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1210 NE 97 St (8)BUILDING PERMIT APPLICATION FBC 2001 Miami Shores Village Building Department $ Value of Work For this Permit l' .00 Type of Work: Describe Work: 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Permit Type (circle): Building Electrical Plumbing C' Mechanical Roofing Owner's Name (Fee Simple Titleholder) � U r' 1' '}1 2- i Phone # 0 g - 1727 1�' Owner's Address 0 1V e "1 / City r1 1 A f-0-14 � State �Z Zip _ft/ g5 Tenant/Lessee Name Phone # Job Address (where the work is being done) f r �� City Miami Shores Village County Miami -Dade Zip Is Building Historically Designated YES NO Contractor's Company Name W4 a 't-74 4 Al 1 - ` Phone C Contractor's Address _51 j k 1 0 5T City rrLt State Zip_ f Qualifier JX7 r) Yr) a I) Architect/Engineer's Name (if applicable) Phone # Square Footage Of Work: ❑Addition ['Alteration ❑New r I a (t° k\j & 5 iro / /O h * * * * * * * * * * * * * * * * * * * * * * * * * * ** F ees * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Submittal Fee $ d � � 0y76Permit Fee $ ,bv �� CCF $ CO /CC Notary $ Training/Education Fee $ Technology Fee $ Scanning $ Radon $ Zoning Bond $ Code Enforcement $ Structural Plan Review. $ Total Fee Now Due $ (Continued on opposite side) Permit No. J C Master Permit No. Repair/Replace ❑ 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. Signature Owner or Agent The foregoing instrument /as acknowledged before me this27 day of 20 C, by 0.424 -4 40F¢ , NOTARY PUB Sign: Print: V I (' My Commissi Chc12 /15/03 APPLICATION APPROVED BY: me or who has produced As identification and who did take an oath. Signature • 4 a``� ----. Contractor The foregoing instrument was before me this 07 day of 440 , 204, by Jor) /E /e-0, or who has produced as identification and who did take an oath. (Certificate of Competency Holder) State Certificate or Registration No. CAC 4 / / Certificate of Competency No. 44;12 / �'.r�4 /1t ° \HIDF 17 2 a MY rOMMI 10N a � F 1rX�l0f �; Jar�uaN i2, 2007 My Co � tdMISSION # DO 176222 sernces eXPIRES: January 12 2007 ** 19t9�r �1:' °;< ********* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * sp rk ° ***Watl�FhaV9 e1`Fd'ntS S `s * * * * * * * * * * * *** ***************************************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Plans Examiner Engineer Zoning .EM ITH 11.8 UNIT FEE ITEM SWITCH OUTLETS UNIT FEE ITEM SPACE HEATERS UNIT FEE IDET LIGHT OUTLETS CENTRAL HEATING it9kiii / 1SHWASHER RECEPTACLES A/C (WIND) iSPOSAL SERVICE TEMPORARY A/C (CENTRAL.) 4 5 1- 1017 1INKING FOUNTAIN SERVICE SIZE IN AMPS DUCT WORK DRAIN SERVICE REPAIR/MIETER CHANGE REFRIGERATION .00R ;EASE TRAP APPLIANCE OUTLETS _ PROCESS AND PRESS PIPING ITERCEPTOR RANGE TCP UNDERGROUND TANKS WATORY OVEN ABOVE GROUND TANKS ,UNDRY TRAY WATER HEATER U.F. PRESSURE VESSELS WASHER MOTORS (1- 1 HP STEAM BOILERS _OTHES -IOWER MOTORS OVER 1— 3 HP HOT WATER BOILERS INK, POT /3 COMP. MOTORS OVER 3— 5 HP MECHANICAL_ VENTILATION INK, RESIDENCE MOTORS OVER 5— 8 HP TRANSPORTING ASSEMBLIES INK, SLOP MOTCRS OVER 8— 10 HP ELEVATORS/ESCALATORS EMPORARY WATER CLOSET MOTORS OVER 10— 25 HP FIRE SPRINKLER SYSTEMS RIVAL MOTORS OVER 25-100 HP COOLING TOWERS ATER CLOSET MOTORS OVER 100 HP VIOLATION `IOIRECT WASTES — A/C WINDOW _ REINSPECTION ATER 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 COMt(RCIAL WATER SERVICE SIGN TUBES EWER CONNECTIONS SIGN TRANSFORMERS TILITY —SEWER SIGN TIME CLOCK TILITY —WATER FIXTURES EPTIC TANK ANTENNA _LAY TELEVISION OUTLETS 2AINFIELO, 4' TILE/RES. VIOLATION JMP S ABANDON SEPTIC TANK REINSPECTION DAXAGE PIT CU. FT. ATCH BASIN ISCHARGE WELL DMESTIC WELL AEA DRAIN OOF INLET t OLAR WATER HEATER c IRE STANDPIPE OOL PIPING AWN SPRINKLER SYSTEM AS RANGE _TER SET (GAS) AS PIPING PLUMBING AdDENKdM'TO BUILDING PERMIT APPLICATION AN APPLICATION FOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. IF A MASTER PERMIT HAS B. OBTAINED, THE OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.) ELECTRICAL MECHANICAL Type lnsp' Pert No. Name Address Company Phone # Inspection Date Approved Correction Re- Insp'n Fee MIAMI SHORES VILLAGE BUILDING DEPART N 305- 795 -2204 Building Inspection Requ st / AFFORDABLE AIR & HEAT, INC. 515 NE. 190TH STREET MIAMI, FL 33179 (305) 940 -0777 Fay io the order of A V v ( j u hi / v7 u r'Y J v CA L BANK 2100 E. HALLANDAL EACH BOULEVARD HALLANDALE, FL 33009 For NC 2-at -/( Date ) / i Z I `I tt 63- 1473 -670 Dollars 8 - - - - - -- 0018.1a On aaa. wr 17.0 • 41 4 r- N_ a ►: n► ar: n ►= n►c n►- nrAI K I K .►= , 1:= Oro ►= .. 0 , r) , 0 = 00,0 40 :41 :41 I. • Ii I 4 :4I :4yc44:a a :4l:4I •' chanscal Perrnit Miami Shores Village 10050 NE 2nd Avenue Phone: 305- 795 -2204 Permit Number: MC2004 -16 Printed: 1/29/2004 Page 1 of 1 Applicant: ELIZABETH M STONEHOUSE HOFFMAN Owner: HOFFMAN ELIZABETH M STONEHOUSE JOB ADDRESS: 1210 NE 97 ST Contractor AFFORDABLE AIR & HEAT Contractor's Address: 515 N. E. 190 St. Local Phone: 305 - 940 -0777 Parcel # 1132050090610 Legal Description: EARLETON SHORES PB 43 - 80 W1/2 LOT 19 & LOT 20 LESS W12.50 FT Fees: Description Amount FEE2004 -934 Building Fee $100.00 FEE2004 -935 CCF $1.80 FEE2004 -936 Notary Fee $5.00 FEE2004 -937 Training and Education Fee $0.60 FEE2004 -938 Technology Fee $2.50 Total Fees: $109.90 Permit Status: APPROVED Permit Expiration: 7/25/2004 Construction Value: $2,475.00 Work: REPLACE 4 TON AIR COND SYSTEM W /10 KW HEAT Signed: (INSPECTOR) Total Fees: $10m Total Receipts: 16.00 JAN 3 0 PAID 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: PERMIT APPLICATION FOR MUNICIPALITIES OF DADE COUNTY (OWNER TO RETAIN COPY) Date 6" ?' 92 Job Address /E/ - /V ; l7 6'7 / _ Tax Folio // Jif e� 76/1 Legal Description,//r�t /9 %o2l L id/ /c2� P / 0 4 J /10 Y Owner / Lessee / Tenant i (.0 1, Master Permit #52 2a3 Owner's Address J 2/ N' , "7 ar /4519/1/ S f' j Phone Address Z -4c:30 N• X/ 7 ,44/ Qualifier , / —'` VV—e v State # Municipal # Competency # /(4 # 'iV&i:ns.Co. Architect /Engineer Address Bonding Company Address Mortgagor Address Permit Type(circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING PENCE SIGN WORK DESCRIPTION 'tl - PLAc c L/40 729,Al 1 .vp, ,c,=.i g 6 % 7 AA) A '714 e- --1 - , A 1- 7t/ -5;7;971.):)Aci2 5;/-57-1 Square Ft. Estimated Cost(value)% ,'5 ©& 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 authort a the above ;red contractor to do the work stated. Contracting Co. ( 1--)F3 K, /VC— Signature Date: ident N -tar as to Own. =r and /or Condo President My Commission Expires: Notary as to Con actor or Owner - Builder My Commission Expires: ** * * * * * * * * * * * * * * * ** PEES: PERMIT *RADON C.C.F. ) NOTARY TOTAL DUE t APPROVED: Fire Other Zoning Building Electrical Mechanical ile- a ` '/ / I hubming Engineering MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT 76 c-/t 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 be complied with, whether herein specified or not. A copy of approved plans and specifications gust be kept at building during progress of the work. /0025 / 8 7 Date -- 4. - O2' , 19.4.6 Owner's Name and Address .R �o_ Nlf /c (t _ j Street 97 �p ' . F Registered Architect and /or Engineer , / �" Name and address of licensed contractor _ ___ ___ — '. 02`1 0 / ii �'W , it 4° / sitt • Location and legal description of lot to be built on: Lot Block Subdivision sc Street and Number where work is to be done /c2/1 0 ? C . T S State work to be done and purpose of building (by floors ) Q_Y_t.R� L2 _Q C.... STATE OF FLORIDA, COUNTY OF DADE. f ss and for no other purpose. 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 $___a;[ BU 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 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 inspection on thesite -o£the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such subcontradtprs, o , Work ta be per rmed under this permit, as are licensed by Miami Shores Village. Remarks (Signed) Before me, the undersigned authority, a notary public, duly authorized to a peared Ci er oaths and take acknowledgments, personally ap- 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. / _ Permit No 771 2 Date ld/ Read, Sworn to and Subscribed before me. Disapproved ` ___t!___ date Notary Public, State of Florida (Signed) - a Building Inspector My Commission Expires PLANNING 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 been obtained from the Planning Board. 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.