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EL-05-324Miami Shores Village R Building Department EP 13 2 10050 N.E.2nd Avenue, Miami Shores, Florida 3313 Tel: (305) 795.2204 Fax: (305) 756.8972 BUILDING Permit No. EL 7--co5 w ,v,4 PERMIT APPLICATION .Master Permit No. FBC 2001 Permit Type (circle): Building Electrical Plumbing Mechanical �jG Roofing Owner's Name (Fee Simple Titleholder) JG- Phone # �OVJ / U 1 — OG 2,0 Owner's Address q, tic o U6 S CityMta� 1 �reS State 'PLO r 1 d ©► Zip Tenant/Lessee Name Phone # Job Address (where the work is being done) _ 3 2 5_ /V, rid .. N' C`` 2 T City Miami Shores Village County Miami -Dade Zip Is Building Historically Designated YES NO L____ Contractor's Company Name 14/ / (9va/,k Ot 1,5CIyict} .T'C Phone # 3 5- 961-%e 3 aZ Contractor's Address t< L% 5—l9 0 /i/, W. % 6 c City 1VliR•n State., Zip 2i 3 / 6 -7 Qualifier Q ✓! Ile 111-6oa/Ne. State Certificate or Registration No. ,4�14 Certificate of Competency No. d S Z� 000 y 7 e' Architect/Engineer's Name (if applicable) Phone # X $ Value of Work For this Permit �/r 0009 0 0 Square Footage Of Work: Type of Work: ❑Addition ❑Alteration &Iew Repair/Replace FI Demolition Submittal Fee $ Permit Fee $ 1t o • 00 CCF $ ©- (lei CO/CC Notary � Training/Education Fee $ 0. Z0 Technology Fee $ 2 •'5 . Scanning $ 3• GO Radon $ Code Enforcement $ Total Fee Now Due $ I N • 30 Zoning Bond $ Structural Plan Review. $ (Continued on opposite side) Bonding Company's Name (if applicable) Bonding Company's Address City State Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State Zip 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. X Signaturermrumentwwals- {� (� X Signature or Agent The foregoing a�k/nowledged before me this The foreg( dayoC<= , �, 2� b 1 �/ i1 Y day of G who is personally UDZ NOTARY Sign: Print to me or who has produced As identification and who who an oath. )D2319g4 NOTARY 13, 2007 S lau Co., Inc p Contractor Vh nt was acknowledged before me this 20 °r, b known to me or who has produced c as identification and who did take an oath. My Commisi on Expires: My Commission Expires: *RY P * * MY COMMISSION # 00 296450 EXPIRES: March 5, 2008 Borded Thru Budget Notary Services APPLICATION APPROVED Bye",��/* S'to/'!S ` Plans Examiner Engineer the 05/13/03 Zoning ADDENDUM' TO BUILDING PERMIT APPLICATION (AN A PLICATION 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 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 AFS DUCT WORK FLOOR DRAIN SERVICE REPAIR/METER 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 ►OTORS D- 1 FP STEAM BOILERS SHOWER MOTORS OVER 1- 3 FP HOT WATER BOILERS SINK, POT/3 CDMP. MOTORS OVER 3- 5 HP MECHANICAL VENTILATION SINK, RESIDENCE MOTORS OVER 5- 8 HP TRANSPORTING ASS56LIES SINK, SLOP MOTORS OVER 8- 10 HP ELEVATORS/ESCALATORS TEWORARY 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 SWIMMING POOL OUTLETS COMMERCIAL WATER SERVICE SIGN TUBES SEWER CONNECTIONS SIGN TRANSFORMERS UTILITY -SEWER SIGN TIME CLOCK UTILITY -WATER FIXTLRES SEPTIC TANK ANTENNA RELAY TELEVISION OUTLETS DRAINFIELD, 4" TILE/RES. VIOLATION PU'P & ABANDON SEPTIC TANK REINSPECTION SOAKAGE PIT CU. FT. CATCH BASIN DISCHARGE WELL DOMESTIC WELL AREA DRAIN RDOF INLET G SOLAR WATER HEATER i FIRE STANDPIPE ; POOL PIPING f LAWN SPRINKLER SYSTEM. I GAS RANGE , ! METER SET (GAS) GAS PIPIN' oR;s Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL rytNrRB'O �t0 1 Phone: (305)795-2204 Fax: (305)756-8972 Inspection Date: 12/27/2005 Inspector: Devaney, Michael Owner: FREDERIC, KETTLY Job Address: 9325 2 Court NW Miami Shores Village, FL Project: <NONE> Permit Type: Imported Permit Inspection Type: Underground Rough Work Classification: <NONE> Phone Number Parcel Number 1131010150380 I Block: Lot: Contractor: ALL QUALITY ELECTRICAL SERVICES, INC Phone: 306/968-7832 Buildina Department Comments Inspector Comments Passed l C) Failed � 0�e_ let��a� c Correction Needed Re -Inspection Fee ($75) No Additional Inspections can be scheduled until re -inspection fee is paid. Tuesday, December 27, 2005 Page 1 of 2 ,'"OL°REs Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL s °thrO F�OR[DP Phone: (305)795-2204 Fax: (305)756-8972 Inspection Date: 12/27/2005 Inspector: Devaney, Michael Owner: FREDERIC, KETTLY Job Address: 9325 2 Court NW Miami Shores Village, FL Project: <NONE> Contractor: ALL QUALITY ELECTRICAL SERVICES, INC Building Denartment Comments Permit Type: Imported Permit Inspection Type: Underground Rough Work Classification: <NONE> Block: Phone Number Parcel Number 1131010150380 Lot: Phone: 305/968-7832 Inspector Comments Passed El Failed Correction Needed Re -Inspection Fee ($75) No Additional Inspections can be scheduled until re -inspection fee is paid. Tuesday, December 27, 2005 Page 2 of 2 mAjew 20 -Tw ►3fr__ DO ti,tz LZ t2a5,ou-r ISSN