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122 NE 92 St (4)BUILDING ELECTRICAL PLUMBING ROOFING i CONTRACTOR OR BUILDER MIAMI SHORES VILLAGE. FLORIDA PERMIT N° 6836 Owner of Building Architect Contractor or Builder Legal Lot Description 1 31 Address of Building Work to be performed under this Permit , l e DATE F 195" Contractor's License No. Subdi- vision Value of Amount of / Project $ II Permit $ This permit b granted to the contractor or builder named above to construct the building or to install the equipment or device described in the application herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings/ or in the statements or specifications and that he assumes responsibility for work done by his agents, servants or employees. Signed. BY • 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 ac- cepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. BY AUTHORITY BUILDING ELECTRICAL PLUMBING ROOFING /1c Owner of Building ` - Archi tect Contractor or Builder MIAMI SHORES VILLAGE. FLORIDA ❑ DATE 195 ❑ PERMIT N? 6922 Contractor's License No. -- ❑ Work to be performed under this Permit Legal Lot Description Bl. Address of Building / CONTRACTOR OR BUILDER Subdi- vision Value of 1 Amount of Project $ 1 Permit $ 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 co npiiance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes responsibility for work done by his agents, servants or employees. Signed.B 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 ac- cepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. BY AUTHORITY lUILDING ELECTRICAL 'LUMBING )wner of uilding .rchitect ability for work done by his agents, servants or employees. In consideration of ertaining thereto and in u accepting this permit I ACTOR OR BUILDER MIAMI SHORES VILLAGE, FLORIDA PERMIT N? 5541 Work to be performed under this Permit : ontractor -r Builder - .egal Lot Bl. )escription .ddress of : uilding__ 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 appli- ation herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any •lans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked t 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 .ermit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowl ge of the orcinces and `gulations pertaining to the work covered hereby whether shown on the plans awings or in the statements or specification ar that he asf umes respon- *u'vt. w'1.. Signed. Subdi- vision Value of Project BY DATE Contractor's License No. By a - s Amt. of + Permit AUTHORITY 194 INSPECTOR the issuance to me of this permit I agree to perform the work covered tereunder in compliance with all ordinances and regulations strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. assume responsibility for all work done by either myself, my agent, servant or employee. BUILDING ELECTRICAL PLUMBING Legal Description. Address of Building Lot ROOFING ❑ Work to be performed under this Permit Owner of / .� Building ! Architect Contractor or Builder y �� 7.K�• -` MIAMI SHORES VILLAGE, FLORIDA DATF. -- /� 1 * 1954_ Contractor's License No ERMIT IN? 11482 Bl. Subdi- vision i• Project $ This permit is granted tD 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 dra s in the statements or specifications and that he assumes responsibility for work done by his agents, servants or employees. �� Signed Value of Amt. of Permit $ BY r In consideration of the issuance to me of this permit I agree to perform the Nor covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or spe ' ications submitted to the proper authorities of Miami Shores Village. In accepting this permit fas ume responsbility for all work done by either, myself, y agent, servant or employee. �� ' ! /' _3 ,,_ 2 NTRACTOR OR BUILDER B MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date �ime Type Insp'n Permit No)) Z. O O 3'S 3 Name Address Company Phone #--; DS' R 1 For Inspector / oa t Approved Correction ❑ Re- Insp'n Fee ❑ 17 0-1) s)©sci Date Type Insp'n Permit No. Name Y, Company , Phone # ^^�� For Inspectors Al 03 Nam Approved Le" Correction MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Re- Insp'n Fee ❑ c \l o ❑ �iY�l2® 3 MIAMI SHORES VILLAGE BUILDING DEPARTM 305- 795 -2204 Building Inspection Req Permit No. Date _ Time Type Insp'n C.) r 'Name ,��audi /. Address ( 1' 5 Compan Phone # 30 .6:3 For Inspector � ,��,,,�/ Appro / (/- Correction ❑ Re- Insp'n Fee ❑ Ao 3 Date 'Type Insp'n Permit No. Name Address For Inspecto i Approve /' Correction Re- Insp'n Fee ,!I SHORES VILLAGE ALDING DEPARTMENT 305- 795 -2204 Building Inspection Request Time Company ' S ) Phone # ' 2 er I nspection Number: INSP -5207 Inspection Date: 0112312006 Inspector: Perez, JanPierre Owner: PYKE, BRYAN AND ANNA Job Address: 122 92 Street NE Project: <NONE> Miami Shores Village, FL Contractor: BACCIT INC Building Department Comments Wednesday, January 18, 2006 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL P e: (305)795 -2204 Fax: (305)756 -8972 c., Permit Number: MC- 1 -06 -33 Permit Type: Mechanical - Residential Inspection Type: Final Work Classification: Addition /Alteration Block: Phone Number (305)751 -0650 Parcel Number 1132060133280 Lot: Phone: 305 - 687 -5012 Page 2 of 2 Inspector Comments Passed t Failed Correction Needed Re- Inspection Fee ($75) No Additional Inspections can be scheduled until re- inspection fee is paid. I nspection Number: INSP -5207 Inspection Date: 0112312006 Inspector: Perez, JanPierre Owner: PYKE, BRYAN AND ANNA Job Address: 122 92 Street NE Project: <NONE> Miami Shores Village, FL Contractor: BACCIT INC Building Department Comments Wednesday, January 18, 2006 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL P e: (305)795 -2204 Fax: (305)756 -8972 c., Permit Number: MC- 1 -06 -33 Permit Type: Mechanical - Residential Inspection Type: Final Work Classification: Addition /Alteration Block: Phone Number (305)751 -0650 Parcel Number 1132060133280 Lot: Phone: 305 - 687 -5012 Page 2 of 2 Issue Date: 1/10/2006 Expires: 01/05/2007 Owner's Name: BRYAN AND ANNA PYKE Permit Type: Mechanical - Residential Work Classification: Addition /Alteration Job Address: 122 92 Street NE Miami Shores Village, FL Contractor(s) BACCIT INC Phone 305 - 687 -5012 Primary Contractor Yes Comments: REPLACE 2 CENTRAL AIR CONDITIONING SYSTEM Additional Information Tons: 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 CCF Education Surcharge Notary Fee Permit Fee - Additions /Alterations Scanning Fee Technology Fee Total: Amount $3.00 $1.00 $5.00 $175.00 $3.00 $4.40 $191.40 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 Parcel #: Block: Section: Permit Status: APPROVED Permit Number: MC- 1 -06 -33 Phone: (305)751 -0650 1132060133280 Lot: PB: Total Square Feet: 0 Total Valuation: $ 5,000.00 Required Inspections Rough Rough Duct Ventilation Smoke Test Hood Smoke Det Test Final Invoice Number MC - 1 - 06 - 23369 Total: Amt Due $191.40 A y 1 ; A 1 • G. A( 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. BUILDING PERMIT APPLICATION FBC 2001 $ Value of Work For this Permit Type of Work: ['Addition ['Alteration Describe Work: ' Ism 1 C% CA Total Fee Now Due $ (Continued on opposite side) I l .40 Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Permit Type (circle): Building Electr'cal " ` Plumbing C Roofing (4 Phone # tib5) Zci MO, Owner's Name (Fee Simple Titleholder) /fril) „ Owner's Address CitynZ2bn.' tj t State ` Zip Tenant/Lessee Name Phone # Permit No. M C _ I — CX:" " 33 Master Permit No. Job Address (where the work is being done) /02c, A)& W''.. City Miami Shores Village County Miami -Dade Zip Is Building Historically Designated YES NO Phone #(3 (v p 7' °��)) Contractor's Address ),..)• g City 1 -4pt, u�' i, State . 3 ` U �'� r , Zip LL Qualifier �• v.: `: Contractor's Company Nam' �, State Certificate or Registration No. Certificate of Competency No. C 4-c_ y69,3 Architect/Engineer's Name (if applicable) Phone # Square Footage Of Work: ['New (Repair/Replace ❑ Demolition * * * * * * * * * * * * * * * * * * * * * * *t **i * Wei * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Submittal Fee $ Permit Fee $ CCF $ cx:: CO /CC Notary $ 5 . CV Training/Education Fee $ 1- CCD Technology Fee $ 4 .4-0 Scanning $ 3. CO Radon $ Zoning Bond $ Code Enforcement $ Structural Plan Review. $ JAN 1 7 PAID C 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. 1 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 Owner or Agent The foregoing instrument was acknowledged before me this day of:YU() , 2005by Ann Cr P/ K'e, who is personally known to me or who has produced pires NOTAR Sign: Print: My Co mission Expires: * * * * * * * * * * * * * * * * * * * * * * * ** APPLICATION APPROVED BY: Chc 05/13/03 As identification and who did take an oath. el , 1M 13 , :111, 11 On Iea lily 4 tl it Flon,lin„ Cr, 1 , •, ******************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** * * * * * * * * * * * * * * * * * * * * * ** ** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** *** 4* 44****** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** L 1 t 1 Contractor The foregoing instrument was acknowledged before me this S da of N . , 20 Ofg who is personally known to me or who has produced Lb as identification and who did take an oath. NOTARY PUB Sign: Print: My NO OF LORIDA 1r . sw iii Expire . .7Z. 3 i19 fission Ex pi r eDo nde• Thru Atlantic Bonding Co., In 7. UIILIC -S Zoning Plans Examiner Engineer .ADDENDUM TO BUILDING PERMIT APPLICATION FIRE STANDPIPE POOL PIPING LAWN SPRINKLER SYSTEM GAS RANG_ METER SET (GAS, GAF PIPING AN ArBLICATIOIr FQR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. OBTAINED, THE OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON PLUMBING ELECTRICAL IF A MASTER. PERMIT HAS B. SUBSEQUENT APPLICATIONS.) MECHANICAL FEE ITEM SPACE HEATERS UNIT FEE iEM TU3 UNIT FEE ITEM UNIT SWITCH OUTLETS ATH IDE T LIGHT OUTLETS CENTRAL HEAT I NS 1.-tJ 4 4, 4, ISHWASHER I I RECEPTACLES A/C (WIND) ISPOSAL I SERVICE TEMPORARY A/C (CENTRAL) o?llIS 3 . RINKI13 FDJNTAIN I SERVICE SIZE IN AMPS DUCT WORK LOOK DRAIN SERVICE REPAIR/METER CHANGE REFRIGERATION TRAP APPLIANCE OUTLETS PROCESS AND PRESS PIPING REASE • I RANGE TOP UNDERGROUND TANKS NTERCEPTCR OVEN ABOVEGROUND TANKS .AVATCRY TRAY WATER HEATER U.F. PRESSURE VESSELS .AUNDRY :LOTHES WASHER MOTORS Cr- 1 If STEAM BOILERS ;HOWER MOTORS OVER 1- 3 FP HOT WATER BOILERS MOTORS OVER 3- 5 I-F MECHANICAL VENTILATION ;INK. POT /3 COMP. SINK, RESIDENCE MOTORS OVER 5- 8 HP TRANSPORTING ASSEMBLIES SINK, SLOP MOTORS OVER 8- 10 If ELEVATORS/ESCALATORS TEMPORARY WATER CLOSET MOTORS OVER 1C- 25 HP FIRE SPRINKLER SYSTE} URINAL MOTORS OVER 25-100 HP COOLING TOWERS HATER CLOSET I MOTORS OVER 100 FP VIOLATION INDIRECT WASTES I 1 1 A/C WINDOW I REINSPECTION WATER SUPPLY T0: 1 I 1 AIR CONDITIONERS A/C UNIT 1 I 1 STRIP HEATER FIRE SPRINKLER 1 I 1 GENERATORS TRANSFORMERS 1 HEATER -NEW INST. I 1 1 GENERATORS HEATER - REPLACE 1 1 GENERATORS TRANSFORMERS LAWN SPRINKLER -WELL 1 1 SPECIAL PURPOSE 1 SWIMdING POOL ( OUTLETS COMMERCIAL WATER SERVICE SIGN TUBES SEWER CONNECTIONS � • SIGN TRANSFORMERS . UTILITY -SEWER 1 SIGN TIME CLOCK UTILITY -WATER 1 I F I XTLRES SEPTIC TANX I ANTENNA RELAY TELEVISION OUTLETS GRAINFIELD, TILE/RES. VIOLATION • PUMP & ABANDON SEPTIC TANK REINSPECTION SOAKAGE PIT CU. FT. CATCH BASIN I DISCHARGE Y+EL_ I DOMESTIC WELL 1 1 AREA DRAIN I ROOF INLET I SOLAR WATER HEATER .ADDENDUM TO BUILDING PERMIT APPLICATION FIRE STANDPIPE POOL PIPING LAWN SPRINKLER SYSTEM GAS RANG_ METER SET (GAS, GAF PIPING AN ArBLICATIOIr FQR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. OBTAINED, THE OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON PLUMBING ELECTRICAL IF A MASTER. PERMIT HAS B. SUBSEQUENT APPLICATIONS.) MECHANICAL Permit Number: MC- 1 -06 -33 Invoice Number: MC -1 -06 -23369 Applicant: BRYAN AND ANNA PYKE Company Name: Date 01/17/2006 Permit Receipt Payment Type CheckNum Check CC Amount $191.40 Total Payment: $191.40 Tuesday, January 17, 2006 Page 1 of 1 Miami Shores Villa 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Printed: 10/31/2002 Applicant: ANNA Owner: LEON JOB ADDRESS: 122 NE 92 Parcel # 1132060133280 Permit Status: Signed: Approved Work: POOL HOOK UP X/L7L, Electrical Permit Permit Number: EL2002 -353 LEON ANNA ST c ontractor SHINE MAINTENANCE ELECTRICAL Contractor's Address: 7323 NW 8 ST Local Phone: Permit Expiration: 4/29/2003 Construction Value: $750.00 Page 1 of 1 pet.4A O - DO X0,0 Total Fees: Total Receipts: $0.00 Legal Description: MIAMI SHORES SEC 1 AMD PB 10 -70 LOT 12 & W1/2 LOT 11 BLK 24 LOT SIZE If there is no permit package accessible on the job -site for inspectors to verify, there will be no inspections. Re- inspection fee is $50.00, which must be paid in advance before calling for another inspection. This Permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the application herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes responsibility for work done by his agents, servants or employees. 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 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, serva is employes. (Contractor or Builder) BY: FOR nn PAY k�l TO THE ORDER OF Miami, Florida I qc.6 p p (9 a ESSIG POOLS, INC. 1800 NE 151ST STREET NORTH MIAMI, FL 33162 Mellon United National Bank 0087L570 1:06 70096461: 00 2 L /33020o errrly,i CONTRACTOR ,t / Name 1 ___ : _mat . e'j 14E EL . ' License No. Address /JO P 3'6(-) 1- g 9-0 / Telephone 2 0 f - 6 ► J y f• 7 Qualifier Name � ` ' 0 'J` s co ji ,b PROPERTY OWNER pt<ceS 1)- 1 o- E �7 oZ 7-rv.r� � S Address 14. S,f o de Home Telephone Business Telephone Fax ARCHITECT New Construction Enclosure Name Pf- Wit Alteration Exterior t I Repair 1 License No. Demolish Address 9. ., ^ (4) 7.7 ,frtie Telephone t9 f 271 0 (/? 6 Add'l Attachment Fax Other Add'I Detachment TYPE OF MANAGEMENT (✓ ) New Construction Enclosure Alteration Exterior Repair Alteration Interior Demolish Relocation of Structure Shell Only Foundation Only Add'l Attachment Other Add'I Detachment Other Master Permit No. Subsidiary Permit N INSTRUCTIONS - The following steps must be taken to obtain a permit from the Miami Shores Village: Step 1. Complete the attached permit application which must be signed by the property owner and qualifier. Both signatures must be notarized. Please print or type to allow for a more accurate processing of your application. If roofing work will be done, a roofing application must be submit- ted along with this permit application. Step 2. Submit the completed application with all necessary documents to the Building, Planning and Zoning Department for processing. During the processing of your application, you may be asked to submit additional information. PERMIT TYPE (✓ ) Building Electrical Mechanical Plumbing LPGX Roofing Fence Other Address Apt. PERMIT CHANGE (✓ ) Chg. Contractor Renewal Revision Extension Supplement Reinspection City Tax Assessed/Appraised Value State PERMIT APPLICATION p poc, -Woo e- Zip Folio Number Description of Work Lot l' a— Block a y Subdivision M . S Ito t4-el PB 1 0 PG . 70 Zoning Current Use of Property �y� / ` Square Feet Units Floors Proposed Use of Property Value of Work 7I-0 Bldg Value Tenant Information Linear Feet Flood Zone Base Floor Elev. ENGINEER License No. Address Telephone Fax Page 2 IMPORTANT NOTICES DO NOT BEGIN ANY WORK WITHOUT HAVING RECEIVED YOUR VALIDATED PERMIT AND PERMIT CARD. Applying for a permit does not grant the right to begin construction. HOURS OF CONSTRUCTION are limited to: Monday through Friday from 7:30 a.m. to 6:00 p.m., and Saturday from 8:00 a.m. to 5:00 p.m. No inspections will be conducted on weekends or holidays. 2. All construction of demolition areas MUST BE MAINTAINED IN A CLEAN, NEAT AND SANITARY CONDITION free from construction debris. 3. STREETS AND NEIGHBORING PROPERTIES SHALL BE KEPT FREE FROM DIRT AND DEBRIS. 4. SWALES MUST BE PROTECTED FROM BEING DAMAGED BY EQUIPMENT OR VEHICLES, AND MAY NOT BE USED FOR STORAGE. A bond is required for work in or near the street/sidewalk. 5. CONSTRUCTION TRAILERS ARE PROHIBITED ON SINGLE FAMILY RESIDENTIAL CONSTRUCTION SITES. Other construction may have a trailer which requires a separate permit. 6. PORTABLE TOILETS for a construction site require a separate permit. 7. DO NOT DISCHARGE WATER INTO THE RIGHT OF WAY OR STORM DRAINS without approval from the Building, Planning and Zoning Department. 8. EQUIPMENT AND MATERIALS SHALL BE STORED at least 10 feet from the edge of pavement. 9. Department of Health and Rehabilitative Services (HRS) approval is required for applications involving septic tanks. Department of Environmental Resources Management (DERM) and/or Miami -Dade Water and Sewer Department (MDWASD) approval is required for applications involving sewers. AFFIDAVIT - Please read carefully. Application is hereby made to obtain a permit to do work and installation as indicated. I, the OWNER of the property, certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits are required for ELECTRICAL, PLUMBING, POOL, EXTERIOR DOOR, MECHANICAL, WINDOW, FENCE, DRIVEWAY, ROOFING and SIGNS and there may be additional permits required from other governmental agencies. I, the OWNER of the property, have disclosed all information related to any work at the property performed in the prior twelve months to the Building Official. Further, I am fully aware that if the cumulative cost of work to my home or business under this and any other permit equals or exceeds fifty percent (50 %) of the fair market value of the structure, the entire structure must meet the present federal flood criteria for finished floor elevation. I am also fully aware that if the total cost of work to my home or business under this and any other permit exceeds fifty percent (50 %) of the replacement cost of the structure, then the entire structure must conform to the current code requirements of the Building Code. WARNING TO OWNER: Your failure to record a NOTICE OF COMMENCEMENT may result in you paying twice for improvements to your property. If you are spending more than $2,500 or intend to obtain financing, you may wish to consult with your attorney or lender before recording your Notice of Commencement. The Notice of Commencement must be recorded at: 22 N.W. 1st Street, 1" Floor, (305) 679 -1078. Once recorded, the Notice of Commencement must be POSTED AT THE JOB SITE in accordance with Section 713 -35 of Florida Statutes. Review the brochure at Village Hall on Construction Lien Law and Choosing a Contractor. STATE OF FLORIDA, COUNTY OF MIAMI -DADE Personally known OR, Produced Identification Personally known PERMIT APPLICATION F FLORIDA, C o - NT/ OF MIAMI -DADE Signature of Owner Signature of Contractor / Qualifier sworn to and subscribed before me this day of Sworn Print Name Print Name to and subscribed bell. a!J /1 Signature of Notary Public - State of Florida Si: a ..e of Notary Pu tic - State R SHERMAN SEAL: SEA Notary Public, State of Florida My comm. exp. May 24, 2003 Comm. No. CC819725 1 day of OR, Produced Identification Type of Identification Produced: Type of Identification Produced: ELECTRICAL TvI'I•: Minimum Fee QTY. TYPI. Dryer Q.LV. 'rm.: Outlet, Appliance QTY. . Lvpi; Service Repair Q . I . V . A/C Central 1 -3 Ton Fan Dryer Vents, Number of Outlet, Wall Ventilation, Cost Service, Temporary Air Handler, Tons A/C Central 4 -7 Ton Piping, Flammable Liquid Fire Pump Outlet, Switch Fire Sprinkler System Signs A/C Central 8 -15 Ton Bath Fan - Vented, # Fixture - Fluorescent Pressure Vessel Oven Space Heater (kw) A/C Central 16-20 Ton Fixture Light Parking Lot Lights Spas/Hot Tubs A/C Central 20+ Ton Flood Lights Plugmold/Strip Subfeeds, No. of Amps A/C Window FPL - Load Central Posts Swim Pool, Commercial ,/ 1 Air Conditioners Garbage Disposal Range/Range Top Swim Pool, Residential Chiller Generators, etc. Receptacles Switchboards Clear Violations Heat Recovery Refrigerator, Comm. (p/PH) Temp Serv., Construction Compactor Low -volt, Burglar Refrigerator, Domestic Temp for Test - 30 days Deep Freezer Low -volt, Fire Renew - Temp Service Water Closet Demolition Low -volt, Intercom/Teleph. Repair Circuits Water Heater Dishwasher Low -volt, Television Service, Number of Amps Water Heater New NIECHANICAL TYPE Minimum Fee QI•y. 'I Condensate Drain QTv. T'YI'I, Generator QTY. 7'11'1': Refrigeration, Tons Q'f\'. A/C Central, Tons Cooling Tower Heating Strips, each Vent Hood, Cost A/C Wall/Win. Tons Dryer Vents, Number of Paint Booth Ventilation, Cost Solar Water Heater Air Handler, Tons Ductwork, Cost of Piping, Flammable Liquid Periodic Inspections Barbecue Fire Sprinkler System Process/Pressure Piping Cap - Fixture Bath Fan - Vented, # Fireplaces, Number of Pressure Vessel Pump and Abandon PLUi113ING rm.: A/C Condensate ()Ty. TV'I'P. Drains, Roof QTY. 'rm.: Miscellaneous Fixture QTV. TV'I'E Soakage Pit QT V'. Bath Tub Drinking Fountain Miscellaneous Repairs Solar Water Heater Bidet Filter Replace Pool Piping Sprinkler Repair Cap - Fixture Fountain Pump and Abandon Sprinkler System Cap - Water Gas - Appliance Pump, Domestic Supply, AC Well Cap - Sewer Gas - Natural Pump, Fire Stand Temporary Toilet Catch Basin Gas - Propane Pump, Re- circulate Temporary Water Closet Clothes Washer Gas Piping Pump, Replace - Pool Urinal Dental Chair Grease Trap Pump, Sprinkler Utility - Sewer Discharge Well Ice Maker Pump, Sump Utility - Water Dishwasher Indirect Wastes Relay Repair Vacuum Pump Disposal Interceptor Roof Inlet Water Closet Domestic Well Laundry Tray Septic Connection Water Heater Drainfield, 4" Tile/Res. Lavatory Septic Tank Water Heater New Drains, Area Meter Set (Gas) Sewer Connection Water Re -pipe Drains, Floor Minimum Fee Shower Water Service Drains, French Miscellaneous Equipment Sink Well, Supply Page 3 PERMIT APPLICATION INSTRUCTIONS: Please indicate the type of work being performed and quantity(ies) in the space provided below. RECEIVED AND REVIEWED BY: DATE: SECTION BY DATE Zoning Electrical s•'7®'Z-Za. Mechanical Plumbing /(J •& ,ev Fire Public Works Structural Building Official Page 4 OFFICE USE ONLY C11ECK LIS'I' ❑ OWNER - BUILDER FORM (Attach) ❑ FIRE DEPARTMENT APPROVAL (Commercial / multi - family) ❑ CONCURRENCY (New Construction) ❑ OTHER (Specify & Attach) $3.00 per page (Scanning Fee) Miami Shores Village Bond Metropolitan Dade County (C.C.F.) Inspector State Educational Fund State DCA (Radon) Code Enforcement Fine Zoning Review Notary ❑ PROOF OF OWNERSHIP (Attach) ❑ HRS / DERM APPROVAL (Septic / Sewer) ❑ IMPACT FEE (New Construction) ❑ OTHER (Specify & Attach) $ ee? n t2PC> 4. It k 116.4A ( sq.ft. = x/1000 x 0.60) (¢.005 /sq.ft.) (¢.01 /sq.ft.) TOTAL $ O PERMIT APPLICATION ❑ CONDO ASSOCIATION APPROVAL (Attach) ❑ BPR APPROVAL (Restaurants) ❑ CONTRACTOR REGISTRATION (On File) PERMIT FEES ISSUING OFFICIAL REVIEWED AND PREPARED BY: DATE: CONDITION OF APPROVAL Revised July 2001 10050 N.E. 2ND AVE., MIAMI SHORES, FL • (305) 795 -2207 • FAX (305) 756 -8972 • http : / /www.miamishoresvillage.com • APPLICATION FOR BUILDING PERMIT Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build- ing 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 the work. / / =' Date �,19 Owner's Name and Address. -.... �..I- ., '. - -, -, - , - ° --- f ....... No.. -- ' Street s , Registered Architect and /or Engineer. ........ -u .�.:?.; /.� '? ' Name and address of licensed contractor Location and legal description of lot to be built on: Lot _ Block Subdivision. Street and Number where work is to be done State work to be done and purpose of building (by floors) New Building - Remodeling MIAMI SHORES VILLAGE Disapproved / Date (Signed) L� �., � Building Ins = ' tor BUILDING INSPECTION DEPARTMENT Addition Repairs - - and for no other purpose. No. of Stories , To be constructed of Kind of foundation ..._n - -. Roof A Govering Estimated Total cost of improvements $ Amount of Permit $ - Zone cubage required _Plan Cubage Distance to next nearest building Size of Building Lot Maximum live load to be borne by each floor I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may be sent to The undersigned applicant for this building pennit 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 subc ntractors,- on work to be performed under this permit, as are licensed by Miami Shores Village. / // Remarks (Signed) -.. -- .._....- ..... �i STATE OF FLORIDA, COUNTY OF DADE. j ss Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap- peared 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, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are e. Permit No.._._(; Date Read, Sworn to and Subscribed before me. Notary Public, State of Florida My Commission Expires PLANNING BOARD DATE Chairman Member Member Member Member ....... Member Council Approved Date Disapproved Date NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has been obtained from the Planning Board. A re- inspection fee of $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and /or workmanship. afi,(L 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 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/ a % ? ,---- % F Owner's Name and Address ( V " ` � No / : Street �' C G Registered Architect and /or Engineer Employing Electrician's Name Location and Legal Description Lot Street and Number where work is to be performed —No 1. Amount of Permit $ STATE OP FLORIDA, } COUNTY OF DADE. MIAMI SHORES VILLAGE ELECTR ICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT I ss. (Signed) (Signed)... � ... b/ Date.. Street Block Subdivision Street /— State work to be performed and purpose of building (By Floors) New Building Remodeling .a Addition � Repairs No. of Stories $ervi Overhead d F Size Feeders % ' Main Sw. �' Conduit Man . �� / Underground ,• , Amps Main Fuses 1 Amps Tape Installation— Conduit Tubing B.X.L Metal Moulding Electrical Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts is obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of orida Permanent Supplement, and has complied with the provisions thereof, and will require similar compliance from all contractors or su .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 Et e• performed under this permit, as are licensed by Miami Shores Village. Master Electrician. 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 PLUG RECE'P'T'S FIXTURES NO. LAMPS REFRIG. OUTLET IRON OUTLET RANGE OUTLET RANGE CONN. WATER HEATER W. HEAT. CONN. ACE HATER STRIP HEATER TOTAL CONTR. // LIST �' ■ . ,- _, o / / / ' CHECK Lm i ,..,. ENT. SW. DIST. CAD. SERVICE TEMP. SERVICE PERM. MOTORS 0.1 HP MOTORS 1•5 HP NEON TRANS. RADIO TOTAL • CHECK afi,(L 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 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/ a % ? ,---- % F Owner's Name and Address ( V " ` � No / : Street �' C G Registered Architect and /or Engineer Employing Electrician's Name Location and Legal Description Lot Street and Number where work is to be performed —No 1. Amount of Permit $ STATE OP FLORIDA, } COUNTY OF DADE. MIAMI SHORES VILLAGE ELECTR ICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT I ss. (Signed) (Signed)... � ... b/ Date.. Street Block Subdivision Street /— State work to be performed and purpose of building (By Floors) New Building Remodeling .a Addition � Repairs No. of Stories $ervi Overhead d F Size Feeders % ' Main Sw. �' Conduit Man . �� / Underground ,• , Amps Main Fuses 1 Amps Tape Installation— Conduit Tubing B.X.L Metal Moulding Electrical Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts is obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of orida Permanent Supplement, and has complied with the provisions thereof, and will require similar compliance from all contractors or su .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 Et e• performed under this permit, as are licensed by Miami Shores Village. Master Electrician. 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. STATE OF FLORIDA, COUNTY OF DADE. j ss MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT t Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build- ing 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 the work. Owner's Name and Address. -Vt / f a R T AA F By I Ai Registered Architect and /or Engineer Name and address of licensed contractor .. ,A4./.4 NV SW P c R CO 4`,1 c O ' /V e Location and legal description of lot to be built on: Lot Block Subdivision Street and Number where work is to be done. -.. Z . ' /Y // 9� fi ) State work to be done and purpose of building (by floors) i e ti. . nn ar412 ,T --{ ._,/ A ri. 4 ..zde,....,c. -- and for no other purpose. New Building Remodeling Addition Repairs No. of Stories / To be constructed of Kind of foundation Roof Covering /.-t..-erz — Estimated Total cost of improvements $.. 2 0 Amount of Permit $ Zone cubage required _Plan Cubage Distance to next nearest building Size of Building Lot Maximum live load to be borne by each floor I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may be sent to Date �� 2 ,19 No ,4 Street. .4,14 Notary Public, State of Florida 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. Remarks (Signed) Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap- peared 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, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. p/ Permit No �' S 2 -Z- Date 3-- " - r Read, Sworn to and Subscribed before me. Disapproved /�/ / (Signed) wV` ( J.�-- ...._y Building I..:pector My Commission Expires PLANNING BOARD DATE Chairman Member Member Member Member Member Council Approved Date Disapproved Date NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has been obtained from the Planning Board. A re- inspection fee of $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and /or workmanship. Permit No, c 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, 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. Owner's Name and Address 1 Registered Architect and /or Engineer Employing Electrician's Name ... / 4 ", / ...16i.w Location and Legal Description Lot Block Subdivision Street and Number where work is to be performed —No STATE OF FLORIDA, 1 COUNTY OF DADE. I SS. MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT 4 No Street t l r - No / "` Street Street "/ State work to be performed and purpose of building (By Floors) New Building Remodeling Addition Service Overhead Size Feeders Conduit Main Sw Underground Type of Installation — Conduit Tubing B.X.L Amount of Permit $ 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. My Commission Expires NOTE: A re.inspection fee of $1.00 will be made when such materials and /or workmanship. . --• d1 Date { ( Signed) ....�2... / Amps Main Fuses Amps .Metal Moulding Repairs No. of Stories ,e! (Signed) Electrical Inspector ccepts his 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 Master Electrician. 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. Notary Public, State of Florida re• inspection is made necessary by improper notice for inspection, or faulty 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 TOTAL LIST /•••■ ! s 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 Permit No, c 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, 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. Owner's Name and Address 1 Registered Architect and /or Engineer Employing Electrician's Name ... / 4 ", / ...16i.w Location and Legal Description Lot Block Subdivision Street and Number where work is to be performed —No STATE OF FLORIDA, 1 COUNTY OF DADE. I SS. MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT 4 No Street t l r - No / "` Street Street "/ State work to be performed and purpose of building (By Floors) New Building Remodeling Addition Service Overhead Size Feeders Conduit Main Sw Underground Type of Installation — Conduit Tubing B.X.L Amount of Permit $ 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. My Commission Expires NOTE: A re.inspection fee of $1.00 will be made when such materials and /or workmanship. . --• d1 Date { ( Signed) ....�2... / Amps Main Fuses Amps .Metal Moulding Repairs No. of Stories ,e! (Signed) Electrical Inspector ccepts his 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 Master Electrician. 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. Notary Public, State of Florida re• inspection is made necessary by improper notice for inspection, or faulty BUILDING ELECTRICAL PLUMBING Owner of Building MIAMI SHORES VILLA, FLORIDA PERMIT 1sT2 5541 Work to be performed under this Permit i '1 Architect Contractor °T , or Builder i�1dJ . —.00 Legal Lot B1. Description Address of -.) Building / -x, .. ./ A f 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 appli- cation 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 014 responsibility for a thorough knowl -. ge of the or nces and regulations pertaining to the work covered hereby whether shown on the plans awing6 o`r in the statements or specification • that he a im s respon- sibility for work done by his agents, servants or employees. Signed Subdi- vision Value of Project BY DATE i PECTdR Contractor's License No 7 ~ d Amt. of Permit 11. C2 By ' r 6 AUTHORITY 194 In consideration of the issuance to me of this permit I agree to perform the work covered Jiereunder in compliance with rdinances nd. re ]moons pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authti Is of biiamithdr ifiage. In accepting his permit I assume responsibility for r all work done by either myself, my agent, servant or employee. s 10 10 f rte* i 70 : , iiiira"', C O RACTOR OR BUILDER t t l Permit ______ Owner's Name and Address _ = Registered Architect and /or Engineer Employing Electrician's Name ___r_______________ Location and Legal Description Lot___ New Building 1 STATE OF FLORIDA, COUNTY OF DADE. ss. Amount of Permit $ _ / (Signed) My Commission Expires (Signed) MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT Remodeling Addition Repairs Notary Public. State of Florida 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._____ _______ ___ _______. —:_ No. Street__ Block__________ Subdivision _____________- __-_ -_ ._,- -___ -. Street and Number where work is to be performed —No / --- _____ —_ Street__,-- ____ -� -, State work to be performed and purpose of building (By Floors) No. of Stories Service Uverhead d Size Feeders__ Conduit___l_ __ Main Sw._ ,; __ Amps. Main Fuses_ _ P —_- - --- � =--- -= - -- -Amps. Type of Installation— Conduit Tubing 1 ` B.X.L. Metal Moulding 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 com- plied 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 under signed agrees to employ only such sub - contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. Master Electrican. 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, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. 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 TOTAL CONTR. LIST / , i - , L �r, / / , ,,, ,F CHECK ` \ ENT. SW. DIST. CAD. SEj9 TEMP. SERVICE t'ERM. MOTORS 0-1 HP MOTORS 1 -5 HP NEON TRANS. RADIO TOTAL CONTR. LIST ---Z:1--- �/ CHECK t l Permit ______ Owner's Name and Address _ = Registered Architect and /or Engineer Employing Electrician's Name ___r_______________ Location and Legal Description Lot___ New Building 1 STATE OF FLORIDA, COUNTY OF DADE. ss. Amount of Permit $ _ / (Signed) My Commission Expires (Signed) MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT Remodeling Addition Repairs Notary Public. State of Florida 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._____ _______ ___ _______. —:_ No. Street__ Block__________ Subdivision _____________- __-_ -_ ._,- -___ -. Street and Number where work is to be performed —No / --- _____ —_ Street__,-- ____ -� -, State work to be performed and purpose of building (By Floors) No. of Stories Service Uverhead d Size Feeders__ Conduit___l_ __ Main Sw._ ,; __ Amps. Main Fuses_ _ P —_- - --- � =--- -= - -- -Amps. Type of Installation— Conduit Tubing 1 ` B.X.L. Metal Moulding 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 com- plied 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 under signed agrees to employ only such sub - contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. Master Electrican. 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, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. 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. 4 fi p. • le" te / �'