EL-04-249MS 25 ZOO
BUILDING
PERMIT APPLICATION
FBC 2001
Permit Type (circle): Building
Owner's Name (Fee Simple Titleholder)
Owner's Address /I
City Lc,tr t 1 Shot State / L
Tenant/Lessee Name
j 19/0t4 /&24
ob Address (where the work is being done)
City lviiami Shores Village
Is Building Historically Designated YES
Architect/Engineer's Name (if applicable) E
$ Value of Work For this Permit 0
Type of Work: ❑Addition ❑Alteration
Describe Work: T f D lr
A-ry, . rn,
Total Fee Now Due $
(Continued on opposite side)
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
County Miami -Dade Zip
/' Plumbing Mechanical Roofing
ek Ve M l / Phone #0 gs r U 7 er J�
I go /Y 1 , )4/ S
NO
Zip
Permit No.
Master Permit No. B P O L -031
L3
Phone # airy$�° eto
Contractor's Company Name Pco co �� frt, '0 Phone # &r -) ,2. 1 -3 Q7 0
Contractor's Address 1 2,1 ST 1I 1A) 11--l A t 9l e
City State (-- Zip 7 3 0
Qualifier 4 [6 € fl % P -c r \ curiae
State Certificate or Registration No. e- C._— 00 0 Ii. a3 Certificate of Competency No.
* * * * * * * * * * * * * * * * * * * * * * * * * ** *Fees * * * * * * * * * * * * **
Submittal Fee $ Permit Fee $ / o ®'
Notary SS,1 a Training/Education Fee $ ` f b
Scanning $
Phone #
Radon $ Zoning
Code Enforcement $ Structural Plan Review. $
Square Footage Of Work:
ew ❑ Repair/Replace
-.0 i ce 472 M-t a ieh
* * * * * * * * * * * * * **
CCF$ — 0 0 • CO/CC
Technology Fee $ 9, 31
Bond $
J Dem
u► oW
Si e
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
Chc 05/13/03
4/7
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 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 $2500, 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 commence ent must be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued. In th- abse e of such posted notice, the
inspection will not be approved and a reins ection fee will be charged.
Contractor
oing instrument was acknowledged before me this 27
200A, by
me or who has produced
ntification and who did take an oath.
The for
day of
who is personally kn
NOTARY PUBLIC•
Sign:
Print:
My Commission Expires:
1190
fl
Bonding Inc.
**** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *
�—S
Zoning
Inns Examiner
Engineer
J D
'ZARR,, JN.!valtsi 'y
P H A r 1 AEA /h is' /VC
.TRpt LER.
MD AP/
A
/ - 1)1 = '!*
ti ot/r4.04e
1 4 /5-ler /No-, j-ew
2. 7 J 5fk 7"PP c',PU kJ
49 /= "'11M • 4"C 7 i9 CGt':s
irO L # T - .. C .
fano 141.4P.>
ar 5 A
e
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ZOO A I'"aPs
1 .--- ' ..—
I APPROVED
i
BY
DATE
•PC,
LIMING
f
• SiRUCTURAL
1 ---,--
t ELECTRICAL
PLUMBING
MECHAN:C,AL
t B DG.
1 3U.. TO COMPLIANcE WITH ALL rEJERAL
STATE hND COUNTY RULES AND REGULAIIONS
t — —
101:321 ViLLAttl
1.
Miami Shores Village
10050 NE 2nd Avenue
Phone: 305 - 795 -2204
Printed: 9/21/2005
Applicant: BARRY
Owner: UNIVERSITY
JOB ADDRESS: 140
Contractor POWER PRO
Local Phone: 305 - 687 -7080
Parcel # PARC2004 -8
N.W. 115
Legal Description:
Electrical Permit
Permit Number: EL2004 -249
UNIVERSITY
BARRY
ST.
Page 1 of 1
Contractor's Address: 18800 NW 2 AVE 214
Fees: Description Amount
FEE2004 -8738 Building Fee $175.00
FEE2004-8739 CCF $3.00
FEE2004 -8740 Notary Fee $5.00
FEE2004 -8741 Training and Education Fee $1.00
FEE2004 -8742 Technology Fee $4.37
FEE2005 -12654 Renewal/Extension Fee $175.00
Total Fees: $363.37
Total Fees: $363.37
Total Receipts: $363.37
Permit Status: APPROVED Permit Expiration: 3/6/2006 Construction Value: $5,000.00
Work: TEMP SERVICE TO TRAILER
SEA 2 1 2005
Signed: (INSPECTOR)
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
10050 NE 2nd Avenue
Phone: 305 - 795 -2204 Permit Number: EL2004 -249
Printed: 8/26/2004
Applicant: BARRY
Owner: UNIVERSITY
JOB ADDRESS: 140 N.W. 115
Contractor POWER PRO
Local Phone: 305 - 687 -7080
Parcel # PARC2004 -8
Legal Description:
Electrical Permit
UNIVERSITY
BARRY
ST.
Page 1 of 1
Contractor's Address: 18800 NW 2 AVE 214
Fees: Description Amount
FEE2004 -8738 Building Fee $175.00
FEE2004 -8739 CCF $3.00
FEE2004 -8740 Notary Fee $5.00
FEE2004 -8741 Training and Education Fee $1.00
FEE2004 -8742 Technology Fee $4.37
Total Fees: $188.37
Total Fees: $188.37
Total Receipts: $0.00
Permit Status: APPROVED Permit Expiration: 2/21 /2005 Construction Value: $5,000.00
Work: TEMP SERVICE TO TRAILER
Signed: (INSPECTOR)
In consideration of the issuance to me of this permit, 1 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: