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EL-07-398Issue Date: 3/1/2007 Owner's Name: RUTH CROCKETT Permit Type: Electrical - Residential Work Classification: Addition /Alteration Job Address: 9145 4 Avenue NE Expires: 08/28/2007 Additional Information Miami Shores Village, FL 33138 Contractor(s) Phone METRO ELECTRIC SERVICE INC 305 - 945 -1991 Primary Contractor Yes 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 responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL, PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work. OWNERS 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. Futhermore, I authorize the above -named contractor to do the work stated. Fees Due CCF Education Surcharge Notary Fee Permit Fee - New Construction Scanning Fee Technology Fee Total: Amount $0.60 $0.20 $5.00 $150.00 $3.00 $3.75 $162.55 Building Department File Copy Applicant Signature Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Fax: (305)756 -8972 Permit Parcel #: Block: Section: Permit Status: APPROVED Permit Number: EL -2 -07 -398 Phone: 305 - 754 -0495 1132060140080 Lot PB: Total Square Feet Total Valuation: Reauired Inspections 0 $ 1,000.00 Alteration Underground Rough WW Service Change Meter Box Fire Alarm Relocation Final Invoice Number EL - 3 - 07 - 27702 Total: Amt Due $162.55 C)( Yt 1 MAR 0 9 20071 Amt Paid NOTICE: In addition to the requirements of this permit, there may be additional restrictions applicable to this property that may be found in the public records of this county. AND THERE MAY BE ADDITIONAL PERMITS REQUIRED FROM OTHER GOVERNMENTAL ENTITIES SUCH AS WATER MANAGEMENT DISTRICTS, STATE AGENCIES, OR FEDERAL AGENCIES. Date Friday, March 9, 2007 03/09/2007 Check Receipt Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Fax: (305)756 -8972 Permit Number: EL -2 -07 -398 Invoice Number: EL -3 -07 -27702 Applicant: RUTH CROCKETT Company Name: Owner Address: 9145 NE 4 AVE MIAMI, FL 33138 -3118 Job Address: 9145 4 Avenue NE Miami Shores Village, FL 33138 Payment Type Check Number 1097 Amount $162.55 Change $0.00 Total Payment: $162.55 Page 1 of 1 Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 BUILDING 8 01 0 - - - , O145 P ermit No. PERMIT APPLICATION Master Permit N . iee FBC 2004 Permit Type: Electrical Owner's Name (Fee Simple Titleholder) Phone # City,114fit State Owner's Address Tenant/Lessee Name E- MAIL: Job Address (where the work is being done City Miami Shores Village FOLIO / PARCEL # Is Building Historically Designated YES Contractor's Company Name Contract a is Address r Ci t Qualifier Name State Certificate or Registr. ton No. E -MAIL: Architect/Engineer's Name (if applicable) Value of Work For this Permit $ Type of Work: ['Addition Describe Work: Structural Review. $ E Alteratio Submittal Fee $ Notary $ ' Training /Education Fee $ Scanning $ Radon $ Bond $ Code Enforcement $ 9/e/6 County NO Permit Fee $ Miami -Dade ['New DPBR $ Zip. 3 3 /$ e Phone # 71g- CvE ' FFFi 2 8 2001 B Y: Zip 3/ i Double Fee $ zip 39/0( Phone # C® r ( rn Certificate of Competency No. Phone # Square / Linear Footage Of Work: **** *oYOYieoY #*****BexoYoYxxxxx * *** e9:****xxx *ei **** Yxx xoYxxxxxxxxaY*4eoY4ex9:xxxxxx***** CCF $ (9 • CO /CC Technology Fee $ ✓ 7 75 Zoning $ Total Fee Now Due $ © /Replace [' Demoliti s n 16.55 . See Reverse side -->o 9 Hp Cklbq't 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 Zi 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. l 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 Signature Owner or Agent Contractor The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this day of , 20 _ , by , day of , 20 , by who is personally known to me or who has produced who is personally known to me or who has produced As identification and who did take an oath. as identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Sign: Sign: Print: Print: My Commission Expires: My Commission Expires: s ' ex xx i :xx xxxxxxxxx xxxxxx xxxx xxxxxxxxxxxxx xxx xxxxxxxxx xxxxxxxxxxxxxxxxxxxxxxxxxx xxxxx****xxxxxxxxxxxxxxxxxxxxxx APPLICATION APPROVED BY: (Revised 02/08/06) .725; Plans Examiner Engineer Zoning BUILDING PERMIT - APPLICATION FI3C 2001 Permit Type (circle): Building Owner's Name (Fee Simple Titleholder) Owner's // Adess ?74 Cit3 �o'lre k IL' Tenant/Lessee Name State Certificate or Registration No. $ Value of Work For this Permit 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 Job Address (where the work is being done) / /6•° / 4/".. .4/". 4/(,e City Miami Shores Village County Miami -Dade Zip _ 13 Is Building Historically Designated YES NO Contractor's Company Name AA 40 I I'4,1 c_ .c-e4) 8 c dr Phone # ?QC— LI ('7 1 86 Z9 -*6 Contractor's Address SI 16 act 1't-■ � 1 x' '�— (7g6- 0 5_64041) City ' l ei 1 State r L Zip , 3 l ° » Qualifier A O . b ('fS _cCt ✓11`O .) Type of Work: ['Addition ❑Alteration DNew Describe Work: i i€ , 44keivyttee, Permit No. Master Permit No. aG o e>6.2,5;5. Plumbing Mechanic koofing Phone # # Eo Certificate of Competency No. Ai 7 Architect/Engineer's Name (if applicable) Phone # Square Footage Of Work: Repair/Replace El Demolition ****************************F ** * * **** * * * * * * *** Submittal Fee $ Permit Fee $ CCF $ CO /CC Notary $ Training/Education Fee $ Technology Fee $ Scanning $ Radon $ Zoning Bond $ Code Enforcement $ Structural Plan Review. $ Bonding Company's Name (if applicable) 1 - a 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 Signature Owner or Agent / s Contract The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this Z3 day of ,20 ,by day of _ ,2007,by who is personally known to me or who has produced ho is personally known to me o o. as produce As identification and who did take an oath. ific =° io Wand who did e an oath. NOTARY PUBLIC: NOTARY PUBLIC: / Sign: Sign: -: -W = --sgt Print: Print: chc 05/13/03 '/1 My Commission Expires: My Commission Expires: ° m� ° 0 ;a o CO a < Qn /o °O°o S3y�a; �3 : 4 °000 °° OZ. 111 0,111910 " APPLICATION APPROVED BY: Plans Examiner Engineer Zoning ITEM BATH TUB UNIT FEE ITEM SWITCH OUTLETS UNIT FEE ITEM SPACE (EATERS UNIT_ FEE BIDET LIGHT OUTLETS CENTRAL HEATING B!S1YASHER RECEPTACLES A/C (WIND) DISPOSAL SERVICE TEMPORARY A/C (CENTRAL) DRINKING FOUNTAIN SERVICE SIZE IN AMPS DUCT WORK FLOOR DRAIN SERVICE REPAIR/METER CHAFE 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 OVER 1- 3 FP HOT WATER BOILERS SINK, POT/3 COMP. MOTORS OVER 3- 5 HD MECHANICAL VENTILATION SINK, RESIDENCE MOTORS OVER 5- 8 If TRANSPORTING ASSEMBLIES SINK, SLOP MOTORS OVER 8- 10 FP 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: 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 CONNECT I ONS .SIGN TRANSFORMERS UTILITY -SEWER SIGN TIME CLOCK UTILITY -WATER FIXTLRES SEPTIC TANK ANTENNA RELAY TELEVISION OUTLETS DRAINFIELD, 4' TILE/RES. VIOLATION PUP &ABANDON SEPTIC TANK REINSPECTION SOAKAGE PIT CU. FT. _ CATCH BASIN DISCHARGE WELL DOMESTIC WELL AREA DRAIN R00F INLET , SOLAR WATER HEATER FIRE STANDPIPE POOL PIPING LAWN SPRINKLER SYSTEM 1 GAS RANGE METER SET (GAS) GAS PIPING ADDENDUM TO BUILDING PERMIT APPLICATION s (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.) PLUMBING ELECTRICAL MECHANICAL