37 NE 97 St (6)PAY
TO THE
ORDER OF
Miami Shores illage
10050 NE 2nd Avenue
Phone: 305 -795 -2204
Printed: 10/11/2002
Applicant: PAUL
Owner: CALLI
JO ADDRESS: 37 NCB 97
Contractor ATLANTIS ELECTRICAL CORP
Local Phone:
Parcel # 1132060130980
Work:
s. o
Permit Status: APPROVED Permit Expiration:
INSTALLATION OF NEW OUTLETS FOR NEW ADDITION
ATLANTIS ELECTRICAL CORP.
12803 SW 20TH TER. PH. 305 -551 -9002
MIAMI, FL 33175
COMMERCEBANK
NATIONAL ASSOCIATION
1601 East 41h Avenue
Hialeah. Florida 33010
13
FOR
000 3 3 5 30 a:0670 L0 509ae 1, 38700 L 59511°06
lectrical Permit
Permit Number: EL2OO2 =333
Legal Description: MIAMI SHORES SEC 1 AMD PB 10 -70 LOTS 15 & 16 BLK 7 LOT SIZE 100.000
4/9/2003
CALLI
PAUL
ST
Contractor °s Address: 12803 SW 20 TERR
o,o0
Construction Value:
$3,100.00
If there is no permit package accessible on the job -site for inspectors to verify, there will be no inspections.
---1 ki Q.,
i .i U
10 —(
DATE
1 $
DOLLARS
3353
63- 1050/670
8
1 ,s 0
Total Fees: WOO
Total Receipts: $0.00
Seerny rove.
Page 1 of 1
Re- inspection
ation herefor in strict compliance with all
cations that may have been submitted to
or if the plans are changed without
)nsibility for a thorough knowledge of the
at he assumes responsibility for work done
is pertaining thereto and in strict conformity
tsponisibility for all work done by either
CONTRACTOR
New Construction
Name P1l LA rSii EZEll\1CAL. Gti-Z
Alteration Exterior
License No. S ri t 0 000 .2
Repair
Address 4 �-
(c)- 63 St...) J-0
...-t i /a tt ( L 3 - 341
Demolish
�
Telephone3p )JJ 1 '"J 0�.. Fax 53 c-J �_
11
1
Qualifier Name Fl`f C l , C.a - Y
Foundation Only
TYPE OF MANAGEMENT (1 )
New Construction
Enclosure
Alteration Exterior
Repair
Alteration Interior
Demolish
Relocation of Structure
Shell Only
Foundation Only
Add'! Attachment
Other
Add'l Detachment
Other
171 1
- T ::1 1 ,1'" :I
INSTRUCTIONS!- The 1'ollowing steps must be taken to a permitfrotn' the M a i Sho es Vil'la1;e:
Step 1.
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.
Job Address:
`1 t ' S�t �t.n,c l St��. s �L
Address
Apt.
Folio Number
Lot Block
Subdivision PB I PG
Current Use of Property (1 - 11 -- 5. Q. 4
Proposed Use of Property
Tenant Information
PERMIT TYPE ( )
Building
Electrical
Mechanical
Plumbing
LPGX
Roofing
Fence
Other
t/
PE MIT CHANGE (r/ )
Chg. Contractor
Renewal
Revision
Extension
Supplement
Reinspection
ARCHITECT
Name
License No.
Address
Telephone
Fax
PROPERTY OWNER
Name C Q
Address
Home Telephone
Business Telephone
Fax
PERMIT APPLICATION
Master Permit No. ?)? a0.-2,-(sr?
Subsidiary Permit No. 1/' - Q() �
City State Zip
Description of Work �' � (� ° of l"-2 u ° 24 I--
v—Q-
C. cQ cQ . fi
Linear Feet
Zoning
Square Feet Units Floors
O Va1ue of Work 3 • 3 0
Tax Assessed/Appraised Value
Flood Zone Base Floor Elev.
Bldg Value
ENGIINEER
Name
License No.
Address
Telephone
Fax
Page 2
I 1POICIA Ni' NOT1('1:S
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.
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 in 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
Signat e of • wner
Print Name
Sworn to and subscribed before me this day of
Signature of Notary Public - State of Florida
SEAL:
STATE OF FLORIDA, CY OF MIAMI -DADE
Signature of Contractor / Qualifier
.L C- t.j c s _ P 3
Print Name
Sworn to and subscribed before me this
[[[
SEAL:
Public tate of ' orida
n
PERMIT APPLICATION
day ol7 ec ,
ure of N
Personally known OR, Produced Identificatio
Personally known OR, Produced Identification )) //
Type of Identification Produced: Type of Identification Produced? 2. � T6g
ELECTRICAL
TYPE
Minimum Fee
Q'I'1'.
TYPE
Dryer
QTY.
TYPE
Outlet, Appliance
QTY.
TYPE
Service Repair
(fly.
A/C Central 1 -3 Ton
Fan
Outlet, Wall
'23
Service, Temporary
A/C Central 4 -7 Ton
Fire Pump
Outlet, Switch
/0
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/PIHI)
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
TYI'1•
Minimum Fee
QTY.
TYPE
Condensate Drain
QTY.
T1
Generator
Q•I'Y.
'I'YI'f:
Refrigeration, Tons
Q'fl'.
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
Piping, Flammable Liquid
Periodic IInspections
Barbecue
Fire Sprinkler System
Process/Pressure Piping
Supply, AC Well
Bath Fan - Vented, #
Fireplaces, Number of
Pressure Vessel
Temporary Toilet
PLUi\1 RING
TYPE PI.
A/C Condensate
QTY
TYPE
Drains, Roof
QTY
"I'1'1'E
Miscellaneous Fixture
()Ty.
"I'YI'i
Soakage Pit
()Ty.
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
INSTRUCTIONS: Please indicate the type of work being performed and quantity(ies) in the space provided below.
RECEIVED AND REVIEWED BY:
A.
PERMIT APPLICATION
DATE: /; 49 7
SECTION
BY
DATE
Zoning
Electrical
/ ,o1,��r'
Mechanical
Plumbing
Fire
Public Works
Structural
Building Official
Page 4
OFFICE USE ONLY
('IIF.('KLIST
U OWNER - BUILDER FORM
(Attach)
0 FIRE DEPARTMENT
APPROVAL (Commercial /
multi - family)
O CONCURRENCY
(New Construction)
O OTHER
(Specify & Attach)
PER111T FEES
$3.00 per page (Scanning Fee)
Miami Shores Village
Bond
Metropolitan Dade County (C.C.F.)
Inspector State Educational Fund
State DCA (Radon)
Code Enforcement Fine
Zoning Review
Notary
REVIEWED AND PREPARED BY:
❑ PROOF OF OWNERSHIP
(Attach)
❑ HRS / DERM APPROVAL
(Septic / Sewer)
❑ IMPACT FEE
(New Construction)
❑ OTHER
(Specify & Attach)
5
(s .6. x/1000
x
(¢.005 /sq.ft.)
(¢.01 /sq.ft.)
PERMIT APPLICATION
❑ CONDO ASSOCIATION APPROVAL
(Attach)
❑ BPR APPROVAL (Restaurants)
❑ CONTRACTOR REGISTRATION
(On File)
TOTAL $
DATE: / 7
CONDITION OFA PPROVAL
Revised July 2001
10050 N.E. 2ND AVE., MIAMI SHORES, FL • (305) 795 -2207 • FAX (305) 756 -8972 • http : / /www.miamishoresvillage.com
Permit No
M AM SHoRC S VOILLACC
ELECTRICAL INSPECTION DEPARTMENT
AFFLLOCAT0 0 N FOR [ IL[ L C T O t AL F M O T
Application is hereby made for the approval of the detailed statement of the p ns and specification: ner. with submitted for the building or other
structure herein described. This application is made in complia . and conformity with the Building Ordinance of Miami Shores Village, Florida,
and all provisions of the Laws of the State of Flori..a all ordinances • Miami Shores Village and all ules and regulations of the Building Division
of Miami Shores Village shall be complied with, whe.her herein speci.ied or not. A copy of approved plans and specifications must be kept at
building during ; rogress of wo,
Owner's Name and Address. ... Co.Ho Gib spll.o. ....._ No.... 37 . Eo ... Street_.. ... 97th. . Streets
Registered Architect d or Enginrer .
Employing Electricians Name. . Bros o Electric Corp. No 1387 .
Location and Legal Description .ot . ...... .. ........... . Block
Street and Number where work is to be performed —No . . 9 7 t h . Street. ... 3- 7. E
State work to be performed and purpose of buildings (By Floors).... ...
New Budding ... . . . ..... .... Remodeling..._.. _ Addition
. Repa:rs.
Service Overhead Size Feede
Undergr :rid
Type Installation — Conduit.
... -.- ..Co duct.
.T big..
. ..Main Sw
.B.X L .
Amount of Permit $ ..... .. 2o .. READY...FQR. - F.INALdSi ...
The undersigned -pplicanl or this build' g pe' it doe hereby ce tify that he understands and
labor under the . to +ida W,,rkmen s Compe: sat:on Act, being Section 5966, Compiled General Laws
has complied v.ith the provisions thereof. and will require simii ::- compliance from all contractors or
work to be performed under this permit; and will post o, cause to be posted for inspection on the site
as are required b: the Act The undersign. d agrees to c. plo ' only such sub contractors, on work to
licensed by Miami Shores `'illage
(Signed)
OF FLORIL•A, 1
COUNTY OF DADE. 1?
ss.
. Amps. .. . .
.Metal Moulding.
D te.. .. 611.6/ 6 S
Subdivision.... ........
r„
..Main .uses.
77%
.street . .. o .. o 54th o St.
...No. of Stories A
Master Electrician.
....Amps
El-ctr. al Inspector
ccepts his obl.gatii.ns as an employer of
of Florida P .rmanent Supple, ent an.
sob- contractors employed by him in the
of the work sue., public notice or notices
be , .'rforn ed under this perm., as a e
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 constru. tion, a d he ha carefully r the foregoin 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.
SWITCH
OUTLETS
LIGH -
OUTLETS
PLUG
REC' 'P'T - S
■ 1XTURES
NO LAMPS
REFRIG.
01'TL -.
IRON RANCE
OUTLET OU'LET
RANG/
CL`NN
WAT' R
HEAT :R
N.. ..-.
CONN
So.
HE ER
STRIP
HEATED'
TOTAL
CONTR
LAST
CH :Eli
ENT.
S' .
DI - 1
C AS.
E: V :E
. _ P.
SERV.C'
P•RM
•■O.O
0.1 HP
. TORS
1 -S HP
Ni-' N
TRr.N'
RADIO
TOTAL
Co; .
u:T
1
pump
1
CHE.K
Permit No
M AM SHoRC S VOILLACC
ELECTRICAL INSPECTION DEPARTMENT
AFFLLOCAT0 0 N FOR [ IL[ L C T O t AL F M O T
Application is hereby made for the approval of the detailed statement of the p ns and specification: ner. with submitted for the building or other
structure herein described. This application is made in complia . and conformity with the Building Ordinance of Miami Shores Village, Florida,
and all provisions of the Laws of the State of Flori..a all ordinances • Miami Shores Village and all ules and regulations of the Building Division
of Miami Shores Village shall be complied with, whe.her herein speci.ied or not. A copy of approved plans and specifications must be kept at
building during ; rogress of wo,
Owner's Name and Address. ... Co.Ho Gib spll.o. ....._ No.... 37 . Eo ... Street_.. ... 97th. . Streets
Registered Architect d or Enginrer .
Employing Electricians Name. . Bros o Electric Corp. No 1387 .
Location and Legal Description .ot . ...... .. ........... . Block
Street and Number where work is to be performed —No . . 9 7 t h . Street. ... 3- 7. E
State work to be performed and purpose of buildings (By Floors).... ...
New Budding ... . . . ..... .... Remodeling..._.. _ Addition
. Repa:rs.
Service Overhead Size Feede
Undergr :rid
Type Installation — Conduit.
... -.- ..Co duct.
.T big..
. ..Main Sw
.B.X L .
Amount of Permit $ ..... .. 2o .. READY...FQR. - F.INALdSi ...
The undersigned -pplicanl or this build' g pe' it doe hereby ce tify that he understands and
labor under the . to +ida W,,rkmen s Compe: sat:on Act, being Section 5966, Compiled General Laws
has complied v.ith the provisions thereof. and will require simii ::- compliance from all contractors or
work to be performed under this permit; and will post o, cause to be posted for inspection on the site
as are required b: the Act The undersign. d agrees to c. plo ' only such sub contractors, on work to
licensed by Miami Shores `'illage
(Signed)
OF FLORIL•A, 1
COUNTY OF DADE. 1?
ss.
. Amps. .. . .
.Metal Moulding.
D te.. .. 611.6/ 6 S
Subdivision.... ........
r„
..Main .uses.
77%
.street . .. o .. o 54th o St.
...No. of Stories A
Master Electrician.
....Amps
El-ctr. al Inspector
ccepts his obl.gatii.ns as an employer of
of Florida P .rmanent Supple, ent an.
sob- contractors employed by him in the
of the work sue., public notice or notices
be , .'rforn ed under this perm., as a e
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 constru. tion, a d he ha carefully r the foregoin 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.
\ : APPLECATB LLN F ELECT
Permit No 6 l
r
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 2._.
Registered Architect and /or Engine fi'_
State work to be performed and purpose of building (By Floors)
New Building 1- _- ___-- -_____ Remodeling Addition.
Service Overhead Size Feeders
Underground
Amount of Permit $
STATE OF FLORIDA,
COUNTY OF DADE. as.
My Commission Expires
gArlAVA SHORES VB LL GE
ELECTRICAL INSPECTION DEPARTMENT
,� N
Conduit /4 2 - Main Sw
No.______�_�`�
Employing Electrician's Name /
Location and Legal Description Lot .1 _5 L Bloch
Street and Number where work is to be performed —No 37
Amps.
Type of Installation— Conduit Tubing B.X.L. Metal Moulding
(Signed)
AL FE OT
Date
Repairs
Street
No. of Stories!f! r 2.
_(Signed)! A– ------------ -- - - -_ — _�.
Electrical Inspector.
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice fox '
materials and /or workmanship.
Notary Public. State of Florida
Master Electrican.
No._� . " - --- � z��____ Street -- 7 -' �r
Subdivision_0 %% „^_
Main Fuses__ /f>. rL _____Amps.
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 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, on work to be performed under this permit, as
licensed by Miami Shores Village.
are
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 be has carefully read the foregoing application, and that he did sign the same, and that all
therein by him stated are true.
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
C L s T R
I
J �
(�
C'D
F:
D 7
l
' - , '
C
•
d .
/
/
CHECK
_
ENT.
SW.
DIST.
CAB.
SERVICE
TEMP.
SERVICE
PERM.
MOTORS
0-1 HP
MOTORS
1-9 HP
NEON
TRANS.
RADIO
TOTAL
CONTR.
LIST
CHECK
\ : APPLECATB LLN F ELECT
Permit No 6 l
r
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 2._.
Registered Architect and /or Engine fi'_
State work to be performed and purpose of building (By Floors)
New Building 1- _- ___-- -_____ Remodeling Addition.
Service Overhead Size Feeders
Underground
Amount of Permit $
STATE OF FLORIDA,
COUNTY OF DADE. as.
My Commission Expires
gArlAVA SHORES VB LL GE
ELECTRICAL INSPECTION DEPARTMENT
,� N
Conduit /4 2 - Main Sw
No.______�_�`�
Employing Electrician's Name /
Location and Legal Description Lot .1 _5 L Bloch
Street and Number where work is to be performed —No 37
Amps.
Type of Installation— Conduit Tubing B.X.L. Metal Moulding
(Signed)
AL FE OT
Date
Repairs
Street
No. of Stories!f! r 2.
_(Signed)! A– ------------ -- - - -_ — _�.
Electrical Inspector.
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice fox '
materials and /or workmanship.
Notary Public. State of Florida
Master Electrican.
No._� . " - --- � z��____ Street -- 7 -' �r
Subdivision_0 %% „^_
Main Fuses__ /f>. rL _____Amps.
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 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, on work to be performed under this permit, as
licensed by Miami Shores Village.
are
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 be has carefully read the foregoing application, and that he did sign the same, and that all
therein by him stated are true.
- r
\BUILDING
ELECTRICAL
PLUMBING
Owner of
Building
•
CONTRACTOR OR BUILDER
MIAMI SHORES VILLAGE, FLORIDA p ��
194
Contractor'0 C
License o:
PERMIT N? 5716
Work to be performed under this Permit
Bl.
Architect
i
*Contractor �, ,
or Builder
• Legal Loin, / 1
Description
Address of 3 7/1/6. P Value of Amt. of /4 es
Building Project Permit
This permit is granted to the contractor or builder named above to co 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 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 knowl�•. 4 e� of t ordfnances and
regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specificatio �' ii? �' .: ssumes respon-
sibility for work done by his agents, servants or employees. •
Signed.
Subdi-
vision
INSPECTOR
In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance mti
pertaining thereto and in strict conformity with the plans, drawings, statements or specific. '..ns submitted to the proper a
In accepting this permit I assume responsibility for all work do j by eit�aer 'self, my ervant 7 ployee.
By
regulations
Shores Village.
Permit No
Owner's Name and A
Employing Electrician's Name
New Building Remodeling
7, (6 Service Overhead Size Feeders
Underground
APPLOCATl DR ELECTRICAL OCTAL PC R M IT
Date
Application is hereby made for the approval of the detailed statement of the plans and specifications herew submitted for the building o: other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Fiv ;Ida,
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.
Registered Architect and /or En sneer
Location and Legal Description Lot
Street and Number where work is to be performed —No
State work to be performed and purpose of building (By Floors)
m i l °.W SH R E S VOILA C
0
[ L[ CTIt3ICI L, OFISP CTION D(EI'ARTMI:=NT
a
Conduit.. Z- Main Sw /
No ff7 Street.. 7/1.2 °-t
Street /'Q. /
Block Subdivision.
Type of Installation— Conduit ✓ Tubing... .. B.X.L.. Metal Moulding
Street
Addition Repairs No. of Stories
Amps Main Fuses . / S Amps
A r
ectrical Inspector.
ons as an employer of
Amount of Permit $ ... (Signed) )\
iZS"- P✓c�61's E
-2 ^C -45 -51..4 The undersigned applicant for this building permit does hereby eel tify that he understands and accepts his obli�
i f.4. bo r under the Florida Workmen's Compensation Act. being Section 5966, Compiled General Laws
S has complied with the provisions thereof, and will require similar compliance from all contractors or
work to be performed under this permit; and will post or cause to be posted for inspection on the site
as are required by the Act. The undersigned agrees to employ only such sub- contractors, on work to
licensed by Miami Shores Village.
1
STATE OP FLORIDA, }
COUNTY OP DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths
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, and he has carefully read the foregoing application, and that he
therein by him stated are true.
88.
(Sig` '
Y 7
Master Electrician.
fits y
of Florida Pe!manent Supplement, and
sub-contractors employed by him in the
of the work such public notice or notices
be performed under this permit, as are
and take acknowledgments, personally
did sign the same, and that all facts
My Commission Expires Notary Public, State of Florida
NOTE: A re-inspection fee of $1.00 will be made when ouch re-inspection is made necessary by improper notice for inspection, or faulty
materials and /or workmanship.
SWITCH
OUTLaTS
LIGHT
OUTLETS
PLUG
RECE'P•T'S
FIXTURES
NO. LAMPS
RaFRIG.
OUTLET
IRON
OUTLET
RANGE
OUTLET
RANGE
CONN.
WATER
HEATER
W. HEAT.
CONN.
SPACE
HIATeR
STRIP
HEATER
0121/-
AA(_ 4/
��-
TOTAL
GLIOr
LID,
/
Z -
cf
(; 2
CHQCR
7
ENT.
SW.
DIST.
CAB.
SERVICE
TEMP.
SERVICE
PERM.
PAOTORS
0.1 HP
MOTORS
1•9 HP
NEON
TRANS.
RADIO
TOTAL
CONTR.
LICIT
/
CHacR
Permit No
Owner's Name and A
Employing Electrician's Name
New Building Remodeling
7, (6 Service Overhead Size Feeders
Underground
APPLOCATl DR ELECTRICAL OCTAL PC R M IT
Date
Application is hereby made for the approval of the detailed statement of the plans and specifications herew submitted for the building o: other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Fiv ;Ida,
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.
Registered Architect and /or En sneer
Location and Legal Description Lot
Street and Number where work is to be performed —No
State work to be performed and purpose of building (By Floors)
m i l °.W SH R E S VOILA C
0
[ L[ CTIt3ICI L, OFISP CTION D(EI'ARTMI:=NT
a
Conduit.. Z- Main Sw /
No ff7 Street.. 7/1.2 °-t
Street /'Q. /
Block Subdivision.
Type of Installation— Conduit ✓ Tubing... .. B.X.L.. Metal Moulding
Street
Addition Repairs No. of Stories
Amps Main Fuses . / S Amps
A r
ectrical Inspector.
ons as an employer of
Amount of Permit $ ... (Signed) )\
iZS"- P✓c�61's E
-2 ^C -45 -51..4 The undersigned applicant for this building permit does hereby eel tify that he understands and accepts his obli�
i f.4. bo r under the Florida Workmen's Compensation Act. being Section 5966, Compiled General Laws
S has complied with the provisions thereof, and will require similar compliance from all contractors or
work to be performed under this permit; and will post or cause to be posted for inspection on the site
as are required by the Act. The undersigned agrees to employ only such sub- contractors, on work to
licensed by Miami Shores Village.
1
STATE OP FLORIDA, }
COUNTY OP DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths
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, and he has carefully read the foregoing application, and that he
therein by him stated are true.
88.
(Sig` '
Y 7
Master Electrician.
fits y
of Florida Pe!manent Supplement, and
sub-contractors employed by him in the
of the work such public notice or notices
be performed under this permit, as are
and take acknowledgments, personally
did sign the same, and that all facts
My Commission Expires Notary Public, State of Florida
NOTE: A re-inspection fee of $1.00 will be made when ouch re-inspection is made necessary by improper notice for inspection, or faulty
materials and /or workmanship.
MIAMI SHORES VILLAGE, FLORIDA
BUILDING ❑ / DATE '
19
ELECTRICAL � PERMIT
PLUMBING N9 6555 contractor's ti T
ROOFING ❑ License »o.
❑ Work to be performed under this Permit_
Owner of
Building
Architect
Contractor ;?
or Builder
Description II Bl L Subdi_
Legal Lot vision
Address of Value of 1 Amount of
Building Project $ II 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 applica-
tion 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 respon-
sibility for work done by his agents, servants or employees.
Signed. 1 INSPECTOR
In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinan 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 as
cepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee.
•
CONTRACTOR OR BUILDER
BY AUTHORITY
';
AOOOT �'
Service Overhead
Amount of Permit $
STATE OF FLORIDA, }
COUNTY OF DADE.
Underground Size Feeders
ss.
1
O
MAMI sHnnEs VOLLAGE
ELECTRICAL INSPECTION DEPARTMENT
AFPLiCA II N FoR ELECTRO AL PC QMUT
Permit No
Date 1 " 0 / / i
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 L .b ..::
No
Registered Architect and /or En ineer-
m! / Employing Electrician's Nae. ('. :�' ` lA ¢ 1q,a • J Street
Location and Legal Description Lot Block Subdivision
Street and Number where work is to be performed —No Street
State work to be performed and purpose of building (By Floors)
New Building Remodeling Addition Repairs No. of Stories
Conduit Main Sw Amps Main Fuses Amps
Type of Installation — Conduit Tubing B.X.L Metal Moulding
The undersigned applicant for this building permit does hereby certify that he understands and a
labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws
has complied with the provisions thereof, and will require similar compliance from all contractors or
work to be performed under this permit; and will post or cause to be posted for inspection on the site
as are required by the Act The undersigned agrees to employ only such cub - contractors on work to
(Signed)
Electrical Inspector.
ccepts his obligations as an employer of
of Florida Permanent Supplement, and
subcontractors employed by him in the
of the work such public notice or notices
be performed under this permit, as ar.
licensed by Miami Shores Village. d �[
(Signed)
Street
Master Electricia
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, and 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.
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
/
l/
CHECK
ENT.
SW.
DIST.
CAB.
SERVICE
TEMP.
SERVICE
PERM.
MOTORS
0.1 HP
MOTORS
1•3 HP
NEON
TRANS.
RADIO
TOTAL
CONTR.
LIST
CHECK
Service Overhead
Amount of Permit $
STATE OF FLORIDA, }
COUNTY OF DADE.
Underground Size Feeders
ss.
1
O
MAMI sHnnEs VOLLAGE
ELECTRICAL INSPECTION DEPARTMENT
AFPLiCA II N FoR ELECTRO AL PC QMUT
Permit No
Date 1 " 0 / / i
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 L .b ..::
No
Registered Architect and /or En ineer-
m! / Employing Electrician's Nae. ('. :�' ` lA ¢ 1q,a • J Street
Location and Legal Description Lot Block Subdivision
Street and Number where work is to be performed —No Street
State work to be performed and purpose of building (By Floors)
New Building Remodeling Addition Repairs No. of Stories
Conduit Main Sw Amps Main Fuses Amps
Type of Installation — Conduit Tubing B.X.L Metal Moulding
The undersigned applicant for this building permit does hereby certify that he understands and a
labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws
has complied with the provisions thereof, and will require similar compliance from all contractors or
work to be performed under this permit; and will post or cause to be posted for inspection on the site
as are required by the Act The undersigned agrees to employ only such cub - contractors on work to
(Signed)
Electrical Inspector.
ccepts his obligations as an employer of
of Florida Permanent Supplement, and
subcontractors employed by him in the
of the work such public notice or notices
be performed under this permit, as ar.
licensed by Miami Shores Village. d �[
(Signed)
Street
Master Electricia
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, and 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.
MIAMI _SHORES VILLAGE, FLA. N9 6225
SOB s t C R '
ADDRESS 2 Co 9n ST
t
INSPECTION t A7
TIME READY I V 0 u f I rA-0 " 9 ° ® °Ml
REMARKS •
cu.�o
INSPECTOR- DATE
MIAI4L $H VILLAGE, FLA. N®
4 o
JOB Cc 0, .�
ADDRESS - 1 /J
INSPECTION FV-P Qv.,
TIME READY p
REMARKS:
INSPECTO
6266
//-
DATE
1 L1ZCTROCAL INSPECTION CTION D[ PARTMENT
AFFILICATO N F o Q ELC CST OC AL P R OT
(
Permit No
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building of other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Fiu :ida,
and all provisiono of the Lawo of the State of Florida, all ordinanceo of Miami Shores Village and all ruleo and regulationo of the Building Division
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved piano and opecificationo must be kept at
building during progress of work.
eE7 / 47 street 3)OC��.F).5/
Owner's Name and Address No treet ....
Registered Ar and / Engineer
Employing Electriciaft's Name. / 7 / 4217 C/ (41-- Street
Location and Legal Description Lot Block Subdivision
Street and Number where work is to be performed— No.. ........ 3.7... � �� ? ) '�� ' Street
State work to be performed and purpose of building (By Floors) 't <" Dr-if
New Building Remodeling Addition Repairs No. of Stories
STATE OF FLORIDA, }
COUNTY OF DADS.
0
(Signed)
Data / Q i C�7 7r
Service Overhead Site Feeders Conduit Main Sw Ampa Main Fuses Amps
Underground
Type of Installation— Conduit Tubing B.X.L Metal Moulding
C2
Amount of Permit $ (Signed)
Electrical Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations ao an employer of
labor under the Florida Workmen'o Compensation Act. being Section 5966, Compiled General Laws of Florida P'manent Supplement, and
has complied with the provisions thereof, and will require similar compliance from all contractors or oub- 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 10 employ only such sub contractors, on wor to be performed u >." er this 1 s as are
licenoed by Miami Shores Village. tie
Matter Electrician.
so.
Before me, the underoigned authority, a notary public, duly authorized to adminioter oaths and take acknowledgments, personally
appeared
to me well known, and who, being by me firot duly sworn, upon oath deposes and says that he io the
of the above described conotruction, and he has carefully read the foregoing application, and that he did sign the same, and that all facto
therein by him otated are true.
My Commiocion Eupire° Notary Public, State of Florida
NOTE: A re•inopection fee of 0.00 will be made when ouch re•inapection io made necessary by improper notice for inspection, or faulty
material° and /or workmanship.
SWITCH
OUTLETS
LIGHT
OUTLETS
PLUG
RECe'P'T•S
FIXTURES
NO. LAMPO
RaPRIO.
OUTLET
IRON
OUTLET
RANGE
OUTLET
RANGE
CONN.
WATER
HEATER
W. HEAT.
CONN.
SPACE
HEATER
STRIP
HEATER
TOTAL
� " "
CONTR.
LIOT
CoaQCR
N
/J
//
/i
0
ENT.
SW.
DIST.
CAS.
SERVICE
TAMP.
SERVICE
PERd.
MOTOR0
0.1 HP
PMOTORG
1.8 HP
NEON
TRANS.
RADIO
TOTAL
Comm.
LIOT
CHECK
1 L1ZCTROCAL INSPECTION CTION D[ PARTMENT
AFFILICATO N F o Q ELC CST OC AL P R OT
(
Permit No
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building of other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Fiu :ida,
and all provisiono of the Lawo of the State of Florida, all ordinanceo of Miami Shores Village and all ruleo and regulationo of the Building Division
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved piano and opecificationo must be kept at
building during progress of work.
eE7 / 47 street 3)OC��.F).5/
Owner's Name and Address No treet ....
Registered Ar and / Engineer
Employing Electriciaft's Name. / 7 / 4217 C/ (41-- Street
Location and Legal Description Lot Block Subdivision
Street and Number where work is to be performed— No.. ........ 3.7... � �� ? ) '�� ' Street
State work to be performed and purpose of building (By Floors) 't <" Dr-if
New Building Remodeling Addition Repairs No. of Stories
STATE OF FLORIDA, }
COUNTY OF DADS.
0
(Signed)
Data / Q i C�7 7r
Service Overhead Site Feeders Conduit Main Sw Ampa Main Fuses Amps
Underground
Type of Installation— Conduit Tubing B.X.L Metal Moulding
C2
Amount of Permit $ (Signed)
Electrical Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations ao an employer of
labor under the Florida Workmen'o Compensation Act. being Section 5966, Compiled General Laws of Florida P'manent Supplement, and
has complied with the provisions thereof, and will require similar compliance from all contractors or oub- 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 10 employ only such sub contractors, on wor to be performed u >." er this 1 s as are
licenoed by Miami Shores Village. tie
Matter Electrician.
so.
Before me, the underoigned authority, a notary public, duly authorized to adminioter oaths and take acknowledgments, personally
appeared
to me well known, and who, being by me firot duly sworn, upon oath deposes and says that he io the
of the above described conotruction, and he has carefully read the foregoing application, and that he did sign the same, and that all facto
therein by him otated are true.
My Commiocion Eupire° Notary Public, State of Florida
NOTE: A re•inopection fee of 0.00 will be made when ouch re•inapection io made necessary by improper notice for inspection, or faulty
material° and /or workmanship.
Type Insp'n
Permit No.
Name C
Address
Compan
Phone #
For Inspecto
Approved
Correction
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
wilding Inspection Request
Time
(VOL
Name & Date
Re -Insp' n Fee —.
io
,_,Y/2
// i /7 Y
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
Building Inspection Request
Date Time
Type Insp'n ) 6-;t C 1 L-
---- Permit No. ` ,A — Y 3 )
Name 0/1 I
Address �� 7 5
Compan 4 �. G- ,2 t 5'
Phone #
For Inspecto l ;f Name & • . -
Approve P �0
Correction
® ‘7752/Z'l •7
Re- Insp'n Feel, 0-
3 c 9 1 --- 0 5 o ,// �-
f'r l 2 c
A/4 Va
6em2- J
T72' ' &e-e7 i&
Miami Shores Village
10050 NE 2nd Avenue
Phone: 305 - 795 -2204
Printed: 2/28/2003
Applicant: PAUL
Owner: CALLI
J = ADDRESS: 37
Contractor BRINKS HOME SECURITY INC
Local Phone: 305 - 558 - 6625
Permit Status:
APPROVED Permit Expiration:
Work: BURGLAR ALARM
If there is no permit package accessible on the job -site for inspectors to verify, there will be no inspections. Re- inspection
fee is $50.00 Whict — - -- - - -- –
, r n -z. ��- �••.•+ �••�.._•...• ,,�..��.: �.�.�,. - „. -.� ..- ,.n..... -tea. r i t h a n r r d d a m r n f. S r r F a r A / n r_ d r t a i l s
This Permit is granted •
ordinances pertaining the
and approved by the prop
authorization. A further c
ordinances and regulatior
by his agents, servants o.
In consideration of the'
with the plans, drawings,
myself, my agent, servan
Parcel # 1132060130980
Fees:
FEE2003 -1256
FEE2003 -1257
Description
Building Permit Application Fee
CCF
Total Fees:
Amount
$60.00
$0.60
$60.60
Total Fees: $60.60
Total Receipts: $0.00
Signe
9
L .
Signed: c _ ,
NE 97
BRINK'S BIOME SECURITY
5765 N.W. 158TH STREET
MIAMI LAKES, FL 33014
PAY
TO THE
ORDER
FOR
nQ Ation661-€
Bank of America.
Customer Connection ��
n °00a069u°
Electrical Fermat
Permit Number: EL2003 -49
8/27/2003
CALLI
PAUL
ST
Contractor's Address: 5765 NW 158 ST
Construction Value:
$199.00
\b b rM00 & 20o b 5 5 6 b 0.38 b 511°
Page 1 of 1
Legal Description: MIAMI SHORES SEC 1 AMD PB 10 -70 LOTS 15 & 16
DATE - c)7 t)/
BLK 7 LOT SIZE 100.000
4069
32 -1 /1110 TX
0
44es is /) /.aO
0 ,1nce
DOLLARS e
PROPERTY OWNER
New Construction
Name S R A 1-1 CA LL?
Address 3 .. 7
IAA t is aA t
g. q 7
S p-(o (E 5
�?-
4C s 3 138
Home Telephone 3
05_ 75
— + b ,).-
Business Telephone
Demolish
Fax
Relocation of Structure
TYPE OF MANAGEMENT (1 )
New Construction
Enclosure
Alteration Exterior
Repair
Alteration Interior
Demolish
Relocation of Structure
Shell Only
Foundation Only
Add'll Attachment
Other
Add'] Detachment
Other
• •.• , •« :inn' -,i* >. y • •
INSTRUCTIOITS owing steps must be taken to obta a permit From the l�iiLLn)i SI;o�es i6lage:
Step I. Complete the attached permit application which must be signe4l ' tQe Qrogtlry n r:tfd'quolleler. Both signatures must be notarized. Please
print or type to allow for a more accurate processing of your applicatei. Il lofPrewlit will fie,done, a roofing application must be submitted
along with this permit application. •
•• • • • • • ••• o•
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
Job Address:
Address
Folio Number //'5d °C' 0/1 ff
Lot Block
Subdivision PB PG
�f
Current Use of Property �'"
Proposed Use of Property
Tenant Information
PE MIT TYPE ( )
Building
Electrical
Mechanical
(Plumbing
LPGX
Roofing
(Fence
Other
ARCHITECT
Name
License No.
Address
Telephone
Fax
7 /ye 9 7 �7--
Apt.
]PERMIT CHANGE ( )
Chg. Contractor
]Renewal
(Revision
]Extension
Supplement
Reinspection
• • • •• •• •
• • • • • • • • •
• • • • • • • • •
• • • • • • . 0
° • • • • • • • • ° • °
•• ••
• • •
• Mastgr Pegnit l\o.
° Subsidiar�•Pe>:nit tor•
• • •
• ••••
••• ••• • • •
iW /AM / ,P4 r6-5
City State
Description of Work
Zoning Linear Feet
Square Feet its
Value of Work Bldg Value
Tax Assessed/Appraised alue
Flood Zone Base Floor Elev.
ENGINEER
Name
License No.
Address
Telephone
Fax
CONTRACTOR
PERMIT APPLICATION
Floors
33 .5/3 e
Zip
Telephone o - � Fax
(ll, v
Qualifier Name `��
Page 2
• •• •• • • • •• •.
• • • • • • • • • •
• • • • • . • • •
• • • • • • • • •
*410 • • • • 000 • •
I\11'OR'f.‘N'I' NOTICES
• • •
DO NOT BEGIN ANY WORK WITHOOT JLA3119G RECE3VEDyOUR VALIDATED PERMIT AND PERMIT CARD. Applying for a permit does not grant
the right to begin construction. HOURS OF CONSTRUCTION tut4imited 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 PROPERtts S11 KgP't.F$Et FROM DIRT AND DEBRIS.
4. SWALES MUST BE PROTECTED FROM DING tro4cE0 ICY eQQIP ?ENT OR VEHICLES, AND MAY NOT BE USED FOR STORAGE. A bond is
required for work in or near the street/sidewiflli.. •. : : • • : : • ..
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.
�I FI awn - - 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 in 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, Ip 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 FLORI DS,�C�OUNTY OF MIAMI -DADE
Signature o Owner
^�a . NU;
int Name
om 2 and subscribed before m /�� • y of
J w
Signat tary Pdblic - State
SEAL:
Personally known • '•' e7lt,"PI•oduced Identification
Type of Identification Produced:
STATE OF FLORI! = C!1J TY OF MIAMI -DADE
Signat
4
Prin Name
Sworn to apAsubscribed b
Signatu
SEAL:
11ic
',tyro
PERMIT APPLICATION
EX! RES: Juntui,2.004
':drr:.i' �w
Personally known OR, Produced Identification
Type of Identification Produced:
,.,
L1c ]CAL:
l'1'I.
minimum Fee
_• r '—.- - -
T � -- f
QTY. TYPE
Dryer
.,
... r -- ---- _ _ , ..,�T.
L -_.�1
(1T'. 1'_'1'C -
- •Oatlet, p . li , it e •
(111'.
'I 1'1'1';
Service epair
QTY.
A/C Central 1 -3 Ton
Fan
Odtm, wall • • • • • • •
Heating Strips, each
Service, Temporary
A/C Central 4 -7 Ton
]Fire Pump
Outlet, Switch
Paint ]Booth
Signs
A/C Central 8 -15 Ton
Fixture - Fluorescent
Oven
Piping, Flammable Liquid
Space Heater (kw)
A/C Central 16-20 Ton
]Fixture Light
NH Parking Lot Lights
Process/Pressure Piping
Spas/Hot Tubs
A/C Central 20+ Ton
t ! -1
Plugmold/Strip
Pressure Vessel
Subfeeds, No. of Amps
A/C Window
FPL - Load C tral
Posts
Swim Pool, Commercial
Air Conditioners
Garbage Disposal
MI Range/Range Top
Swim Pool, Residential
Chiller
., /
`-M Receptacles
Switchboards
Clear Violations
Heat Recovery
Refrigerator, Comm. (p/PH)
Temp Serv., Construction
Compactor
Deep Freezer
!
Refrigerator, Domestic
Temp for Test - 30 days
Low -volt, Fire
Renew - Temp Service
Pump, Sprinkler
Utility - Sewer
Demolition
]Low -volt, IIntercom/Teleph.
Repair Circuits
Ice Maker
Pump, Sump
Dishwasher
]Low -volt, Television
Service, Number of Amps
Dishwasher
Indirect Wastes
MECHANICAL
TITE
Minimum Fee
QT 1'.
TYI'E
Condensate Drain
QTY'. 11'1'1?
Generator
()Ty. TYI'E
Refrigeration, Tons
()Ty.
A/C Central, Tons
„.. +,
QT).
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
Piping, Flammable Liquid
Periodic IInspections
]Barbecue
Fire Sprinkler System
Process/Pressure Piping
Pump and Abandon
Bath Fan - Vented, #
Fireplaces, Number of
Pressure Vessel
Gas - Appliance
...., ,_.
PI�U�91311�'
t
TYPE
A/C Condensate
.,�..� -
QTY.
_ .r. 1 1 7 "v
I' PE
Drains, Roof
Q'I IY.
..c ,��, ec= ,�.,,-1 ^.-Tr
"I'1'PE
Miscellaneous Fixture
QTY.
-ter-- ___, , .-
fl'I'E
Soakage Pit
„.. +,
QT).
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
INN
Page 3
0 • • O • • • • • • • •
• • O • • • • • • •
• 0 • • • • • • •
• 0 • • • • • •
o 0 011 • • • • 000
•
•••
•
••• •
•• •
000
PERMIT APPLICATION
INSTRUCTIONS: Please indicate the type of work being pariormed•atnd gtianiiti(ie the space provided below.
0
RECEIVED AND REVIEWED BY: DATE:
Page 4
OFFICE USE ONLY
❑ OWNER - BUILDER FORM
(Attach)
❑ FIRE DEPARTMENT
APPROVAL (Commercial /
multi - family)
❑ CONCURRENCY
(New Construction)
❑ OTHER
(Specify & Attach)
$3.00 per page (Scanning Fee)
Miami Shores Village
Bond
Metropolitan Dade County (C.C.F.)
Inspector State Educational Fund
State DCA (Radon)
Code Enforcement Fine
Zoning Review
REVIEWED AND PREPARED BY
• •• .. • • • .• •.
• • • • • • • • • •
• • • • ••• • • • • •
• • • • • • • • • •
•••. • ••••••• •
••• •
• .• •
•
CHECKLIST
•
• • • • • •
•
• IJ PROOFtr OWNERSHIP
(Attach)
•• ••• •• • • • ••
•
• • • ❑• FIRS F EZE$M 'PJ OVAL
••• • •: (Septic L Seiler • •.
❑ IMPACT FEE
(New Construction)
❑ OTHER
(Specify & Attach)
$ (�
$ ( ( sq.ft. = x/1000
x ¢.60)
$ (¢.005 / sq.ft.)
$ (¢•01 /sq.ft.)
SECTION
Zoning
Electrical
Mechanical
Plumbing
Fire
Public Works
Structural
Building Official
BY
DATE
/ , 4 2 . 3
PERMIT APPLICATION
❑ CONDO ASSOCIATION APPROVAL
(Attach)
❑ BPR APPROVAL (Restaurants)
❑ CONTRACTOR REGISTRATION
(On File)
PERMIT FEES
TOTAL $
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
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
Building Inspection Request
Dat Time
Type Insp n
Permit No. 7)
Name e L r
Address ,9 C l 7 .S
Company
Phone #
For Inspecto
Approved
Correction
Re- Insp'n Fee
72 .E - . (, 1 C 1 r�
1 '
47-1 r / -/fly'
c-)
�sz 3°
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
Building Inspection Request
Time
Date
Type Insp
Permit No
Name
Address
A— Company
Phone #
For Inspector: /�� Nam
Approve
�� /.
Correction
Re- Insp'n Fee
20 03 - ?J
6 / — -eat r® ,R
57'Z / i v--d- 7i
-