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124 NE 96 St (6)Type Insp'n MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 B ldi g Inspection Req Date / Time Approved Correction Re- Insp'n Fee cr-th Permit No. IC 1 E 20O- q 3 . Name eo CDd I 1 . Address 1D-4 ( 1.0 S+ Company (31 (Air2_5&45--- . 3 I .2.e Phone # 30S ^ ' 2 0 - For Inspector:''. a '7 ) J Name & Date r C' 7,x'.°7 q \Y-\ OYCer 4 oPe, -\ MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date 6 Time Type Insp'n Tie IQi rCil - Permit No. GP 0-006— f `g. Name CQ dhl`G - Address 1' k NE Q G (51— Compan \ Uft 0 1(,/ t. ae,SS Phone # For Inspector: 6P 1 1 l� Name & Date Approved Correction ❑ Re- Insp'n Fee ❑ , MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date(, / °fi Time Type Insp'n k s ' 1Ckr ) Permit No. (.`?)1 ��� �� __ c - Name Ct C i Address F _ Company V fl ( f d fr 1 Phone # For Inspector: 3 ' 1 103 Name & Date Approved Correction ❑ Re- Insp'n Fee ❑ Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Printed: 5/30/2003 Applicant` *R -f±U O - --RAHN c d; l c Owner: (c c ' fl °\ A-r �r 0 JOB ADDRESS: 124 NE 96 ST Contractor BLUE BREEZE AC Local Phone: 305 - 865 -1220 Parcel # 1132060132690 Mechanical Permit Permit Number: ME2003 -93 Contractor's Address: 736 NW 107 ST Page 1 of 1 Legal Description: MIAMI SHORES SEC 1 AMD PB 10 -70 LOT 12 & 13 BLK 20 LOT SIZE 100.000 (P12-(J;jc- 0-0 c . 6 �•a� Total Fees: same-A. Total Receipts: $0.00 Permit Status: Approved Permit Expiration: 11/26/2003 Construction Value: $1,939.00 Work: DUCT WORK RE DO REPLACE EXISITNG DUCT WIRK IN SFR Signed: .f (INSPECTOR) In consideration of the issuance to me of this permit, I agree to perform the wort conformity with the plans, drawings, statements or specifications submitted to the done by either myself, my agent, servants or employes. Signed: (Contractor of BLUE BREEZE AIR CONDITIONING 736 NW 107TH STREET MIAMI, FL 33168 (305) 865 -122 PAY TO /A in I V 444 66 THE ORDER OF t Gi O !(/ BANK OF AMERICA 63. 27/6 Memo c4-4 /4646 " E12-013.93 1 :06 31.00 2 7 71: 00366069655011' 547 L Date 54711 H .. ` X30 $ 6/ L� DOLLARS • ELECTRICAL TYPE. Minimum Fee QTY. TYPE Dryer QTY. TYPE Outlet, Appliance QTY Tv PEE Service Repair Q11 A/C Central 1 -3 Ton Fan Outlet, Wall Service, Temporary A/C Central 4 -7 Ton Fire Pump Outlet, Switch Signs A/C Central 8 -15 Ton Fixture - Fluorescent Oven Space Heater (kw) A/C Central 16-20 Ton Fixture Light Parking Lot Lights Spas/Hot Tubs A/C Central 20+ Ton Flood Lights Plugmold/Strip Subfeeds, No. of Amps A/C Window FPL - Load Central Posts Swim Pool, Commercial Air Conditioners Garbage Disposal Range/Range Top Swim Pool, Residential Chiller Generators, etc. Receptacles Switchboards Clear Violations Heat Recovery Refrigerator, Comm. (p/PH) Temp Serv., Construction Compactor Low -volt, Burglar Refrigerator, Domestic Temp for Test - 30 days Deep Freezer Low -volt, Fire Renew - Temp Service Water Closet Demolition Low -volt, Intercom/Teleph. Repair Circuits Water Heater Dishwasher Low -volt, Television Service, Number of Amps Water Heater New MECHANICAL TYPE Minimum Fee QTY. TYPE Condensate Drain QTY. TYPE Generator QTY. TYPE Refrigeration, Tons QTY. A/C Central, Tons Cooling Tower Heating Strips, each Vent Hood, Cost A/C Wall/Win. Tons Dryer Vents, Number of Paint Booth Ventilation, Cost Air Handler, Tons Ductwork, Cost of 2,500 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 PL (J 1B1NG TYPE A/C Condensate QTY .n.l,l; Drains, Roof ()Ty. Tug.: Miscellaneous Fixture QTV Ty ri Soakage Pit Q ' I Y 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 PERMIT APPLICATION INSTRUCTIONS: Please indicate the type of work being performed and quantity(ies) in the space provided below. RECEIVED AND REVIEWED BY: DATE: Page 4 OFFICE USE ONLY CHECKLIST ❑ OWNER - BUILDER FORM (Attach) ❑ FIRE DEPARTMENT APPROVAL (Commercial / multi - family) ❑ CONCURRENCY (New Construction) ❑ OTHER (Specify & Attach) $3.00 per page (Scanning Fee) Miami Shores Village Bond Metropolitan Dade County (C.C.F.) $ f , 0 Inspector State Educational Fund $ State DCA (Radon) $ Code Enforcement Fine Zoning Review Notary Cl PROOF OF OWNERSHIP (Attach) ❑ HRS / DERM APPROVAL (Septic / Sewer) ❑ IMPACT FEE (New Construction) ❑ OTHER (Specify & Attach) $ SECTION Zoning Electrical Mechanical Plumbing Fire Public Works Structural Building Official BY f DATE (sq.ft. = x/1000 (¢.005 / sq.ft.) (¢.01 /sq.ft.) f PERMIT APPLICATION ❑ CONDO ASSOCIATION APPROVAL (Attach) ❑ BPR APPROVAL (Restaurants) ❑ CONTRACTOR REGISTRATION (On File) PERNIIT FEES TOTAL $ ISSUING OFFICIAL REVIEWED AND PREPARED BY: DATE: CONDITION OF APPROVAL Revised July 2001 10050 N.E. 2ND AVE., MIAMI SHORES, FL • (305) 795 -2207 • FAX (305) 756 -8972 • http : / /www.miamishoresvillage.com Page 2 IsIPORTANT NOTICES DO NOT BEGIN ANY WORK WITHOUT HAVING RECEIVED YOUR VALIDATED PERMIT AND PERMIT CARD. Applying for a permit does not grant the right to begin construction. HOURS OF CONSTRUCTION are limited to: Monday through Friday from 7:30 a.m. to 6:00 p.m., and Saturday from 8:00 a.m. to 5:00 p.m. No inspections will be conducted on weekends or holidays. 2. All construction of demolition areas MUST BE MAINTAINED IN A CLEAN, NEAT AND SANITARY CONDITION free from construction debris. 3. STREETS AND NEIGHBORING PROPERTIES SHALL BE KEPT FREE FROM DIRT AND DEBRIS. 4. SWALES MUST BE PROTECTED FROM BEING DAMAGED BY EQUIPMENT OR VEHICLES AND MAY NOT BE USED FOR STORAGE. A bond is required for work in or near the street/sidewalk. 5. CONSTRUCTION TRAILERS ARE PROHIBITED ON SINGLE FAMILY RESIDENTIAL CONSTRUCTION SITES. Other construction may have a trailer which requires a separate permit. 6. PORTABLE TOILETS for a construction site require a separate permit. 7. DO NOT DISCHARGE WATER INTO THE RIGHT OF WAY OR STORM DRAINS without approval from the Building, Planning and Zoning Department. 8. EQUIPMENT AND MATERIALS SHALL BE STORED at least 10 feet from the edge of pavement. 9. Department of Health and Rehabilitative Services (HRS) approval is required for applications involving septic tanks. Department of Environmental Resources Management (DERM) and/or Miami -Dade Water and Sewer Department (MDWASD) approval is required for applications involving sewers. 1. 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 ip you paying twice for improvements to your property. If you are spending more than $2,500 or intend to obtain financing, you may wish to consult with your attorney or lender before recording your Notice of Commencement. The Notice of Commencement must be recorded at: 22 N.W. 1st Street, 1" Floor, (305) 679 -1078. Once recorded, the Notice of Commencement must be POSTED AT THE JOB SITE in accordance with Section 713 -35 of Florida Statutes. Review the brochure at Village Hall on Construction Lien Law and Choosing a Contractor. STATE OF FLORIDA, COUNTY OF MIAMI -DADE Signature of Owner ARru o e. AD! LL A Print Name rn o and subscribed before me thisday of Personally known � OR, Produced Identification N * DD066963 P RES: October 23, 2005 R. Notary Service & Bonding, In Type of Identification Produced: STATE OF FLORIDA, C Signature of Continegf Signature of N SEAL: Personally known PERMIT APPLICATION NTY OF MIAMI -DADE Print Name Sworn and subscribed before me this r g 1 ' day of IACt OR, Produced Identification Type of Identification Produced: CONTRACTOR New Construction Nam ro Enclosure License o. J ig t no 9 Alteration Exterior Address 76( Q L ®7. V `4- . r 1, 53kCQ8 Repair Telep one p/_' 5- _ 1? 7 \J F ^ s (lj n _ b �(.. 74 � �(S Qualifier Name m.s 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 Step 1. Job Address: PERMIT TYPE (✓ ) Building Electrical Mechanical Plumbing LPGX Roofing Fence Other INSTRUCTIONS - The following steps must be taken to obtain a permit from the Miami Shores Village: Complete the attached permit application which must be signed by the property owner and qualifier. Both signatures must be notarized. Please print or type to allow for a more accurate processing of your application. If roofing work will be done, a roofing application must be submit- ted along with this permit application. Step 2. Submit the completed application with all necessary documents to the Building, Planning and Zoning Department for processing. During the processing of your application, you may be asked to submit additional information. APPLICATION /Z4 q 6 5T Address Folio Number // 3 2 o so O/ 3 Z C? 0 Description of Work I .. CIO LA- (C K Lot Block JO1OI& ,Q409t j L1>Oti IA) Linear PB PG Zoning r Feet Apt. /7 / / City �PE PERMIT APPLICATION Master Permit No. i 03 Subsidiary Permit No. State Current Use of Property Square Feet Units Floors 0 is Proposed Use of Property t o of Work I , f 3 9 . Bldg Value Tenant Information Tax Assessed/Appraised Value Flood Zone Base Floor Elev. PERMIT CHANGE (✓ ) Chg. Contractor Renewal Revision Extension Supplement Reinspection ARCHITECT Name License No. Address Telephone Fax PROPERTY OWNER Name ^ : .Ol Address Home Telephone Business Telephone Fax ENGINEER Name License No. Address Telephone Fax MIAMI SHOREg VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date dam. Time Type Insp'n h no Permit No. 1 e.-. d0(..53 - 93 Name A 1 xo Address `) N c I cST Company 31 & 7S- Phone # 3c5 -- ) D.D-o For Inspector: Nc 9 `,p 3 Name & Date Approved Correction Re- Insp'n Fee •M AMI SHORES VILLAGE • BUILDING INSPECTION DEPARTMENT. . APPLICATION FOR BUILDING. PERMIT' Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build - in; or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami ti ,'.res Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and r :gu:ations of the Budding Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of the work. Date ..._ , Owner's Name and Address y v No.� V �� Street..., • Registered Architect and /or Engineer:_ ... ...... Name and address of licensed contractor L.?oation and legal description of lot to be built on: Lot Block 'Subdivision Street and Number where work is to be done / 2 `/ State %vonk to be done and yuipose of building (by floors).._ -.F A E,:imated Total cost of improvements $..• [ 0 O 0'0 Perna No D:sapproved , 5 Bred ) Bui Date O 2 4s/1/, /r • Read, Sworn to and Subscribed before me. and for no other purpose. New Bu :ldin, ............ . . .... Remodeling 'Addition: Repairs No. of Stories .. To be constructed, of - Kind of foundation Roof Covering Amount of Permit $ cubage required -Plan Cubage Distance to next nearest building Size of Building Lot MaA :anon live load to ba 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 sent to.. . .. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of i.ri.or under the Florida Workmen's Compensation Act, being Section 54)GG, Compiled General Laws of Florida, Permanent Supplement. has complied xvith the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him fr. 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 su sus / ors, on work to be performed under this permit, as are licensed by Miami Shores Village. .' F arks (Signed) . STATE OF FLORIDA, COUNTY 07 DADE. ss. Before me, the undersigned authority; a notary public, duly authorized to administer oaths and take acknowledgments, personally ap- reared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the. above described construction, that he has carefully reac foregoing application, and that he did sign the same, and that all facts :L :cin by him stated are true. I/ 7 3 Date S •Notary Public, ,State of Florida ing Inspector / My Commissiori Expires NING BOARD DATE C:.a :r :ran Member • lit.:Aber - Member ,.!umber Member 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 1ljard• re- in.,i,ecuen lee of 51.00 will be charged when such re- inspection is mado necessary by improper notice for inspection or faulty .0 ien..s and /or workmanship. 6Lit,e,4_„ /7,- Vf 2€ 2V - .e-t,zt/% I go Al 06)-.