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MECHANICAL• �,� /� 8 '5 g 11 '� � r�" , ;`"�•-� . � Job Address � �� Date �A � � � �{`�'g Tax Folio Legal Description � ` T 'I/ / A Owner / Lessee / Tenant Pc VA .0 T k■int\ Owner's Address Contracting Co. ` a_C Qualifier\-m(L+'iW,(0 State # Municipal # Competency # Ins.Co. Architect /Engineer Address Bonding Company Address Mortgagor Address - - -_ Permit Type(circle one): BUILDING ELECTRICAL PLUMBI G MECHANICAL ROOFING PAVING PENCE SIGL WORK DESCRIPTION _L. n lcuk , OM A - 1 7 0 r A f) r L A, " c)' kVy 6,4 Square Ft. Estimated Cost(value)Qooc WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DC SO MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTENT TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOU! NOTICE OF COMMENCEMENT). Application is hereby made to obtain a permit to do work and installation as indicated above, an on the attached addendum (if applicable). I certify that all work will be performed to meet th standards of all laws regulating construction in this jurisdiction. I understand that separat permits are required for ELECTRICAL, PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK. OWNER'S AFFIDAVIT: I be done in compliance authorize th bove Si re Date: SHEILA DONOVAN STATE OF FLORIn �Y'� ✓'�' C$fi /6tP . k5Presi My Commission ExpireFS' \DED Notary as APPROVED: PERMIT APPLICATION FOR MUNICIPALITIES OF DADE COUNTY (OWNER TO RETAIN COPY) ** * E C t 5 517 certify that all the foregoing information is ac orate and that all work wil with all applicable laws regulating constru ion and , zoning. Furthermore, ed contractor to the work stated. of owner and /or ndo President FEES: PERMIT 21,W RADON C.C.F. c' NOTARY TOTAL DUF,26 i gily Master Permit # .c Phone v 15 6 1 - 9:3 1 g Address p3e; Ss# : Phone C d ' 1 1 yNt Fire Building Plumbing_ Signatu of cto DONOVA Notary STATE OF FLORIDA ,d Public My Comm Exp7/ Notary as to • ntracEt@ppj My Commission Expires: * * * — Builder * ** Other Electrical Engineering PERMIT NO. STATE OF FLORIDA: COUNTY OF DADE: THE UNDERSIGNED hereby gives notice that improvements will be made to certain real property. and in accordance with Chapter 713, Florida Statutes, the following information is provided in this Notice of Commencement. /3 Z 7' 1. Legal description of pr perty and street address: io2 ' P ' • 9 ' 3 y S � / _e ck G 9 ,2 3 2. Description of improvement: 1> .2 /2 t y 3.Owner(s me address: / 73 ' 9. J,.3 riq y i U / nd a /d 11' Interest in property: Name and address of fee simple titleholder: 4. Contractor's name and address: PI, 33/G')- 6. Lender's name and address: Signature of Owner Print Owners Name Sworn to and subscribed Notary Public f Print Notary's Name < �t 7-MA L, My Commission Expires: 7 j NOTICE OF COMMENCEMENT different date is specified) <-71//- TAX FOLIO NO. 1/ 3.20v 2 7 - DO; D _ 1)9,r AA 4 mil M IA) A/ 5. Surety:(Payment bond required by owner from contractor, if any) Name and address: Amount of bond $ TEsVi a- V AN STATE OF FLORIDA My Comm Exp7/31/ ONDED 9384 15979 1993 DEC: 15 10 :00 7. Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as provided by Section 713.13(1)(a)7., Florida Statutes, Name and address: 8. In addition to himself.,Owner designates the following person(s) to receive a copy of the Lienor's Notice as provided in Section 713.13(1)(b), Florida Statutes. Name and address: 9. Expiration date of this Notice of Commencement: (the expiration date is 1 year from the date of recording unless a , 19 3 • 33/3r- Prepared �b ^ j2 ?v / `��' / `v / Address: -7& 3r / " / `T /' ,71- -1 /G Permit No ! ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT 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, Fiurida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulationo 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 MIAMI SHORES VILLAGE Registered Architect and /or Engineer Employing Electrician's Name ... r � � 1 a... /J�� / �/ fJl ? o Street. Location and Legal Description Lot Block Subdivision (Signes1 4e/ Date..l..r No /0 ' Street' Street and Number where work is to be performed —No State work to be performed and purpose of building (By Floors) New Building Remodeling Addition Repairs No. of Stories Street The undersigned applicant for this building permit does hereby certify that he understands and 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 sub-contractors, on work to licensed by Miami Shores Village. STATE OF FLORIDA, COUNTY OF DADE. I �'' Before me, the undersigned authority, a notary public, duly authorized to administer oaths /97Q q ? � Master Elect4ician. Service Overhead Size Feeders Conduit Main Sw Amps Main Fuses Amps Underground p p Type of Installation— Conduit Tubing B.X.L .Metal Moulding Amount of Permit $ (Signed ) Electrical Inspector accepts his obligations as an employer of of Florida Permanent Supplement, and sub-contractors employed by him in the of the work such public notice or notices be performed under this permit, as 'are 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 facto 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 REFRIG. OUTLET IRON OUTLET RANGE OUTLET RANGE CONN. WATER HEATER W. HEAT. CONN. SPACE HEATER STRIP HEATER ar e OTAL kT CONTR. LIST ,_ CHECK ENT. SW. DIST. CAB. SERVICE TEMP. SERVICE PERM. MOTORS 0.1 HP MOTORS 1.5 HP NEON TRANS. RADIO TOTAL CONTR. LIST 45 SIC CHECK Permit No ! ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT 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, Fiurida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulationo 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 MIAMI SHORES VILLAGE Registered Architect and /or Engineer Employing Electrician's Name ... r � � 1 a... /J�� / �/ fJl ? o Street. Location and Legal Description Lot Block Subdivision (Signes1 4e/ Date..l..r No /0 ' Street' Street and Number where work is to be performed —No State work to be performed and purpose of building (By Floors) New Building Remodeling Addition Repairs No. of Stories Street The undersigned applicant for this building permit does hereby certify that he understands and 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 sub-contractors, on work to licensed by Miami Shores Village. STATE OF FLORIDA, COUNTY OF DADE. I �'' Before me, the undersigned authority, a notary public, duly authorized to administer oaths /97Q q ? � Master Elect4ician. Service Overhead Size Feeders Conduit Main Sw Amps Main Fuses Amps Underground p p Type of Installation— Conduit Tubing B.X.L .Metal Moulding Amount of Permit $ (Signed ) Electrical Inspector accepts his obligations as an employer of of Florida Permanent Supplement, and sub-contractors employed by him in the of the work such public notice or notices be performed under this permit, as 'are 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 facto 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. r BUILDING PERMIT APPLICATION FBC 2001 Master Permit No. (3, 3* -, 77_///' ? Permit Type (circle): Building Electrical Plumbing Mechanical Roofing Owner's Name (Fee Simple Titleholder) �/',,� ��5' 5,..4.4 A Owner's Address /x'/3 .(// 9:3 X07 City ;e■:+ -r/ State ?._ • Tenant/Lessee Name Phone # Job Address (where the work is being done) City Miami Shores Village County Miami -Dade Zip Is Building Historically Designated YES NO Contractor's Company Name €',eve '1,' Yid -de /ii 1 4) Phone # (3i' ( ?e,e, ?8 Contractor's Address 933 3 A.) (t) City ,A-4.4 A'4'4. State i / A .P . Zip '3 :3 / Z l Qualifier 7 ✓?c -�i' G,_6, State Certificate or Registration No. Certificate of Competency No. Architect/Engineer's Naive (if applicable) Phone # $ Value of Work For this Permit Type of Work: ❑Addition ❑Alteration ❑New ❑ Repair/Replace ❑ Demolition Describe Work: ,C/oga/ 't /c / " ,4t1 4e/e i('1,f Total Fee Now Due $ (Continued on opposite side) Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (365) 795.2204 Fax: (305) 756.8972 zAeo Square Footage Of Work: Permit No. 140U– IC (-) Phone 3e ✓� 4 °, 7��^ Zip e * * * * * * * * * * * * * * * * * * * * * * * * * * ** F ees * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Submittal Fee $ I � Permit Fee $ I [/'L L t'/O CCF $ CO /CC Notary 8 Training/Education Fee $ Technology Fee $ Scanning S Radon $ Zoning Bond $ 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 Signature Owner or Agent The foregoing instrument was acknowledged before me this day of , 20 , by who is personally known to me or who has produced As identification and who did take an oath. NOTARY PUBLIC: Sign: Print: My Commission Expires: Chc 05/13/03 C • tractor The foregoing instrument was acknowledged before me this day of , 20 _, b3S aQ 2%9��6gg who is personally kno f i t NOTARY PUBL - Sign: = "; c Bonding Co., Inc. Print: My Commission Expires: ***************************************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** *************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** * * * * * * * * * * * ** * * ** * * * * * * * * * * * * * * * * * * * * * * * * * * * ** APPLICATION APPROVED BY: V i' , 2666 Plans Examiner Engineer Zoning 4e an oath. ITEM BATH TUB UNIT FEE ITEM SWITCH OUTLETS UNIT FEE ITEM SPACE HEATERS UNIT FEE BIDET LIGHT OUTLETS CENTRAL HEATING DISHWASHER RECEPTACLES A/C (WIN)) DISPOSAL SERVICE TEMPORARY A/C (CENTRAL) DRINKING FOUNTAIN SERVICE SIZE IN A6PS 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 If 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 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 HP 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 SWIMMING POOL OUTLETS COMMERCIAL WATER SERVICE SIGN TUBES SEWER CONNECTIONS .SIGN TRANSFORMERS UTILITY -SEWER SIGN TIME CLOCK UTILITY -WATER FIXTLIFRES SEPTIC TANK ANTENNA RELAY TELEVISION OUTLETS DRAINFIELD, 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 ' i ADDENDUM TO BUILDING PERMIT APPLICATION (AN APPLICATION FOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. IF A MASTER PERMIT HAS B. OBTAINED, THE OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQ - CATIONS.) PLUMBING ELECTRICAL MECHANICAL Mechanical Permit Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Permit Number: MC2004 -194 Printed: 11 /5/2004 Applicant: SANTIAGO BERNAL Owner: BERNAL SANTIAGO JOB ADDRESS: 1213 NE 93 ST Contractor CANE AIR CONDITIONING AND INSTALLAT H1tlf tor's Address: 7327 N. W. 8 STREET Local Phone: 305 - 266 - 7800 Parcel # 1132050270020 Page 1 of 1 Legal Description: BAY LURE PB 44 -63 E5OFT LOT 2 & W25FT LOT 3 Fees: Description Amount FEE2004 -10928 Building Fee $100.00 FEE2004 -10929 CCF $0.60 FEE2004 -10930 Technology Fee $2.50 FEE2004 -10931 Training and Education Fee $0.20 FEE2004 -10932 Scanning Fee $3.00 Total Fees: $106.30 Total Fees: $106.30 Total Receipts: $K Permit Status: APPROVED Permit Expiration: 5/1/2005 Construction Value: $1,000.00 Work: NEW DUCT WORK FOR ADDITION MASTER BP 2004 -1400 VEC 0 t' FAIR 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: BLK 1 LOT