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1184 NE 91 Terr (10)3 &t t� MIAMI SHORES VILLAG BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date 18 Io5 Type Insp'n 1. !VArt— Permit No. -PC_C5 — 1 8b Name 1 L-1■ W -r1*c a 1 Address 1 4 € 91 -- rkez Company ( Phone# 3c:5)-798 -7II3 Inspection Date , / 9 I °� Approved Correction Re- Insp'n Fee Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Permit Number: PL2005 -186 Printed: 6/13/2005 Applicant: BRENDA WESTHORP Owner: WESTHORP BRENDA JOB ADDRESS: 1184 NE 91 TERR Contractor Local Phone: Parcel # 1132050010460 Signed: (INSPECTOR) Plumbing Permit Contractor's Address: Permit Status: APPROVED Permit Expiration: 12/6/2005 Construction Value: $2,500.00 Work: REPLACE EXISTING DRAINS & CONNECT TO SEPTIC RUN NEW COPPER PIPES TO BATHROOM Page 1 of 1 Legal Description: 5 53 42 WATERSEDGE PB 9 -141 E45FT OF LOT 22 & W4OFT OF LOT 23 Fees: Description Amount FEE2005 -8027 Building Fee $190.00 FEE2005 -8028 CCF $1.80 FEE2005 -8029 Training and Education Fee $0.60 FEE2005 -8030 Technology Fee $4.75 FEE2005 -8031 Notary Fee $5.00 FEE2005 -8032 Scanning Fee $3.00 Total Fees: $205.15 Total Fees: $205.15 Total Receipts: $0.00 1 PAID 11\ c rr C 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 1pn CE BUILDING_ _ _ PERMIT APPLICATION FBC 2001 Permit Type (circle): Building Owner's Name (Fee Simple Titleholder) 2) Owner's Addrp `\ BA 1.16 City µleIM\ State F4., 5 Value of Work For this Permit Submittal Fee S Notary S n CC) Scanning S 500 Code Enforcement 5 Total Fee Now Due S k— t -c - r.►1 (1 ontinued on opnosite side Training /Education Fee 5 Radon S Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Electrical Tenant/Lessee Name Phone # Job Address (where the work is being done) if".-Q. Ct S ol, tOUVL 52 — _ City Miami Shores Village County Miami -Dade k . J , Phone # (3 A J 7 TQi/4CR Is Building Historically Designated YES NO Contractor's Company Name 0 OM ( X..) Phone # Contractor's Address City State Zip Qualifier State Certificate or Registration No. Certificate of Competency No. Architect/Engineer's Name (if applicable) Phone # Type of Work: Addition ❑Alteration El New Re air/Re lace [� p p Demolition Describe Work: laesz Q •ct Onninee&T a lt) 1(,?/24/"' ? rd-S - tit) locrttv-oor--t Permit No. Master Permit No. Zip 33!38 lumbin Mechanical Roofing Square Footage Of Work: t Zip * * * * ** * * * * * * * * * * * * * * * * * * * *** Feed * * * * * * * * * * * * * ** * ** * * ** * * * * ** Permit Fee 5 1 CCF 5 ti 80 CO /CC Zoning Structural Pian Review. S Technology Fee 5 4.7,E Bond c Bonding Company's Name (if applicable) N 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 Contrathtor 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: ************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** ******************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** **** * * * * * * * * * * * * * * * * * * * * * * * * **** **# ***4 **+ k******* **# *******# ******* ************#****#*** *** APPLICATION APPROVED Chc 05/13/03 ‘ - 0 Plans Examiner Engineer Zonm_ RAP & 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 ADDENDUM TO BUILDING PERMIT APPLICATION (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.) UNIT 1 1 FEE ITEM SWITCH OUTLETS 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 QVER 1- 3 hP MOTORS OVER 3- 5 FP MOTORS OVER 5- 8 HP MOTORS OVER 8- 10 HP MOTCRS OVER 10- 25 HP IOTORS 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 REINSPECTION UNIT FEE ITEM PLUMBING BATH TUB BIDET DISHWASHER DISPOSAL DRINKING FOUNTAIN FLOOR DRAIN GREASE TRAP INTERCEPTOR LAVATORY LAUNDRY TRAY CLOTHES WASHER SHOWER 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 • ELECTRICAL MECHANICAL