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ELECTRICALBUILDING PERMIT APPLICATION FBC 2001 Permit Type (circle): Building ( Electric Plumbing Mechanical Roofing t",_, ° Owner's Name (Fee Simple Titleholder) �„ t , Phone # $ Value of Work For this Permit Type of Work: gddition Describe Work: Total Fee Now Due $ (Continued on opposite side) Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 ❑Alteration Permit Fee $ Submittal Fee $ Notary $ Training/Education Fee $ Owner's Address 1 '� City State Zip Tenant /Lessee Name WK L' b1i��.l4�_ Phone # Job Address (where the work is being done) City Miami Shores Village County Miami-Dade Zip Is Building Historically Designated YES NO Contractor's Company Name S 1.. � � \ V # .> � �' l e A, _ ?-W1 7 Contractor's Address CSc • City IA., xA State T L Zip . S _q j Qualifier Ca kr- ` `� V_N, i;•,c_ z State Certificate or Registration No. C ��,� \2,1 Certificate of Competency No. CH. E. � , . . Architect/Engineer's Name (if applicable) Phone # - L tty i d t ❑New, reeS Master Permit No. S uare Footage Of Work: CCF $ Permit No. ltepair/Replace * * ** * * * * * * * * * * * * * * * * * * * * * ** Technology Fee $ Scanning S Radon $ Zoning Bond $ Code Enforcement $ Structural Plan Review. $ CO /CC ❑ Demolition Bonding Company's Name (if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State Zip Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment: Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. APPLICATION APPROVED BY: Chc 05/13/03 Signature Signature Owner or Agent Contractor The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this " I— day of , 20 , by , day of I e , 20 r, by who is personally known to me or who has produced who is personally known to me or who has produced As identification and who did take an oath. as identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Sign: Sign: t7 ly('.G,et -et. .• • •. ° B� %. Ll1IS FERNANDEZ Print: Print: * a t * MY COMMISSION # DD 348488 My Commission Expires: My Commission Expires: ,P !!!!� ' P EXPIRES: November 7, 2008 9T ` O OF Fl�a\O Bonded Thor Budget Notary Services ***************************************************************************** * * * * * * * * ** * * * * * * * * * * * * * * * * * * * ** Plans Examiner Engineer Zoning 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Owner's Address (Ogg 14 Citv /17, ' r3 i `n rt f State , F Tenant/Lessee Name Al Architect/Engineer's Name (if applicable) Type of Work: Addition Describe Work: Total Fee Now Due $ (Continued on opposite side) w ami Shores Villa ilding Department BUILDING Permit No PERMIT APPLICATION � / Master Permit ;No. ';� FBC 2001 Permit Type (circle): Building Owner's Name (Fee Simple Titleholder) Q T to S 509, 40 5 c. Phone # et 7 5t V Job Address (where the work is being done) (Q& u ,Jt. e t 7 c5( City Miami Shores Village County Miami -Dade Is Building Historically Designated YES NO Contractor's Company Name fr e.re £ ��tf --�� Phone #_G S 3le - 46 e Contractor's Address 1060 d St-A city () ' State 9t/ Zip Qualifier � O ,rle 5 r ` r& State Certificate or Registration No. 6607 17? 3v Certificate of Competency No. air $ Value of Work For this Permit � C= Square Footage Of Wow': ❑Alteration ['New CCF $ 1 CO /CC Permit F$ 6 Zip Phone # done 1` Plumbing Mechanics_ Roofing 20 ) 75 » 24 3 Zip ❑ Repair/Replace ❑ Demolition Submittal Fee S Notary S Training/Education Fee S. i`, Technology Fee $ Scanning S � — ' Radon S Zoning Bond S Code Enforcement $ Structural Plan Review. $ Bonding Company's Name (if applicable). Bonding Company's Address City State Zip Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State Zip Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature The foregoing instrument was acknowledged before me this f o / ^';,(ftiregoing instrument was a owledged before me this /7 day of • r , 20t-> by + i � K . " r. ;�.r �� , day of , �,k. l , 20o((, by hc.r (�_t Veru ma� ) , who is°11ersonally known tt The or who has produced who is personally known to me or who has produced NOTAR) : LIC: Sign Print: My Commission Expires: Own' r or Agent ************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** APPLICATION APPROVED BY: Chc 05/13/03 As identification and who did take an oath. as identifica ij d ;eked/4041X an oath. Signature NOTARY PUBLIC: Sign: Print: Contr • My Commission DD251705 �,� © w Expires September 21 2007 1- 14iLe4:14, My Commission Expires: )- • 21 , 20.7 ? *************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** f' : ' lans Examiner Engineer Zoning Electrical Permit Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Permit Number: EL2005 -22 Printed: 3/4/2005 Page 1 of 1 Applicant: AZUCENA ESPINOSA Owner: ESPINOSA AZUCENA JOB ADDRESS: 1084 NE 97 ST Contractor CARLY ELECTRICAL SERVICE Contractor's Address: 680 FLAGAMI BLVD. Local Phone: (305)261 -8077 Parcel # 1132050170190 Legal Description: REV PL MIAMI SHORES SEC 8 Fees: Description Amount FEE2005 -1972 Building Fee $250.00 FEE2005 -1973 CCF $1.80 FEE2005 -1974 Training and Education Fee $0.60 FEE2005 -1975 Technology Fee $6.25 FEE2005 -1976 Scanning Fee $3.00 Total Fees: $261.65 Permit Status: APPROVED Permit Expiration: 7/18/2005 Construction Value: $2,200.00 Work: NEW ELECTRICAL PANEL BOX. UPGRADING MAIN HOUSE TO CODE. ELECTRIC Signed: (INSPECTOR) PB 43 -51 LOT 7 BLK 181 LOT Total Fees: $261.65 Total Receipts: $0.00 ON. MASTER, GUEST, 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. Signed: (Contractor or Builder) BY: BUILDING ELECTRICAL PLUMBING Owner of Building MIAMI SHORES VILLAGE, FLORIDA PERMIT N? 8923 Contractor's License No. Work to be performed under this Permit Architect DATE 1941 Contractor or Builder Legal Lot Bl. Subdi Description vision Address of Value of Amt. of Building__ Project 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 appli- cation herefor in strict compliance with all ordinances pertaining thereto and with the understanding, that the work will be performed in compliance with anv 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 respon- sibility for work done by his agents, servants or employees. Signed: 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. CONTRACTOR OR BUILDER BY AUTHORITY BUILDING ELECTRICAL PLUMBING Owner of Building Architect Contractor or Builder Legal Lot Description Address of Building 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: 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. CONTRACTOR OR BUILDER MIAMI SHORES VILLAGE, FLORIDA PERMIT N° 9837 Work to be performed under this Permit 131. Subdi- vision Value of Project $ DATE 195 Contractor's License No Amt. of Permit $ BY AUTHORITY SWITCH OUTLETS LIGHT OUTLETS PLUG RECE'P'T'G FIXTURES NO.LAMPS REFRIG. OUTLET IRON OUTLET RANCH OUTLET RANGE CONN. WATER HEATER W. HEAT. CONN. SPACE HEATER STRIP HEATER TOTAL CONTR. LIST CHECK ENT. DIET. SW. CAB. SERVICE'_ �.' :P. SERVICE PERM. MOTORS 0_1 HP MOTORS 1-5 HP NEON TRANS. RADIO TOTAL CON TR. LIST I d t / ` 1 ... - ::.:1( Permit No. = _ Y_ _ Registered Architect and /or Engineer _— Employing Electrician's Name_ Location and Legal Description Lot___ -. Service Overhead Size Feeders Conduit Underground Type of Ir.smllatior,— Conduit Tubing. Amount of Permit �- -- _------- - - - - -- STATE OF FLORIDA, COUNTY OF DADE. ss. My Commission Expires MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTM ENT APPLICATION FOR ELECTRICAL PERMIT App'.icatic 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 S`e.o.rs Viilag stall be complied with, whether herein specied or not. A copy of approved plans and specifications must be kept at building during progress cf work. Owners Name and Address No -- - --� - �---------- �=----- - - -__. Street- ---- `-- ----=-- «— .,w - - - -- The undersigned applicant for this building permit does hereby ce under the Florida Workmen's Compensation I ct, being Section 5966, plied with the provisions thereof, and will require similar compliance performed under this permit: and will post or cause to be posted fcr required by the Act. The under signed agrees to employ only such licensed by Miami Shores Village. Block (Signed) (Signed) Date Street____ 1. Subdivision ______________— ___________ Street Street and Number where work is to be performed— No _�___.__ State work to be performed and purpose of building (By Floors) New Building Remodeling Addition Repairs —___ No. of Stories. Main Sw. —_____ Amps. Main Fuses.. B. :C.L. Metal Moulding __-- �- -- -�_ Notary Public. State of Florida Amps. Electrical Inspector. rtify that he understands and accepts his obligations as an employer of labor Compiled General Laws of Florida Permanent Supplement, and has corn- from all contractors or sub - contractors employed by him in the work to be inspection on the site of the work such public notice or notices as are sub- contractors, on work to be performed under this permit, as are — 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 he 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 Ea of 51.00 gill bz in :c c rrhen such -e- inspection it made necessary by impropc: notice for inspection, or faulty materials an: /or worcxanship. Permit ________ State work to be performed and purpose of building (By Floors) MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT 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 `lrir,V t i3 ea_ No ` U j ' " '_ —_ Street___ " _ V Registered Architect and /or Engineer Employing Electrician's Name _____ C Rx 3 7th, Y@ _- 1.E3Vr.k _ ! Jii- � No. i �� ��►) • ��__ `��______ Street_ ____ Location and Legal Description 161 u f " f ` Subdivision__" J —_____ ___________ .� Street and Number where work is to be performed —No l Of4. • 1 �> �+ i t h � Street ►.ix " yiUiioiieo Date___ 2 / 6 / t U New Building X Remodeling .Addition Repairs Overhead .._ Conduit___ Main Sw._ —`__` - Amps. Main Fuses_ — 4'l3 �` _____Amps. Servi O tid Size Feeders ___ Type of Installation— Conduit Tubing B.X.L Metal Moulding Amount of Permit $_ 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 bas 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, onorle to be performed under this permit, as are licensed by Miami Shores Village. STATE OF FLORIDA, COUNTY OF DADE. ss. (Signed) _ 4- (Signed) _ 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 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. No. of Stories. Master Elcctrican. 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 6 18 28 16 1 i' 1 CHECK ENT. SW. DIST. CAB. SERVICE TEMP. SERVICE PERM. MOTORS 0-1 HP MOTORS 1 -5 HP NEON TRANS. RADIO TOTAL. CONTR. LIST 1 1 1 CHECK Permit ________ State work to be performed and purpose of building (By Floors) MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT 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 `lrir,V t i3 ea_ No ` U j ' " '_ —_ Street___ " _ V Registered Architect and /or Engineer Employing Electrician's Name _____ C Rx 3 7th, Y@ _- 1.E3Vr.k _ ! Jii- � No. i �� ��►) • ��__ `��______ Street_ ____ Location and Legal Description 161 u f " f ` Subdivision__" J —_____ ___________ .� Street and Number where work is to be performed —No l Of4. • 1 �> �+ i t h � Street ►.ix " yiUiioiieo Date___ 2 / 6 / t U New Building X Remodeling .Addition Repairs Overhead .._ Conduit___ Main Sw._ —`__` - Amps. Main Fuses_ — 4'l3 �` _____Amps. Servi O tid Size Feeders ___ Type of Installation— Conduit Tubing B.X.L Metal Moulding Amount of Permit $_ 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 bas 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, onorle to be performed under this permit, as are licensed by Miami Shores Village. STATE OF FLORIDA, COUNTY OF DADE. ss. (Signed) _ 4- (Signed) _ 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 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. No. of Stories. Master Elcctrican.