The URL can be used to link to this page

PLUMBINGt BUILDING PERMI FBC 2001 NOV 0 X004 Permit Type(circle Building Electrica Owner's Name (Fee Simple Titleholder) Owner's Address 7 Q, *j 03 City On (S (V\ r. State Tenant/Lessee Name Job Address (where the work is being done) City Miami Shores Village Contractor's Company Name $ Value of Work For this Permit (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 Plumbin O County Permit No. i-ce4 — / 4L_ Master Permit No. 13 P 0 LI Zip �3c23 Phone # eiftrArr Miami -Dade Mechanical Roofing Phone # 305: 'j17 Zip 333; is Building Historically Designated YES NO R. ( Ce,D 465 k, O Contra tor's 6a2- � y J () / y2 A V City / /", • r State �� Zip 3J3 3 42-- Qualifier C.. - • /Aes 7Q6 v1 State Certificate or Registration No. C FCO J 7 Architect/Engineer's Name (if applicable) /f/14 Phone # 4/I/1 C!a- 30,S- ' 'Q'° - LIl - M4 ,os Phone # .7Q 9sr9- 0096 Certificate of Competency No. CFCOS 1 Square Footage Of Work: Type of Work: ['Addition ffiAlteration ❑New ❑ Repair/Replace El Demolition Describe Work: ?OA./ 1 i ?i N 1.1 NES A' wAT 2.> N6S .v/2 d - 0 * * * * * * * * * * * * * * * * * * * * * * * * * * ** F ees * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Submittal Fee $ Permit Fee $ ► J� CCF $ 0 . CO /CC p ' - -- Notary $ ` Training/Education Fee $ 0 w Technology Fee $ i a Scanning $ Radon $ Zoning Bond $ Code Enforcement $ -� Structural Plan Revile . $ S p / � Total Fee Now Due $ P I 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 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 ac owledged before ) me this day of/L.7j , 200,4y f flS / 7r( 'l9 who is personally known to me or ho has produced NOTARY PUBLIC: Sign: sia' Print: My Commission Expires: Chc 05/13/03 As identification and who did take an oath. Maria June 21, 2007 °9NDFDTAU TROY FAN i'SURA C IW Contractor The foregoing instrument was acknowledg-: 'efore me this-3 day of ` ?J r , 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: 1 GGG Se- r ry Rodriguez : - MYCOMMICSION# DD186986 EXPIRES June 22, 2007 BQNfFA THRI I TEM CAR! muRANCC, INC ***************** * *:* * * * * * * * * * * * * * * * * * * * * * * * * * ** ***************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** * * * */ ******************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** APPLICATION APPROVED BY Engineer Zoning ITEM BATH TUB UNIT • FEE ITEM SWITCH OUTLETS UNIT FEE ITEM SPACE HEATERS UNIT FEE BIDET LIGHT OUTLETS CENTRAL HEATING DISHWASHER RECEPTACLES A/C (WIND) DISPOSAL SERVICE TEMPORARY A/C (CENTRAL) DRINKING FOUNTAIN SERVICE SIZE IN AMPS DUCT WORK FLOOR DRAIN SERVICE REPAIR/METER CHANGE REFRIGERATION GREASE TRAP APPLIANCE OUTLETS PROCESS AND PRESS PIPING INTERCEPTOR RANGE TOP UNDERGROUND TANKS LAVATORY OVEN ABOVE GROUND TANKS LAUNDRY TRAY WATER HEATER U.F. PRESSURE VESSELS CLOTHES WASHER MOTORS 0- 1 HP STEAM BOILERS SHOWER MOTORS QVER 1- 3 FP HOT WATER BOILERS SINK, POT /3 COMP. / MOTORS OVER 3- 5 I4 MECHANICAL VENTILATION SINK, RESIDENCE MOTORS OVER 5- 8 HP TRANSPORTING ASSEMBLIES SINK, SLOP MOTORS OVER 8- 10 HP ELEVATORS/ESCALATORS TEMPORARY WATER CLOSET MOTORS OVER 10- 25 HP FIRE SPRINKLER SYSTEMS URINAL MOTORS OVER 25-100 HP COOLING TOWERS WATER CLOSET MOTORS OVER 100 HP VIOLATION INDIRECT WASTES- A/C WINDOW REINSPECTION WATER SUPPLY TO: 3 rd SiNk 1 AIR CONDITIONERS A/C UNIT STRIP HEATER FIRE SPRINKLER GENERATORS TRANSFORMERS HEATER -NEW INST. GENERATORS TRANSFORMERS HEATER - REPLACE GENERATORS TRANSFORMERS LAWN SPRINKLER -WELL SPECIAL PURPOSE SWIMMING POOL OUTLETS COMMERCIAL WATER SERVICE SIGN TUBES SEWER CONNECTIONS SIGN TRANSFORMERS UTILITY -SEWER SIGN TIME CLOCK UTILITY -WATER FIXTURES SEPTIC TANK _ ANTENNA RELAY TELEVISION OUTLETS DRAINFIELD, 4' TILE/RES. VIOLATION PUMP & ABANDON SEPTIC TANK REINSPECTION SOAKAGE PIT CU. FT. 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 4 ADDENDUM TO BUILDING PERMIT APPLICATION (AN APPLICATI01'N FOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. IF A MASTER PERMIT HAS B. OBTAINED, TH.1 OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.) PLUMBING ELECTRICAL MECHANICAL r Miami Shores Village 10050 NE 2nd Avenue Printed: 11/24/2004 Applicant: Owner: JOB ADDRESS: 170 NE 96 Parcel # 1132060132630 Signed: (INSPECTOR) Signed: (Contractor or Builder) Plumbing Permit Phone: 305 - 795 -2204 Permit Number: PL2004 -314 ST Contractor ALL CLOGBUSTERS OF BROWARD Contractor's Address: 6244 S. W. 192 AVE. Local Phone: 305 - 490 -4926 Legal Description: 1 53 41 6 53 42 MIAMI SHORES SEC 1 AMD PB 10 - 70 LOTS 1 TO 3 INC BLK 20 Fees: FEE2004 -11637 FEE2004 -11638 FEE2004 -11639 FEE2004 -11640 FEE2004 -11703 Description Building Fee CCF Training and Education Fee Technology Fee Submittal Fee Total Fees: Amount $175.00 $0.60 $0.20 $4.38 ($50.00) $130.18 Total Fees: $130.18 Total Receipts: $0.00 Permit Status: APPROVED Permit Expiration: 5/2/2005 Construction Value: $800.00 Work: RUN DRAIN LINES AND WATER LINES FOR 1 -3 COMPACT SINK 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. BY: Page 1 of 1 Date Type Insp'n Permit No. Name Address Company Phone # Inspection Date Approved Correction Re- Insp'n Fee MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305.795 -2204 Buildin Inspection Request p sT /74,44-t--. ? I_ oSF- 3 /4 1 7o NE f' St.