EL-02-290Date .� o 2. Job Address
State # G 5 06 ? Municipal #
Legal Description Historically Designated: Yes
Owner/Lessee/Tenet L art7/ �//i(r/Si', y'
Owner's Address J/3C4) Are ,2'
Contracting Co. $4I aox
Qualifier Odd J. • X0 4 /%l C7 C
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
10050 N.E. 2nd Avenue • Miami Shores, Florida 33138.305- 795 -2204
/66 iU cJ / /s
ss#
Square Ft. Estimated Cost (value)
Signature of owner and/or Condo President
FEES: PERMIT e c' RADON
Tax Folio
Master Permit # — O / / i6 S / Apoo" 1
Phone q41,..d. a ! < " --2
Address /23n it) /32 ,/Y N'°/a"v;' 3344
27 S ?/- V'Vr
Competency # `Ins. Co.
No
IF THERE IS NO PERMIT PACKAGE ACCESSIBLE ON THE JOB SITE FOR INSPECTORS TO VERIFY,
THERE WILL BE NO INSPECTION. RE- INSPECTION FEE IS $50.00 AND MUST BE PAID IN ADVANCE
BEFORE CALLING FOR ANOTHER INSPECTION.
Permit Type (circle one): BUILDING ELECTRICAL, PLUMBING MECHANICAL ROOFING
WORK DESCRIPTION: - 441,'7 •P Vd i Ct E b474 .c 6L1 7, ,
WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY RESULT IN
YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH
YOUR LENDER OR ANY ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.)
Application is hereby made to obtain a permit to do work and installation as indicated above, and on the attached addendum (if applicable). I certify that
all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits are required
for all disciplines.
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. Furthermore, I authorize the above named contractor to do the work stated.
Date Signature of tractor or Owner Builder Date
Mary Ann Parks
y � My Commission DD036455
Nap Sr ,s October 06, 2005
Notary as to Owner and/or Condo President Date Notary as to C Z, tractor or Owner Builder
My Commission Expires My Commission Expires
C.C4F :'l% ,� -� NOTARY
Date
BOND
APPROVED: TOTAL DUE 1� 0
Zoning Building Electric
Mechanical Plumbing Structural Engineer
®z_
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 MPS
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
MOTORS 0- 1 HP
STEAM BOILERS
SHOWER
MOTORS OVER 1 - 3 HP
HOT WATER BOILERS
SINK, POT /3 COMP.
MOTORS OVER 3- 5 HP
MECHANICAL VENTILATION
SINK, RESIDENCE
MOTORS OVER 5- 8 HP
TRANSPORTING ASSEMBLIES
SINK, SLOP
MOTORS OVER 8- 10 HP
ELEVATORS/ESCALATORS
TEMPORARY WATER CLOSET
MOTORS OVER 10- 25 HP
FIRE SPRINKLER SYSTEMS
URINAL ..
OVER 25-100 HP
COOLING TOWERS
WATER CLOSET
_
MOTORS OVER 100 FP
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
FIXTURES
SEPTIC TANK
_
,HENNA
'
RELAY
-TELEVISION OUTLETS
og3
DRAINFIELD, 4" TILE/RES.
..
VIOLATION
PUMP & ABANDON SEPTIC TANK
REINSPECTION
.
SOAKAGE PIT CU. Fj. •
-
Vo; ceil'�o , ,
/$3
CATCH BASIN
DISCHARGE WELL
DOMESTIC WELL
AREA DRAIN
ROOF INLET
SOLAR WATER HEATER
=IRE STANDPIPE
'COL PIPING
•
-AWN SPRINKLER SYSTEM
1AS RANGE
WATER SET (GAS)
AS 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
Miami Shores Village
10050 NE 2nd Avenue
Phone: 305 - 795 -2204 Permit Number: EL2002 -290
Printed: 9/6/2002
Applicant: BARRY UNIVERSITY
Owner: UNIVERSITY BARRY
JOB ADDRESS: 11300 NE 2 AVE
Electrical Permit
Page 1 of 1
Contractor BLACK BOX NETWORK SOLUTIONS INC Contractor's Address: 1230 SW 132 ND CT SUITE 11
Local Phone:
Parcel # 1121360000050
Legal Description: 36 52 41 40 AC SEI /4 OF NE1 /4 LESS E35FT & LESS W4OFT LOT SIZE 1740400
l, C'CC
Total Fees: $O:99
Total Receipts: $0.00
Permit Status: Approved Permit Expiration: 3/5/2003 Construction Value: $40,000.00
Work: INSTALLATION OF VOICE & DATA CABLING TO EACH ROOM
•
If there is no permit package accessible on the job -site for inspectors to verify, there will be no inspections. Re- inspection
fee is $50.00, which must be paid in advance before calling for another inspection.
This Permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the application herefor in strict compliance with all
ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans, drawings, statements or 'specifications that may have been submitted to
and approved by the proper municipal authorities. This Permit may be revoked at any time if the work is not 'done in compliance with such ordinances or if the plans are changed without
authorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the
ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes responsibility for work done
by his agents, servants or employees.
Signed:
SPECTOR) BY:
In consideration of e Issuance to e 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, drawi r gs, statemen 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 age rvants or em
Sign (Contractor or Builder) BY:
BLACK BOX
`O
Network Services
12115 28TH STREET NO., ST. PETERSBURG, FL 33716
PHONE (727) 571 -4144
PAY of p t /414"z0 caJ h L7
TO THE N.. F ./1 / ..t i� ,c- S
ORDER N � V �/
OF
•
• Three Mellon Bank Center
Pittsburgh, PA
il'03648011' 404330/60W 076m76230
Mellon 6 433 0 NO. 0 3 6 4 8 0
AMOUNT
1
CHEC • OVER $10,000.00 REQUIRE TWO SIGNATURES.
CHECKS OVER $100,000.00 REQUIRE THREE SIGNATURES.
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