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401 NE 95 St (4)Date 4/ Type Insp'n..----d Permit No. Name Address Company Phone # ® Y. � ` ,-.=e0ePD For Inspector: Approved Correction Re- Insp'n Fee MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Time 2 Name & b Date Type Insp'n Permit No. Name Address IAMI SHORES VILLAGE LDING DEPARTMEN 305- 795 -2204 uilding Inspection Req Ti Company A400 Phone # 9 t ' cx For Inspector: , Names -D Approved,/ Correction ❑ ? / Re- Insp'n Fee ❑ 2ce�3 y`i1 MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date Company Phone # For Inspector:/ \t1 Approved Correction ❑ Re- Insp'n Fee ❑ Type Insp Permit No.�� Name - - C (A-et-Lek Address 'o ! �' c:_c er 4 Pte'/; ?-i � Registered Architect and /or Engineer APPLICATION FOR ELECTRICAL PERMIT Permit No Date r 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 No Street I r Employing Electrician's Name Location and Legal Description Lot Block Subdivision Street and Number where work is to be performed —No L Street State work to be performed and purpose of building (By Floors) STATE OF FLORIDA, l COUNTY OF DADE. I SS. MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT I% p No - c: Street New Building Remodeling Addition Repairs No. of Stories Service Overhead Size Feeders Conduit Main Sw Amps Main Fuses Amps Underground Type of Installation — Conduit Tubing B.X.L Metal Moulding Amount of Permit $ r1 (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 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 notice, as are required by the Act. The undersigned agrees to employ only such subcontractors, on work to be performed under this permit, as arc licensed by Miami Shores Village. (Signed) Master Electrician. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the of the above described construction, and he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. My Commission Expires Notary Public, State of Florida NOTE: A re-inspection fee of $1.00 will be made when such re-inspection is made necessary by improper notice for inspection, or faulty materials and /or workmanship. SWITCH OUTLETS LIGHT OUTLETS PLUG RECE'P'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.'..Hc" NEON TRANS. RADIO TOTAL CONTR. LIST , CHECK / Registered Architect and /or Engineer APPLICATION FOR ELECTRICAL PERMIT Permit No Date r 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 No Street I r Employing Electrician's Name Location and Legal Description Lot Block Subdivision Street and Number where work is to be performed —No L Street State work to be performed and purpose of building (By Floors) STATE OF FLORIDA, l COUNTY OF DADE. I SS. MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT I% p No - c: Street New Building Remodeling Addition Repairs No. of Stories Service Overhead Size Feeders Conduit Main Sw Amps Main Fuses Amps Underground Type of Installation — Conduit Tubing B.X.L Metal Moulding Amount of Permit $ r1 (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 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 notice, as are required by the Act. The undersigned agrees to employ only such subcontractors, on work to be performed under this permit, as arc licensed by Miami Shores Village. (Signed) Master Electrician. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the of the above described construction, and he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. My Commission Expires Notary Public, State of Florida NOTE: A re-inspection fee of $1.00 will be made when such re-inspection is made necessary by improper notice for inspection, or faulty materials and /or workmanship. OUTLETS MOTORS RECEPTACLES GENERATORS STOVES WATER H'TERS SIGNS BILLBOARDS OTHER APPARATUS 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 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: Date 193 Owner/ _ _ � r ' - Address Building Contractor Electrical Contractor :. r • Location of proposed work: Lot Details of proposed work: Number of Motors H P. Volts Address (if other than owner or contractor) aiami cSliores9 llage F L O R I D A it Amps , c. Block Subdivision Building: - _.Old or new Number of stories Used as Description of proposed work Phase Additional Information Signature of Applicant (SPACE BELOW FOR INSPECTOR'S USE ONLY) Work begun Inspected Work finished Final inspection Inspector BUILDING ELECTRICAL PLUMBING ROOFING Owner of Building Architect Contractor or Builder Legal Lot Description Address of Building 11 CONTRACTOR OR BUILDER MIAMI SHORES VILLAGE, FLORIDA PERMIT '11T? 13879 Work to be performed under this Permit BI. Subdi- vision Value of Project $ DATE 195 Contractor's License No Amt. of 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 application herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes responsibility for work done by his agents, servants or employees. Signed: L BY 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 accepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. III NO. STREET PART OF LOT LOT BL'K SUBDIVISION 1...41412t ..[�"� f Bi oards Other Apparatus Permit Fee Outlets Motors Receptacles Generators Stoves Water Heaters 1...41412t ..[�"� f Bi oards Other Apparatus Permit Fee ELECTRICAL PERMIT N. B. —This Permit must be on display on the premises during the construction. Owner of Building Co t ractor or Electrician Dated 19: Miami Shores Village, Fla , ,.2 f/y cJd Hamm chores96llage F L O A I D A OFFICE OF ELECTRICAL DEPARTMENT LO CATI 0 N DESCRYPTION OF WORK � Thts 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 Inspec}Sr. In consideration of the issuance to me of the foregoing Electrical Permit, I herebyragree 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. NUMBER - OF 7'7 N9 689 • 7 / -. '" -11- io (Seal) m•7) NO. STREET PART OF LOT LOT BL'K SUBDIVISION Id/ » ,f / i f Permit Fee Outlets Motors Receptacles Generators Stoves Water Heaters " , 9 4 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 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 p ans 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. 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. 19 / cJhores 9lllage F L 0 R I D A OFFICE OF ELECTRICAL DEPARTMENT Miami Shores Village, Fla , , j f 19 : j f f LO CATI O N DESCRIPTION OF WORK NUMBER OF , Electrical Inspector. N° 689 (Seal) MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT Permit No c 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 Lawspf the SState of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village s be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress y;{ work. , Owner's Name and Address' / Registered Architect and/or ( Enginee ., -,� Employing Electrician's Name. STATE OF FLORIDA, 1 COUNTY OF DADE. I 66. Location and Legal Description Lot Block Subdivision Street and Number where work is to be performed —No State work to be performed and purpose of building (By Floors Amount of Permit $ No f _ % Street NO New Building Remodeling Addition Repairs Street Street <, rc No. of Stories Service Overhead Site Feeders Conduit Main Sw Amps Main Fuses Amps Underground Type of Installation -- -Conduit Tubing B.X.L Metal Moulding (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 complied with the provisions thereof, and will require similar com pliance from all fontractors or subcontractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspe oft /I �� on the site of t work such public notice or notices as are required by the Act. The undersigned agrees to employ only such sub-cont( org,/An to be/performed tine* this permit, as are licensed by Miami Shores Village. �� ��/ , (Signe Master Electrician. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the of the above described construction, and he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. My Commission Expires Notary Public, State of Florida NOTE: A re-inspection fee of $1.00 will be made when such re-inspection is made necessary by improper notice for inspection, or faulty materials and /or workmanship. SWITCH OUTLETS LIGHT OUTLETS PLUG RECE'P'T'S FIXTURES NO. LAMPS REFRIO. OUTLET IRON OUTLET RANGE OUTLET RANGE CONN. WATER HEATER W. HEAT. CONN. StACIC 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 c 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 Lawspf the SState of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village s be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress y;{ work. , Owner's Name and Address' / Registered Architect and/or ( Enginee ., -,� Employing Electrician's Name. STATE OF FLORIDA, 1 COUNTY OF DADE. I 66. Location and Legal Description Lot Block Subdivision Street and Number where work is to be performed —No State work to be performed and purpose of building (By Floors Amount of Permit $ No f _ % Street NO New Building Remodeling Addition Repairs Street Street <, rc No. of Stories Service Overhead Site Feeders Conduit Main Sw Amps Main Fuses Amps Underground Type of Installation -- -Conduit Tubing B.X.L Metal Moulding (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 complied with the provisions thereof, and will require similar com pliance from all fontractors or subcontractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspe oft /I �� on the site of t work such public notice or notices as are required by the Act. The undersigned agrees to employ only such sub-cont( org,/An to be/performed tine* this permit, as are licensed by Miami Shores Village. �� ��/ , (Signe Master Electrician. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the of the above described construction, and he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. My Commission Expires Notary Public, State of Florida NOTE: A re-inspection fee of $1.00 will be made when such re-inspection is made necessary by improper notice for inspection, or faulty materials and /or workmanship. ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT Permit No 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. STATE OF FLORIDA, COUNTY OF DADE. Il SS. MIAMI SHORES VILLAGE , , - , - Ownei s Name and Address . No - / Street . i ./....a,. t....i. Registered Architect and /or Engineer 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 — 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 complied with the provisions thereof, and will require similar compliance from all contractors or subcontractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such subcontractors, on work to be performed under this permit, as are licensed by Miami Shores Village. (Signed) Master )electrician. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the of the above described construction, and he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. My Commission Expires Notary Public, State of Florida NOTE: A re•inspection fee of $1.00 will be made when such re•inspection is made necessary by improper notice for inspection, or faulty materials and /or workmanship. SWITCH OUTLETS LIGHT OUTLETS PLUG RECE'P'T'S FIXTURES NO. LAMPS REFRIG. OUTLET IRON OUTLET RANGE OUTLET RANGE CONN. WATER HEATER W. HEAT. CONN. SPACE HEATER STRIP HEATER +,_' •/ J,♦ TOTAL. CONTR. LIST J CHECK ENT. SW. DIST. CAB. SERVICE TEMP. SERVICE PERM. MOTORS O.1 HP MOTORS 1.3 HP NEON TRANS. RADIO TOTAL CONTR. LIST CHECK ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT Permit No 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. STATE OF FLORIDA, COUNTY OF DADE. Il SS. MIAMI SHORES VILLAGE , , - , - Ownei s Name and Address . No - / Street . i ./....a,. t....i. Registered Architect and /or Engineer 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 — 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 complied with the provisions thereof, and will require similar compliance from all contractors or subcontractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such subcontractors, on work to be performed under this permit, as are licensed by Miami Shores Village. (Signed) Master )electrician. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the of the above described construction, and he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. My Commission Expires Notary Public, State of Florida NOTE: A re•inspection fee of $1.00 will be made when such re•inspection is made necessary by improper notice for inspection, or faulty materials and /or workmanship. BUILDING ❑ DATE '' 195 ELECTRICAL ❑ PERMIT N? 14 219 PLUMBING ❑ ROOFING ❑ Work to be performed under this Permit Owner of Building Architect Contractor or Builder Legal Lot II Bl. Description CONTRACTOR OR BUILDER MIAMI SHORES VILLAGE, FLORIDA Subdi- vision Contractor's License No Address of Value of Amt. of • Building i Project $ 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 application herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes responsibility for work done by his agents, servants or employees. Signed • BY 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 accepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. BY AUTHORITY BUILDING ELECTRICAL PLUMBING ROOFING ❑ Work to be performed Owner of Building ! j MIAMI SHORES VILLAGE, FLORIDA PERMIT N° 15382 under this Permit Architect Zontractor or Builder Legal Lot II MI. Subdi- Description vision Address of Building Value of Project $ DATE Amt. of Permit $ '1 195 Contractor's License No This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the application herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes responsibility for work done by his agents, servants or employees. CONTRACTOR OR BUILDER Signed- BY 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 accepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. BY AUTHORITY PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date f / 9/0 Job Address Legal Description a el A:4 pf Owner / Lessee / Tenant Owner's Address /a Contracting Co. - /�'��,� y s sit /.. % �, Qualifier � - / Phone State # ,,r -' ,3 /5 Municipal # Competency # Ins .Co . Architect /Engineer Address Bonding Company Signature of owner aid /or Condo President Date: !; Notary as tOwne/ My Commission Exp,i �y Si ** * * * * OFFICIAL SEAL (F ond6UPifle%�iaei€t • My Comrniss!o7 E�nires June 4, 195u Comm. N. CC 235953 * * FEES: PERMIT 304' RADON C.C.F. , APPROVED: Zoning Mechanical /,` Tax Folio 1 ,�a�® �O � ©I I * * * Date: Signature of Con Master Permit #,3".//r5.* Phone Address 7 .5 /rD/�J,..1 %/— , y Address Address Permit Type(circle one):ILDING E, ICAL • ING MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION Square Ft. Estimated Cost(value) ;;-2 WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT). Application is hereby made to obtain a permit to do work and installation as indicated above, and on the attached addendum (if applicable). I certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits are required for ELECTRICAL, PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK. OWNER'S AFFIDAVIT: I certify that all the foregoing information is a ,'urate and that all work will be done in compliance with all applicable laws regulating construct ;- .nafid zoning. Furthermore, I authorize the above -named contractor to do the work stated. 1 _,4* *,4 9 0/`# ,y OFFICIAL SEAL Notary as tp V004 ,tor eleJOARWrEfuilder My Commissl T $l ,,re Coms� ion ;� �;'�r�: �,�,° June rq,I 4, 1996 Expires '• o' Comm. No. CC 205953 * * * * * * ** NOTARY TOTAL DUE Fire Other y� Building Electrical( / Plumbing Engineering PROPERTY OWNER New Construction Name �� ui e A . �� � Address V E 9 i/ Home Telephone Home Repair Business Telephone Alteration Interior Fax Demolish TYPE OF MANAGEMENT (✓ ) New Construction Enclosure Alteration Exterior Repair Alteration Interior Demolish Relocation of Structure Shell Only Foundation Only Add'l Attachment Other Add'l Detachment Other INSTRUCTIONS - The following steps must be taken to obtain a permit from the Miami Shores Village: Step 1. Step 2. Submit the completed application with all necessary documents to the Building, Planning and Zoning Department for processing. During the processing of your application, you may be asked to submit additional information. APPLICATION State Job Address: Complete the attached permit application which must be signed by the property owner and qualifier. Both signatures must be notarized. Please print or type to allow for a more accurate processing of your application. If roofing work will be done, a roofing application must be submitted along with this permit application. Address Apt. City Folio Number // 3?-0e' 0 4< �� Description of Work, Lot Block Subdivision PB PG Zoning Linear Feet Current Use of Property 1� Ai/' Square Feet Units Floors Proposed Use of Property Value of Work 4, 1. Bldg Value Tenant Information PERMIT TYPE (✓ ) Building Electrical Mechanical Plumbing LPGX Roofing Fence Other PERMIT CHANGE (✓ ) Chg. Contractor Renewal Revision Extension Supplement Reinspection ARCHITECT Name License No. Address Telephone Fax 'piD t \ e : - \ O PERMI P �.�A I Master Permit No. j� p Subsidiary Permit No. , L 23 �" _ U Tax Assessed/Appraised Value Zip Flood Zone Base Floor Elev. ENGINEER Name License No. Address Telephone Fax CONTRACTOR Address 9;y7 /114 " 41 / " Telephone f? fr-pries. Fax Qualifier Name Page 2 IMPORTANT NOTICES 1. DO NOT BEGIN ANY WORK WITHOUT HAVING RECEIVED YOUR VALIDATED PERMIT AND PERMIT CARD. Applying for a permit does not grant the right to begin construction. HOURS OF CONSTRUCTION are limited to: Monday through Friday from 7:30 a.m. to 6:00 p.m., and Saturday from 8:00 a.m. to 5:00 p.m. No inspections will be conducted on weekends or holidays. 2. All construction of demolition areas MUST BE MAINTAINED IN A CLEAN, NEAT AND SANITARY CONDITION free from construction debris. 3. STREETS AND NEIGHBORING PROPERTIES SHALL BE KEPT FREE FROM DIRT AND DEBRIS. 4. SWALES MUST BE PROTECTED FROM BEING DAMAGED BY EQUIPMENT OR VEHICLES, AND MAY NOT BE USED FOR STORAGE. A bond is required for work in or near the street/sidewalk. 5. CONSTRUCTION TRAILERS ARE PROHIBITED ON SINGLE FAMILY RESIDENTIAL CONSTRUCTION SITES. Other construction may have a trailer which requires a separate permit. 6. PORTABLE TOILETS for a construction site require a separate permit. 7. DO NOT DISCHARGE WATER INTO THE RIGHT OF WAY OR STORM DRAINS without approval from the Building, Planning and Zoning Department. 8. EQUIPMENT AND MATERIALS SHALL BE STORED at least 10 feet from the edge of pavement. 9. Department of Health and Rehabilitative Services (HRS) approval is required for applications involving septic tanks. Department of Environmental Resources Management (DERM) and/or Miami -Dade Water and Sewer Department (MDWASD) approval is required for applications involving sewers. AFFIDAVIT - Please r ead carefully. Application is hereby made to obtain a permit to do work and installation as indicated. I, the OWNER of the property, certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits are required for ELECTRICAL, PLUMBING, POOL, EXTERIOR DOOR, MECHANICAL, WINDOW, FENCE, DRIVEWAY, ROOFING and SIGNS and there may be additional permits required from other governmental agencies. I, the OWNER of the property, have disclosed all information related to any work at the property performed in the prior twelve months to the Building Official. Further, I am fully aware that if the cumulative cost of work to my home or business under this and any other permit equals or exceeds fifty percent (50 %) of the fair market value of the structure, the entire structure must meet the present federal flood criteria for finished floor elevation. I am also fully aware that if the total cost of work to my home or business under this and any other permit exceeds fifty percent (50 %) of the replacement cost of the structure, then the entire structure must conform to the current code requirements of the Building Code. WARNING TO OWNER: Your failure to record a NOTICE OF COMMENCEMENT may result in you paying twice for improvements to your property. If you are spending more than $2,500 or intend to obtain financing, you may wish to consult with your attorney or lender before recording your Notice of Commencement. The Notice of Commencement must be recorded at: 22 N.W. 1st Street, P' Floor, (305) 679 -1078. Once recorded, the Notice of Commencement must be POSTED AT THE JOB SITE in accordance with Section 713 -35 of Florida Statutes. Review the brochure at Village Hall on Construction Lien Law and Choosing a Contractor. STATE OF FLORIDA, COUNTS OF MIAMI -DADE Signature of Owner Me . b. En. Al Print Name or,and subscribed before me this _ �id Signature o • f • I«�, ( {;. •0BLES = MY Cr MISSION It CC 921872 • PIRES: June 4, 2004 Ii a•- ,, o moo, 3.anded Notary Public Undotwriter. . SEAL: Personally known OR, Produced Identification Type of Identification Produced: STATE OF FLORI Signatur Y OF MIAMI -DADE Print Name Sy orn to d subscribed before me this day of Signature SEAL: PERMIT APPLICATION - Si teyf_Flo . eve JULIO ROBLES M COMMISSION # CC 921872 EXPIRES: June 4, 2004 '. 4ce, ' Bonded Thai Notary Public Underwriters ..I....!e '-'. e.cnc,= +e +c* -. •> • Personally known OR, Produced Identification Type of Identification Produced: ELECTRICAL TYPE. Minimum Fee QTY. TYPE Dryer QTY. TYl'E Outlet, Appliance QTY. TYPE. Service Repair QTY. A/C Central 1 -3 Ton Fan Dryer Vents, Number of Outlet, Wall Ventilation, Cost Service, Temporary Air Handler, Tons A/C Central 4 -7 Ton Piping, Flammable Liquid Fire Pump Outlet, Switch Fire Sprinkler System Signs A/C Central 8 -15 Ton Bath Fan - Vented, # Fixture - Fluorescent Pressure Vessel Oven Space Heater (kw) A/C Central 16-20 Ton Fixture Light Parking Lot Lights Spas/Hot Tubs A/C Central 20+ Ton �,�� j� Plugmold/Strip Subfeeds, No. of Amps A/C Window FPL - Load C ntral Posts Swim Pool, Commercial Air Conditioners Garbage Range/Range Top Swim Pool, Residential Chiller life,,Receptacles Pump, Sprinkler Switchboards Clear Violations Hea ery Refrigerator, Comm. (p/PH) Temp Serv., Construction Dislflwas:Ter Compactor 'Indirect Wastes ow -volt, Burg Relay Repair Refrigerator, Domestic Vacuum Pump Temp for Test - 30 days Disposal Deep Freezer 'Interceptor Low- vo1Fire r:oof'Inlet Renew - Temp Service Water Closet Domestic Well Demolition Laundry Tray Low -volt, Intercom/Teleph. Septic Connection Repair Circuits Water Heater Drainfiekl, 4" Me/Res. Dishwasher Lavatory Low -volt, Television Septic Tank Service, Number of Amps Water Heater New Drains, Area MECHANICAL TYPE Minimum Fee QTY. TYPE Condensate Drain QTY. TYPE. Generator QTY. TYPE Refrigeration, Tons QTY. A/C Central, Tons Cooling Tower - Heating Strips, each Vent Hood, Cost A/C Wall/Win. Tons Dryer Vents, Number of Paint Booth Ventilation, Cost Solar Water Heater Air Handler, Tons Ductwork, Cost of Piping, Flammable Liquid Periodic Inspections Barbecue Fire Sprinkler System Process/Pressure Piping Cap - Fixture Bath Fan - Vented, # Fireplaces, Number of Pressure Vessel Pump and Abandon PLUMBING TYPE A/C Condensate QTY. TYPE Drains, Roof QTY. TYPE Miscellaneous Fixture QTY. TYPE. Soakage Pit QTY. Bath Tub Drinking Fountain Miscellaneous Repairs Solar Water Heater Bidet Filter Replace Pool Piping Sprinkler Repair Cap - Fixture Fountain Pump and Abandon Sprinkler System Cap - Water Gas - Appliance Pump, Domestic Supply, AC Well Cap - Sewer Gas - Natural Pump, Fire Stand Temporary Toilet Catch Basin Gas - Propane Pump, Re- circulate Temporary Water Closet Clothes Washer Gas Piping Pump, Replace - Pool Urinal Dental Chair Grease Trap Pump, Sprinkler Utility - Sewer Discharge Well lice Maker Pump, Sump Utility - Water Dislflwas:Ter 'Indirect Wastes Relay Repair Vacuum Pump Disposal 'Interceptor r:oof'Inlet Water Closet Domestic Well Laundry Tray Septic Connection Water Heater Drainfiekl, 4" Me/Res. Lavatory Septic Tank Water Heater New Drains, Area Meter Set (Gas) Sewer Connection Water Re -pipe Water Service Drains, Lileor Minimum Fee Shower Drains, French Miscellaneous ]Equipment Sink Well, Supply Page 3 PERMIT APPLICATION INSTRUCTIONS: Please indicate the type of work being performed and quantity(ies) in the space provided below. RECEIVED AND REVIEWED BY: DATE: Page 4 OFFICE USE ONLY CHECKLIST ❑ OWNER - BUILDER FORM (Attach) ❑ FIRE DEPARTMENT APPROVAL (Commercial / multi- family) ❑ 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 Zoning Review REVIEWED AND PREPARED BY: ❑ PROOF OF OWNERSHIP (Attach) ❑ HRS / DERM APPROVAL (Septic / Sewer) ❑ IMPACT FEE (New Construction) ❑ OTHER (Specify & Attach) $ - 6 ) (s 9 .ft. = x/1000 x ¢.60) $ (¢.005 /sq.ft.) $ (¢.01 /sq.ft.) DATE PERMIT APPLICATION ❑ CONDO ASSOCIATION APPROVAL (Attach) ❑ BPR APPROVAL (Restaurants) ❑ CONTRACTOR REGISTRATION (On File) PERMIT FEES TOTAL $ SECTION Zoning Electrical Mechanical Plumbing Public Works Structural Building Official DATE: CONDITION OF APPROVAL Revised July 2001 10050 N.E. 2ND AVE., MIAMI SHORES, FL • (305) 795 -2207 • FAX (305) 756 -8972 • http : / /www.miamishoresvillage.com Year: 2002 2001 Land Value: $89,447 $77,729 Building Value: $92,291 $84,368 Market Value: $181,738 $162,097 Assessed Value: $181,738 $162,097 Total Exemptions: $181,738 $162,097 Taxable Value: $0 $0 Summary Details: Folio No.: 11- 3206 - 014 -0600 Property: 401 NE 95 ST Mailing Address: MIA SHORES BAPTIST CH INC 370 GRAND CONCOURSE MIAMI SHORES FL 33138 -2747 Property Information: Primary Zone: 1000 SINGLE FAMILY RESIDENCE CLUC: 0001 RESIDENTIAL- SINGLE FAMILY Beds /Baths: 3/2 Floors: 2 Living Units: 1 Adj Sq Footage: 2 Lot Size: 10,725 SO FT Year Built: 1941 Legal Description: MIAMI SHORES SEC 2 PB 10 -37 LOT 13 & W1/2 LOT 14 BLK 53 LOT SIZE 75.000 X 143 OR 12461 -1077 0385 1 Sale Information: Miami -Date My Home My Home miamidade. • o Show Me: 'Property Information Ld Search By: Select Item z i 124611077 Sale O /R: Sale Date: /1985 Sale Amount: 160,000 Assessment Information: ACTIVE TOOL: SELECT Digital Orthophotography - March 2001 0 %1,f; We appreciate your feedback, please take a minute to complete our survey. 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