775 NE 97 St (3)Owner's Name and Address
Amount of Permit $
M IAMI SHORES VILLAGE
`i 1 3 ELECTRICAL INSPECTION DEPARTMENT
17' C 3 --- FOR ELECTRICAL PERMIT
�' o e
Permit No-A,: .0. Date
Employing Electrician's Name
Service Overhead Size Fe
Underground
Application is , y made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other
structure here' escribed. 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. o
Registered Architect and /or Engineer
Location and Legal Description Lot Block
Street Street and Number where work is to be performed —No Z f
State work to be performed and purpose of building (By Floors)
New Building V Remodeling Addition Repairs No. of Stories
eders° ` : �j 4
C a
No
(Signed)
711
Street a..
..
No 6' 1
Street
Conduit Main Sw �� Amps Main Fuses Amps
Type of Installation— Conduit Tubing i B.X.L Metal Moulding
The undersigned applicant for this building permit does hereby certify that he understands and accepts
labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Fl
has complied with the provisions thereof, and will require similar compliance from all contractors or sub
work to be performed under this permit; and will post or cause to be posted for inspection on the site of t
as are required by the Act. The undersigned agrees to employ only such subcontractors, o
licensed by Miami Shores Village.
Street
Subdivision
//
✓d i
a
c , Lc - .
Electri Inspector.
hi. bligations as an employer of
Permanent Supplement, and
ractors employed by him in the
e work such public notice or notices
this permit, as are
M Electrician.
STATE OF FLORIDA, }
COUNTY OF DADE. ss`
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'7'S
FIXTURES
1 NO. LAMPS .
�7 /
REFR10.
OUTLET
IRON
OUTLET
RANGE
OUTLET
RANGE
CONN.
WATER
HEATER
W. HEAT.
CONN.
ACE
HEA TER
STRIP
HEATER
TOTAL
CONT
ST
(/ 7
/ '9
j
2
7,
l
I
CHECK
ENT.
SW.
DIET.
CAB.
SERVICE
TEMP.
SERVICE
PERM.
A.)A
CS f*�` -
MOTORS
04 HP
MOTORS
I.8 HP
NEON
TRANS.
A f u
Y�
RADIO
TOTAL
CONTR.
LIST
I
1
,P
CHECK
Owner's Name and Address
Amount of Permit $
M IAMI SHORES VILLAGE
`i 1 3 ELECTRICAL INSPECTION DEPARTMENT
17' C 3 --- FOR ELECTRICAL PERMIT
�' o e
Permit No-A,: .0. Date
Employing Electrician's Name
Service Overhead Size Fe
Underground
Application is , y made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other
structure here' escribed. 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. o
Registered Architect and /or Engineer
Location and Legal Description Lot Block
Street Street and Number where work is to be performed —No Z f
State work to be performed and purpose of building (By Floors)
New Building V Remodeling Addition Repairs No. of Stories
eders° ` : �j 4
C a
No
(Signed)
711
Street a..
..
No 6' 1
Street
Conduit Main Sw �� Amps Main Fuses Amps
Type of Installation— Conduit Tubing i B.X.L Metal Moulding
The undersigned applicant for this building permit does hereby certify that he understands and accepts
labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Fl
has complied with the provisions thereof, and will require similar compliance from all contractors or sub
work to be performed under this permit; and will post or cause to be posted for inspection on the site of t
as are required by the Act. The undersigned agrees to employ only such subcontractors, o
licensed by Miami Shores Village.
Street
Subdivision
//
✓d i
a
c , Lc - .
Electri Inspector.
hi. bligations as an employer of
Permanent Supplement, and
ractors employed by him in the
e work such public notice or notices
this permit, as are
M Electrician.
STATE OF FLORIDA, }
COUNTY OF DADE. ss`
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.
APPLICATION FOR ELECTRICAL PER
Permit No '-'
Date
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 wo
Owner's Name and Address
Registered Architect and /or Enginee T Employing Electrician's Name ., No Street..A W . , : 0 2 .',
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
Service Overhead Size Feeders Conduit Main Sw Amps Main Fuses Amps
Underground
Type of Installation -- Conduit Tubing B.X.L Metal Moulding
STATE OF FLORIDA, 1
COUNTY OF DADE. I
n
88.
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
Amount of Permit $ (Signed)
�,�l ~ No 7 7 V Street I1 y7
(Signed)...
/
lectrical Inspector. .
The undersigned applicant for this building permit does hereby certify that he understands and accepts his oblations as an employer of
labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Feranent Supplement, and
has complied with the provisions thereof, and will require similar compliance from all contractors or sub•contrasrs 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 to employ only such subcontractors, on work to be performed under this permit, as are
licensed by Miami Shores Village.
aster Electrician.
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
LICHT
OUTLETS
PLUG
RECE•P•T'S
FIXTURES
NO. LAMPS
REFRIG.
OUTLET
IRON
OUTLET
RANGE
OUTLET
RANGE
CONN.
WATER
HEATER
W. HEAT.
CONN.
RACE
HEATER
STRIP
HEATER
TOTAL
CONTR.
LIST
CHECK
ENT.
SW.
DIST. SERVICE
CAB. TEMP.
SERVICE
PERM.
MOTORS
0.1 HP
MOTORS
1•5 HP
NEON
TRANS.
RADIO
TOTAL
CONTR.
UST
/ ,ip
1
CHECK A rc/
/. , f � �
APPLICATION FOR ELECTRICAL PER
Permit No '-'
Date
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 wo
Owner's Name and Address
Registered Architect and /or Enginee T Employing Electrician's Name ., No Street..A W . , : 0 2 .',
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
Service Overhead Size Feeders Conduit Main Sw Amps Main Fuses Amps
Underground
Type of Installation -- Conduit Tubing B.X.L Metal Moulding
STATE OF FLORIDA, 1
COUNTY OF DADE. I
n
88.
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
Amount of Permit $ (Signed)
�,�l ~ No 7 7 V Street I1 y7
(Signed)...
/
lectrical Inspector. .
The undersigned applicant for this building permit does hereby certify that he understands and accepts his oblations as an employer of
labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Feranent Supplement, and
has complied with the provisions thereof, and will require similar compliance from all contractors or sub•contrasrs 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 to employ only such subcontractors, on work to be performed under this permit, as are
licensed by Miami Shores Village.
aster Electrician.
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.
PROPERTY OWNER
New Construction
Name
'�®
Address 775 N
97
�r,7:_
Home Telephone
Demolish
Business Telephone
Relocation of Structure
Fax
Foundation Only
TYPE OF MANAGEMENT (✓ )
New Construction
Enclosure
Alteration Exterior
Repair
Alteration Interior
Demolish
Relocation of Structure
Shell Only
Foundation Only
Add'I Attachment
Other
Add'I Detachment
Other
Step 1.
Job Address:
PERMIT TYPE (✓ )
Building
Electrical
Mechanical
Plumbing
LPGX
Roofing
Fence
Other
• i',' CEOVEn
Folio Number 11– 3 3. -- WO– 011 — 2 330 Description 1 .f ork
Lot Block Ze
PERMIT CHANGE (✓ )
Chg. Contractor
Renewal
Revision
Extension
Supplement
Reinspection
ARCHITECT
Name
License No.
Address
Telephone
Fax
PERMIT APPLICATION
Master Permit No. ff 1 rd�L
Subsidiary Permit No. •
INSTRUCTIONS - The following steps Must he 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 submitted
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
Subdivision PB PG Zoning Linear Feet
Current Use of Property Square Feet Units Floors
Proposed Use of Property Value of Work /7 Bldg Value
Tenant Information Tax Assessed/Appraised Value
Flood Zone Base Floor Elev.
ENGINEER
Name
License No.
Address
Telephone
Fax
CONTRACTOR
Name
• a o SAD f;
Address 7043, 4 , 2 , 0 //C &i&
Telephone y' ' Fax
Qualifier Name
AffffrAridri
Page 2
1\IPOR'I' NT NOTICES
1. 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.
V FII):1\'I'I' - 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.
0:J�'71 •
of Owner
DA,
ft
�lic - S 'tejta s
MY COMMISSI • # CC 921872
EXPIR . une 4, 2004
Banded Thu Notary Put> Undaavriters
f
STATE
Print Name
worn t5and subscribed before me this 4'
Signature of
SEAL:
Personally known
Y OF MIAM
OR, Produced Identification
Type of Identification Produced:
STATE OF FLORIDA LINTY OF MIAMI -DADE
Signa
Prin 'ame
Sworn to d subscribed before me this t
Signat Nota
SEAL:
Personally known
Public - Sta of Florida
PERMIT APPLICAT ON
JULIO ROBLES
AY COMMISSION # CC 921872
EXPIRES: June 4, 2004
•SOndedThru Notary Pu5Iic Under riters
- 0', ' •'uce
Type of Identification Produced:
SECTION
BY
DATE
Zoning
Electrical
' --
i/ /
Mechanical
Plumbing
Fire
Public Works
Structural
Building Official
Page 4
OFFICE USE ONLY
CHECKLIST
❑ OWNER - BUILDER FORM
(Attach)
❑ FIRE DEPARTMENT
APPROVAL (Commercial /
multi - family)
❑ CONCURRENCY
(New Construction)
❑ OTHER
(Specify & Attach)
❑ PROOF OF OWNERSHIP
(Attach)
PERMIT 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
REVIEWED AND PREPARED B
❑ HRS / DERM APPROVAL
(Septic / Sewer)
❑ IMPACT FEE
(New Construction)
❑ OTHER
(Specify & Attach)
$ sop 1 e
$
0 0 60 ( sq.ft. = x/1000
x ¢.60)
$ e ) 0 (4.005 /sq.ft.)
(¢.01 /sq.ft.)
PERMIT APPLICATION
❑ CONDO ASSOCIATION APPROVAL
(Attach)
❑ BPR APPROVAL (Restaurants)
❑ CONTRACTOR REGISTRATION
(On File)
Tact), Fee-
TOTAL
OCT 0 7 PAID
C 42)SCD.
$ C3,30
ISSUING OFFICIAL
e�
DATE: 2' % �A
CONDITION OF APPROVAL
Revised July 2001
10050 N.E. 2"° AVE., MIAMI SHORES, FL • (305) 795 -2207 • FAX (305) 756 -8972 • http : / /www.miamishoresvillage.com
ELEC'T'RICAL
TYPE
Minimum Fee
QTY.
TYPE
Dryer
QTY.
i'VPI.:
Outlet, Appliance
QTY.
TYPE
Service Repair
Q'I'V.
A/C Central 1 -3 Ton
Heating Strips, each
Fan
Outlet, Wall
Service, Temporary
- Paint Booth
A/C Central 4 -7 Ton
Fire Pump
Outlet, Switch
Piping, Flammable Liquid
Signs
A/C Central 8 -15 Ton
Fixture - Fluorescent
Process/Pressure Piping
Oven
Space Heater (kw)
A/C Central 16-20 Ton
Pressure Vessel
Fixture Light
Parking Lot Lights
Spas/Hot Tubs
A/C Central 20+ Ton
. ��
' �' /�—
/
Plugmold/Strip
Subfeeds, No. of Amps
A/C Window
FPL - Load ntral
Posts
Swim Pool, Commercial
Air Conditioners
Garbage Di posal
Range/Range Top
Swim Pool, Residential
Chiller
/E4,-
Receptacles
Switchboards
Clear Violations
Heat Recovery
Refrigerator, Comm. (p/PH)
Temp Serv., Construction
Compactor
e w�- d ur a
Refrigerator, Domestic
Temp for Test - 30 days
Deep Freezer
Low -vo , '
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. •fvpi;
Generator
QTY. TYPE:
Refrigeration, Tons
QTY.
A/C Central, Tons
QTY.
Cooling Tower
Heating Strips, each
Vent Hood, Cost
A/C Wallin. Tons
Dryer Vents, Number of
- Paint Booth
Ventilation, Cost
Air Handler, Tons
Ductwork, Cost of
Piping, Flammable Liquid
Periodic Inspections
Barbecue
Fire Sprinkler System
Process/Pressure Piping
Pump and Abandon
Bath Fan - Vented, #
Fireplaces, Number of
Pressure Vessel
Gas - Appliance
PLUN1131NG
TYPE
A/C Condensate
QTY
TYPE
Drains, Roof
Q
"fYI'E
Miscellaneous Fixture
Q
"I'YI'E
Soakage Pit
QTY.
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: