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PLUMBING
Type Insp'n Permit No. Name Address Company Phone # MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date �—� Inspection Date Approved Correction Re- Insp'n Fee 7L- - k SIL RECEIVED DEC 2 02004 fi Ti1�Tl� BUILDING PERMIT APPLICATION FBC 2001 Permit Type (circle): Building Owner's Name (Fee Simple Titleholder) e O Iy ri eU X 1 Q)1/ hone # Owner's Address 3U $ Are Q q l /Q' I'd? FL 35137 City a /►'t / trzdJ State FL Zip 33/3 Y Tenant/Lessee Name Phone # ( being done) © Arm Job Address where the work is bein done 3 9 cr q 5) Alta ?71 • F1 3 3131 City Miami Shores Village Is Building Historically Designated YES Contractor's Address City ' 1 et Qualifi Type of Work: ❑Addition Describe Work: q00' _S Total Fee Now Due $ (Continued on opposite side) $ Value of Work For this Permit Miami Shores Village B xi Building Department 10050 N.E. 2nd. Avenue, Mi Shores, Florida 3313$ Tel: (305) 795.2204 Fax: (305) 756.$972 Permit No. // — S. Master Permit No. Electrical Contractor's Company r N f ame p U/ , s l � Iq.31 kJ 64' l Sta ❑Alteration f darn NO Mechanical P/cL Phone# ai FL a3166 Zip 33/66 Ro ofing Comity , Miami -Dade Zip - IDt Arr Architect/Engineer's Name Of applicable) Phone # Square Footage O.f Work: Repair /Replace 0 Demo ******************************F *** Submittal Fee $ Permit Fee $ f CO CCF $ I '. 6 CO /CC Notary $ Training/Education Fee $ ' 6U Technology Fee $ LL '33.- Scanning $ `) ' CO Radon $ Zoning Bond $ 4 ' 0 0 Code Enforcement $ Structural Plan Review. $ 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 such posted notice, the inspection will not be approved and a reinspection fee will be charged. a c -� Signature �v���= '�:r,�� �� Signatur Owner or Agent The foregoing instrument was acknowledged before me this 17 The foregoing instrument w acknowledged before me this / 7 day of Ji; , 2OGt - by , day of - we f , 20 V, by who is personally known to me or who has produced who is personally known to me or who has produced As identification and who did take an oath. as identification and who did take an oath. My Commissi NOTARY PUBLIC: Sign: Print: %(t �IAIE didi ,stAL • AM ARILYS VALDEZ 1Z1QUII f�1S1T')i1021LORIDA C MMISSIO1J NO. DD140143 ,n ThkilfWAISION EXP. AUG. 7.2006 Sign: 4LL� NOTARY PUBLIC: ***************************************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** State Certificate or Registration No. (Certificate of Competency Holder) ARILYS VALDEZ Print: F }MIV Y Li JC T 40141 Z;U (s'S�iurjNtf u iaa�4.s My Comn7issitff azighwoN EXP. AUG. 7.2006 Certificate of Competency No. ontractor ************************************* ****** J*************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** APPLICATION APPROVED BY: �j / 2 / -'YY C/ Plans Examiner Engineer Zoning Chc 12/15/03 ITEM BATH TUB UNIT FEE ITEM SWITCH OUTLETS UNIT FEE ITEM SPACE HEATERS UNIT FEE BIDET LIGHT OUTLETS CENTRAL HEATING DISHWASHER RECEPTACLES A/C (WIND) DISPOSAL SERVICE TEMPORARY A/C (CENTRAL) DRINKING FOUNTAIN SERVICE SIZE IN AMPS DUCT WORK FLOOR DRAIN SERVICE REPAIR/1ETER CHANGE REFRIGERATION GREASE TRAP APPLIANCE OUTLETS PROCESS AND PRESS PIPING INTERCEPTOR RANGE TOP UNDERGROUND TANKS LAVATORY OVEN ABOVE GROUND TANKS LAUNDRY TRAY WATER HEATER U.F. PRESSURE VESSELS CLOTHES WASHER MOTORS 0- 1 HP STEAM BOILERS SHOWER MOTORS OVER 1- 3 HP HOT WATER BOILERS SINK, POT /3 COMP. MOTCRS OVER 3- 5 If MECHANICAL VENTILATION SINK, RESIDENCE MOTORS OVER 5- 8 HP TRANSPORTING ASSEMBLIES SINK, SLOP MOTORS OVER 8- 10 HP ELEVATORS/ESCALATORS TEMQORARY WATER CLOSET MOTORS OVER 10- 25 HP FIRE SPRINKLER SYSTEMS URINAL MOTORS OVER 25-100 HP COOLING TOWERS WATER CLOSET MOTORS OVER 100 HP VIOLATION INDIRECT WASTES - A/C WINDOW REINSPECTION WATER SUPPLY TO: AIR CONDITIONERS • A/C UNIT STRIP HEATER FIRE SPRINKLER GENERATORS TRANSFORMERS • HEATER -NEW INST. GENERATORS TRANSFORMERS HEATER - REPLACE GENERATORS TRANSFORMERS LAWN SPRINKLER -WELL SPECIAL PURPOSE SWIMIIING POOL OUTLETS CC ERCIAL WATER SERVICE SIGN TUBES SEWER CONNECTIONS SIGN TRANSFORMERS UTILITY -SEWER SIGN TIME CLOCK UTILITY -WATER F I XTI,RES SEPTIC TANK ANTENNA RELAY TELEVISION OUTLETS 4' TILE/RES. VIOLATION P INFIELD, ABANDON SEPTIC TANK REINSPECTION SOAKAGE PIT CU. FT. CATCH BASIN DISCHARGE WELL DOMESTIC WELL AREA DRAIN ROOF INLET SOLAR WATER HEATER FIRE STANDPIPE POOL PIPING LAWN SPRINKLER SYSTEM GAS RANGE METER SET (GAS) GAS PIPING • ADDENDUM TO BUILDING PERMIT APPLICATION (AN APPLICATION FOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. IF A MASTER PERMIT HAS B. OBTAINED, THE OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.) PLUMBING ELECTRICAL MECHANICAL STATE OF FLORIDA DEPARTMENT OF HEALTH ONSITE SEWAGE TREATMENT filE1114 CONSTRUCTION PERMIT THIS PERMIT IS NOT FOR AN ADDITION. EM CENTRAX #: 13 -SG -2323 DATE PAID: FEE PAID : $ RECEIPT . OSTDSNBR : 04 -4182 -R CONSTRUCTION PERMIT FOR: Innovative Other [ - ]New System [ ]Existing System [ ]Holding Tank [ [ X )Repair [ ]Abandonment [ ]Temporary [ NA ] APPLICANT: De Molyneux, James & Crawfor AGENT: RF0037205, Hernandez Luis PROPERTY STREET ADDRESS: 309 NE 99 St Miami FL 33138 LOT: 15 BLOCK: 40 SUBDIVISION: Miami Shores Section [Section /Township /Range /Parcel No.] PROPERTY ID #: 11- 3206 - 013 -5490 [OR TAX ID NUMBER] S \, TEM MUST BE CONSTRUCTED IN ACCORDANCE WITH SPECIFICATIONS AND STANDARDS OF CHAPTER 64E -6,FAC DEPARTMENT APPROVAL OF SYSTEM FACTORY BASIS FORFOISgUNANCEFOF THIS S PERMITC REQUIRE TIME EQ. ANY CHANGE IN OAT ERUIRMITE EN APPLICANT TO MODIFY THIS PERMIT BEING MADE NULL AND OID. COMPLIANCE WITH OTHER FEDERAL, STATE OR LOCAL PERMITTING REQUIRED FOR PROPERTY DEVELOPMENT. SYSTEM DESIGN AND SPECIFICATIONS T [ 1050 ]Gallons SEPTIC TANK A 1 0 ]Gallons N [ 0 ]GALLONS GREASE INTERCEPTOR CAPACITY K [ 0 ]GALLONS DOSING TANK CAPACITY [ 0 ]GALLONS © [0 ]DOSES PER 24 HRS # PUMPS[ 0 ] D [ 400 1SQUARE FEET PRIMARY DRAINFIELD SYSTEM R [ 0 ]SQUARE FEET FILLED [ N ]MOUND [ N ] . A TYPE SYSTEM: [ '�/ )STANDARD [ N ] I CONFIGURATION: [ f ]TRENCH [ \/ 1BED [ N ] N F LOCATION TO BENCHMARK: Existing Finished Floor Elev.: 12.00 Ft NGVD I BOTTOMION OF PROPOSED TO BE S ITE [ 2.4 1 BENCHMARK/REFERENCE 1 FEET ] [ BELOW] BENCHMARK /REFERENCE POINT E BOTTOM OF DRAINFIELD T D FILL REQUIRED: [ 0.0 ]INCHES EXCAVATION REQUIRED: [ 42.0 ] INCHES MULTI - CHAMBERED /IN SERIES: [Y ] MULTI - CHAMBERED /IN SERIES: [Y ] OTHER REMARKS: 1.•Install 400 sq. ft. of drainfield in bed configuration. 2.. Install' 12" of slightly limited soil under the bottom of drainfield• proposed absortion 3. Perimeter of excavation area shall be at least 2 ft. wider than the p ro P bed. appropriate and a solid 4. Existing 1050 gal. septic tank to be inspected for an a propriate pump - vertical deflector installed on the outlet device. 5. Invert elevation of drainfield to be no less than 7.60' NGVD. 6. Bottom of drainfield elevation to be no ; s M than 7.10' T NGVD. A °'GETION(S) THE SEPTIC TANK SH21 e" _ s=i.'.I; r AN1 A SOLID QEFLECT10t1 DEVicE INSIALLFD :ii T14E (JUTLEI TEE TITLE: SPECIFICATIONS BY: Icaza, Carlos . CHD APPROVED BY: Icaza, Carlos TITLE: Engineer I Dade EXPIRATION DATE: 3/16/05 DATE ISSUED: 12/16/04 OH`401 03/97 (Obsoletes previous editions which may not be used) . -. ,,..m.,er_._ 6744- 001 - 401.6 -0) [ostas_cons ao16 -i) Page 1 of 2 NOTICE OF COMMENCEMENT A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME � OF FIRST INSPECTION 3 ` 7 PERMIT NO. TAX FOLIO NO. /1' 06 - ©13 STATE OF FLORIDA: COUNTY OF MIAMI -DADE: THE UNDERSIGNED hereby gives notice that improvements will be made to certain real property, and in accordance with Chapter 713, Florida Statutes, the following information is provided in this Notice of Commencement. 4. Contractor's name and address: '7a3Q )'?cal �� • �av»l �L X3/66 5. Surety: (Payment bond required by owner from contractor, if.arAy) Name and address: Amount of bond $ 6. Lender's name and address: 9. Expiration date of this Notice of Commencement: (the expiration 'fferent date is sp ci (A la/ 1 k. eCli k W.l.`�- gnature Owner Print Owner's Name 1A VA , A A N - X1.-1. r° m Sworn to and subscribed b t _ day of r OFFICIAL NOTARY SEAL ARILYS VALDEZ OTARY :, ST TE OF FLORIDA 1 �,�, , id V . DDI40143 C • . • XP. uu, 7. two Notary Public rale Print Notary's Name My commission expires: 123.01 -52 PAGE 4 8/02 ARVFY R-tt w. 11111111111111111111111111113111111111111111 CF NI 2005R00n2149 DR L'.k 22961 Ps 4522; (1Ps) RECORDED 01/03:2005 11:54:39 HARVEY RUVII'4, CLERK. OF COURT 1IIAMI -DADE COUNTY, FLORIDA LAST PAGE 1. Legal descriptioA of pro erty and street/address: 0 /V L q PL 3313?. if ovv i s See 1 AMI /J-j'(7 7310P t 40 2. Description of improvement: 0- 4 1 0 -`70 3. Owner(s) n me and addres : 0 N Interest in property: 400 t 6 rQ l n Name and address of fee simple titleholder: circuit an i. iYJnfY 0 5 7. Persons within the state of Florida designated by Owner upon whom notice ther documents may be served" provided by Section 713.13(1)(a)7., Florida Statutes, Name and address: 8. In addition to himself, Owners designates the following person(s) to receive a copy of the Lienor's Notice as provided in Section 713.13(1)(b), Florida Statutes. Name and address: date is 1 year from the date of recording unless a Prepared by / U 15 OU 11 l (1 D num6vL C 6 Addr s: 3 q - � � tavn v 331 h .I: Z'3ls'ti► /:Z?l Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Printed: 12/28/2004 Applicant: JAMES DE MOLINEUX Owner: REX CRAWFORD JOB ADDRESS: 309 NE 99 Contractor LUIS QUALITY PLUMBING Local Phone: 305 - 553 -7155 Parcel # 1132060135490 Signed: (INSPECTOR) Signed: (Contractor or Builder) Plumbing Permit Permit Number: PL2004 -363 REX CRAWFORD JAMES DE MOLINEUX ST Contractor's Address: 7939 N. W. 64 ST. Page 1 of 1 Legal Description: MIAMI SHORES SEC 1 AMD PB 10 -70 LOTS 15 & 16 & W1/2 17 BLK 40 LOT SIZE Fees: FEE2004 -13168 FEE2004 -13170 FEE2004 -13172 FEE2004 -13173 FEE2004 -13174 FEE2004 -13175 Description Building Fee CCF Training and Education Fee Technology Fee Scanning Fee Builders Bond Total Fees: Amount $175.00 $1.80 $0.80 $4.37 $3.00 $300.00 $484.97 Total Fees: $484.97 Total Receipts: $484.97 Permit Status: APPROVED Permit Expiration: 6/18/2005 Construction Value: $3,500.00 Work: DRIANFIELD 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. BY: Miami Shores Village 10050 NE 2nd Avenue Phone: 305- 795 -2204 Permit Number: PL2004 -363 Printed: 12 /28/2004 Applicant: JAMES DE MOLINEUX Owner: REX CRAWFORD JOB ADDRESS: 309 NE 99 Contractor LUIS QUALITY PLUMBING Local Phone: 305 - 553 -7155 Parcel # 1132060135490 Permit Status: APPROVED Permit Expiration: 6/18/2005 Construction Value: $3,500.00 Work: DRIANFIELD Signed: (INSPECTOR) Plumbing Permit REX CRAWFORD JAMES DE MOLINEUX ST Contractor's Address: 7939 N. W. 64 ST. Page 1 of 1 Legal Description: MIAMI SHORES SEC 1 AMD PB 10 - 70 LOTS 15 & 16 & W1/2 17 BLK 40 LOT SIZE Fees: FEE2004 -13168 FEE2004 -13170 FEE2004 -13172 FEE2004 -13173 FEE2004 -13174 FEE2004 -13175 Description Building Fee CCF Training and Education Fee Technology Fee Scanning Fee Builders Bond Total Fees: Amount $175.00 $1.80 $0.80 $4.37 $3.00 $300.00 $484.97 Total Fees: $484.97 Total Receipts: $484.97 P4 /D 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 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Printed: 12 /28/2004 Applicant: JAMES DE MOLINEUX Owner: REX CRAWFORD JOB ADDRESS: 309 NE 99 Contractor LUIS QUALITY PLUMBING Local Phone: 305 - 553 -7155 Parcel # 1132060135490 Signed: (Contractor or Builder) Plumbing Permit Permit Number: PL2004 -363 REX CRAWFORD JAMES DE MOLINEUX ST Contractor's Address: 7939 N. W. 64 ST. Permit Status: APPROVED Permit Expiration: 6/18/2005 Construction Value: $3,500.00 Work: DRIANFIELD BY: Page 1 of 1 Legal Description: MIAMI SHORES SEC 1 AMD PB 10 -70 LOTS 15 & 16 & W1/2 17 BLK 40 LOT SIZE Fees: FEE2004 -13168 FEE2004 -13170 FEE2004 -13172 FEE2004 -13173 FEE2004 -13174 FEE2004 -13175 Description Building Fee CCF Training and Education Fee Technology Fee Scanning Fee Builders Bond Total Fees: Amount $175.00 $1.80 $0.80 $4.37 $3.00 $300.00 $484.97 Total Fees: $484.97 Total Receipts: $484.97 44 /0 2 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. LOT t mumum.moimmiaftwismwomm.mmmum=mmmmmamm CRECKID (X] Intl, ARS NOT IN CONPLIANCS NITS STATUTE:OR 7:717 AND'INUST St CORRICTSD: APPLICANT: -, • AGENT X., (1 7-L. /714 • • • -- • PRopsin =miss, DENIRTNENT - or 'MALTS TRIDIT 110, DINOSRL..SYSTRN CONSTRUCTION rksisacTrox amp FINAL APPROVAL •• • : . • r lT n; . , ONSITI MAGI =RA TANN (01] (02) (03) (04) (05) (06] (07] (OS] (09) 514/C58 I RS I n,VAIR A INSTALLATION TANK Slit (I) Oa (2] MAIM MATERIAL OUTLAST =VIC/ - MULTI-CRAM/RID cx,/ II 1 OUTIAT FILTER LIMISND et-e.lefL4..„ _ - wATuarimme LEVEL IMPTX TO LID e• DRAINFIXLD INSTALLATION [10 ] AREA 11]... 1213 c.-SQ11T (11) DISTRIBUTION 101 *NADIR 6-e"'" (12) NUMBER OF DRAINLINtS f-e ( 13 ) DRUMLINS SZPARATION ‘• • (14) (15) DEP= OF COVZR/Z (16) ILWATIOt (A5ov54W4!!!ETAsm [17] [12) DOSING PUMPS [ 19 ] FLOORAGATE SI „r" (20) AGORSGATi IXcUJIVI PUhil ' [21] AGGRXGATX osrma/ 1 DRAINLINS SLOPS FILL / XXCAVATIOINATERIAL (22] FILL AMOUNT..2 [23] FILL =TUN' [261 SICAVATION DMZ (25) AREA =LC = 126 ] RXPLACSKENT NKTIGLIA,L BIPLAMTION or VIOLATIONS /' =au= t ` • • CONSTRUCTION ( / DI SAPPROVZ411 • ?MAL SYST16tpPRO / SAPPROVID ] DX 4016, 10/97 (Previous..1ditionsNarte Utod) Installer / Contractor PROMS= ID fis c7: cKD A)) C. CHD PNEUFT 110.03eK • oats - lc? - F11 PAID . iNCIIPT •:, " •. ■NME.1■....;■••■ . . SNTBACXS (27] sftram wawa. jr/"3. [111 DITC11I rT (29) PRIVATI Eiiiir77777777747-777-4,T. (30] PUBLIC WILLS /7 PT (31] ,zatioariativizzas •' 7 • •; . 132] POTARLS WATER LIKES _,:"•<7 FT (33] .BUILDINGAPPOUNDATIONCPT. (36] PROPERTY LIMNS Fr (33] • • ?ILIAD / MOUND-SYSTEWc (36) DRAINFIRLD COVER [37) SSOULDSRS. (38] SLOPES (39] sTAXILIEATION ADDITIONAL unrosmaTioN -;-'•-• • (40) monsTRocTso ARIA (41] sToslowsnAtumorr• [42] ALAI= [43) NAINTNNANCN AGRKKKAINT 144) soxyar ANSA (45) LOCAT/lie (661 FINAL SITS OWING 1a71 ccormumTpoR • • • (641) oTput Ahasoommarz 3. (49) ' NE PUMP= j4 ] [30] TAW CRUSXBD DA= DATEI Paws 2 of 3 B =B II 1 Septic Tanks • Grease Traps 6 Drain Fields • Sewer JBl Cleaning CC /0000652 • Stale Certified • Septic Tank Contractor P.O. Box 612333 • North Miami, Florida 33261.2333 Phone: (305) 5585818 FACSIMILE TRANSMISSION Date: l 0 3 Please deliver t ese documents immediately to: SEPTIC & ORAIN. INC To: J Jl_0 Of: 1' J: Giii25. Fax # v ) From: Dade (305) 558 -5818 Brow (954) 920 -5099 Fax (305) 893 -0270 # Of Pages Including Cover Sheet MESSAGE: 1 '24 Hour Service M Licensed & Insured" MIAMI SHORES VILLAGE BUILDING DEPARTM ' 305- 795 -2204 Building Inspection Request Date 14 (1S l�v Type Insp'n i 'v1 14- Giln'18 �nCi vt i"��� Permit No. ?t- V 3 0 3 Name D YY1-O 1 T 'ln 2 V2 . Address 309 N L- sT Company e)010 r i e a 1 6 (?���, `, Phone # a - 5Sg 8 1 Inspection Date 1 2 /10 I O 3 Approved Correction Re- Insp'n Fee Date Type Insp'n Permit No. Name Address Company Phone # Inspection Date Approved Correction Re-Insp'n Fee MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Buildi g I i spection Request J BUILDING PERMIT APPLICATION FBC 2001 Permit Type (circle): Building Electrical ame (Fee Simple Titleholder) er's Address 3o "/ Ti /0,6, City ) t S g Tenant/Lessee Name b" Job Address (where the work is being done) City Miami Shores Village Is Building Historically Designated YES Contractor's Company Name Contractor's Address City Qualifier Architect/Engineer's Name (if applicable) $ Value of Work For this Permit Type of Work: ❑Addition ❑Alteration Describe Work: 4 1 Scanning $ Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 County -D de Phone NO ) ) t) J -4.)CP, hone Permit No. 1 NI Master Permit No. Mechanical Zip Phone # RECEIVED DEC 1 2 208 Roofing 3'57.6 Square Footage Of Work: 5G 54 Submittal Fee $ 4 %(0 • 19 • Permit Fee $ I 1 S • 00 * * * * * * * * * * * * * * * * * * * * * ** F ees * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Notary $ 5 • OD • Training/Education Fee s ► (n0 . Radon $ CCF $ k • x 0 Technology Fee $ 4-37 7 BondS app. Code Enforcement $ Structural Plan Review. $ Total Fee Now Due $ 461e? . (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 such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature NOT Sign: rent: Chc 10/14/03 Owner or Agent g / The foregoing instrument was acknowledged before me this) The foregoing instrument was acknowledged before me this 1 -, day of R.- , 2003, by , day of who is personally known to me or who has produced As identification and who did take an oath. n My Commission Expires: Signature NOTARY PUBLI Sign: Print: , 2c , by T1 'CI r 1110,1 , My Commission Expires: Contractor who is personally known to me or who has produced identification and who did take an oath. iaDen DD gciS (Certificate of Competency Holder) c. State Certificate or Registration No. Certificate of Competency No. *** * * * * * * * * * * * * * * * * * * * * * * * * *** * * ** APPLICATION APPROVED BY J l / • / 3 Plans Examiner Engineer Zoning ******************************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** 12/11/2003 14:55 3055133472 CONSTRUCTION PERMIT FOR: System [ ]Holding Tank ( 1 Innovative Other [ )New System [ 1 Existing Y [ 51 ]Repair [ ]Abandonment [ ]Temporary ( NA 1 APPLICANT: MoiYneux, James D. AGENT: SR0921116, PARILLA ROBERT PROPERTY STREET ADDRESS: 309 NE 99 St Miami Shores FL 33138 SUBDIVISION: Miami Shores No. 1 [Section /Township /Range /Parcel No.) PROPERTY ID #: 11- 3206-013-5490 [OR TAX ID NUMBER] LOT: 15 SPECIFICATIONS BY: Andre. Paul APPROVED 6Y: Andre, Paul Ow 4016, D3/97 CENTEAX 4: 13 -80 -18 STATE OF FLORIDA DATE PAID: LH ON S IT SEW AGE OF TEE A T TM E , T AND DISPOSAL SYSTEM FEE PAID : $ pNI_W TREATMENT MI` RECEIDT CON9T]tUCTION PERMIT OSTDSNER : 03-3774- -IR BLOCK: 40 OSTDS FAGE 01 STANAARDS OF CHAPTER 64E-6,FAC SYSTEM MUST BE CONSTRUCTED IN ACCORDANCE WITH SPECIFICATIONS �AND SPECIFIC TIME PEERIODMENT R. AN YPCH°NGE IN MATERIAL FACTSTWHICCH SERVED BASIS F R OF THIS PERM'I'T, N THIS REQUIRE THE APPLICANT TO DO SUCH THE?PPLIUCATIFROM COMPLIANCE L= I BEING WITH OTHER AND COMPLIANCE WITH OEER FEDERAL• STATE OR LOCAL PERMITTING REQUIRED FOR PROPERTY DEVELOPMENT. SYSTEM DESIGN AND SPECIFICATIONS T [ 900 ]Gallons SEPTIC TANK A ( 0 ]GallcnS N [ 0 ]GALLONS GREASE INTERCEPTOR CAPACITY K ( 0 ]GALLONS DOSING TANK CAPACITY [ 0 1GALLONS B [0 ]DOSES PER 24 HRS 4 PUMPS[ 0 1 D 300 ]SQUARE FEET PRIMARY DRAINFIELD SYSTEM M R [ 0 1 SQiJARE FEET FILLED A TYPE SYSTEM: [ N ]STANDARD ( N N ) BED T. CONFIGURATION: 1 N ]TRENCH F LOCATION TO BENCHMARK; Existing Finished Floor Ele N '•:12.1 Ft BELOTF ]BENCHMARK /REFERENCE POINT I ELEVATION OF PROPOSED SYSTEM SITE [ 2.1 1 [ FEET ] [ E BOTTOM OF DRAINFIELD TO BE [ 4.6 ] [ FEET ] 1 BELOW] BENCHMARK /REFERENCE POINT D FILL REQUIRED :i 0.0 ]INCHES EXCAVATION REQUIRED: [ 42.0 ] INCHES OF V ? [i V DATE ISSUED: 12/11/ Qr ptE.MOL (Obsolete! previou editions which tnny net }e %iced) ,5744.nri- a ^_16 -01 I1 do corm MULTI- CHAMBERED /IN SERIES: rY ] MULTI - CHAMBERED /IN [ ] M 0 1 ND [ N ] [ N 1 SERIES: IY 1 OTHER REMARKS: 1.Inatall 900 gallons Septic tank cat 4 w/ an approved outlet filter 2.Inatall 300 avers feet Dreir.field in bad configuration. 3.2uvert elevation of the drainfiald to be no lees than 8.00 ft NGVD 4.Bottom elevation of the drainfiald to be no leas than 7.50 ft NGVD 5.The licence accordance contractor inta11in system i m eeponsible for installing the minimum thank capacity THIS PERMIT I3 NOT FOR ADDITION. TITLE: AA TI'T'LE: professional Engirt Dade CHD - :. ^ ,.; " T1ON DATE: 3/10/04 Far :Vc •- r. • y Pace 1 cf 2 TU3 UNIT FEE ITEM UNIT SWITCH OUTLETS FEE ITEM 1.14 SPACE HEATERS IT FEE LIair OUTLETS CENTRAL HEAT IIG ASHER RECEPTACLES A/C (WIND) SAL SERVICE TEMPORARY A/C (CENTRAL) :ING FOUNTAIN SERVICE SIZE IN AMPS DUCT WORK 1 CRAIN SERVICE REPAIR/YETER CHANGE REFRIGERATION ;E TRAP APPLIANCE OUTLETS PROCESS AND PRESS PIPING ;CEPTCR RANGE TOP UNDERGROUND TANKS TORY OVEN ABOVE GROUND TANKS :(Y TRAY WATER HEATER U.F. PRESSURE VESSELS fiS WASHER MOTORS 0- 1 FP STEAM BOILERS ER MOTORS OVER 1- 3 FP HOT WATER BOILERS POT /3 COMP. MOTORS OVER 3- 5 FP MECHANICAL VENTILATION • , RESIDENCE MOTORS OVER 5- 8 If TRANSPORTING ASSEMBLIES , SLOP MOTCRS OVER 8- 10 HP ELEVATORS/ESCALATORS CRARY WATER CLOSET MOTCRS OVER 10- 25 If F IRE SPRINKLER SYSTEMS 'Ai MOTORS OVER 25-100 FP COOLING TOWERS R CLOSET MOTORS OVER 100 1P VIOLATION RECTiWA &TEAS A/C WINDOW RE INSPECT ION :R SUPPLY TO: AIR CONDITIONERS 'C UNIT STRIP HEATER IRE SPRINKLER GENERATORS TRANSFCI RS :ATER -NEW INST. GENERATORS TRANSFERS :ATER- REPLACE GENERATORS TRANSFORMERS km SPRINKLER -WELL SPECIAL PURPOSE 11U4411C POOL OUTLETS COMMERCIAL VIER SERVICE SIGN TUBES :R CONNECTIONS SIGN TRANSFORMERS .ITY -SEWER SIGN TIME CLOCK .ITY -WATER / FIXTLRES TIC TANK ✓ ANTENNA 1Y TELEVISION OUTLETS INFIELD, 4' TILE/RES. ' VIOLATION & ABANDON SEPTIC TANK REIISPECTION (AGE PIT DJ. FT. ,1 BASIN a ARGE WELL EST IC WELL • A DRAIN _ • F INLET 1 AR WATER HEATER ' .. E STANDPIPE L PIPING • N SPRINKLER SYSTEM —� . RANGE ER SET (GAS) PIPING . ADDENDUM TO BUILDING PERMIT APPLICATION APPLICATION FOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. IF A MASTER PERMIT E.AS B. 'AIMED, .THE OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.) PLUMBING ELECTRICAL MECHANICAL Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Printed: 12 /15/2003 Applicant: JAMES DE MOLINEUX Owner: REX CRAWFORD JOB ADDRESS: 309 NE 99 Contractor BOBS SEPTIC & DRAIN INC Local Phone: 305 - 558 -5818 Parcel # 1132060135490 Signed: (INSPECTOR) Plumbing Permit Permit Number: PL2003 -342 Permit Status: APPROVED Permit Expiration: 6/9/2004 Construction Value: $2,500.00 Work: REPLACE SEPTIC TANK AND DRIANFIELD Contractor's Address: 1020 NE 130 ST REX CRAWFORD JAMES DE MOLINEUX ST Page 1 of 1 Legal Description: MIAMI SHORES SEC 1 AMD PB 10 -70 LOTS 15 & 16 & W1/2 17 BLK 40 LOT SIZE Fees: FEE2003 -8234 FEE2003 -8235 FEE2003 -8236 FEE2003 -8237 FEE2003 -8238 FEE2003 -8239 Description Builders Bond Building Fee CCF Notary Fee Training and Education Fee Technology Fee Total Fees: Amount $300.00 $175.00 $1.80 $5.00 $0.40 $4.37 $486.57 Total Fees: $486.57 Total Receipts: $0.00 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: I' Type Insp'n Permit No. Name Address Company Phone # MIAMI SHORES VILLAGE BUILDING DEPARTMEN 305- 795 -2204 Building Inspection Request Date I Ti ate For Inspector: / ` ( o Approved Correction Re-Insp'n Fee o ,k,-,-k,e-, Miami Shores Village Building Department 10050 N.B.2nd'Avenue, Miami Shores, Florida 33138 Tel: (305) 795 Fax (305) 756.8972 BUILDING Permit No. L 2 2006 PERMIT APPLICATION ' Master Permit No FBC 2004 Permit Type (circle): Building { +leetrical Plumb . + Meckanical Owner's Name (Fee Simple Titleholder) Tl 44Dy1. E T' Phone # d� • Owner's Address 3 b�, ' y t 413- � Av4... City ■ M-1 Safe) State L Zip 33 7 2 Tenant/Lessee Name Phone # Job Address (where the work is being done) /CP) Ng /''7 5 - City Miami Shores Villa'ae FOLIO / PARCEL It 11 3 Is Building Historically Designated YES NO Contractor's Company Name /4/Z LLQ sr6 / , e $E!(4,4m, Phone # 30 �'g © Contractor's Address 6 ,2'z �f , $ . by. j9„� if i/se City ?e7riggf. -e- Pr /ve S tate ,GG • Zip S 4 Qualifier Name C . M 965 7V9 Phone 0 3 S- - 0 , 0947 State Certificate or Registration No. e °,. j am_`. L 1 9-31 Certificate of Competency No. C #' C 0,5'6 9 Architect/Engineer's Name (if applicable) � + G l� L'7� " Phone 0 Value of Work For this Permit $ 4 700 Type of Work: Addition lAlteraton Describe Work: (on 3A, County . Miami -Dade Zip g3); 013 s Squ ONew rkYiO f .rmi eeesr s him ■vaa t 000aPtt 4 OI wa-s ik upwt ow come ' .Mac ' Roofing Notary $ Training/Education Fee Technology Fee Scanning $ Radon $ DPBR $ Zoning $ Bond $ Code Enforceit $ Double Fee $ Structural Review. $ Total Fee Now Due $ See Reverse side -+ inear Footage Of Work: Submittal Fee $ Permit Fee $ CCF $ CO/CC 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 $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Afo, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which o curs seven 7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be ap ed and a,reinspe ction fee will be charged. Signature wner or Agent l The foregoing instrument was acknowledged before me this 2 '! day of i , 4/A .! by DM who is p sonally kn Sign: Print: NOTARY PUBLIC: My Commission Expires: a * * * * * * * * * * * * * * * * * * * * * * * * ** * fix 1 APPLICATION APPROVED BY: (Revised 02/08/06) As identification and who did take an oath. me or who has produced HIi N.N..$NSioi• SEAN BRITT * * *APPMFAAglk* Expires 1 000 Bonded thru, 000)432 Fbride Ndtary /7 Engineer Signature Contractor The foregoing instrument was acknowledged before me this day of Ape-1 L- , 20 ap by who is personally known to me or who has produced as identification and who did take an oath. NOTARY P June 2Z 2007 BONDED THRU TROY FAIN iNaJKV, &t. mt. Sign: lCei '.` ( Print: Maria Rodriguez My Commission Expires: **** i*************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** (Plans Examiner Zoning Issue Date: 5/4/2006 Owner's Name: CARRIE MUTTER Permit Type: Plumbing - Residential Work Classification: Gas Job Address: 309 99 Street NE Additional Information Miami Shores Village, FL 33138- Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Fax: (305)756 -8972 Permit Expires: 10/23/2006 Contractor(s) Phone Primary Contractor ALL CLOGBUSTERS OF BROWARC 305 - 490 - 4926 Yes Comments: NEW UNDERGROUNG GAS TANK TO SUPPLY A NEW GENERATOR Type of Work: GAS LINE Additional Info: GAS TANK Classification: Residential Type of Piping: Bond Return : 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 zoning. Futhermore, I authorize the above -named contractor to do the work stated. Building Department File Copy Applicant Signature Parcel #: Block: Section: Permit Status: APPROVED Permit Number: PL -4 -06 -1068 Phone: (305)790 -1480 1132060135490 Lot: PB: Total Square Feet: 0 Total Valuation: $ 900.00 Required Inspections Press Test ROW Final Fees Due CCF Education Surcharge Permit Fee - Additions /Alterations Scanning Fee Total: Amount $0.60 $0.20 $160.00 $3.00 $163.80 Invoice Number PL - 5 - 06 - 24709 Total: Amt Due $163.80 Amt Paid NOTICE: In addition to the requirements of this permit, there may be additional restrictions applicable to this property that may be found in the public records of this county. AND THERE MAY BE ADDITIONAL PERMITS REQUIRED FROM OTHER GOVERNMENTAL ENTITIES SUCH AS WATER MANAGEMENT DISTRICTS, STATE AGENCIES, OR FEDERAL AGENCIES. FEATURES • ••• • • • • • • • • • • • •• • • • • • • • • • • • • • • • • • • • ••• • • • • • • • • • • • • • ••• • • • •. • • • • • • • •• • •• • • • • • • • • • • • • • • • • • •• • • • • • • • • • ••• • • • • • • • • • • Q• 0 6 . •• •• • • • •• ••• •• • • StandbyPodver Ra�tirm :: • • • • • 25 kW 60 Hz STANDARD EQUIPMENT • All input connections in one single area • High coolant temperature shutdown • Low oil pressure shutdown • Low coolant level automatic shutdown • Overspeed automatic shutdown • Crank timer • Exercise timer • Oil drain extension • Cool flow radiator • Closed coolant recovery system • UV /Ozone resistant hoses • Innovative design and fully prototype tested • UL2200 Listed • Solid state frequency compensated voltage regulator • Dynamic and static battery charger • Sound attenuated acoustically designed enclosure • Quiet test for low noise level exercise • Acoustically designed engine cooling system • High flow low noise factory engineered exhaust system Liquid Cooled Gas Engine Generator Sets GENERAC 2.5L ENGINE • Watertight state of the art electrical connectors • Mainline circuit breaker • Radiator drain extension • Battery charge alternator • 2 Amp static battery charger • Battery and battery cables • Battery rack • Fan and belt guards • Isochronous governor Naturally Aspirated Gaseous Fueled • State of the art digital control system with R100 digital control panel • Watertight electrical connectors • Rodent proof construction • High efficiency, low distortion Generac designed alternator • Vibration isolated from mounting base • Matching Generac transfer switches engineered and tested to work as a system • All components easily accessible for maintenance • Electrostatically applied powder paint GENERAC® POWER SYSTEMS, INC. • • • • • • • • • ••• • • • • • • • • • • • • ••• • • • • ••• • • • • •. • • • • • • • • • • • • • • • • • • • • •. • APPLICATION & ENG1NF RFNG' MX' 11••$ ! 11 1111 • • ••• • • • GENERATOR SPECIFICATIONS • • • • • • • ••• • • TYPE �• •�•....r...•...�........r• syDchronous ROTOR INSULATION •... .;....•.....••....•....•.'..... • :ass H STATOR INSULATION • • • • • • • ••• • • Class H TOTAL HARMONIC DISTORTION <3.5% TELEPHONE INTERFERENCE FACTOR (TIF) <50 ALTERNATOR OUTPUT LEADS 3 PHASE 4 wire BEARINGS Sealed Ball COUPLING Flexible Disc LOAD CAPACITY (STANDBY RATING) 25 kW EXCITATION SYSTEM Direct NOTE: Generator rating and performance In accordance with 1S08528 -5, BS5514, SAE J1349, 1S03046, and D1N6271 standards. VOLTAGE REGULATOR TYPE Electronic SENSING Single Phase REGULATION t 1% FEATURES V/F Adjustable Adjustable Voltage and Gain LED Indicators GENERATOR FEATURES ❑ Revolving field heavy duty generator ❑ Directly connected to the engine ❑ Operating temperature rise 120 °C above a 40 °C ambient ❑ Insulation is Class H rated at 150 °C rise ❑ All models are fully prototyped tested CONTROL PANEL FEATURES 0 SEVEN LED INDICATOR LIGHTS ❑ ADDITIONAL FUNCTIONS • System ready • Utility sensing • Low fuel pressure • Delay on utility failure for engine start • Low battery • Engine warm -up before transfer • Low oil pressure • Delay to retransfer to utility • High coolant templlow coolant temp • Engine cooldown timer • Overspeed • Exerciser not set • Overcrank ❑ INTERNAL FUNCTIONS: • 3 position switch (auto, off and manual) • 2 wire start for any transfer switch • Communicates with the Generac RTS transfer switch • Built -in 7 day exerciser • Selectable engine speed at exercise • Governor controller is built into the master control board • Temperature range -40 °C to 70 ° C ENGINE SPECIFICATIONS MAKE Generac MODEL In line CYLINDERS 4 DISPLACEMENT 2.5 Liter BORE 3.78 STROKE 3.40 COMPRESSION RATIO 9.4:1 INTAKE AIR SYSTEM Naturally Aspirated VALVE SEATS Replaceable LIFTER TYPE Solid O.H.C. GOVERNOR SPECIFICATIONS TYPE Electronic FREQUENCY REGULATION Isochronous STEADY STATE REGULATION + 0.25 ADJUSTMENTS Speed Yes Droop Yes ENGINE LUBRICATION SYSTEM OIL PUMP Gear OIL FILTER Full flow spin -on cartridge CRANKCASE CAPACITY 4 Quarts ENGINE COOLING SYSTEM TYPE Closed WATER PUMP Belt driven FAN SPEED 2090 FAN DIAMETER 16 inches FAN MODE Pusher FUEL SYSTEM FUEL TYPE Natural gas, propane vapor CARBURETOR Down Draft SECONDARY FUEL REGULATOR Standard FUEL SHUT OFF SOLENOID Standard OPERATING FUEL PRESSURE 5" - 14" H2O ELECTRICAL SYSTEM Rating definitions - Standby: Applicable for supplying emergency power for the duration of the utility power outage. No overload capability is available for this rating. (All ratings in accordance with BS5514, IS03046 and 01N6271). (All ratings in accordance with BS5514, IS03046, IS08528 and DIN6271). QT025 BATTERY CHARGE ALTERNATOR 12V 30 Amp STATIC BATTERY CHARGER 2 Amp RECOMMENDED BATTERY Group 26, 525CCA SYSTEM VOLTAGE 12 Volts • ... • • • ... .. .. • • • .. .. • • • • • • • • • • • • • ... • • • • • • • • • • • • • ... • • • • ... • • • •. .. QT025 • .• • . • • • •• 1 1" 1 4' 1 1 1 1 1 1 OPERATING DATA "' • GENERAC® POWER SYSTEMS, INC. RATING: All three phases units are rated at 0.8 power factor. All single phase units are rated at 1.0 power factor. STANDBY RATING: Standby ratings apply to installations served by a reliable utility source. The standby rating is applicable to varying loads for the duration of a power outage. There is no overload capability for this rating. Ratings are in accordance with ISO - 3046 -1. Design and specifications are subject to change without notice. KW rating is based on LPG Fuel and may derate with natural gas. QT025 KW RATING ••• • • • •• ••• •• 25 • ENGINE SIZE • • • • • • • • • • • • • GENERATOR 2.5 Liter 4 -cyl inline OUTPUT VOLTAGE/KW - 60Hz KW AMP CB Size 120/240V, 1- phase, 1.0 pf 25 104 125 120/208V, 3- phase, 0.8 pf 25 85 100 GENERATOR LOCKED ROTOR KVA AVAILABLE Cal VOLTAGE DIP OF 35% Single phase or 208 3 -phase 40 480V 3 -phase 50 ENGINE FUEL CONSUMPTION (Natural Gas) (Propane) Natural Gas Propane (ft' /hr.) (gal /hr.) cu ft/hr Exercise cycle 60 0.65 24 25% of rated load 140 1.53 56 50% of rated load 220 2.40 87 75% of rated load 300 3.27 119 100% of rated load 380 4.15 151 ENGINE COOLING Air flow (inlet air including alternator and combustion air) ft /min. 1,438 System coolant capacity US gal. 3.0 Heat rejection to coolant BTU /hr. 95,000 Max. operating air temp. on radiator °C ( °F) 60 (150) Max. ambient temperature °C ( °F) 50 (140) COMBUSTION AIR REQUIREMENTS Flow at rated power 60 Hz cfm 75 SOUND EMISSIONS IN DBA Exercising at 7 meters 58 Full load at 7 meters 69 EXHAUST Exhaust flow at rated output 60 Hz cfm 227 Exhaust temp. at muffler outlet °F 1,000 ENGINE PARAMETERS Rated synchronous RPM 60 Hz 1800 HP at rated KW 60 Hz 40 POWER ADJUSTMENT FOR AMBIENT CONDITIONS Temperature Deration 3% for every 10 °C above - °C 25 1.65% for every 10 °F above - °F 77 Altitude Deration 1% for every 100 m above - m 183 3% for every 1000 ft. above - ft. 600 • ... • • • ... .. .. • • • .. .. • • • • • • • • • • • • • ... • • • • • • • • • • • • • ... • • • • ... • • • •. .. QT025 • .• • . • • • •• 1 1" 1 4' 1 1 1 1 1 1 OPERATING DATA "' • GENERAC® POWER SYSTEMS, INC. RATING: All three phases units are rated at 0.8 power factor. All single phase units are rated at 1.0 power factor. STANDBY RATING: Standby ratings apply to installations served by a reliable utility source. The standby rating is applicable to varying loads for the duration of a power outage. There is no overload capability for this rating. Ratings are in accordance with ISO - 3046 -1. Design and specifications are subject to change without notice. KW rating is based on LPG Fuel and may derate with natural gas. INTERCONNEdTIbNS ••• Ground Level Concrete Slab EXHAUST MUFFLERS ENCLOSED WITHIN O • • .• •• • • • • • • • • • • • • • • • •• • • • •• • • ••• • • • • • • • • • • • • • • • • • • • ••• • • • • Battery Charger Input Xfer Sw Input FUEL LINE CONNECTION 3/4• NPT FEMALE COUPLING • • •.. • • • ••• • •• • • • • •• •• • • • • • • • • • • • • .. • • • .. ••• •• •. MI;nOlcbtpre; ZQ 25 QT • • • • • • • • • • .. • • • • • ••• •• GENERAL 8 00000ao R100 CONTROL PANEL INSTALLATION LAYOUT 71 37 LEFT SIDE VIEW 111 GENERATOR CONNECTION BOX 00 VISE ACTION LATCH, ONE PER DOOR, ONE LIFT -OFF DOOR PER SIDE OF GENERATOR Ref Dwg OF7555 35.7 1 CIRCUIT BREAKER SIZE KW VOLTS / AMPS LUG SIZE 20 240 1 0 90 #6 to 1/0 20 208 3 0 80 #6 to 1/0 Concrete Slab Transfer Switch To Generator Control Panel �29�{ QT025 1 � REAR VIEW GENERAC° POWER SYSTEMS, INC. • P.O. BOX 8 • WAUKESHA, WI 53187 262/544 -481 1 • FAX 262/544 -4851 Bulletin 017141 OSBY / Printed in USA 03.05, Rev. 08.05 ® 2005 Generac Power Systems, Inc. All rights reserved. All specifications are subject to change without notice. • ••• • • • ... • .. • • • .. .. • • • • ... • • • • • • • • • • • • ... • • • • .. • RT$. pitAo0i4fic Transfer Switch 100,- 4 00 . Amps 600 VAC 100 - 400 Amp RTS NEMA 3R • 100 AMP TRANSFER SWITCH This 100 amp Transfer switch has an integrated load center for picking up the emergency circuits. It is especially useful where the main service is large and only a portion of the building load will be served by the generator. Internal point to point wiring for the generator connection and the 12 circuits from the main distribution point are included. DESCRIPTION Generac RTS automatic transfer switches are designed to operate with the Generac R -100 control used on the 1.5, 2.5, 3.0 and 3.9 liter QT series gaseous generators. The transfer switches are UL 1008 listed for standby operation. STANDARD FEATURES The standard 100 - 400 amp transfer switch is housed in a steel NEMA 3R enclosure, with electrostatically applied powder paint. The Heavy Duty contactor is a UL recognized device, designed for years of service. The connection between the RTS and the Generator control is 7- # 14 wires. The service entrance rated transfer switches have a UL listed Mainline circuit breaker ahead of the transfer switch for full downstream protection. 200 AMP HUB SWITCH The 200 amp hub switch comes complete with a 200 amp meter socket and built in wiring harness for quick and easy installation. The switch is also service entrance rated with a 200 amp mainline circuit breaker installed and wired. Generator and load center conduits and wiring are not included. GENERAC® POWER SYSTEMS, INC. Amps 100 100 100 200 200 400 400 Voltage 1201240, 10 120/240,1 o 120/208, 3o 277/480, 3e 120/2,0, o 120/240, 10 120/208, 3o 277/480, 3o 201240, 10 120/240, lo 120/208, 3e 277/480, 3e Load Transition Type (Automatic) Open Transition W/12 Cir. Ld. Ctr. Open Transition Open Transition Ser. Ent. Rated Open Transition Open Transt Ser. Ent. Rated Open Transition Open Transition Enclosure Type NEMA 1 NEMA 3R NEMA 3R NEMA 3R NEMA 3R A 3R NEMA 3R Express Install Kit Included Yes No No No No No ' , No Withstand Rating (Amps) 10,000 10,000 10,000 10,000 10,000 18,000 ' 18,000 Lug Range 2/0 - #14 400 MCM - #4 600 MCM - #4 or 2250 MCM Extemal Dimensions (H" x W" x D ") 120/240,10 &120/208,30 277/480, 30 27 13x7 24x20x7 36 x 24 x 10 24x13x7 20x15x7 24x13x7 36x24x10 48x30x Unit Weight (Ibs.) 30 26 42 48 50 95 105 • • FUNCTIONS • •• • • • • • • • • • •• • • ••• • • • • • Utility voltage drop -•ut• • • Timer to generator start • • • • SPECIFICATIONS ••• • • • • • • • •• • • • • • • • • • • • • •• • • • • • • • •••••• • TYPICAL CONNECTION •• • • • • • ••• All Timing and sensing functions originate 1n the R•100 controller• • • • • •• • • • • • . • • • • The transfer switch can be operated manually without power applied. Generator RTS N1 N1 N2 N2 Neutral Neutral 23 23 194 194 RTS 100 -400 Amp Transfer Switch <60% 15 seconds Engine warm up delay 10 seconds Standby voltage sensor •.•... ... • ..• ••.• •• 90% Utility voltage pickup '• �.•�...�...�.. �...�...� • ' • >80% Re- transfer time delay • • ' ' 1 " • ' 15 seconds Y •...�...•........•...•...•...• • Engine cool -down time? • • • • • • • • • • • 60 seconds Exerciser 15 minutes every 7 days GENERACm POWER SYSTEMS, INC. • P.O. BOX 8 • WAUKESHA, WI 531 87 262/544 -481 1 • FAX 262/544 -4851 Bulletin 0171320SBY / Printed in USA 03.05 © 2005 Generac Power Systems, Inc. All rights reserved. All specifications are subject to change without notice. RECEIVED NOV 1 0 2003 Total Fee Now Due $ 1.3 1 s 1 0 (Continued on opposite side) Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 BUILDING PERMIT APPLICATION FBC 2001 Permit Type (circle): Building Electrical Plumbing Mechanical Roofing Owner's Name (Fee Simple Titleholder) r+ 4 m iS V Owner's Address V /V '= 5 9 S i y f City gfl / ShSIR[% State l I Tenant/Lessee Name Zip Job Address (where the work is being done) 0429 4" / 5S City Miami Shores Village County Miami -Dade Is Building Historically Designated YES NO V Contractor's Company Name PV IIE `S Ph/ M /3 //1) Contractor's Address )71 ` ti) /a 3 P1, Cit /V' 'Q' /' State f� Qualifier ( 1 / 19/2 / � p U ` l /7 , 7 Permit No. 2;(16-30s Master Permit No. q/ 70 4 3.s,.r3 Phone # NV' -'? — 7 " Zip Phone it ( ey z Zip o 3 / J' 3 Architect/Engineer's Name (if applicable) Phone # S Value of Work For this Permit Square Footage Of Work: Type of Work: Addi 'on ❑Alteration :New ❑ Repair/Replace ❑ Demolition Describe Work: , J T Q--00/7/ q3 / 7) 0 / 7 / / 7- Ng . - 7.V 7C . --. -.5/f/ Cf/ t_ IS6ci. Submittal Fee $ SO CO Permit Fee $ 1 CCF$ Notary $ Training/Education Fee $ Technology Fee $ Scanning $ Radon $ Bond $ Code Enforcement $ Structural Plan Review. $ Signature Signature aet, 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 such posted notice, the inspection will not be approved and a reinspection fee will be charged Owner or Agent The foregoing instrument was acknowledged before me this day of . 20 _, by , day of // , 20 03, by Palk s who is personally known to me or who has produced who i ersonally known to me or who has produced As identification and who did take an oath. The foregoing instrument was acknowledged before me this Contractor as iden i i cation and who did take an oath. NOTARY PUBLIC: NOTARY PUBLI Sign: Sign: Print: Print: My Commission Expires: My Commission Expires: —ZL (Certificate of Competency Holder) State Certificate or Registration No. Certificate of Competency No. ******* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * APPLICATION APPROVED BY: Chc 10/14/03 ***************************** * * * * * * * * * * * * * * * * * * * *** * * * * * * * ** Plans Examiner Engineer Zoning • M H TUB UNIT .' FEE ITEM SWITCH OUTLETS UNIT FEE ITEM SPACE HEATERS UNIT FEE ET LIGHT OUTLETS CENTRAL HEATING ;WASHER RECEPTACLES A/C (WIND) ?OSAL SERVICE TEMPORARY A/C (CENTRAL) NKIHG FOUNTAIN SERVICE SIZE IN A.WS DUCT WORK :ce DRAIN SERVICE REPAIR/METER CHANGE REFRIGERATION :ASE TRAP APPLIANCE OUTLETS PROCESS AND PRESS PIPING :`RCEPTOR RANGE TOP UNDERGROUND TANKS IATORY 1 OVEN ABOVE GROUND TANKS BOY TRAY WATER HEATER U.F. PRESSURE VESSELS :THES WASHER MOTORS 0- 1 HP STEAM BOILERS )WER MOTORS OVER 1- 3 HP HOT WATER BOILERS X. POT /3 COMP. MOTORS OVER 3- 5 1P MECHANICAL VENTILATION NK, RESIDENCE MOTORS OVER 5- 8 IP TRANSPORTING ASSEMBLIES NK. SLOP MOTORS OVER 8- 10 HP [ ELEVATORS/ESCALATORS WORARY WATER CLOSET MOTORS OVER 10- 25 I'P FIRE SPRINKLER SYSTEMS. I HAL MOTORS OVER 25-100 HP COOLING TOWERS TER CLOSET l MOTORS OVER 100 HP VIOLATION DIRECT-WASTES A/C WINDOW REINSPECTION .TER SUPPLY TO: AIR CONDITIONERS A/C UNIT STRIP HEATER FIRE SPRINKLER GENERATORS TRANSFORMEERS • i HEATER -NEW INST. GENERATORS TRANSFORMERS i HEATER - REPLACE GENERATORS TRANSFORMERS LAWN SPRINKLER -WELL SPECIAL PURPOSE • SWIMMING POOL OUTLETS CONERCIAL WATER SERVICE SIGN TUBES WER CONNECTIONS SIGN TRANSFORMERS ILITY- SETTER 1 SIGN TIME CLOCK ILITY -WATER FIXT1J ES PTIC TANK ANTENNA LAY TELEVISION OUTLETS AINFIELD. 4' TILE/RES. VIOLATION MP & ABANDON SEPTIC TANK REINSPECTION !AKAGE PIT CU. FT. ,TCH BASIN SCHARGE WELL 'MESTIC WELL ?EA DRAIN ;CF INLET t • iLAR WATER HEATER `, IRE STANDPIPE OL PIPING - , 1'WN SPRINKLER SYSTEM LS RANGE :TER SET (GAS) LS PIPING ADDENDUM TO BUILDING PERMIT APPLICATION v APPLICATION FOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. IF A MASTER PERMIT HAS B. STAINED, THE OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.) PLUMBING ELECTRICAL MECHANICAL Miami Shores Village 10050 NE 2nd Avenue Printed: 11/12/2003 Applicant: JAMES DE MOLINEUX Owner: REX CRAWFORD JOB ADDRESS: 309 NE 99 Contractor PULLES PLUMBING COMPANY Local Phone: Parcel # 1132060135490 Signed: (INSPECTOR) Plumbing Permit Phone: 305 - 795 -2204 Permit Number: PL2003 -303 REX CRAWFORD JAMES DE MOLINEUX ST Contractor's Address: 8541 SW 133 PL Permit Status: APPROVED Permit Expiration: 5/8/2004 Construction Value: $2,400.00 Work: BATHROOM ADITION TOILET HAND SINK SHOWER Signed: (Contractor or Builder) BY: Page 1 of 1 Legal Description: MIAMI SHORES SEC 1 AMD PB 10 -70 LOTS 15 & 16 & W1/2 17 BLK 40 LOT SIZE Fees: Description Amount FEE2003 -7057 Building Fee $180.00 FEE2003 -7058 CCF $1.80 FEE2003 -7059 Training and Education Fee $0.60 FEE2003 -7060 Technology Fee $4.50 Total Fees: $186.90 Total Fees: $16 90 IS8 Total Receipts: $0.00 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. MIAMi SHORES VILLAGE BUILDIN INSPECTION DEPARTMEN APPLICATION FOR BUILDING PERMIT Application is hereby made for the approval of the det. sled statemen of the plans and specifications herewith submitted for the build- ing or o h. -ructure her 1 described This t t licatic is made in compliance and con-o m ty w•th the Building Ordinance of Mia ii Shores Villatie, or da, and all pro isions of the Laws e f the State of 1• Lrid. all o d nances ,,f Mi ni Shores Village and all rules and regu a -ion. of the Building Div.. i of •ram Sho. iilage 1 1 1 a , o. ipl.ed with, whether herein specified or not. A copy of approved plans and specificati .m must be ket at building durin progress of tl.e wcrk. Date Owner' Name and Address_____ No Street_ Registered Architect and /or Engineer._. Name nd address of licem,ed contractor. Disapproved _ Date (Signed) ____ Chairman Member _ ___ _ _ ______ _ Member Council Approved -- -- - - - - - -- - - - -- Location and legal description of lot to be built on: Lot. __ Block._ ___- Subdivision Street and Number where work is to be done. State work to be done and purpose of building (by floors) _ and for no other purpose. New Building _ Rernodeling ___ _ ._. Addition._.. _ _._ _.._ __ _ Repairs. _ No. of Stories To be constructed of __ _ _ Kind of foundation Roof Cov >ring._ Estimated T. :tal cost of improvements $__ - - -c - *00 Amount ce Permit $._. Zone ^ubage required __. _-Plan Cubage___. Distance to next nearest building_ - _ _ ___Size of Building Lot Maximum live load to be borne by each floor .. _____ ___ _. hereby submit all the plans and specirications for said building. All notices with reference to the building and its construction may be sent to The unde signed appli ant for th's budding permit does hereby certify t'rat he understands and accepts his .•bligations as an employer of 1 bor under he Florida Workmen's Compensation Act being S- -tion 5966 Coi p led Gen al Laws of Florida P r anon. S,ipph vent, and h s compl ed w he prov "cons thereof, and will require s.milar come lance from all contractors or sub - contractors emplo •ed by him in the wo k to be p rf -med under th s pern it and ill post or cause to be posted for inspection on the site of the work su :h public note e or •otires as are requir d by the Act. The u. d.r ign -d agrees to employ only such abcontr• ctors, on work to be perform d der this permit as are licensed by M am. Shores ' it : ge. Remarks ( Signed) - -- - - - - STATE OF FLORIDA, COUNTY OF DADE. j ss. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally Ap- peared and who, being by me first d. ly sworn, upon oath deposes and says that he is the of th abov de .c ibed istruction t. h has care' ally read the foreg ing application, and that he did sign the sane, and that all facts therein by him stated are tr ie. Permit No < - - $0 _ Date ___ '� _D� _� Read, Sworn to and Subscribed before me. Notary Public State of Florida Building n ector My Com:nission Expires ,19 to me well known, PLANNING BOARD DATE Member Member Member _ _ . .Date Disapproved Date NOTE: A charge of $1.00 will be made for making corrections or changes to this application tftrr approval his been obtained from the Plant' ng Board A re--inspection fee of $1.00 will be charged when such re- inspection is e necessary by improper notice for inspe :•t or fa• ity materials and /or workmanship. M±e'tweir� +�. 9 I MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Permit No. AV -/ Date . �R 5-3 Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted fo a building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village,. Florida and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Divisior of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept al building during progress of work. Owner's Name and Address - A. - - ..,S,1.-4. o No._._._____.. -_ ._ ._ ........ - - -. -.. Street _ Registered Architect and /or Engineer .__.___ . _..__ Employing Plumber's Name. _- - "' _. No ...__ - -- .___..___ Street.. _ -_ - -. Location and Legal Description Lot----- - - - -._ . ock_ ._.__ - _._ -.. Subdivision- L ------ __ - -_ -- y. Street and Number where work is to be performed —No'' _.>rc.. _. __ ___._ _ .. Street.- State work to be performed and purpose of building (By Floors ) _ _. New Building Remodeling ___ Addition Repairs No. of Stories Size Septic Tank 6 o .Type of Tank___ ___ Feet of Drain 'The -- - - -_ -- -- ; -- - - Dist. Feet of Tank or Drain Field from Well 0t� Nature of Water Supp : &Well . __._ - . Size of Soakage Pit_. Amount of Permit $. Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5986, Compiled General Laws of Florida Permanent Supplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub-contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such sub - contractors, on work to be performed under this permit, as en licensed by Miami Shores Village. (Signed) / 4 U _ __ -.._. Master Plumber. -,� k r ;" STATE OF FLORIDA, l as. , ( J COUNTY OF DADE. ( Before me, the undersigned authority, a n public, duly authorized to administer oaths and take acknowledgments, personally appeare to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all lac therein by him stated are true. NOTE: A re- inspection fee of $1.00 will be nade' when such re- inspection is made necessary by improper notice for inspection, or Lid materials a sd /or workmanship. My Commission Expires 47 S (Signed) Atli/ 'Capacity Cals. Notary Public, State of Florida CLOSET[ BATH TUBS SHOWER[ LAVA. TORIES SINK[ SLOP SINKS LAUNDRY Tugs URINALS I NA CATCH BASIN FLOOR DRAIN DRINKING FOUNT' NS TOTAL FIXTURIn - - CONTR. LIST 1 / 1 / I _ CHECK � LC ? J —' 7S Z' _ SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP . 011. 14 1AT1R WELL SPRKLR. SYSTEM SWIM 'G POOL (.0 Ci ILAA.,.. CONTR. LIST CHECK / / / j 0 f U J ` 3!� MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Permit No. AV -/ Date . �R 5-3 Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted fo a building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village,. Florida and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Divisior of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept al building during progress of work. Owner's Name and Address - A. - - ..,S,1.-4. o No._._._____.. -_ ._ ._ ........ - - -. -.. Street _ Registered Architect and /or Engineer .__.___ . _..__ Employing Plumber's Name. _- - "' _. No ...__ - -- .___..___ Street.. _ -_ - -. Location and Legal Description Lot----- - - - -._ . ock_ ._.__ - _._ -.. Subdivision- L ------ __ - -_ -- y. Street and Number where work is to be performed —No'' _.>rc.. _. __ ___._ _ .. Street.- State work to be performed and purpose of building (By Floors ) _ _. New Building Remodeling ___ Addition Repairs No. of Stories Size Septic Tank 6 o .Type of Tank___ ___ Feet of Drain 'The -- - - -_ -- -- ; -- - - Dist. Feet of Tank or Drain Field from Well 0t� Nature of Water Supp : &Well . __._ - . Size of Soakage Pit_. Amount of Permit $. Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5986, Compiled General Laws of Florida Permanent Supplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub-contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such sub - contractors, on work to be performed under this permit, as en licensed by Miami Shores Village. (Signed) / 4 U _ __ -.._. Master Plumber. -,� k r ;" STATE OF FLORIDA, l as. , ( J COUNTY OF DADE. ( Before me, the undersigned authority, a n public, duly authorized to administer oaths and take acknowledgments, personally appeare to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all lac therein by him stated are true. NOTE: A re- inspection fee of $1.00 will be nade' when such re- inspection is made necessary by improper notice for inspection, or Lid materials a sd /or workmanship. My Commission Expires 47 S (Signed) Atli/ 'Capacity Cals. Notary Public, State of Florida ' /� � ' / -_~`� ' � / / . "/( / . ^ ; ,, A 1 Passed ct r Comments Failed Correction Needed Re- Inspection Fee ($75) No Additional Inspections can be scheduled re- inspection fee is paid . until Inspection Date: 12/13/2006 Inspector: Levrack, James Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Owner: MUTTER, CARRIE Job Address: 309 99 Street NE WO Miami Shores Village, FL 33138- DEC L11f 1 3 u Project: <NONE> Contractor: ALL CLOGBUSTERS OF BROWARD Building Department Comments Tuesday, December 12, 2006 Block: CG7 Permit Type: Plumbing - Residential Inspection Type: Final Work Classification: Gas Phone Number (305)790 -1480 Parcel Number 1132060135490 Lot: Phone: 305 - 490 -4926 Page 1 of 2