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EL-04-122Parcel # 1121360000040 Legal Description: Signed: (INSPECTOR) Electrical Permit Miami Shores Village 10050 NE 2nd Avenue Phone: 305- 795 -2204 Permit Number: EL2004 -122 Printed: 5/10/2004 Applicant: BARRY UNIVERSITY Owner: STUDENT UNION JOB ADDRESS: 11300 N MIAMI AVE STUDENT UNION BARRY UNIVERSITY Contractor SUPERIOR ELECTRICAL CONTRACTORS lNContractor's Address: 1407 EL RADO Local Phone: Page 1 of 1 Fees: Description Amount FEE2004 -4682 Building Fee $2,800.00 FEE2004 -4683 CCF $48.00 FEE2004 -4684 Technology Fee $5.60 FEE2004 -4685 Training and Education Fee $16.00 Total Fees: $2,869.60 Total Fee412,869.60 Total Receipts: $0.00 Permit Status: APPROVED Permit Expiration: 11/6/2004 Construction Value: $80,000.00 Work: FIRE ALARM INSTALLATION in consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responisibility for all work done by either myself, my agent, servants or employes. Signed: (Contractor or Builder) BY: MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305 - 795 -2204 Building Inspection Req Date d Type Insp'n Permit No: Name Address 1 ) 5 Company Phone # Inspection Date Approved Correction Re- Insp'n Fee Fa us S2eeyv d CONTRACTOR 51) tZ.{tetG do ,. Name Name 13m014 License No. c . co orei Address - - , 4 40. 15°140 . _t M4v11 i ) 1 '1=10474 5392 Telephone 305 - {1}I, -4,323 Fax 305 - 5`13 -D41 Qualifier Name Rollo wo 1" i, it iwz PROPERTY OWNER New Construction Name 13m014 ' ON iqpig% ° Address iNIiiln41 - ° ttiniore4 i It •33110 Address Home Telephone 3330 Telephone Business Telephone 306 - g gC1 - 7616 Fax Fax Shell Only ARCHITECT New Construction Name r IFA TrI15W ) -t∎1 • License No. 1 Address +550 8ikturwize No/4,y 1 K't7- Woos- -two Coa'tA4- C-Td1/4451 rz PL . 331 Address Telephone 3 411-(0 — t10Z.. 3330 Telephone 06-4 ylp1 _ No?, ENGINEER New Construction Name STE' V't.t ie. F'g • Enclosure License No. 1 Address Sop g .E. , 3- Pf- ( setimuzo*c,o) rEoZiPA 3330 Telephone 06-4 ylp1 _ No?, Fax 9$ Vo 7 -5 /-52. Shell Only TYPE OF MANAGEMENT (✓ ) New Construction ✓ Enclosure Alteration Exterior Repair Alteration Interior Demolish Relocation of Structure Shell Only Foundation Only Add'l Attachment Other Add'I Detachment Other Step 1. 2004 INSTRUCTIONS - The following steps must be taken to obtain a permit from the Miami Shores Village: Complete the attached permit application which must be signed by the .groper y 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 Job Address: 113AD !J- Misr. j Address Folio Number Lot Block Subdivision PB Current Use of Property Proposed Use of Property Tenant Information PERMIT TYPE (✓ ) Building Electrical Mechanical Plumbing LPGX Roofing Fence Other Apt. PERMIT CHANGE (✓ ) Chg. Contractor Renewal Revision Extension Supplement Reinspection no rncuq Description of Work PERMIT APPLICATION Master Permit No. 15k ZZ - tt tom. Subsidiary Permit No. t41.;;4 0 ore-SS City Pi- State Bldg Value 33% AArie-tvi .vvr k RA.%[Z L f ' Zip PG Zoning Linear Feet Square Feet Units Floors Value of Work 4. SOt000 - Tax Assessed/Appraised Value Flood Zone Base Floor Elev. 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 FI .F.CTRICAL, 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 Village Hall on Construction Lien Law and Choosing a Contractor. STATE OF FLO COUNTY OF MIAMI-DADE Signature o Owner Signa e of Contra Print Name Signature of Notary Public - State of Florida SEAL: SEAL: STATE OF FLORIDA, COUNTY 0 Print Warne Signature o otary Sworn to and subscribed before me this day of Sworn d subscribed before me this day of GUTIERREZ ry Public - State of Florida Pytknrr issb[16ciesMay18,2007 Commission # DD)92330 tbnded6pt tl YASSa PERMIT APPLICATION -DADE Personally known OR, Produced Identification Personally known OR, Produced Identification Type of Identification Produced: Type of Identification Produced: ELECTRICAL EN. PI. Minimum Fee QTY. TYPE Dryer QTY. TYPI; Outlet, Appliance Q I N. "I'YPE Service Repair QTY. A/C Central 1 -3 Ton Heating Strips, each Fan Outlet, Wall Service, Temporary Paint Booth A/C Central 4-7 Ton Fire Pump Outlet, Switch Piping, Flammable Liquid Signs A/C Central 8 -15 Ton Fixture - Fluorescent Piping Oven Space Heater (kw) A/C Central 16-20 Ton - Pressure Vessel Fixture Light Parking Lot Lights Spas/Hot Tubs A/C Central 20+ Ton Flood Lights Plugmold/Strip Subfeeds, No. of Amps A/C Window 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 TY PE Minimum Fee QTY. TYPE Condensate Drain QTY. TYPE. Generator QTY. TYPE Refrigeration, Tons Q Y. A/C Central, Tons QTY. Cooling Tower Heating Strips, each Vent Hood, Cost A/C WaWWm. Tons Dryer Vents, Number of Paint Booth Ventilation, Cost Air Handler, Tons Ductwork, Cost of Piping, Flammable Liquid Periodic Inspections Barbecue Fire Sprinkler System Piping Pump and Abandon Bath Fan - Vented, # Fireplaces, Number of - Pressure Vessel Gas - Appliance PLUMBING TYPE A/C Condensate QTY. TYPE Drains, Roof QT Y. TYPE Miscellaneous Fixture QTY. T1 1'E 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: SECTION BY DATE Zoning Electrical Bhwyy Mechanical Plumbing Fire Public Works Structural Building Official Page 4 OFFICE USE ONLY CIIECKLIST ❑ 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 ❑ PROOF OF OWNERSHIP (Attach) ❑ HRS / DERM APPROVAL (Septic / Sewer) ❑ IMPACT FEE (New Construction) ❑ OTHER (Specify & Attach) PERMIT FEES $ Q 0 $ , 0 0 (sq.ft. = x/1000 ($.005 /sq.ft.) (¢.01 /sq.ft.) PERMIT APPLICATION ❑ CONDO ASSOCIATION APPROVAL (Attach) ❑ BPR APPROVAL (Restaurants) ❑ CONTRACTOR REGISTRATION (On File) ISSUING OFFICIAL REVIEWED AND PREPARED BY: DATE: CONDITION OF APPROVAL Revised July 2001 10050 N.E. 2Nn AVE., MIAMI SHORES, FL • (305) 795 -2207 • FAX (305) 756 -8972 • http : / /www.miamishoresvillage.com