ELECTRICAL (2)2ND FLOOR ROUGH
Passed
Inspector Comments
iii' "
. / ,I t'.
ANc- ' -
'\ (i b ott
0- r
\ -,r\
Failed
Correction
Needed
Re- Inspection
Fee
($75)
No Additional Inspections can be scheduled
re- inspection fee is paid.
until
Inspection Number: INSP -8544
Inspection Date: 02/02/2006
Inspector: Devaney, Michael
Owner: ROLPH, RODNEY & FRANCES
Job Address: 453 92 Street NE
Project: <NONE>
Thursday, March 23, 2006
Miami Shores Village, FL
Contractor: P & M ELECTRIC INC
Building Department Comments
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Pho : (305)795 -2204 Fax: (305)756 -8972
cL
Permit Number: EL2005 -133
Permit Type: Imported Permit
Inspection Type: r
Work Classification: Addition /Alt ration
Block:
Sep
9r1V/ •
Phone Number (305)762 -6756
Parcel Number 1132060140260
Lot:
Phone: 305 - 949 -6373
Page 1 of 2
Inspection Number: INSP•1
Inspection Date: 03/24/2006
Inspector: Devaney, Michael
Owner: ROLPH, RODNEY & FRANCES
Job Address: 453 92 Street NE
Miami Shores Village, FL
Project: <NONE>
Contractor: P & M ELECTRIC INC
Building Department Comments
Monday, March 27, 2006
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Nttlltl�C ; t i33
Permit Type: Imported Permit
Inspection Type: Final
Work Classification: Addition /Alteration
Block:
Phone Number (305)762 -6756
Parcel Number 1132060140260
Lot:
Phone: 305 - 949 -6373
Page 1 of 2
Passed
Inspector Comments
Failed
Correction
Needed
Re- Inspection
Fee
($75)
No Additional Inspections can be scheduled
re- inspection fee is paid.
until
Inspection Number: INSP•1
Inspection Date: 03/24/2006
Inspector: Devaney, Michael
Owner: ROLPH, RODNEY & FRANCES
Job Address: 453 92 Street NE
Miami Shores Village, FL
Project: <NONE>
Contractor: P & M ELECTRIC INC
Building Department Comments
Monday, March 27, 2006
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Nttlltl�C ; t i33
Permit Type: Imported Permit
Inspection Type: Final
Work Classification: Addition /Alteration
Block:
Phone Number (305)762 -6756
Parcel Number 1132060140260
Lot:
Phone: 305 - 949 -6373
Page 1 of 2
EL2005 -133
Inspection History
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores FL 33138 -0000
Phone: (305)795 -2204 Fax: (305)756 -8972
Project: <NONE>
Owner: RODNEY & FRANCES ROLPH
Phone: (305)762 -6756
Job Address: 453 92 Street NE Parcel: 1132060140260
Miami Shores Village, FL
Block: Lot:
Scheduled Insp # Inspection Type
09/30/2005 INSP2005 -4158 Electrical
PARTIAL APPROVAL. FLOOR SLAB OK
02/02/2006 INSP -8544 Rough
2ND FLOOR ROUGH
03/24/2006 I N S P -13056 Final
Inspection Status
Inspector
None None
Imported Permit
Date Completed
9/30/2005
APPROVED
Partially Approved Michael Devaney 2/6/2006
APPROVED Michael Devaney 3/24/2006
Monday, March 27, 2006 Page 1 of 1
Inspection Date: 03/24/2006
Inspector: Devaney, Michael
Owner: ROLPH, RODNEY & FRANCES
Job Address: 453 92 Street NE
Project: <NONE>
Miami Shores Village, FL
Contractor: P & M ELECTRIC INC
Building Department Comments
Monday, March 27, 2006
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Permit Type: Imported Permit
Inspection Type: Final
Work Classification: Addition /Alteration
Block:
Phone Number (305)762 -6756
Parcel Number 1132060140260
Lot:
Phone: 305 - 949 -6373
Page 2 of 2
Passed
Inspector Comments
Failed
Correction
Needed
Re- Inspection
Fee
($75)
No Additional Inspections can be scheduled
re- inspection fee is paid.
until
Inspection Date: 03/24/2006
Inspector: Devaney, Michael
Owner: ROLPH, RODNEY & FRANCES
Job Address: 453 92 Street NE
Project: <NONE>
Miami Shores Village, FL
Contractor: P & M ELECTRIC INC
Building Department Comments
Monday, March 27, 2006
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Permit Type: Imported Permit
Inspection Type: Final
Work Classification: Addition /Alteration
Block:
Phone Number (305)762 -6756
Parcel Number 1132060140260
Lot:
Phone: 305 - 949 -6373
Page 2 of 2
Inspection Number: I
Inspection Date: 02/02/2006
Inspector: Devaney, Michael
Owner: ROLPH, RODNEY & FRANCES
Job Address: 453 92 Street NE
Project: <NONE>
Miami Shores Village, FL
Contractor: P & M ELECTRIC INC
Building Department Comments
Wednesday, February 1, 2006
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Pho (305)795 -2204 Fax: (305)756 -8972
Permit Type: Imported Permit
Inspection Type: Rough
Work Classification: Addition /Alteration
Block:
19 '7.aok1 40
Phone Number (305)762 -6756
Parcel Number 1132060140260
Lot:
Phone: 305- 949 -6373
Page 1 of 2
V?"7714Y/
Passed /
Inspector Comments
rjg ''°
Z'6 ®,
Failed
Correction
Needed
Re- Inspection
Fee
($75)
No Additional Inspections can be scheduled
re- inspection fee is paid.
until
Inspection Number: I
Inspection Date: 02/02/2006
Inspector: Devaney, Michael
Owner: ROLPH, RODNEY & FRANCES
Job Address: 453 92 Street NE
Project: <NONE>
Miami Shores Village, FL
Contractor: P & M ELECTRIC INC
Building Department Comments
Wednesday, February 1, 2006
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Pho (305)795 -2204 Fax: (305)756 -8972
Permit Type: Imported Permit
Inspection Type: Rough
Work Classification: Addition /Alteration
Block:
19 '7.aok1 40
Phone Number (305)762 -6756
Parcel Number 1132060140260
Lot:
Phone: 305- 949 -6373
Page 1 of 2
BUILDING !! , Permit No. 133
PERMIT APPLICATION / aster Permit No. 0/ — /9
FBC 2001
Permit Type (circle): Building Plumbing
Owner's Name (Fee Simple Titleholder)
Owner's Address l c q2
City iikii,t144x c-W/ICI? Q'S State �—
Tenant/Lessee Name
Job Address (where the work is being done)
City Miami Shores Villa a County Miami -Dade
Is Building Historically Designated YES
Contractor's Company Name ? f &i t L
Contractor's Address f 7 2( � t /5 ,51
Cit 4/ 114 State L
Qualifier sc ar -
State Certificate or Registration No. Certificat
Architect/Engineer's Name (if applicable)
$ Value of Work For this Permit
Total Fee Now Due $
(Continued on opposite side)
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (3f)-3 7952204 Fax: 305) 756.8972
4 x/E gz 5/
NO
Code Enforcement $ Structural Plan Review. $
Phone #
Zip 33 / 38�
Phone #
Phone #
Mechanical Roofing
Zip 3 3! 38'
2(49? cp75
3 9%'Q co 37
zip 33/ Q 1
Square Footage Of Work: 00 37f
Type of Work: Addition ❑Alteration ['New ❑ Repair/Replace
r El Demolition
Describe Work: e r' C CU 63. 112:1 � f 5,,� / e 1,1 CLS 2 Y'
Vla,A
* * * * * * * * * * * * * * * * * * * * * * * * * ** *F * * * * * * * * * ** * * * * * * * * * * * * * * **
�
Submittal Fee $ Permit Fee $ ► 0 ' 35° C $ '
Notary $ Training/Education Fee $ Technology Fee $
Scanning $ Radon $ Zoning Bond $
CO/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 must be posted at the job site
for the first inspection which occurs seven (7) dys after the building permit is issued. In the absence of such posted notice, the
inspection will not be ved and • ection fee w' I be charged.
Signature
APPLICATION APPROVED BY:
chc 05/13/03
As identification and who did take an oath.
Owner or �J'�` ,p
The foregoing instrument was acknowledged before me this I The foregoing instrument was acknowledged before me this lu
day of t 20 by ,eO 44944474/ , day of r , 20 by cC.D77 7 t1'A_ Q.,'
who is personally known to me or who has d
rouced who is personally known to �' L-
P p y me or who has produced T�
NOTARY PUBLIC:
Sign:
✓ ,��i►sY,Py Annette Diaz
• Print: -.' # P r i nt: , ��'!!��e�•, A nnette D • _ O s s , on = 1
Commis # DD43999S
My Commission Expir ^
; � fl# �, . Expires: .. ,. Expires JUMP
12 , 2009
Contractor
as identification and who did take an oath.
NOTARY PUBLIC: /`
Sign:
** *** * *** ** ** ** ** ** *** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** * * ** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
T�.���Plans Examiner
Engineer
Zoning
Issue Date: 1/13/2006 Expires: 12/22/2006
Owner's Name: RODNEY & FRANCES ROLPH
Permit Type: Imported Permit
Work Classification: Addition /Alteration
Job Address: 453 92 Street NE
Miami Shores Village, FL
Miami Shores Village
10050 N.E. 2nd Avenue
Miami Shores, FL 33138 -0000
Phone: (305)795 -2204 Fax: (305)756 -8972
Permit
Contractor(s)
P & M ELECTRIC INC
Phone
305 - 949 -6373
Primary Contractor
Yes
Comments:
ELECTRICAL FOR ADDITION AS PER PLANS
Additional Information
Perm Type: Electrical
Alpha Four:
Alpha Six:
Pay Amount: 495.48
Bond Return :
Alpha Two:
Alpha Five: RESIDENTIAL
Pay Date: 9/19/2005
Pay Comments:
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.
Re
Parcel #:
Block:
Section:
Electrical
Fees Due
Change of Contractor
Revision Fee
Total:
Amount
$75.00
$35.00
$110.00
Building Department File Copy
Applicant Signature
Invoice Number
imp -1 -06 -23449
imp -12 -05 -23220
Total:
!JAN 3 oPAID
Amt Due
$35.00
$75.00
Permit Status: APPROVED
Permit Number: EL2005 -133
one: (305)762 -6756
1132060140260
Lot:
PB:
Total Square Feet: 0
Total Valuation: $ 7,000.00
uired Ins • ections
Am Paid
$75.00
$75.00
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.
Submittal Fee $
BUILDING . #-
PERMIT APPLICATION
FBC 2001
Permit Type (circle):
Owner's Name (Fee Simple Titleholder)
Owner's Address 4 '5 j c `l 2 s
City LL" �_5— State
Tenant/Lessee Name
Job Address (where the work is being done
City Miami Shores Village_
Is Building Historically Designated YES
Contractor's Company Name _ t /al/al U
Contractor's Address (; G; /' / t) k)
City
/(1/'Ur Y'1 j
Qualifier JL ` i
State Certificate or Registration No. ( � OPT' e/
Architect /Engineer's Name (if applicable)
$ Value of Work For this Permit
Notary $
Building
Type of Work:
Describe Work: till �.�,itfe S 5 - e g ��tr � a ,,� I s, /¢Sy $uJ ckes
4&
b- S ► S'H V Ca. 61e de,/ t �v v . a
-f0 ee°
Training /Education Fee $
Scanning $ (r) Radon $
Code Enforcement $
Total Fee Now Due $
(Continued on opposite side)
Ctg
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
Electrical
Permit Fee $
Plumbing
State
456 #e 92
County Mia .' -Dade
NO
ddition ❑Alteration [New
Structural Plan Review. $
zip 33/3 "
Phone #
Phone #
Zip
Permit No. 1 L 05-133
33
Master Permit No.
Mechanical Roofing
Phone # 0,5)1(92627 50
Zip -3 3/3
Certificate of Competency No.
Phone #
Square Footage Of Work:
3327
❑ Repair /Replace
* * * * * * * * * * * * * * * * * * * * * * * ** F ees * * * * * * * * * * * * * * * * * * * * * * * * ** **
Zoning Bond $
( 756-0
❑ Demolition
CCF $ ' CO/CC
Fee $
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
Contractor
The foregoing instrument w. s aN ledged before me this The foregoing instrument was acknowledged before me this / C
day of ,20
'SO " , day of 49 /// ,200 ,.10.3 C. /9 /; 6&' - / �cZ
who is personally known to e or I has produced who is personally known to me or who has produced TL
As identi / f acie(
NOTARY PUBLIC: NOTARY PUBLIC: n.,,,. .............e.,... ®�
+ . � � LOS REY @S
Comm# 000308772
Sign: Sign: Expires 4/812008
Print: \ / Print:
My Commission Expires:
Own :r or A
and who did take an oath.
***************************************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
APPLICATION APPROVED BY:
chc 05/13/03
Signature
as identification and who did take an oath.
Om (800 .4254
ifietcl et, 0 , j
My Commission Expires: '�/ D/
* * * * * * * * * * * **
a.S Plans Examiner
Engineer
Zoning
ITEM
BATH TUB
UNIT
FEE
ITEM
SWITCH OUTLETS
UNIT
FEE
ITEM
SPACE HEATERS
UNIT
FEE
BIDET
LIGHT OUTLETS . CENTRAL HEATING
DISHWASHER
RECEPTACLES A/C (WIND)
DISPOSAL
SERVICE TEMPORARY A/C (CENTRAL)
DRINKING FOUNTAIN
SERVICE SIZE IN AMPS DUCT WORK
FLOOR DRAIN
SERVICE REPAIR/IITER CHANGE REFRIGERATION
GREASE TRAP
APPLIANCE OUTLETS PROCESS AND PRESS PIPING
INTERCEPTOR
RANGE TOP UNDERGROUND TANKS
LAVATORY
__ OVEN -_ ABOVE GROUND TANKS
LAUNDRY TRAY
__ WATER HEATER U.F. PRESSURE VESSELS
CLOTHES WASHER
MOTORS C- 1 HP STEAM BOILERS
SHOWER
MOTORS OVER 1- 3 If HOT WATER BOILERS
SINK, POT /3 COMP.
MOTORS OVER 3- 5 HP MECHANICAL VENTILATION
SINK, RESIDENCE
MOTORS OVER 5- 8 HP TRANSPORTING ASSEMBLIES
SINK, SLOP
MOTORS OVER 8- 10 If ELEVATORS/ESCALATORS
TEMPORARY WATER CLOSET
MOTORS OVER 10- 25 HP FIRE SPRINKLER SYSTEW
URINAL
MOTORS OVER 25-100 HP COOLING TOWERS
WATER CLOSET
I MOTORS OVER 100 I•P -_ VIOLATION
INDIRECT WASTES-
A/C WINDOW REINSPECTION
WATER SUPPLY TO:
AIR CONDITIONERS
A/C UNIT
STRIP HEATER
FIRE SPRINKLER
I GENERATORS TRANSFORMERS
1
'HEATER -NEW INST.
1 1 GENERATORS TRANSFORMERS
1
HEATER - REPLACE
1 GENERATORS TRANSFORMERS 1 1
LAWN SPRINKLER -WELL
SPECIAL PURPOSE
SWIMMING POOL
OUTLETS COMMERCIAL 1
WATER SERVICE
-_ SIGN TUBES -_
SEWER CONNECTIONS
SIGN TRANSFORMERS -_
UTILITY -SEWER
SIGN TIME CLOCK
UTILITY -WATER
FIXTLRES
SEPTIC TANK
ANTENNA
RELAY
TELEVISION OUTLETS ' i -
DRAINFIELD, 4' TILE/RES.
VIOLATION
PUMP S ABANDON SEPTIC TANK
REINSPECTION 1
SOAKAGE PIT CU. FT.
Q7 I I A -M
CATCH BASIN
w
DISCHARGE WELL
P 9�� M . WI
DOMESTIC WELL
AREA DRAIN
ROOF INLET
SOLAR WATER HEATER
FIRE STANDPIPE
POOL PIPING
1
LAWN SPRINKLER SYSTEM
GAS RANGE
METER SET (GAS
1
GAS PIPIN
(AN APPLICATION FOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. IF A MASTER PERMIT HAS B.
OBTAINED, THE "U;INER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.)
PLUMBING
ADDENDUM TO BUILDING PERMIT APPLICATION
ELECTRICAL
MECHANICAL
6?
ELECTRICAL CRITIQUE SHEET
� ep /, 7 -
j
,�7.. t z)Li
Miami Shores Village
Building Department
Permit No. ;�� 6-11-` "
Job Name
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
Owner's Nam Simple Titleholder)
Owner's Address 4 J S /(1 E �z w( �T
City I Cc (S1i.00 State t
Tenant/Lessee Name Phone #
Job Address (of where the work is being done)
City .CZUvt , 5 LZ.d ' t. County,
Legal Description
/� z: -" Phone # ?e5 99' 9 -
Contractor's Company Name -- ec: tt
'
Contractor's Address / ' 3 /U� "if _57
City /V State d
Qualifier S C D ? 7 S he
Describe Work:
I hereby certify that the work has been abandoned and /or the contractor is unable or
unwilling to complete the contract.
Shores harmless from all,,legal involv • i ent.
Signature
The foregoing instrument was acknowledged before me this
this
day of • 20 by
NOTARY PUBLIC•
Sign:
Miami Shores Village Building Department
� .`
,,, ,,,,,, Annette Diaz
Print: 4t!...9�
:: . Commission #DD439999
My Commiss'ayb, + zpires: JUNE 12, 2009
1 't,°,i, ,5,; www.AA.tONI■i OTARY.cora
Rev. 09/19/03)
0
***** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
'tQ / k
who is personally known to me or who has produced
As identification and who did take an oath.
Change of Contractor ��,��----,�
Permit NoNG
-13
Phone #
Zip 3 13 R
Zip S
Zip 23/e7/
old the Building Official and the Village of Miami
Signature
Contractor
I t ' The foregoing instrument was acknowledged before me
day of • f' , 20 05 , by SO 77 / lrii ke t
L..
who is personally known to me or who has produced
NOTARY PUBLIC:
Sign:
Print:
as identification and who did take an oath.
,
,ro ':fa Annette Diaz
My Commissioi tx s:il _Commission #DD439999
Y'�``Expires: JUNE 12 2009
W.AA RONNOTARYco al
*
**************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
7
Signed: (INSPECTOR)
Miami Shores Village
10050 NE 2nd Avenue
Phone: 305- 795 -2204 Permit Number: EL2005 -133
Printed: 9/19/2005
Applicant: FRANCES ROLPH
Owner: ROLPH FRANCES
JOB ADDRESS: 453 NE 92 ST
Contractor P & M ELECTRIC INC
Local Phone: 305 - 949 -6373
Parcel # 1132060140260
Electrical Permit
Contractor's Address: 1936 NE 148 ST
Page 1 of 1
Legal Description: 6 53 41 MIAMI SHORES SEC 2 PB 10 -37 E1/2 LOT 18 ALL LOTS 19 & 20
Fees: Description Amount
FEE2005 -7271 Building Fee $475.00
FEE2005 -7272 CCF $4.20
FEE2005 -7273 Technology Fee $11.88
FEE2005 -7274 Training and Education Fee $1.40
FEE2005 -7275 Scanning Fee $3.00
FEE2005 -12579 Change of Contractor $75.00
Total Fees: " $570.48
Total Fees: $570.48
Total Receipts: $495.48
Permit Status: APPROVED Permit Expiration: 10/23/2005 Construction Value: $7,000.00
Work: ELECTRICAL FOR ADDITION AS PER PLANS
SEP 1 9 PAID
cab
In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict
conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responisibility for all work
done by either myself, my agent, servants or employes.
Signed: (Contractor or Builder) BY: