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ELECTRICAL PERMIT1Vlidri11 31101Cs V 111d,gt Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 . Tel: (305) 795.22Q4..ax:43 756.8972 BUILDING li IV 1 � 3 Permit No. 61. 4 b V -33i PERMIT APPLICATION j 4 ' Master Permit No. OA* — l3( 4 7 FBC 2001 Permit Type (circle): Building M A Plumbing Mechanical / Roofing Owner's Name (Fee Simple Titleholder) A(ZTl0. 1J1e.)1�►. Phone # 3o�- 7 (-) -Q ( Owne41'4 dress � �/ kl e . ` 91 5 l diSrge City t `7IIC: State L Zip '33 1 3g Tenant/Lessee Name Phone # Job Address (where the work is being done) '3-3 IS 9 ( � ST'S City Miami Shores Village County Miami -Dade Zip �3 t'12::. Is Building Historically Designated YES NO v j �/G U(, 7� , f1�JA / f Contractor's Company Name'i' ec '4 Phone # 7 J 6 3 / Contractor's Address a9 4 57 City /0/ .dam /, State Zip Qualifier t 5 : 1'2,69- - e z 7 713. 1 Architect/Engineer's Name (if applicable) Phone # $ Value of Work For this Permit / / O ©D Square Footage Of Work: Type of Work: ❑Addition ['Alteration jgNew X- Repair/Replace ❑ Demolition Describe Work: - ek GCV-14&i— Ally r C.•til4) Ov a-t- ' e - \IC-E' 0 11 *W '61460-414/ AG tij r r * * * * * * * * * * * * * * * * * * * * * * * * * * ** F ees * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** tar Submittal Fee $ 5 i . Permit Fee 5 ; �e' ' "-- CCF $ 0-ti 0 Notary $ Training/Education Fee $ Technology Fee 5 Scanning $ Radon $ Bond $ t! Code Enforcement 5 Structural Plan Review. $ Total Fee Now Due $ (Continued on opposite side) 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 tb 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 thatall 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 LtNDER 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 occ s seven (7) days after the building permit is issued In the absence of such posted notice, the inspection will not be appr' ed ' d a reinspectio ° ee will be. charged. • Signature ontractor The foregoing ent was ac ..wle, d before the this The foregoing instrument was acknowledged before me this /7 day of , 20 _ , by , day of IVO (/- , 200 by who is personally known to me or who has produced who is personally known to nie o'r who has produced As identification and who did take an oath as identification and who did take an oath. NOTARY PUBLIC: / Sign: _ i , / , .Sign: .. A- etGec... (/aX. . - Print: .. - 44 a k //sue, : 1,/,Wd &' ,7. , ' .. �3tatiR) My Commission Expires: ""(141, ""(141, AD C MAD VALDES NOTARY PUBLIC: Print: or c%2 -6 1/64 /4' S My Commission Expires: * * * * * * * * * * * * * * * * * * * * ** er or Age State Certificate or Registration No. Certificate of Competency No. **************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** APPLICATION APPROVED BY: 42 ,2 Chc 10/14/03 !//6 r of Competency Holder) MADELIN VALDES 41 .54,`: s: `' M ° g R I- 8.10 FI. Notary ZFS: Apnl 06, 2008 1400.3. NOTARY FL Notary Dismmt Arc. Co. ********************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** �.� of- 9 it✓vv.4 Plans Examiner Engineer Zoning h Z UNIT FEE ITEM UNIT SWITCH OUTLETS FEE ITEM SPACE HEATERS INIT FEE LIGHT OUTLETS CENTRAL HEATING ASHER RECEPTACLES A/C (WILE)) SAL SERVICE TEMPORARY A/C (CENTRAL) :ING FOUNTAIN SERVICE SIZE IN AMPS l Sb DUCT WORK I DRAIN SERVICE REPAIR/YETER CHA.NtE � , REFRIGERATION ;E TRAP APPLIANCE OUTLETS PROCESS AND PRESS PIPILD TEPTOR • RANGE TOP UNDERGROUND TANKS [CRY OVEN ABOVE GROUND TANKS :RY TRAY WATER HEATER U.F. PRESSURE VESSELS -ES WASHER MOTORS 0- 1 FP STEAM BOILERS ER MOTORS OVER 1- 3 HP HOT WATER BOILERS POT /3 COMP. MOTORS OVER 3- 5 HP MECHANICAL VENTILATION , RESIDENCE MOTORS OVER 5- 8 FP TRANSPORTING ASSEMBLIES , SLOP MOTORS OVER 8- 10 HP ELEVATORS/ESCALATORS , CRARY WATER CLOSET MOTORS OVER 10- 25 FP FIRE SPRINKLER SYSTEMS :. MOTORS OVER 25-100 FP COOLING TOWERS R CLOSET MOTORS OVER 100 FP VIOLATION RECT -WASTES A/C WINDOW REINSPECTION :R SUPPLY T0: AIR CONDITIONERS 'C UNIT STRIP HEATER IRE SPRINKLER GENERATORS TRANSFORMERS :ATER -NEW INST. GENERATORS TRANSFORMERS :ATER - REPLACE GENERATORS TRANSFORMERS Val SPRINKLER -WELI SPECIAL PURPOSE iIM,1ING POOL OUTLETS COMl,ERCIAL - 4TER SERVICE SIGN TUBES :R CONNECTIONS SIGN TRANSFORMERS .ITY -SEWER SIGN TIME CLOCK .ITY -WATER F IXTIRES .--- -r NO TANK ANTENNA kY TELEVISION OUTLETS INFIELD, 4' TILE/RES. VIOLATION & ABANDON SEPTIC TANK REILSPECTION .-- {AGE PIT CU. FT. 0 )i BASIN CHARGE WELL ESTIC WELL • A DRAIN • • F INLET i AR WATER HEATER I . . E STANDPIPE L PIPING • N SPRINKLER SYSTEM RANGE ER SET (GAS) --^ PIPING ADDENDUM TO BUILDING PERMIT APPLICATION APPLICATIOP FOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. IF A MASTER PERMIT FAS B. 'AIMED, :ME OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.) PLUMBING ELECTRICAL MECHANICAL Parcel # 1132060136510 Electrical Permit Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Permit Number: EL2004 -331 Printed: 11/30/2004 Applicant: MARTIN MEJIA Owner: MEJIA MARTIN JOB ADDRESS: 333 NE 91 ST Contractor SANSON ELECTRICAL PLUS INC Contractor's Address: 3995 SW 4 ST Local Phone: 305 -443 -8808 Page 1 of 1 Legal Description: 1 53 41 6 53 42 MIAMI SHORES SEC 1 AMD PB 10 -70 LOT 17 & W1/2 LOT 18 BLK Fees: Description Amount FEE2004 -11751 Building Fee $200.00 FEE2004 -11752 CCF $0.60 FEE2004 -11753 Training and Education Fee $0.20 FEE2004 -11754 Technology Fee $5.00 FEE2004 -11755 Submittal Fee ($50.00) Total Fees: $155.80 Total Fees: $155.80 Total Receipts: $0.00 QEC C -C 1 PAI Permit Status: APPROVED Permit Expiration: 5/18/2005 Construction Value: $1,000.00 Work: ELECTRICAL MAIN UPGRADE, CAN OVERHEAD SERVICE AND NEW ELECTRICAL FOR NC UNIT- MASTER PERMIT #04 -1367 Signed: (INSPECTOR) 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: Date (p "20?"fJ Job Address Legal Description Lessee / Tenant R-)41.10/101M19 4 tA 41'1 EA. t4,60> JM Owner's Address S'C(,I, Address00 241, LUVItq - 9.0D Qualifier Ro rie Rb41.9Se<. e- r6 ©c State # _ Municipal # Competency # Contracting Co. Architect /Engineer /4 43 Address Bonding Company Address Mortgagor Address Permit Type(circle one): BUILDING 'LECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION Square Ft. PERMIT APPLICATION FOR MIAMI SHORES VILLAGE 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 construction and zoning. Furthermore, I authorize the above -named contractor to do the work stated. Signatur o dwner'and /or Co t Date: G ( nd President / Notary as to Owner, and .: /o t My Commission E *piresre. C);"1-141,7,:- - :«v l-1 • b .13 :: i:i�.r.Z.L ** * * 3 33 'N E. q ! 1 ` ' a- I) F a � Vl L°-'F�-S Estimated Cost(value) 4 CEO u - 333 R,e. 9( .51' ss# Phone 3 g 44 J a 1 37 Tax Folio g/ 3 .gOG 03 Signature of Cont Date: Master Permit # 3 166 Phone 75 2 Ins.Co. ctor or Owner- Builder KMc Tnmom ,1).0 %3 Notary as to Contractor or Owner- Builder My Comm i s s i ofl j 1 �OlAL ;; TAM V SEAL ' 6 NW o co�:.:.:,.:on e:ummm * * * * �lQ f�tl *t7::ii2SS!11x11 am * ** _ FEES: PERMIT t 1 ( RADON C.C.F. 1 r r NOTARY TOTAL DUE T APPROVED: Fire Other Zoning Building Electrical Mechanical Plumbing Engineering MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Bu Inspection Request Date t MIA,/e, tbarik .• \\ Type Insp'n Permit No. Name t.i( ,L,) q Address ° 5 / Company ( e,h-LA - --( Phone # O5 c9/& — 0(07 Inspection Date ,,�, Approved L Correction ❑ Re- Insp'n Fee ❑ c. rj ° ,vdv7c 1 / 'Yd BUILDING ELECTRICAL PLUMBING ROOFING Architect Contractor or Builder Legal Description Address of Building Lot L PERMIT N? 13247 Owner of Building MIAMI SHORES VILLAGE, FLORIDA DATE ❑ Work to be performed under this Permit Bl. • Signed • , Subdi- vision Contractor's License No r Value of Amt. of 7- ` Project $ Permit $ i -, y 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. BY `r v 4 ‘3/4 In consideration of the issuance to me of this permit I agree to\.pgrform 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 eitl}er, myself, my agent, sery ant or employee. CONTRACTOR OR BUILDER V APPLICATION FOR ELECTRICAL PERMIT Permit No / 1 Date Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations 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. ^ I 1 Owner's Name and Address ' t ' No 70 Street f/. ! Registered Architect and /or Engineer Employing Electrician's Name � ! .,iG:r. f � No 1-. -7/ s Location and Legal Description Lot F7 Street and Number where work is to be performed —No State work to be performed and purpose of building (By Floors) STATE OF FLORIDA, 1 COUNTY OF DADE. I ss. MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT Street... . a lock Subdivision .-- ,,..G� Street ' 't ( Signed )/ 4 Master Electrician. 1-- (J. New Building / Remodeling Addition Repairs No. of Stories Overhead �' / e Service Size Feeders.. e r` Conduit.. - t- 1 %....Main Sw..,,P t ,.E?.. Amps - - Main Fuses Amps Type of Installation — Conduit Tubing B.X.L Metal Moulding Amount of Permit $ f (Signed) Electrical Inspector. . The undersigned applicant for this building permit does 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 compliance from all contractors or sub-contractors 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 subcontractors, on work to be performed under this permit, as are licensed by Miami Shores Village. 1�! 4 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 are true. My Commission Expires Notary Public, State of Florida NOTE: A re-inspection fee of $1.00 will be made when such re-inspection is made necessary by improper notice for inspection, or faulty materials and /or workmanship. SWITCH OUTLETS LIGHT OUTLETS - --J 1 ('/ ) LL` � � — PLUG RECE'P'T'S FIXTURES NO. LAMPS REFRIG. OUTLET IRON OUTLET RANGE OUTLET RANGE CONN. WATER HEATER W. HEAT. CONN. SPACE HEATER STRIP HEATER TOTAL CONTR. LIST / 17 - - --- --- _ J f f .- � // --" 1 / J t / r1 CHECK ENT. SW. DIST. CAB. SERVICE TEMP. SERVICE PERM. MOTORS 0.1 HP MOTORS 1.5 HP NEON TRANS. RADIO TOTAL CONTR. CHECK " - V APPLICATION FOR ELECTRICAL PERMIT Permit No / 1 Date Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations 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. ^ I 1 Owner's Name and Address ' t ' No 70 Street f/. ! Registered Architect and /or Engineer Employing Electrician's Name � ! .,iG:r. f � No 1-. -7/ s Location and Legal Description Lot F7 Street and Number where work is to be performed —No State work to be performed and purpose of building (By Floors) STATE OF FLORIDA, 1 COUNTY OF DADE. I ss. MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT Street... . a lock Subdivision .-- ,,..G� Street ' 't ( Signed )/ 4 Master Electrician. 1-- (J. New Building / Remodeling Addition Repairs No. of Stories Overhead �' / e Service Size Feeders.. e r` Conduit.. - t- 1 %....Main Sw..,,P t ,.E?.. Amps - - Main Fuses Amps Type of Installation — Conduit Tubing B.X.L Metal Moulding Amount of Permit $ f (Signed) Electrical Inspector. . The undersigned applicant for this building permit does 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 compliance from all contractors or sub-contractors 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 subcontractors, on work to be performed under this permit, as are licensed by Miami Shores Village. 1�! 4 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 are true. My Commission Expires Notary Public, State of Florida NOTE: A re-inspection fee of $1.00 will be made when such re-inspection is made necessary by improper notice for inspection, or faulty materials and /or workmanship. Owner's Name and Address MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT ._ Permit No I ' Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations 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. ,�. �.. No 3 3 Registered Architect and /or Engineer Employing Electrician's Name...,, 1..i. ;_e.r... ° ! Street Location and Legal Description Lot Block Subdivisiop r . Street and Number where work is to be performed —No 3 3 3 Street....,/ # y • d a • State work to be performed and purpose of building (By Floors) New Building ` Remodeling Addition Repairs No. of Stories Service Overhead Size Feeders Conduit Main Sw Amps Main Fuses Amps Underground Type of Installation — Conduit Tubing B.X.L Metal Moulding Amount of Permit $ (Signed) Electrical Inspector. The undersigned applicant for this building permit does 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 compliance 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, on work to be performed under this permit, as are licensed by Miami Shores Village. (Signed) ...% t STATE OF FLORIDA, n. Master Electrician. COUNTY OF DADS. } ss. L7 Date Street. .11 ' 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 are true. My Commission Expires Notary Public, State of Florida NOTE: A re-inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty m erials and /or workmanship. SWITCH OUTLETS LIGHT O UTLETS PLUG R ECE'P'T'S FIXTURES N O. LAMPS REFRIG. OUTLET IRON OUTLET RANGE OUTLET RANGE CONN. WATER H EATER W. HEAT. CONN. SPACE H EATER STRIP H EATER TOTAL CONTR. LIST CHECK ENT. SW. DIST. CAB. SERVICE TEMP. SERVICE PERM. MOTORS 0.1 HP MOTORS 1.5 HP N EON TRANS. RADIO TOTAL CONTR. LIST CHECK Owner's Name and Address MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT ._ Permit No I ' Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations 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. ,�. �.. No 3 3 Registered Architect and /or Engineer Employing Electrician's Name...,, 1..i. ;_e.r... ° ! Street Location and Legal Description Lot Block Subdivisiop r . Street and Number where work is to be performed —No 3 3 3 Street....,/ # y • d a • State work to be performed and purpose of building (By Floors) New Building ` Remodeling Addition Repairs No. of Stories Service Overhead Size Feeders Conduit Main Sw Amps Main Fuses Amps Underground Type of Installation — Conduit Tubing B.X.L Metal Moulding Amount of Permit $ (Signed) Electrical Inspector. The undersigned applicant for this building permit does 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 compliance 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, on work to be performed under this permit, as are licensed by Miami Shores Village. (Signed) ...% t STATE OF FLORIDA, n. Master Electrician. COUNTY OF DADS. } ss. L7 Date Street. .11 ' 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 are true. My Commission Expires Notary Public, State of Florida NOTE: A re-inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty m erials and /or workmanship.