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1037 NE 91 Terr (5)Correction MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305 -795 -2204 Building Inspection Request Date Time Type Ins •' s i - Permit No Q 3 Name „6, Address _� Cam' )J 7P/e Company Phone # � ��1� _ / -0 For Inspector: - t )ame & Date Re- Insp'n Fee ❑ MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305 -795 -2204 Building Inspection Request Date Type Insp'n Permit No. 'L2 t) C i Name L. Address ) 0 3 1 Company T fl 1 Phone # 3 �� �'� C� 7 0S ? S For Inspector) /g/ `dame Approved Correction frio v , Q y Re- Insp'n Fee C� 3 "7 Type Insp'n ` /' • Permit No. Name Address/ 03 Company Phone # For Inspector: 9,4 @. . App f Correction MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305 -795 -2204 Building Inspection Request Date Time -. rI 1 Re- Insp'n Fee Di ©?-7 _- 1¢ di 7. Kto ief'%, c cif G1,v0GvrZ a >G -t 4& fie/ e_ e iLooi- r TO al a2 d 6 ,0- 0 4 / 4 C '°0', For Inspector• Correction MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305 -795 -2204 Building Inspection Request Date �Q,�/� Time Type Insp'n �C� e Permit No. - " c 7O Name t �yy� ,,�f►►22 +bee Address / '�✓ l A6 Company Phone # / 0 .2-) Approve/ •K Re- Insp'n Fee os-t5 ej°i�. c +o Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Permit Number: EL2002 -237 Printed: 7/25/2002 Applicant: ALISON HARKE Owner: HARKE ALISON JOB ADDRESS: 1037 NE 91 TERR Contractor IDIK ELECTRIC INC Local Phone: Parcel # 1132050010050 Signed: Signed: Electrical Permit Contractor's Address: 11370 SW 26 ST Legal Description: WATERSEDGE PB 9 -141 LOT 5 & E1/2 LOT 4 & LOT 6 Page 1 of 1 to, oo J 0 O Total Fees: Total Receipts: $0.00 Permit Status: Approved Permit Expiration: 1/18/2003 Construction Value: $1,100.00 Work: NEW ELECTRIC FOR LIGHTING, REFRIGERATOR, GFI KITCHEN REMODEL — If there is no permit package accessible on the job -site for inspectors to verify, there will be no inspections. Re- inspection fee is $50.00, which must be paid in advance before calling for another inspection. This Permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the application herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes responsibility for work done by his agents, servants or employees. 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, dra ngs, 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, - rvants oi- ployes. (Contractor or Builder) BY: BLK 1 LOT ELECTRICAL 'rm.: Minimum Fee ()Ty. .LV.I'F Dryer QTY. 'rm.: Outlet, Appliance QTY. TYPE Service Repair Q.I.V. A/C Central 1 -3 Ton Fan Outlet, Wall • i '5 ilk Service, Temporary A/C Central 4 -7 Ton Fire Pump Outlet, Switch '2/ Signs A/C Central 8 -15 Ton Fixture - Fluorescent Oven Space Heater (kw) A/C Central 16-20 Ton 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 I\1ECHANICAL TVI'I. QTY. TYPI. ()Ty. TVI'F, Minimum Fee Condensate Drain Generator (11 1'. 'rvi'1•: RPfrioeratinn Tons QTY. A/C Central, Tons QT1'. Cooling Tower QTV. Heating Strips, each Vent Hood, Cost A/C Wall/Win. Tons Dryer Vents, Number of Paint Booth Ventilation, Cost Air Handler, Tons Ductwork, Cost of Piping, Flammable Liquid Periodic Inspections Barbecue Fire Sprinkler System Process/Pressure Piping Gas - Appliance Bath Fan - Vented, # Fireplaces, Number of Pressure Vessel Gas - Natural PLUNIBING TYPE A/C Condensate QTY. TYPE, Drains, Roof QTY. TYPE Miscellaneous Fixture QT1'. mg.: Soakage Pit QTV. 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 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 13E 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 ELECTRICAL, 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 coct of w ork t 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 tllage Hall on Construction Lien Law and Choosing a Contractor. STATE OF FLORIDA, COUNTY OF MIAMI -DADE STATE 0 Si titre of Owner Print Name Sworn to and subscribed before me this day of Signature of Notary Public - State of Florida SEAL: Type of Identification Produced: Personally known OR, Produced Identification Personally known ignature of Contractor / Qualifi 7 Print Name worn to and subscribed before me this 1 day of J) Signatur of Notary Public - State SEAL: - PERMIT APPLICATVN 01 /1/16 of Florida Robert Oransky MY COMMISSION # CC820360 EXPIRES March 23, 2003 NDED THRU TROY FAIN INSURANCE, INC OR, Produced Identification Type of Identification Produced: 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: CONTRACTOR New Construction Name . c) , V____ �.�tfit--,, Addresss License No. 9 c L^ G 0 2 i\ C 2 3 7 NE .7 / I ea_ In /4/f,, vitges , Address \, 1 1 o w Cr, S t.-. k t,, I `ice. \ fp S Rripair Telephone 5s-2 _ O 1 SZo Fax 2.:2Z9 2.:2Z9 ^ p � 7 (, Z-? Qualifier Name _=\,) , 2--)" P r� Demolish PROPERTY OWNER New Construction Name A sa / it t iuc , /,n � / Addresss - 33/3'g 3 7 NE .7 / I ea_ In /4/f,, vitges , Home Telephone .5 iS6 -301y J !! Rripair Business Telephone Alteration Interior Fax Demolish TYPE OF MANAGEMENT (✓ ) New Construction Enclosure Alteration Exterior Rripair Alteration Interior Demolish Relocation of Structure Shell Only Foundation Only Add'I Attachment Other Add'l Detachment Other Page 4 OFFICE USE ONLY CHECKLIST ❑ 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 Notary ❑ PROOF OF OWNERSHIP (Attach) ❑ HRS / DERM APPROVAL (Septic / Sewer) ❑ IMPACT FEE (New Construction) ❑ OTHER (Specify & Attach) PERMIT FEES ( z .6. x/1000 $ (¢.005 /sq.ft.) $ (¢.01 /sq.ft.) SECTION Plumbing Fire Public Works Structural Building Official BY DATE Zoning Electrical ?2'� Mechanical PERMIT APPLICATION ❑ CONDO ASSOCIATION APPROVAL (Attach) ❑ BPR APPROVAL (Restaurants) ❑ CONTRACTOR REGISTRATION (On File) TOTAL $ CONDITION OF APPROVAL Revised July 2001 10050 N.E. 2ND AVE., MIAMI SHORES, FL • (305) 795 -2207 • FAX (305) 756 -8972 • http : / /www.miamishoresvillage.com INSTRUCTIONS - The following steps must be taken to obtain a permit from the Miami Shores Village: Step 1. I ob Address: Master Permit No. Subsidiary Permit No. PERMIT APPLICATION ©a ' c23 Complete the attached permit application which must be signed by the property 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 Folio Number escription of Work 'N e1A - 4 -TIL LL H7 /i J r Lot Block EF{LI(sefeATD/t I &F-1 — K R6'- i1'b &L- Subdivision P Current Use of Property Proposed Use of Property Tenant Information PERMIT TYPE (✓ ) Building Electrical Mechanical Plumbing LPGX Roofing Fence Other l03 N C 73- T?JR r'- t�w�.i SNOB€ s, 33 t-s8 Address Apt. J City State Zip Chg. Contractor Renewal Revision Extension Supplement Reinspection ARCHITECT Name License No. Address Telephone Fax B PG Zoning Linear Feet Square Feet Units Floors diue of Work () % 00 Bldg Value Tax Assessed/Appraised Value Flood Zone Base Floor Elev. PERMIT CHANGE (✓ ) ENGINEER Name License No. Address Telephone Fax My Commission Expires: FEES: PERMIT APPROVED: Zoning Mechanical PERMIT APPLICATION FOR MI Job Address Date Legal Description /Owner/Lessee / Tenan Address 1 037 `6 I II Q /LR Contracting Co. COASTAL PLUMBING CO. OF MIAMI Queer ROBERT E. BRINCEFIELD CUAZ ✓t f '7 owneF -der Condo Presids.Rk \CIA ,428, 7 Notary as to Owner and/•r Condo Presitllt #CC 471)58e :a uPc, STAB 0 0 ss# Tax Fo'a l ( 3 Historically Designated: Yes RADON C.C.F. NOTARY I SHORES VILLAGE Phone Address 285 N.E. 185th Street state # CFCO -19042 Municipal # 6264 Competency # CFCO -19042 Ins. Co. Gateway Ins. Agency Architect/Engineer Address Bonding Company Address Mortgagor Address Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION REPLACE EXISTING ELECTRIC WATER HEATER Square Ft. Estimated Cost (value) 200.00 No Master Permit # 263 - 463 - 122 Phone 651 -4429 WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO 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.) Application is hereby made to obtain a permit to do work and installs' ion as indicated above, and on the attached addendum (if applicable). I 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 ELECTRICAL, PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK. 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. Furthermore, I authorize the above -named contractor to do the work stated. Signature of Contractor or 0 Notary as to Contractor o My Commission Expires: Electrical $ ol ro 758 -3614 �� / - v 7 - r_B Q \CIA S 67; - ", Date .MISSION • •.'9 : . c 2 �aE , ' . • •* wner-ANdeiCC 477159 :Z§S. 9 q • •rb .° : pQ TOTAL DUE Engineering Date//4Y Job Address 1 0 3 7 IMF TecrgGe Tax Folio /1 , /ZOJ / /' 6-19 7 Legal Description4q Owner / Lessee / Tenant G of n 02 44a CXP Owner's Address /0 f 7 e ('9 C,4 Phone 753'-56._ 7 Contracting Co. kGkc 9-etc 1 " l S � r Qualifier ✓ sln° ef g. /� ti S SS# Phone State # Municipal # Competency # f plf Ins.Co. Architect /Engineer Address Bonding Company Address Mortgagor Address Permit Type(circle one): BUILDING WORK DESCRIPTION LECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN eJ. ` 1 r 6 c Je ( e I eG 11 c c c / - F - or f�ie l Square Pt. ✓ Estimated Cost(value0 � *' WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO 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). Application is hereby made to obtain a permit to do work and installation as indicated above, and on the attached addendum (if applicable). I 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 ELECTRICAL, PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK. OWNER'S AFFIDAVIT: I certify that all the foregoing information is be done in compliance with all applicable laws regulating construc authorize the above -named contractor to do the work sta / d. APPROVED: Signa rg A Date: J�((� ( � PERMIT APPLICATION ]FOR MIAMI SHORES VILLAGE er and /or Condo President Nc(tfary /as to Owner a My Commission Expire; ". CHIIRCH tats of Eland3 n ) cgrARtbi9aPptil 30, 1996 No. CC191545 �►: ? Fire Mechanical Plumbing; e. /ec- sero'ce; rtvJJ2 P ** * * * * * * * * * V FEES: PERMIT , €l O RADON C.C.F. /1 6 NOTARY J �� Zoning Building Master Permit #„:4J Wi Address 1 "7 7 7E: vow l Y Ai( G0I - YoYn‘ t all work will Signature 91 Date: /O�( ntrac • or Owner- Builder ,.. .,r, . JOSEPHINE CHURCH tar as to Ci =x• *vBlvitd89B My Commission - '� No. CC191545 zoning. Other Electrical Engineering State of Florida ermore, I * ** TOTAL DUE��p 5O ITEM BATH TUB UNIT FEE ITEM SWITCH OUTLETS UNIT 4 FEE ITEM SPACE HEATERS UNIT FEE BIDET LIGHT OUTLETS 1,0 CENTRAL HEATING DISHWASHER RECEPTACLES 8 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 2 14,:5) 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 HP HOT WATER BOILERS SINK, POT /3 COMP. MOTORS OVER 3- 5 HP 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 If COOLING TOWERS WATER CLOSET MOTORS OVER 100 If 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 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 _ (AN APPLICATION FOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. IF A MASTER PERMIT HAS BEEN OBTAINED, THE OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.) PLUMBING ADDENDUM TO BUILDING PERMIT APPLICATION ELECTRICAL MECHANICAL MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT Permit No Date la f 9 ! l P Application is hereby made for the approval of the detailed statement of the plans and specifications herewith > for the building of other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Fiv:ida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulation's of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. M � Q / / Owner's Name and Address I.!. (/��'� � �"� ` No /03 ? y �• Street [ 7r-4 Registered Architect and /or Engineer Emplo g Ellectriciaa6 Nam. ��� r..Q C' ✓ c' No. 11 3 ia�don &Cd Le el Deecriptid„ Lot v' 11 3..� + f Block ` Street and Number where work is to be performed —No `... 7 N ce. State work to be performed and purpose of building (By Floor A New Building Remodeling Street t Addition Repairs No. of Stories.... Servi erground Type of Installati Amount of Permit S .. STATE OF FLORIDA, 1 COUNTY OF DADE. u. ders.4 / 4 Conduit.. Main Sw l-5 Tubing.. ... B.X.L... Metal Moulding (Signed) Al Wickt ` � (Signed) Amps (Sal Main Fuses Amps Electrical Inspector. The undersigned applicant -for this building permit dots hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section .5966, Compiled General Laws of Florida Permanent Supplement, and has complied with the provisions thereof, and will require similar cor.:ipliance from all contractors or subcontractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such sub-contractors /lon wdrk to A : rformed under licensed by Miami Shores Village. Street Subdivision. r • .49/E Muter Electrician. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath .deposes and says that he is the of the above described construction, and he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated arc true. My Commission Expires Notary Public, State of Florida NOTE: A re-inspection fee of 81.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty materials and /or workmanship. SWITCH Ou LIGHT 0 PLUG RECE•P•T's FIXTURES NO LAMPS REPRIO. OUTLET IRON OUTLET RANGE OUTLET RANGE CONN. WATER HEATER W. HEAT. CONN. SPACE H STRIP H TOTAL CONTR. LIST CHECK ENT. SW. DIET. CAR. SERVICE TEMP. SERVICE PERM. MOTORS 0.1 HP MOTORS 1.0 HP NEON TRANS. RADIO TOTAL CONTR. LIST CHECK MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT Permit No Date la f 9 ! l P Application is hereby made for the approval of the detailed statement of the plans and specifications herewith > for the building of other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Fiv:ida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulation's of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. M � Q / / Owner's Name and Address I.!. (/��'� � �"� ` No /03 ? y �• Street [ 7r-4 Registered Architect and /or Engineer Emplo g Ellectriciaa6 Nam. ��� r..Q C' ✓ c' No. 11 3 ia�don &Cd Le el Deecriptid„ Lot v' 11 3..� + f Block ` Street and Number where work is to be performed —No `... 7 N ce. State work to be performed and purpose of building (By Floor A New Building Remodeling Street t Addition Repairs No. of Stories.... Servi erground Type of Installati Amount of Permit S .. STATE OF FLORIDA, 1 COUNTY OF DADE. u. ders.4 / 4 Conduit.. Main Sw l-5 Tubing.. ... B.X.L... Metal Moulding (Signed) Al Wickt ` � (Signed) Amps (Sal Main Fuses Amps Electrical Inspector. The undersigned applicant -for this building permit dots hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section .5966, Compiled General Laws of Florida Permanent Supplement, and has complied with the provisions thereof, and will require similar cor.:ipliance from all contractors or subcontractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such sub-contractors /lon wdrk to A : rformed under licensed by Miami Shores Village. Street Subdivision. r • .49/E Muter Electrician. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath .deposes and says that he is the of the above described construction, and he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated arc true. My Commission Expires Notary Public, State of Florida NOTE: A re-inspection fee of 81.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty materials and /or workmanship. Date/6 Legal Owner / Lessee Owner PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Job Address /b3 / � ¢c'C / L Description- �7 / 4 / Tenant (MVP. /',f . s Address /037 i3 /U C 9 T Contracting Co. klo rd& Qualifier Uirr/)1 /J1( ___911La Tax Folio / 1 3)05:44S4 Oiet Master Permit 1fr3s 51a? Phone P79,-06 iiV • 69/ -b I n c Address ( H /'Fr!ff Phone (05S -- (46(3- - 7 State # Municipal ;'f Competency # EFC Ins.Co. Architect /Engineer Address Bonding Company Address Mortgagor Address Permit Type(circle one): BUILDING 'LECTRICAL PLUMBING MECHANICAL ROOFING PAVING PENCE SIGN WORK DESCRIPTION Square Ft. Estimated Cost(value) WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO 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). Application is hereby made to obtain a permit to do work and installation as indicated above, and on the attached addendum (if applicable). I 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 ELECTRICAL, PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK. 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 constru Lion and zoning. Furthermore, I authorize the above -named contractor to do the work state Signature of owner and /or Condo President Date: Notary as to Owner and /or Condo President My Commission Expires: APPROVED: Signature of Contractor or Owner- Builder Date: /0 Notary as to Cont ct•r o Owner- Builder My Cori on Expires: P /O //� 7 LINDA LOVEJOY • 7 J My Commission CC303876 • ** * * * * * * * * * * �i 44 0F fla qsd . c • Expires Aug. 01,1997 * * * * * * PEES: PERMIT3O /44 RADON C.C.P. • O NOTARY TOTAL DUE Fire Other Zoning Building 'lectrical Mechanical Plumbing, Engineering b/ G4 6 -1.9-a-44.-c,,t,..,L