353 NE 94 St (12)Permit No
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT ?
c .. r .,f..1.7.... 0.. �,.2
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith Elubmitted 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
with, whether herein specified or not. A copy of approved plans and specifications must be kept at
of Miami Shores Village shall be complied
building during progress of work
Owner's Name and Address 11L,,e,
Registered Architect and /or Engineer
Employing Electrician's Name .... / No / 7 / k7 y Street ll�•.
Location and Legal Description Lot Block Subdivision
Street and Number where work is to be performed —No 5...�l�t. c '/ /� Stree
MIAMI SHORES VILLAGE
No . , 6:3 L , 9 4/ Street.... (6 -
State work to be performed and purpose of building (By Floors)....
New Building Remodeling Addition Repairs No. of Stories
Service Overhead Size Feeders Conduit Main Sw Amps Main Fuses Amps
Underground
Type of Installation — Conduit Tubing B.X.L Metal Moulding
Amount of Permit $
STATE OF FLORIDA, j
COUNTY OF DADE. I
55.
(Signed)
(Signed)
Ele rical Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations s an employer of
labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent upplement, and
has complied with the provisions thereof, and will require similar compliance from all contractors or sub-contractors employed •y 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 suh•contrac , on work to be performed under this p it as are
licensed by Miami Shores Village.
3 � ✓ � Mas" Electrician.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths
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.
and take acknowledgments,
personally
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.
DIET.
CAB.
SERVICE
TEMP.
SERVICE
PERM.
MOTORS
0.1 HP
MOTORS
1 -5 HP
NEON
TRANS.
RADIO
TOTAL
CONTR. L197
L18T
/
/
CHECK
Permit No
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT ?
c .. r .,f..1.7.... 0.. �,.2
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith Elubmitted 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
with, whether herein specified or not. A copy of approved plans and specifications must be kept at
of Miami Shores Village shall be complied
building during progress of work
Owner's Name and Address 11L,,e,
Registered Architect and /or Engineer
Employing Electrician's Name .... / No / 7 / k7 y Street ll�•.
Location and Legal Description Lot Block Subdivision
Street and Number where work is to be performed —No 5...�l�t. c '/ /� Stree
MIAMI SHORES VILLAGE
No . , 6:3 L , 9 4/ Street.... (6 -
State work to be performed and purpose of building (By Floors)....
New Building Remodeling Addition Repairs No. of Stories
Service Overhead Size Feeders Conduit Main Sw Amps Main Fuses Amps
Underground
Type of Installation — Conduit Tubing B.X.L Metal Moulding
Amount of Permit $
STATE OF FLORIDA, j
COUNTY OF DADE. I
55.
(Signed)
(Signed)
Ele rical Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations s an employer of
labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent upplement, and
has complied with the provisions thereof, and will require similar compliance from all contractors or sub-contractors employed •y 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 suh•contrac , on work to be performed under this p it as are
licensed by Miami Shores Village.
3 � ✓ � Mas" Electrician.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths
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.
and take acknowledgments,
personally
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.
/6
'7
Permit No.....///5
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submi(ted 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
Type of Installation — Conduit
STATE OF FLORIDA, 1
COUNTY OF DADE. I
fl MIA
APPLICATION FOR ELECTRICAL PERMIT
65.
12.
Registered Architect and /or Engineer
Employing Electrician's Name
Location and Legal Description Lot / .v
/ Block s —� Subdivision
�/ E. ‘ 1 3/ C Street
State work to be performed and purpose of building (By Floors)
Street and Number where work is to be performed —No
New Building \f Remodeling Addition
ELECTRICAL INSPECTION DEPARTMENT
Service Overhead Site Feeders / Conduit.../ ,.Main Sw / 9 Amps Main Fuses Amps
incirrgrnnnrl
B.X.L Metal Moulding
SRORES VILLAGE
No Street
No
9 3. Street
Repairs No. of Stories
Amount of Permit $... (Signed)
Electrical Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of
labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and
has complied with the provisions thereof, and will require similar compliance from all contractors or subcontractors employed by him in the
work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices
as are required by the Act. The undersigned agrees to employ only such subcontractors, on work to be performed under this permit, as are
licensed by Miami Shores Village.
(Signed)C.. ' 'f -s �G•�li E � ..
Master Electrician.
Date
My Commission Expires Notary Public, State d
NOTE: A re-inspection fee of $1.00 will be made when such re-inspection is made necessary by improper noti
materials and /or workmanship.
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 th
therein by him stated are true.
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
C L ST
/
o 7
c I , p p " � r �
:f
O
A / 6
/
/ � j
��°
/
Ri
/
•2 q
/
9-- v /d
{,/&.
V ( )
CHECK
ENT.
SW.
DIST.
CAB.
SERVICE
TEMP.
SERVICE
PERM.
MOTORS
0.1 HP
M OTORS
1.5 HP
N EON
TRANS.
RADIO
TOTAL
CONTR.
LI ST
1(9%
_
'
,
CHECK
/ 0
-
P
..
_
/6
'7
Permit No.....///5
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submi(ted 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
Type of Installation — Conduit
STATE OF FLORIDA, 1
COUNTY OF DADE. I
fl MIA
APPLICATION FOR ELECTRICAL PERMIT
65.
12.
Registered Architect and /or Engineer
Employing Electrician's Name
Location and Legal Description Lot / .v
/ Block s —� Subdivision
�/ E. ‘ 1 3/ C Street
State work to be performed and purpose of building (By Floors)
Street and Number where work is to be performed —No
New Building \f Remodeling Addition
ELECTRICAL INSPECTION DEPARTMENT
Service Overhead Site Feeders / Conduit.../ ,.Main Sw / 9 Amps Main Fuses Amps
incirrgrnnnrl
B.X.L Metal Moulding
SRORES VILLAGE
No Street
No
9 3. Street
Repairs No. of Stories
Amount of Permit $... (Signed)
Electrical Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of
labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and
has complied with the provisions thereof, and will require similar compliance from all contractors or subcontractors employed by him in the
work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices
as are required by the Act. The undersigned agrees to employ only such subcontractors, on work to be performed under this permit, as are
licensed by Miami Shores Village.
(Signed)C.. ' 'f -s �G•�li E � ..
Master Electrician.
Date
My Commission Expires Notary Public, State d
NOTE: A re-inspection fee of $1.00 will be made when such re-inspection is made necessary by improper noti
materials and /or workmanship.
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 th
therein by him stated are true.
BUILDING
PERMIT APPLICATION
FBC 2001
Permit Type (circle): Building Electrical Plumbing
Owner's Name (Fee Simple Titleholder) lac'\ - S - Vmk.i._ � N Phone #
Owner's Address ''+ -3 �- �! S G
City ''/"c J h o07P tate /= - Zip
Tenant/Lessee Name Phone #
Job Address (where the work is being done)
City Miami Shores Village
•
Miami Shores Village
RECEuVi =° ldin Department
SEP 0 0 2003 g p
$ Value of Work For this Permit " � ��
iechanica
Permit No. kl 00g— no
Master Permit No.
Roofing
County Miami -Dade Zip '3(
Is Building Historically Designated YES NO
' Name � cd):-C ,,f4C ;7 Phone #
Contractor's Company
Contractor s Address c�� c�� � ��
City C� � State / 1Q -- Zip 330-23
Qualify -i (4I - / ' t- 4
* * * * * * * * * * * * * * * * * * * * * * * * * * ** F ees * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
Architect/Engineer's Name (if applicable) • Phone #
Architect/Engineer's Address
City State Zip
Square Footage Of Work:
Number of: Bays Stories Families edrooms Baths
Type of Work: ❑Addi p / ❑Alteration , ❑New Repair/Replace ❑ Demolition
Describe Work: . �y 2 &C < �'.A''r_�'y 7-�' -s ) ��
X19, �& --, - is � �A /, R y7 ,
v -e - / �
County Escrow Fee $ 2 O Permit Fee $ 9 (e- Notary $
Education/Training Fee $ Tech $ Scanning $ Radon $
Code Enforcement $ Bond $ Str uct. $
Minus Plans Check Fee $ Total Fee Now Due $ �j l� n y0 (Continued on opposite side)
?aM 3 Cc
Bonding Company's Name (if applicable)
Bonding Company's Address
City State Zip
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
City State Zip
Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has
commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating
construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS,
WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC
OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all
applicable laws regulating construction and zoning.
"WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR
PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING,
CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
COMMENCEMENT."
Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be p ted at the job site
for the first inspection whic occurs seven (7) days after the building permit is issued. In the absence of sucl/pjsted notice, the
inspection will no 2 , pi? -d and reinsp c ' n fe / 11 be charged.
M
chc7/7 /03
Owner or Agent
The foregoing instrument was acknowledged before me this 3
day of � tom, 20 _, by N At 1 A A∎<
who is personally known to me or who has produced
As iden lion and who did take an oath.
APPLICATION APPROVED BY:
The foregoing instrument was acknowledged before me this 3
day or, k. • , 200.5 , by i R 11-t. 0 (-}-.P eL e t L ,
who is personally known to me or
has produced
identificatio and who did take an oath.
• .ig- es
NOTARY PUBLIC:
Sign:
Print:
g .s
• My cnmmi:eim IM174mi
My Co mission Expires: Expires August 03, 2006
My Commission Expire .of Expires August 03, 2006
(Certificate of Competency Holder)
State Certificate or Registration No. cA C 04 r .Y 2 Certificate of Competency No.
4 1, v �- ,3 C ( 1 c'1 Plans Examiner
Engineer
Zoning
TEM
ATH TUB
UNIT
FEE
ITEM
SWITCH OUTLETS
UNIT
FEE
ITEM
SPACE HEATERS
UNIT
FEE
IDET
LIGHT OUTLETS
CENTRAL HEATING
,ISHWASHER
RECEPTACLES
A/C (WIND)
iISPOSAL
SERVICE TEMPORARY
,
A/C (CENTRAL)
X
RINKING FOUNTAIN
SERVICE SIZE IN AMPS
DUCT WORK
'LOOK DRAIN
SERVICE REPAIR/METER CHANGE
REFRIGERATION
;REASE TRAP
APPLIANCE CURETS
PROCESS AND PRESS PIPING
NTERCEPTOR
RANGE TCP
UNDERGROUND TANKS
OVEN
ABOVE GROUND TANKS
.AVATORY
TRAY
WATER HEATER
U.F. PRESSURE VESSELS
.AUNDRY
:LOTHES WASHER
MOTORS 0- 1 HP
STEAM BOILERS
.TOWER
MOTORS OVER 1- 3 HP
HOT WATER BOILERS
;INK, POT /3 COMP.
MOTORS OVER 3- 5 HP
MECHANICAL VENTILATION
;INK, RESIDENCE
MOTORS OVER 5- 8 HP
TRANSPORTING ASSEMBLIES
;INK, SLOP
MOTORS OVER 8- 10 HP
ELEVATORS/ESCALATORS
TEMPORARY WATER CLOSET
MOTORS OVER 10- 25 HP
FIRE SPRINKLER SYSTEMS
JRINAL
MOTORS OVER 25-100 FP
COOLING TOWERS
WATER CLOSET
MOTORS OVER 100 FP
VIOLATION
INDIRECT WASTES
A/C WINDOW
REINSPECTION
MATER SUPPLY TO:
AIR CONDITIONERS
A/C UNIT
STRIP HEATER
1
FIRE SPRINKLER
GENERATORS TRANSFORMERS
HEATER -NEW INST.
GENERATORS TRANSFORMERS
HEATER - REPLACE
GENERATORS TRANSFORMERS
LAWN SPRINKLER -WELL
SPECIAL PURPOSE
SWIMMING POOL
CUTLETS COMIM€RC I AL
WATER SERVICE
SIGN TUBES
SEWER CONNECTIONS
SIGN TRANSFORMERS
JTILITY -SEWER
SIGN TIME CLOCK
JTILITY -WATER
FIXTURES
SEPTIC TANK
ANTENNA
IELAY
TELEVISION OUTLETS
)RAINFIELD, 4' TILE/RES.
VIOLATION
'LAP & ABANDON SEPTIC TANK
REINSPECTION
SOAKAGE PIT CU. FT.
CATCH BASIN
DISCHARGE WELL
DOMESTIC WELL
AREA DRAIN
ROOF INLET
SOLAR WATER HEATER
=IRE STANDPIPE
POOL PIPING
LAWN SPRINKLER SYSTEM
GAS RANGE
METER SET (GAS)
GAS PIPING
-1 ADDENDUM TO BUILDING PERMIT APPLICATION
AN APPLICATION FOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. IF A MASTER PERMIT HAS B.
OBTAINED, THE OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.)
PLUMBING
ELECTRICAL
MECHANICAL
ELECTRICAL
TYPE
Minimum Fee
QTY. TYPE
Dryer
QTY. 'rm.:
Outlet, Appliance
QTY.
'rl'rf:
Service Repair
QTY.
A/C Central 1 -3 Ton
Fan
Outlet, Wall
Service, Temporary
A/C Central 4 -7 Ton
Fire Pump
Outlet, Switch
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
" ::: _
Plugmold/Strip
Subfeeds, No of Amps
A/C Window
FPL - Load • ntr •
Posts
Swim Pool, Commercial
Air Conditioners
Chiller
Garbage 1 s s i .1
r_.� -- ter.._ –..
• .. ° /, WC - _
Range/Range Top
.�
,,, Receptacles
--
Swim Pool, Residential
Switchboards
-
Clear Violations
Heat R
Refrigerator, Comm. (p/PH)
Temp Serv., Construction
Compactor
' ow-
Refrigerator, Domestic
Temp for Test - 30 days
Deep Freezer
Low -volt, Fire
Renew - Temp Service
Dental Chair
Demolition
Low -volt, Intercom/Teleph.
Repair Circuits
Utility - Sewer
Dishwasher
Low -volt, Television
Service, Number of Amps
Pump, Sump
MECHANICAL
Tl'1'E.
Minimum Fee
QTY.
TYI'i
Condensate Drain
QTY.
'I'1'1'I:
Generator
QT1.
T1'1 %.
Refrigeration, Tons
Q•rl .
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
Supply, AC Well
Bath Fan - Vented, #
Fireplaces, Number of
Pressure Vessel
--
Temporary Toilet
-
PLUMBING
TYPE
A/C Condensate
QTY
TYPE
Drains, Roof
QTY"
TYI'I:
Miscellaneous Fixture
VI Y
'11 PE
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
1 in
r i
I
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:
,ep"zr/
DATE: ..;7.-7-5'W-°,c'_>
SECTION
BY
DATE
Zoning
Electrical
"il
vim, %'v_
Mechanical
Plumbing
.
Fire
Public Works
Structural
Building Official
Page 4
OFFICE USE ONLY
CI1ECKLIST
❑ OWNER - BUILDER FORM
(Attach)
❑ FIRE DEPARTMENT
APPROVAL (Commercial /
multi - family)
❑ CONCURRENCY
(New Construction)
❑ OTHER
(Specify & Attach)
$3.00 per page (Scanning Fee)
Miami Shores Village
Bond
Metropolitan Dade County (C.C.F.) $
Inspector State Educational Fund $
State DCA (Radon) $
Code Enforcement Fine
Zoning Review
REVIEWED AND PREPARED BY:
❑ PROOF OF OWNERSHIP
(Attach)
❑ HRS / DERM APPROVAL
(Septic / Sewer)
O IMPACT FEE
(New Construction)
❑ OTHER
(Specify & Attach)
PLRAIIT FEES
(sq.ft. = x/1000
x ¢.60)
(¢.005 /sq.ft.)
(¢.01 /sq.ft.)
PERMIT APPLICATION
❑ CONDO ASSOCIATION APPROVAL
(Attach)
❑ BPR APPROVAL (Restaurants)
❑ CONTRACTOR REGISTRATION
(On File)
TOTAL $
DATE: ' e/ )
CONDI'T'ION OF APPROVAL
Revised July 2001
10050 N.E. 2ND AVE., MIAMI SHORES, FL • (305) 795 -2207 • FAX (305) 756 -8972 • http:/ /www.miamishoresvillage.com
Page 2
1\II'OIt 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.
FFI m\'I "1' - 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 $2,500 or intend to obtain financing, you may wish to consult with
your attorney or lender before recording your Notice of Commencement. The Notice of Commencement must be recorded at:
22 N.W. 1st Street, 1" Floor, (305) 679 -1078. Once recorded, the Notice of Commencement must be POSTED AT THE JOB SITE in
accordance with Section 713 -35 of Florida Statutes. Review the brochure at Village Hall on Construction Lien Law and
Choosing a Contractor.
STATE OF
"
RI A, 5j$LcW-MIAMI-DADE
Signature o Owner
Print Name
Sworn to and subscribed before me this 13
Signature of
SEAL:
Personally known
JoH4 i
JU 1r, ROBLES
MY COMMISSION It CC 921872
• • a EXPIRES: June 4 2004
t vr Bonded Thru Notary Public Undeiwrilers
OR, Produced Identification
Type of Identification Produced:
STATE OF FLORIDA, C OF MIAMI - DADE
Signature
Prin ame
w nd subscribed before me this f ‘
•
Signature of
SEAL:
PERMIT APPLICATION
UO ROBLES
*= MY COMMISSION e C.C, 92
EXPIRES: flume n, e onA •
J4; Bonded Thru Nola, Um*:
Personally known OR, Produced Identification
Type of Identification Produced:
CONTRACTOR
Name� //
5 „ j
Liee�se No. C r, .0 A o b ?...../
Address fl A/A) / /t; L(/a •
i-I4 /t 3 3 1yy
/_
Telephone gi g pyry - Fax
Qualifier Name d
� L . Gi l _
PROPERTY OWNER
Name ,,ajJV Oie/CAed r /(7414/577A/e--
Address ,.r3 , fie
Home Telephon IS
0
7 7 0 9 /
Business Telephone
Fax
TYPE OF MANAGEMENT (✓ )
New Construction
Enclosure
Alteration Exterior
Repair
Alteration Interior
Demolish
Relocation of Structure
Shell Only
Foundation Only
Add'I Attachment
Other _
Add'I Detachment
Other
VR&F
INSTRUCTIONS - The following steps must be fake[! 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
3 S3 sr
Address
inrcrovro
Folio Number / • 0/3 -4//
Lot Block
Subdivision PB PG
PERMIT TYPE (✓ )
Building
Electrical
Mechanical
Plumbing
LPGX
Roofing
Fence
Other
Apt.
PERMIT CHANGE (✓ )
Chg. Contractor
Renewal
Revision
Extension
Supplement
Reinspection
ARCHITECT
Name
License No.
Address
Telephone
Fax
Master Permit No. E I c 3 —
SP 2 3 200 Subsidiary Permit No.
/41 Sh6/
City
Description of Wprk
Zoning /
Square Feet
Value of Work
f2
PERMIT APPLICATION
334J:9
Zip
Linear Feet
Units Floors
Bldg Value
Tax Assessed/Appraised Value
Flood Zone Base Floor Elev.
ENGINEER
Name
License No.
Address
Telephone
Fax
SEP 3 ()PAID 4etel $ CC) C.X.
APPLICATION FOR CERTIFICATE OF RE- OCCUPANCY
1, g 2 o r 5 t e' / / U E �/'r >i k e , hereby apply for a certificate
to re- occupy the single family residence known as: (address)
353 Al 9g S 7 r e e—� , Miami Shores, Florida.
Legal Description:
Lot: / 1 Bbock ! S
Applicant
Print
v �9 e e[ LCIC
PB & PG: /0 — 70
I hereby certify that I understand that the zoning of the property is for single- family residential use
and that it is unlawful for more than one family to reside therein. I also understand that any
Certificate of Re- Occupancy that may be issued by Miami Shores Village, certifies only that the
referenced property is being used for single - family purposes and that such Certificate does not
constitute any representation, warranty or certification as to the condition of the dwelling or other
structures on such
Dated //3_
* * ** 1 * * * * * ** * * * * * * * * * * * * * * * * * * * * * * * * * *z_ * * **
For purposes of conducting the inspection required by Section 902 of the Miami Shores Land
Development and Zoning Code, please contact:
gbf
_ 6-
Contact Name: E 51-A �p h Q t (, or, 2� / .22 Telephone: 76 ni 9 5? -'e 71, 3 4/
Buyer Seller Realtor < Company Name at) 10/1.0 Li( k°) m k,-
Application Fee (S50) paid: Cash Check No. 1? SS
K Inspected by: Approved Denied Date
Comments:
PAGE 1OF2
CER'l IF KATE OF RE- OCCUPANCY
On behalf of Miami Shores Village, Florida, the undersigned certifies that the property
described in the above application has bee inspected for purposes of re- occupancy pursuant to
Sections 901 and 902 of the Miami Shores Land Development and Zoning Code and that such
property may be re- occupied by the above applicant for single - family residential purposes.
MIAMI SHORES VILLAGE, FLORIDA
By
Date of Certification:
THIS (J R'11kICATE VERIFIES THAT THE REFERENCED
PROPERTY HAS BEEN INSPECTED BY MIAMI SHORES
VILLAGE AND HAS BEEN DETERMINED TO PRESENTLY
COMPLY WITH THE SCHEDULE OF REGULATIONS OF THE
MIAMI SHORES LAND AND DEVELOPMENT CODE
PERTAINING SOLELY TO THE REQUIREMENT THAT EACH
ONE - FAMILY DWELLING IS USED AND INTENDED TO BE
USED FOR A ONE - FAMILY DWELLING PURPOSE ONLY;
HOWEVER, THIS CER nHCATE DOES NOT CONSTITUTE ANY -
REPRESENTATION OR WARRANTY AS TO THE CONDITION
OF THE DWELLING OR OTHER STRUCTURES ON THE
PREMISES DESCRIBED HEREIN, OR ANY ASPECT OF SUCH
CONDITIONS AND INTERESTED PERSONS ARE ADVISED AND
ENCOURAGED TO MAKE THEIR OWN INSPECTION OF THE
PREMISES IN ORDER TO DETERMINE THE CONDITION,
THEREOF.
PAGE 2 .OF 2
Miami Shores Village
10050 NE 2nd Avenue
Phone: 305 - 795 -2204 Permit Number: EL2003 -72
Printed: 3/18/2003
Applicant: KEVIN TROIKE
Owner: TROIKE KEVIN
JOB ADDRESS: 353 NE 94 ST
Contractor P & M ELECTRIC INC Contractor's Address: 1936 NE 148 ST
Local Phone: 305 - 949 -6373
Parcel # 1132060136110 Legal Description: MIAMI SHORES SEC 1 AMD PB 10 -70 LOT 12 & W2OFT OF LOT 13 BLK 45 LOT SIZE
e _e.uv .1)K, A 6o. 0 0
C ( ` S o O
Permit Status: APPROVED Permit Expiration: 9/10/2003
Work: ELECTRICAL UPDATE
If there is no permit
fee is $50.00, which mi
This is granted to (hi
ordinances pertaining thereto
and approved by the proper m
authorization. A further condit
ordinances and regulations pe
by his agents, servants or emp
Signe
In consideration of the issuai
with the plans, drawings, states
myself, my agent ts or
PAY TO THE
ORDER Cr,
D / Signed: / (4 MEMO
Electrical Permit
s, o
Construction Value:
P & M ELECTRIC, INC.
1936 N.E. 148TH STREET
NORTH MIAMI, FL 33181 -1137
$4,700.00
Page 1 of 1
ktOD
Total Fees: $DSO
Total Receipts: $0.00
Bank of America
ACH R/T 063100277
3
Q
11'00746311' 1:0630C/004 7f: 00 L59 5 29 20 L L
DOLLARS
7463
63 -4/630 FL
1348
I)(?IP LOOP
m BE 30'
(AFB; CHIN)
. •rl-
• ' 200A
METER
2' 1 \HCIVE ROOF
aY 80(CD41
rua w +a
piAsitc
st.c�a)is
F111T511ED (RA7lE
ITvc SLICE
PANEL
1
1J'U' )114 hEP T11
MAIN CB
•
r •
1
ouzo 04 101-.11
•
TEN) Isar
J st.
Ir
nun Qulu
•
•
MIN. ➢IS;OIJNECT
SUB C
- PANEL
PER S.F•D.C,
• ,CONTRI
'I-10011•4•_
Concluc'.•or s Cce
' Condui size
Conduit type-
- r -u roof
Ground wlr-c ritz e_
R aline
Han
Slab Breakers
1
SIGNATURE OF CONTRACTOR
NOTARY
110
0v ArpS
_An p
SUB FEEDS
Ner+ _
Type
Size 4r
Bond �'lze -
II SEDE PANEL ) -�
Rating �/ A,4Is
Bond BL.s S .__ •%es _ __ J•JQ
1)
n5os,7(t )
e
Y\./
(\, -) \/ I- )
BY _ •
.. ..
•
• • ..
• • •
• • •••• •
.
• .
•••• • •
• • • •
• •
•
• •
•••• • ..
• • •
•••
• ••••
• •
• ••••
•
• - • • •
• . ..
• • • •
fine Slale
KEVIN JOHN TROIKE
353 NE 94 ST
IAMI SHORES. FL 33138 -0000
10 -07 -60 M 6 -01
.,,.
, - , r10-08-1992
T620- 510 -60- 367 -0 "a? -07 1999
CLASS: E
SAFE DR VER =7 -08-
ELECTRICAL
TYPE
Minimum Fee
QTY.
TYPE.
Dryer a
e r'' ,
r111
i utl : , Appli41ce
QTY.
T1 PI':
Service Repair r Ra e
Q'FY.!
,
A/C Central 1 -3 Ton
Fan
Dryer Vents, Number of
OutleT, *an'
Ventilation, Cost
Service, Temporary
Air Handler, Tons
A/C Central 4 -7 Ton
Piping, Flammable Liquid
Fire Pump
Outlet, Switch
Fire Sprinkler System
Signs
A/C Central 8 -15 Ton
Bath Fan - Vented, #
Fixture - Fluorescent
Pressure Vessel
Oven
Space Heater (kw)
A/C Central 16-20 Ton
Fixture Light
Parking Lot Lights
Spas/Hot Tubs
A/C Central 20+ Ton
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
Minimum Fee
QTY. TYPE
Condensate Drain
QTY. TYPE
Generator
QT1'. TYPE
Refrigeration, Tons
QTY !
A/C Central, Tons
Cooling Tower
Heating Strips, each
Vent Hood, Cost
A/C Wall/Win. Tons
Dryer Vents, Number of
Paint Booth
Ventilation, Cost
Solar Water Heater
Air Handler, Tons
Ductwork, Cost of
Piping, Flammable Liquid
Periodic Inspections
Barbecue
Fire Sprinkler System
Process/Pressure Piping
Cap - Fixture
Bath Fan - Vented, #
Fireplaces, Number of
Pressure Vessel
Pump and Abandon
PLUMBING
TYPE
A/C Condensate
QTY.
TYPE
Drains, Roof
QTY.
TYPE
Miscellaneous Fixture
cm'.
TYPF:
Soakage Pit
Q r Y.
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
• • • •
• • • • • • • • • • •
• • • • • • PERMIT APPLICATION
• ••••••• ..•.
.•.
• •
• •• •
•
•••
INSTRUCTIONS: Please indicate the type of w.oi2c be irk pet'Itrmgd gnii guantity(ies) in the space provided below.
•
RECEIVED AND REVIEWED BY: DATE:
SECTION
BY
DATE
Zonin •
Electrical
- % /���
/pre 8
Mechanical
Plumbing
Fire
Public Works
Structural
Building Official
Page 4
OFFICE USE ONLY
❑ OWNER - BUILDER FORM
(Attach)
O 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
Notary
• • • •
• • • • •
• • • • • •
•••• •• •
•
• •
• •
••. •
• •
❑ IMPACT FEE
(New Construction)
c3
$
$ O
•
•.•
•
CHECKLIST
• • • •
O P11OOF'OF OWNERSHIP •
(Attach)
•• •• • •• • • • ••
• • • • • • • •
❑ HR$ 7 DER34 74)3OZ✓AX
(Septic i 8ev<+er): • • • :
❑ OTHER
(Specify & Attach)
•
( x .60) x/1000
(¢.005 /sq.ft.)
(¢.01 /sq.ft.)
•
•
• •
PERMIT APPLICATION
❑ CONDO ASSOCIATION APPROVAL
(Attach)
❑ BPR APPROVAL (Restaurants)
O CONTRACTOR REGISTRATION
(On File)
PERMIT FEES
TOTAL $ 63 0 0
ISSUING OFFICIAL
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
Page 2
• •• •
• • • • • • • • • •
• • • ••• • •
• • • • • • • •
•••• ••••••• •
PERMIT APPLICATION
IMPORTANT NOTICES
DO NOT BEGIN ANY WORK WITHOUT HAVING RrCpVXLIYOU& vALIt (ATED HERMIT AND PERMIT CARD. Applying for a permit does not grant
the right to begin construction. HOURS OF CONSTRUCTION are limited to: RAbAday 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 iNl2 S CONDITION free from construction debris.
3. STREETS AND NEIGHBORING PROPERTIES SHALL Bt k.EPVF EE FROM +IRT AND JIEBRIS.
4. SWALES MUST BE PROTECTED FROM BEING DAMA1iED OIR 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.
TA
ORIDA, COUNT I F MIAMI -DADE
ignature of Owne c
Print Name
worn to and subscribed before me this
Signature of i,i•tary Public - tate of orida c3,+�o
900z • )9O'lt'? ? Hidx
Y � ;;yLuV � 7d A i fi
SEAL:
Personally known OR, Produced Identification
Type of Identification Produced: rL f 0 —
TATE�OF FLOR Y OF I�ADE
Signature of Contractor / Qualifier
Print Name
S .rn to and subscribed before me this ` v
/
SEAL:
gnature s Nota ' ' .c - State df Flori
anoN sands v ro
Personally known ■ 61?, cea iaeen` iikauo
, a )4098 ya eIOBuV
pe of Identification Produced:
CONTRACTOR
Name 4m (/ �
i '
G � :
License No. �, 0 n `0 T
Address t 3, / i _ 1 945 t
.1\ R..3 1c
Telephone Q v9 1O / 3 Fax. 5 9
-em 9S 7
( 77 /
Qualifier Nam 1 R. l /fin ads -
Q
/PROPERTY OWNER
New Construction
e
rC p�t/-,n„ /Zei/A SL
Enclosure
Address Js-3 vi/a `e
Alteration Exterior
l
Home Telephoqe03 75, /3 4/
h Pi
Business Telephhor „ / l
z �
S
Fax
TYPE OF MANAGEMENT (✓ )
New Construction
/
Enclosure
Alteration Exterior
V
Repair
Alteration Interior
Demolish
Relocation of Structure
Shell Only
Foundation Only
Add'I Attachment
Other
Add'l Detachment
Other
INSTRUCTIONS - The following steps oust be taken to obtain a permit from the Miami Shores Village:
Step 1. Complete the attached permit application which must bo si�nad l Pthe 6i'bbertJewner and qualifier Both signatures must be notarized Please
print or type to allow for a more accurate processing of yaur p:ljc'9tiQif. If 'to work will be done, a roofing application must be submit-
ted 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 PPLlC VI'ION
Job Address: 3 ? / °' v 7� 5 /12i vvyi;
Address
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
Block
Apt.
.. •
PERMIT CHANGE (✓ )
Chg. Contractor
Renewal
Revision
Extension
Supplement
Reinspection
ARCHITECT
Name
License No.
Address
Telephone
Fax
• • - .. .. •
• • • .. •
• • • .
• • • • • • • • • • • •
.
• ..• • • •
City
State
ascription of Work /i.
PERMIT APPLICATION
t OO - 2
••• • Mastgr P No.
• •• •
• • • • • • Subsid i airy •Permit No.
35)5
Zip
Zoning Linear Feet
Square Feet Units Floors
L' �� a l ue of Work t'''' 9'2oo i ,7 Bldg Value
Ta3t Assessed/Appraised
Flood Zone
Base Floor Elev.
ENGINEER
Name
License No.
Address
Telephone
Fax