EL-04-1054 It Miami Shores Village «)
Building Department AP 2 2 /004
BUILDING
PERMIT APPLICATION
FBC 2001
Permit Type (circle): Building
C y T
Architect/Engineer's Name (if applicable)
$ Value of Work For this Permit C 7'`
Cc \soul
/0050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
Permit No. E ( 200 - e I �,
CJS
Master Permit No. .8P c2-00c2- ' 103
CCP
Owner's Name (Fee Simple Titleholder) Early Phone #
Owner's Address
City State Zip
Tenant/Lessee Name Phone #
Type of Work: ❑Addition ❑Alteration /�
Describe Work: /� i ova J- %Ce, S
Plumbing Mechanical Roofing
Job Address (where the work is being done) //3 6 0 , A7.7)
City Miami Shores Village County Miami -Dade Zip
Is Building Historically Designated YES NO
Contractor's Company Name 7 X/ d �� -��✓ Tia-1 Phone # C if � ` " 7
Contractor's Address /S7 /2..4 L y/. 5 //
6* � a v -C State (-- Zip 3 'M . )
Phone #
Square Footage Of Work:
❑ Repair/Replace ❑ Demolition
CC.6
****************************Fees****************************** l
Submittal Fee $ Permit Fee $ 4x/�� ° C- 0 ® CCF $ Lj ) U
Notary $ Training/Education Fee $ l 3. U U Technology Fee $ �0
Scanning $ Radon $ Bond $
Code Enforcement $ Structural Plan Review. $
Total Fee Now Due $ L� S, D
(Continued on opposite side)
• b
Electrical Permit
Miami Shores Village
10050 NE 2nd Avenue
Phone: 305 - 795 -2204 Permit Number: EL2004 -105
Printed: 4/29/2004
Applicant: BARRY UNIVERSITY STUDENT UNION
Owner: STUDENT UNION BARRY UNIVERSITY
JOB ADDRESS: 11300 N MIAMI AVE
Contractor TOTAL CABLING SOLUTION INC
Local Phone:
Parcel # 1121360000040 Legal Description:
Fees:
FEE2004 -4277
FEE2004 -4278
FEE2004 -4279
FEE2004 -4280
Description
Building Fee
CCF
Training and Education Fee
Technology Fee
Total Fees:
Signed: (INSPECTOR)
Contractor's Address: 15712 SW 41 ST SUITE 11
Amount
$2,400.00
$41.40
$13.80
$60.00
$2,515.20
Permit Status: APPROVED Permit Expiration: 10/19/2004 Construction Value: $68,578.00
Work: INSTALLATION OF VOICE AND DATA BABLING INFRASTRUCTURE
Page 1 of 1
Total Fees$2,5 5.20
Total Receipts: $010
a uks
0
\ c7§) . ` °5
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:
TGS
r Total Cabling Solutions
KS
agar
Timothy C. Orr, RCDD
15712 SW 41" Street
Suite 11
Davie, FL 33331
tel 954.846.8787 ext 332
fax 954.846.9311
cel 954.931.1305
tim @totalcable.com
VOICE . DATA . VID
Iry
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 AF 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."
N!tice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must
p in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
ii;iose 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 thesence of such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
Chc 10/14/03
Owner or Agent
The foregoing instrument was acknowledged before me this
day of , 20 , 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 Expires:
************ * * * * * * * * * * * * * * * * * * * * ** * * * * * * * **
APPLICATION APPROVED BY:
Signatur
,r4 r
sOontractor
T1 foregoing instrument was acknowledged before me this
day , 2O
uk
who is personally known to me or _ �� r ® a D0088234
2006
as identificati
vat Atlantic BondingCo.,Inc.
NOTARY PUBLIC:
Sign:
Print:��,,�� yye�esC
My Commission Expires: . , 3cL
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(Certificate of Competency Holder)
State Certificate or Registration No. 6- s 036 ? Certificate of Competency No.
* * * * ****+h+F******** * * ** RAN * *** ** ** ******** ******* ** * ***
Plans Examiner
Engineer
Zoning