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ELECTRICAL PERMITBUILDING I ELECTRICAL PLUMBING n PERMIT N? 8041 ROOFING I Owner of Building a n Architect Contractor or Builder Legal Lot Description 1 1 BI Address of Building CONTRACTOR or BUILDER MIAMI SHORES VILLAGE, FLORIDA Work to be performed under this Permit Date Contractor's License No. Subdi- vision Sq. Ft. Value of Amount of / Project 11 Permit a BY AUTHORITY 1 — -- 19/ ! 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 applica- tion herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with anv plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. 'Phis 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 resposiisibility 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 respon sibility for work done by his agents, servants or employees. Signed•' (INSPECTOR) BY In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulation 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 either, myself, my agent, servant or employee. BUILDING ELECTRICAL PLUMBING ROOFING Architect Contractor cr Builder Legal Description Address of Building C I n Owner of Building Lot 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 applica- tion herefor in s trict 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 respon- sibility for work done by his agents, servants or employees. Signed _ NSc-EOTOR In consideration of tha issuance to me of this permit I agree to perform the work covered hereunder in complice ce 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 ac• cepting this permit I aasumo responsibility for all work done by either, myself, my agent, servant or employee. CONTRACTOR OR BUILDER MIAMI SHORES VILLAGE, FLORIDA PERMIT N? 7643 Work to be performed under this Permit_ Bl. Subdi- vision Value of Project $ DATE_ 19 -- Contractor's License No. _ — Amount of Po iiit $ BY AUTHORITY ;fl r, • -4 MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date /OS Type Insp'n - Permit No. ZOO Name 9C) ( r) Pb (rci Address Z-ZZ "47q l G _s-r Compan 1 l SY--)c''- c v k, 7p - Phone # Inspection Date OG / 2 _9 105 Approved Correction Re- Insp'n Fee MIAMI SHORES VILLAGE UIL P ING DEPARTMENT 305- 795 -2204 1127 ,c Building Inspection Request Date 10 4361 Type Insp'n e" Permit No. `-c--CD3 - 208 Name -P� Address C 14E- 42E7. t Company l C- Phone # C� g& Z O - 9d Inspection Date 1 0 ) ri 1c5 _ A roved CI �/ L/ Approved � _ Correction lV f '. , Re- Insp'n Fee ❑ , � 677 c /_(e MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Bu'lding Inspection Request DateDliq I°5 Type Insp'n goL) H Permit No.E 20 8 nor Name 1 �tt-d Si�l� Ji L�$� Address 469 1 S-r Company A Li �� r —r c Phone # ( ) 2EO 9 0 40 Inspection Date 1 D 20 05 Approved Correction Re- Insp'n Fee 7cg )-W7 ) ©/a a - evf- 7 Inspection Date: 09/20/2006 Inspector: Devaney, Michael Owner: PALMER, MARTIN Job Address: 469 91 Street NE Project: <NONE> Miami Shores Village, FL 33138- Contractor: ANCO ELECTRIC INC. Building Department Comments Tuesday, September 19, 2006 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspector Comments Block: Permit Type: Electrical - Residential Inspection Type: Final Work Classification: Temp for Construction Phone Number Parcel Number Lot: 305 - 310 -4673 PARC2004 -1 6 Phone: (305)260 -0455 Passed Failed Correction Needed Re- Inspection Fee ($75) No Additional Inspections can be scheduled until re- inspection fee is paid . z p°6710a kea ___96 Page 2 of 2 Permit Number: EL -9 -06 -2276 Invoice Number: EL -9 -06 -26085 Applicant: BRUCE & LAURIE DAVIDSON Company Name: Owner Address: 1900 S. BAYSHORE DRIV MIAMI, FL 33133 Job Address: 469 91 Street NE Miami Shores Village, FL 33138- Date Monday, September 11, 2006 09/11/2006 Check Receipt Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Fax: (305)756 -8972 Payment Type Check Number 2806 Amount $106.30 Change $0.00 Total Payment: $106.30 Page 1 of 1 BUILDING PERMIT APPLICATION FBC 2004 Permit Type (circle): Building Electrical Owner's Name (Fee Simple Titleholder) Owner's Address !r "p ` -', f i City v I ��;�', State Zip Tenant/Lessee Name Phone # Job Address (where the work is being done) City Miami Shores Village County Miami -Dade Zip FOLIO / PARCEL # Is Building Historically Designated YES NO \. Contractor's Company Name _/ Contractor's Address �; �y:. /1 f 7( 1 1 in 15 City ..7 .0- , -; / � Qualifier Name , 1 v ,. ° (C ) ( r c , C State Certificate or Registration No ; '' f _. Architect/Engineer's Name (if apl t,) Value of Work For this Permit' 1 if Type of Work: ©Addition Describe Work: i' Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Plumbing Master Permit No. {= t ' • Phone # Structural Review. $ Total Fee Now Due $ Permit No. 7 - 7 C- - Mechanical Rooting 0- one # tage Of Work: ] Repair/Replace ** ** *** ** * **** * * * * * * * * * * *, ****** * * ** *, Fees, * * * * * *: rat * * ****** *** *** * * * *** * * * * * * * *** * *** .;�� Submittal Fee $ Permit Fee $ / d eat" CCF $ �:`' / CO /CC Notary, $ Training/Education Fee $ > „r / Technology Fee $ Scanning $ Radon $ DPBR $ Zoning $ Bond 5 Code Enforcement $ Double Fee $ 7 r' See Reverse side - kAdyt' Demolition Bonding Company's Name (if applicable) Bonding Company's Address City State 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 ir..formation 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 5e charged Signat i ' The fore day of who NOTARY PUBLIC: Sign: Print: (Revised 02/08/06) Owner or Agent g instrument as acknowledged before me this 2c (e, by na11y kno or who has produced who is( ersonally knownto me or who has produced as identification and who did take an oath. MARTIN J. PALMER 4 pr Cane 000322310 P\ N ry Public State of Florida Expires Ka ttteen amtltan yf41Hl FlMyp rye` Inc s identification and who did take an oath. /., Zip — — Signature Sign: Print: J Contractor The foregoing instrument was acknowledged before me this _ , day of _, 20 , by NOTARY PUBLIC: My Commissio My Commission Expires: * * * * * * * * * * * * * ** -. * * l'r iF ** ** iC**lFa4ik9fiC9C] B] F*1k' 3tiC1F] F' 1F1F1FIFi 4fFik ]Yik iYaFlhlk]Yita'l*a1r1k1Yf *** SYtCirai' v: 7Y] t1Fi@ SF*9Fft*lFik*lt iY4[ltfY]F*** *1kfr)FiY] *** / w APPLICATION APPROVED By � �� >� • �'��'E;-v- Plans Examiner Engineer Zoning for owners: Page 1 01 2 NOTE: ELECTRIC SERVICE WILL BE DISCONNECTED "WITHOUT NOTICE" UPON 30 DAY TERMINATION UNLESS APPLICATION IS RENEWED It is understood that the temporary - electrical approval by the Miami Shores Village, Building & Zoning Department given in connection with the building being constructed under. Building Permit No. aF 2- , 4- C Electrical Permit No. 4 iliii F)� . at address: � GE- AFFIDAVIT FOR 30 DAY TEMPORARY- ELECTRIC SERVICE (To be executed by Owner and/or Tenant, Building & Electrical Contractor) day of Notary Pu lic, of Florida at Large My Commission Expires: Sworn and subscribed before me thi BUILDING AND ZONING DEPARTMENT 10050 N.E. SECOND AVENUE MIAMI SHORES. FLORIDA 33138-2382 TELEPHONE (305) 795-2204 FAX (305) 756-8972 is being given only for construction purposes or for testing the following installations being made in said structure: Sub - paragraph 4501.3 (d) (3) of the South Florida Building Code provides for a 30 day maximum approval only in an URGENT NECESSITY for electric current exists. Necessity shall include the use of current for irrigation, security, humidity control, emergency power and lighting, such as for testing or construction purposes, provided the Electrical Contractor and owner do hereby agree to assume the responsibility of maintaining the installation in such a manner that there is no hazard to life and property. Such approval is in no event to be considered a release of said structure for purposes of use and occupancy, and no occupancy shall be granted or permitted until final inspections have been called for and approved by the inspection divisions concerned, and an occupancy permit obtained. The undersigned also understand that the temporary -electric approval is subject to rescission and cancellation, and electric power can be cut off at the discretion of the Building and Zoning Department and will be disconnected if the building concerned is occupied before final inspections are approved and occupancy permit obtained. M vIA � , being first duly sworn, depose and say that I am the owner of the above described property, and that I agree that the structure covered in this agreement shall not be occupied until the building contractor has obtained approval of final inspections. SKIN SIGN �.ai • r, ` ublc State of Florida Kathleen Hamilton My Commission DD 32340 Ex, ices 05/2 r to Sworn and s 30 DAY TE v1PORAR'z - ELECTRIC SERVICE (continue) / L - - 2.:E Ged • being first duly sworn, depose'andAay that I am the Electrical Contractor for the above described property an that the electrical installations as now existing will not create a safety hrrnard temporary- service is connecte' Sworn and subscribed before me thi s . ), - day of , Notary Public, State of Florida at Lar My commission expires: day of Notary Public, My Commission E p it being first duly sworn, depose and said that I am the Building Contractor of the above described property and that I will not permit occupancy of this building until final division obtained and that I have the authority the owner of said property is concerned to prohibit occupancy until such final inspections are ob Notary Public State of Florida Kathleen Hamilton DD5 r 2340 Expires r ; i 10 SIGNATURE OF ELECTRICAL LNSPECTOR Date: Page 2 of 2 SI N " OF NOTARY PUBLIC Release to FLORIDA POWER & LIGHT CO. by: ( name) Date.: e SIGNA fJRE OF ELECTRICAL CONTRACTOR To: (name) n � TURE OF BUILDLNG CONTRACTOR Issue Date: 9/7/2006 Owner's Name: MARTIN PALMER Permit Type: Electrical - Residential Work Classification: Temp for Construction Job Address: 469 91 Street NE Comments: 30 DAY TEMP ELECTRIC Additional Information Miami Shores Village, FL 33138- Contractor(s) ANCO ELECTRIC INC. Phone (305)260 -0455 Primary Contractor Yes Type of Work: Classification: Residential Additional Info: 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 responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL, PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work. OWNERS 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. Futhermore, I authorize the above -named contractor to do the work stated. Fees Due Amount CCF $0.60 Education Surcharge $0.20 Permit Fee - Additions /Alterations $100.00 Scanning Fee $3.00 Technology Fee $2.50 Total: $106.30 Invoice Number EL -9 -06 -26085 Total: Amt Due $106.30 Amt Paid Building Department File Copy Applicant Signature Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Fax: (305)756 -8972 Permit Expires: 05/31/2006 Permit Status: APPROVED Permit Number: EL -9 -06 -2276 Phone: 305 -310 -4673 Parcel #: PARC2004 -16 Block: Lot: Section: PB: Total Square Feet: 0 Total Valuation: $ 1,000.00 Re • uired Ins • ections Final NOTICE: In addition to the requirements of this permit, there may be additional restrictions applicable to this property that may be found in the public records of this county. AND THERE MAY BE ADDITIONAL PERMITS REQUIRED FROM OTHER GOVERNMENTAL ENTITIES SUCH AS WATER MANAGEMENT DISTRICTS, STATE AGENCIES, OR FEDERAL AGENCIES. _- ...-• -- r- ----- -- -- - - - Passed Inspector Comments _ 4 i / 3�''' �� Failed Correction Needed Re- Inspection Fee ($75) No Additional Inspections can be scheduled re- inspection fee is paid. until inspection Number: INSP -32193 Permit Number: EL2005 -208 Inspection Date: 11/1312006 Inspector: Devaney, Michael Owner: PALMER, MARTIN Job Address: 469 91 Street NE Project: <NONE> Miami Shores Village, FL 33138 Contractor: ANCO ELECTRIC INC. Monday, November 13, 2006 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 K27 8 ED Block: C_! 0?aU� -q7o Permit Type: Imported Permit Inspection Type: Final Building Work Classification: <NONE> Phone Number 305 - 310 -4673 Parcel Number 1132060140141 Lot: Phone: (305)260 -0455 Page 2 of 2 Related Permits Driveways /Sidewalks /Slabs Electrical - Residential Fence /Wall Imported Permit Imported Permit Imported Permit Imported Permit Mechanical - Residential Paint Plumbing - Residential Roof Permit Number DS -6 -06 -1661 EL -9 -06 -2276 FW -6 -06 -1652 EL2005 -208 BP2004 -920 PL2005 -193 EL2005 -209 MC -12 -05 -1264 PT -6 -06 -1634 PL -9 -06 -2333 RF -12 -05 -1118 Application Date 06/20/2006 07/06/2004 07/06/2004 06/24/2005 07/06/2004 07/06/2004 06/24/2005 07/06/2004 07/06/2004 09/13/2006 12/06/2005 Expiration Date 04/28/2007 03/19/2007 03/20/2007 05/13/2007 03/12/2006 04/30/2007 04/18/2006 04/14/2007 04/14/2007 04/16/2007 03/24/2007 Status CLOSED CLOSED CLOSED APPROVED CLOSED CLOSED CLOSED CLOSED CLOSED CLOSED CLOSED BUILDING FBC 2001 Owner's Address Contractor's Address Submittal Fee $ ' Notary S 5. -) Scanning $ ) Code Enforcement $ S Value of Work For this Permit (Continued on opposite side Training /Education Fee S Radon S __ Total Fee Now Due $ ���' • Miami Shores Village Building Department 10050 N.E,2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Permit No. PERMIT APPLICATION % Master Permit No. � � " Permit Type (circle): Building ( - Plumbing Mechanical Roofing Owner's Name (Fee Simple Titleholder) /)., r. f) 4.),-4 ir ,. 7 6 . 4- ' c' /,5. • City_/ / ,,, ;f ,. -I State , o -t , i Zip Tenant/Lessee Name Phone # Phone # Job Address (where the work is being done) ( "/ A City Miami Shores Village County Miami -Dade Is Building Historically Designated YES NO )C City _%,, 4 L -f ( State / -- Zip Qualifier State Certificate or Registration No._ e ( /<Y e :' s e - Certificate of Competency No. Zip Contractor's Company Name 7 //, Aie ' ( E %l_' /C / Phone # Architect/Engineer's Name (if applicable) Phone # �°,' ? ' Square Footage Of Work: Type of Work: Addition ['Alteration jgiNew ❑ Repair/Replace ❑ Dcmo ition Describe Work: .f- c : "7/ /f'i . d. f --+=f. _ ° ;_,rw 'c: e rr' ,?e /tc' c, 4 ****************************F Permit Fee $� Pd s ' 6 CCF S . • Structural Plan Review. 5 CO /CC Technology Fee S l i> Zoning Bond c Bonding Company's Name (if applicable) Bonding Company's Address City State 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 afier 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 The foregoing instrument was acknowledged before me this The foregoing instrument was ac gp Iedd`ge�d �before me this ' Y , 7 0F , by r/�'�S ( c'voo! day of , 20 , by , day of( who is personally known to me or who has produced who is rsonally known to me or who has produced as is emification and who did take an oath. As identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBL Sign: Sign: Print: Print: My Commission Expires: My Co i mission Expires: *, F, F ' Rd[ dC, FSi> i% iY, r*****. FdC**** 14 FdC Y h) k' IC F F*dC F' Jf* wwY. 9CT', 4d.', YiC**** ikiF ,F,F1Y,FiF*,Fr'x,k]F,F,k,F,' *A',C,'s,F,Yi **::'.'. i:s':**** ***lc** *'****,Faf,F*** **********************************************4 ****************************************************m******** . * * ****** APPLICATION APPROVED BY:j chc 05/13/03 Owner or Agent Zip Signature / 1 Contrac Plans Examiner Engineer Zoning Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Printed: 6/27/2005 Applicant: MARTIN Owner: PALMER JOB ADDRESS: 469 Contractor ANCO ELECTRIC INC. Local Phone: Parcel # PARC2004 -16 Signed: N.E. 91 Legal Description: (INSPECTOR) Signed: (Contractor or Builder) Electrical Permit Permit Number: EL2005 -208 PALMER MARTIN ST. Contractor's Address: 3020 SW 79TH AVE Fees: FEE2005 -8826 FEE2005 -8827 FEE2005 -8828 FEE2005 -8829 FEE2005 -8830 FEE2005 -8831 Description Building Fee CCF Notary Fee Training and Education Fee Technology Fee Scanning Fee Total Fees: Amount $472.00 $8.40 $5.00 $2.80 $11.80 $3.00 $503.00 Total Fees: $503.00 Total Receipts: $0.00 Permit Status: APPROVED Permit Expiration: 12/21/2005 Construction Value: $13,500.00 Work: ELECTRICAL FOR SIGLE FAMILY HOME RESIDENCE 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: Page 1 of 1 Lied 28 Inspection Date: 11/07/2006 Inspector: Devaney, Michael Owner: PALMER, MARTIN Job Address: 469 91 Street NE Project: <NONE> Miami Shores Village, FL 33138 Contractor: ANCO ELECTRIC INC. Building Department Comments Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, Fi_ Phone: (305)795 -2204 Fax: (305)756 -8972 Block: Permit Type: Imported Permit Inspection Type: Final Work Classification: <NONE> Phone Number Parcel Number Lot: Phon -: (305)260 -0455 305 - 310 -4673 PARC2004 -16 Monday, November 6, 2006 Page 1 of 2 Passed Inspector Comment Pi Ter Lae ��� � � � � #P7-.1c./ �� C� f/2-717-0e--,W — ,- /zlL ”, 7 p „����z Failed - Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled re- inspection fee is paid . 7 , until Inspection Date: 11/07/2006 Inspector: Devaney, Michael Owner: PALMER, MARTIN Job Address: 469 91 Street NE Project: <NONE> Miami Shores Village, FL 33138 Contractor: ANCO ELECTRIC INC. Building Department Comments Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, Fi_ Phone: (305)795 -2204 Fax: (305)756 -8972 Block: Permit Type: Imported Permit Inspection Type: Final Work Classification: <NONE> Phone Number Parcel Number Lot: Phon -: (305)260 -0455 305 - 310 -4673 PARC2004 -16 Monday, November 6, 2006 Page 1 of 2 Miami Shores Village BUILDING PERMIT APPLICATION FBC 2001 Permit Type (circle): Building Electrical Job Address (where the work is being done) City Miami Shores Village Is Building Historically Designated YES S Value of Work For this Permit Type of Work: ❑Addition ❑Alteration Describe Work: (Continued on opposite side) Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 County Miami -Dade NO Permit No. Master Permit No. Plumbing Mechanical Owner's Name (Fee Simple Titleholder) Owner's Address City State Zip Tenant/Lessee Name Phone # Phone # Architect/Engineer's Name (if applicable) Phone # Zip Contractor's Company Name ,_ Kiqy Phone # Contractor's Address Cite State Zip Qualifier State Certificate or Registration No. Certificate of Competency No. Square Footage Of Work: t / Jr/ (. .//CT Submittal Fee S.. '' Permit Fee $ .3/ e €f l` CCF S ` Notar} S Training/Education Fee S � - i Technology Fee S Scanning S Radon S Zoning Bond S Code Enforcement S Structural Plan Review. S Total Fee Now Due $ ,w • CO /CC - Roofing ❑ Repair/Replace ❑ Demolition 4 R 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 Ali 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 tnust 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 Contractor 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: ************************************************************************::**** * ** * * * * * * * * * * * * * * * * * * * * * * * * * * ** * * * * *** *** ***& *************************************************************** ** ** **** ** ******** * *** * **** ** ** APPLICATION APPROVED BY: 2 C -- - / A ' 1 Plans Examiner Chc 05/13/03 Engineer Zoning Date ®/� ' 1 7 Job Address Contracting Co. -,r PERMIT APPLICATION FOR MIAMI SHORES VILLAGE 10050 N.E. 2nd Avenue • Miami Shores, Florida 33138 • Phone: 305 - 795 -2204 • Fax: 305 - 756 - 8972 Owner's Address JJ7 // (- e.,./ Qualifier ) ( / > <,= 1 !� (1 State # `= ° ° d `' ' j ✓ ' Municipal # Signature of owner and/or Condo President Legal Description d /Vt., • /2) Owner /Lessee/Tenet Master Permit # / i WORK DESCRIPTION: <!< ,d / . (1 /('''( Historically Designated: Yes No Tax Folio Phone Competency # Square Ft. Estimated Cost (value) ° 7 , .2V :', Address // ' Y // x, ' : i /7' ; - f ti Ins. Co. IF THERE IS NO PERMIT PACKAGE ACCESSIBLE ON THE JOB SITE FOR INSPECTORS TO VERIFY, THERE WILL BE NO INSPECTION. RE- INSPECTION FEE IS $50.00 AND MUST BE PAID IN ADVANCE BEFORE CALLING FOR ANOTHER INSPECTION. � Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING 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, CONSLLT WITH YOUR LENDER OR ANY 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 all disciplines. OWNERS AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable Iaws regulating construction and zoning. Furthermore, I authorize the above named contractor to do the work stated. Date Signature oftiontractor or Owner Builder ;)ate Notary as to Owner and/or Condo President Date Notar'as to Contractor or Owner Builder My Commission Expires My Commtission 1=3#irct -- • Date ?EES: PERMIT RADON C.C.F NOTARY BOND APPROVED: .._ -- y - TOTAL DUE Zoning Building • Electrical Mechanical Plumbing Structural Engineer ADDENDUM TO BUILDING PERMIT APPLICATI'- PLUMBING ELECTRICAL (AN ARP3.ICATION 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.) MECHANICAL ITEM BATH TUB UNIT FEE ITEM SWITCH OUTLETS .4; UNIT FEE ITEM SPACE HEATERS UNIT FEE BIDET LIGHT OUTLETS V*5? CENTRAL HEATING DISHWASHER RECEPTACLES A/C (WIND) DISPOSAL SERVICE TEMPORARY A/C (CENTRAL) DRINKING FOUNTAIN SERVICE SIZE IN AMPS (/527 fl DUCT WORK FLOOR DRAIN SERVICE REPAIRAMETER CHANGE REFRIGERATION GREASE TRAP APPLIANCE OUTLETS PROCESS AND PRESS PIPING INTERCEPTOR RANGE TOP / UNDERGROUND TANKS LAVATORY OVEN / ABOVE (ROUND TANKS LAUNDRY TRAY WATER HEATER / U.F. PRESSURE VESSELS CLOTHES WASTER 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 FP ELEVATORS/ESCALATORS TEMPORARY WATER CLOSET MOTCRS OVER 10- 25 HP FIRE SPRINKLER SYSTEMS URINAL MOTORS OVER 25-100 HP 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 (v, ir) / 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 FIXTLRES SEPTIC TANK ANTENNA RELAY TELEVISION OUTLETS DRAINFIELD, 4° TILE/RES. VIOLATION PUMP 8 ABANDON SEPTIC TANK REINSPECTION SOAKAGE PIT CU. FT. g6e,lIP csik_i 5 CATCH BASIN lec�.5 .S',. �a"e 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 APPLICATI'- PLUMBING ELECTRICAL (AN ARP3.ICATION 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.) MECHANICAL -., YVJLI-/Ll1V : _.... _: ►aV�: +s�► .i AUUCNiUM. If A MASTER PERMIT HAS B. ;B`PAINIrD THE4OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT OR SUBSEQUENT APPL CATIO S.) RECEPTACLES SERVICE TEIPORARY SERVICE SIZE IN AI,PS 59, SERVICE REPAIR/ IER APPLIANCE OUTLETS 1,CTORS OVER 3- 5 FP I,OTORS OVER S• 8 tP MOTORS OVER 8- 10 tP )CTC>RS OVER 10- 35 tP POTCRS OVER 35-100 tP IDTORS OVER 100 HP AIR COPaITIOPRS STRIP HEATER GENERATORS TRAKTCRARS GENERATORS TRAttFOR>(RS GENERATORS TRANSFOV RS SPECIAL PLRPOSE OUTLETs ClWRCIAI. RE INSPECT ION OUCT NORK REFRIGERATION PROCESS AID PRESS PIPING IItlERGROUAO TANXS ABOVE GROUND TANKS U.F. PRESSURE VESSELS STEAM BOILERS ITT WATER BOILERS MECHANICAL VENTILATION TRAN5P0RTtNG ASSEI€LIES SIGN TL€ES SIGN TRANSFCR1ERS SIGN TILE CLOCK FIXTURES ANTENNA TELEVISION OUTLETS VIOLATION :VATORY :UKIJRY TRAY FOUNTAIN A/C UNIT FIRE SPRINKLER t -NEIL INST. HEATER-REput LAWN SPRINKLER -?ELL SWIMIlte POOL «ATER SERVICE PIT CU. FT. UNIT FEE 1TE» Sw I TCti OUTLETS L I a l' OMITS CENTRAL HEATING A/C (NM) E.4 TH TU3 CET S iLtSl{ER UNXING ;EASE TRAP +TERCEPTOR PLUMBING _DINES NASITER - aEER :iX, POT/3 COW. NK. RESIOENCE NX, SLOP :WORMY HATER a I NAL ;TER CLOSET 'DIRECT ;TER $PPLY TO: ER COIOOECTIOHS I l : TY- SELLER • 1L ITY- #EATER FT IC TANK LAY W 8 ASAWON SEPTIC TANK TCH SOiARGE WELL w<STIC 1NELL EA CRAIN CF I tILET LAR ;E STANCPIPE CL PIPIIG ,N SFR DOTER TER SET (US) S PIP»G ELECTRICAL MECHANICAL I 43 ' ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERNUT Tc.)4-4 MIAMI SHORES VILLAGE Permit No 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 :ules 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. Owner's Name and Address No Street Registered Architect and/or Engineer c-- 1 P nVoyi lectrician's Name., A. v i a L. on and Legal Description Lot Block Subdivision is. IV ,7 rreet and Number where work is to be performed—No Street Amount of Permit $ STATE OF FLORIDA, } COUNTY OF DADE. SS. Service Overhead Size Feeders Conduit Main Sw Underground Type Installation—Conduit Tubing B.X.L No Street jate work to be performed and purpose of building (By Floors) LC 4.9 a New Building Remodeling Addition Repairs No. of Stories (Signed) The undersigned applicant for this building permit does hereby certify that he understands and a labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws has complied with the provisions thereof, and will require similar compliance from all contractors or work to be performed under this permit; and will post or cause to be posted for inspection on the site as are required by the Act. The undersigned agrees to employ only such subcontractors, on work to licensed by Miami Shores Village. Amps Main Fuses Amps Metal Moulding. ............... • y Electrical Inspector. ccepts ISfs obligations as an employer of of Florida Permanent Supplement, and subcontractors employed by him in the of the work such public notice or notices be performed under this permit, as are (Signed) Master Eiectricia-a. 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, aid 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 PLUG RECE'P'T'S FIXTURES NO. LAMPS REFRIO, OUTLET IRON OUTLET RANGE OUTLET RANGE CONN. WATER HEATER W. HEAT. CONN. SPACE HE 2R STRIP HEATER TOTAL CONTR. LIST CHECK ENT. SW. DIST. CAS. SERVICE TP. SERVICE PERM. . . , ' , MOTORC 0.1 HP P.:OTORS 1.5 HP NECN TRANS. RADIO TOTAL CON.. LIST CHECK I 43 ' ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERNUT Tc.)4-4 MIAMI SHORES VILLAGE Permit No 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 :ules 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. Owner's Name and Address No Street Registered Architect and/or Engineer c-- 1 P nVoyi lectrician's Name., A. v i a L. on and Legal Description Lot Block Subdivision is. IV ,7 rreet and Number where work is to be performed—No Street Amount of Permit $ STATE OF FLORIDA, } COUNTY OF DADE. SS. Service Overhead Size Feeders Conduit Main Sw Underground Type Installation—Conduit Tubing B.X.L No Street jate work to be performed and purpose of building (By Floors) LC 4.9 a New Building Remodeling Addition Repairs No. of Stories (Signed) The undersigned applicant for this building permit does hereby certify that he understands and a labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws has complied with the provisions thereof, and will require similar compliance from all contractors or work to be performed under this permit; and will post or cause to be posted for inspection on the site as are required by the Act. The undersigned agrees to employ only such subcontractors, on work to licensed by Miami Shores Village. Amps Main Fuses Amps Metal Moulding. ............... • y Electrical Inspector. ccepts ISfs obligations as an employer of of Florida Permanent Supplement, and subcontractors employed by him in the of the work such public notice or notices be performed under this permit, as are (Signed) Master Eiectricia-a. 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, aid 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. 'Inspection Number: INSP-16902 Inspection Date: 05/11/2006 Inspector: Devaney, Michael Owner: PALMER, MARTIN Job Address: 469 91 Street NE Project: <NONE> Contractor: ANCO ELECTRIC INC. Building Department Comments Wednesday, May 10, 2006 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Miami Shores Village, FL 33138 Permit Number: EL2005 -209 Block: Permit Type: Imported Permit Inspection Type: Final Work Classification: Electric Phone Number Parcel Number Lot: 305-310 -4673 PARC2004 -16 Page 1 of 2 Passed Inspector Comments / ��� " r#A1e , -.7 1-c % ,,� x oj a e )7 6' Failed Correction Needed Re- Inspection Fee ($75) No Additional Inspections can be scheduled re- inspection fee is paid. until 'Inspection Number: INSP-16902 Inspection Date: 05/11/2006 Inspector: Devaney, Michael Owner: PALMER, MARTIN Job Address: 469 91 Street NE Project: <NONE> Contractor: ANCO ELECTRIC INC. Building Department Comments Wednesday, May 10, 2006 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Miami Shores Village, FL 33138 Permit Number: EL2005 -209 Block: Permit Type: Imported Permit Inspection Type: Final Work Classification: Electric Phone Number Parcel Number Lot: 305-310 -4673 PARC2004 -16 Page 1 of 2 . 4485 MIAMI SHORES VILLAGE BUI L ING ) EPARTMENT 305- 795 -2204 Building Inspection Request Dated ? T 9 Type Insp' n� f� A'd�l�✓� ®/� J _ °� Permit No. Name 711/ S , /ii- P f Address V6 9 ,e �./ 57 Company �- , Phone # , % i s '- ; g 7 °— ‘7 Inspection Date Approved Correction Re- Insp'n Fee MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305-795-2204 Building inspection Request Date: Type Insp'n ; /- / Permit No. f' - Name A; 6 Address -; Company ,/ Phone # Inspection Date Approved Correction Re-Insp'n Fee • BUILDING U �' � Permit No. PERMIT APPLICATION FBC 2001 Tenant'Lessee Name Contractor's Company Name Contractor's Address City Qualifier Architect/Engineer's Name (if applicable) X /):( • State $ Value of Work For this Permit.. Miami Shores Village Building Department 10050 N.E2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Permit Type (circle): Building ( Electrical Plumbing Mechanical Roofing Owner's Name (Fee Simple Titleholder) ti� , f 17j;✓2t. w;;._ �' ", - Phone # Owner's Address `/ �' 'V(. '2/ , d City / 47 , ;'l( s a State Job Address (where the work is being done) t` (i. City Miami Shores Village County Miami -Dade Zip Is Building Historically Designated YES NO • `7 / WA Phone # e Zip State Certificate or Registration No. e - ( Ca'' , Certificate of Competency No. Zip Phone # 1 - Phone # C Square Footage Of Work: Master Permit No.467 4- C 'Or: (ci nt-r Type of Work: ❑Addition ❑Alteration NIew ❑ Repair/Replace ❑ Demolition Describe Work: Total Fee Now Due 5 Submittal Fee $ c Permit Fee 5 e c' ' � ° CCF $ ' .61-r° CO /CC Notary S 5- O i Training /Education Fee $ t) _ 00 Technology Fee S t)" :3 - Scanning $ i. lX- Radon $ Zoning Bond 5 Code Enforcement $ Structural Plan Review. $ (Continued on opposite side) * * * * * ** * * * * * ** * * * * * * * * * *** ** Fees : * **** * * * ** * * * * ******* * *r*** ** 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 OK AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Notice to Applicant: As a condition to the issuance of a building permit with an estirnated 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. �9 Signature Signature APPLICATION APPROVED BY ehc 05/13/03 NOTARY PUBLIC: Owner or Agent Contrac The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this 2-57 day of , 20 _ , by , day of , 20 6) by Prakic, ,0 who is personally known to me or who has produced As identification and who did take an oath. NOTARY PUBLIC: Sign: Sign: �. Print: Print: My Commission Expires: My Commiss4Expires: who is nally known to me or who has produced aside ification and who did take an oath. ************************************************************************•******* *** * * * * * * * * * * * * * * * * * * * * * * * * ** * * * * ** * * * * * * * * * * * * *? ** *** ** *** ** *** ** ** ** * * * * * * * * * * * * * * * * * * * * * ** ** * * * : ** * * * * * ** * * * * * ** * * * ** * * *** ** ** , /'4/ -�. Plans Examiner Engineer Zoning • ITEM BATH TUB UNIT FEE ITEM SWITCH OUTLETS UNIT FEE ITEM SPACE HEATERS UNIT FEE BIDET LIGHT OUTLETS CENTRAL HEATING DISHWASHER RECEPTACLES 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 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 If 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 HP 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 SWIMfi1ING 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 ORAINFIELD, 4" TILE/RES. VIOLATION PUMP 8 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 B. OBTA.NED, THE OWNER'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 Permit Number: EL2005 -209 Printed: 6/27/2005 Applicant: MARTIN Owner: PALMER JOB ADDRESS: 469 N.E. 91 Contractor ANCO ELECTRIC INC. Local Phone: Parcel # PARC2004 -16 Fees: Description Amount FEE2005 -8832 Building Fee $100.00 FEE2005 -8833 CCF $0.60 FEE2005 -8834 Notary Fee $5.00 FEE2005 -8835 Training and Education Fee $0.20 FEE2005 -8836 Technology Fee $2.50 FEE2005 -8837 Scanning Fee $3.00 Total Fees: $111.30 Total Fees: $111.30 Total Receipts: $0.00 Permit Status: APPROVED Permit Expiration: 12/21/2005 Construction Value: $450.00 Work: TEMPORARY POWER FOR CONSTRUCTION Signed: Legal Description: (INSPECTOR) Electrical Permit PALMER MARTIN ST. Contractor's Address: 3020 SW 79TH AVE Signed: (Contractor or Builder) BY: Page 1 of 1 _ 1 2 8 P AD c- 1 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.