EL-02-358Q
Pay To
The Order Of
For " �—
Miami Shores Village
10050 NE 2nd Avenue
Phone: 305 - 795 -2204
Printed: 11 /1/2002
Applicant: BARRY UNIVERSITY
Owner: STUDENT UNION
JOB ADDRESS: 11300 N MIAMI
Contractor BORRELLFIRE SYSTEMS
Local Phone: 954- 791 -9003
Parcel # 1121360000040
Total Fees:
Total Receipts: $0.00
Permit Status: Approved Permit Expiration: 4/30/2003 Construction Value: $10,000.00
Work: Installation of an fm200 fire supression system for a computer 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 advanna hnf.......- =- - pection.
LA-
P.D.Q. PERMITTING SERVICES, INC.
PH. 954- 321 -8586
6416 EMERALD LAKE DRIVE
MIRAMAR, FL 33023
FIRST UNION NATIONAL BANK
FIRSTUNION.COM
ORG. 003 R/T 087008432
00
Ott
1:0670064321:200000 2 76 3644V 3775
Legal Description:
Date — O'
Electrical Permit
Permit Number: EL2002 -358
^
� V Dollars L'J
STUDENT UNION
BARRY UNIVERSITY
AVE
Contractor's Address: 3811 SW 47 AVE STE 611
BY:
Page 1 of 1
tall the equipment or device described in the application herefor in strict compliance with all
ice with any plans, drawings, statements or specifications that may have been submitted to
rk is not done in compliance with such ordinances or if the plans are changed without
'tractor or builder named above assumes the responsibility for a thorough knowledge of the
Swings or in the statements or specifications and that he assumes responsibility for work done
r in compliance with all ordinances and regulations pertaining thereto and in strict conformity
ores Village. In accepting this permit I assume responisibility for all work done by either
BY:
CONTRACTOR
- Name /� / 5T �+ n�
�(I`� L F� /2g 31 ei 7 sJ' , is Uc
License NI). gig / �` y► D - /„
J 7
Address 7� 5 , z Q c /
7 five -- S - f . 1
F4-.Mw. PC. 333/4
Telephone 95e/ 7q/ 9ao3Fax l'5 711 o �f
1
Qualifier Name gfi LW g - RDA
PROPERTY OWNER
Name
CDR64 Oat" MONO CDIR4 a n¢ OP Pohl fn4
Address i 1 zoo N 6 QNd A U6
PhtAMI 3140264
Home Telephone
Business Telephone 30 5 4,4 - 3'74
Fax 3 - 8`1 - 37
TYPE OF MANAGEMENT (✓ )
New Construction
Enclosure
Alteration Exterior
I
Repair
Alteration Interior
Demolish
Relocation of Structure
Shell Only
Foundation Only
Add'l Attachment
Other
Add'I Detachment
Other
INSTRUCTIONS - The following steps must be taken to obtain a permit from the Miami Shores Village:
Step 1.
x Job Address:
Complete the attached permit application which must be signed la the property owner and qualifier. Both signatures must be notarized. Please
print or type to allow for a more accurate processing of your application. If roofing work will be done, a roofing application must be submit-
ted along with this permit application.
Step 2. Submit the completed application with all necessary documents to the Building, Planning and Zoning Department for processing. During the
processing of your application, you may be asked to submit additional information.
APPLICATION
Address
G AQ AJ6R WAX. 24)0 PL Co
Folio Number f 1- MG - aka - 0o50
1
Apt.
Lot Block
Subdivision PB PG
Current Use of Property
Proposed Use of Property
Tenant Information
PERMIT TYPE (✓ )
Building
Electrical
Mechanical
Plumbing
LPGX
Roofing
Fence
Other
PERMIT CHANGE (✓ )
Chg. Contractor
Renewal
Revision
Extension
Supplement
Reinspection
PERMIT APPLICATION
Master Permit No. b 01 C t 1
Subsidiary Permit No.
4 t0 -
MI '
City State Zip
es,
De cription of Work 1111STAtt,AI R4200 ON OF JAN
Fi RE SufPRESSiow sYGTEM Foe. A ComPuTER toM
Linear Feet
Zoning
Square Feet Units Floors
Value of Work
Bldg Value
61
Tax Assessed/Appraised Value
Flood Zone Base Floor Elev.
ENGINEER
Name
License No.
Address
Telephone
Fax
Page 2
IMPORTANT NOTICES
1. DO NOT BEGIN ANY WORK WITHOUT HAVING RECEIVED YOUR VALIDATED PERMIT AND PERMIT CARD. Applying for a permit does not grant
the right to begin construction. HOURS OF CONSTRUCTION are limited to: Monday through Friday from 7:30 a.m. to 6:00 p.m., and Saturday from 8:00 a.m.
to 5:00 p.m. No inspections will be conducted on weekends or holidays.
2. All construction of demolition areas MUST BE MAINTAINED IN A CLEAN, NEAT AND SANITARY CONDITION free from construction debris.
3. STREETS AND NEIGHBORING PROPERTIES SHALL BE KEPT FREE FROM DIRT AND DEBRIS.
4. SWALES MUST BE PROTECTED FROM BEING DAMAGED BY EQUIPMENT OR VEHICLES, AND MAY NOT BE USED FOR STORAGE. A bond is
required for work in or near the street/sidewalk.
5. CONSTRUCTION TRAILERS ARE PROHIBITED ON SINGLE FAMILY RESIDENTIAL CONSTRUCTION SITES. Other construction may have a trailer
which requires a separate permit.
6. PORTABLE TOILETS for a construction site require a separate permit.
7. DO NOT DISCHARGE WATER INTO THE RIGHT OF WAY OR STORM DRAINS without approval from the Building, Planning and Zoning Department.
8. EQUIPMENT AND MATERIALS SHALL BE STORED at least 10 feet from the edge of pavement.
9. Department of Health and Rehabilitative Services (HRS) approval is required for applications involving septic tanks. Department of Environmental Resources
Management (DERM) and/or Miami -Dade Water and Sewer Department (MDWASD) approval is required for applications involving sewers.
AFFIDAVIT - Please read carefully.
Application is hereby made to obtain a permit to do work and installation as indicated. I, the OWNER of the property, 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 ELECTRICAL, PLUMBING, POOL, EXTERIOR DOOR, MECHANICAL, WINDOW, FENCE, DRIVEWAY,
ROOFING and SIGNS and there may be additional permits required from other governmental agencies.
I, the OWNER of the property, have disclosed all information related to any work at the property performed in the prior twelve
months to the Building Official. Further, I am fully aware that if the cumulative cost of work to my home or business under this and
any other permit equals or exceeds fifty percent (50 %) of the fair market value of the structure, the entire structure must meet the
present federal flood criteria for finished floor elevation. I am also fully aware that if the total cost of work to my home or business
under this and any other permit exceeds fifty percent (50 %) of the replacement cost of the structure, then the entire structure must
conform to the current code requirements of the Building Code.
WARNING TO OWNER: Your failure to record a NOTICE OF COMMENCEMENT may result in you paying twice for
improvements to your property. If you are spending more than $2,500 or intend to obtain financing, you may wish to consult with
your attorney or lender before recording your Notice of Commencement. The Notice of Commencement must be recorded at:
22 N.W. 1st Street, 1" Floor, (305) 679 -1078. Once recorded, the Notice of Commencement must be POSTED AT THE JOB SITE in
accordance with Section 713 -35 of Florida Statutes. Review the brochure at Vi 1 on Construction Lien Law and
Choosing a Contractor.
STATE OF
CCyQ.EV N AMMO/10
Print Name
Sworn to and subscribed before me this 2 day of
2002 .
. 7,�.
a p S 0 1 116MONICA ACEVEDO SOTO
MY COMMISSION # CC 841281
s1 EXPIRES: May 31, 2003
1 = r OTARY Fla Notary SeMoa & Boring Co.
otary Pub
SEAL:
of Owner
Personally known
RIDA, COY OF MIAMI-DADE
OR, Produced Identification
Type of Identification Produced:
STATE % O % i ��: _ • MIAMI-DADE
.fie A, e
MI t
Print Name �L
® d subscribed before me this ti. U day of
Signature of Notary PubupnState age& R Bush
Is Commission #DD125160
�. Bo nded T6rn July 13, 2006
AF ,�o Atlantic BondingC0.,11IC.
SEAL:
Personally known
k■B P a t
PERMIT APPLICATION
•
OR, Produced Identification
Type of Identification Produced:
ELECTRICAL
TYPE
Minimum Fee
QTY.
TYPE
Dryer
QTY.
TYPE
Outlet, Appliance
QIY.
TI 'PE
Service Repair
Q"I"Y.
A/C Central 1 -3 Ton
Fan
Dryer Vents, Number of
Outlet, Wall
Ventilation, Cost
Service, Temporary
Air Handler, Tons
A/C Central 4-7 Ton
A Piping, Flammable Liquid
Fire Pump
Outlet, Switch
Fire Sprinkler System
Signs
A/C Central 8 -15 Ton
Bath Fan - Vented, #
Fixture - Fluorescent
Pressure Vessel
Oven
Space Heater (kw)
A/C Central 16-20 Ton
Fixture Light
Parking Lot Lights
Spas/Hot Tubs
A/C Central 20+ Ton
Flood Lights
Plugmold/Strip
Subfeeds, No. of Amps
A/C Wmdow
FPL - Load Central
Posts
Swim Pool, Commercial
Air Conditioners
Garbage Disposal
Range/Range Top
Swim Pool, Residential
Chiller
Generators, etc.
Receptacles
Switchboards
Clear Violations
Heat Recovery
Refrigerator, Comm. (p/PH)
Temp Serv., Construction
Compactor
Low -volt, Burglar
Refrigerator, Domestic
Temp for Test - 30 days
Deep Freezer
Low -volt, Fire
/
Renew - Temp Service
Water Closet
Demolition
Low -volt, Intercom/Teleph.
Repair Circuits
Water Heater
Dishwasher
Low -volt, Television
Service, Number of Amps
Water Heater New
MECHANICAL
TYPE
Minimum Fee
QTY. TYPE
Condensate Drain
QTY. I I PE
Generator
QTY. TYPF,
Refrigeration, Tons
QTI.
A/C Central, Tons
Cooling Tower
Heating Strips, each
Vent Hood, Cost
A/C Wall/Wm. Tons
Dryer Vents, Number of
Paint Booth
Ventilation, Cost
Solar Water Heater
Air Handler, Tons
Ductwork, Cost of
A Piping, Flammable Liquid
Periodic Inspections
Barbecue
Fire Sprinkler System
r- Process/Pressure Piping
Cap - Fixture
Bath Fan - Vented, #
Fireplaces, Number of
Pressure Vessel
Pump and Abandon
PLUMBING
TYPE
A/C Condensate
QTY.
TYPE
Drains, Roof
QTY.
TYPE
Miscellaneous Fixture
QT Y.
TYPE
Soakage Pit
QTY.
Bath Tub
Drinking Fountain
Miscellaneous Repairs
Solar Water Heater
Bidet
Filter Replace
Pool Piping
Sprinkler Repair
Cap - Fixture
Fountain
Pump and Abandon
Sprinkler System
Cap - Water
Gas - Appliance
Pump, Domestic
Supply, AC Well
Cap - Sewer
Gas - Natural
Pump, Fire Stand
Temporary Toilet
Catch Basin
Gas - Propane
Pump, Re- circulate
Temporary Water Closet
Clothes Washer
Gas Piping
Pump, Replace - Pool
Urinal
Dental Chair
Grease Trap
Pump, Sprinkler
Utility - Sewer
Discharge Well
Ice Maker
Pump, Sump
Utility - Water
Dishwasher
Indirect Wastes
Relay Repair
Vacuum Pump
Disposal
Interceptor
Roof Inlet
Water Closet
Domestic Well
Laundry Tray
Septic Connection
Water Heater
Drainfield, 4" Tile/Res.
Lavatory
Septic Tank
Water Heater New
Drains, Area
Meter Set (Gas)
Sewer Connection
Water Re -pipe
Drains, Floor
Minimum Fee
Shower
Water Service
Drains, French
Miscellaneous Equipment
Sink
Well, Supply
Page 3
PERMIT APPLICATION
INSTRUCTIONS: Please indicate the type of work being performed and quantity(ies) in the space provided below.
RECEIVED AND REVIEWED BY: DATE:
Page 4
OFFICE USE ONLY
CHECKLIST
❑ OWNER - BUILDER FORM
(Attach)
❑ FIRE DEPARTMENT
APPROVAL (Commercial /
multi- family)
❑ CONCURRENCY
(New Construction)
❑ OTHER
(Specify & Attach)
$3.00 per page (Scanning Fee)
Miami Shores Village
Bond
Metropolitan Dade County (C.C.F.)
Inspector State Educational Fund
State DCA (Radon)
Code Enforcement Fine
Zoning Review
Notary
❑ PROOF OF OWNERSHIP
(Attach)
❑ HRS / DERM APPROVAL
(Septic / Sewer)
❑ IMPACT FEE
(New Construction)
❑ OTHER
(Specify & Attach)
$ CP
(sq.ft. = x/1000
x ¢.60)
(¢.005 /sq.ft.)
$ (¢.01 /sq.ft.)
$
SECTION
Zoning
Electrical
Mechanical
Plumbing
Fire
Public Works
Structural
Building Official
BY
DATE
PERMIT APPLICATION
❑ CONDO ASSOCIATION APPROVAL
(Attach)
❑ BPR APPROVAL (Restaurants)
❑ CONTRACTOR REGISTRATION
(On File)
PERMIT FEES
TOTAL $
ISSUING OFFICIAL
REVIEWED AND PREPARED BY: DATE:
CONDITION OF APPROVAL
Revised July 2001
10050 N.E. 2ND AVE., MIAMI SHORES, FL • (305) 795 -2207 • FAX (305) 756 -8972 • http : / /www.miamishoresvillage.com