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440 NE 94 St (7)PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date - c /P' ?7jobAddress 4140 tiE 9' s 7` Tax Folio I/ 3 2-06 C'/ yr - 0 330 Legal Description Historically Designated: Yes N Owner/Lessee / Tenant L E k /14 /G E L S Master Permit # �p 9� / J y o 7 E 7 Phone Address K7--a O 5 w 3 s T',F /- Owner's Address 5 4' FY 5 7 Contracting Co. Rb B / 2 oz. N Qualifier '<-'- a Aft € L n State # r1') I 11- Municipal # Architect/Engineer Bonding Company Mortgagor Address Permit Type (circle one): BUILDING ELECTRICAL PLUMBING ROOFING PAVING FENCE SIGN WORK DESCRIPTION TO �, � - '4- e - £ 7 l N (– to �- Signature of owner and/or Condo President Date FEES: PERMIT V RADON APPROVED: Zoning Building SS# Phone Z S' 0 s S' Competency # © One/2.4'3'7 Ins. Co. Address Address 3 To .v Square Ft. Estimated Cost (value) 1/ 1/22c 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 authorize the above -named contractor to do the work stated. Signature of Contractor or Owner- Builder Electrical Date Notary as to Owner and/or Condo President Date Notary as to Contractor or Owner - Builder _ .. Date My Commission Expires: My Commission F,xpires ,�-, s` •) r : °' E b . oZ - / i "9' I Ii !' p X11 C.C.F. / NOTARY BOND TOTAL DUE — 7a , Mechanical Lj i, ;r, / Plumbing Engineering 'It/ LIVE and SHOP in BEAUTIFUL MIAMI SHORES Village Office: 754-754! MIAM 3s -t) Village - — r 7j I/7-C° h 1iek, Maintenance Superintendent Bradford, Building Inspector . Petrey, Recreation Director e Grundy, Librarian m . m . MEMBERS LIBRARY BOARD Carl F. Paulsen, Chairman Mrs. A. Alston Fisher, Jr. Mrs. Dean R. Miller Mrs. Robert S. Lafferty, Jr. Roland M. Stafford Place Village Hall Country Club Country Club Country Club Country Club Country Club Country Club Country Club Country Club Country Club Country Club Community Center MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR = UILDING PERMIT Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build- ing 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 he 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__._ Nov Owner's Name and Address . .. ca.A_aJ_ CI g .+s s t it q c- ev No 5 "° Street N E `r 4' V Registered Architect and /or Engineer Name and address of licensed contractor_ __ A �! ' Cy L . e o ? Z 9 4 S Lk) 4 12 - - M ir e Location and legal description of lot to be built on: Lot Block Subdivision Street and Number where work is to be done ° " State work to be done and purpose of building (by floors) C�tv,n -Z'& 3 7.0 r• n � ��d D 6rb� ^ Zh r GNP 'Z S_ f7 4� �t C New Building Remodeling Addition Repairs No. of Stories To be constructed of Kind of foundation Roof Covering Estimated Total cost of improvements $ Amount of Permit $ Zone cubage required plan Cubage Distance to next nearest building Size of Building Lot 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 pennit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Supplement, and has complied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such subcontractors, on work to be performed under this permit, as are licensed by Miami Shores Village. Remarks_.._ _ ( Signed) 1 1%!/. • Notary Public, State of Florida and for no other purpose. STATE OF FLORIDA, COUNTY OF DADE. j ss. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap- peared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the. of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. J I Z Permit No 1 (� �� Date I `- .1... d, Sworn to and Subscribed before me. Disapproved (Signed) Building Ind. • ctor My Commission Expires PLANNI ,t BOARD DATE Chairman Member Member Member Member Member Council Approved Date Disapproved Date NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has hecn obtained from the Planning Board. A re 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. In ertn1t1' tl# : ..................... Inspection Date: 07/19/2006 Inspector: Perez, JanPierre Owner: GOODENOW, GARY AND MARY Job Address: 440 94 Street NE Miami Shores Village, FL 33138- Project: <NONE> Contractor: AFFORDABLE AIR & HEAT Building Department Comments Monday, July 17, 2006 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 JUL 2 4 RECO Block: Permit Type: Mechanical - Residential Inspection Type: Final Work Classification: New Phone Number (305)757 -5235 Parcel Number 1132060140330 Lot: Phone: 305 - 770 -4167 Page 2 of 2 Passed Inspector Comments Al \ l/te Failed Correction Needed Re- Inspection Fee ($75) No Additional Inspections can be scheduled re- inspection fee is paid . until In ertn1t1' tl# : ..................... Inspection Date: 07/19/2006 Inspector: Perez, JanPierre Owner: GOODENOW, GARY AND MARY Job Address: 440 94 Street NE Miami Shores Village, FL 33138- Project: <NONE> Contractor: AFFORDABLE AIR & HEAT Building Department Comments Monday, July 17, 2006 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 JUL 2 4 RECO Block: Permit Type: Mechanical - Residential Inspection Type: Final Work Classification: New Phone Number (305)757 -5235 Parcel Number 1132060140330 Lot: Phone: 305 - 770 -4167 Page 2 of 2 Receipt Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Fax: (305)756 -8972 Permit Number: MC -6 -06 -1791 Invoice Number: MC -7 -06 -25443 Applicant: GARY AND MARY GOODENOW Company Name: Owner Address: 440 NE 94 ST MIAMI SHORES, FL 33138. Job Address: 440 94 Street NE Miami Shores Village, FL 33138- Date Wednesday, July 12, 2006 07/12/2006 Check Payment Type Check Number 2862 Amount $112.10 Change $0.00 Total Payment: $112.10 Page 1 of 1 BUILDING ° PERMIT APPLICATION FBC 2001 Owner's Address Tenant/Lessee Name Phone # $ Value of Work For this Permit 11o44' ' Code Enforcement $ Structural Plan Review. $ Total Fee Now Due $ (Continued on opposite side) HZ.10 Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Te r 1 : 305) 756.8972 -f ' EIVE JUL 1 2 Pain Permit No. Master Permit No. City m / / if i J JW YC tate I Zip Permit Type (circle): Building Elec Plumbing ( Me hanical Roofing Owner's Name (Fee Simple Titleholder) ma �(r de79 Phone # N � Job Address (where the work is being done) 440 NC Q4L City Miami Shores Village County Miami -Dade Zip Is Building Historically Designated YES NO Contractor's Company Name p�'v ,-m'' Phone # 0 - '0 .- 27 � Contractor's Adddd�resns'• 1lf i\ j I O 3 f I�l/ City fY VU,UI' U/ State Zip (1 Qualifier N,�/') f ��Qi!'7 State Certificate or Registration No.Cf f 4 ' l / l Certificate of Competency No. Architect /Engineer's Name (if applicable) Phone # Square Footage Of Work: Type of Work: ❑Addition ElAlteration New *Repair/Replace ❑ Demolition Describe Work: repla6c 3-- ) Air hand 4.-K IN 16,diu * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** nnsq �1C - 1 - 1 � I Submittal Fee $ Permit Fee $ l $ �/ CCF $ 1 . Z-C) CO /CC Notary $ - CO Training /Education Fee $ O 40 Technology Fee $ 2. Scanning • Co ' Radon $ Zoning Bond $ vp2 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 COM _ MENT." Signature NOTARY P Sign: Print: Notice t promise in whose proper for the first insp inspection will not b wner or Agent The foregoing instrument was acknowledged before me this 3 r The for g instrument was acknowledged before me this tfode day of jig , 20 a__, by na fru* day of , 20 2 , by t "/ i eil7 who is personally known to me or who has produced 635C i 12_ As identification and who did take an oath. / o is personally known to me-erWI10 has produced My Commission Expires: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must that a copy of the notice of commencement and construction lien law brochure will be delivered to the person t to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site • h occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the d and a reinspection fee will be charged. Signature •s° ,, , THERESA R. MONTALVO rP ;40,:74;:i `OS : Notary Public - State of Florida "� neStcrniviasapiEet AA a m P00g of �t ;?;•• Commission # DD 433552 Bonded By National Notary Assn, NOTARY PUBLIC: Sign: Print: My Commis * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** ****************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** * * * * * * * * * * * ** APPLICATION APPROVED BY: chc 05/13/03 40 05, Contractor as identification and who did take an oath. * * ** * ** * * * * * * * * * * * * * * ** (011/; * Plans Examiner Engineer Zoning * ** ITEM 3ATH MB UNIT FEE ITEM SWITCH CUTLETS UNIT FEE ITEM SPACE HEATERS UNIT FEE 3IDET LIGHT CUTLETS CENTRAL HEATING 10,a/V I )ISHWASHER RECEPTACLES A/C (WIND) )ISPOSAL SERVICE TEMPORARY A/C (CENTRAL ) 3-1/3,0 I i JRINKIIC FOUNTAIN SERVICE SIZE IN AM S DUCT WORK FLOOR DRAIN SERVICE REPAIRAETER CHANGE REFRIGERATION GREASE TRAP APPLIANCE CUTLETS PROCESS AND PRESS PIPING INTERCEPTOR RANGE TOP UNDERGROUND TANKS LAVATORY OVEN ABOVE GROUND TANKS LAUNDRY TRAY WATER HEATER U.F. PRESSURE VESSELS CLOTHES WASHER MOTORS 0- 1 FP STEAM BOILERS SHOWER MOTORS OVER 1- 3 FP HOT WATER BOILERS SINK, POT /3 COW . MOTORS OVER 3- 5 I$ 6ECHANICAL VENTILATION SINK, RESIDENCE MJTCRS OVER 5- 8 FP TRANSPORTING ASSEkBLIES SINK, SLOP MOTORS OVER 8- 10 FP ELEVATORS/ESCALATORS TEM'ORARY WATER CLOSET MOTORS OVER 10- 25 FP FIRE SPRINKLER SYSTEMS URINAL MDTCRS OVER 25-100 FP COOLING TOWERS WATER CLOSET MOTORS OVER 100 FP VIOLATION INDIRECT WASTES A/C WINDOW REINSPECTJON WATER SUPPLY TO: AIR CONDITIONERS A/C UNIT STRIP HEATER F IRE SPRI NKLER GENERATORS TRANSFORMERS HEATER -NEW INST. I GENERATORS . TRANSFORMERS HEATER- REPLACE I GENERATORS TRANSFORMERS 1 LAWN SPRINKLER -WELL SPECIAL PURPOSE SWIMdING POOL OUTLETS COWERCIAL WATER SERVICE SIGN TUBES SEWER CONNECTIONS ,•.SIGN TRANSFORMERS UTILITY -SEWER SIGN TIRE CLOCK UTILITY -WATER FIXTURES SEPTIC TAN); ANTENNA . TELAY TELEVISION CUTLETS )RAINFIELD, 4' TILE/RES. 'DR VIOLATION E ABANDON SEPTIC TANK RE I NSPECT ION OAKAGE PIT CU. FT. :ATM BASIN )ISCHARGE WELL )OMESTIC WELL REA DRAIN: f J ;OOF INLET OLAR WATER HEATER IRE STANDPIPE J I OOL PIPING I I AWN SPRINKLER SYSTEW AS RANEE I I _TER, SET (GAS) 6.S 1 I I I PIPIT. f 1 I 1 1 !-% 1 1 L. 1 V 1\ 1 1 V I PLUMBING 11 LJ✓LI IJ VIVI 1 V LJU J. 1-U 11\ V I L 16iY1 t 1 AN AL'PLICATION FOR BUILDING PERMIT MUST ACCOMPANT THIS ADDENDUM. IF A MASTER PERMIT HAS B. OBTAINED, THE OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.) ELECTRICAL Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Fax: (305)756 -8972 Permit Issue Date: 7/3/2006 Expires: 01/01/2999 Owner's Name: GARY AND MARY GOODENOW Permit Type: Mechanical - Residential Work Classification: New Job Address: 440 94 Street NE Additional Information Miami Shores Village, FL 33138- Contractor(s) AFFORDABLE AIR & HEAT Phone 305 - 770 -4167 Primary Contractor Yes Com ments: REPACLE 3 TON AIR HANDLER WITH 8 KW HEAT Tons: 3 Classification: Residential Additional Info: 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, servants, or employes. I understand that separate permits are required for ELECTRICAL, PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work. OWNERS AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Futhermore, I authorize the above -named contractor to do the work stated. Fees Due CCF Education Surcharge Notary Fee Permit Fee - Additions /Alterations Scanning Fee Technology Fee Total: Amount $1.20 $0.40 $5.00 $100.00 $3.00 $2.50 $112.10 Building Department File Copy Parcel #: Block: Section: Permit Status: APPROVED Permit Number: MC -6 -06 -1791 Phone: (305)757 -5235 1132060140330 Lot: PB: Total Square Feet: Total Valuation: Required Inspections 0 $ 1,696.00 Rough Rough Duct Ventilation Smoke Test Hood Smoke Det Test Final Invoice Number MC - 7 - 06 - 25443 Total: Amt Due $112.10 4 JUL 1 2 PAID CK z56z Amt Paid NOTICE: In addition to the requirements of this permit, there may be additional restrictions applicable to this property that may be found in the public records of this county. AND THERE MAY BE ADDITIONAL PERMITS REQUIRED FROM OTHER GOVERNMENTAL ENTITIES SUCH AS WATER MANAGEMENT DISTRICTS, STATE AGENCIES, OR FEDERAL AGENCIES .