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EL-3-07-460�s!°P;ry Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138-0000 ^F��t„�.� Phone: (305)795-2204 Permit NO. EL-3-07-460 P m t Permit Type: Electrical - Residential e r m Work Classification: Addition/Alteration Permit Status: APPROVED Issue Date: 3/12/2007 1 Expiration: 09/08/2007 Project Address Parcel Number Applicant 833 NE 96 Street 1132060142800 PATSY KNOX Miami Shores Village, FL 33138- Block: Lot: Owner Information Address Phone Cell — PATSY KNOX 833 NE 96 ST MIAMI SHORES FL 33138-2521 Contractor(s) Phone Cell Phone INDUSTRIAL ELECTRICAL SYSTEM C 305/228-1384 Type of Work: ELECTRICAL Additional Info: REPAIR/REPLACE Classification: Residential Fees Due Amount CCF $1.20 Education Surcharge $0.40 Permit Fee - New Construction $150.00 Scanning Fee $3.00 Technology Fee $3.75 Total: $158.35 Total Amt Paid $ 0.00 $ 0.00 yment Type: )1#* 2 8 PAID [Valuation: $2,000.00 otal Sq Feet: 0 L] Amt Due $ 0.00 4vailable Inspections: I Inspection Type: W rice Change erground Rough :r Box Alarm 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 Authorized Signature: Owner / Applicant / Contractor / 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. Building Department Copy March 12, 2007 AND THERE MAY BE ADDITIONAL PERMITS REQUIRED FROM OTHER GOVERNMENTAL ENTITIES SUCH AS WATER MANAGEMENT DISTRICTS, STATE AGENCIES, OR FEDERAL AGENCIES. Monday, March 12, 2007 1 Miami Shores Village S� Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 BUILDING PERMIT APPLICATION FBC 2004 Permit Type: Electrical MApk �0 8 2007 f ..�hhl: --------- Permit No. Master Permit No., oal,2�� et�f !zc 7 -y28 3 jblo'1 Owner's Name (Fee Simple Titleholder) RkL)yQo L�. NrnoriQkeS Phone# (7$6)Z'Si6 5,4-75 Owner's Address - A33 0 F_ 96 S'wer-A City State Flerit�e. Zip [15Mg1 331,68 Tenant/Lessee Name Phone # E-MAIL: ,( . Job Address (where the work is being done) $3-A, "P ot 6 Saven-k City Miami Shores Village County Miami -Dade Zip (�3�ps1 33)38 POLIO / PARCEL # 113-L066i42800 Is Building Historically Designated YES NO� Contractor's Company Name Contractor's Address IeJ5 city J1 Qualifier Name State Certificate of Architect/Engineer's Name (if applicable) Value of Work For this Permit $ 4 7Z5 Type of Work: Describe Work: ❑Alteration zip 33/72, Phone # 0d.6- z?, Certificate of Competency No. dVd Square / Linear Footage Of Work: EM El Submittal Fee $ Permit Fee $ CCF S 1.90 CO/CC o Notary $ Training/Education Fee $ - Technology Fee $ 3 -- 0 Scanning $ 3-M Radon $ DPBR $ Zoning $ Bond $ Code Enforcement Structural Review. $ Double Fee $ _ Total Fee Now Due $ I rJg' See Reverse 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 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 thisjurisdiction. 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 S2500, 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. S Signature =7--3'.se •D/a// Signature L aD,%L/ Owner or Agent Contractor The fore''g//oing instrument was acknowledged before me this v The foregoing instrument was acknowled ed b fore /me this day of N , 206a, by /7 L //F/tcl/ ��% �� / S, day of W&04 2007 by who is personally known to me or who has produced As identification and who did take an oath. NOTARY PUBLIC: Sign: Print: My Commission (Revised 02/08/06) FRANC13Ch who is personally known to me or who has produced identification and who did take an oath. NOTARY PUBLIC: Sign: Print: v/GXJ Engineer Zoning ADDENDUM TO BUILDING PERMIT APPLICATION AN APPLICATION FOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. IF A MASTER PERMIT HAS BEEN OBTAINED, THE OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS. PLEASE CIRCLE O DISCIPLINE APPLIED FOR: PERMIT # PLUMBING ELECTRICAL MECHANICAL ITEM UNIT FEE ITEM UNIT FEE ITEM UNIT FEE BATH TUB SWITCH OUTLETS SPACE HEATERS DISHWASHER LIGHT OUTLETS ICENTRAL HEATING DISPOSAL RECEPTACLES A/C (WIND) FLOOR DRAIN SERVICE TEMPORARY A/C (CENTRAL) GREASE TRAP ISERVICE SIZE IN AMPS DUCT WORK INTERCEPTOR ISERVICE REPAIR/METER CHANGE IREFRIGERATION LAVATORY JAPPLIANCE OUTLETS 1PROCESS AND PRESS PIPING LAUNDRY TRAY I RANGE TOP JUNDERGROUND TANKS CLOTHES WASHER 1OVEN JABOVE GROUND TANKS SHOWER IWATER HEATER U.F. PRESSURE VESSELS SINK. POT/3 COMP. IMOTORS 0-1 HP STEAM BOILERS SINK, RESIDENCE. MOTORS OVER 1-3 HP HOT WATER BOILERS SINK, SLOP. MOTORS OVER 3-5 HP MECHANICAL VENTILATION TEMPORARY WATER CLOSET MOTORS OVER 5-8 HP ITRANSPORTING ASSEMBLIES URINAL MOTORS OVER 8-10 HP ELEVATORS/ESCALATORS WATER CLOSET IMOTORS OVER 10-25 HP. FIRE SPRINKLER SYSTEMS INDIRECT WASTES MOTORS OVER 25-100 HP COOLING TOWERS WATER SUPPLY TO: MOTORS OVER 100 HP VIOLATION A/C UNIT A/C WINDOW REINSPECTION FIRE SPRINKLER AIR CONDITIONERS HEATER -NEW INST. ISTRIP HEATER HEATER -REPLACE IGENERATORS TRANSFORMERS LAWN SPRINKLER -WELL IGENERATORS TRANSFORMERS SWIMMING POOL IGENERATORS TRANSFORMERS WATER SERVICE ISPECIAL PURPOSE SEWER CONNECTIONS OUTLETS COMMERCIAL UTILITY -SEWER SIGN TUBES UTILITY -WATER SIGN TRANSFORMERS SEPTIC TANK SIGN TIME CLOCK RELAY IFIXTURES FAINFIELD, 4" TILE/RES. JANTENNA PUMP & ABANDON SEPTIC TANK ITELEVISION OUTLETS SOAKAGE PIT CU. FT. VIOLATION CATCH BASIN REINSPECTION DISCHARGE WELL DOMESTIC WELL �j 0 AREA DRAIN ROOF INLET SOLAR WATER HEATER FIRE STANDPIPE POOL PIPING LAWN SPRINKLER SYSTEM j. GAS RANGE ., METER SET (GAS) 4 GAS PIPING S yHoaEs��`y Inspection Worksheet F� Miami Shores Village ��-n//Q'� m 10050 N.E. 2nd Avenue Miami Shores F� 2 J =sus — v F/.GRID P' Phone: (305)795-2204 Fax: (305)756-8972 nspection Number: INSP-42516 Permit Number: EL-3-07-460 Inspection Date: 04/1012007 Permit Type: Electrical - Residential Inspector: Devaney, Michael Inspection Type: Underground Rough Owner: KNOX, PATSY Work Classification: Addition/Alteration Job Address: 833 96 Street NE Miami Shores Village, FL 33138- Phone Number Parcel Number 1132060142800 Project: <NONE> Block: Lot: Contractor: INDUSTRIAL ELECTRICAL SYSTEM CORP Phone: 305/228-1384 Building Department Comments REPLACE 200 AMO RELOCATE RANGE RECEPTACLE, ADD SERVICES DISCONECT TO AHU AND A/C COMPRESSOR APR 1 1 2007 Inspector Comments Passed � �(. � ��y�/l C � I S �� Failed �9/{ Correction Needed Re -Inspection ❑ Fee ($75) No Additional Inspections can be scheduled until re -inspection fee is paid. Monday, April 9, 2007 Page 2 of 2 w:. 'b, ' ; $ SNoncsy`� Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 frMA2Y nspectionNumber: INSP-42522 Permit Number. EL-3-07-460 Inspection Date: 08/01/2007 Permit Type: Electrical - Residential Inspector: Devaney, Michael Owner: KNOX, PATSY Job Address: 833 96 Street NE Miami Shores Village, FL 33138- Project: <NONE> Inspection Type: Final Work Classification: Addition/Alteration Block: Phone Number Parcel Number 1132060142800 Lot: Contractor: INDUSTRIAL ELECTRICAL SYSTEM CORP Phone: 305/228-1384 Buildina Denartment Comments REPLACE 200 AMO RELOCATE RANGE RECEPTACLE, ADD SERVICES DISCONECT TO AHU AND A/C COMPRESSOR AUG 0 2 2007 Passed Inspector Comments cc Failed Correction Needed Re -Inspection ❑ Fee ($75) No Additional Inspections can be scheduled until re -inspection fee is paid. Tuesday, July 31, 2007 Page 2 of 2