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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