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117 NE 95 St (7)MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Reques Type Insp'n ry ' no / • 2w--L Date Permit No. Name Address Company Phone # Inspection Date 1—(p7 Approved ❑ Correction Re- Insp'n Fee ❑ / )7ij V /Z ff_ ,x "c Approved Correction Re- Insp'n Fee MIAMI SHORES VILL GE BUILDING DEPARTM N 305- 795 -2204 Building Inspection Requ Dat Type Insp'n )) Permit No. E l 0 ~' 33 1 Name Address Company Phone # Inspection Date ❑ l tp�1/�lzc. S/ •ERZ' - 2 f3.77 TEM ATH TUB UNIT FEE ITEM SWITCH OUTLETS UNIT FEE ITEM SPACE HEATERS UNIT FEE IOET LIGHT OUTLETS CENTRAL HEATING ISHWASHER RECEPTACLES A/C (WIND) ISPOSAL SERVICE TEhPCPJ Y A/C (CENTRAL) KINKING FOUNTAIN SERVICE SIZE IN APPS DUCT WORK LOOK DRAIN SERVICE REPAIR/6(TER CHANGE REFRIGERATION REASE TRAP APPLIANCE OUTLETS PROCESS AND PRESS PIPING 4TERCEPTOR RANGE TOP UNDERGROUH) TANKS AVATCRY OVEN ABOVE GROUND TANKS AUNDRY TRAY _ WATER HEATER U.F. PRESSLRE VESSELS LOTHES WASHER M3TCRS 0- 1 HP STEAM BOILERS OWER I0TORS OVER 1- 3 FP HOT WATER BOILERS INK, POT /3 CORP. MOTORS OVER 3- 5 FP MECHANICAL VENTILATION INK, RESIDENCE MOTORS OVER 5- 8 If TRANSPORTING ASSEMBLIES INK, SLOP MOTCRS OVER 8- 10 FP ELEVATORS/ESCALATORS EWORARY WATER CLOSET MOTORS OVER 10- 25 FP FIRE SPRINKLER SYSTEMS RINAL MDTCRS OVER 25-100 FP COOLING TOWERS ATER CLOSET —' MOTORS OVER 100 FP VIOLATION `DIRECT WASTES A/C WINDOW REINSPECTION ATER SLPPLY TO: AIR 03NDITIONERS 3 ) / ' A/C UNIT STRIP HEATER O FIRE SPRINKLER GENERATORS TRANSFORMERS HEATER -NEW INST. GENERATORS TRANSFORIRS HEATER- REPLACE GENERATORS TRANSFc1¢RS LAWN SPRINKLER -WELL SPECIAL PURPOSE SAIWING POOL OUTLETS CO €RCIAL WATER SERVICE SIGN TUBES r EWER CONNECTIONS SIGN TRANSFORI,€RS r iILITY -SEWER SIGN TIME CLOCK ;ILITY -WATER FIXILRES :PTIC TANK ANTENNA :LAY TELEVISION OUTLETS tAINFIELD, 4' TILE/RES. VIOLATION .W & ABANDON SEPTIC TANK REINSPECTION • JAKAGE PIT CU. FT. ,TCH BASIN SCHARGE WELL .MESTIC WELL :EA DRAIN :OF INLET �— :LAR WATER HEATER RE STANDPIPE CL PIPING NN SPRINKLER SYSTEM S RANGE TER SET (GAS) S PIPING AN APPLICATION FOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. IF A MASTER PERMIT HAS B. OBTAINEDr THE OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.) PLUMBING ELECTRICAL MECHANICAL Contractor's Address $ Value of Work For this Permit /09 00 Total Fee Now Due $ / 03, 3 • (Continued on opposite side) 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.E L D3 —33} PERMIT APPLICATION Master Permit No. (Yl F 2_003-D\ 0 1 FBC 2001 Permit Type (circle): Building j Plumbing Mechanic all Roofing Owner's Name (Fee Simple Titleholder) L y bteKa Phone # p gb400 Owner's Address / 1'7 ■J q � � / City 17)14 ��- / State �'t/ Zip , a Tenant/Lessee Name Phone # Job Address (where the work is being done) / / A "/ & ✓ T City Miami Shores Village County Miami -Dade Is Building Historically Designated YES NO Contractor's Company Name b14i2�l 't % � 2Z Z ailra Phone # *A Zip Submittal Fee Permit Fee $ /7' Ov Notary $ Training/Education Fee $ -� • Zip - 3 /7 Architect/Engineer's Name (if applicable) Phone # Square Footage Of Work: Type of Work: ❑Addition ['Alteration i [New /( Repair/Replace ❑ Demolition Describe Work: lAil t' 416 vJ / h &z * * * * * * * * * * * * * * * * * * * * * * * * * * ** F * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** CCF $ Technology Fee $ ' 7) Scanning$ Radon$ C , ; 0 INSM -i_q ,_N Mt ItCUG;I Structural Plan Review. $ L�,iL.T C VvIh,NG Code Enforcement $ CI ,.,._,,, 1 .,,,,_,Lt„ E I.) IA OF A/C I,, J.. 1..I_fvT , HO i WATER HEATERS Aid.. :.T .t.r< EQUIPMENT TO OBTAIN Cur <kECT WIRE SIZES AND 0. EHCURRENT PROTECTION. 47' _ ::SCE CAPACITY ;., ?ROV1IED. J,,,LC; 10 ELECTRICAL iN. ECTION. 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 i ection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection wi t be ap and a reinspection fee will be charged. Signature Owner or Agent The foregoing instnunent was acknowledged before me this /0 day of W , 2Q, by -CV\ Ltem or who has produced on and who did take an oath. NOTARY P 's L • 13 '`y4, 4 / y, p' '? , Sign: //—* �� ,, Print: 1 , ' „ 1 " , ty Chc 10/14/03 ersonally kno�� My Commission Expires: APPLICATION APPROVED BY: My Commission Expires: Signature NOTARY PUBLIC: Sign: Print: Contractor The foregoing instrument was acknowledged before me this /O day of No,/ �3 by BOf 4 14 1S/ %� , dime or who has produced 'on and who did take an oath. ' e.� lAen ***************************************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** (Certificate of Competency Holder) State Certificate or Registration No.__EZ00/ /40 Certificate of Competency No. *************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** ** * ********************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** ee;(4,z7Z Vt e- `Plans Examiner Engineer Zoning MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Reques Date e�( a (Q� Type Insp'n Pro \ A la Permit No. % x^ 1 1 '?J 3 I Name 160 p , 0 1 pn'C Address I � ►�C�Q S s Company r Vi able_ Phone # 'G L j - 1119 . Inspection Date Approved Correction Re- Insp'n Fee qqq (414( mSCJ 3: . Permit No Em to in Ie t i ati'e N e..�IQpC,ts/) lops / o o 1/ a '/,� Q ca on and Lega Description Lot.. a/.7 4J ( i it Amount of Permit $ ws STATE OF FLORIDA, COUNTY OP DADE. Ij es' My Commission Expires MIAMI SHORES VILLAGE (Signed)fi.. ., ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT QQ Date V.ftlA....5,..L9g1). Application is hereby made for the approval of the detailed statement of the plane 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, Fiu :ida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulation: 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... Registered Architect and /or Engineer _t 41.0040 n /H '� Block �� Subdivision ,�.' A' Street and Number where work is to be performed —No / / 7 N e treet State work to be performed and purpose of building (By Floors). .. . �f.l cv,e4e4e J t / !/ / New Building Remodeling Addition Repairs No. of Stories Notary Public, State of Florida Service Size Feeders Conduit Main Sw Amps Main Fuses Amps nderground 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 obligations as an employer of labor under the Florida Workmen's Compensation Act. being Section 3966, 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•contratrs, on work to be pe orrned under this permit, as are licensed by Miami Shores Village. aster Electrician. Before me, the undersigned authority, a notary public, duly a thorited to administer oaths and take acknowledgments, personally appeared J a.m e.6 C....... .Co an. � //.. � to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the .. E i e � c&( eon 1a�r of the above described construction, and he has carefully read the foregoing application and that he did sign the same, 3pd that all facts therein by him stated are true. M iiAINU I f ON &APINGBbJAN. 1 �p RNR NOTARY P41111.10 UMW Mt 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 0 LIGHT OUTLETS PLUO PIECE' P'T - s FIXTURES NO LAMPS REFRIO. OUTLET IRON OUTLET RANG[ OUTLET RANGE CONN. WATER HEATER W. HEAT. CONN. SPACE HEATER STRIP H TOTAL CONTR. LIST CHECK ENT. SW. DIET. CAR. SERVICE TEMP. SERVICE PERM. L / MOTORS 0.1 HP MOTORS 1.e HP NEON TRANS. RADIO - TOTAL CONTR. LIST 2 ..r ✓c CM[CK 1 . VS . Permit No Em to in Ie t i ati'e N e..�IQpC,ts/) lops / o o 1/ a '/,� Q ca on and Lega Description Lot.. a/.7 4J ( i it Amount of Permit $ ws STATE OF FLORIDA, COUNTY OP DADE. Ij es' My Commission Expires MIAMI SHORES VILLAGE (Signed)fi.. ., ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT QQ Date V.ftlA....5,..L9g1). Application is hereby made for the approval of the detailed statement of the plane 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, Fiu :ida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulation: 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... Registered Architect and /or Engineer _t 41.0040 n /H '� Block �� Subdivision ,�.' A' Street and Number where work is to be performed —No / / 7 N e treet State work to be performed and purpose of building (By Floors). .. . �f.l cv,e4e4e J t / !/ / New Building Remodeling Addition Repairs No. of Stories Notary Public, State of Florida Service Size Feeders Conduit Main Sw Amps Main Fuses Amps nderground 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 obligations as an employer of labor under the Florida Workmen's Compensation Act. being Section 3966, 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•contratrs, on work to be pe orrned under this permit, as are licensed by Miami Shores Village. aster Electrician. Before me, the undersigned authority, a notary public, duly a thorited to administer oaths and take acknowledgments, personally appeared J a.m e.6 C....... .Co an. � //.. � to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the .. E i e � c&( eon 1a�r of the above described construction, and he has carefully read the foregoing application and that he did sign the same, 3pd that all facts therein by him stated are true. M iiAINU I f ON &APINGBbJAN. 1 �p RNR NOTARY P41111.10 UMW Mt 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. ELECTRICAL PERMIT A N° _ 68 1144143+NIS BUILDING INSPECTION DEPARTMENT limo , 1 .. L L1 Y NAME ADDRESS - LICENSE NO. Owner of Building e. Architect and/or Engineer Contractor or Builder___ZZ.i_1-4__a_L_Law- - Proposed Location LOT NAME NAME BLOCK SUB-DIVISION ADDRESS AMOUNT RECD. PAYMENT ACCT. DEPT. MIAMI SHORES VILLAGE z - . 4 4.■ '7 ADDRESS - - LICENSE NO NO. This permit is issued to ..f.i.__.f.._ - • ' -:.,...e..- '" ' C f 1 , . the building above described, as per application, Plans and Specifications heretofore filed in this office. This permit is graMed upon the express condition that all facts stated in the application are true and that the construction complies strictly with the plans and specifications submitted, and in accordance and compliance with the building laws of the State of Florida and with the building ordinances and zoning laws of Miami Shores Village, and rules and regulations of the building department of Miami Shores Village. This permit may be revoked at any time upon the violation of any provisions of said laws, ordinances or rules and regulations, or upon any change in the plans and specifications unauthorized by the building inspector. .,A,/ . • STREET INSPECTOR In consideration of the issuance to me of this permit I hereby agree to the proposed construction in strict conformity with the application and plans and specifications thereof heretofore by me submitted, and in compliance with all provisions of all building laws of the State of Florida, all the building ordinances and zoning laws of Miami Shores Village and all rules and regulations of the building rlepartment of Miami Shores Village. ..., - Dated______ ____b_ i _, 194_ --..... — 1 ------4 , - , / '' -4_ 4-.. - ..,..... (SEAL) NOTE: A charge of $1.00 will be made for making corrections or changes to this application after appikval has been obtained from the Planning Board. 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 CEILING BRACKETS RECPTACLES SWITCHES STOVES WATER HEATERS SIGNS OTHER • BRACKETS MAIN SUBS BRANCHES BASEMENT _ FLOORS FIXTURES ONLY NUMBERS OF TOTAL OUTLETS SIZE OF SIZE •EwVICE CONDUIT No. CIRCUITS LIGHTS CEILING BRACKETS MAIN SUBS BRANCHES BASEMENT FIRST la, 640 /1 SECOND THIRD Frill PT 14 A -SS / 193 ELECT RICAL DIVISION OF THE CITY OF MIAMI - Desiring your certificate of Approval, application is hereby made for an inspection of the electric installation in the premises stated below, for which undersigned agrees to correct any infractions of the National Electric Code and the City Ordinance pointed out by Inspector. LOCATION AVOID DELAY BY GIVING FULL AND ACCURATE INFORMATION. ALL SPACES MUST BE FILLED OR APPLICATION WILL BE RETURNED BUILDING - -NEW OR OLD IUNDERLINE WHICH) APPLICATION No 1 7 / SPECIFICATIONS DATE LOT NUMBER F * ! 7 /fPBL'O A - 1 CKK NUMBER 2 SUBDIVISION / " // �O STREET AND NUMBER �'/ RR / Ai% -' , () 3 SIDE 4 . - ' 4 `"r H ;l OWNER A fair of / OCCUPANT OCCUPIED As ` f S' WORK -- ADDITIONAL, - NNE EW W, ALTERATION OR REPAIR H. P. OF EACH MOTO• VOLTS TOTAL AMPS PHASF KIND OF INSTALLATION OPEN OR CONCEALED KNOB, RX., BX., MLDG., CONDUIT, METALLIC TUBING REMARKS CONTRACTOR BY D f �y�p .`> {:�A � �7 M-r e. 4 � C- . trt. I� l INSPECTION WANTED t .4 / ADDRESS r t - , RECEIVED BY INSPECTOR PROGRESS WILL INSPECT AGAIN ROUGH WIRING FINAL No CORRECTED TEMPORARY DAYS. DATE ISSUED SPACE BELOW FOR INSPECTOR'S USE ONLY INSPECTED • REMARKS FEE REMITTED INSPECTOR MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT Permit No ' ----- �� /9S S �-- -------- Date - - -- - - 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 4 _,t___ (/ 111A.. No. -__ / / _ ( we Street 9 g SR* Registered Architect and /or Engineer / QM 0... Employing Electrician's Name _/ k _l- Location and Legal Description Lot_ 'Block_ ________________ Subdivision__—____ Street and Number where work is to be performed —No. ?_ � _ I � L__tr� Street �," � State work to be performed and purpose of building (By Floors) _ f '' � Y -. L. , z; ,_ __._ .._ ___ ^_-____-.--„___ —_ - New Building Remodeling Addition Repairs No. of Stories_____L __ STATE OF FLORIDA, - COUNTY OF DADE ss. My Commission Expires $Si No Amount of Permit $ (Signed) ‘A? 4/ l4L Street___ —_ -t-i- Service Overhead Size Feeders____ Conduit____ ! __ Main Sw Amps. Main Fuses Underground Type of Installation— Conduit Tubing B.X.L. Metal Moulding Amps. 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. (Signed) ____ /. .4 Notary Public, State of Florida t r.. t 1 . 1i ?ter Electricap. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally apared 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. k 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 CHECK ENT. SW. DIST. CAB. SERVICE TEMP. SERVICE PERM. MOTORS 0-1 HP MOTORS 1 -5 HP NEON TRANS. RADIO TOTAL CONTR. LIST CHECK MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT Permit No ' ----- �� /9S S �-- -------- Date - - -- - - 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 4 _,t___ (/ 111A.. No. -__ / / _ ( we Street 9 g SR* Registered Architect and /or Engineer / QM 0... Employing Electrician's Name _/ k _l- Location and Legal Description Lot_ 'Block_ ________________ Subdivision__—____ Street and Number where work is to be performed —No. ?_ � _ I � L__tr� Street �," � State work to be performed and purpose of building (By Floors) _ f '' � Y -. L. , z; ,_ __._ .._ ___ ^_-____-.--„___ —_ - New Building Remodeling Addition Repairs No. of Stories_____L __ STATE OF FLORIDA, - COUNTY OF DADE ss. My Commission Expires $Si No Amount of Permit $ (Signed) ‘A? 4/ l4L Street___ —_ -t-i- Service Overhead Size Feeders____ Conduit____ ! __ Main Sw Amps. Main Fuses Underground Type of Installation— Conduit Tubing B.X.L. Metal Moulding Amps. 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. (Signed) ____ /. .4 Notary Public, State of Florida t r.. t 1 . 1i ?ter Electricap. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally apared 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. k 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. Permit No.___t ^___«?_ _____ MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT Date_ � _ " • , – / 9 < `" 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 ( 9 ) N ' L 2 Street_ 6 Registered Architect and /or Engineer — GG1 ± . Employing Electrician's Name 11 �}_F 1�-- _� � l alr - a No 1!�_= IN 3 Street t a Location and Legal Description Lot Block Subdivision________________________ Street and Number where work is to be performed —No / L 7 ° 1� . 2 _ ' Street State work to be performed and purpose of building (By Floors) fi f'4 a -447= A =a : + Ai. ___Z✓ ___s +" e 11.6__________ New Building ,_______ Remodeling Addition Repairs No. of Servi Overhead Size Feeders Conduit °' Main Sw._________________ Amps. Underground p ---------- - - - - -- Main Type of Installation— Conduit Tubing � B.X.L. Metal Moulding Amount of Permit $ (Signed) 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 corn- 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. (Signed) STATE OF FLORIDA, COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take 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. My Commission Expires 160t-cLe) Notary Public. State of Florida Master Electrica r acknowledgments, personally 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' WT S FIXTURES NO. LAMPS REFRIG. OUTLET IRON OUTLET RANGE OUTLET RANGE CONN. WATER HEATER W. HEAT. CONN. SPACE HEATER STRIP HEATER TOTAL CONTR. LIST s� _ PH . CHECK II / ENT. SW. DIST. CAB. SERVICE TEMP. SERVICE PERM. MOTORS 0-1 HP MOTORS 1 -5 HP NEON TRANS. RADIO TOTAL CONTR. LIST CHECK Permit No.___t ^___«?_ _____ MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT Date_ � _ " • , – / 9 < `" 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 ( 9 ) N ' L 2 Street_ 6 Registered Architect and /or Engineer — GG1 ± . Employing Electrician's Name 11 �}_F 1�-- _� � l alr - a No 1!�_= IN 3 Street t a Location and Legal Description Lot Block Subdivision________________________ Street and Number where work is to be performed —No / L 7 ° 1� . 2 _ ' Street State work to be performed and purpose of building (By Floors) fi f'4 a -447= A =a : + Ai. ___Z✓ ___s +" e 11.6__________ New Building ,_______ Remodeling Addition Repairs No. of Servi Overhead Size Feeders Conduit °' Main Sw._________________ Amps. Underground p ---------- - - - - -- Main Type of Installation— Conduit Tubing � B.X.L. Metal Moulding Amount of Permit $ (Signed) 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 corn- 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. (Signed) STATE OF FLORIDA, COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take 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. My Commission Expires 160t-cLe) Notary Public. State of Florida Master Electrica r acknowledgments, personally 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 Owner of Building J h rrnr. • NTRACTOR •R MIAMI SHORES VILLAGE, FLORIDA — DATE _ 194 PERMIT N° • 4227 Contractor's License No Work to be performed under this Permit 7 ILDER INSPECTOR , Antt. of Permit Architect Contractor : , i , or Builder Legal Lot ' Bl. Subdi- Description vision Address of r ` , -°' 1 Value of / Building / / / 0 ."? . ! i k' 1 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 appl cation herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance wi y plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be re ed 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 respon- sibility for work done by his agents, servants or employees. j / J , a r Signed ..� _ V"' By r' 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 a =s responsibility for all work done by either myself, my agent, servant or employee. = BY AUTHORITY FLOORS P I A rUHCS UnL7 NUMBER OF TOTAL OUTLETS SIZE OF SIZE SERVICE CONDUIT No. CIRCUITS LIGHTS CEILING BRACKETS MAIN SUBS BRANCHES BASEMENT - FIRST On if/ 41 SECOND THIRD FOURTH A -63 LOCATION AVOID DELAY BY GIVING FULL AND ACCURATE INFORMATION. ALL SPACES MUST BE FILLED OR APPLICATION WILL BE RETURNED. Ii LOT NUMBER / BLOCK NUMBER ✓ a SUBDIVISION #. �" ' elr • r/ / 4 4 ` STREET AND NUMBER 7 - Se. SIDE " OWNER � e.A.,ii, OCCUPANT OCCUPIED As ' 46"14; By CEILING MASTER ELECTRICIAN BUILDING- -NEW OR OLD (UNDERLINE WHICH) BRACKETS KIND OF INSTALLATION RECEIVED BY INSPECTOR PROGRESS WILL INSPECT AGAIN RECEPTACLES ROUGH WIRING FINAL No CORRECTED t TEMPORARY 1 DAYS. DATE ISSUED APPLICATION ELECTRICAL DEPARTMENT OF THE CITY OF MIAMI Desiring your certificate of Approval, application is hereby made for an inspection of the electric installation in the premises stated below, for which undersigned agrees to correct any infractions of the National Electrical Code and the City Ordinance pointed out by In- spector. SWITCHES 1 FEE REMITTED SPECIFICATIONS Ti fr INSPECTION WANTED DDRESS SPACE BELOW FOR INSPECTOR'S USE ONLY DATF SIGNS NO c i54 4,`- JO 1 939 WORK -- ADDITIONAL, NEW. ALTERATION OR REPAIR H. P. OF EACH MOTOR VOLTS- TOTAL AMPS PHASE OTHER APPARATUS /- ....)Go. /e C IOW N/ OPEN OR CONCEALED KNOB. RX.. BX.. MLDG.. CONDUIT. METALLIC TUBING REMARKS INSP CTE REMARKS x _ / / J �F a /� � �� / , / rI c } � / /41:7_ � 'ICS B INSPECTOR OUTL1f8' MOTORS RECEPTACLES GENERATORS STOVES WATER H'TERB SIGNS BILLBOARDS OTHER APPARAT' MAIN SUB BRANCH Basement First FLOOR NUMBER OF SIZES OF • INSULATION OPEN OR CONCEAL'D NUMBER OF CIRCUITS OUTLETS MOTOR GEN. MAIN SUB BRANCH Basement First Second Third Fourth Other Floors Owner Work begun Work finished 4 Building Contractor Electrical Contractor Location of proposed work: Lot Details of proposed work: Number of Motors Signature of Applicant H P .� YI •' I { J Miami fhores9 llage F L 0 R 1 D A APPLICATION FOR ELECTRICAL PERMIT Application is hereby made for issuance of permit for electrical installation as described below, and for inspection of same after installation: Block Address It U (SPACE BELOW FOR INSPECTOR'S USE ONLY) - -: � Subdivision Building: Oar new Number of stories Used as (/ Description of proposed work Volts . 24) Amps 1 4 Phase Additional Information Address (if other than owner or contractor) Inspected Final inspection , Inspector CEILING BRACKETS RECPTACLE• SWITCHES •TO,YES WATER HEATERS SIGN• Aar OTHER • 1/ MAIN SUSS BRANCHES ° 1 FLOORS FIXTURES ONLY NUMBERS OF TOTAL OUTLETS SIZE OF SIZE SERVICE CONDUIT No. CIRCUITY LIGHTS CEILING BRACKETS MAIN SUSS BRANCHES BASEMENT j) ' %, FIRST SECOND THIRD FeURTH • A••• Desiring your certificate of Approval, application is hereby made for an inspection installation in the premises stated below, for which undersigned agrees to correct any the National Electric Code and the City Ordinance pointed out by Inspector, LOCATION AVOID DELAY B & GIVING FULL AND ACCURATE INFORMATION. ALL SPACES MUST BE SUsoIV7ION LOT NUM OWNER APPLICATION ELECTRICAL DIVISION OF THE CITY OF MIAMI C A ` WILL BE RETURNED vg- STREET AND NUMBER d i , 4 OCK NUMBER e i v BUILDING- -NEW OR OLD (UNDERLINE WHICH) I, %7 Cr OCCUPANT SPECIFICATIONS S1pE DATE No FILLED OR APPLICATION OCCUPIED As WORK -- ADDITIONAL, NEW, ALTERATION OR REPAIR 11. P. OF EACH MOTOn VOLTS TOTAL AMPS PHASF 19 3_ of the electric infractions of KIND OF INSTALLATION OPEN OR CONCEALED KNOB, RX., BX., MLDG., CONDUIT, METAL-1 REMARKS CONTRACTOR By RECEIVED BY INSPECTOR PROGRESS WILL INSPECT AGAIN ROUGH WIRING FINAL No CORRECTED TEMPORARY DAYS. DATE ISSUED REMARKS FEE REMITTED / 7-P ) INSPECTION WANTED ADDRESS SPACE BELOW FOR INSPECTOR'S USE ONLY INSPECTED 'I , Z ✓✓ INSPECTOR NO. STREET PART OF LOT LOT BL'K ; SUBDIVISION Billboards Other Apparatus Permit Fee Motors Receptacles Generators Stoves Water Heaters Signs Billboards Other Apparatus Permit Fee s ...r C/ .r PT ELECTRICAL PERMIT L4 J. B. —This Permit must be on display on the premises during the construction.., Owner of Building // l Contractor or Electricia ''!.',/' Outlets Village. a� Dated 19 Miami choresllage F L 0 A 1 D A OFFICE OF ELECTRICAL DEPARTMENT Miami Shores Village, Fla , /` I✓ 19 DESCRIPTION OF WORK NUMBER OF LO CATI 0 N This Permit is granted upon the express condition that all facts stated in the Application are true and that the construction complies strictly with .lans and specifications submitted and are in accordance with the Electrical Laws of the State of Florida and with the Electrical Ordinances and Code iami Shores Village and the rules and regulations of the Electrical Department of Miami Shores Village. This Permit may be revoked at any time the violation of any provisions of said laws, ordinances, or rules and regulations, or upon any change in the plans and spcitions unauthorized by )epartment. -- In consideration of the issuance to me of the foregoing Electrical Permit, I hereby agree to do the proposled construction in strict conformity with ,plication and the plans and specifications thereof heretofore by me submitted, and in compliance with all provisions of all Electrical Laws of the f Florida, all the Electrical Ordinances and Codes of Miami Shores Village, and all rules and regulations of the Electrical Department of Miami ,4' N° 397 , Electrical Inspector. (Seal) BUILD ELECTRICAL PERMIT A N° PLIIIMEHiNG v ner of Building____ •r � s NAME NAME Architect and /or Engineer NAME Contractor or Builder__2 I< __=i= .s.Af__ Proposed Location' Dated 68 AMOUNT RECD. PAYMENT ACCT. DEPT. ADDRESS ADDRESS ADDRESS MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT ISC /? Al NO. /1-14 , 19 LICENSE NO. LICENSE NO. STREET LOT BLOCK SUB- DIVISION This permit is issued t ,./1-1..,_e_,_/ - . , - i,_1 N .et e•< , l . °i c. To_L_k ✓. _ ( t, the building above described. as per application. Plans and Specifications heretofore filed in this office. This permit is granted upon the express condition that all facts stated in the application are true and that the construction complies strictly with the plans and specifications submitted, and in accordance and compliance with the building laws of the State of Florida and with the building ordinances and zoning laws of Miami Shores Village, and rules and regulations of the building department of Miami Shores Village. This permit may be revoked at any time upon the violation of any provisions of said laws, ordinances or rules and regulations, or upon any,change in the plans and specifications unauthorized by the building inspect INSPECTOR In consideration of the issuance to me of this permit I hereby agree to the proposed construction in strict ' conformity with the application and Tans and specifications thereof heretofore by me submitted, and in compliance with all provisions of all building laws of the State of Florida, all the building ordinances and zoning laws of Miami Shores Village and all rules and regulations of the building S1epartment of Miami Shorts Village. f r � 19*, �N n } 4 a ,'I� 4%1' (SEAL) • m , NOTE: A charge of $1.00 will be made for making corrections or changes to this application after appnbval has been o tained from the Planning Board. 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. NO. STREET PART OF LOT LOT BL'K SUBDIVISION Signs Billboards Other Apparatus Permit Fee Outlets Motors Receptacles Generators Stoves Water Heaters Signs Billboards Other Apparatus Permit Fee ELECTRICAL PERMIT N. B. —This Permit must be on display on the premises during the construction. Owner of Building Contractor or Electrician Dated / / , 19_ l aiami 1 lla F L 0 A D A OFFICE OF ELECTRICAL DEPARTMENT Miami Shores Village, Fla , DESCRIPTION OF WORK NUMBER OF LOCATION . This Permit is granted upon the express condition that all facts stated in the Application are true and that the construction complies strictly with the plans and specifications submitted and are in accordance with the Electrical Laws of the State of Florida and with the Electrical Ordinances and Code of Miami Shores Village and the rules and regulations of the Electrical Department of Miami Shores Village. This Permit may be revoked at any time upon the violation of any provisions of said laws, ordinances, or rules and regulations, or upon any change in the plans and specifications unauthorized by this Department. , Electrical Inspector. In consideration of the issuance to me of the foregoing Electrical Permit, I hereby agree to do the proposed construction in strict conformity with the Application and the plans and specifications thereof heretofore by me submitted, and in compliance with all provisions of all Electrical Laws of the State of Florida, all the Electrical Ordinances and Codes of Miami Shores Village, and all rules and regulations of the Electrical Department of Miami Shores Village. / e) J N° 638 (Seal) NO. STREET PART OF LOT LOT BL'K SUBDIVISION Signs Billboards f ' Permit Fee 1 Outlets Motors Receptacles Generators Stoves Water Heaters Signs Billboards Other Apparatus Permit Fee 1 ELECTRICAL PERMIT N. B. —This Permit must be on display on the premises during the construction. Owner of Building Contractor or Electrician Dated , 19 aiami Aores9lllage F L O R D OFFICE OF ELECTRICAL DEPARTMENT Miami Shores Village, Fla , 19 LO CATI O N' DESCRIPTION OF WORK NUMBER OF N° 412 This Permit is granted upon the express condition that all facts stated in the Application are true and that the construction complies strictly with the plans and specifications submitted and are in accordance with the Electrical Laws of the State of Florida and with the Electrical Ordinances and Code f Miami Shores Village and the rules and regulations of the Electrical Department of Miami Shores Village. This Permit may be revoked at any time pon the violation of any provisions of said laws, ordinances, or rules and regulations, or upon any change in the plans and specifications unauthorized by his Department. , Electrical Inspector. In consideration of the issuance to me of the foregoing Electrical Permit, I hereby agree to do the proposed construction in strict conformity with he Application and the plans and specifications thereof heretofore by me submitted, and in compliance with all provisions of all Electrical Laws of the tate of Florida, all the Electrical Ordinances and Codes of Miami Shores Village, and all rules and regulations of the Electrical Department of Miami > hores Village. (Seal) Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Printed: 5/10/2004 Applicant: LEROY Owner: LLERA JOB ADDRESS: 117 Parcel # 1132060132730 NE 95 Signed: (INSPECTOR) Signed: (Contractor or Builder) Electrical Permit Permit Number: EL2004 -120 LLERA LEROY ST Contractor AFFORDABLE ELECTRICAL CONTRACTORCotttractor's Address: 515 NE 190 ST Local Phone: 305 - 940 - 0777 Legal Description: MIAMI SHORES SEC 1 AMD PB 10 -70 E1/2 LOT 17 W1/2 LOT 19 & LOT 18 BLK 20 Fees: FEE2004 -4692 FEE2004 -4693 FEE2004 -4694 FEE2004 -4695 Description Building Fee CCF Training and Education Fee Technology Fee Total Fees: Amount $100.00 $0.60 $0.20 $2.50 $103.30 Permit Status: APPROVED Permit Expiration: 11/2/2004 Construction Value: $500.00 Work: WIRE A/C 2.5 TON 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. BY: Page 1 of 1 Total Fees: _$12 :4 Total Receipts: $0.00 S3„3 a �`O 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) DIAL SERVICE TEMPORARY A/C (CENTRAL) DRINKING FOUNTAIN SERVICE SIZE IN AMPS DUCT WORK FLOOR DRAIN SERVICE REPAIR/METER 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 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 4 / A/C UNIT STRIP HEATER $ K IA/ / FIRE SPRINKLER GENERATORS TRANSFORMERS 'HEATER -NEW INST. GENERATORS TRANSFORMERS HEATER - REPLACE GENERATORS TRANSFORMERS LAWN SPRINKLER -WELL SPECIAL PURPOSE SWIMIING POOL OUTLETS CO%IERCIAL 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 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.) PLUMBING ELECTRICAL MECHANICAL • Building Department 10050 N.E.24Avenue, Miami Shores, Florida 33138 Tell 40 i w; 414.: y 5)756.8972 BUILDING PERMIT APPLICATION-71_ FBC 2001 Owner's Address ij 1-1 N6 ( .7S City --- YY1Ala 4 State Tenant/Lessee Name Contractor's Company Name $ Value of Work For this Permit Type of Work: Describe Work: Submittal Fee $ SO - 00 Permit Fee $ Training/Education Fee $ Notary $ Scanning $ Radon $ Code Enforcement $ Total Fee Now Due $ S 3 3 b (Continued on opposite side) Miami Shores Village /6"• '4 A Structural Plan Review. $ Permit Type (circle): Building ( •'Elect ' Plumbing Mechanical Roofing Owner's Name (Fee Simple Titleholder) L Phone # Job Address (where the work is being done) /) 7 (E City Miami Shores Village Is Building Historically Designated YES NO County Miami -Dade Permit No. I2a)4 -1 20 Master Permit No. Zip 3`3 IS Phone # Zip Contractor's Address ��► S " i / City //� ��icaa ' , I S��a/t'e� l Zip Qualifier 13 (i (- l�aA /75 / Architect/Engineer's Name (if applicable) Phone # Square Footage Of Work: ['Addition ❑Alteration egNew Repair/Replace ❑ Demolition W 54Z9)'? ) IA) ie(A) * * * * * * * * * * * * * * * * * * * * * * * * * * ** F ees * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** CCF $ - 0 CO /CC a\ 0 Technology Fee $ o, - 0 Zoning Bond $ 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 $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be .osted at the job site for the first inspe on which o rs seven (7) days after the building permit is issued. In the absence of h posted notice, the inspection will n e approve . a d a reinspection fee will be charged. Signature The foregoin day of who is person wner or Agent instrume t was ackno ledged before me this 4' / 1 1/1 known to me or who s produc A, As identification and . w & oath. '� '2� 20 by NOTARY Sign: Print: My Commission Expires: My Commissi ******************************************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** (Certificate of Competency Holder) State Certificate or Registration No. /40 Certificate of Competency No. ************** * * * * * * * * * * * * * * * * * * * * * *$: * * * * * ** APPLICATION APPROVED BY: Chc 12/15/03 ************************ * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Plans Examiner Engineer Zoning Signature Contractor The foregoing instrument was acknowledged before me this day of who is personally known to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: Sign: Print: • * Ey ae ��t . res ** * * * * * * * * ** * * * * * * * * * * * * * * * * ** Type Insp'n MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Re Date Permit No. ei r2-(DO'4 — 1 a-O Name �\QxC cS S- c Address 1 ' `�' � Company i o1 blVG Phone # 303 - 940 - Gin Inspection Date / Approved 111 Correction ❑ �� l/�"L Re- Insp'n Fee ❑ MIAMI SHORES ELAGE BUILDING DEPA TMENT 305- 795 -2204 l Building Inspection Req Date Permit No. C, ` c U4 - 1.30 Name C.o(" Address tn NC S Type Insp'n Companyl \ ►\CACI Phone # Inspection Date Approved Correction Re -Inp'n Fee >I