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867 NE 91 Terr (5)D Type Insp'n Permit No. ame Address Company MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Phone# Inspection Date .' 12210 Approved / i 6 ., 4 7 4.2 •? 4 Correction ❑ Re- Insp'n Fee ❑ Date Type Insp'n p �{ Permit No. MC 0..C)0 2 Name omt` Q Address U Nr t. l {r Company CO " Phone # 3P1 S Inspection Date 1 l S. Z7 Approved Correction Re- Insp'n Fee MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Reques igo 4 - / ✓J 4c Gv rc MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date Type Ins 'n YP P Permit No. Na Address Company Phone # Inspection Date Approved Correction Re- Insp'n Fee BUILDING PERMIT APPLICATION FBC 2001 Permit Type (circle): Building Owner's Name (Fee Simple Titleholder Address £6 7 . '4 9/ City, 44 ,00-6J . State Tenant/Lessee Name Phone # Job Ad 7 y dress (where the work is being done) 6 2 9 1:1 ,jLOz City Miami Shores Village County Miami-I�acte Zip Is Building Historically Designated YES NO Contractor's Company Name � . �� . 4 R C Contractor's Address b0 3 0 �3 VJ --2:-2— City l' AA �'lM� S to 1 ._ Qualifier � J O ` � � `-' ' R C Architect/Engineer's Name (if applicable) Phone # $ Value of Work For this Permit Type of Work: ❑Addition �teration Describe Work: Cr 7 C'e -z-- a� Submittal Fee s 5 Permit Fee $ (CL Training/Education Fee $ Radon $ Notary $ Scanning $ 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 Plumbing echanica Roofing r )y /2OL.e-.9 //e # ?�72— / /�./I/ Zip ❑New *, *gyp * # * * * * * * * * * * * * * * * * ** Fees * * ** * * * * * * * * * * * * ** * * * * * * * * * * ** va Permit No. �dd�7 " �• Master Permit No. co ,#':;'r 3a -- ."23 Phone # SO — Ce) Zip — 3 - 3 1 ' U Square Footage Of Work: ❑ Repair/Replace ❑ Demoliuon CCF S Bond $ Technology Fee $ , '“ JAN 0 8 t r,i0 Code Enforcement $ Structural Plan Review. $ 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 Sign: Chc 10/14/03 NOTARY PUBLIC: Ytt- Owner or Agent The foregoing instrument was acknowledged before me this day of , 20 , by CG.+-.0 , ArN , who is personally known to me or who has produced As identification and who did take an oath. Print: Signature My Commission Expires:^' My Commissiol% . : .: MY COMMISSION # DD200463 EXPIRES ':; f i d;•` SOWED THRU TROY FAI INC (Certificate of Competency Holder) tractor The foregoing instrument was acknowledged before me this �'t^' day of J , 243, by SCf� who is personally known to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: Sign: C .. -✓IiGc, Print: C Vargas MY COMMISSION # D02000463 EXPIRES p State Certificate or Registration No.G 4 C ON 1 61 4 ( Certificate of Competency No. ***************************************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** APPLICATION APPROVED BY: (1 lG J (' • D �' d 4 Plans Examiner Engineer Zoning M H TU3 UNIT • FEE ITEM SWITCH OUTLETS UNIT FEE ITEM SPACE HEATERS UNIT FEE • ET LIG4T OUTLETS CENTRAL HEATING ;MASHER RECEPTACLES A/C (WIND) FOSAL SERVICE TEMPORARY A/C (CENTRAL) NKING FOUNTAIN SERVICE SIZE IN ARS DUCT WORK Z CR DRAIN SERVICE REPAIRAIETER CHANGE REFRIGERATION :ASE TRAP APPLIANCE OUTLETS PROCESS AND PRESS PIPING ERCEPTOR RANGE TOP UNDERGROUND TANKS 'ATORY OVEN ABOVE GROUND TANKS INDRY TRAY WATER HEATER U.F. PRESSURE VESSELS )THES WASHER MOTORS 0- 1 HP STEAM BOILERS T'ER MOTORS OVER 1- 3 HP HOT WATER BOILERS 1K, POT /3 COMP. MOTORS OVER 3- 5 HP MECHANICAL VENTILATION .K, RESIDENCE MOTCRS OVER 5- 8 HP TRANSPORTING ASSEMBLIES {K, SLOP MOTORS OVER 8- 10 FP ELEVATORS/ESCALATORS PORARY WATER CLOSET MOTORS OVER 10- 25 HP FIRE SPRINKLER SYSTEMS INAL MOTORS OVER 25-100 HP COOLING TOWERS TER CLOSET MOTORS OVER 100 HP VIOLATION OIRECT-WASTES A/C WINDOW REINSPECTION TER SUPPLY T0: AIR CONDITIONERS A/C UNIT STRIP HEATER FIRE SPRINKLER GENERATORS TRANSFORMERS • HEATER -NEW INST. GENERATORS TRANSFORMERS HEATER- REPLACE GENERATORS TRANSFCRM¢RS LAWN SPRINKLER -WELL SPECIAL PURPOSE _ • SWIMMING POOL OUTLETS COWERC I AL - WATER SERVICE SIGN TUBES WER CONNECTIONS SIGN TRANSFORMERS ILITY -SEWER SIGN TIME CLOCK ILITY -WATER FIXTLRES PTIC TANK ANTENNA LAY TELEVISION OUTLETS AINFIELD, 4' TILE/RES. VIOLATION MP & ABANDON SEPTIC TANK REINSPECTION AXAGE PIT CU. FT. TCH BASIN SCHARGE WELL MESTIC WELL EA CRAIN OF INLET i LAR WATER HEATER `, RE STANDPIPE OL PIPING AN SPRINKLER SYSTEM S RANGE TER SET (GAS) S PIPING APPLICATION FOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. IF A MASTER PERMIT HAS B. STAINED, TH7f5WNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.) PLUMBING ADDENDUM TO BUILDING PERMIT APPLICATION ELECTRICAL MECHANICAL Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Printed: 1 /12/2004 Applicant: CAROLEE Owner: MCINTIRE JOB ADDRESS: 867 Contractor J M ARCE SERVICE Local Phone: 305 - 262 -3589 Parcel # 1132060050280 Fees: FEE2004 -251 F E E2004 -252 FEE2004 -253 FEE2004 -254 Signed: NE 91 Signed: (Contractor or Builder) Mechanical Permit Permit Number: MC2004 -2 MCINTIRE CAROLEE TERR Contractor's Address: 6030 SW 22 ND ST Page 1 of 1 Legal Description: GOLDEN GATE PARK ADDN PB 6 -130 LOT 23 & E1 OFT OF LOT 22 BLK 2 Description Building Fee CCF Training and Education Fee Technology Fee Total Fees: Amount $106.00 $0.60 $0.20 $2.65 $109.45 Permit Status: APPROVED Permit Expiration: 7/7/2004 Construction Value: $300.00 Work: DUCT WORK (INSPECTOR) Total Fees $109.45 a� Total Receipts: $0.00 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: lye JAN 1 5 PAID