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)-.