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434 NE 95 St (3)- 7- PROPERTY OWNER Name jOhnl � p'G/1✓1 ((/A ,{,� Address / q5�, ,, Micifyil8/7e6ifi. 3s/38 Home Telephone fin/ q , q!V /�{ J . 7 C/`T J Busines s Telephone Fax CONTRACTOR v oG, (�)� W� I Namep n Ia ►II E O r l )w bi V No. License rte `_✓ /l f 1500 Address qcM v Iu i4 • m iiCin/V i 1 1 7q. 33/68 Telephone - l f (� Fax ?05 1/, f,1//4Q 77 S �J7w1 A 1c' n , ahI it Qualifier Name D �1 TYPE OF MANAGEMENT (✓ ) New Construction Enclosure Alteration Exterior Repair 17 Alteration Interior Demolish Relocation of Structure Shell Only Foundation Only Add'! Attachment Other Add'l Detachment Other INSTRUCTIONS - The following steps must be taken to obtain a permit from the Miami Shores Village: Step 1. 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. 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. A PPLICATION Job Address: Current Use of Property Proposed Use of Property Tenant Information PERMIT TYPE ( ) Building Electrical Mechanical Plumbing LPGX Roofing Fence Other LI3 Ne 95th )V'rcinii ores ,7 33158 Address Apt. Folio Number Lot Block Subdivision P� PG Zoning Q / Square Feet 1 ) 00 , 00 ?Value of Work Tax Assessed/Appraised Value Flood Zone Base Floor Elev. PERMIT CHANGE (✓ ) Chg. Contractor Renewal Revision Extension Supplement Reinspection ARCHITECT Name License No. Address Telephone Fax City y /J State Description of Work � /�cJ/ UXI 9QS h PERMIT APPLICATION Master Permit No. Subsidiary Permit No. 4 ' tfXc9-' / Zip Linear Feet Units Floors Bldg Value ENGINEER Name License No. Address Telephone Fax 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 inspect - ons 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 read 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, ls' 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 Signature of Owner , COUNTY OF MIAMI -DADE 7 i s r •: 0 . CC919 421 Q ° r %tS ••. P -` '• O� 04, > o oF� � . ∎,, ` l elt� V Personally known OIL Produced Identification SEAL: Sign ture of Contractor / Qualifier h Print Name S om t and • Signature n otary P , ti c State,.. > CJ I Q • ' °'471. of \'-0% / I/1r, I i n% -�` SEAL: Personally known PERMIT APPLICATION OR, Produced Identification Type of Identification Produced: Type of Identification Produced: 0 PAY TO THE ORDER OF Miami Shores Village 10050 NE 2nd Avenue Phone: 305-795-2204 Printed: 6/19/2002 Applicant: -BEVERLY Owner: -JAME6eN JOB ADDRESS: 434 NE 95 Contractor THE NEW MIAMI SHORES PLUMBING Contractor's Address: 900 NW 144 ST Local Phone: 305-751-2446 Parcel # 1132060140460 Legal Description: MIAMI SHORES SEC 2 PB 10-37 LOTS 6-7 & 8 Permit Status: Approved Permit Expiration: 12/16/2002 Construction Value: INSTALL GAS LINE If there is no permit package accessible on the lob-site for inspectors to verify thArp will ha nn incnon+irsna . . rtri----.....menemr.mmormer..7.r.raramrzns=7,-.13.4ar Secoriiy e II hil fired tIOC Olt e THE NEW MIAMI SHORES PLUMBING, INC. BLUE ACCOUNT 900 N.W. 144TH ST. (30c) * IS I MIAMI, FL 33168 COLONIAL BANK Miami Beach Florida 33140 24 Hr. Banking Call 1-800-897-6935 Lk-3`f cis2f- P -S0-14-t-f cc Plumbing Permit Permit Number: PL2002-156 s a T E 7 r:S-yekA 6 $700.00 / a i , M r[7..7-7135117.7C-7221121U17.7r171.,777r. .31120.,==21,41:=S DATE 1465 8 5 $ Page 1 of 1 63-151/670 01 / 100 DOLLARS Total Fees: $0.00 Total Receipts: $0.00 FOR IPOOL465" 406700L5118 80278 29• Irr BLK 52 LOT SIZE 150.000 X Re-inspection ication herefor in strict compliance with all ifications that may have been submitted to s or if the plans are changed without aonsibility for a thorough knowledge of the that he assumes responsibility for work done .ns pertaining thereto and in strict conformity esponisibility for allwork done by either ELECTRICAL TYPE Minimum Fee QTY. TYPE Dryer QTY. TYPE Outlet, Appliance QTY. TYPE Service Repair QTY. A/C Central 1 -3 Ton Dryer Vents, Number of Fan Ventilation, Cost Outlet, Wall Ductwork, Cost of Service, Temporary Periodic Inspections A/C Central 4 -7 Ton Fire Sprinkler System Fire Pump Outlet, Switch Fireplaces, Number of Signs A/C Central 8 -15 Ton Fixture - Fluorescent Oven Space Heater (kw) A/C Central 16-20 Ton Fixture Light Parking Lot Lights Spas/Hot Tubs A/C Central 20+ Ton Flood Lights Plugmold/Strip Subfeeds, No. of Amps A/C Window FPL - Load Central Posts Swim Pool, Commercial Air Conditioners Garbage Disposal I Range/Range Top Swim Pool, Residential Chiller Generators, etc. Receptacles . Switchboards Clear Violations Heat Recovery Refrigerator, Comm. (p/PH) Temp Serv., Construction Compactor Low -volt, Burglar Refrigerator, Domestic Temp for Test - 30 days Deep Freezer Low -volt, Fire Renew - Temp Service Water Closet Demolition Low -volt, Intercom/Teleph. Repair Circuits Water Heater Dishwasher Low -volt, Television Service, Number of Amps Water Heater New MECHANICAL TYPE QTY Minimum Fee TYPE Condensate Drain QTY TYPE Q . I . Y , Generator .1.1;1,1;, QTY. Refrigeration, Tons 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 Air Handler, Tons Ductwork, Cost of - Piping, Flammable Liquid Periodic Inspections Barbecue Fire Sprinkler System - Process/Pressure Piping Bath Fan - Vented, # Fireplaces, Number of Pressure Vessel PLUMBING .1.Y1,1,, A/C Condensate QTY. .1.1.1,1; Drains, Roof QTY .1.1.1,1; Miscellaneous Fixture QTY . . Soakage Pit Q . 1 . 1 . 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 I Pump, Replace - Pool Urinal Dental Chair Grease Trap Pump, Sprinkler . Utility - Sewer Discharge Well Ice Maker Pump, Sump Utility - Water Dishwasher Indirect Wastes Relay Repair Vacuum Pump Disposal Interceptor Roof Inlet Water Closet Domestic Well Laundry Tray Septic Connection Water Heater Drainfield, 4" Tile/Res. Lavatory Septic Tank Water Heater New Drains, Area Meter Set (Gas) Sewer Connection Water Re -pipe Drains, Floor Minimum Fee Shower Water Service Drains, French Miscellaneous Equipment Sink We11, 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: SECTION BY DATE Zoning Electrical Mechanical _ Plumbing itj\ 6 (' -ci Fire - -- Public Works Structural Building Official Page 4 OFFICE USE ONLY - 1 CIIECKLIST ❑ 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.) $ 0 Inspector State Educational Fund $ State DCA (Radon) $ Code Enforcement Fine Zoning Review ❑ PROOF OF OWNERSHIP (Attach) ❑ HRS / DERM APPROVAL (Septic / Sewer) ❑ IMPACT FEE (New Construction) ❑ OTHER (Specify & Attach) PERMIT FEES (sq.ft. = x/1000 x 0.60) (¢.005 /sq.ft.) (0.01 /sq.ft.) REVIEWED AND PREPARED BY: PERMIT APPLICATION ❑ CONDO ASSOCIATION APPROVAL (Attach) ❑ BPR APPROVAL (Restaurants) ❑ CONTRACTOR REGISTRATION (On File) TOTAL $ 2 $ (� 6 ISSUING OFFICIAL DATE: CONDITION OF APPROVAL Revised July 2001 10050 N.E. 2'"° AVE., MIAMI SHORES, FL • (305) 795 -2207 • FAX (305) 756 -8972 • http : / /www.miamishoresvillage.com Dat MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Time Type Insp'n Permit No. P� ' A 0 Name Address ; 2\ Company Phone # For Inspector. Approved Correction Re- Insp'n Fee MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date 3-A-02 Time Type Insp' n /u Permit No. NameI Address 4L3 r5 S Company Phone For Inspector: Approved Correction Name & Dat 'v Correction ❑ Re- Insp'n Fee ❑ MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date -5 Time Type Insp'n /14.4,;l`4,1,/ t t,e1.:€A) Permit W I- $ 7002,-35" Name Address Y3 9 4 J' Company ?--L Phone # 9� 9 ®/x90 For Inspector: Approved Correction Re- Insp'n Fee ❑ Date Type Insp'Yr 7' ���—, 'iDOC3- ' F/ Address Company Phone # For Inspector: Approved Correction Re- Insp'n Fee MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request o a Time Name - Address Company Phone # MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date 9'30 -o2 Time Type Insp'n /1 / Permit No. L 2'o z " 3s J For Inspector: 5 Approved Correction Re-Insp'n Fee 439 ae 9S g-i Ca, g Type Insp'n Permit No. Name Address Company Phone # MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date S-/.55,02. Time ,,L Li pz. ZAP 515 4 7 / € fr-C 74- eliti ?eV For Inspector /6 " N Date Approved Correction ❑ Re- Insp'n Fee ❑ Type Insp'n Permit No. Name Address Company Phone # MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date — 3 00 2, Time For Inspector: 5 f Approved ^� Correction ❑ Re- Insp'n Fee ; ❑ y L # a_ /p_3 Jh,gR24> 30s"de / -43Zz • • • s CT. e7e4 , 3 y Zeell (3 orjy. 3 Z 72, d ,evtso"' ^ • •• •••" 4 ••••••a• V‘t a " j vt ••• k INS .f7ly :y 1iY 1' v• _. 4 ... I vv • 5/1 • I. /e iff 7 et,4/ et 't , ,a„e 2O9y $'4 111 7:n1 We or 0 2 1/4 A e i": ) Miami Shores Village 10050 NE 2nd Avenue Printed: 4/30/02 PLum Pcvmlt Phone: 305 - 795 -2204 P m t Number: ? L2OO2 1 0 3 m. ^� ent.I Applicant Owner: - JAM€SON 1 ,�,aaY� --BEV JOB ADDRESS: 434 NE 95 ST Contractor AFFORDABLE IRRIGATION INC Contractor's Address: 198 NW 139 ST Local Phone: 305 - 681 -6322 Parcel # 1132060140460 r Page 1 of 1 Legal Description: MIAMI SHORES SEC 2 PB 10 -37 LOTS 6 -7 & 8 BLK 52 LOT SIZE 150.000 X Fees: Description Amount FEE2002 -2428 Building Fee $110.00 FEE2002 -2429 CCF $1.80 Total Fees: $111.80 Total Fees: $111.80 Total Receipts: $0.00 Permit Status: Approved Permit Expiration: 10/23/02 Work: LAWN SPRINKLER INSTALLATION Construction Value: $2,400.00 If there is no permit package accessible on the job -site for inspectors to verify, there will be no inspections. Re- inspection fee is $50.00, which must be paid in advance before calling for another inspection. 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 m or specifications that pertaining thereto and with the understanding that the work will be performed in compliance with any plans, drawings, statements o spec ratio s t at may have a e b een s ubmitted 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: (INSPECTOR) BY: 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: PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date ci / /,0p 6 Z Job Address . 9,5 Tax Folio Legal Description Historically Designated: Yes No Owner/Lessee / Tenant j LtDD i9 I /� f'7�ir� -��/ Master Permit # 1� �' Q � o C `' / V 3 Owner's Address f3 y A/- G STS" 7 Phone ` Contracting Co. �� �� ♦� a c Address / f 1,/,035 s7'. Qualifier , ,4i, i,Leo ,/o _r", -C . SS# Phone(3 ^.r) 6// ‘3 22- State # Municipal # Competency # 70000.11f Ins. Co. Architect/Engineer Address Bonding Company Address Mortgagor Address Permit Type (circle one): BUILDING ELECTRIC PLUMBIN •.s MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION /4 Gt - /t/ FEES: PERMIT Square Ft. Estimated Cost (value) 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. OWNERS AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Furthermore, I authorize the above -named contractor to do the work stated. Signature of jr,' 3'. d/or Condo President Date �f t Z_ N+'� as to Owner : or Condo President Da e My Conunission E pires�, Marco T Rosas * *My Commission CC881 818 %Mae Expires August 9, 2003 APPROVED: Zoning Mechanical Plumbing 4 f-I 9 -.642. C.C.F. ture of Contrac • or Owner- Builder otary as to Contractor or Owner- Builder My Commission Expires: / V ", Edward D. E loft X 44 ".Commission # CC 866406 y ,, ' ll' Expires Oct. 11, 2003 , ; ' r F k Bond Thru �� , Atlantic Bon ding Co., Inc. d NOTARY A.--/ BOND 1144 I TOTAL D Building Electrical Structural Engineer D to Miami Shores Village 10050 NE 2nd Avenue Phone: 305 -795 -2204 Printed: 4/9/2002 Applicant: JOHN Owner: JAMESON JOB ADDRESS: 434 NE 95 Contractor TECO PEOPLES GAS SYSTEM Local Phone: 957 -3857 X7383 Parcel # 1132060140460 This Permit Is granted to the contractor or builder named above to construct the buildin pertaining thereto and with the understanding that the work will be performed In compliant proper municipal authorities. This Permit may be revoked at any time if the work Is not dc which this permit Is grant . s the understanding that the contractor or builder named abc covered hereby whether s • on the plans or drawings or in the statements or specifica i l S i I /i (INSPECTOR) In cons • - - E` ' Issuance to me of this permit, I agree to perform the work coven • plans, drawings, m nts or specifications submitted to the proper authorities of Miam servants or employes. Signed: (Contractor or Buik Plumbing Permit Permit Number: PL2002 -87 PETERSEN BEVERLY ST Contractor's Address: Legal Description: MIAMI SHORES SEC 2 PB 10 -37 LOTS 6-7 & 8 Permit Status: Approved Permit Expiration: 10/6/2002 Construction Value: $600.00 Work: NEW 1/2 PLASTIC SERVICE LINE (NATURAL GAS) PAY TO THE DER OF tJ MEMO HUBERT NUNEZ OR MONICA NUNEZ DBA THE PERMIT CONNECTION P.O. BOX 366 PH. 561- 706 -7201 FORT LAUDERDALE, FL 33302 Page 1 of 1 g e.unt, ?o, 0 o C, p- , 6 Total Fees: Total Receipts: $0.00 If there is no permit package accessible on the job -site for inspectors to verify, there will be no inspections. Re- inspection fee is $50.00, which must be paid in advance before calling for another inspection. BLK 52 LOT SIZE 150.000 X 63- 8413/2670 8 9 2 5 8313588424 ZZO $ 90 h0 DATE -� COLLARS 8 Washington Mutual Washington Mutual Bank. FA Boca Raton/Lyons Financial Center 1670 8851 Glades 8080 1.800.788.7000 Boca Raton, FL 33434 n 24 hour Customer Service 1 : 267 084i3LI:8 3 588 4 2-411 139 25 N. f -r CONSRUCTION NOTES: N. 13/W N.E. 92ND STREET. S.R/W SWALE ALLEY (ASPHALT) 1. ALL CAS PIPELINE CONSTRUCTION TO FOLLOW TECO PEOPLES CAS STANDARDS. 2. TRAFFIC CONTROL SHOULD BE MAINTAINED AND COORDINATED WITH THE APPRORIATE GOVERNMENTAL AGENCY. 3. ALL DISTRUBED ASPHALT /CONCRETE /SOD AREAS TO BE RESTORED TO PRIOR CONDITION, UNLESS OTHERWISE SPECIFIED. SWALE (434) PROP. GAS RISER. B.S. GAS MAIN. 48 HOURS BEFORE DIGGING CALL SUNSHINE 1- 800 - 432 -4770 DATE: ATLAS: T E C O 3/26/02 M 4 SHEET: HEET: 1 ==�0' A/IS 1 /1 PROPOSED 1/2" PLASTIC GAS SERVICE TO: J0: DRAWN BY: 434 N.E. 95TH STREET, MIAMI SHORES, FLA LM 9865 N 1 CONSRUCTION NOTES: ATLAS: M 4 SCALE: .1" 0' N7S DRAWN BY: LM N. 13/W N.E. 92ND STREET. S.R/W SWALE ALLEY (ASPHALT) 1. ALL CAS PIPELINE CONSTRUCTION TO FOLLOW TECO PEOPLES CAS STANDARDS. 2. TRAFFIC CONTROL SHOULD BE MAINTAINED AND COORDINATED WITH THE APPRORIATE GOVERNMENTAL AGENCY. 3. ALL DISTRUBED ASPHALT /CONCRETE /SOD AREAS TO BE RESTORED TO PRIOR CONDITION. UNLESS OTHERWISE SPECIFIED. (434) PROP. GAS RISER. 'AT 10 (SOD) a; 2' PROPOSED 1/2" PLASTIC GAS SERVICE TO: 434 N.E. 95TH STREET, MIAMI SHORES, FLA SWALE ' 2" B.S. GAS MAIN. TECO 48 HOURS BEFORE DIGGING CALL SUNSHINE 1- 800 - 432 -4770 DATE: 3/26/02 SHEET: 1/1 JO: 9865 r PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Dam x//22-16 fob Address 2t )11 ` c S ' P Tax Folio t ^� Legal Description l'- �7W`\ S Z � G Ct 1 Historically Designated: Yes Owner/Lessee / Tenant [eve ."E/lo . Master Permit # � 2 � 1 Owner's Address A 3 E'1 S S 1--- A` S Phone Contracting Co. Address / S 7 7 9 1) tc) t NZ l ' 14 (A,V T2 Gv ! o a p Al. !,i Qualifier 4 S U S V e 6A TV\ SS# 301 951 7 3 g$ ,c7211.2 State # FL- Municipal # Competency # — / G Ins. Co. -- Teo S PL Architect/Engineer Address Bonding Company Address Mortgagor Address Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION /�/P�l/ l /z P G of CP 4 € C/Vi' r U / CE . 4s) TU 4 5 - ( a/ 8' 5 s 4 14 )1' Square Ft Estimated Cost (value) of owner Notary as to Owner and/or Condo President Date • My Commission Expires: FEES: PERMIT RADON APPROVED: Zoning Building Mechanical Plumbing or Condo ridden - c r FLORIDA LU . MONTERO COMMISSION # CC711335 EXPIRES 1/272002 IMAM THRU ASA 1.888- NOTARY1 C.C.F. b NOTARY cpooG2 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 accurate and that all work will be done in compliance with all applicable laws regulating construction an. ,ning. Furthermore, I authorize the above -named contractor to do the work stated. _ 1 citik 1 CT AT! "WONT: tter -Boil EXPIR s 1 atop., � D _ ate Signature of Contractor or O NOTARY ato ".. LUIS MONTERO COIAMISSION • CC711335 EXPIRES 1/272002 SWORD THRII AQP 1 - APIarrrM Notary • � tractor or Owner - Builder Date My Co sion Expires: BOND TOTAL DUEgO • 6 a Electrical Engineering PERMIT APPLICATION FOR MIAMI SHORES VILLAGE � ( Date Z D Job Address Li 104. `t S - .� I Tax Folio 1/ 3 °fib (0'.01 C` � � "' 7 � � Legal Description LO CP , 1 ' (3 1(X.t V 2 - Historically Designated: Yes No r� ` /Lessee / Tenant 5 S �'t l' ZE 4 , ' (A' � / Permit # �!/ t 0 0 °C' , 5 J Owner's Address \ I' 10 c£ 4 C Sr 1 nr) 1 A 5' S Phone 305 - - -/ a \I- Contracting Co. ZF55 t t'bU I S Address I c 1O) C. t S ST /'111 I Qualifier VI P eI - t t Z 6 5 1 SS# Phone 36 S 74.ef ODC State # f i O j Municipal # Competency # Ins. Co. gee / Architect/Engineer Wfff - fir Address q3 `t .r.cc ? (l`47 Bonding Company Address Mortgagor Address Permit Type (circle one): BUILDING ELECTRIC PLUMBIN a MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION Square Ft. Estimated Cost (value) 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 ttached addendum (if applicable). I certify that all work will be performed to meet the standards of all laws regulating construction in this j 'sdiction. I understand that separate permits are required for ELECTRICAL, PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL ORK. OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate laws r- : ating construction and zoning. Furthermore, I authorize the above -n ary .. t' er an or Condo President Commission E TH SHERMAN Notary Public, State of Florida My comm. exp. May 24, 2003 "nrnm. No. CC819725 FEES: PERMIT T . (l RADON APPROVED: Zoning Building Mechanical Ptetac wilder Notary as to Contractor or Owner- Builder My Commission Fxuires: 2 O ,� P' Pi, OFFICIAL OFFlI A UNTOR ES� ' ,w �lV COMMISSION NUMBER < CC840452 M F,, F � ��o MY COMMISSION EXPIRES MAY 26,2003 NOTARY Electrical Plumbing �� �, Engineering_ e done in compliance with all applicable work stated. / — OZ Date / SI-d, Date BOND TOTAL DUE , 0 Permit No MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT 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 Dr. Claude G. Mentzer No._ 434 Street - N.E. 95th Street -- • - - - -_- _ Registered Architect andfor Engineer__ __ -- — - - - - -- - -� -- Employing Plumber's Nanie Rose SEPTIC Tank Co. , Inc. No -- — 2 2 W. 3rd Ave. ,Hialeah, F1- �? __� Street_— — - - - Location and Legal Description Lot Block_ Subdivision ....... ____...... _______.__________ Street and Number where work is to be performed —No 434 Street N.E. 95th St. State work to be performed and purpose of building (By Floors) _ _ ________________________._____ New Building .. Remodeling_____ — ___ —__ Addition Repairs No. of Stories Size Septic Tank --- ------- ------ ----- --- --- - -- - -- -Type of Tank_ Feet of Drain Tile.__3z t __ Blk ! _ Refit. Feet of Tank or Drain Field from Well Nature of Water Supply: City — Well.____ ...... of Soakage Pit Amount of Permit $____3.09_ Capacity Gals. (Shed) - . . 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 5988, Compiled General Laws of Florida Perinanent 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 undersigned agrees to employ only such sub - contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. My Commission Expires (Signed)._ Date.. 7 / 6 / 64 ' u Inspector. Master Plumber. STATE OF FLORIDA, 1 88. COUNTY OF DADE. 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. 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. CLOSETS BATH TUBS S SHOWERS 1 LAVA- TORIES SINKS SLOP SINKS LAUNDRY TUBS URINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT'N6 TOTAL FIXTURES CONTR. LIST _ CHECK SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SW IM'G POOL CONTR. LIST CHECK X Permit No MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT 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 Dr. Claude G. Mentzer No._ 434 Street - N.E. 95th Street -- • - - - -_- _ Registered Architect andfor Engineer__ __ -- — - - - - -- - -� -- Employing Plumber's Nanie Rose SEPTIC Tank Co. , Inc. No -- — 2 2 W. 3rd Ave. ,Hialeah, F1- �? __� Street_— — - - - Location and Legal Description Lot Block_ Subdivision ....... ____...... _______.__________ Street and Number where work is to be performed —No 434 Street N.E. 95th St. State work to be performed and purpose of building (By Floors) _ _ ________________________._____ New Building .. Remodeling_____ — ___ —__ Addition Repairs No. of Stories Size Septic Tank --- ------- ------ ----- --- --- - -- - -- -Type of Tank_ Feet of Drain Tile.__3z t __ Blk ! _ Refit. Feet of Tank or Drain Field from Well Nature of Water Supply: City — Well.____ ...... of Soakage Pit Amount of Permit $____3.09_ Capacity Gals. (Shed) - . . 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 5988, Compiled General Laws of Florida Perinanent 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 undersigned agrees to employ only such sub - contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. My Commission Expires (Signed)._ Date.. 7 / 6 / 64 ' u Inspector. Master Plumber. STATE OF FLORIDA, 1 88. COUNTY OF DADE. 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. 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. OWNER c1iami Aores F L O A ID A PLUMBING PERMIT N9 778 Date Issue to LOT BLOCK SUBDIVISION to install the following described plumbing, in accordance with the laws, statutes and regu- lations of Miami Shores Village, Florida and the State of Florida, governing plumbing and drainage work done in Miami Shores Village, Florida. For a story building at Fixtures Fixtures $ Sewer $ Septic Tank $ %` Total $ Village Plumbing Inspector Received Payment by OWNER LOT BLOCK SUBDIVISION Date ,2 c7 Liarni cJ hores 41llage F L O R ID A Issued to ' • %�•r to install the following described plumbing, in accordance with the laws, statutes and regu- lations of Miami Shores Village, Florida and the State of Florida, governing plumbing and drainage work done in Miami Shores Village, Florida. For a_/ story building at <r Fixtures Fixtures j $ f ' . Sewer / $ Septic Tank $ Total $ PLUMBING PERMIT N9 753 1 Village Plumbing Inspector Received Payment by 'WNER LOT BLOCK SUBDIVISION ssued Hof E J4-4, e to install the foll ing describ( plumbing, in accordance with the laws, statutes and regu- lations of Miami Shores Village, Florida and the State of Florida, governing plumbing and drainage work done in Miami Shores Village, Florida. .. 7 j....... 1 4 744te.;. , .ri,., e For a�story a .� • building at 44/ , / 4'„,,. Jar Fixtures , ! (. • t 4 / . ' . 7/,. -F r t -f ._ h �� �.t'e 41' d dim, Fixtures // "" "}f11 Sewer 0 $ Village Plumbing Inspector ` / V . tic Tank eiami cJhores9llage r L o a n w PLUMBING PERMIT N9 753 Total Received Payment by ` s e BUILDING ELECTRICAL PLUMBING Owner of Building Architect Contractor �" y or Builder ,, f'it,C' Lot MIAMI SHORES VILLAGE, FLORIDA DATE PERMIT N° 6174 Work to be performed under this Permit .4 (L /At Bl. Legal Description Address of Building This permit is : ranted to the contrac or or builder e. above to construct the building or to install the equipment or . evice described in the appli- cation herefor in strict compliance with all ordinances per :fining 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. Subdi- vision Contractor's License No • 2 Value of Project Signed • By INSPECTOR Amt. Permi X38 Oel In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with altgrdinancesand regulations pertaining thereto and strict confo ,o y with the plans, drawings, statementsr sp ifications submitted to the proper author) of Miami Sh&est V ge. In acce is per�iit I assume res nsibilityforr all work done by either myself - ^in , : gent, servant or employee. I'd i ! `C R�OR�BUII.m t AUTHORITY AIONL 194 Flo , - , mow.- +nwrMp ^wFr 011001roMPOPopow.VO. ,. nrc+�{bb�4pMepi °�ma ^q ,.,# '1 • MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Time Date P2 Type Insp'n / 444 Permit No. 'EL 2OV2'•s-.S —" Name J , / Address c;434 71 — Company Phone # r3or �, /37q For Inspector:- Name & Date Approved Correction ❑ 3 Re- Insp'n Fee ❑ MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date T /3 Time Type Insp' n qq Permit No. rZ d e0 2 - Name Address Company Phone # 32a41-14) f ?' e 9L�_s� ( e6616v For Inspector: 34:: 4 Approved Correction Re- Insp'n Fee m,/ MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date -30"4(5.Z, Time Type Insp'n I Ea.�.�e Permit No. 2 L ) O Z Name �(, "�J Address /3 / /!/ 95 �� Company Phone # Approved Correction Re- Insp'n Fee . 3 05 " 9 5 e, , 0 For Inspector- f O 2 N. .• - Date ❑ "lGe�,� (301> 9. s) r 69 - Type Insp'n Permit No. Name Address Company Phone # MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date 3 °4 -Az Time ,I- For Inspector: 3 /f 0 / 2) Date Approved Correction Re- Insp'n Fee (394/ 9s St f.- El /9/7,0-2. PROPERTY OWNE � R y Q � �� L k TA��3D A) ' Name R t'0 L,I�� Address 434 OM f Home Telephone 3 os -- 75-7 — 7 V 7 3 Business Telephone 3 0 S ^ (9 / _ 17 4 tl g _ J _./ n O p — Fax U1/1' -e o c Sc?..- 11 7S-7-/ CONTRACTOR New Construction Name 10 10 1 - e ;: {1(� License No. j Repair Address 2 (o i) I ) nv r (44 itrilvti 33/C0 Alteration Interior Telephone 2 D sc.: i / _i? 7 Fax 1 / J , — -� r y�0 G Qualifier Name j , il � , 04.. Shell Only 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 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. /30 & D I (0a Folio Number Lot Subdivision PB PG Current Use of Property Proposed Use of Property Tenant Information PERMIT TYPE (✓ ) Building Electrical Mechanical Plumbing LPGX Roofing Fence Other 43cl NE 615S j Block Chg. Contractor Renewal Revision Extension Supplement Reinspection ARCHITECT Name License No. Address Telephone Fax Master Permit No. Subsidiary Permit No. - ' o)dC cza [M S City Description of Work 3' rvI Le. jt°ac» c /5 ,'Sc Zoning Value of Work State Linear Feet PERMIT APPLICATION g3i3 F Zip rad d,ap !l- ova/ vfi re> eoa • Square Feet a (o OD Units Floors Bldg Value Tax Assessed/Appraised Value Flood Zone Base Floor Elev. PERMIT CHANGE (✓ ) ENGINEER Name License No. 1 Address Telephone Fax 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 read 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, 1" 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. FLORIDA, COUNTY OF MIAMI -DADE STATE • �G111►_� ' R Signature of Own Print Name Swom to and subscribed before me this k i 02© Signature of Notary SEAL: Personally known ROBIN WILLIAMS [; My Comm EN). 9/29/05 No. DO0S4219 OR, Produced Identification PERMIT APPLICATION TE OF FLOR A OUNTY OF IAMI -DADE Signature o Contractor / Qualifier N n J� Print Name � Sworn to and subscribed before me this 13 day of t C--{_J Public Signature of No SEAL: Personally known . k6 JP ;� + COMMISSION NUMBER ,, +iU. �.. __ M COMMISSION EXPIRES F MAY 11,2002 OR, Produced Identification Type of Identification Produced: Type of Identification Produced: DATE TO THE ORDER OF ACCTS. PAYABLE DISC. OTHER CHECK NUMBER I tn/ U LJLO4 1) ' f aittou 4, I slog ORBECURIT7PUR OBEB TNB DOCUMENT :CONT B'M1CROPRINTINO IN 84NOON..tHEIREVEABE!S DE18 PAY AMOUNT OF MOODY ELECTRIC, INC. 669 N.1N, 90TH STREET MIAMI, FL 33150 891 -1374 TOTAL BANK MIAMI, FLORIDA 11 '0 L 5908" 1:066009 L 5 59: EXPLANATION AMOUNT 35 L03079006 DOLLARS 63- 915/660 15908 CHECK AMOUNT 1 66 . c a AMD' ' C15174EPCMECR'FACENP.ON TOP OF'ANY ORDNARY.PIECE OF.PAPER AND' RUB' CARBON •BAND,AREAIWRN.'A -MARKS WILL TRANSFER:O E`PAPER.OBSAIREE R/Was. #JeioJMNM4+n'a% [VP DRIP LOOP (TJ BE 30' AEG (MIN) cL,n'p _.J 2' i\IJOVE ROOF • F11!TT11ED GRAI1E >r lo trawl uun gum PANEL -4--- L 1 t'_' PLAS - 1IC PVC SLXZNIL____ HHIAIN C1) WO' 111N 11E1'7I1 1 MAI tent• CL/4111' 1�1�LI� UI< ' MAST' I -kIDM: Conchae =tor sue •"4��� �y C ondui•i sti __ ...2 • Condutt -Eypis- .2-'.1', Thr u root' ( E5 ___Y clO C;rovnd Wlrc 11Milt. DI S YONNECT R t t np • Amps Sub Bra oico • _ Amps; • PER S.F.I1.C, 4505.2.(D) • SUB FEEDER New Typo - . Site Mond Utz . 11.• INSIDE PANEL Rothe Z Ae.r T1ond $u5 •t' fly J•!n L ocv - tlo n • • • • . t . ._ Sc __. _. _ ._ ._ . _ _ ...... _ _ -.. — S 1 VAHATUIIE OF t.t11t'f ACTOR ni )1 )Ri D B ELECTRICAL TYPE Minimum Fee QTY. TYPE Dryer QTY. TYPE Outlet, Appliance QTY. TYPE Service Repair QTY. A/C Central 1 -3 Ton Dryer Vents, Number of Fan Ventilation, Cost Outlet, Wall Ductwork, Cost of Service, Temporary Periodic Inspections A/C Central 4 -7 Ton Fire Sprinkler System Fire Pump Outlet, Switch Fireplaces, Number of Signs A/C Central 8 -15 Ton Fixture - Fluorescent Oven Space Heater (kw) A/C Central 16-20 Ton Fixture Light Parking Lot Lights Spas/Hot Tubs A/C Central 20+ Ton Flood Lights Plugmold/Strip Subfeeds, No. of Amps A/C Window FPL - Load Central Posts Swim Pool, Commercial Air Conditioners Garbage Disposal Range/Range Top Swim Pool, Residential Chiller Generators, etc. Receptacles Switchboards Clear Violations Heat Recovery Refrigerator, Comm. (p/PH) Temp Serv., Construction Compactor Low -volt, Burglar Refrigerator, Domestic Temp for Test - 30 days Deep Freezer Low -volt, Fire Renew - Temp Service Water Closet Demolition Low -volt, Intercom/Teleph. Repair Circuits Water Heater Dishwasher Low -volt, Television Service, Number of Amps Water Heater New MECHANICAL TYPE QTY. Minimum Fee TYPE Condensate Drain QTY. Tl' Generator QTY. TYPE QTY. Refrigeration, Tons 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 Air Handler, Tons Ductwork, Cost of Piping, Flammable Liquid Periodic Inspections Barbecue Fire Sprinkler System Process/Pressure Piping Bath Fan - Vented, # Fireplaces, Number of Pressure Vessel 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 Ice Maker Pump, Sump Utility - Water Dishwasher Indirect Wastes Relay Repair Vacuum Pump Disposal Interceptor Roof Inlet Water Closet Domestic Well Laundry Tray Septic Connection Water Heater Drainfield, 4" Tile/Res. Lavatory Septic Tank Water Heater New Drains, Area Meter Set (Gas) Sewer Connection Water Re -pipe Drains, Floor Minimum Fee Shower Water Service Drains, French Miscellaneous Equipment Sink Well, Supply Page 3 kb i o eruck' / S Of /v eoC 6'r ' ' c P T APPLICATION f2C42 -e4 (» v' Ate -, ,9// .0 c.L7 ? ��^r� 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] ❑ 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 ❑ IMPACT FEE (New Construction) CHECKLIST ❑ PROOF OF OWNERSHIP (Attach) ❑ HRS / DERM APPROVAL (Septic / Sewer) ❑ OTHER (Specify & Attach) PERMIT APPLICATION ❑ CONDO ASSOCIATION APPROVAL (Attach) ❑ BPR APPROVAL (Restaurants) ❑ CONTRACTOR REGISTRATION (On File) PERMIT FEES $ (sq.ft. = x/1000 x 0.60) (¢.005 / sq.ft.) (¢.01 /sq.ft.) ISSUING OFFICIAL REVIEWED AND PREPARED BY: SECTION Zoning Electrical Mechanical Plumbing Fire Public Works Structural Building Official BY DATE ��8'lr1G TOTAL $ 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 OUTLETS MOTORS RECEPTACLES GENERATORS STOVES WATER H'TERB SIGNS BILLBOARDS OT A Bt ( . SUB BRANCH Basement Or 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: Owner ' / �_ // J ' �' 1� _' Address Building Contractor Electrical Contractor Location of proposed work: Lot s `7 Bl. k Subdivision / Building:t new Number of stories Used as Description of proposed work Details of proposed work: Number of Motors H P Additional Information �� � S . . 11 ' ar aiami choresc llage F L 0 & 1 D A 1/ Date Amps (SPACE BELOW FOR INSPECTOR'S US E ONLY) Phase '9 Signature of Applicant Address (if other than owner or contractor) 1 93— ( Work begun Inspected Work finished Final inspection J / e , Inspectr . = CEILING BRACKETS RCCPTACLCS SWITCHES STOVES WATER HEATERS SIGNS OTHER S ! ® y SUBS BRANCHES BASEMENT_ FLOORS FIXTURES ONLY NUMBERS OF TOTAL OUTLETS SIZE OF SIZE SERVICE CONDUIT No. CIRCUITS LIGHTS CEILING BRACKETS MAIN SUBS BRANCHES BASEMENT_ d _ `✓ FIRST SECOND THIRD FOURTH ELECTRICAL 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 LOT NUMBER 11:;" BLOCK NUMBER SUBDIVISION STREET AND NUMBES OWNER OCCUPIED As BUILDING-NEW OR OLD (UNDERLINE WHICH) H. P. OF EACH MOTON VOLTS TOTAL. AMPS PHABF KIND OF INSTALLATION REMARKS CONTRACTOR 1 By RECEIVED BY INSPECTOR PROGRESS WILL INSPECT AGAIN ROUGH WIRING FINAL No CORRECTED TEMPORARY DAYS. DATE ISSUED OPEN OR CONCEALED KNOB, RX., BX., MLDG., CONDUIT, METALLIC TUBING SPACE BELOW FOR INSPECTOR'S USE ONLY INSPECTED REMARKS APPLICATION //i /1-r WORK -- ADDITIONAL, NEW, ALTERATION OR REPAIR SPECIFICATIONS 0/ OCCUPANT ADDRESS INSPECTION WANTED FEE REMITTED SIDE No DATE (7 1934. INSPECTOR CEILING BRACKETS RECPTACLES SWITCHES •TO,VE• WATER HEATERS SIGNS OTHER BRACKETS • •UBS BRANCHES BASEMENT v l 0 ti ., FLOORS FIXTURES ONLY NUMBERS OF TOTAL OUTLETS SIZE OF SIZE SERVICE CONDUIT No. CIRCUITS LIGHTS CEILING BRACKETS MAIN •UBS BRANCHES BASEMENT y - ' FIRST SECOND THIRD FALJRTM ELECTRICAL DIVISION OF THE CITY OF 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 BY GIVING FULL AND ACCURATE INFORMATION. ALL SPACES WILL BE RETURNED LOT NUMBE p.� G STREET AND NUMBE A OWNER OCCUPIED As CONTRACTOR BUILDING- -NEW OR OLD (UNDERLINE WHICH) BY RECEIVED BY INSPECTOR PROGRESS WILL INSPECT AGAIN ROUGH WIRING FINAL No. CORRECTED TEMPORARY DAYS.• DATE ISSUED REMARKS APPLI CATION BLOCK NUMBER SUBDIVISION / , OCCUPANT H. P. OF EACH MOTON VOLTS TOTAL AMPS SPACE BELOW FOR INSPECTOR'S USE ONLY INSPECTED FEE REMITTED No DATE MUST BE' *ILLED OR SIDE WORK -- ADDITIONAL, NEW, ALTERATION OR REPAIR SPECIFICATIONS PHASF MIAMI of the electric infractions of APPLICATION KIND OF INSTALLATION OPEN OR CONCEALED KNOB, RX., BX.. MLDG.. CONDUIT, METALLIC TUBING REMARKS INSPECTION WANTED ADDRESS l ( INSPECTOR 198__ i Atlolik.40410404.0, n k e,•.. gk Aryu!M Date N PERMIT APPLICATION FOR MIAMI SHORES VILLA / Job Address q' f'V l s sr Tax Folio 5� 0 / (pV / 416 f Legal DescriptionLbIS (p `) 4--S , 5 (Q JI. Z Historically Designated: Yes /Lessee / Tenant 1I Th ES 0A) 1 . v -r(,l•1 Master Permit # IP u , y N 9 , m ►A • s h�cs �- ss�r • Owner's Address . L , , _, ,` , , - . .1 M1A,1i Conacng Co ,D & f • CO I j I C ' Addres 1 401 Sub I r. * 2.0 Z ) :j 53133 SS # Phone 55,76/-115i //...a.4 &owl Qualifier li �J■416' State if V,000 16, FEES: PERMIT Municipal # Competency # Architect/Engineer Bonding Company Address Mortgagor Address Permit Type (circle one): BUILDIN LECTRIC PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION POO Square Ft. Estimated Cost (value$ 9Q9 , 07) 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 accurate and that all work will be done in compliance with all applicable laws re a ating construction and zoning. Furthermore, I authorize the above -named contractor to do the work stated. ondo President • . c'. /' .,A// Js of own ;•. • • • 0�4 er and/or Condo President Da e y C •mmission ExpiresKENNETN SHERMAN Notary Public, State of Florida My comm. exp. May 24, 2003 Comm. No. CC819725 96; o RADON APPROVED: Zoning Building Mechanical Pltunhing hoot4 (4) C.C.F Phone r )S7 — %U43 Ins. Co. Address (� S W ? 42f• Notary as to Cnnt nr O Rllllder � Y OFFlCIAL NOTARY S' "' My Commis s 011,e IUANATORRES 1 c * COMMISSION NUMBER 9 ;��; % CC840462 Q MY COMMISSION EXPIRES OF MAY 26,2003 No goo a • 4 //7/o,/__ NOTARY — ()-- BOND TOTAL DUE _a Electrical Engineering Permit No Employing Electrician's Name Amount of Permit STATE OF FLORIDA, COUNTY OF DADE. ss. • My Commission Expires MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT Date — ___ __ 1 - -- + -- _ I - ---- 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 0 = ____ ___, � r_.�� No Street Registered Architect and /or Engineer No. Street ------ - - - - -- — — — -- — Location and Legal Description Lot Block ____ Subdivision-- ______ _____--- __________ ..e.W Street and Number where work is to be performed— No._____! l it, e_ f__ _ _ __= a__ Co t c Street �,��°' qq State work to be performed and purpose of building (By Floors) ,/ li --- ___ 4. l.etrie io i New Building Remodeling Addition Repairs No. of Stories Service Overhead Size Feeders____— _—____ � Conduit Main Sw Amps. _ — _ —____ Main Fuses Amps. Underground p Type of Installation— Conduit Tubing B.X.L Metal Moulding (Signed) �,.._f * �' - -y s� �/' 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. r " ° '4 (Signed) Notary Public. State of Florida Master Electrican. tie • 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. 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 Permit No Employing Electrician's Name Amount of Permit STATE OF FLORIDA, COUNTY OF DADE. ss. • My Commission Expires MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT Date — ___ __ 1 - -- + -- _ I - ---- 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 0 = ____ ___, � r_.�� No Street Registered Architect and /or Engineer No. Street ------ - - - - -- — — — -- — Location and Legal Description Lot Block ____ Subdivision-- ______ _____--- __________ ..e.W Street and Number where work is to be performed— No._____! l it, e_ f__ _ _ __= a__ Co t c Street �,��°' qq State work to be performed and purpose of building (By Floors) ,/ li --- ___ 4. l.etrie io i New Building Remodeling Addition Repairs No. of Stories Service Overhead Size Feeders____— _—____ � Conduit Main Sw Amps. _ — _ —____ Main Fuses Amps. Underground p Type of Installation— Conduit Tubing B.X.L Metal Moulding (Signed) �,.._f * �' - -y s� �/' 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. r " ° '4 (Signed) Notary Public. State of Florida Master Electrican. tie • 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. 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. . 1 I Date I q Job Address 4 me 6K sr Legal Description COwner ..essee / Tenant T A auccA ' 4 Owner's Address `1 SSf Contracting Co. I I lOO eLEQ-ex, Qualifier - (1 0 60 State # 00011 Municipal # Historically Designated: Yes Architect/Engineer Bonding Company Mortgagor Permit Type (circle one): BUILDIN PERMIT APPLICATION FOR MIAMI SHORES VILLAGE WORK DESCRIPTION / 5 /91/P �aemc E !/P4 /OP t Square Ft Estimated Cost (value) ature of owner or Condo President JAM, i Ad • f on E otary as to My Commis PERMIT3,.s ' O" RADON APPROVED: Zoning Mechanical c1' PU OrFICIAL 6d'� A` SS . LIARY PATRICIA BRIGGS 2 rte. ..,./. ¶ COngiSS:O NUMBER Q CC335258 43' PAY co tasssION EXP. F OF F\ JAN. 31 1998 Date /9/q6 Tax Folio Building Master Permit # Phone No Address 6,q/(. W Q''S SS # 0 q/ '/3 7' Competency # /6662— Ins. Co. fed" — 7 %rte S Address Address Address ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE 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 accurate and that all work will be done in compliance with all applicable Iiiirii-egulating construction and zoning. Furthermore, I authorize the above -named contractor to do the work stated. Signature of Contractor or Owner -Build Notary as to Coni. ctor My Commission pire C.C.F. €.50 NOTARY Electric 4 P4/ OFFICIAL NO G ARY SEAL y �. MAF2V PATRICIA BRIGGS 4 , COMMISSION NUMBER CC335358 > i r COMMISSION EXP. OF RP JP 1 31,1998 TOTAL DUE SIGN Date 476 Plumbing Engineering ITEM BATH 11.8 UNIT FEE ITEM SWITCH OUTLETS UNIT FEE ITEM SPACE HEATERS UNIT FEE BIDET LIGHT OUTLETS CENTRAL HEATING DISHWASHER RECEPTACLES A/C (WIN)) DISPOSAL SERVICE TEMPORARY A/C (CENTRAL) DRINKING FOUNTAIN SERVICE SIZE IN AMPS JT() DIET WORK FLOOR DRAIN SERVICE REPAIR/hETER CHANGE REFRIGERATION GREASE TRAP APPLIANCE OUTLETS PROCESS AND PRESS PIPING INTERCEPTOR RANGE TOP UNDERGROUW 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 If MECHANICAL VENTILATION SINK. RESIDENCE MOTORS OVER 5- 8 HP TRANSPORTING ASSEMBLIES SINK, SLOP e ' MOTORS OVER 8- 10 HP ELEVATORS/ESCALATORS TEMPORARY . MOTORS OVER 10- 25 HP FIRE SPRINKLER SYSTEMS URINAL MOTORS OVER 25-100 FP COOLING TOWERS WATER CLOSET MOTORS OVER 100 if A/C WINDOW VIOLATION REINSPECTION INDIRECT WASTES WATER SLPPLY TO: AIR CONDITIONERS ' A/C UNIT STRIP HEATER FIRE SPRINKLER GENERATORS TRANSFORMERS HEATER -NEW INST. GENERATORS TRANSFORMERS HEATER-REPLACE - GENERATORS TRANSFORMERS LAWN SPRINKLER -WELL SPECIAL PUIPOSE SWIMMING POOL OUTLETS COMMERCIAL WATER SERVICE SIGN TIEES SEWER CONNECTIONS SIGN TRANSFORMERS UTILITY -SEWER SIGN TIME CLOCK UTILITY -WATER FIXTLRES SEPTIC TANK ANTENNA RELAY TELEVISION OUTLETS DRAINFIELO, 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 (AN APPLICATION FOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. IF A MASTER PERMIT HAS BEEN OBTAINED, THE OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.) PLUMBING ADDENDUM TO BUILDING PERMIT APPLICATION ELECTRICAL MECHANICAL NO. STREET PART OF LOT LOT BL'K SUBDIVISION �J _ i Billboards Other Apparatus Permit Fee Outlets Motors Receptacles Generators Stoves Water Heaters Signs Billboards Other Apparatus Permit Fee ^ . �P . f , ELECTRICAL PERMIT N. B. —This Permit must be on display on the premises during the construction. Owner of Building Contractor or Electrician aiami cShores9 llage F L o A ID A OFFICE OF ELECTRICAL DEPARTMENT Miami Shores Village, Fla , LO CATI 0 N DESCRIPTION OF WORK 19 ■9 420 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. 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. Dated , 19 . -. , Electrical Inspector. (Seal) Outlets Motors Receptacles Generators Stoves Water Heaters Signs Billboards Other Apparatus F J x •'7 ; : . / -/ ELECTRICAL PERMIT N. B. —This Permit must be on display on the premises during the construction. Owner of Building ' / Contractor or Electrician NO. / aiami cJhores9'llage F L O R ID A OFFICE OF ELECTRICAL DEPARTMENT Miami Shores Village, Fla , NUMBER OF LOCATION DESCRIPTION OF WORK // t 19_d' STREET PART OF LOT LOT , o BL'K 1 /L t 1 SUBDIVISION N° _ 378 This Permit is granted upon the express condition that all facts stated in the Application are true and that the construction complies stricti the plans and specifications submitted and are in accordance with the Electrical Laws of the State of Florida and with the Electrical Ordinances and C of Miami Shores Village and the rules and regulations of the Electrical Department of Miami Shores Village. This Permit may be revoked at any tit upon the violation of any provisions of said laws, ordinances, or rules and regulations, or upon any change in the plans and speclfisations unauthorized b, this Department. r ""+ j _ � -4 . l� ` , 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 yrovisions of all Electrical Laws of the State of Florida, all the Electrical Ordinances and Codes of Miami Shores Village, and all rules and regu4tionp o the Electrical Department of Miami Shores Village. fir f , , . /`� / J/ Dated I ` / ! 19 � ‘-41/1 ,{'�t( ▪ E . II (Seal) Date I D Job Address 43 L i A) E 1 C ST Tax Folio Legal Description ,n� II'' Historically Designated: Yes No (OwnerSSee / Tenant JEA- 0 K-U SSA Master Permit # '3 CR /� % Y- r Owner's Address 4 0 6- cis---Sr Phone Contracting Co. MOON lOON E--I -FO SIG 1 State # e- CO 0 1 R ( 3 Municipal # PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Address 667q /1 W Q 's r SS# - 0 //'/ 79 Competency # /6662- Ins. Co. fedi — TP-iVeZEle.r Architect/Engineer Address Bonding Company Address Mortgagor Address Permit Type (circle one): BUILDIN ( ELECTRICAL ' PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION / 5D /V . aev /cc: vP4 ap Square Ft. Estimated Cost (value) 4 /8O6 0 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 accurate and that all work will be done in compliance with all applicable ( Ialiiiitgulating construction and zoning. Furthermore, I authorize the above -named contractor to do the work stated. • ., a Y �• otary as to wne,�..� My Commis •fon E' APPROVED: Zoning Mechanical Air., /fv\/ or Condo President Date ( fie OFFICIAL LI z if ° CO, VISSION HULIBER (i UAW/ PATRICIA BRIGGS CC335258 N MY COMMISSION EXP. F OF F\° JAN. 31,1998 FEES: PERMIT 5 '4° RADON Signature of Contractor or Owner -Build Notary as to Con My Commission C.C.F. e.56 NOTARY Building pire Electric tor 41'w 1P PG9 OFFICIAL NO ARY SEAL 7 0 MARV PATRICIA BRIGGS is .r 4. COMMISSION NUMBER 4 �t�r; Q CC335258 F A p� LI COMMISSION EXP. �F FlP JAN. 31,1998 TOTAL DUE Date 1 4 , 6 Rer Plumbing Engineering NO. STREET PART OF LOT LOT BL'K SUBDIVISION Other Apparatus Permit Fee I l 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 Outlets f ;./ . . i ��. c r . Contractor or Electrician aiami cShores F L o R ID A OFFICE OF ELECTRICAL DEPARTMENT Miami Shores Village, Fla , / 19 LOCATION DESCRIPTION OF WORK NUMBER OF 390 This Permit is granted upon the express condition that all facts stated in the Application are true and that the construction complies strictly with plans and specifications submitted and are in accordance with the Electrical Laws of the State of Florida and with the Electrical Ordinances and Code 4iami 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 specifications unauthorized by Department. / r _ 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 pplication and the plans and specifications thereof heretofore by me submitted, and in compliance with all provisions of all Electrical Laws of the of Florida, all the Electrical Ordinances and Codes of Miami Shores Village, and all rules and regulations of the Electrical Department of Miami s Village. r Dated , 1 9 j (Seal) 1 BUILDING ELECTRICAL PLUMBING Owner of Building Architect Contractor or Builder NTRA@TOR OR BUILDER MIAMI SHORES VILLAGE, FLORIDA DATE `"f 194 PERMIT ■9 2454 Work to be performed under this Permit' J Subdi- vision ,•• 3 .,. .-i _ a Legal Lot Bl. Description Address of Building ! f '� 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 regula- tions 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 perpsi; I assume responsibility for all work done by either myself, my agent, servant or employee. a 1 4 , • Value of Project Contractor's License No. Amt. of Permit BY AUTHORITY BUILDING ❑ ELECTRICAL VI PERMIT N? 11823 PLUMBING ❑ ROOFING Architect Contractor or Builder Legal Description Address of Building Lot / �. ❑ Work to be performed under this Permit Owner of Building 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. t i Signed• BY t% . INSPECTOR In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities `6f Miami Shores Village. In accepting this permit I assume responsibility fo all work done l y either, myself, my agent, servaz;t or employ CONTRACTOR OR BUILDER MIAMI SHORES VILLAGE, FLORIDA E Bl. Subdi- vision Value of Project $ BY DATE r 195 Contractor's License No Amt. of Permit $ AUTHORITY _in,- MOODY# ELECTRIC, INC. 669 N.W. 90 STREET MIAMI, FL 33150 -2166 TEL: (305) 891 -1374 FAX: (305) 758 -2000 , Asii No .' r."' 0 _1) < T al tiE RESIDENTIAL DEMAND LOAD CALCULATIONS W / SQ. FT 3C1o0 K.W. REFRIGERATOR 1-5 K.W. APPLIANCES - 3•D K.W. DISHWASHER ( 5 K.W. GARBAGE DISPOSAL K.W. MICROWAVE j.3 K.W. CLOTHES WASHER j 5 K.W. DRYER .5 O K.W. RANGE K.W. WATER HEATER y -5 K.W. OVEN K.W. FREEZER K.W. TRASH COMPACTOR K.W. GARAGE DOOR MOTOR j .. K.W. JACUZZI K.W. JACUZZI BOOSTER HTR. K.W. IRONING BOARD .R K.W. POOL EQUIPMENT K.W. SPRINKLER PUMP 2 K.W. LANDSCAPE LIGHTS K.W. STEAM SHOWER K.W. A/C WALL UNIT o2 At.r t.5 K.W. SPARE CAPACITY K.W. SPARE CAPACITY K.W. TOTAL CONNECTED LOAD FIRST 10 K.W. @ 100% REST @ 40% A/C @ .1-9% i'G'Pj y3y M /nrni Sh ogeS 33.2 K.w. 10.0 K.W. 9� IS K.W. 34 9 K.W. TS� AL DEMAND LOAD oL 9 K.W. / 240 VOLT = j ` AMPS SEA U / C E' ( PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date (O CO Job Address �� C kS S`C-c2s17\ Tax Folio Legal Description Historically Designated: Yes No Owner/Lessee / Tenant '\4zL.V\ ' e■ Master Permit # 4 7 Owners Address Phone 3 ( S -- S7 - 90q Contracting Co. ��a" e� �C tr Address <<,c, NL5-S S*C State # ���� «i� Municipal # Competency # Ins. Co. .\ L V k Ckf■ Architect/Engineer Address Bonding Company Address Mortgagor Address Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN Qualifier WORK DESCRIPTION Ne - vs /S77 , /6a /.2t-• /71 -4-!/*/ Square Ft. 6D0 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 accurate and that all work will be done in compliance with all applicable laws regulating construction and zonin • _ F ore, I authorize the above-nam o do the work stated. Signature of owner and/or Condo President otary Date My Co feftireliiCOLE A IIR00RT 1 comma* swim CC001267 MY OOMMMINONIX,M12 JULY 2 2001 FEES: PERMIT 3")'1 RADON C.C.F. ' APPROVED: Zoning Building Mechanical Plumbing SS# - Phone (- (T T7( Estimated Cost (value) t / Signature of Contractor or Owner -Buil otary as to Contractor or Owner -Buil ' IAL NOTARY SEAL a NICOLE A BEROERT 0 COMMISSION NUMBER CC6612 MY COMMISSION EXPIRES JULY 2 2001 BOND TOTAL DUE Date Date Electrical Structural Engineer MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT LAS APPLICATION FOR ELECTRICAL PERMIT Permit ___ 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. Amount of Permit $ f/ �o STATE OF FLORIDA, COUNTY OF DADE. ss. My Commission Expires Owner's Name and Address _____ .0/ Registered Architect and /or Engineer Employing Electrician's Name Location and Legal Description Lot Street and Number where work is to be performed —No. State work to be performed and purpose of building (By Floors) — — r No. _. Street- -- ------- - - - - -- — — — ---- - - - - No. Street /';a Street — -- New Building ______ Remodeling Addition Repairs Service Overhead Size Feeders _ Conduit Main S Amps. Main Fuses_ /_^ Underground w. m p _-- -- Type of Installation— Conduit Tubing B.X.L Metal Moulding (Signed) Date____ a Notary Public. State of Florida No. of Stories 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) / • Mastet Electrican. Amps. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared — — — to me 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. 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 H EATER 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 LAS APPLICATION FOR ELECTRICAL PERMIT Permit ___ 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. Amount of Permit $ f/ �o STATE OF FLORIDA, COUNTY OF DADE. ss. My Commission Expires Owner's Name and Address _____ .0/ Registered Architect and /or Engineer Employing Electrician's Name Location and Legal Description Lot Street and Number where work is to be performed —No. State work to be performed and purpose of building (By Floors) — — r No. _. Street- -- ------- - - - - -- — — — ---- - - - - No. Street /';a Street — -- New Building ______ Remodeling Addition Repairs Service Overhead Size Feeders _ Conduit Main S Amps. Main Fuses_ /_^ Underground w. m p _-- -- Type of Installation— Conduit Tubing B.X.L Metal Moulding (Signed) Date____ a Notary Public. State of Florida No. of Stories 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) / • Mastet Electrican. Amps. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared — — — to me 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. 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. - 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 / / / / b� ELECTRICAL PERMIT N. B. —This Permit must be on display on the premises during the construction. Owner of Buildin Cofactor or Electrician Dated + /E 19,) aiami chores9illage F L 0 A 1 D A OFFICE OF ELECTRICAL DEPARTMENT Miami Shores Village, Fla , LOC ION DESCRIPTION OF WORK NUMBER OF 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. o ' • f In consideration of the issuance to me of the foregoing Electrical Permit, I hereby agr e 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 trical Department of Miami Shores Village. N° 390 • , Electrical Inspector. NO. Motors R STREET / PART OF LOT LOT., BL'K Signs B SUBDIVISION O t y , ^ ' 4 ' F Outlets M Motors R Receptacles G Generators S Stoves W Water Heaters S Signs B Billboards O O t t P Permit Fee ���� T s O � �./ ELECTRICAL PERMIT N. B. —This Permit must be on display on the premises during the construction. Owner of Building � `• � ��? Cq�cactor or Electrician 4 t �� iaini Shores Village, Fla , iami cShores9llage F L O B I D A OFFICE OF ELECTRICAL DEPARTMENT DESCRIPTION OF WORK LO CATI 0 N � e 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. N° 420 • , Electrical InspeTr. 19 # In consideration of the issuance to me of the foregoing Electrical Permit, I hereby agree I 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,regulat ;ons o Electrical Department of Miami Shores Village. Dated 9 ( r 19`— ` (Seal) Permit No (:a g 7 Date ! .: ���%�i 1 i M 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. Ownei s Name and Address -. %' , ...... t— ' No 95..y ., Street 1 i Registered Architect and /or Engineer.... / Employing Electrician's Name Amount of Permit $ STATE OF FLORIDA, t COUNTY OF DADE. Ij as. My Commission Expires ELECTRICAL INSPECTION DEPARTMENT MIAMI SHORES VILLAGE APPLICATION FOR ELECTRICAL PERMIT No 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 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 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 t/ e L i n licensed by Miami Shores Village. r, Master Electrician. J/ 5 Street Notary Public, State of Florida 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. 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. ACE HATER STRIP HEATER TOTAL CONTR. LIST 6 CHECK 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 (:a g 7 Date ! .: ���%�i 1 i M 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. Ownei s Name and Address -. %' , ...... t— ' No 95..y ., Street 1 i Registered Architect and /or Engineer.... / Employing Electrician's Name Amount of Permit $ STATE OF FLORIDA, t COUNTY OF DADE. Ij as. My Commission Expires ELECTRICAL INSPECTION DEPARTMENT MIAMI SHORES VILLAGE APPLICATION FOR ELECTRICAL PERMIT No 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 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 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 t/ e L i n licensed by Miami Shores Village. r, Master Electrician. J/ 5 Street Notary Public, State of Florida 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. Permit No 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. Owners Name and Address e7/ Registered Architect and /or Engineer Employing Electrician's Name 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) New Building Remodeling Addition STATE OF FLORIDA, } COUNTY OF DADE. MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT Date (1 o 83. No 473 e&treet 95-:1>4)./ RfC. ..No71/ 7 Street.�.,./Ae s� Street 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 sub-contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. (Signed)62.-44 aster 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. ACE HATER 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 / / / $040 C CHECK Permit No 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. Owners Name and Address e7/ Registered Architect and /or Engineer Employing Electrician's Name 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) New Building Remodeling Addition STATE OF FLORIDA, } COUNTY OF DADE. MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT Date (1 o 83. No 473 e&treet 95-:1>4)./ RfC. ..No71/ 7 Street.�.,./Ae s� Street 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 sub-contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. (Signed)62.-44 aster 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.