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EL-04-299
PE FB IRECEl'VED r/ ..� $zox IT A'PLI City Miami Shores Village ATION Qualifier W s -,-` Architect/Engineer's Name (if applicable) tfr 1 A. $ Value of Work For this Permit a .S700 Submittal Fee $ Notary $ ` Scanning $ '- Code Enforcement $ Total Fee Now Due $ (Continued on opposite side) Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Permit No. �� � ° OO - a4 , 7 Master Permit No. Permit Type (circle): Building Electrical Plumbing Mechanical Roofing Owner's Name (Fee Simple Titleholder , 1 wA � r ' �i Ffe Nl .1 5F�hone # ---)C7 —12 S Owner's Address 21,t( 0744-S City IV 140141 /hVLI S S State Zip 3 J Tenant/Lessee Name Phone # Job Address (where the work is being done) 5 &J t 7' County Miami Dade Is Building Historically Designated YES NO Contractor's Company Namee,,.J.-tea tWh... v Phone Contractor's Address e )J 't- 4 -t,_ City State CPI zip 53 / z /! zip Phone # Square Footage Of Work: Type of Work: ['Addition ['Alteration ❑New ❑ Repair/Replace ❑ Demolition Describe Work: ite.� C.In . 43 l- a i' ■,G c ******** ******************** F * * * *** ** ** ** * * * * * * * ** * * * * * ** Permit Fee $ ® ®' CCF $ / Sa Training/Education Fee $ ®4 Technology Fee $ • Radon $ � Bond $ - Structural Plan Review. $ Bonding Company's Name (if applicable) Bonding Company's Address City State Zip Mortgage Lender's N (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 Signature Owner or Age The foregoing instrument was acknowledged before me this day of a ' by ( /10,-(2)---S who i i rsonally known to n t 'who .` produced NOTARY Sign: My Commission Expires: a ' Commission#DD323870 Ex • May 26, 2008 ' Ada Ike •,n, 1 g 1 L. State Ce'c or 6 ***************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** ******************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** APPLICATION APPROVED BY Chc 10/1483 - As identification and who did take an oath. NOTARY PUBLIC: Sign: Print: . My Commissio • *** ** * ** * * * *r *** * * * * * * * * * * * * * ** :era * * * ** (Certificate of Competency Holder) Certificate of Competency No. Engineer Zoning The foregoing instrument was acknowledged before me thi e' d a y o f ( 9 c , 2 0 who is personally known to me or who has produced as identification and who did take an oath. Dec. 4. 2008 4:06PM GE C r ) &I Bennett Power Group a0D4-fl Formerly Bennett Electric Sendai Co. & Deno Utilities 6900 NE 4 Court Miami,, F133138 Phone (305) 759.1668 Facsimile (305) 754.1877 Company: ,j4trLeo Date: From: Valle Higgins Ph. 305.759-1666 Ext. 10 imllogbennettpaivergroup_com No. 2305 P. 1 3 0 7 q mi-ce;-0,1 1:4‘ fax number: Miami Shores Village Building Department Permit Number EL 0 Review C mple io 1-Bat iM 1 sfA 0 '&" .2. k4 Or e7g total number of pages including cover: 3 s- 73 - ).‘ _ Phounum --------nders Ifbrene n bar= : RE: your reference number; ACCOUNT 1"/CYNIEN BAL. DUE MIAMI SHORES VILLAGE BUILDING DEPARTMET)TT 305- 795 -2204 B ilding Inspection Request Date( I TypeInsp'n a)-cu Permit No. eA0(4-0-qq Name cCI Address g " J c s Company 1 • Phone # Inspection Date Approved Correction Re- Insp'n Fee ❑ o 1, C - �� rte ��� / l FP DRIP LOOP rrl BE 10' fir-Ti (MIN) n "'J 7Th ( 200A 2' 'WOVE R117F 1 • • •• •• • • Fl1 ITS) IED GRADE • i 0 (WI Kra tun) ? L e- rukIg su =l auc • 171P • PVC sumo c:L•ucr • MAIN CI3 1 • WO' MN IMP 1•11 1 • PANEL • • • -NI rUvt iiur J Ip J • • • • WOO{ yKf144 SA • aw'z ORlXllrQ RUN a tuu • • SUB C Ei . PANEL • WS EDE PANEL Ratan© c: 2; — / S O A Bond Bl,ss . .__ Yes No • Locvtcon PER S.F.u.C. '5O6,2110 • N T R U •I. Q 1L.L 1.r1 N 00 • • • 1C1JL• IC 1i :: I" • 'Llatket: P.0 : wr ;... CP Conduct sltr • Conduit size _•��,____ Conduit type: P V Thru roof y f a .._ NO Ground wirc HAW. DIS ONHECT Rating, • „. .Apps Hain 1' 3� _Apps Sub Breakers 0 Amps S UB FEED New Ner ,..._�.,. Type Size • • Bond raze.. r S Iul1ATURE OF itIITR/►CTOR • , , • • • • NOTARY • ._ -. . _............._._. �_ _ •••. •• ••••••.._ •••• •••• •-- Existing_,_ - • • (ll ' E D R • • • ELECTRICAL TYPE Minimum Fee QTY. TYPE Dryer QTY. TYPE - Outlet, Appliance QTY. TYPE Service Repair QTY. A/C Central 1 -3 Ton 1 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) - Fountain A/C Central 16-20 Ton Fixture Light - Parking Lot Lights Spas/Hot Tubs Cap - Water 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 - Utility -. Water • - Demolition - Low -volt, Intercom/Teleph. - Repair Circuits Relay Re air - Dishwasher .- Low -volt, Television - Service, Number of Amps [' , ®6 6 A. - PLUMBING TYPE A/C Condensate QTY. TYPE - Drains, Roof QTY. TYPE Miscellaneous Fixture QTY. TYPE - Soakage Pit QTY. Bath Tub - Drinking Fountain - IVTlscellaneous Repairs - Solar Water Heater - Bidet - Filter Replace - Pool Pi . ing - Sprinkler Re , air Cap - Fixture - Fountain - Pump and Abandon - Sprinkler System - Cap - Water - Gas - Appliance - Pump, Domestic - Supply, AC Well Cap - Sewer Gas - Natural - Pump, Fire Stand - Tem rary Toilet Catch Basin - Gas - Propane - Pump, Re- circulate - ; Temporary Water Closet - Clothes Washer - Gas Piping - Pump, Re dace - Pool - Urinal - Dental Chair - Grease Tra;. - Pum., Sprinkler - Utility - Sewer Discharge Well - Ice Maker - Pum , Sum 1 - Utility -. Water • - Dishwasher - Indirect Wastes - Relay Re air - Vacuum Pum' - Dis i osal - Interceptor - Roof Inlet - Water Closet Domestic Well - Laund Tray - Septic Connection Water Heater Drainfield, 4" Tile/Res. - Lavatory - Septic Tank -Water Heater New - - Drains, Area - Meter Set (Gas) - Sewer Connection - Water Re- ' i ' -- Drains, Floor - Minimum Fee - Shower - Water Service - - Drains, French - Miscellaneous Equipment - Sink - Well, Sup ily Page 3 PERMIT APPLICATION INSTRUCTIONS: Please indicate the type of work being performed and quantity(ies) in the space provided below. MECHANICAL TYPE Minimum Fee A/C Central, Tons A/C Wall/Wm. Tons Air Handler, Tons Barbecue Bath Fan - Vented, # QTY. TYPE Condensate Drain Cooling Tower Dryer Vents, Number of Ductwork, Cost of Fire Sprinkler System Fireplaces, Number of QTY. TYPE MI ME - Generator Heating Strips, each Paint Booth Piping, Flammable Liquid Process/Pressure Piping Pressure Vessel QTY. TYPE Refrigeration, Tons Vent Hood, Cost Ventilation, Cost Periodic Inspections QTY.: RECEIVED AND REVIEWED BY: DATE: