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ELECTRICALMIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT Permit No Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building of other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village,'Fiu:ida, 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 Wesley D. Carter & Mary E. Elder No 575 Street N.E. 95th Street Registered Architect and /or Engineer Employing Electrician's Name No Street Location and Legal Description Lot 22 & W 2 23 Block 54 Pltbk 10 -37 Sub division Miami Shores Section 2 575 Street N.E. 95th Street Add 2 AC Units, relocate washer /dryer. Street and Number where work is to be performed —No State work to be performed and purpose of building (By Floors) New Building Remodeling X Addition Date February 8 1988 Repairs No. of Stories 1 Service Overhead Size Feeders Conduit Main Sw Amps Main Fuses Amps Underground Type of Installation — Conduit X Tubing B.X.L .Metal Moulding Amount of Permit appeared therein by him stated are true. 110YARY POOL1O PAYE OF FLORIDA GY COMISSIOO EXP. GAY 17.1991 rmeV Y lay "tiommissron Expires (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. STATE OF FLORIDA, l COUNTY OF DADE. I °°' Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally Wesley D. Carter to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the Owner of the above described construction, and he has carefully read the foregoing akplication, and that he did sign the same, and that all facts Notary Public, State of Florida NOTE: A re-inspection fee of 81.00 will be made when such re-inspection is made necessary by improper notice for inspection, or faulty materials and /or workmanship. SWITCH 0 LIGHT OUTLETS PLUG RECt•P•T'S FIXTURES NO LANDS RaFRmo. OUTLET IRON OUTLET RANGE OUTLET RANGE CONN. WATER HEATER W. HEAT. CONN. SPACE HEATER STRIP NEATER TOTAL CONTR. LIST 2 1 1 1 CHECK 1 n� ,'{ /� 11 / \'W '�+�/ ic D/ may/ -Jy/ '/ . rl 6t DO ENT. Sw. DIST. CAS. SERVICE TEMP. SERVICE FERN. Dryer MOTORS 0.1 NP MOTORS 1.5 HP NEON TRANS. RADIO TOTAL CONTR. LIST 1 2 r� CHECK , i �j 2 I WO n`[ 1 7 4 MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT Permit No Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building of other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village,'Fiu:ida, 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 Wesley D. Carter & Mary E. Elder No 575 Street N.E. 95th Street Registered Architect and /or Engineer Employing Electrician's Name No Street Location and Legal Description Lot 22 & W 2 23 Block 54 Pltbk 10 -37 Sub division Miami Shores Section 2 575 Street N.E. 95th Street Add 2 AC Units, relocate washer /dryer. Street and Number where work is to be performed —No State work to be performed and purpose of building (By Floors) New Building Remodeling X Addition Date February 8 1988 Repairs No. of Stories 1 Service Overhead Size Feeders Conduit Main Sw Amps Main Fuses Amps Underground Type of Installation — Conduit X Tubing B.X.L .Metal Moulding Amount of Permit appeared therein by him stated are true. 110YARY POOL1O PAYE OF FLORIDA GY COMISSIOO EXP. GAY 17.1991 rmeV Y lay "tiommissron Expires (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. STATE OF FLORIDA, l COUNTY OF DADE. I °°' Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally Wesley D. Carter to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the Owner of the above described construction, and he has carefully read the foregoing akplication, and that he did sign the same, and that all facts Notary Public, State of Florida NOTE: A re-inspection fee of 81.00 will be made when such re-inspection is made necessary by improper notice for inspection, or faulty materials and /or workmanship. February 1, 1988 Wesley D. Carter 575 N.E. 95th Street Miami Shores, F1 33138 Miami Shores Village Bulding & Zoning Department 10050 N.E. 2nd Avenue Miami Shores, F1 33138 Gentlemen, 1781 N.W. NORTH RIVER DRIVE MIAMI, FLORIDA 33125 (305) 325 -1930 Attached are applications for Building, Air Conditioning and Electrical Permits. I have attached two copies plans for permit use with this letter. Please contact me at 757 -2638 or 871 -7992 if you have any questions concerning this application. Very Truly Yours, \,,,_),„A6C Cads: Wes Carter THE POOLE AND KENT COMPANY MECHANICAL CONTRACTORS ;UILDING • LECTRICAL 'LUMBING In cons Jertaining ther n accepting xs of nd in rmit I .1 • ass e' . responsi MIAMI SHORES VILLAGE, FLORIDA PERMIT N? 7217 Work to be performed under this Permit )weer of / wilding ei` rrchitect lontractor )r Builder ega1 Lot Bl. )escription address of luilding This permit is granted to the contractor or builder named above to construct the building or to install the equipment or d'evice described in the appli- : ation herefor in strict compliance with all ordinances pertaining thereto and w th the understanding that the work will be performed in compliance with any )tans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked t any time if the work is not done m compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this iermit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and egulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes respon- ibility for work done by his agents, servants or employees. Subdi- vision Value of Project DATE 194_ Contractor's License No. Axnt. of Permit Signed By INSPECTOR permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations e plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. all work done by either myself, my agent, servant or employee. 1 CONTRACTOR OR BUILDER BY AUTHORITY goo P. rve f. Date - a F> Job Address S. ME: qs SA. Tax Folio Legal Description Owner / Lessee / Tenant c Z17• Master Permit # 9;03 Owner's Address S 5 O 5 PhonelSU, ' 3 Contracting Co. ' RI SCAt (MC:, r \c\. C� C rt Phone 5 ' o� " 9 765 Qualifier State it ONO 4g Municipal 0O- 64g Competency # c ccc $ i? Ins.Co.1- Architect /Engineer Address Address Mortgagor Address Permit Type(circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION ( .p..� �%' ,4 c90D i , Bonding Company ignature Date: otary to Owner an My Commission Expir * * * APPROVED: - 195 ®' M °ran; 5 1°4 2c.S PERMIT APPLICATION FOR MIAMI SHORES VILLAGE 6 FEES: PERMIT o 'er Square Ft. Estimated Cost(value) I NO(S bC5 WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT). Application is hereby made to obtain a permit to do work and installation as indicated above, and on the attached addendum (if applicable). I certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits are required for ELECTRICAL, PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK. OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Furthermore, I author e the above amed contractor to do the work stated. or Condo President Oh Cf,'.L .'�' 5 A rpAcr RY 7 ''S AT'E OF FLORIDA P+iIISSION Nk • C:C UNC IS UNE301 Address 1S �S q /i Signature of Co Date otary =s to ontractor My Co ission Expires: * * * * *' * RADON C.C.F. I t , NOTARY Fire Other Zoning Building Mechanical Plumbing OFRC A $,, IR�C �F'FLORIDA COMMISSION NO. CC298854 Y COMMISSION EXP. JUNE 30,1997 Owner- Builder * * ** TOTAL DUE Electric' i Apr Engineering ITEM BATH TUB UNIT FEE ITEM SWITCH OUTLETS UNIT FEE ITEM SPACE HEATERS UNIT FEE BIDET LIGHT OUTLETS CENTRAL HEATING DISHWASHER RECEPTACLES / A/C (WINO) DISPOSAL SERVICE TEMPORARY A/C (CENTRAL) DRINKING FOUNTAIN SERVICE SIZE IN MPS DUCT WORK FLOOR DRAIN SERVICE REPAIR/METER CHANGE 4bo/1 REFRIGERATION . GREASE TRAP APPLIANCE OUTLETS PROCESS AND PRESS PIPING INTERCEPTOR RANGE TOP UNDERGROUND TANKS LAVATORY OVEN ABOVE GROUND TANKS LAUNDRY TRAY WATER HEATER U.F. PRESSURE VESSELS CLOTHES WASHER MOTORS 0- 1 If STEAM BOILERS SHOWER MOTORS OVER 1- 3 HP HOT WATER BOILERS SINK, POT /3 COMP. MOTORS OVER 3- 5 HP MECHANICAL VENTILATION SINK, RESIDENCE MOTORS OVER 5- 8 HP TRANSPORTING ASSEMBLIES SINK, SLOP MOTORS OVER 8- 10 HP ELEVATORS/ESCALATORS TEMPORARY WATER CLOSET MOTORS OVER 10- 25 HP FIRE SPRINKLER SYSTEMS URINAL MOTORS OVER 25-100 HP COOLING TOWERS WATER CLOSET MOTORS OVER 100 HP VIOLATION INDIRECT WASTES A/C WINDOW REINSPECTION WATER SUPPLY TO: AIR CONDITIONERS A/C UNIT STRIP HEATER FIRE SPRINKLER GENERATORS TRANSFORMERS HEATER -NEW INST. GENERATORS TRANSFORMERS HEATER - REPLACE GENERATORS TRANSFORMERS LAWN SPRINKLER -WELL SPECIAL PURPOSE SWIMMING POOL OUTLETS COMMERCIAL WATER SERVICE SIGN TUBES SEWER CONNECTIONS SIGN TRANSFORMERS UTILITY -SEWER SIGN TIME CLOCK UTILITY -WATER FIXTURES SEPTIC TANK ANTENNA RELAY TELEVISION OUTLETS GRAINFIELD, 4" TILE/RES. VIOLATION PUMP & ABANDON SEPTIC TANK REINSPECTION SOAKAGE PIT CU. FT. CATCH BASIN DISCHARGE WELL DOMESTIC WELL AREA DRAIN ROOF INLET SOLAR WATER HEATER FIRE STANDPIPE POOL PIPING LAWN SPRINKLER SYSTEM GAS RANGE METER SET (GAS) GAS PIPING • (AN APPLICATION FOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. IF A MASTER PERMIT HAS BEEN OBTAINED, THE OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.) PLUMBING ADDENDUM TO BUILDING PERMIT APPLICATION ELECTRICAL MECHANICAL BUILDING ❑ ELECTRICAL Fri PLUMBING ❑ ROOFING ❑ Owner of Building Architect Contractor or Builder Legal Description Address of Building Lot CONTRACTOR OR BUILDER MIAMI SHORES VILLAGE, FLORIDA PERMIT IN? 11806 Work to be performed under this Permit Bl. Subdi- vision Value of Project $ BY DATE 195 Contractor's License No Amt. of Permit $ This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the application herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes responsibility for work done by his agents, servants or employees. Signed. n' BY INSPECTOR In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. � 1 �. AUTHORITY BUILDING ELECTRICAL PLUMBING Owner of Building Architect / Contractor or Builder \N. Legal Description Address of Building Lot MIAMI SHORES VILLAGE, F'LI J IDA DATE / m Contractor's Licelise No ERMIT N° 7353 Work to be performed under this Permit Bl. Subdi- vision Value of Project 194_ BY This permit is gr ed tic contractor or builde' named above to construct the building or to install the equipment orr evice described in the appli- cation herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above assumes the responsibilit for a thorough knowledge o£. the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings oriui the t t cents or specifications and that ho' respon- sibility for work done by his agents, servants or employees a , , . , - • f Signed. � ' '`,�. 4 / 1- ,If .• _ -By * ( IN SPECTOR y / =%' In consideration of the issuance to me of this permit I agree to perform th work covered hereunder in compliance with all ordinances and regulations pertaining thereto dnd in strict c nformity with the plans, drawings, statepiputs or specifications submitted to the proper authorities of Miami Shores Village. In acceptingf cis ermit I assun ' responsibility for a work done by either myself, my agent, servant or employee. , 7 1 -/ ' % i `CONTRACTOR OR BUILDER AUTHORITY New Building Amount of Permit $_ ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT < r/Ff ��, Date t� I �:7 Permit No.�____� -- Application is, / hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. Owner's Name and Address F CI - 4� l ' No Street ___________________ ___________��_. Registered Architect and /or Engineer Employing Electrician's Name ____ l 7�:!c 1 ___ Location and Legal Description Lot Street and Number where work is to be performed —No State work to be performed and purpose of building (By Floors) STATE OF FLORIDA, COUNTY OF DADE. MIAMI SHORES VILLAGE My Commission Expires 22.1 Block (Signed) No ?Pi �rJ L' Street__` °d' " — Sub Street '7l___-__-- -- _ -�_ -- Remodeling Addition.. Repairs No. of Stories Servi Overhead Size Feeders $ Conduit.__ — Main Sw..1 / Amps. UBdergtoUnd Type of Installation— Conduit Tubing B.X.L Metal Moulding (Signed) 8 Main Fuses___________.Amps. Notary Public. State of Florida Electrical Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The under signed agrees to employ only such sub - contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. 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. 1 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 C L ST / 7- 2 - ' ( / J / L '- - •1 CHECK ENT. SW. DIST. CAB. SERVICE TEMP. SERVICE PERM. JJ 0 MOTORS O -1 HP MOTORS t -S HP NEON TRANS. RADIO TOTAL CONTR. LIST / f CHECK New Building Amount of Permit $_ ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT < r/Ff ��, Date t� I �:7 Permit No.�____� -- Application is, / hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. Owner's Name and Address F CI - 4� l ' No Street ___________________ ___________��_. Registered Architect and /or Engineer Employing Electrician's Name ____ l 7�:!c 1 ___ Location and Legal Description Lot Street and Number where work is to be performed —No State work to be performed and purpose of building (By Floors) STATE OF FLORIDA, COUNTY OF DADE. MIAMI SHORES VILLAGE My Commission Expires 22.1 Block (Signed) No ?Pi �rJ L' Street__` °d' " — Sub Street '7l___-__-- -- _ -�_ -- Remodeling Addition.. Repairs No. of Stories Servi Overhead Size Feeders $ Conduit.__ — Main Sw..1 / Amps. UBdergtoUnd Type of Installation— Conduit Tubing B.X.L Metal Moulding (Signed) 8 Main Fuses___________.Amps. Notary Public. State of Florida Electrical Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The under signed agrees to employ only such sub - contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. 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. 1 Owner's Name and Address ___ MIAMI SHORES VILLAGE PPLICATION FOR ELECTRICAL PERMIT Permit No._. Date d / Application s hereby mad ' for the approval of the detailed statement of the plans and specifications herewith submi ed for the building or other structure herein described. his application is made in compliance and conformity with the Building Ordinance of iami 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. y , .2 d ELECTRICAL INSPECTION DEPARTMENT Employing Electrician's Name r _l % Location and Legal Description Lot .,I� L t-= Registered Architect and /or Engineer Street___—______ — __ Subdivision_�,2__ ___ __�. Street and Number where work is to be performed—No .______�___� Street_ ��c�; ��L� __ ~ State work to be performed and purpose of building (By Floors) o Remodeling Addition Repairs New Building_ - Service Overhead Size Feeders Conduit__ Main Sw. Underground Amount of Permit $ STATE OF FLORIDA, COUNTY OF DADE. ss. My Commission Expires No Block__ (Signed) No.___ s$ v Type of Installation— Conduit_____ Tubing — B.X.L Metal Moulding Amps. Main Fuses__ _ Amps. Electrical Inspector. The undersigned plicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Wo kmen'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 sucb public notice or notices as are required by the Act. The under signed agrees to employ only such sub - contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. (Signed) ______ Notary Public. State of Florida No. of Stories 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 the of the above described construction, that he has carefully read the foregoing application, and that be 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 . EATER ) STRIP HEATER TOTAL C ONTR. LIST C -= - _— � -------- -,,,,. . -- ____ ' ---c.-- - — CHECK • ENT. SW. DIST. CAB. SERVICE TEMP. SEI!VIffE� PEGM. W' (,.. '� F MOTORS 0-1 HP MOTO S'�N 1 -511P/ , EON , TRANS. ('w • RADIO TOTAL CONTR. LIST i' -% CHECK „I i' Owner's Name and Address ___ MIAMI SHORES VILLAGE PPLICATION FOR ELECTRICAL PERMIT Permit No._. Date d / Application s hereby mad ' for the approval of the detailed statement of the plans and specifications herewith submi ed for the building or other structure herein described. his application is made in compliance and conformity with the Building Ordinance of iami 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. y , .2 d ELECTRICAL INSPECTION DEPARTMENT Employing Electrician's Name r _l % Location and Legal Description Lot .,I� L t-= Registered Architect and /or Engineer Street___—______ — __ Subdivision_�,2__ ___ __�. Street and Number where work is to be performed—No .______�___� Street_ ��c�; ��L� __ ~ State work to be performed and purpose of building (By Floors) o Remodeling Addition Repairs New Building_ - Service Overhead Size Feeders Conduit__ Main Sw. Underground Amount of Permit $ STATE OF FLORIDA, COUNTY OF DADE. ss. My Commission Expires No Block__ (Signed) No.___ s$ v Type of Installation— Conduit_____ Tubing — B.X.L Metal Moulding Amps. Main Fuses__ _ Amps. Electrical Inspector. The undersigned plicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Wo kmen'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 sucb public notice or notices as are required by the Act. The under signed agrees to employ only such sub - contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. (Signed) ______ Notary Public. State of Florida No. of Stories 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 the of the above described construction, that he has carefully read the foregoing application, and that be 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. BUILDING ELECTRICAL PLUMBING Owne Building In co pertaining the In acceptin Wor t .be // `' ( f MIAMI SHORES VILLAGE, FLORIDA PERMIT N? 7217 performed under tJis Permit M CONTBCTOR M BUILDER Bl. Value of Project BY DATE / 0 r' 194. - Contractor's �Ic�n No Archi I' Contra�dr ;� or Bui er f f` Leal" / Lot Descripti n Ac dre s of . -2 e r - Building G. , /, This permit is g : nted to the contractor or build ' named above to construct the building or to install the equipment o < evice described in the appli- cation herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be pe ' ormed in compliance with any plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further conditi o u on which this permit is granted is the understanding that the contractor or builder named above assumes resp n bility for a thorough knowledge . ' e rdinances and regulations pertaining to the work covered hereby whether shown on the plans or drawi�f' or in ieThtatements or specifications and at iissu} es respon- sibility for work done by his agents, servants or employees.; '/f i --✓' Signed • s , - ,. • ,� r `' _: J V INS a s permit I agree to pe the -work covered hereunder in compliance with all ordinances and regulations the plans, drawings, state ents or specifications submitted to the proper authorities of Miami Shores Village. r all work done by ei r myself, my agent, servant or employee. s AUTHORITY Registered Architect and /or Engineer Employing Electrician's Name �! State work to be performed and purpose of building (By Floors) STATE OF FLORIDA, •' COUNTY OF DADE. 1 Amount of Permit $ ... ss. MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT Permit No /A.. Date Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. Owner's Name and Address t ; , .": .4 No i2 ,Streer ..4; Location and Legal Description Lot Block Subdivision No Street and Number where work is to be performed —No Street v New Building Remodeling Addition �� Repairs No. of Stories ti n 2/, Street Service Overhead Size Feeders Conduit Main Sw Amps Main Fuses Amps Underground Type of Installation — Conduit Tubing B.X.L Metal Moulding The undersigned applicant for this building permit does hereby certify that he understands and a labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws has complied with the provisions thereof, and will require similar compliance from all contractors or work to be performed under this permit; and will post or cause to be posted for inspection on the site as are required by the Act. The undersigned agrees to employ only such subcontractors, on work to licensed by Miami Shores Village. (Signed) • Electrical Inspector. ccepts his obligations as an employer of of Florida Permanent Supplement, and subcontractors employed by him in the of the work such public notice or notices be performed under this permit, as are (Signed) Master Electrician. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the of the above described construction, and he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. My Commission Expires Notary Public, State of Florida NOTE: A re-inspection fee of $1.00 will be made when such re-inspection is made necessary by improper notice for inspection, or faulty materials and /or workmanship. SWITCH OUTLETS LIGHT OUTLETS PLUG RECE'P'T'S FIXTURES NO. LAMPS REFRIG. OUTLET IRON OUTLET RANGE OUTLET RANGE CONN. WATER HEATER W. HEAT. CONN. SPACE HEATER STRIP HEATER TOTAL. CONTR. LIST CHECK ENT. SW. DIST. CAB. SERVICE TEMP. SERVICE PERM. M OTORS 0.1 HP M OTORS 1.5 HP N EON TRANS. RADIO TOTAL CONTR. IST LIST CHECK Registered Architect and /or Engineer Employing Electrician's Name �! State work to be performed and purpose of building (By Floors) STATE OF FLORIDA, •' COUNTY OF DADE. 1 Amount of Permit $ ... ss. MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT Permit No /A.. Date Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. Owner's Name and Address t ; , .": .4 No i2 ,Streer ..4; Location and Legal Description Lot Block Subdivision No Street and Number where work is to be performed —No Street v New Building Remodeling Addition �� Repairs No. of Stories ti n 2/, Street Service Overhead Size Feeders Conduit Main Sw Amps Main Fuses Amps Underground Type of Installation — Conduit Tubing B.X.L Metal Moulding The undersigned applicant for this building permit does hereby certify that he understands and a labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws has complied with the provisions thereof, and will require similar compliance from all contractors or work to be performed under this permit; and will post or cause to be posted for inspection on the site as are required by the Act. The undersigned agrees to employ only such subcontractors, on work to licensed by Miami Shores Village. (Signed) • Electrical Inspector. ccepts his obligations as an employer of of Florida Permanent Supplement, and subcontractors employed by him in the of the work such public notice or notices be performed under this permit, as are (Signed) Master Electrician. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the of the above described construction, and he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. My Commission Expires Notary Public, State of Florida NOTE: A re-inspection fee of $1.00 will be made when such re-inspection is made necessary by improper notice for inspection, or faulty materials and /or workmanship. WORK DESCRIPTION PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date 03 -d 1- 0/ Job Address $75 Id ,E".. 9 S 3I. Tax Folio t Z 10 J'a 1 "2-2 r s Legal Description A , ■or,,u. j4 a e . 2— / a Historically Designated: Yes Owner/Lessee / Tenant % /1 F.e / i7 Master Permit # Owner's Address S 7 S N F 9 S S T' "4,4; ..11-1•31-A: ,f /C Phone . 4.1 — 75 Co 6 Y S3 Contracting Co. /VI CI, 'i✓ E, / G.s sdc. A dress (J '0 0 -X c.). 7S gv P , Qualifier ,n S L , (. , V 1 S �,J ` SS# Phone .3° Z ( Y - L c L 0 State # ( » 4 C, O .570 42 Municipal # Competency # Ins. Co. Architect/Engineer Address Bonding Company Mortgagor Address Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN Address r sT1 ) — T.-43 ck.. u. al." Square Ft. Estimated Cost (value) (( et 1' y , f, - 32v6 £1 `/ 07‘a No WARNING TO OWNE YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY OF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.) Application is hereby made to obtain a permit to do work and installation as indicated above, and on the attached addendum (if applicable). I certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits are required for ELECTRICAL PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK. OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Furthermore, I authorize the above -named contractor to do the work stated. Signature of owner d;licalMesidZ 295 0 3 0 V -, , Notary as t.. s er : d/ on V i s -:,11 to My Commission Expires CLAMS) VILLAR NOTARY PUBLIC STATE O�pRIDA COMMISSION NO. t MY COMMISSION EXP. MAR. FEES: PERMIT �p ®'PP RADON APPROVED: Zoning Mechanical C.C.F. 3 Signature of Contractor or Owner- Builder Building Electrical 3 - f? 0 Notary as to Contractor or Owner - Builder Date My Commission Expires: 0 u,,,,, W. Keith Phillips, III ,Commission # GC 829610 E xpires June 14, 2003 0 )1 . Bonded Thru •, Inc. Atlantic Bonding NOTARY BOND TOTAL DUE 3 8 - c/ Date Plumbing Structural Engineer CONTRACTOR Name ( priks 6 .1-1 iks7 F CS t tJ C• e License No. C coo OO a ci G Address t O 1 P w 1- (_ O s 'r• (ilA-Me Telephone(305) 0 7 Fax C30 0 65_4 -g 691 Qualifier Name 4 M! 5 1.1. 8 e. 14 iu Ai j PROPERTY OWNER New Construction Name a. V S I l �1J 0 LO e Z' Enclosure Address s 7 S /&I t q .� i (; avn i Shore Et 3 31 3 ? Home Telephone p 0 S). ( 9q L 9 9 J O J Repair Business Telephone Alteration Interior Fax Demolish TYPE OF MANAGEMENT (✓ ) New Construction Enclosure Alteration Exterior Repair Alteration Interior Demolish Relocation of Structure Shell Only Foundation Only Add'l Attachment Other Add'l Detachment Other INSTRUCTIONS - The following steps must be taken to obtain a permit from the Miami Shores Village: Step 1. Step 2. Job Address: Folio Number Lot Subdivision Complete the attached permit application which must be signed by *he property ownewand qualifier. Both signatures must be notarized. Please print or type to allow for a more accurate processing of your applicatian• ICroofiog:fork will be done, a roofing application must be submit- • ted along with this permit application. • • • • • •• • • • • • ••• •• 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 S lU(; Qs 5-Viee+ fY) ;Arlii 5horFs FC. 3 31 - n-0273/ State Zip HOOK op ?Do / & Q u, i Qtn eft 1 1 1-i 3 a 0 &-b, q" Q-2 6 v p(escription of Work PG Zoning Linear Feet Current Use of Property Square Feet Units Floors Proposed Use of Property / lr, alue of Work ()O Bldg Value Tenant Information _ Tax Assessed/Appraised Value Flood Zone Base Floor Elev. PERMIT TYPE (✓ ) Building Electrical Mechanical Plumbing LPGX Roofing Fence Other Address Apt. Block 5 1 .1 PB PERMIT CHANGE (✓ ) Chg. Contractor Renewal Revision Extension Supplement Reinspection ARCHITECT Name License No. Address Telephone Fax • • • • • • • • • • • • • • • • • • • • • • • • • • • .•• • • • • • • • • • • • • • • • • • • • • • • .. Master Permit No. • • Si4 sidiaty, Pe�r>�it;l�o,� • • • • • • .• . • . . City PERMIT APPLICATION D3- ss ENGINEER Name License No. Address Telephone Fax Page 2 IMPORTANT NOTICES DO NOT BEGIN ANY WORK WITHCDJT,H.VCNG RECEIVED YOUR'VALIDATED PERMIT AND PERMIT CARD. Applying for a permit does not grant the right to begin construction. HOURS OF CONSTRUCTION are limited'ttk 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. An construction of demolition areas MUST BE MAINTAINED IN A CLEAN, NEAT AND SANITARY CONDITION free from construction debris. 3. STREETS AND NEIGHBORING PROPEIMriS SraLi<tt KeliT1:1111 MGM DIRT AND DEBRIS. 4. SWALES MUST BE PROTECTED FROM EINC 15 A�1h1'3 $ Y•rt JIPICIENT OR VEHICLES, AND MAY NOT BE USED FOR STORAGE. A bond is required for work in or near the street/side • • • • • • • • 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 FL Q IDA, COUNTY OF MIAMI -DADE Signature of Owner C- 2118A L . S- Lope-2.— X Print Name Sworn to and subscribed before me this ,, 9 day of r•bQ3 . • • • • • • • • • • . • • • • • • • • • • • • • • 4100 • • • • • • • • • • • • • •.• • • • • .•. • • l.(.h.Xi OD • Gi Signature of Notary Public - State of Florida SEAL SEAL: • PaY P ee, OFFICIAL NOTARY 2 • 0 COMMISSION NUMBER i ' < DDO5arfi7 ,3'450 e OQ MY COMMISSION EXPIRES OF FL OCT. 122005 Personally known OR, Produced Identification STATE OF FLORIDA, COUNTY OF MIAMI -DADE fr• . /7. Signat of Contractor / Qualifier 644 E5 M. 6e.e. Print Name Sworn to and subscribed before me this A 7 02.00.3 . SEAL: PERMIT APPLICATION Signature of Nntaryr Puhlir Gym .s P„rdd OFFICIAL NOTARY SEAL J `' {tV Ppe 6. ARLENE D ROSNER �� COMMISSION NU:.oeER 00058667 A. + .• MY COMMISSION EXPIRES OF ‘.9`.• OCT 12.2005 Personally known OR, Produced Identification Type of Identification Produced: Type of Identification Produced: Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Printed: 3/4/2003 Applicant: GUSTAVO & SHEILA Owner: LOPEZ JOB ADDRESS: 575 NE 95 Contractor PHASE MASTERS Local Phone: Parcel # 1132060140760 Permit Status: Work: MARS POOLS INC. 1000E ATLANTIC BLVD, STE 11 POMPANO BEACH, FL 33060 954-946 -4596 Tamarac 0021 5600 N. University Dr. Tamarac, FI 33351 Electrical Permit Permit Number: EL2003 -55 LOPEZ GUSTAVO & SHEILA ST Contractor's Address: Legal Description: MIAMI SHORES SEC 2 PB 10 -37 LOT 22 & W1/2 OF 23 BLK 54 LOT SIZE 75.000 9_2-(AA`k47, - /v,00 Total Fees: Total Receipts: $0.00 0 Permit Expiration: 8/31/2003 Construction Value: If there is no permit package accessible on the job -site for inspectors to verify, there will be no inspections. Re- inspection r ....-....,-. >.........- -- -_ - ,� ip '_ ankAt /antic W S e c u r i I t e n h a n c e d d o c u m e n t . S e e back for d e t _I s_[ 6'7083;7631: 00,SS7 ?2790Il's DATE - 7 3 P .' , . .. TO THE, ,/� / ORDAYER O , F 1 �. " l y ' / ' ' 7 (7/ es p V / ��� C 5 ev 1_4, & `; h ly 6' ✓e god / %0o, 1014 63-8376/2670 ' 021 i$ '785 ,/9 DOLLARS 8 Page 1 of 1 on herefor in strict compliance with all tions that may have been submitted to if the plans are changed without ;ibility for a thorough knowledge of the he assumes responsibility for work done pertaining thereto and in strict conformity )onisibility for all work done by either ELECTRICAL TYPE. Minimum Fee QTY. TYPE. Dryer Q1 v. •I YPI: • 1 t • t.Appleance • - - • • • ••• QTY. TYPE Service Repair Q'rV. 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 O 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 'I ECHA NI CA L TYPE Minimum Fee QTY. TYPE Condensate Drain QTY. TYPE Generator QTY. TYPE. Refrigeration, Tons Q'FY. 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 PLUI\IBING TYPE A/C Condensate QTY. TYPE Drains, Roof QTY. TYPE Miscellaneous Fixture QTY. TYPE Soakage Pit QTY. Bath Tub Drinking Fountain Miscellaneous Repairs Solar Water Heater Bidet Filter Replace Pool Piping Sprinkler Repair Cap - Fixture Fountain Pump and Abandon Sprinkler System Cap - Water Gas - Appliance Pump, Domestic Supply, AC Well Cap - Sewer Gas - Natural Pump, Fire Stand Temporary Toilet Catch Basin Gas - Propane Pump, Re- circulate Temporary Water Closet Clothes Washer Gas Piping Pump, Replace - Pool Urinal Dental Chair Grease Trap Pump, Sprinkler Utility - Sewer Discharge Well Ice Maker Pump, Sump Utility - Water Dishwasher Indirect Wastes Relay Repair Vacuum Pump Disposal Interceptor Roof Inlet Water Closet Domestic Well Laundry Tray Septic Connection Water Heater Drainfield, 4" Tile/Res. Lavatory Septic Tank Water Heater New Drains, Area Meter Set (Gas) Sewer Connection Water Re -pipe Drains, Floor Minimum Fee Shower Water Service Drains, French Miscellaneous Equipment Sink Well, Supply Page 3 • • • • • • • • ••• • • • • • • • • • • • -• 1 • ••• • • • • • • ••• . • • ' • •• • .. • PERMIT APPLICATION INSTRUCTIONS: Please indicate the type of work being}trformed aQicCquaOtity((4 in the space provided below. RECEIVED AND REVIEWED BY: DATE: SECTION BY DATE Zoning Electrical ,� .?f+'/r/?af Mechanical Plumbing Fire Public Works Structural Building Official Page 4 OFFICE USE ONLY ❑ OWNER - BUILDER FORM (Attach) ❑ FIRE DEPARTMENT APPROVAL (Commercial / multi - family) ❑ CONCURRENCY (New Construction) O 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 • • • • • ••• • ••• • • • • •• •• • • • • • • •• • • • • • • • • • • • • • • ••• • j • • CHECKLIST KLIST • • • • • • • ❑ PRbOF OF ONWERSHIP (Attach) •• •• • • • • • • .• • • • • • • • • • • • ❑:HRH/ DFg1 4P OVAL • • • • •: :Sc pt?c. S9wir) • ❑ IMPACT FEE (New Construction) ❑ OTHER (Specify & Attach) PER11I'I' FEES $ ,9®' CPO (x 0)'1000 (¢.005 /sq.ft.) (¢.01 /sq.ft.) PERMIT APPLICATION ❑ CONDO ASSOCIATION APPROVAL (Attach) ❑ BPR APPROVAL (Restaurants) ❑ CONTRACTOR REGISTRATION (On File) REVIEWED AND PREPARED BY: DATE: CONDITION OFAPPROV'A Revised July 2001 10050 N.E. 2ND AVE., MIAMI SHORES, FL • (305) 795 -2207 • FAX (305) 756 -8972 • http : / /www.miamishoresvillage.com Date 6) I5 Job Address ?7$ 44 f7 Tax Folio)) W6 /i P22D Legal Description ll `V- 4. v` W S i )' Owner / Lessee / Tenant 7 ® Fl�I4 Master Permit 4 Owner's Address ,7c 44 9.c `7 Contracting Co. / iZ 749 %/1/6' Qualifier 4.114 Jl - State floOdM6PV Architect /Engineer Address Bonding Company Address Mortgagor Address Permit Type(circle one): BUILDING E RI j PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION ivA(^ Square Ft. Estimated Cost(value) WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT). Application is hereby made to obtain a permit to do work and installation as indicated above, and on the attached addendum (if applicable). I certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits are required for ELECTRICAL, PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK. 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 =n• • ning. F thermore, I au ,o ize j,!bove -named contractor to do the work stated. gnat Date: Notary as to • TTY My Commission Expit'Y-e ** * * * * * * * * * * * ** C.C.F. NOTARY TOTAL DUE ' Fire Other Building Electrical Mechanical Plumbing Engineering C /l c = /0 FEES: PERMIT lbw APPROVED: PERMIT APPLICATION FOR MIAMI SHORES VILLAGE G rki9V/ Municipal Competency # Zoning sident ondoJ '661trt5 My Commission Expires so ' June 4, 1996 4- Comm. No. CC 205953 RADON SS46 /_ 7Phone Ins.Co. • Notary ' s to'Co t ,''o ff My Commission • \�` Ep p � ' ;qr \\ F OF r**" Comm. No. CC 205953 SEAL r • , e0 44010 . My Commission E•< ires June 4 . 1993 Type Insp'n- Permit No. Name MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date Time Address 3 � 57 Company qA Phone # For Inspector: Approved Correction Re- Insp'n Fee 0 Name & Date 7 t ' • - J,- / d X"® ®/ d%'/2r Date Type Insp'n Permit N Name Address Company Approved Correction MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Reque r ∎4711... D Re- Insp'n Fee Time \, Phone # For Inspector /1 Name & Date /0127',A-?,7