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EL-07-2339 � d 1 Miami Shores Village �- ,5 10050 N.E. 2nd Avenue Miami Shores, FL 3313 8-0000 Phone: (305)795 -2204 Expiration: 05/1712008 Project Address Parcel Number Applicant 355 NE 93 Street 1132060136290 JEFFREY GROOM Miami Shores Village, FL Block: Lot: Owner Information Address Phone Cell JEFFREY GROOM 355 NE 93 ST MIAMI FL 33138 -2854 Contractor(s) Phone Cell Phone Valuation: $ 2,00 JC ELECTRIC INC (305)754 -6949 Total Sq Feet: 0 Type of Work: Available Inspections: Additional Info: Inspection Type: Classification: Residential Final Service Change ® Meter Box Fire Alarm Underground Rough ® ((��// Alteration el Relocation MIAMI SHORES VILLAGE W.W. Fees Due Amount Total Amt Paid Amt Due CCF $1.20 Education Surcharge $0.40 $ 0.00 $ 0.00 Notary Fee $5.00 Permit Fee - Additlons/Alterations $150.00 Payment Type: Scanning Fee $3.00 Technology Fee $3.75 Total: $163.35 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 November 19, 2007 Authorized Signature: Owner if Applicant / Contractor / Agent Date Building Department Copy Monday, November 19, 2007 1 Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 BUILDING . -� Permit No. rL PERMIT APPLICATIO , ; Master Permit No. FBC 2004 Permit Type: Electrical Owner's Name (Fee Simple Titleholder) ' aaow Phone # Owner's Address -35,5 NE 9,3,-57 �° City �wl�e7*!/ S/Z State Zip Tenant /Lessee Name M/14 Phone # E -MAIL: Job Address (where the work is being done) Z5,5 W r 93 S T - City Miami Shores Village County Miami -Dade Zip FOLIO / PARCEL # Is Building Historically Designated YES NO Contractor's Company Name `jc EA es -i - C . Phone # 30 — ---T-X44 —049 Contractor's Address 00 01 City Vii �u,1-x Sl vOve State C_ Zip 3 Qualifier Name Phon - 3 0 - 5 - 7,5 cl State Certificate or e gistration No. 0 Y Certificate of Competency No. E - MAIL: C - P- I& - ML Architect /Engineer's Name (if applicable) Phone # Value of Work For this Permit $ �, �- ^z Square / Linear Footage Of Work: i Type of Work: ❑Addition ❑Alteration ❑New ❑ Repair/Replace F] Demolition Describe Work: j7t /,fA -, 2 Ad icxr.xxr,xxi:xr. icxr.xxx *xxxr.r.icr.r.rxr.r, xicxic it r.r.xx r. r.r.r.r.r.x�:i; r.icrxxie iexxi: is is r. is is icr .xr. xiex *r.xr. a; is rxxicx is Submittal Fee $ Permit Fee CCF $ �,f (J y CO/CC Notary $ Training /Education Fee $ Technology Fee $ U Scanning $ Radon $ DPBR $ Zoning $ Bond $ Code Enforcement $ Double Fee $ Structural Review. $ Total Fee Now Due $ See Reverse side -� Bonding Company's Name (if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State Zip Application is hereby made to obtain a permit to do the work and installations as indicated. l 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: 1 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 Signatur Signature wrier or Agent Contractor ll The foregoing instrument was acknn{o-wled ed before me this i The foregoing i rument w cknowledged before me this 6 day of (�I/C�ldt �"20 o�T by day of /V o ✓er �a�. , 20 6 �, by who is personally known to me or who as proLc q�"pL, who is personally known to me or who has pro ed As identification and who did take an oath. as identification and who did take an oath NO ARY LIC: NOTARY PUBLIC: �'0\ pQ d a ELAINE C. PANAY10TOU Sign: o ° Notary Prtblic, State ofF hrw c�xplres March 29, 2"009 Print: V to, 0 7 412467 Print: did« Boo ea My Commissio Expires: 3 C 2� My Commission Expires: APPLICATION APPROVED BY . Examiner Engineer Zoning (Revised 02 /08/06) ADDENDUM TO BUILDING PERMIT APPLICATION AN APPLICATION FOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. IF A MASTER PERMIT HAS BEEN OBTAINED, THE OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS. PLEASE CIRCLE 0 DISCIPLINE APPLIED FOR: PERMIT # CL t Z PLUMBING ELECTRICAL MECHANICAL ITEM UNIT FEE ITEM UNIT FEE ITEM UNIT FEE BATH TUB SWITCH OUTLETS SPACE HEATERS DISHWASHER LIGHT OUTLETS CENTRAL HEATING DISPOSAL RECEPTACLES A/C (WIND) FLOOR DRAIN ISERVICE TEMPORARY A/C (CENTRAL) GREASE TRAP I SERVICE SIZE IN AMPS 66 f _ DUCTWORK INTERCEPTOR SERVICE REPAIR/METER CHANGE REFRIGERATION LAVATORY APPLIANCE OUTLETS PROCESS AND PRESS PIPING LAUNDRY TRAY RANGE TOP UNDERGROUND TANKS CLOTHES WASHER OVEN I JABOVE GROUND TANKS SHOWER WATER HEATER U.F. PRESSURE VESSELS SINK. POT /3 COMP. MOTORS 0 -1 HP STEAM BOILERS SINK, RESIDENCE. MOTORS OVER 1 -3 HP HOT WATER BOILERS SINK, SLOP. MOTORS OVER 3 -5 HP MECHANICAL VENTILATION TEMPORARY WATER CLOSET MOTORS OVER 5 -8 HP TRANSPORTING ASSEMBLIES URINAL MOTORS OVER 8 -10 HP ELEVATORS/ESCALATORS WATER CLOSET MOTORS OVER 10 -25 HP FIRE SPRINKLER SYSTEMS INDIRECT WASTES MOTORS OVER 25 -100 HP ICOOLING TOWERS WATER SUPPLY TO: MOTORS OVER 100 HP VIOLATION A/C UNIT A/C WINDOW REWSPECTION FIRE SPRINKLER AIR CONDITIONERS HEATER-NEW INST. STRIP HEATER HEATER - REPLACE GENERATORS TRANSFORMERS LAWN SPRINKLER -WELL GENERATORS TRANSFORMERS SWIMMING POOL GENERATORS TRANSFORMERS WATER SERVICE SPECIAL PURPOSE. SEWER CONNECTIONS IOUTLETS COMMERCIAL UTILITY -SEWER I SIGN TUBES UTILITY-WATER ISIGN TRANSFORMERS SEPTIC TANK I SIGN TIME CLOCK RELAY IFIXTURES FAINFIELD, 4" TILE/RES. JANTENNA PUMP & ABANDON SEPTIC TANK ITELEVISION OUTLETS SOAKAGE PIT CU. FT. VIOLATION CATCH BASIN IREINSPECTION 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 IUZLk Ulu ' MST ...... VE Stpt:}F Cfattclfa�'�ar site �r� ,_,,,. C®ndul stzc... —. F r) R E 10 ' vr•u • •• a�pApT y 0g CT , Man Sub UraWcars 0 �4 �A, 0— S UB FEEDER " e t o . • New—, MAIN C13 Typq PANEL FWL Mood Slate "` q . . . ll�- 5 40 r, me . ...... - - -- . rr�i �i" �a� °— �. • to Ti• ODE PANEL , e _ Ljp r ,., °... • ,C0NT ttt&l,t�q,..l! L � .b.i�. s G Oc-) o 8.1.0 s. a f:1 tsBBt° NOTA fl y a . �aea� �f$an • r 13 Y Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL �caRia' Phone: (305)795 -2204 Fax: (305)756 -8972 Scheduled Inspection Date: July 01, 2009 Permit Type: Electrical - Residential Inspector: Devaney, Michael Inspection Type Final Owner: GROOM, JEFFREY Work Classification: Addition /Alteration Job Address: 355 NE 93 Street Miami Shores, FL Phone Number Parcel Number 1132060136290 Project: <NONE> Contractor: JC ELECTRIC INC Phone: (305)754 -6949 Building Department Comments . replace panel add four flood lights at corner of house Inspector Comments Passed , Failed Correction Needed Re- Inspection Fee No Additional inspections can be scheduled until re- inspection fee is paid. F„' inanon inns nlease call: (305)762 -4949 0--- --F 40 4 Inspection Worksheet Miami Shores Village `¢ 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 I�lu00 Permlt Number .* Scheduled Inspection Date: July 01 2009 Permit Type: Electrical - Residential Inspector: Devaney, Michael Inspection Type: Final Owner: GROOM, JEFFREY Work Classification Addition/Alteration Job Address: 355 NE 93 Street Miami Shores, FL Phone Number Parcel Number 1132060136290 Project: <NONE> Contractor: JC ELECTRIC INC Phone: (305)7546949 Building Department Commen replace panel add four flood lights at corner of house Inspector Comments Passed Failed Correction — Needed Re- Inspection .�_r Fee - r No Additaonal irlspectlons can be, scheduled untll re inspection feels paid. - a For4nspectlQnspled - 62,4949