�d49ry In NH) IfEL.DISEASE-EAEMPLOYE $ 1.000,00 IDESCRIPTION F PERATIONS below EL DISEASE-POLICY LIMIT $ 1,000,00 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedvte,maybe a(}achgd Ir more%paw la mqutred) License LPG17356 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Miami Shores Village THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Building DBpartment ACCORDANCr,WITH THE POLICY PROVISIONS. 10050 NE 2nd Ave Miami Shores,FL 33138 AUTHORIZED REPRESENTATIVE ®1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD Miami Shores Village � Building Department JUN 14 2816 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 Tel:(305)795-2204 Fax:(305)756-8972 INSPECTION LINE PHONE NUMBER:(305)762-4949 FBC 2014 BUILDING Master Permit No. PL PERMIT APPLICATION Sub Permit No. ❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑CANCELLATION ❑ SHOP p CONTRACTOR DRAWINGS JOB ADDRESS: D�g N �' �o Q S k City: Miami Shores County: Miami Dade Zip: _j Folio/Parcel#: `t— D 0( —0 `['`� 00 �O Is the Building Historically Designated:Yes NO V Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER:Name(Fee Simple Titlgholder):__ - 61? a,e /I�XRhone#: -2®_5 Address: � �/ 4,eY fl�'e 14 City: State: �®�� ` Zip: 3 7®3e o Tenant/Lessee Name: Phone#: ` Email: ` CONTRACTOR:Company Name: 1Q!��`^� "jz `r N` L\Qte Phone#: 3CsS_ ')\%—CA5:T o Address: v7 \9- r1"� \0 A-,,� \ City: 60t rx&, State: e� Zip: 3 3 lz' I Qualifier Name: (�Crj+�S v� ��+- Phone#: State Certification or Registration#: L\ v ` e3 J �o Certificate of Competency#: DESIGNER:Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit:$ , ) ' O Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration [-New ❑ Repair/Replace ❑ Demolition Description of Work: G^S `k ` k T—V1®Y`^ Y\.-z' KA Y1 P der Specify color of color thru tile: //^^�� Submittal Fee$ Permit Fee$ 1 L CCF$ 1` ZV CO/CC$ 0 Scanning Fee$ . CO Radon Fee$ �•2-7 DB�Pd R$ � ;?E� Notary$ E5•CD Technology Fee$ 160 Training/Education Fee$ ® � T� 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-certrfied copygf theTecarded notice of cammenceffwnt-must-b-e poted at rhe fob3ite 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 arged. Signature g `=- Longest Run: 18 Feet lNew 1/2"Galvanized Pie 1 Foot Total Load: 60.000 BTU's New Range(30") 60.000 BTU's Tvpe of Gas: Propane Gas New 1/2"Outlet. New 112"Shut Off Valve ITI Materials: Galvanized Pipe: New Outlet(S) 1 New Connection (S) 1 4' Florida Building Code - FUEL GAS 2014 Chart#402.4(28)(11"W.C.)(Galvanized Pipe) Propane Tank (Cut Sheet) PY 10-PSI to 11"W.C.Gas system New 1/2"Galvanized Pipe, istraDved to the wall. PL 1 -23 Gallon(100 pound)Propane Tank. �G Above Ground Tank. 3/4"Outlet. Two Stage Intergral Regulator. JON 14 2016 10 PSI to 11"W.C.Gas Sys m. i 10'Minimum from any source of ignition. SSSS 5'Minimum From A SSSS.. Door Window oropening. New 3/4"Galvanized Pie 1 Foot 10' SSSS SSSS.. 0 Soso.. SSSS s 00.00 INew 112"Galvanized Pipe, 0 000 ••••• strapped to the wall. •• •• •••• 0.00•• SSSS.. 00 0 . 000000 00000. Shares Vi 11,, e 3' I .. SSSS SSSS.. - Bl° DATE :-'DT - _ T 0C CP,IPI WICE WI fN ALL FEDERAL �_.1,,N i f HtA--7S AND R,EGULA-IONS Around The Clock Gas Services Installation done in accordance ith FBC 20 �.. .,, EDW VER LPGO17366/CCN 02P000359 NFPA 54& 58 regulations as a as all local Gid ``�ti:: �� 13117 N.W. 107th Ave Unit# 17 6/6/2016 14:11 •= MY coMMISs #EEa6737 ` � EX RES January 22,2017 Hialeah Gardens, Florida 33018 Amaury Gonzalez .• Phone: 305 231-36321 Fax: 305 231-4180 Job Address: 824 N 1 0th Street L4. `°"' Florida Buildinq Code - FUEL GAS 2014 Chart#402.4(28)(11"W.C.)(Galvanized Pipe) Propane Tank (Cut Sheet) 10-PSI to 11"W.C.Gas System d New Range(30") 60.000 BTU's New 1/2"Outlet. New 1/2"Shut Off Valve 4' N O 10' R T ...Fd . . .... ° .... 1 -23 Gallon(100 pound)Propane Tank. • Above Ground Tank. • 3/4"Outlet. ��••� • : °..: Two Stage Intergrai Regulator. -----KD ...... :...:. • 10 PSI to 11"W.C.Gas Sys M. •°'• e••. 10'Minimum from an ••a 0 •••• •°••• sourceofl nation. •• •• •••• •••••• 5'Minimum From A • Door Window oropening. ...... Front of House N E 100th Street Around The Clock Gas Services Installation done in accordanc ith FB 201 ,, LPGO17366/CCN 02P000369 NFPA 54 &58 regulations as a as all cal EDW I�/ER 13117 N.W. 107th Ave Unit# 17 6/6/2016 14:11 •' MY COM ION#EEa6T3 5 Hialeah Gardens, Florida 33018 Amaury Gonzalez ,,' XPIRESJanuary22,2017 Phone: 305 231-36321 Fax: 305 231-4180 Job Address: 824 N th Stre ` o Steel 100,200,420 lb. Specifications Steel 11 200, 420 lb. Specifications d 1& I C..3*m [406mm] Mon-Vain NFr Jim r 6 66a tf9 t� Ih UPT 43.0' :. [1092mm] so OA 1001b. f; 2001b• Ift"M ad On s�.. A. i�i 151 11 0)NPT IkFM 1 �f4' MPT 0:NFT Fkma Gauge(1')NFT D.Vapor Swvice Valve(3/4-)wr gat f' 4=111116 LPG Water Cylinder Footring • • TASME Capacity Capacity Tare Weight Volume Collar Height O/s Specification : Cylinder gallons Ib Ib cu in inches inches 6 239 b • ;( tL• • • t9 51 14 5 DOT-4BW240 23 •• • 1 • • 47.2 ••g74 • 147:4• 91314 6.6 19.0 DOT-4BW240 99.1 ••1000• Z72.6 •'277317Y7 � 6.6 22.0 DOT-4BW240 ••• 0 0 • ••• • 0