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969 NE 92 St (13)MIAMI.SHORES VILLAGE BUILDING DEPARTME 305- 795 -2204 Building Inspection Request Date Type Insp'n F 0 'lit � , � �^ �L" Permit No. e-‘ Dons D°sq Name O Ur Address 90q‘ GW g Company Q' / Phone # Z OS q t7J 4 -o 2 S• Inspection Date � o -4 Approved W) Correction Re-Insp'n Fee ❑ ❑fie - 714r `f": � r � ,,0 Date/ Type Insp'n Permit No. Name Address Company Phone # MIAMI SHORES VILL BUILDING DEPARTM 305- 795 -2204 Building Inspection Request Inspection Date Approved Correction Re- Insp'n Fee MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305-795-2204 /, Building Inspection Request \ • ( Date - , f „ Type Insp'n „ Permit Name \s s, ei • Address Company Phone # Inspection Date -/:.• • / - Approved Correction Re-Insp'n Fee a MIAMI SHORES VILLAGE BUILDING DEPARTMENT fc Building Inspection Request .„/ , Date Time Type Insp'n Permit No. . / Name t (7 e-777; Address Company Phone # 305-795-2204 For Inspector: Name & Date_ /--- --'--- --- Approved 0 -'>' z/i) — Correction 0 7' ' t-- -' Re-Insp'n Fee 0 t r?' . , • - „ MIAMI S ORES VILLAGE UILDING DEPARTMENT 305- 795 -2204 Building Inspection Requ-st y/ 3 Time Date -, ;. -r . Type Insp' 1•i Permit No. F L 2 ®Q 3-3 Nam- 1, Address 9 1 r-, Company Phone # - 3 &S ' J 1 r For Inspector: 1//2S boa EName & Date Approved Correction Re- Insp'n Fee MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request t-, Na Date ( i Time Type Insp'n V °i / Permit No. Name • Address E „ \ . ) Company 0 C ' 7 Phone # ) U L ) For Inspector: I ? ! ? Name &.Date Approved Correction Re- Insp'n Fee i MIAMI SHORES VILLA .E BUILDING DEPARTMEN 305- 795 -2204 Building Inspection Request Date ;_ ^� iii,•)) E. Type Insp'n �, , Permit No. y , Name Address '4, 1 Company y��! Phone# Inspection Date Approved Correction Re- Insp'n Fee Building Department BUILDING PERMIT APPLICATION FBC 2001 Permit Type (circle): Building Electrical Plumbing Mechanical Roofing Owner's Name (Fee Simple Titleholder) Owner's Address City . � , Tenant/Lessee Name i ! ) ;• ,� , Job Address (where the work is being done) City Miami Shores Village County Miami -Dade Zip Is Building Historically Designated YES Contractor's Company Name ¶State Contractor's Address .� - i4. 4 - -- City 1 z - .1,,,i, , Sate • Qualifier " "s,' a- ��T ;:� A "•:'-',..,;. Miami Shores Village , �' State NO Number of: Bays Stories Families ew Minus Plans Check Fee $ 42 Phone # 4 , $ Value of Work F'orihist'Pprmit Square Footage Of Work: Type of Work: ['Addition ['Alteration Describe Work: " -- � o ` 3✓ ic• � County Escrow Feed' '— Permit Fee $, %� Zip Pccid CC. $30.00 is 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Permit No. E L oo 3 • ' 5 ' Master Permit No. Phone # Phone # Bedrooms ❑ Repair/Replace * * * * * * * * * * * * * * * * * * * * * * * * * * ** F ees ** * * * * * * * * * * * * * * * * * * * * * * * * * * ** Notary 'r Baths ssnnanssnnnnssa Zip Architect/Engineer's Name (if applicable) - Phone # Architect/Engineer's Address City '- Zip • f . ❑ Demolition melon • D00228040 Sanded through Malay wan., Inc. MMm. Education/Training Fee $ Tech $ Scanning $ on $ Code Enforcement $ Bond $ Struct. $ Total Fee Now Due $ (Continued on opposite 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. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature Signature - - Owner or Agent The foregoing instrument was acknowledged before me this day of . 20 by , day of , 20 _, by 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. NOTARY PUBLIC: Sign: Print: My Commission Expires: Contractor The foregoing instrument was acknowledged before me this NOTARY PUBLIC: Sign: Print: My Commission Expires:: ************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** (Certificate of Competency Holder) State Certificgtt o Reg3 tt'atiprj N' &. Certificate of Competency No. chc7/7 /03 as identification and who did take an oath. 0 000220040 1 '45 71 dte APPLY araoec Plans Examiner Engineer Zoning ITEM BATH TUB UNIT FEE ITEM SWITCH OUTLETS UNIT 30 FEE g© ITEM SPACE HEATERS UNIT FEE BIDET LIGHT OUTLETS 15 p CENTRAL HEATING DISHWASHER RECEPTACLES yIb A/C (WIND) DISPOSAL SERVICE TE PORARY A/C (CENTRAL) DRINKING FOUNTAIN SERVICE SIZE IN AM'S 406 4) DUCT WORK FLOOR DRAIN SERVICE REPAIR/IETER CHANGE REFRIGERATION GREASE TRAP APPLIANCE OUTLETS Li 24/ PROCESS AND PRESS PIPING INTERCEPTOR RANGE TOP 11 UNDERGROUND TANKS LAVATORY OVEN ABOVE GROUND TANKS LAUNDRY TRAY WATER HEATER 1 ,y 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 If MECHANICAL VENTILATION SINK, RESIDENCE MOTORS OVER 5- 8 If TRANSPORTING ASSEMBLIES SINK, SLOP MOTORS OVER 8- 10 HP ELEVATORS/ESCALATORS TE)FORARY WATER CLOSET MOTORS OVER 10- 25 HP FIRE SPRINKLER SYSTEMS URINAL MOTORS OVER 25-100 HP COOLING.TOWERS WATER CLOSET MOTORS OVER 100 If VIOLATION INDIRECT- WASTES • A/C WINDOW REINSPECTION WATER SUPPLY TO: AIR CONDITIONERS / , q , � ' A/C UNIT STRIP HEATER FIRE SPRINKLER GENERATORS TRANSFORMERS HEATER -NEW INST. GENERATORS TRANSFORMERS HEATER - REPLACE GENERATORS TRANSFORMERS LAWN SPRINKLER -WELL SPECIAL PURPOSE SWIMMING POOL OUTLETS COIJ ERCIAL WATER SERVICE SIGN TUBES SEWER CONNECTIONS SIGN TRANSFORMERS UTILITY -SEWER SIGN TIME CLOCK UTILITY -WATER FIXTURES SEPTIC TANK ANTENNA y '6› RELAY TELEVISION OUTLETS Li DRAINFIELD, 4" TILE/RES.= VIOLATION PU* & 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 ADDENDUM TO BUILDING PERMIT APPLICATION (AN APPLICATION FOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. IF A MASTER PERMIT HAS B. OBT,INED, THE OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.) f PLUMBING ELECTRICAL MECHANICAL