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PL-03-318ECEDVE) QEC fl ? 2003 BUILDING PERMIT APPLICATION Miami Shores Village Building Department ` / /e//- 3206 /wo 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Permit No. pL, ZEO 3 3I g Master Permit No. FBC 2001 Permit Type (circle): Building Electrical Plumbing Mechanical Roofing Owner's Name (Fee Simple Titleholder) VA S rE 1P zo- 4 a Phone # 3 0 S 75 7 z( Owner's Address W. Nr %% St". C i t y ICI S 1 t &5 State 1 - Zip �3[ Tenant/Lessee Name Phone # (3 05 ) g? ? Job Address (where the work is being done) S E City Miami Shores Village County Nflami Dade Zip Is Building Historically Designated YES NO IV I . /2ii1ceS, 5''r -- Contractor's Company Name F/® - QS i S 10 citY2✓' ) Phone # ( l Contractor's Address 6 f /6 el City f'Yl / Qualifier Iefiz'i $ Value of Work For this Permit ,J9�dO State �L Type of Work: ['Addition ❑Alteration [New 4 Describe Work: ` �a' ,O & ?.{/ - 7e 7/O a. * * * * * * * * * * * * * * * * * * * ** * * * ** *F * * * * * * * * * * * * * * * ** 00 Submittal Fee $ ' Ck1 2[Z`( Permit Fee $ ) " Notary $ Training/Education Fee $ Scanning $ Radon $ Code Enforcement $ Total Fee Now Due $ (Continued on opposite side) Zip 5 Architect/Engineer's Name (if applicable) Phone # Square Footage Of Work: pair/Rep lace ❑ Demolition * * * * * * * * * * * CCF $ Technology Fee $ Bond $ Structural Plan Review. $ Bonding Company's Name (if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name (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 All WAVIT: 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. Chc 10/14/03 Signature , Signature/ J / / I' Owner or Agent Contractor The for { oing instrument was acknowledged before me thisc20l ( The fo j ing instrument was acknowledged before me this °P" d a y of l- , 20 ° , byR O 5C. rr C, t-{ tf LT Z. , day of ✓ C , 20 by j �c+` 6"' .oet` Wi" who is personally known to me or who has produced who is personally known to me or who has produced PPvfa)7 //At .5* an As identification and who did take an oath. /( fl awe as iden.. cation and who did take an oath. • WOO it uOIssiuwOO NOTARY 'UBLIC: Sign: Print: My Commission Expires: APPLICATION APPROVED BY: ............. ............. „.............� PUBLIC• asq A WN ep NW� tfszt -z nA papuc8 ••` =o ; 's Sign: Nott, E Print: sm. SSSSSS easaiOltsals ; - ' ^' ,• ' Expires 8/11/2008 My Commission Ex ;,,o . g h . (Certificate of Competency Holder) State Certificate or Registration No. Vii- - 6 / Certificate of Competency No. Plans Examiner Engineer Zoning MIAMI SHORES VILLAGE BUILDING DEPARTMEN 305- 795 -2204 Building Inspection Requeslh Date ( -1 ` � ` 0 51a,AirstA Type Insp'n wOJ p !Uvvt 6i n" ? Permit No. �. O ?J - 5 2 Name I re S Address (DOD-- A[C 9(p 5r • Company -"EOui rY)Q.OT -24 . Phone# O 5 323 't(occ, 1 Inspection Date Approved Correction Re- Insp'n Fee M H TUB UNIT - FEE ITEM SWITCH OUTLETS .UNIT FEE ITEM SPACE HEATERS UNIT FEE • ET LIGHT OUTLETS CENTRAL. HEATING H RECEPTACLES A/C (WIND) POSAL SERVICE TEWORARY A/C (CENTRAL) NKING FOUNTAIN SERVICE SIZE IN WS DUCT WORK OR DRAIN SERVICE REPAIRMETER CHANGE i REFRIGERATION ASE TRAP APPLIANCE OUTLETS PROCESS AND PRESS PIPING 1RCEPTOR RANGE TOP UNDERGROUND TANKS 'ATORY OVEN ABOVE GROUND TANKS INDRY TRAY WATER HEATER U.F. PRESSURE VESSELS ITHES WASHER MOTORS 0- 1 If STEAM BOILERS }yam MOTORS OVER 1- 3 HP HOT WATER BOILERS 8t, POT/3 COMP. MOTORS OVER 3- 5 If MECHANICAL VENTILATION 1K, RESIDENCE MOTORS OVER 5- 8 HP TRANSPORTING ASSEM3LIES 84 SLOP MOTORS OVER 8- 10 HP ELEVATORS/ESCALATORS MARY WATER CLOSET MOTORS OVER 10- 25 MP FIRE SPRINKLER SYSTEMS INAL MOTORS OVER 25-100 HP COOLING TOWERS TER CLOSET - MOTORS OVER 100 HP VIOLATION )IRECT- WASTES A/C WINDOW REINSPECTION TER SUPPLY TO: AIR CONDITIONERS A/C UNIT STRIP HEATER FIRE SPRINKLER GENERATORS TRANSFCRAERS i HEATER -NEW INST. GENERATORS TRANSFORIERS i HEATER- REPLACE Q GENERATORS TRANSFORMERS SPECIAL PURPOSE _ • LANAI SPRINKLER -WELL SWIIMING POOL OUTLETS COMERCIAL ' WATER SERVICE SIGN TUBES ' ER CONNECTIONS SIGN TRANSFORMERS ILITY -SEWER SIGN TIME CLOCK ILITY -WATER FIXT1.RES 'TIC TANK ANTENNA AY TELEVISION OUTLETS 4INFIELA, 4' TILE/RES. VIOLATION ,P & ABANDON SEPTIC TANK REINSPECTION KALE PIT CU. FT. TCH BASIN XIARGE WELL STIC WELL EA DRAIN OF INLET 1 • _AR WATER HEATER `, RE STANDPIPE 1 PIPING • MR SPRINKLER SYSTEM 3 RANGE TER SET (GAS) 3 PIPING 1 ADD4NDUM TO BUILDING PERMIT APPLICATION 1 �LIC ATION FOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. IF A MASTER PERMIT RAS B. BTAINED, THE OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.) PLUMBING ELECTRICAL • MECHANICAL NOTICE OF COMMENCEMENT A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF FIRST INSPECTION PERMIT NO. PC, 3 / TAX FOLIO NO. // ' - ?, °(1 - 0/ cJ r /L/l STATE OF FLORIDA: COUNTY OF MIAMI -DADE: THE UNDERSIGNED hereby gives notice that improvements will be made to certain real property, and in accordance with Chapter 713, Florida Statutes, the following information is provided in this Notice of Commencement. 1. Legal description of property and street/address: I / 51)026'5 S&2 si ( 1 U I0 J/JL a/4 cal Lod sf?e JYrec 2. Description of improvement: C- pi a c ( . » 0-k r / /e 3. Owner(s) name and address: NO ( 43 et s+ Pres l y 166) c? hLX&h 6.15 C,OcR (, 5 % /�li -� ( 2:. 33/ 3 g Interest in property: ©W A/6 S Name and address of fee simple titleholder: 5 nC 4. Contractor's name and address: Plow - I`'(. sky s P/1/17),6) , Se? vices ZnC - C2 /' 3 57J / 5 �'! / ' i �h'�i' Ft • 53 / r J • 5. Surety: (Payment bond required by owner from contractor, if any) Name and address: Amount of bond $ 6. Lender's name and address: 7. Persons within the state of Florida designated by Owner upon whom notices or other documents may be served as provided by Section 713.13(1)(a)7., Florida Statutes, Name and address: 8. In addition to himself, Owners designates the following person(s) to receive a copy of the Lienor's Notice as provided in Section 713.13(1)(b), Florida Statutes. Name and address: 9. Expiration date of this Notice of Commencement: (the expiration E CT Fi_(nnA. CO 1i E CAF C�AG� Ti i r at :his is a rie cooy cf The ' r= on this ofi ce' n day of 1G /17/VE.Sf ^o hand and Official e r. 20 _ ER K, D f Circuit and County Court D.C. 123.01 -52 PAGE 4 8/02 Signature of Owner / Print Owner's Name fr✓ 1f/v ?-ne /t. different date is specified) Sworn to and subscribed before me this 1C.4 day of �-)CE en be , 20 . Notary Public OIL Print Notary's ame '''rJII[1r:MTEFIr# r"1�# My commission expires: all (t DORYS M. .. . ocw Banded through NoiaryAuf..Inc. 11111111111111111111111111111111111111111111 : t4 20003R0923221 OR Bk 21905 €'s 1041; Ups) RECORDED 12/16/2003 12:47:50 HARVEY RUVIN, CLERK OF COURT MIAMI -DADE COUNTYr FLORIDA LAST PAGE date is 1 year from the date of recording unless a Prepared by 1IL L i- 0 0/ ZD Address: G l33 ail La/ a /9147 -Ave Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Printed: 12/5 /2003 Applicant: Owner: JOB ADDRESS: 602 NE 96 Parcel # 1132060141410 Signed: (INSPECTOR) Plumbing Permit Permit Number: PL2003 -318 ST Contractor FLOW MASTERS PLUMBING SERVICES INCContractor's Address: 14231 SW 74TH STREET Local Phone: Page 1 of 1 Legal Description: MIAMI SHORES SEC 2 PB 10 -37 LOTS 1 TO 10 INC BLK 61 LOT SIZE Fees: Description Amount FEE2003 -7845 Building Fee $120.00 FEE2003 -7846 CCF $2.40 FEE2003 -7847 Technology Fee $3.00 FEE2003 -7848 Training and Education Fee $0.80 Total Fees: $126.20 Total Fees: $126.20 Total Receipts: $ Permit Status: APPROVED Permit Expiration: 5/30/2004 Construction Value: $3,800.00 Work: replace water heater DEC 16 PAID In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances 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 accepting this permit I assume responisibility for all work done by either myself, my agent, servants or employes. Signed: (Contractor or Builder) BY: