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ELECTRICALD Permit No. Name Address Company Phone # MIAMI SHORES VILLAGE BUILDING DEPARTM NT 305- 795 -2204 Building Inspection Reques, Time Type Insp'n M1-C For Inspector / 1 / N Name & Date Approved Correction Re- Insp'n Fee i MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date Time Type Insp'� � O- , ff (G Permit No. — Name Address Compa Phone # Approved Correction Re- Insp'n Fee For Inspector: 1 1 1 03 ❑ 7 i/„w -- .• 'A Date Type Ins Permit No. Name Address Phone # For Inspector: Approved Correction Re-Insp'n Fee MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Reques Compan�'' Tim Name & Date o MIAMI SHORES VILLAGE / BUILDING DEPARTMENT / 305- 795 -2204 Building Inspection Request Date Time ) �_ Type Insp' � 9st�if' // gfi° Permit No. - ' t9 3 Name Address Company Phone # For Inspector: Approved Correction Re- Insp'n Fee 95 °� /D' / (0/. i f Date Type Insp n Permit No. Comp Phone # MIAMI SHORES VILLA BUILDING DEPARTME 305- 795 -2204 Building Inspection Request Time Address C9 -- 1b / For Inspector: OA Name & D Approved Correction Re- Insp'n Fee Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Permit Number: EL2003 -106 Printed: 4/28/2003 Applicant: MARIA Owner: JORGE JOB ADDRESS: 42 Contractor LIGHTING IMPRESSIONS Local Phone: 954- 327 -1444 Parcel # 1132060130330 Signed: NE 94 Electrical Permit JORGE MARIA ST Contractor's Address: 2555 SUGARLOAF LANE Page 1 of 1 Legal Description: MIAMI SHORES SEC 1 AMD PB 10 -70 LOT 7 & E1/2 OF LOT 8 BLK 3 LOT SIZE Fees: Description Amount FEE2003 -2522 Building Permit Application Fee $60.00 $60.00 Total Fees: Total Fees: $60.00 Total Receipts: $0.00 Permit Status: APPROVED Permit Expiration: 10/25/2003 Construction Value: $1,200.00 Work: RE -WIRE HOUSE AS PER MIKE DEVANEY 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. (Contractor or Builder) BY: iii ^ .r. - U� i;� r . 7U 1 � u u 1 r ,i "i,v 1 PERMIT APPLICATION FOR MIAMI SHORES VILLAG 10050 N.E 2nd Avenue • Miami Shores, Florida 33138 • Phone: 305- 795 -2204 • Fax: 3 Date A • A • QS Job Address 42 A 3' Tax Folio Legal Description ''A �%'/1 Historically Designated: Yes Owner /Lessee/Tenet �, ® Q Master Permit '# v ' c: 3 Owner's Address A Z Contracting Co. •— 1:10 _. ®V.A`S Address . gS5S ` Oefpf. - Qualifier %I ® >4 State # Municipal # Competency # Ins. Co. IF THERE IS NO PERMIT PACKAGE ACCESSIBLE ON THE JOB SITE FOR INSPECTORS TO VERIFY, THERE WILL BE NO INSPECTION. RE- INSPECTION FEE IS $50.00 AND MUST BE PAID IN ADVANCE BEFORE CALLING FOR ANOTHER INSPECTION. EC WORK DESCRIPTION: ° NI OSS. �� d °-= 2,E.- °-= 2,E.- Permit Type (circle one): BUILDING Phone Square Ft. Estimated Cost (value) \ 7-,O0 ,E,C EDVED 2 2 2003 SS# Phone SA • 2 a7 • AAA PLUMBING MECHANICAL ROOFING 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 OBTAIIN FINANCING, CONSULT WITH YOUR LENDER OR ANY 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 all disciplines. OWNERS AFFIDAVIT: 1 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 owner and/or Condo President Notary as to Owner and/or Condo President My Commission Expires Date Sign FEES: PERMIT ‘e CPO RADON APPROVED: Zoning Building Electrical Mechanical Plumbing EDWIN L WH.KING MY COMMISSION M CC 867247 EXPIRE a u Date Notary as to Contractor or Owner Build My Commission Expires l 1 C.C.F TOTAL DUE Date Date BOND Structural Engineer 7:.4 ;TH TLB UNIT FEE ITEM SWITO1 OUTLETS UNIT 7, FEE ITEM SPACE hEATERS UNIT FEE CET LIGHT OUTLETS (w CENTRAL NEATING ISHWAS�iER RECEPTACLES t% A/C (WIND) 1S?OSAL SERVICE TEW /RY A/C (CENTRAL) ;INKING FOUNTAIN SERVICE SIZE IN ARS DUCT K K .CDR DRAIN SERVICE REPAIRMTER CHANGE REFRIGERATION ;EASE TRAP APPLIANCE OUTLETS PROCESS AND PRESS PIPING iTERCEPTOR RANGE TOP UNDERGROUIO TANKS ;VATORY OVEN ABOVE GROUND TANKS :UNDRY TRAY RATER HEATER U.F. PRESSURE VESSELS _OTHES WASHER I1DTCAS 0- 1 HP STEAM BOILERS OWER MOTCAS OVER 1- 3 HP HOT WATER BOILERS INK, POT/3 COMP. M)TCAS OVER 3- 5 NP MECHANICAL VENTILATION INK, RESIDENCE MOTORS OVER 5- 8 FP TRANSPORTING ASSE FLIES INK, SLOP MICAS OVER 8- 10 HP ELEVATORS/ESCALATORS EWORARY WATER CLOSET MJTCPS OVER 10- 25 HP FIRE SPRINKLER SYSTEMS ;INAL MOTORS OVER 25-100 HP COOLING TOWERS ;TER CLOSET MJTCAS OVER 100 FP VIOLATION "DIRECT WASTES A/C WINDOW REINSPECTION ATER SUPPLY TO: ^r AIR CONDITIONERS A/C UNIT STRIP HEATER FIRE SPRINKLER GENERATORS TRANSFORMERS HEATER -NEW INST. GENERATORS TRANSFORMERS HEATER- REPLACE GENERATORS TRANSFCR1€RS LAWN SPRINKLER -WELL SPECIAL FUME SWIWING POOL CUTLETS COWERCIAL WATER SERVICE SIGN TUBES :WER CONNECTIONS SIGN TRANSFORMERS "ILITY -SEWER SIGN TIME CLOCK "ILITY -WATER FIXTURES ?TIC TANK ANTENNA :LAY TELEVISION OMITS AIRFIELD, 4' TILE/RES. VIOLATION • A E ABANDON SEPTIC TANK REINSPECTION ':RAGE PIT CU. FT. .TCH BASIN SOHARGE WELL MESTIC WELL EA CRAIN CF IILET LAR WATER HEATER RE STANDPIPE CL PIPING . 01 SPRINKLER SYSTEM S RANGE TER SET (GAS) S PIPING AN APPLICATION FOR BUILDING PERMIT RUST ACCOMPANY THIS ADDENDUM. IF A MASTER PERMIT HAS B. 03TAINE'b, THE OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.) PLUMBING ELECTRICAL MECHANICAL Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Printed: 2/4/2003 Applicant: MARIA Owner: JORGE JOB ADDRESS: 42 Contractor LIGHTING IMPRESSIONS Local Phone: 954- 327 -1444 Parcel # 1132060130330 NE 94 Electrical Permit Permit Number: EL2003 -28 JORGE MARIA ST i Total Fees: Total Receipts: $0.00 Permit Status: APPROVED Permit Expiration: 8/3/2003 Construction Value: work: KITCHEN REMODELING UPGRADE PANEL AND SERVICE �\- If there is no permit pal � �� f a is $50.00, which must This Permit is granted to the cc ordinances pertaining thereto and and approved by the proper muni authorization. A further condition ordinances and regulations perta by his agents, servants or emplo! Contractor's Address: 2555 SUGARLOAF LANE Page 1 of 1 Legal Description: MIAMI SHORES SEC 1 AMD PB 10 -70 LOT 7 & E1/2 OF LOT 8 BLK 3 LOT SIZE PAY TO THE ORDER OF FOR LEADING BUILDERS CORP OPERATING ACCOUNT 1437 NW 9th ST DANIA, FL 33004 'CAk( S AA N~7A.j t 11YLT6643 bbl 4 1 I y FIRST UNION NATIONAL BANK OF FLORIDA R/T 067006432 63- 643/670 4 b() (hAl tk1V11 4i0 IMO i 4 79 ! 70064 3 21: 200000 7 38 10 500• THIS DOCUMENT CONTAINS A COLORED BACKOROUNOON_ WHITE PAPER,_MIOROPRINT 19.LOOATED SELOW- Tyl9_WARNINO BANQ, 1479 $ 1 99— DOLLARS Signed In consideration of the issuanc with the plans, drawings, statem myself, my agent, servants or ei Signed: Li 171 A DMSION OF AQUATRONIGS CORPORMN' : EC0001093 .• • • • • • • • • • • • • • • • • • .•. • ••• • •• • • • • • • •• • • • • • • • ••• • • • •• •• • inl • . '. • • •• ••• •• • • .••- H--t LAN • 'U 5wrIcH ON ,4 T71MM 53 5 -wA swrrH af j _•• PRIOR TO INSTALLATION OF ROUGH y��1 // ELECTRIC WIRING Y'I 12W NAMEPLATE DATA OF AIC EQUIPMENT, HOT WATER HEATERS AND OT,rE "EQUIPMENT TO OBTAIN CORRECT WIRE SIZES AND OVERCURRENT PROTECTION. aDECriMg SEI°3vOC[ . CQPQCO4f1 MU$T PROD MOD[ D., SUC3JECT ELECTRICAL INSPECTION. 2555 SUGARLOAF LANE • FORT LAUDERDALE, FL 33312 • (954) 327 -1444 .... • • • •..... •.... • • 0000 • •..l • . • • ... • • • ...... METERCAN COMBO 120/240V 200 A MAIN C/B 10,000AIC • ..... • •• •• • • • • . ...... 3 -2/0 THHN /W CU IN 2 IMC ..... . • • • • #4 bare CU cu gnd stake 9 1/0 AL TRIPLEX, 50' 3 -2/0 & THHN /W CU In 2 EMT 0 cW HOUSE PANEL 200A 120/240V ML❑ 100' LIGHTING IMPRESSIONS 1- 29 -03(df d) 50 kVA, z= 1.178% MARIA JORGE RESIDENCE, 42 NE 94TH STREET, MIAMI SHORES Filename: Jorge.rrr ... • • • • • • •• -. -.'y • L.. Lighting and Small Appliance /Laundry Circuits Floor Area SmAppNo LaundNo Line..VeutraJ, • • . • • • • • • • • • • • • ... 1450 2 1 Lighting Summary Standard 5, 5,048 Optional 8,850 5, .. •• • .. • 04$ • • • • . • • • • • Ranges & Ovens O ; ; : • . • • • ••• .• Range No. No? Nameplate •Lihe Neutral 1 1 10999 2 0 0 3 0 0 Range /Oven Summary Standard 8,000 5,600 Optional 10,999 5,600 Dryers Dryer No. No? Nameplate Line Neutral 1 1 5520 2 0 3 0 Dryer Summary Standard 5,520 3,864 Optional 5,520 3,864 Heating and Cooling: Actual Number = 1 Name M? Ph No Amps Volts VA HP Line Neutral 1 M 1 1 29.0 240 6,960 0 1 9 1 1 41.6 240 1 9,984 0 Heat /Cool Summary Standard 9,984 0 Optional 6,960 0 Fixed Appliances: Actual Number = 2 Name M? Ph No Amps Volts VA HP Line Neutral dishwasher M 1 1 120 1200 1,200 1,200 sprinkler M 1 1 8.75 240 2,100 0 Fixed Appliance Summary Standard 3,300 1,200 Optional 3,300 1,200 Other Appliances: Actual Number = 2 Name M? Ph No Amps Volts VA HP Line Neutral microwave 1 1 120 1100 1,100 1,100 refrigerator M 1 1 10 120 1,200 1,200 Other Appliance Summary Standard 2,300 2,300 Optional 2,300 2,300 25% of Max Motor: Line is Std Only; Neutral for Both Maximum Phase Amps Volts 1 10 120 Heat /Cool Phase Amps Volts 0 Fixed Appl. Phase Amps 1 8.75 Other Appl. Phase Amps 1 10 Max Motor Summary Standard Only SUMMARY • ••• • • • . • • • .. • • F o l i s : : . :••• • • • • • • • • • • ;-••• • • • • ... 240 Vo1,ts ": .. • •• • • • • • • • • • • 2 -L0 •••• • • • 300 300 • ••• • •• • • • • • • • • . , . . • • • .•• •• ...•• Standard Line Neutral Total Total = 34,452 18,312 Maximum Amperage = 144 76 Service Voltage = 240 Service Phase = 1 Optional Line Neutral Total Total = 25,348 18,312 Maximum Amperage = 106 76 Service Voltage = 240 Service Phase = 1 Z3 25 27 2°1 11 \l • •• • • . • .. • • • • • • • • • • • • • • • • • Z ( ‘z) o 4 .. • S0 12 Zo `4 '11\ c..izo Zo t � C t5 \-- v- \ ZZ l5 Z' 15 Zb Z6 lAcaooNN 5Z ••• 11. Cow? � P • • •• • • • • • ••• • • • • • • • • • •• • • • ••° •• •• • ••• • ••• • • • • • • • • • • . • • • • • • • • • • • • • • •• • •• • • • • ••• • • •• • • ••• • • • • ••• • • • • • • • • • • • • • • • • • • • • • • • • • • • •• •• • • • •• •• • • • ••• • • • ••• ELECTRICAL TYPE Minimum Fee QTY. TYPE Dryer .. • (1".'Y. . . "I'YPE Out et,•A fl f 1tadcc QTY. 'I'VI'1: 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 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 _ MECHANICAL TYPE Minimum Fee QTY. 'TYPE Condensate Drain QTY. TYPE Generator QTY. TYPE Refrigeration, Tons QTY. A/C Central, Tons Cooling Tower Heating Strips, each Vent Hood, Cost A/C Wall/Win. Tons Dryer Vents, Number of Paint Booth Ventilation, Cost 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. 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 2 Si _r ature of Owner M 2IA c. TotQ 1 ) , n 6 � 'nt Name -9 a , L •.. • • • • • • •.. • •.. • • • IMPORTANT NOTICES DO NOT BEGIN ANY WORK WITHOUT HAVING RECEIVED YOUR•VALIDpZ'F.D 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 week ends or holidays. 2. All construction of demolition areas MUST BE MAIN1bA1M Iq1 A. s1,246 SANITARY CONDITION free from construction debris. 3. STREETS AND NEIGHBORING PROPERTIES SHALL BE ICEP ] fRrE DEBRIS. 4. SWALES MUST BE PROTECTED FROM BEING ➢OM ErBT EtVIPME 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. STATE OF FLORIDA, COUNTY OF MIAMI -DADE Sworn to and subscribed before me this ;9 day of JAvvtl`Ay, Signature of SEAL: ISABEL MOUNA MY COMMISSION # CC 974864 EXPIRES: October 12, 2004 Thti Notary Pubfic Unclammer Personally known r/ OR, Produced Identification Personally known OR, Produced Identification Type of Identification Produced: •.. ••• • • ••. • • • • • • • • • • ••. • • • • • • • • PERMIT APPLICATION " rre of Contrac .r / • ua ✓ d Y � ame Sworn to and subscribed before me this t day of " KIMBERLY NNEGAN MY COMMISSION iJ DD058646 "%t EXPIRES: September 19.2005 1-8003-ROTARY A. Notary Satwce 8 B011aft9. tr Signature of No SEAL: I F FLO • � •, NTY OF MIAMI -DADE Type of Identification Produced: Page 3 • • . • • • ••• • • • • • • • • • • .•• • • • • • •. • • • • ••• PERMIT APPLICATION •.• • • ••• •• • •• INSTRUCTIONS: Please indicate the type of worjbeing'Orf wined aria gtfantity(ies) in the space provided below. RECEIVED AND REVIEWED BY: DATE: CONTRACTOR New Construction Name Ll& // t4 �� i & t ki ,t 9 „ � L 11 // kit 1 Enclosure License No. , n, 3 3313' Address "2-355- C �,, Pt,- L Pi_ IVOki . Vt- 333( 7 X, Repair Telephone q91. 3 ' 1 +IL1 Fax /94. 1' 3 . 1 `1 q, Qualifier Name 0A to 000 6 Demolish PROPERTY OWNER New Construction \ M API lat C. 3-1' a6E \ Address Enclosure 4-01 NE 014 S- r -. pn 1 A m I 5)+ 12 �� 3313' Home Telephone C30`S /5 /— 6 l . Repair Business Telephone (mod S) a i 3 _ 1 a3 Alteration Interior Fax Demolish TYPE OF MANAGEMENT (✓ ) New Construction Enclosure Alteration Exterior Repair Alteration Interior Demolish Relocation of Structure Shell Only Foundation Only Add'l Attachment Other Add'l Detachment Other Page 4 OFFICE USE ONLY LI 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 Notary ••. • • • • • ••• • ••• • • • • • • • • • • •• • •• • • • ❑ IMPACT FEE (New Construction) SECTION Zoning Electrical Mechanical Plumbing Fire Public Works Structural Building Official BY DATE • • • • • • • • • • ••• • • • • • • • ••• ❑ PROOF OF OWNERSHIP • • (Aita.Gh) • • • • • • • • • • • • • •• • • • ❑ %W./haft 4PpRpVAt (Septic / Sewer, • • • • ❑ OTHER (Specify & Attach) (X .ft. = x/1000 (¢.005 /sq.ft.) (¢.01 /sq.ft.) PERMIT APPLICATION CHECKLIST ❑ CONDO ASSOCIATION APPROVAL (Attach) ❑ BPR APPROVAL (Restaurants) ❑ CONTRACTOR REGISTRATION (On File) PERMIT FEES TOTAL $ 1 � CONDITION OFAPPRO'SAL Revised July 2001 10050 N.E. 2ND AVE., MIAMI SHORES, FL • (305) 795 -2207 • FAX (305) 756 -8972 • http : / /www.miamishoresvillage.com ... � IL iLF N r �� y \ irit 0 INSTRUCTIONS - The following steps must be taken to obtain a permit from the Miami Shores Village: • Step 1. Job Address: Address Folio Number Lot Block Subdivision PB PG Current Use of Property Proposed Use of Property Tent Information PERMIT TYPE (✓ ) Building Electrical Mechanical Plumbing LPGX Roofing Fence Other PERMIT CHANGE (✓ ) Chg. Contractor Renewal Revision Extension Supplement Reinspection • • • • • • • • • • ••• • • • • • • • • • • • •• • • • • • ••• • •. :M ster its ni No. • 'Subsidiary Velnlit No. •• • • • • ••• ••• Tax Flood Zone Base Floor Elev. PERMIT APPLICATION • ••• Complete the attached permit application which mus;i�e siineti t ' tie Qroller€v and qualifier. Both signatures must be notarized. Please print or type to allow for a more accurate processing ofyour . ppiic�tidfi! • lf Woofing 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 B uilding, Planning and Zoning Department for processing. During the processing of your application, you may be asked to submit additional information. APPLICATION Mt km( r. 33 State Zip Apt. / City I/ �/ Description of Work II✓ (1 7 / 4 ( 5 4 j r, I(�� 017619~ k Zoning Linear Feet Units Floors Sq a Feet ee�� ue of Work Pi 00 Bldg Value ssessed/Appraised Value ENGINEER Name License No. Address Telephone Fax 4 /,/(, /44 Block Subdivision ne is Namo Licallo. Add. or Phone General Zone Req.Cu.Ft. « ?a (6i O Plat Restriction Checked by Cu. Cont . By a /1) By i To Planning a ing Board % � // // �'; � �� Approved Rejected Re- Submitted to P.S. Approved Rejected Plans & Spec. Checked by To Council Approved Bldg. Permit No. Date h _ °i�- Fee Type C1 1) n Stories New Construction Alterations Repairs Plumbing Permit No Septic Tank Sewer Misc tl New Const. 'Electrical Permit No. Date Fixtures tt Heater . tf Motors tt Mi s c t 1 tf New Construction Alteration Building inspection Da o B Foundation { 1 ii -e" a r � Beams & Lintels e fi Final Final Clean -Up PlurnbLng Inspection !Da e — , . By Re-insp By Re -Insp By Roughing t Fixtures Sewer Septic Tank r, / /c --(,, ` Solar Heater / Final Certificate Electrical Inspection Date y Poug aing Fixtures Final Service 00h0 to rower. i Coo Cert o Occup.Issued / % Contractor Lic.N•'. Add. or Phone e Date - If If n Alteration • � � C GA /(9 / Roof Fee u tt tt Ruairs Fee ft it — tt ft Re airs No. Street Rejected Cost 1//6 0 61 • Re-insp By Re --Insp By Re- Insp By Re -Insp By 1 1 � r Permit MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT Date e-1/ d Application is hereby mad 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 Registered Architect and /or Engineer Employing Electrician's Name Location and Legal Description LO/ Street and Number where work is to be performed —No Amount of Permit $ STATE OF FLORIDA, } COUNTY OF DADE. ss. My Commission Expires No--- - - ---- Street22 _• No Block State work to be performed and purpose of building (By Floors) New Building - Remodeling Addition.. Repairs A A Conduit._ Overhead . __ �� a Main Servi Size Feeders. Underground Type of Installation— Conduit Tubing (Signed) Street__ ____G9 Subdivision. Ri Street Notary Public. State of Florida No. of Stories Electrical Inspector. Amps. - -- Main Fuses. !/ Amps. B.X.L Metal Moulding 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 le drforrp Ip4 r is permit, as are licensed by Miami Shores Village. ° e�Jl �/ UU��II LL (Signed G 6 t 2 t. it— Master Electrican. 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 of the above described construction, that be 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'8 FIXTURES NO. LAMPS REFRIG. OUTLET IRON OUTLET RANGE OUTLET RANGE CONN. WATER HEATER W. HEAT. CONN. SPACE HEATER STRIP HEATER TOTAL CONTR. LIST Qo� // (% . / ` A CHECK ENT. SW. DIST. CAB. SERVICE TEMP. SERVICE PERM. MOTORS 0-1 HP MOTORS 1 -5 HP NEON TRANS. RADIO TOTAL CONTR. LIST V CHECK 1 � r Permit MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT Date e-1/ d Application is hereby mad 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 Registered Architect and /or Engineer Employing Electrician's Name Location and Legal Description LO/ Street and Number where work is to be performed —No Amount of Permit $ STATE OF FLORIDA, } COUNTY OF DADE. ss. My Commission Expires No--- - - ---- Street22 _• No Block State work to be performed and purpose of building (By Floors) New Building - Remodeling Addition.. Repairs A A Conduit._ Overhead . __ �� a Main Servi Size Feeders. Underground Type of Installation— Conduit Tubing (Signed) Street__ ____G9 Subdivision. Ri Street Notary Public. State of Florida No. of Stories Electrical Inspector. Amps. - -- Main Fuses. !/ Amps. B.X.L Metal Moulding 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 le drforrp Ip4 r is permit, as are licensed by Miami Shores Village. ° e�Jl �/ UU��II LL (Signed G 6 t 2 t. it— Master Electrican. 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 of the above described construction, that be 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. 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 regula- tions of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of the work. Date Owner's Name and Addre : v L ° No Registered Architect and /or Engineer_ Name and address of licensed contractor Locatio and al esc tion of lot to built on: Subdivision /� Lot /V Block Subdiv � �` � ? �` ( T State work to be done and purpose of building (by floors) � 1� w Stree`E and Number where work is to be done and for no other puose. New Building t Remodeling __ Addition.. Repairs No. of To be constructed of_____ (L� __ _ Kind of foundation____ = _: 6 /) C _ Roof Coveri r___` Estimated Total cost of improvements $__. // r! 2 0 O __Amount of Permit $ p Zone cubage required � - ' ' C Plan Cubage — �� ( II Distance to next nearest building Maximum live load to be borne by each floor I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may be sent to The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Supplement, and has complied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for i p tion on \the site of the ork such public notice or notices as are required by the Act. The undersigned agrees to employ only such sg on - actors, one l{vork to bgVperformed under this permit, as are licensed by Miami Shores Village. i Remarks (Signed) , / STATE OF FLORIDA, I COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer appeared 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 state are true. q F ( - ) G / Permit No._ �_ Date / C A Read, Sworn to and Subscribed before me. Chairman Member MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Disapproved — ___ ____ _____ ___ Date (Signed) Size of Building Lot Building Inspector My Commission Expires oaths and take Notary Public, State of Florida Street- _ acknowledgments, personally PLANNING BOARD DATE Member Member Member Member Council Approved to me well known, _Date Disapproved Date NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has been obtained from the Planning Board. 0 A re- inspection fee of $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and /or workmanship. ship. / ,,i ' \ Contracting Co. /4 / Qu.iifier -Hara,A State # E r �, ^ /l Fe _�)1(C -? FEES: PERMIT, <5f / 46 ' RADON APPROVED: Zoning Mechanical PERMIT APPLICATION FOR MIAMI SHORES VILLAGE I e 1D( 013 0330 Leggy Description 1 O i Historically Designated: Yes No 6 xeS / Tenant (l v4 a I 0 O 1 Master Permit # Owner's Address Ll� >Lie �� S� l r, i/aiY► 3�an°3 3/ 8 I Phone SUS) 7.5 6/ % / � � f Date 9g/Job Address 4 /3R / e ) (57 Tax Folio Municipal # Competency # Architect/Engineer Address Bonding Company Address Mortgagor Permit Type (circle one): BUILDING ECTRICAL>PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION �' �� _` (1 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 FINANCLNG, 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 an . = ._:. -. = - -. .e done in compliance with all applicable laws regulating construction and zoning. Furthermore, I authorize the abov ted. sident Signature of owner air Condo 4.i ddij Notary as to O and/or Con. . reside e . L My Commissio ! _ pire39FFtClAL NOT ' S TANi vi n,OR1DA I CUM i' - PO2 l y MY CO` D e Address Address /G 50.1 3 i; ver /eve. �Q0 /' %0 /C' - - 4 1) I F 77Z k Building Notary as to Contractor .r Owner -Bu der My Commission yx_ esUFFiCIAL TARYSEAL TAMMY T ROSS NOTARY PUBLIC STATE OF FLORIDA COMMISSION NO. CC751631 MY COMMISSION EXP. JUNE 15,2002 C.C.F. • ° NOTARY TOTAL DUE Electric Plumbing Engineering Ins. Co. 2U /'(X ,5deocs