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EL-04-295BUILDING PERMIT APPLICATION FBC 2001 Permit Type (circle): Building Owner's Name (Fee Simple Titleholder) eVilrl4 0 ( Phone # - Owner's Address J 130° NG �, „ 0 c ��JJ Cit Mont.; 3 hcrc' State r� lO1�1d, Tenant/Lessee Name Job Address (where the work is being done) bariLl ()AA itCr3 City Miami Shores Village County Miami-Dade Is Building Historically Designated YES NO Contractor's Company Name Contractor's Address c 2c)Cr) City Qualifier Type of Work: ❑Addition ❑Alteration Describe Work: \la Q Ck Q1 Submittal Fee $ Notary $ brol i •C'Ln1 A5 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 118 State Plumbing Permit Fee $ f "r 'too Training/Education Fee $ O. Master Permit No. Zip 33 I co Phone # - Phone # Zip o ****************************Fees****************************** OCT 1 9 2D04 / Permit N. . (O l 2 Mechanical Roofing & OY * .e1 Zip 35 qty - 445 r7 7 7 State Certificate or Registration No. EA - cy3r4 55 / Certificate of Competency No. q r2 E OC Architect/Engineer's Name (if applicable) 4,4 Phone # $ Value of Work For this Permit O • Q Square Footage Of Work: ❑ Repair/Replace ❑ Demolition CCF $ 1 7 • CO /CC Technology Fee $ Scanning $ Radon $ '"°- Zoning Bond $ Code Enforcement $ Structural Plan Review. $ Bonding Company's Name (dapplicable) Bonding Company's Address City State Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State' 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 commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature Owner or Agent The foregoing instrument was acknowledged before me this / 9 tk The foregoing instrument was acknowledged before me this day of Alb 6e � , 20 vq by u / LG -e rg S , day of 200H, by who is personally known to me or who has produced Fl • who is personally known to me or who has produced C) Rnv • a C. As identification and who did take an oath. — as identification and who did take an oath. NOT %ij/�UBLIC: Sign: etsc,o.. Print: My Commission Expires: Chc 05/13/03 _ - - -� --- VERONICA A. GALLI Notary Public - State of Florida M .1 My Commission Expiate May 9, 20D8 Op als ,aohreD0084895 lay 14a olitif APPLICATION APPROVED BY: — CAMPUS SERVICES — PAUL CARSTENS Facilities Director, Barry University Higher Education Services, 11300 NE 2nd Avenue, Miami Shores, FL 33161 Telephone: 305 -899 -3791 • Fax 305 - 899 -3794 e -mail: pcarstens @mail.barry.edu NOTARY PUBLIC• Si :***. Sodexho Member of Sodexho Alliance 1A3 Print: 0 2.4tAg i g Zunibun ,.t La Bunbury My Commission EXJ ^ commission CC979842 * * * * * * * * * * * * * * * * * * * ** ****************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** *********************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** . Plans Examiner Engineer Zoning PUMP & ABANDON SEPTIC TANK REINSPE SOAKAGE PIT CU. FT. r•}qT? 4- 74I.t. L u� CATCH BASIN DISCHARGE WELL DOMESTIC WELL AREA DRAIN ROOF INLET SOLAR WATER HEATER FIRE STANDPIPE POOL PIPING LAWN SPRINKLER SYSTEM GAS RANGE METER SET (GAS) GAS PIPING ITEM PLUMBING BATH TUB BIDET DISHWASHER •DISPOSAL DRINKING FOUNTAIN FLOOR DRAIN GREASE TRAP INTERCEPTOR LAVATORY LAUNDRY TRAY CLOTHES WASHER MOWER SINK, POT/3 COMP. SINK, RESIDENCE SINK, SLOP TEMPORARY WATER CLOSET URINAL WATER CLOSET INDIRECT WASTES - WATER SUPPLY TO: A/C UNIT FIRE SPRINKLER HEATER -NEW INST. HEATER- REPLACE LAWN SPRINKLER -WELL SWIMMING POOL WATER SERVICE SEWER CONNECTIONS UTILITY -SEWER UTILITY -WATER SEPTIC TANK RELAY ..M .rt A T•. P Tr ADDENDUM TO BUILDING PERMIT APPLICATION r "a• } (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.) ELECTRICAL MECHANICAL UNIT FEE ITEM SWITCH OUTLETS MOTORS OVER 10- 25 HP LIGHT OUTLETS RECEPTACLES SERVICE TEMPORARY SERVICE SIZE IN AMPS SERVICE REPAIR/METER CHANGE APPLIANCE OUTLETS RANGE TOP OVEN WATER HEATER MOTORS 0- 1 HP MOTORS OVER 1- 3 1•P MOTORS OVER 3- 5 HP MOTORS OVER 5- 8 HP MOTORS OVER 8- 10 HP MOTORS OVER 25-100 HP MOTORS OVER 100 HP A/C WINDOW AIR CONDITIONERS STRIP HEATER GENERATORS TRANSFORMERS GENERATORS TRANSFORMERS GENERATORS TRANSFORMERS SPECIAL PURPOSE OUTLETS COMMERCIAL SIGN TUBES .SIGN TRANSFORMERS SIGN TIME CLOCK FIXTURES ANTENNA TELEVISION OUTLETS UNIT FEE ITEM SPACE HEATERS CENTRAL HEATING A/C (WIND) A/C (CENTRAL) DUCT WORK REFRIGERATION PROCESS AND PRESS PIPING UNDERGROUND TANKS ABOVE GROUND TANKS U.F. PRESSURE VESSELS STEAM BOILERS HOT WATER BOILERS MECHANICAL VENTILATION TRANSPORTING ASSEMBLIES ELEVATORS/ESCALATORS FIRE SPRINKLER SYSTEMS COOLING TOWERS VIOLATION REINSPECT ION UNIT FEE Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Printed: 10 /26/2004 Applicant: Owner: UNIVERSITY JOB ADDRESS: 11300 NE 2 Parcel # Electrical Permit Permit Number: EL2004 -295 UNIVERSITY AVE Contractor DOUG HEDDEN ELECTRIC, INC. Contractor's Address: 2200 N. W. 118 AVE. Local Phone: 888 672 - 7177 Page 1 of 1 Legal Description: 36 52 41 40 AC SE1 /4 OF NE1 /4 LESS E35FT & LESS W4OFT LOT SIZE 1740400 Fees: Description Amount FEE2004 -10500 Building Fee $150.00 FEE2004 -10501 CCF $1.20 FEE2004 -10502 Training and Education Fee $0.40 FEE2004 -10503 Technology Fee $3.75 Total Fees: $155.35 Total Fees: $155.35 Total Receipts: $0.00 Permit Status: APPROVED Permit Expiration: 4/17/2005 Construction Value: $2,000.00 Work: VOICE AND DATA .00T 2 6 PAID 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: