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275 NE 94 St (4)MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build- ing 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 the work. Date. 17" , 19.r a cede-VW No - Z5. Street!! ..9 Owner's Name and Address._. - .. Registered Architect and /or Engineer .___ Name and address of licensed contractor_ , .-.�. � 15 - .cg 'V01 Location and legal description of lot to be built on: Lot Block Subdivision Street and Number where work is to be done f State work to bed e a purpose of building (by floors) <- / - � and for no other purpose. New Building Remodeling Addition Repairs No. of Stories To be constructed of Kind of foundation Roof Covering Estimated Total cost of improvements $ ...... /79 Amount of Permit $ Zone cubage required Plan Cubage Distance to next nearest building Size of Building Lot Maximum live load to be borne by each floor I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may be sent to 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 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 pblic notice or notices as are required by the Act. The undersigned agrees to employ only such s}tbcontractprs, y rk - .� performed under this permit, as are licensed by Miami Shores Village. -� Remarks ( Signed )j STATE OF FLORIDA, COUNTY OF DADE. ss. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap- peared 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. Permit No ` �� Date `� ° ' Read, Sworn to and Subscribed before me. Disapproved /� Date °_ i' Notary Public, State of Florida ( Signed) (4.-' 'd ° O - -.:47 ' 4 Building Inspector My Commission Expires / PLANNING BOARD DATE Chainnan Member Member Member Member Member Council Approved Date Disapproved Date NOTE: A charge of $1.00 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 $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and /or workmanship. • 7 / rf SWITCH OUTLETS LIGHT OUTLETS PLUG RECE'T'S FIXTURES NO. LAMPS REFRIG. OUTLET IRON OUTLET RANGE OUTLET RANGE CONN. WATER HEATER W. HEAT. CONN. S CALE H ATER STRIP HEATER TOTAL ONTR. FIST !' / ' • % ENT. SW. DIST. CAB. SERVICE TEMP. SERVICE PERM. J 1 � ` / L_ -> MOTORS 04 HP MOTORS 1.5 HP NEON TRANS. RADIO TOTAL CDx R. UST /7 CHECK Permit No Owner's Name and Address Amount of Permit $ STATE OF FLORIDA, , l COUNTY OF DADE. j MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT Date l� 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. ss. Registered Architect and /or neer n Employing Electrician's Name / ' No Street / Location and Legal Description Lot Block Subdivision Street and Number where work is to be performed —No Street State work to be performed and purpose of building (By Floors) New Building Remodeling Addition Repairs No. of Stories Service Overhead Size Feeders Conduit Main Sw Amps Main Fuses Amps Underground Type of Installation— Cond�pit Tobin 13.X L Metal Mouldin g r _� �- / /�� � L / My Commission Expires s a No , (Signed) } • The undersigned applicant for this building permit does hereby certify that he understands and a labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws has complied with the provisions thereof, and will require similar compliance from all contractors or work to be performed under this permit; and will post or cause to be posted for inspection on the site as are required by the Act. The undersigned agrees to employ only such subcontractors, on work to licensed by Miami Shores Village. Street. Notary Public, State of Florida I Electrical Inspector. ccepts his obligatio as an employer of of Florida Per a nt Supplement, and sub•contracto ployed by him in the of the work such public notice or notices be performed under this permit, as are Master Electricia 7/ (YL ... 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. 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. Owner's Name and Address Registered Architect and /or Engineer BUILDING INSPECTION DEPARTMENT MIAMI SHORES VILLAGE APPLICATION FOR BUILDING PERMIT Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build- ing 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 ie°" complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of \the work. ) �— Date . - , 19 ' No._ Street Name and address of licensed contractor u = _4- _ w_ ___y_ Location and legal description of lot to be built on: Lot Block ___, n $ubdivision _.. j 9 ; r / i Street and Number where work is to be done „_ �� - _- %` " �" / _ State work to be done and purpose of building (by floo {)_ ,� I, and for no other purpose. New Building Remodelifig ' Addition Repairs No of Stories To be constructed of K' undatio 13.o Covering Estimated Total cost of improvements $ F' �' Amount of Permit $ L '<c). ^ }" '' Zone cubage required 7 .Plan Cubage Distance to next nearest building Size of Building Lot Maximum live load to be borne by each floor I hereby submit all the plans and specifications for said building. All notices' with reference to the building and its construction may be sent to 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 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 subcontractors, on work to be performed under this permit, as are licensed by Miami Shores Village. Remarks (Signed) � � . fi- -� - -= STATE OF FLORIDA, COUNTY OF DADE. j ss. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap- peared 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 hhs carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. Permit No. Date �� � ��; /' Read, Sworn to and Subscribed before me. Disapproved Date — ( Signed) Building Inspector My Commission Expires Notary Public, State of Florida PLANNING BOARD DATE Chairman Member Member Member Member Member Council Approved Date Disapproved Date NOTE: A charge of $1.00 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 $1.00 will be charged 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 "1 M , Legal Description Address of Building Lot PERMIT IT? 12725 n Work to be performed under this Permit CONTRACTOR OR BUILDER MIAMI SHORES VILLAGE, FLORIDA --"'' Value of Project $ This permit is nted to the contractor or builderinam!>tf above to c jstruct the building or to install the equipment or device described in the app on herefor in strict comp ante with all ordinances pertaining thereto and wit the understanding that the work will be performed in compliance with any plans, drawings, statements or specifications that may have been submitted to anIt appsdved 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 p ns are changed without authorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above alsumts the responsibility for a thorou• knowledge of the ordinances and re:ulati• .s pertaining to the work covered hereby whether shown on the plans or drawing{ or in the statemejts or umes responsibility . or rk done by his agents, servants or employees. BY i DATF ' 195_ Contractor's License No. Amt. of Permit Signed: INItt454 ► c$ ti .. ; s— In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance wi ordinances aid 40gulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper orities of Miami S�orda Village. In accepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. AUTHORITY MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build- u ing or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami ,, `•Jhores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and ibgulations 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 the work. Owner's Name and Address • Registered Architect and /or Engineer Name and address of licensed contractor. CC) Location and legal description of lot to be built on: t Block Street and Number where work is to be done Date_.__ , 19 . 2 .0. kzaga r sscAL cc, z40 (45, c2 Subdivision 2. State work to be done and purpose of building (by floors) t __� and for no other purpose. New Building Remodeling Addition To be constructed of Kind of foundation Roof Covering 0 Estimated Total cost of improvements $ Q 00 Amount of Permit $ Zone cubage required .Plan Cubage DIstance to next nearest building. g ��� _ 4 _ Size of Building Lot Maximum live load to be borne by each floor__ I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may be sent to 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, Pennanent 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 subcon.:ctors, n to be .erformed under this permit, as are licensed by Miami Shores Village. Remarks STATE OF FLORIDA, i COUNTY OF DADE. ss PLANNI My Commission Expires__ OARD __ . DATE No Z7 5 Street.._ - r c?4 Repairs No. of Stories Chairman Member Member _..__.___.__ Member Member ._ - -_- -•_ _ --- .. Member - Council Approved Date Disapproved Read, Sworn to and Subscribed before me. Notary Public, State of Florida Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap- peared 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. Permit No._____J/ � Date Disapproved _._ _ _.. _�_ Date_ ( Signed) %� 0 Building Inspector to me well known, Date NOTE: A charge of $1.00 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 $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and /or workmanship. 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 the work. Owner's Name and Address 72 Z To be constructed of Registered Architect and /or Engineer p� 7 5 Y i �y � i ,� p Name and address of licensed contractor E g , 6 / - 7 3 �/ 1/� G✓ 7 5 71 ,aE .-r / . 3 Location and legalescription of lot to be built on: A� ` 6 �� iy ( In g Subdivision / �4 AMP 1 1 .� 0' / 3 J 97 APPLICATION FOR BUILDING PERMIT Lot J2 ii/ Block -p Street and Number where work is to be done d -5- ?c ev 99 MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT be done an purpose of building (by floors). state ex for colors (submit mples) 000- 0 Amount of Permit 3 X/ Date No. 2 j'_5 19 k1 Street i V5+ No of Stories • and for no other purpose. New Building Remodeling Addition Repairs Kind of foundation of Covering Estimated Total cost of improvements Zone cubage required Plan Cubage Distance to next nearest building Size of Building Lot Maximum live load to be borne by each floor I hereby submit all plans and specifications for said building. All notices with reference to the building and its construction may be sent to 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 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 : - a" ploy only su ubcontractors. on work to be performed under this permit. as are licensed by Miami Shores Village. Remarks (Signed) STATE OF FLORIDA COUNTY OF DADE. } ss. 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, 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. 0101Z9 Date l I 1 0 i41 Read, Sworn to and Subscribed before me. Permit No. Disapproved Date Notary Public. State of Florida (Signed) Building Inspector My Commission Expires PLANNING BOARD DATE Chairman Member Member Member Member Member Council Approved late Disapproved Date NOTE: A charge of 825.00 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 825.00 will be charged when such re-inspection is made necessary by improper notice for inspection or faulty materials and/or workmanship. o= ffcc) ��,��-/ BUILDING ELECTRICAL PLUMBING ROOFING Owner of Building Architect Contractor or Builder Legal Lot Description CONTRACTOR OR BUILDER MIAMI SHORES VILLAGE, FLORIDA PERMIT Work to be performed under this Permit B1 N° 4130 DATE 19 Contractor's License No. Subdi- vision Address of Value of II Amount of Building Project $_ > I Permit $ 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 applica- tion 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 or in the statements or specifications and that he assumes respon- sibility for work done by his agents, servants or employees. Signed. INSPECTOR 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 as cepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. BY AUTHORITY 1V11d1T11 ►Ji1UrC5 v 111agc Building Department • 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 BL PE Fs( eau alat0 Perm Ownt Owne City_ Tenn Contractor's Address 7351 NW 7th ST. "R" Qualifier RICHARD ARNETTE $ Value of Work For this Permit $4000. Total Fee Now Due $ (Continued on opposite side) / 9. 9° Permit No. W1 Master Permit No. ;al Plumbing ' Mechanical Roofing r TED & DONNA Phone # 305- 754 -0200 (AMI SHORFS, Fl 33138 zip 33138 Phone # Job A / j/ NE 94 STREET City _ ty ami -Dade Zip 33138 Is Building Historically Designated YES NO Contractor's Company Name R.E.A. AIR COND. INC. Phone # 305 - 266 -6627 City MIAMI state FL zip 33126 Architect/Engineer's Name (if applicable) Phone # Square Footage Of Work: Type of Work: ❑Addition ❑ Alteration CI New ® Repair/Replace Describe Work: A/C CHANGE OUT 4 TON COND/ AHU 10KW * * * * * * * * * * * * * * * * * * * * * * * * ** * s * * * * * * * * * * * * * * * * * * * * * * * * * ** Submittal Fee $ Permit Fee $ \ l V e CCF $ p V 0 --�1 Notary Training/Education Fee $ t Technology Fee $ 3 • s `� Scanning $ Radon $ Bond $ Code Enforcement $ Structural Plan Review. $ ❑ Demolition Bonding Company's Name (if applicable) Bonding Company's Address City Mortgage Lender's Name (if appli bit) Mortgage Lender's Ad 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 CONDmONERS, 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 rein , -ction fee will be. charged. Signa State Zip The fore / oing instalment was ac ..w1ed;;ed before me this day of ti 1, . , 20 05, by _ E/ who is personally known to me or who has produced who is : rsonally kno to me or who has produced 4 4,, PATRICIA S. HA N Wili my mMMt4S10N # /30371403 w EXPIRES: December 07.NOS As identification and who did take an oath. A • Print: My Commission Expires: ***************************************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** State Certificate or Registration No. Certificate of Competency No. ***************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** * * * * * * * * ** * * * * * * * ** * * * * * ** * * * * * * * * * * * * * * * * * * * * * * * * * * ** APPLICATION APPROVED BY: ( Plans Examiner Engineer Zoning Chc 10/14/03 UBLIC: Owner or Agent as identification and who did take an oath. NOTARY Si (Certificate of Competency Holder) Signature Contractor The fore •'ng instrument was day ofi,' 20Q5b Print: My Commission Exp dged before me thisj(1 Page 3 PERMIT APPLICATION I INSTRUCTIONS: Please indicate the type of work being performed and quantity(ies) in the space provided below. II ELECTRICAL TYPE QTY. TYPE QTY. TYPE QTY. TYPE QTY. Minimum Fee A/C Central 1 -3 Ton A/C Central 4-7 Ton A/C Central 5 -15 Ton A/C Central 16-20 Ton A/C Central 20+ Ton A/C Window Air Conditioners Chiller Clear Violations Compactor Deep Freezer Demolition Dishwasher Dryer Fan Fire Pump Fixture - Fluorescent Fixture Light Flood Lights FPL - Load Central Garbage Disposal Generators, etc. Heat Recovery Low -volt, Burglar Low -volt, Fire Low -volt, Intercom/Teleph. Low -volt, Television Outlet, Appliance Outlet, Wall Outlet, Switch Oven Parking Lot Lights Plugmold/Strip Posts Range/Range Top Receptacles Refrigerator, Comm. (p/PH) Refrigerator, Domestic Renew - Temp Service Repair Circuits Service, Number of Amps Service Repair Service, Temporary Signs Space Heater (kw) Spas/Hot Tubs Subfeeds, No. of Amps Swim Pool, Commercial Swim Pool, Residential Switchboards Temp Sere, Construction Temp for Test - 30 days MECHANICAL TV1'! Minimum Fee QTY. TYPI'. QTY. TYPE QTY. TYPE QTY. A/C Central, Tons A/C Wall/Win. Tons Air Handler, Tons Barbecue Bath Fan - Vented, # Condensate Drain Cooling Tower Dryer Vents, Number of Ductwork, Cost of Fire Sprinkler System Fireplaces, Number of Generator Heating Strips, each Paint Booth Piping, Flammable Liquid Process/Pressure Piping Pressure Vessel Refrigeration, Tons Vent Hood, Cost Ventilation, Cost Periodic Inspections PLUMBING T1'1'1.: QT1'. T1'11F. Q1'1'. TYPE QTY. TYPE Drains, Roof Drinking Fountain Miscellaneous Fixture MTlscellaneous Re . . irs Soakage Pit Solar Water Heater QTY A/C Condensate Bath Tub Bidet Cap - Fixture Filter Replace Fountain Pool Piping Pump and Abandon Pump, Domestic Pump, Fire Stand Pump, Re- circulate Pump, Replace - Pool Pump, Sprinkler Pura Sum Relay Repair Roof Inlet Septic Connection Septic Tank Sewer Connection Shower Gas - Appliance Gas - Natural Gas - Propane Gas Piping Grease Trap Ice Maker Indirect Wastes Interceptor Laundry Tray Lavatory Meter Set (Gas) Minimum Fee Cap - Water Cap - Sewer Catch Basin Clothes Washer Dental Chair Discha : e Well Dishwasher Disposal Domestic Well Drainfield, 4" Tile/Res. Drains, Area Drains, Floor Drains, French Miscellaneous Equipment Sink Sprinkler Repair Sprinkler System Supply, AC Well Temporary Toilet Temporary Water Closet Urinal Utility - Sewer Utilit - Water Vacuum Pump Water Closet Water Heater Water Heater New Water Re -pipe Water Service Well, Supply RECEIVED AND REVIEWED BY: DATE: Page 4 • .OFFICE USE ONLY CHECKLIST ❑ OWNER - BUILDER FORM (Attach) ❑ FIRE DEPARTMENT APPROVAL (Commercial / multi- family) O CONCURRENCY (New Construction) ❑ OTHER (Specify & Attach) $3.00 per page (Scanning Fee) Miami Shores Village Bond Metropolitan Dade County (C.C.F.) $ Inspector State Educational Fund $ State DCA (Radon) $ Code Enforcement Fine r Zoning Review ❑ PROOF OF OWNERSHIP (Attach) ❑ HRS / DERM APPROVAL (Septic / Sewer) ❑ IMPACT FEE (New Construction) ❑ OTHER (Specify & Attach) SECTION Zoning Electrical Mechanical Plumbing Fire Public Works Structural Building Official BY DATE (sq.ft. = x/1000 x 0.60) (0.005 / sq.ft.) (0.01 / sq.ft) PERMIT APPLICATION O CONDO ASSOCIATION APPROVAL (Attach) ❑ BPR APPROVAL (Restaurants) ❑ CONTRACTOR REGISTRATION (On File) PERIIIIT FEES TOTAL $ ISSUING OFFICIAL REVIEWED AND PREPARED BY: DATE: CONDITION OF APPROVAL Revised July 2001 10050 N.E. 2'''D AVE., MIAMI SHORES, FL • (305) 795 -2207 • FAX (305) 756 -8972 • http : / /www.miamishoresvillage.com Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Printed: 4/18/2005 Applicant: DONNA Owner: NEUWEILER JOB ADDRESS: 275 NE 94 Mechanical Permit Permit Number: MC2005 -46 NEUWEILER DONNA ST Contractor R E A AIR CONDITIONING INC Contractor's Address: 7351 NW 7 STREET SUITE R Local Phone: 305 - 266 -6627 Parcel # 1132060133830 Legal Description: MIAMI SHORES SEC 1 AMD PB 10 -70 LOT 22 & W1/2 LOT 23 BLK 28 LOT SIZE Fees: Description Amount FEE2005 -4930 Building Fee $140.00 FEE2005 -4931 CCF $2.40 FEE2005 -4932 Training and Education Fee $0.80 FEE2005 -4933 Technology Fee $3.50 FEE2005 -4934 Scanning Fee $3.00 Total Fees: $149.70 Total Fees: $149.70 Total Receipts: $0.00 Permit Status: APPROVED Permit Expiration: 10/10/2005 Construction Value: $4,000.00 Work: A/C CHANGE OUT 4 TON AIR CONDITIONER / AHU 10 KW Signed: (INSPECTOR) Page 1 of 1 Vs 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: 4 MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305 -795 -2204 Building Inspection Request Date d1 I IO5 Type Insp'n V1AtiN,A,1 • Permit No. ' 2005 1 16 Narne rria !Jd{JW ?tiff Address 275 ijE c 4 ST Company Phone # 011105 4 Inspection Date Approved Correction Re- Insp'n Fee 'qL en I( OW f aid j r be ttitir Too pi o Z"b he 1tY Ti . Z 0 Lax[ to Ul