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362 NE 92 St (3)BUILDING PERMIT APPLICATION FBC 2001 Permit Type (circle): Building Electrical (,Plumbin Mechanical Roofing Owner's Name (Fee Simple Titleholder) W 14.A Phone # .366— 61 —0 C t- Owner's Address 362. N C - C Z Z 1,3 -S!T' zip '3V Phone # City 1-Q\ 1 N ` S , State -� Tenant/Lessee Name Job Address (where the work is being done) City Miami Shores Villa a County Miami -Dade Zip Is Building Historically Designated YES NO Contractor's Company Name � 1 pe_ I t PLCA ..-14 k - 1 Phone # Contractor's Address 76 5 c t% a� i Ni L - City a i State Zip 3 ' Qualifier C4e1 C- ? G Architect/Engineer's Name (if applicable) - Phone # Architect/Engineer's Address City ` State Zip $ Value of Work For this Permit G L C .C6 Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Permit No. P 1OO c", 2555 Master Permit No89 ,3CO3— Square Footage Of Work: Number of: Bays Stories Families Bedrooms Baths Type of Work: ❑Addi n ®Alteration ❑New ❑ Repair/Replace ❑ Demolition Describe Work: i Z"' 4 - k 7 1 K l, C_ 4 * *** * * * * * * * * * * * * * * * * * * * * * * ** F ees * * * *** * * * * * * * * * * * * * * * * ** * ** (J� // County Escrow Fee $ . ( Permit Fee $ ht 6' Notary $ Education/Training Fee $ Tech $ Scanning $ Radon $ Code Enforcement $ Bond $ Struct. $ Minus Plans Check Fee $ Total Fee Now Due $ (Continued on opposite side) ?WC) 30.00 GC 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 The foregoing ins day of who is personally NOTARyPUBLIC: Sign: Print: My Commission Expires: ynt cknowledged before me this o actor The foregoing instrument w ac knowledged before me this el day of 20 CA, by FiV P! a /t, wn to me or who has produced who is personally known to me or who has produced L as identification and who did take an oath. As identification and who did take an oath. Signatuie ********************************************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** (Certificate of Competency Holder) State Certificate or Registration No. * * * * * * * * * * * * * *I * * * * * * * * * * * * * * ** r APPLICATION APPROVED BY: � �/ // chc7/7 /03 NOTARY PUBLIC:. Sign: y� jr.(`� ' .•�1� Print: /I/Wi f, : _: l/• / 6- My Commission Expires: Certificate of Competency 9a Oar► s ?� "sop rani * *4* * * * ******************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * Plans Examiner Engineer Zoning MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT Permit No Date C 21 4 re:t 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. s Owner's Name and Address Sr 1 1 7 S /,� �' , No ' Street Registered Architect and /or Engineer rr�� Employing Electrician's Name ... .I'-- � `� a W ' 4Aoc^ Street Location and Legal Description Lot Block Street and Number where work is to be performed— No...3Z r �.2.•.– .94 Street �y State work to be performed and purpose of building (By Floors) L:Z. '" ! $'. .., �.�?.. s 44 New Building Remodeling Addition Repairs No. of Stories Amount of Permit $ 4 STATE OF FLORIDA, } COUNTY OF DADE. SS. (Signed) ....1 Cf% Y2 (Signed) v5 ei ` /17,9 414 f„)' Subdivision Service Overhead Size Feeders Conduit Main Sw Amps Main Fuses Amps Underground Type of Installation — Conduit Tubing B.X.L Metal Moulding Electrical Inspector. The undersigned applicant for this building permit does hereby certify that he understands and acs Oifs his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws if f Florida Permanent Supplement, and has complied with the provisions thereof, and will require similar compliance from all contractors or subcontractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such subcontractors, on work to be 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'7'S FIXTURES NO. LAMPS REPRIG. OUTLET IRON OUTLET RANGE OUTLET RANGE CONN. WATER HEATER W. HEAT. CONN. ACE HATER STRIP HEATER TOTAL CONTR. LIST / / CHECK ENT. SW. DIST. CAB. SERVICE TEMP. SERVICE PERM. MOTORS 0.1 HP (p�� //p MOTORS 1.5 HP NEON TRANS. ?, i9i == RADIO TOTAL CONTR. LIST CHECK MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT Permit No Date C 21 4 re:t 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. s Owner's Name and Address Sr 1 1 7 S /,� �' , No ' Street Registered Architect and /or Engineer rr�� Employing Electrician's Name ... .I'-- � `� a W ' 4Aoc^ Street Location and Legal Description Lot Block Street and Number where work is to be performed— No...3Z r �.2.•.– .94 Street �y State work to be performed and purpose of building (By Floors) L:Z. '" ! $'. .., �.�?.. s 44 New Building Remodeling Addition Repairs No. of Stories Amount of Permit $ 4 STATE OF FLORIDA, } COUNTY OF DADE. SS. (Signed) ....1 Cf% Y2 (Signed) v5 ei ` /17,9 414 f„)' Subdivision Service Overhead Size Feeders Conduit Main Sw Amps Main Fuses Amps Underground Type of Installation — Conduit Tubing B.X.L Metal Moulding Electrical Inspector. The undersigned applicant for this building permit does hereby certify that he understands and acs Oifs his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws if f Florida Permanent Supplement, and has complied with the provisions thereof, and will require similar compliance from all contractors or subcontractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such subcontractors, on work to be 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. BUILDING ELECTRICAL PLUMBING ROOFING ❑ Owner of Building Architect Contractor or Builder Legal Description Address of Building �. Lot MIAMI SHORES VILLAGE. FLORIDA ❑ ° PERMIT N? 7840 CONTRACTOR OR BUILDER B1. Work to be performed under this Permit— J Y , 4 Suadi- vision Sq. Ft Value of Project $ 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 9 in theitatements or specifications and that he assumes responsibility for work done by his agents, servants or employees. l Signed: •^ INFPECTOR In consideration of the issuance to me of this permit I agree to perform the work covered h under in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications su itted 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. / BY DATE 7. 2 4 Contractor's a License No ''° e /f Amt. of Permit $ d AUTHORITY 195C' 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 tt.e 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 Registered Architect andlor Engineer New Building Remodeling I hereby submit all plans and specifications for said buildi Permit No. Disapproved (Signed) MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Building Inspector s 2- N, C-11 .2- kict,sd+uge. Name and address of licensed contractor ( ,Q � 1 C F C Date No. Street faQ p 5 " 7 fi'Cr G (2 e :) - / Location and legal de iptionn of e built on: /�j� s� ry / Lot `� ofe 6� a l l Subdivision 71 �` ./ G f ®E7 �� 6 y�� (, � S . Street and Number where work is to be done � `�' * ` - � � } l� , State work to be done and purpose of building (by floors), state exterior colors (submit samples) `- ; y" 9� ' L 1 C I&J1 i l /G/J / /A/DX fps P-7 � /cc/ - �vu �t3T[�t and for no other purpose. Addition Repairs No. of Stories lb be constructed of Kind f foundation Roof Covering Estimated Total cost of improvements $ r G Amcunt of Permit $ 0 f Zone cubage required Plan Cubage Distance to next nearest building Size of Building Lot Maximum live load to be borne by each floor All notices with refere:ace to the building and its construction may be sent to �) (P 0 /3 W � . i / " LA/ C The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligatons 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 there and will . -.uire similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or caus be pos =• •r inspection on the site of the work such public notice or notices as are required by the Act. The unde.signed agree to • ploy o on wor. •• e performed under this permit, as are licensed by iami Shores Village. Remarks 1 9' TO oa / 1 0 (Signed) STATE OF FLORIDA 1 Before me, the undersigned authority, a notary p lic, duly authorized to administer oaths and take acknowledgments, personally appeared "9 2 /) / ,' ° h.--/_/ ,JL � to me well known. / '2 � and who, being by me first duly sworn, upon oath deposes and says that he is the '. F ,L( / 't' /-- 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. Z? Date b ~ Read, Sworn to and Subscribed before me. I Date a ei,/ & p}��y, f L 1 d a ax/ A IKn LS�"Tif,;di0� rl ()(t(D1 t t L hhl'r My Commission Ezpires COF1tuISSlO1 EX PIRES JULY 15; 1992 BONDED s'NS!! 99tiCKLEBERRY'4 A5501.11ilES PLANNING BOARD DATE 19 ) Chairman Member Member Member Member Member Council Approved Date Disapproved Date NOTE: A charge of $25.00 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 $25.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials andlor workmanship. 1/ MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT / Date 4 / /l.�/ / Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building of other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Fiv:ida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulation's 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 !"i/ . 7 jQ ,' // �L �'� ��s No 3 Street Registered Architect and /or Engineer.. /" Employing I loying E cuiciah s Name. 4 � 17 �� / .. !�/ .......... 6.To 9 Street Location and Legal Description ot....... Block. 1 M Subdiviaion..2/ ° Anti Permit No..46.S S O .?9/-/J27 uJ 9 2 Sr: LAC Street / a .s'� State work to be performed and purpose of building (By Floors �� ' L?'' t �a� • �,�T /O 4ie New Building Remodeling Addition Repairs No. of Stories Street and Number where work is to be performed —No Service Overhead Site Feeders Conduit Main Sw Amps Main Fuses Amps Underground Type of Installation — Conduit Tubing.. ... B.X.L .Metal Moulding Amount of Permit STATE OF FLORIDA, COUNTY OF DADE. f ss' (Signed ectriul . ector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act. being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has complied with the provisions thereof, and will require similar compliance from all contractors or subcontractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such sub contractors, on w.rk to be pe formed under this permit, as are licensed by Miami Shores Village. (Signe /s6 1 0 Electrician. Before me, the undersigned authority, a notary public, duly authori:ted 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 51.00 will be made when such re-inspection is made necessary by improper notice for inspection, or faulty materials and /or workmanship. SWITCH 0 LIGHT OUTLETS PLUG RECE'P'T'S FIXTURES NO LAM •S REIRIG. OUTLET IRON OUTLET RANGE OUTLET RANGE CONN. WATER HEATER W. HEAT. CONN. SPACE H STRIP H TOTAL CONTR. LIFT CHECK ENT. SW. DIST. CAS. SERVICE TEMP. SERVICE PERM. MOTORS 0.1 HP MOTORS 1.5 HP NEON TRANS. RADIO TOTAL CONTR. LI•T CHECK 1/ MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT / Date 4 / /l.�/ / Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building of other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Fiv:ida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulation's 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 !"i/ . 7 jQ ,' // �L �'� ��s No 3 Street Registered Architect and /or Engineer.. /" Employing I loying E cuiciah s Name. 4 � 17 �� / .. !�/ .......... 6.To 9 Street Location and Legal Description ot....... Block. 1 M Subdiviaion..2/ ° Anti Permit No..46.S S O .?9/-/J27 uJ 9 2 Sr: LAC Street / a .s'� State work to be performed and purpose of building (By Floors �� ' L?'' t �a� • �,�T /O 4ie New Building Remodeling Addition Repairs No. of Stories Street and Number where work is to be performed —No Service Overhead Site Feeders Conduit Main Sw Amps Main Fuses Amps Underground Type of Installation — Conduit Tubing.. ... B.X.L .Metal Moulding Amount of Permit STATE OF FLORIDA, COUNTY OF DADE. f ss' (Signed ectriul . ector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act. being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has complied with the provisions thereof, and will require similar compliance from all contractors or subcontractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such sub contractors, on w.rk to be pe formed under this permit, as are licensed by Miami Shores Village. (Signe /s6 1 0 Electrician. Before me, the undersigned authority, a notary public, duly authori:ted 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 51.00 will be made when such re-inspection is made necessary by improper notice for inspection, or faulty materials and /or workmanship. MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT Permit No /2 Date 9 -°26 -7 3 Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building of other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Fiv;ida, 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..... 771 °M 5 IC--15 j Registered Architect and /or Engineer Employing Electriciad's Name/ IV y E /6' Location and Legal Description Lot ss. State work to be performed and purpose of building (By Floors) New Building Remodeling Addition Amount of Permit $ (Signed) No t.-96 Street A £ . q ' No. / . 9 9 Street • D;, e 36)/ Block Subdivision. Street and Number where work is to be performed —No ' Street / 9 Repairs No. of Stories Service Overhead Site Feeders Conduit Main Sw Amps Main Fuses . Amps Underground Type of 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 his ol3hg Lions as an employer of labor under the Florida Workmen's Compensation Act. being Section 5966, Compiled General Laws of Florida /? rmanent 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 sib contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. (Signed) •� 5 Master Electrician. STATE OF FLORIDA, COUNTY OF DADE. 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 depose:; 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 tn.e. My Commission Expires Notary Public, State of Florida NOTE: A re-inspection fee of $1.00 will be made .xhen 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 OUTLItT RANGE CONN. WATER HEATER W. HEAT. CONN. SPACE HEATER STRIP HEATER TOTAL CONTR. LIST CHECK ' ENT. SW. DIET. CAB. SERVICE TEMP. SERVICE PERM. MOTORS 0.1 HP MOTORS 1.8 HP NEON TRANS. RADIO TOTAL GLST LIS �'t_ /6 1) y'/' (f / I • CHECK a MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT Permit No /2 Date 9 -°26 -7 3 Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building of other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Fiv;ida, 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..... 771 °M 5 IC--15 j Registered Architect and /or Engineer Employing Electriciad's Name/ IV y E /6' Location and Legal Description Lot ss. State work to be performed and purpose of building (By Floors) New Building Remodeling Addition Amount of Permit $ (Signed) No t.-96 Street A £ . q ' No. / . 9 9 Street • D;, e 36)/ Block Subdivision. Street and Number where work is to be performed —No ' Street / 9 Repairs No. of Stories Service Overhead Site Feeders Conduit Main Sw Amps Main Fuses . Amps Underground Type of 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 his ol3hg Lions as an employer of labor under the Florida Workmen's Compensation Act. being Section 5966, Compiled General Laws of Florida /? rmanent 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 sib contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. (Signed) •� 5 Master Electrician. STATE OF FLORIDA, COUNTY OF DADE. 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 depose:; 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 tn.e. My Commission Expires Notary Public, State of Florida NOTE: A re-inspection fee of $1.00 will be made .xhen such re-inspection is made necessary by improper notice for inspection, or faulty materials and /or workmanship. Date g ` / 7.5 Job Address ,haC �� / �� Tax Folio //"302 0 (r/' - O 13 -64UJO f � F -ot y Le Description vx;SnCi( S('�: I AP�-tn p5 I0-7 L.O4° L 5c' D F I"i_o - rt7 -- Ui t i _t Sb�g Lessee / Tenant � eli\e A \AI\11-61 W 1L- - •14►∎ -t - ATCA Fc Master Permit # 3,8.= Owner's Address Contracting Co. ■ Qualifier ** * APPROVED: FEES: PERMIT Zoning PERMIT APPLICATION FOR MIAMI SHORES VILLAGE 6� � E wvLc,s,res 3 t�g State t't 60142cipal # Competency # Ins Architect /Engineer Address Bonding Company Mortgagor Permit Type(circle one): BUILDING / l WORK DESCRIPTION X1.42. l — /9 — X12;ti-te Square Ft. Estimated Cost(value) WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT). Application is hereby made to obtain a permit to do work and installation as indicated above, and on the attached addendum (if applicable). I cert::fy that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits are required for ELECTRICAL, PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK. OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Furthermore, I au th- above -named contractor o do the work stated. !Si: ature • D or Condo Preside Notary as t• - •••• •ent My Commissi ,., �,tT n :+Ntliiim ,d li,t,.y:;►i .x i, A. CU:«w.l4Ao dil IsJn{.i,:F{ v " , ' i is Q *a C Oui,rit. Q J Celt 1 OF F\.O ,4i0.1.1 1 1 + + 1 SS# Phone * * * RADON C.C.F. 0-- • Address Phone r )J 5 '2'" /)(1 Address Address LUMBING MECHANICAL ROOFING PAVING FENCE SIGN S gnature of C•'tractor or Owner- Builder Date: .L... , /_.. 1 otary as My Commis lder ,,,,l,,,Pp�.yle .•L(AH �.sL � � CC,i1 .1 .A ii{NoCM 1' * CO ., + a: PA M• c1s1(1 sfl Q0 {V {4 ** OF F ;.4.r1. 1,1j A .4 NOTARY TOTAL DUE c,•�'� * Fire Other Building Electrical Mechanical Plumbing Engineering BUILDING PERMIT APPLICATION Miami Shores Village Building Department sEp 23[1 Mom\ _ 1 10050 N.E.2nd Avenue Mi i Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Permit No. A)I , . Master Permit No. "PCW'5 - 17r'� FBC 2001 Permit Type (circle): Building (_ Electrical Plumbing Mechanical Roofing Owner's Name (Fee Simple Titleholder) e cA \.\ r (' Phone # Owner's Address 3(0)- C O■ Z Sk City c —'. S State Tenant/Lessee Name Zip Phone # �� Job Address (where the work is being done) ' P 9 2 ` City Miami Shores Village County Miami -Dade Zip j li z, Is Building Historically Designated YES NO Contractor's Company Name L S Q d `t \E Ci1ZIC.- Phone # i?- fffi Contractor's Address ? ‘•• City ►� ...��. State L Zip 3P Qualifier CQJw rte Architect/Engineer's Name (if applicable) - Phone # Architect/Engineer's Address City State Zip $ Value of Work For this Permit ' \ 2J o R . - Square Footage Of Work: Number of: Bays Stories Families Bedrooms Baths Type of Work: DAddition DAlteration [JNew ® Repair/Replace ❑ Demolition Describe Work: ,.i . r vt ,rQ S * * * * * * * * * * * * * * * * * * * * * * * * * * ** Fees * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** County Escrow Fee $ Permit Fee $ � � '' ` e-tr Notary $ Education/Training Fee $ Tech $ Scanning $ Radon $ Code Enforcement $ Bond $ S truct. $ Minus Plans Check Fee $ Total Fee Now Due $ (Continued on opposite side) cb\dt .CC 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 $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement st be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the abse ce such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature Owner or Agent The foregoing instrument was acknowledged before me this day of , 20 _, by Sign: Print: My Commission Expires: chc7r7 /03 Signature NOTARY PUBLIC: Sign: Print: Contractor p The foregoing instrument was acknowledged before me this l6 day of !L/Y l , 20 43 , by Cii�'11i who is personally known to me or who has produced who is personally known to me or who has produced As identification and who did take an oath. as identification and who did take an oath. NOTARY PUBLIC: ************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** (Certificate of Competency Holder) State Certificate or Registration No. Certificate of Competency No. ..4h I ••, rr . i 1 n F . - _ My Commission Expirek •': Commission to CC 902276 **************4.************************** ********** a*********************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Engineer Zoning g� re* Jan. 17, 2004 za , * .$M *r! * * ** • Atlantic Bonding Co., Inc APPLICATION APPROVED BYE / % l ilt t! //$ / � Plans Examiner ITEM BATH TUB UNIT FEE ITEM SWITCH OUTLETS UNIT FEE ITEM SPACE HEATERS UNIT FEE BIDET LIGHT OUTLETS CENTRAL HEATING DISHWASHER RECEPTACLES G 91f A/C (WIND) DISPOSAL SERVICE TEMPORARY A/C (CENTRAL) DRINKING FOUNTAIN SERVICE SIZE IN AMPS DUCT WORK FLOOR DRAIN SERVICE REPAIR/IIETER CHANGE REFRIGERATION GREASE TRAP APPLIANCE OUTLETS €3' 40/Z PROCESS AND PRESS PIPING INTERCEPTOR RANGE TOP ?,7,-- UNDERGROUND TANKS LAVATORY OVEN ABOVE GROUND TANKS LAUNDRY TRAY WATER HEATER, 1 /4Y U.F. PRESSURE VESSELS CLOTHES WASHER 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 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 i HEATER -NEW INST. GENERATORS TRANSFORMERS I 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 FIXTURES SEPTIC TANK ANTENNA ' RELAY TELEVISION OUTLETS DRAINFIELD, 4" TILE/RES. VIOLATION PUMP & 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 PLUMBING 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 SUBSEQUENT APPLICATIONS.) ELECTRICAL MECHANICAL MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date it - a -4)3 Time Type Insp'n Permit No. t 1� - n 21 / Name £ «l'eurn Address c5& 2- A/E 9 o2 bT • Company Phone # OOS • ,50 ' a /D3 For Inspector: e' I/ /i310'b Name & Date App, oved C4' Correction Re- Insp'n Fee ❑ ❑ / ,fit /— e) MIAMI' SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Reque Date Type Insp' n Permit No. El .003 - r Name g-CPFUce • Address 1 J g S • Company L J62 IJE 1254- Phone # Inspection Date Approved Correction Re- Insp'n Fee