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Pool Electrical3DS t / 5 G MIAMI SHORES VI LAGE BUILDING DEPART ' ENT 305- 795 -2204 Building Inspection Reque Date? 1 0 - Time Type Insp'n Permit No. 4 Z - 2,0o,--36> I Name Address Compan Phone # Q`{c(-0 For Inspecto 11 / / O 3 tName & Date Approved Rg Correction Re- Insp'n Fee ❑ ❑ /7-71, Pty C AO' i XatP - j '.r /41We v Le'- e S S' re. - .14 e X e, , `e 0, e/t �ce e- 7 /c J ', -e $ 2-yy la Approved Correction Re- Insp'n Fee MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Re Name Address Company Phone # For InspectoR / Time D Type Insp'n Permit No. - 2,00 Name / jRi 0 DataS Type Insp'n Permit No. Correction Re- Insp'n Fee ® 67 MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Name Address Q 1 _ r. c 1 Q Company 17tr� y Phone # \ /1 ' O pe) 1) For Inspector 0)0 e Name Approved ❑ Time 15! /3/e-fv. 1.4ee S reP f3 ° X rfrvv- kI fre,f c 1.- Type Insp'n Qi �.� f Permit No. -, :) Name Address Date Time " !!/ For Inspector: Approved` Correctiod Re- Insp'n Fee MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request • / /v' Phone #� Company Jr • IA Name & Date 171 O MIAMI SHORES VILLAGE BUILDING DEPART 305- 795 -2204 Building Inspection Req Date Time Type Insp Permit No. L , ©„ Name �l � Address j- I\A 7 " / `�� -11//7L Compa Phone # 5-G q to f For Inspector: �� Name & Date �5 ❑ �i�e Approve Correction Re- Insp'n Fee griV / (/d — , `/ a /lS;/./Ay do's / 1/4-1/29/e . _ &6'/- -d of eye 2/2-- MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date Time Type Insp'n ^ q 1 Permit No. 1 , b t x O/ Nam Address I a I • i 1 1 ) c-P1 / Compan 1 Phone # For Inspector: / I 1 Q.3 t, Name Approved Correction Re- Insp'n Fee ce ❑ Y yetit° ® ri •• • • • . • • • • •. • • • • • • •••• • • • • /% • ••• • • fj' ,- \,I • x • •�• • • ••• • • lt 1 • • • • • �//•� • ' -Neuu• •••• _ OA LL'• J J •��. • • • <*,% • • ✓.5 - • f 2 " 09 c A„ ' F - FM- 0d5 ti 22 ® ma y ,,� //�G,1 t © 1 ril i 3 s E red • g .3 /D fr P o 1 © O L ! . T . 7 . ‘3,97 4 ETAM SH8RES VILAGrl SUBJECT iO COPLIAt.: Wfl LL EDRi, STATE AND COUNTY ES it \;i) a:T:1E5 NO gESPONSIBILITIES FOR ACOURACs,' ▪ O 6"RT,.."?. 'NESE Pvils. COL THE'QVINFLOMOA COr.E P.S P.DOPTED THE f:RCHITE(.;1", :L J CONTR.( r;;:-6,:ifsiGED 4 OF Ai.' • • 01: NOT S',%;./!;IECIALLY • • • • • • • • • • • • • • 0 • • • .410 • • • •0 0:41 :0 • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • •• • • •• • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • ••• • • • • • • • • •• •• • • • •• •• • • • • • • • • • • • • le9 o / • • • • • • • • •• • • • • •• • • • • • • • •••• • • • • • • •. np,rp • • • • • l� ..t; '- • • 1' �. • •tea► • • �� 42e-k • • C'A iv 2 ¢ ` 0 ' wa2,,,f / / o� S� .1 ✓.4 ixv.'o o v en' ,z..0 IL). CG. �. C--rt 0 "..,el Vic, lJ� o" L1JD z Iz • dy G -to rei- fo . NI) 10 ell Qu iy' iO4-‘2 L)) (00 14e6 r f,,to• (Ar9 — 311. 7 11 u)142- i-kA Jeh5ol'f S C. 5 •jjn • /0 - /( o Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Permit Number: EL2002 -326 Printed: 10 /8/2002 Applicant: FRANCISCO CAMPA Owner: CAM PA FRANCISCO JOB ADDRESS: 1201 NE 91 TERR Contractor �i Contractor's Address: 19710 SW 99 CT Local Phone: Parcel # 1132050010210 Signed: Electrical Permit Page 1 of 1 Legal Description: WATERSEDGE PB 9 -141 LOT 25 & E5FT OF LOT 24 & WLY 20FT OF LOT 26 - 4 0�Z ,.. 4-60_ 0 0 /1 Permit Status: Approved Permit Expiration: 4/2/2003 Construction Value: $2,000.00 Work: UPGRADE & RELOCATE SERVICE AND RELOCATE NC COMPRESSOR Total Fees: Total Receipts: $0.00 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. Signed' �� /iii `_� i S - ECTOR) BY: In consideration of the is ance 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, teme . r 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, serva f or a plo s. REG C01 102302 1217 NC#01 002231 gUECK $61.20 (Contractor or Builder) BY: CONTRACTOR Name v'+ -eNeX16 i 5 E/P -r G License No. L C /6s3 Address * - 7(O ` 1 c 1 ir4 /c - 3 -' f 7 Telephone 3 a 53 1504 Fax 305 2 5q 6 Qualifier Name Grec S� c.ut„ -�"1 PROPERTY OWNER New Construction /� Name P ryN'<<tSC 0 C/9MPA Enclosure Address 1 1 N� e3 ( Te -r An /Aryl r .511 aroma 1CL 33 (-3 $ Home Telephone 3o 5 754- o p gg Repair Business Telephone 30 5 4_1-2 / O C 5 Alteration Interior Fax Demolish TYPE OF MANAGEMENT (✓ ) New Construction Enclosure Alteration Exterior Repair X Alteration Interior Demolish Relocation of Structure Shell Only Foundation Only Add'l 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.) $ 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 SECTION Zoning Electrical Mechanical Plumbing Fire Public Works Structural Building Official BY DATE (s .ftt. = x/1000 Inspector State Educational Fund $ (t.005 /sq.ft.) (¢.01 /sq.ft.) PERMIT APPLICATION ❑ CONDO ASSOCIATION APPROVAL (Attach) ❑ BPR APPROVAL (Restaurants) ❑ CONTRACTOR REGISTRATION (On File) TOTAL $ ISSUING OFFICIAL CONDITION OF APPROVAL Revised July 2001 10050 N.E. 2 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 I. Complete the attached permiapplication which trust 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. A PPLICATION Job Address: � P I 14 E Address Apt. City Folio Number description of Work Lit-e rKlci 2 4 re ,(06(k-Le 3Q -C1(i . e Lot Block QAd ('e 1 OC � JJ ' QA e...d -eSS�f Subdivision PB PG J Current Use of Property Square Feet Proposed Use of Property Value of Work Tenant Information ax Assessed/Appraised Value Flood Zone Base Floor Elev. PERMIT TYPE (✓ ) Building Electrical Mechanical Plumbing LPGX Roofing Fence Other 91 — re" - r PERMIT CHANGE (✓ ) Chg. Contractor Renewal Revision Extension Supplement Reinspection ARCHITECT Name License No. Address Telephone Fax Master Permit No. Subsidiary Permit No 1Y19KYY S�CI( PERMIT APPLICATION EL 33138 State Zip Zoning Linear Feet Units Floors O OO . Bldg Value ENGINEER Name License No. Address Telephone Fax ELECTRICAL TN'1 Minimum Fee QTY TYPE Dryer QTY TYPE Outlet, Appliance (1 "I'vPI; Service Repair 27Sow, QT). A/C Central 1 -3 Ton Cooling Tower Fan Outlet, Wall Service, Temporary A/C Central 4 -7 Ton - Paint Booth Fire Pump Ventilation, Cost Outlet, Switch Air Handler, Tons Signs Ductwork, Cost of A/C Central 8 -15 Ton Fixture - Fluorescent Oven Space Heater (kw) Process/Pressure Piping A/C Central 16-20 Ton Fixture Light Bath Fan - Vented, # Parking Lot Lights Fireplaces, Number of 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 iIECHANICAL TYPE Minimum Fee QTY. TYPE Condensate Drain QTY TYPE Generator ()Ty. TYPE Refrigeration, Tons () 1 A/C Central, Tons Bath Tub Cooling Tower - Heating Strips, each Vent Hood, Cost A/C Wall/Win. Tons Dryer Vents, Number of - Paint Booth Filter Replace Ventilation, Cost Pool Piping Air Handler, Tons Sprinkler Repair Ductwork, Cost of - Piping, Flammable Liquid Periodic Inspections Barbecue Fire Sprinkler System Process/Pressure Piping Cap - Water Gas - Appliance Bath Fan - Vented, # Pump, Domestic Fireplaces, Number of - Pressure Vessel Cap - Sewer PLUMBING TYPF A/C Condensate Ty. TYPE Drains, Roof QTN' TYPE Miscellaneous Fixture QTy. TYPE Soakage Pit Q 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 IIIPORTANT NOTICES 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 PROTEUI ED 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 BE 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. 1. 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 cost of work to 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 Village Hall on Construction Lien Law and Choosing a Contractor. STATE,OF FLORIDA, COUNTY OF MIAMI -DADE / l lai�T - ra ‘114.1 --1111111.- XANIIIIIIII PoiI 12�911/L/ G4 �i •9,0 7/¢ Print Name ((�� / ^�� r/ ,,�� om to and su.1 ribed before me thisat& day of laV / Owner Signature .tart' blicl tate of Florida `tis;�P D. M. Jackson SEAL: 1 ,l,. MY COMMISSION # DD137335 EXPIRES "s..,r; 0. August 26, 2006 PF h .... BONDED THRU TROY FAIN INSURANCE, WC Personally known OR, Produced Identification Type of Identification Produced: PERMIT APPLICATION STATE OF F MIAMI -DADE Signature of Contracto Print Name Sworn to and sub- • - • `re me this crU' day of l) C.'k laer SignaAro • Publi ` :24• SEAL: = *; State of Florida D. M. Jackson COMMISSION # DD137335 EXPIRES August 26, 2006 BONDED THRU TROY FAIN INSURANCE, INC Personally known / ` 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: 0 rl PAY TO THE ORDER OF 3 Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Printed: 11/21/2002 plicant: FRANCISCO Owner: CAMPA L JOB ADDRESS: 1201 NE Contractor SHINE MAINTENANCE ELECTRICAL -Local Phone: (r ) � Parcel # 1132050010210 Total Fees: Total Receipts: 21 $0.00 Permit Status: Approved Work: POOL HOOKUP If thorn is nn nnrmi+ r.�i.l.�.... QV/ 0D J ESSIG POOLS, INC. 1800 NE 151ST STREET NORTH MIAMI, FL 33162 Permit Expiration: CAMPA FRANCISCO 91 TERR Legal Description: WATERSEDGE PB 9 -141 LOT 25 & E5FT OF LOT 24 & WLY 20FT OF LOT 26 • :L.1.. .... 44... . L. .:a. a-- ---"--` 7 1- kc4n 7J a -C`t° 0 Mellon Un ed National nk Miami, Florida r FOR �1 /4i 11'0873 26e ':0670096461: 00 2 1 Electrical Permit Permit Number: EL2002 -381 5/18/2003 Contractor's Address: 7323 NW 8 ST eck4 01 PM DOLLAR1 3 30 2011' Construction Value: $900.00 87326 63 -9642 670 Detall. an Slid , cri . ,te r Page 1 of 1 Re- inspection lication herefor in strict compliance with all :ifications that may have been submitted to Is or if the plans are changed without ponsibility for a thorough knowledge of the that he assumes responsibility for work done ins pertaining thereto and in strict conformity responisibility for all work done by either CONTRACTOR BY ��,,�� �� r 0p Nam5K(„16 alN - (Pil�►p'P(.Ni oLie �1• 1) I • l.{Z` 1J License No.. /V p n0O l t \ 1- t Address 13 5 O g y p W I �L- - Telephoneti „( 01 , 1 \ \ i Fax O� 2 r ` r 7 el , i 17 / / Qualifier Name ,.. l ft Mechanical SECTION BY DATE Zoning Address , , /V • e. g Yawn, s4-xores, ri 3 3/ 3 p Electrical ,L° 7 ,tom er`. Mechanical Fax Demolish Plumbing Relocation of Structure // .T/ --e, L, Fire / Foundation Only Public Works Add'I Attachment Structural Add'' Detachment Building Official Other PROPERTY OWNER /, �w Name p,L �i /" � Ci tk 1 Name h'ancr w ' L a ` Address , , /V • e. g Yawn, s4-xores, ri 3 3/ 3 p Home Telephone Cc t1'J ( 2 0 ! d Business Telephone Alteration Interior Fax Demolish ENGINEER /, �w Name p,L �i /" � Ci tk 1 License No. Enclosure Address Alteration Exterior Telephone Cc t1'J ( 2 0 ! d Fax Fax Alteration Interior TYPE OF MANAGEMENT (✓ ) New Construction Enclosure Alteration Exterior Repair Alteration Interior Demolish Relocation of Structure Shell Only Foundation Only Add'I Attachment Other Add'' Detachment Other Page 4 OFFICE USE ONLY CIIECKLIST ❑ OWNER - BUILDER FORM (Attach) ❑ FIRE DEPARTMENT APPROVAL (Commercial / multi- family) ❑ CONCURRENCY (New Construction) ❑ OTHER (Specify & Attach) PERMIT FEES $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 $ — ISSUING OFFICIAL REVIEWED AND PREPARED BY: DATE: Revised July 2001 10050 N.E. 2ND AVE., MIAMI SHORES, FL • (305) 795 -2207 • FAX (305) 756 -8972 • http : / /www.miamishoresvillage.com ❑ PROOF OF OWNERSHIP (Attach) • HRS / DERM APPROVAL (Septic / Sewer) ❑ IMPACT FEE (New Construction) ❑ OTHER (Specify & Attach) (X .ft. = x/1000 (¢.005 /sq.ft.) (¢.01 /sq.ft.) PERMIT APPLICATION ❑ CONDO ASSOCIATION APPROVAL (Attach) ❑ BPR APPROVAL (Restaurants) ❑ CONTRACTOR REGISTRATION (On File) TOTAL $ CONDITION OF APPROVAL INSTRUCTIONS - The following steps must be taken to obtain a permit from the Miami Shores Village: Step 1. Master Permit No. Subsidiary Permit No. PERMIT APPLICATION 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 Job Address: PERMIT TYPE (✓ ) Building Electrical Mechanical Plumbing LPGX Roofing Fence Other ALE. ci far- Address Apt. Folio Number Lot Block PB Subdivision1Ckr y (. Current Use of Property OU Proposed Use of Property Tenant Information PERMIT CHANGE (✓ ) Chg. Contractor Renewal Revision Extension Supplement Reinspection ARCHITECT Name Address License No. Telephone Fax mow .h bre s �1 City State Description of Work poo L +tOD l.Lf ° 33 Zip PG / 4 I Zoning Linear Feet Square Feet Units Floors Value of Wor D Bldg Value Tax Assessed/Appraised Value Flood Zone Base Floor Elev. ELECTRICAL TVPF, Minimum Fee QTY. TYPE Dryer QTY. TYPE Outlet, Appliance Q " I'l•. i'Vi'I•: Service Repair Q Y. A/C Central 1 -3 Ton Heating Strips, each Fan Outlet, Wall Service, Temporary Paint Booth A/C Central 4 -7 Ton " / Fire Pump Outlet, Switch Piping, Flammable Liquid Signs A/C Central 8 -15 Ton Fixture - Fluorescent Process/Pressure Piping Oven Space Heater (kw) A/C Central 16-20 Ton Pressure Vessel 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 l 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 nIECHANICAL TYPE Minimum Fee QTV. TYPE Condensate Drain QTY. TVI'1': Generator QTY. •1'1 Refrigeration, Tons QT1 ". A/C Central, Tons QTV. Cooling Tower 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 Pump and Abandon Bath Fan - Vented, # Fireplaces, Number of Pressure Vessel Gas - Appliance PLUNIBING TYPE A/C Condensate tin'. TVI'I Drains, Roof QTY. TVI'1•: Miscellaneous Fixture QTV. TYPE 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 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 PROTE(, I'bD 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 BE 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. 1. 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 cost of work to 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 Village Hall on Construction Lien Law and Choosing a Contractor. STATE OF FLORIDA, COUNTY OF MIAMI -DADE Signature of Owner Print Name Sworn to and subscribed before me this day of Signature of Notary Public - State of Florida SEAL: Personally known OR, Produced Identification STATE OF Signatf Contractor / Qualifier Print Name Swworn to and subscribed bet'. e . e this /4 iila Signat 1, . rr bl " - State of on SEAL: Personally known KENNETH SHERMAN Notary Public, State of Florida My comm. exp. 24, 2003 rnmrr •.3 CC819725 OR, Produced Identification PERMIT APPLICATION Y OF MIAMI -DADE Type of Identification Produced: 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: