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882 NE 97 St (10)1 Owner's Name and Address /) M Registered Architect and /or Engineer Name and address of licensed contractor Location and legal description of lot to be built on: Disapproved Date (Signed) MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build- ing 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 arid specifications must be kept at building during progress of the work. /1126 /P Date , 14_12 No. _ Street___ l '244/ 10. GJ, 6 Remarks____ (Signed) Lot_ Block Subdivision_ Street and Number where work is to be done ____ . ,___,______, State work to be done and purpose of building (by floors)._ ____ ___' __ 6teel / and for no other purpose. New Building Remodeling Addition Repairs No. of Stories To be constructed of Kind of foundation Roof Covering Estimated Total cost of improvements $1 O Amount of Permit $__P ( Zone cubage required- ___ Plan Cubage Distance to next nearest building _ ____.Size of Building Lot Maximum live load to be home by each floor I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction_ may be sent to 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 5968, Compiled General Laws of Florida, Permanent Supplement, and has complied 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 undersigned agrees to employ only such subcon ' acto(§; on <work to e performed under this permit, as are licensed by Miami Shores Village. STATE OF FLORIDA, COUNTY OF DADE. ss Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap- peared 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 construe on, that he has carefully read the fo going application, and that he did sign the same, and that all facts therein by him stated e true. � Permit No 3 � Date Read, Sworn to and Subscribed before me. Notary Public, State of Florida My Commission Expires PLAN G BOARD DATE Chairman Member Member Member Member Member Council Approved. Date Disapproved Date NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has been obtained from the Planning Board. A re fee of $1.00 will be charged when such re inspection is made necessary by improper notice for inspection or faulty materials and /or workmanship. BUILDING ELECTRICAL PLUMBING ROOFING Owner of Building PERMIT Architect Contractor or Builder Legal Description Lot MIAMI SHORES VILLAGE, FLORIDA B1 CONTRACTOR OR BUILDER N9 7838 Work to be performed under this Permit DATE �f Contractor's License No. BY AUTHORITY 19 Subdi- vision Address of Value of _ Amount of Building `' ' Project $— ( 1 C 1 Permit $ e 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. -e. -. t INSPECTOR In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance witt all orclincmces and regulations pertaining thereto cmd in strict conformity with the plans, drawings, statements or specifications submitted to the proper authoritips of Miami Shores Village. In ac. cepting this permit I assume responsibility for call work done by either, myself, my agent, servant or employee. ABBOT ti PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date S � ay./ c-/ Job Address f7 Tax Folio //- c32 O 6 '/ y Z Legal Description 107 s et'ock � o/ &7ry.4i c s � o a c s � ec � %o a .3 book /b 4 7 , _ 3 } Owner / Lessee / Tenant Master Permit it 3 j 5b) Owner's Address peliZ . 9 7 374 c c `T Contracting Co. Rio / N4o W di/e&4C7' Le_4' / Phone 7'5 9 - 2,6 Address /4//c Qualifier Se / 2 6 - ; p p ? 2 Q � .Z - - S S 4 # Phone 4 v 2 e 7 53 3 _5 c' 3 586 State i 0- Municipal #P Competency # Ins.Co. Architect /Engineer �(pA14 (_ack) 6o, Bonding Company Mortgagor Address Permit Type(circle one): BUILDING ELECTRICAL PLUMBING a ct-P---i. Pe le_ WORK DESCRIPTION v 06 //.9 I. o...) o e 7e 774 , ors... E.q -i reef,. Signature of owner and /or Condo President Date: Off h a ( �G ; 9/0)19Y Notary as to Owner and My Commission Expires: APPROVED: Zoning and RY PU OFFICIAL NOTARY SEAL �� e Ji BARBARA ANN FUOAZZ: cT ,BARBARA Mechanical Clr✓1 1 t t Address ,- /'O A /0 7 $7' I -� (4 33/ Address Square Ft. Estimated Cost(value) Fire Building Plumbing_ ROOFING PAVING FENCE SIGN . .Z ,o 7- :- o // kw . vr�'- 3 WN gnatu of Contr ' ctor 1 Owiier- Builder ate: My Av..,. ''annall , t0.�� 01.adt ,o riOwner- Builder My Commission Yieig �e�s. t -L : COMMISSION NU r� Q CC36019 ** * * * * � ,� Q a f COMMrssION El i'. * * * * * * * ** �( FO F F`0.._ MAR 19 .� FEES: PERMIT � RADON C.C.F. NOTARY TOTAL DUE 7 e Other Electrical Engineering Inspection Number: INSP -26454 Permit Number: MC -9 -06 -2313 Inspection Date: 10/16/2006 Inspector: Grande, Claudio Owner: CLEEK, RONALD Job Address: 882 97 Street NE Project: <NONE> Miami Shores Village, FL Contractor: EDD HELMS ELECTRIC & A/C INC Building Department Comments Wednesday, October 11, 2006 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 u9 0 Permit Type: Mec/ianical - Residential Inp pection Type: Final Work Classification: Addition /Alteration Block: Phone Number Parcel Number 1132060142700 Lot: Phone: 305 - 653 -2520 Page 1 of 2 Inspector Comments O Ilbill/b Passed I„ II Failed Correction Needed Re- Inspection Fee ($75) No Additional Inspections can be scheduled until re- inspection fee is paid. Inspection Number: INSP -26454 Permit Number: MC -9 -06 -2313 Inspection Date: 10/16/2006 Inspector: Grande, Claudio Owner: CLEEK, RONALD Job Address: 882 97 Street NE Project: <NONE> Miami Shores Village, FL Contractor: EDD HELMS ELECTRIC & A/C INC Building Department Comments Wednesday, October 11, 2006 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 u9 0 Permit Type: Mec/ianical - Residential Inp pection Type: Final Work Classification: Addition /Alteration Block: Phone Number Parcel Number 1132060142700 Lot: Phone: 305 - 653 -2520 Page 1 of 2 Date Tuesday, September 19, 2006 09/19/2006 Check Receipt Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Fax: (305)756 -8972 Permit Number: MC -9 -06 -2313 Invoice Number: MC -9 -06 -26154 Applicant: RONALD CLEEK Company Name: Owner Address: 882 NE 97 ST MIAMI SHORES, FL 33138. Job Address: 882 97 Street Miami Shores Village, FL Payment Type Check Number 3751 Amount $223.05 Change $0.00 Total Payment: $223.05 Page 1 of 1 Issue Date: 9/14/2006 Expires: 03/13/2007 Owner's Name: RONALD CLEEK Permit Type: Mechanical - Residential Work Classification: Addition /Alteration Job Address: 882 97 Street Additional Information Miami Shores Village, FL Contractor(s) Phone EDD HELMS ELECTRIC & A/C INC 305 - 653 -2520 Yes Primary Contractor Comments: REPLACE EXISTING 5 SPLIT SYSTEM Tons: Classification: Residential Additional Info: 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 responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL, PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work. OWNERS 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. Futhermore, I authorize the above -named contractor to do the work stated. Fees Due Amount CCF $3.60 Education Surcharge $1.20 Permit Fee - Additions /Alterations $210.00 Scanning Fee $3.00 Technology Fee $5.25 Total: $223.05 Invoice Number MC - 9 - 06 - 26154 Total: Amt Due $223.05 SEP 19 PWOO Cif 2 757 Amt Paid N_ Building Department File Copy vaj Applicant Signature Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Fax: (305)756 -8972 Permit Parcel #: Block: Section: Permit Status: APPROVED Permit Number: MC - - - 2313 Phone: 1132060142700 Lot: PB: Total Square Feet: 0 Total Valuation: $ 6,000.00 Re ' uired Ins . ections Final NOTICE: In addition to the requirements of this permit, there may be additional restrictions applicable to this property that may be found in the public records of this county. AND THERE MAY BE ADDITIONAL PERMITS REQUIRED FROM OTHER GOVERNMENTAL ENTITIES SUCH AS WATER MANAGEMENT DISTRICTS, STATE AGENCIES, OR FEDERAL AGENCIES. Architect/Engineer's Name (if applicable) Value of Work For this Permit $ Type of Work: Describe Work: r ['Addition Bond $ Code Enforcement $ Structural Review. $ Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 BUILDING 011 146 PERMIT APPLICATION etwil w ,,• FBC 2004 FOLIO / PARCEL # J i— 31D(o - & i' t 2 ? Do ` Is Building Historically Designated YES NO / DAlteration Submittal Fee $ Permit Fee $ Notary $ Training/Education Fee $ 1.20 Scanning $ 3.00 Radon $ DPBR $ Permit No C, Master Permit No. Job Address (where the work is being done) a g d - NS 9 . 5i City Miami Shores Village County Miami -Dade Zip Double Fee $ Phone # Square / Linear Footage Of Work: Total Fee Now Due $ Permit Type (circle): Building Electrical Plumbing �( Owner's Name (Fee Simple Titleholder) s `2 Phone # Owner's Address ygg, ,u F._ "1 51-4-66 Ci 0 C'eS State 'P1.. Zip .3 3 i 3 g Tenant/Lessee Name Phone # / D Roofing 6C3 Z 32) Contractor's Company Name � 14 -C( 12, S - C T• �� Phone # Contractor's Address 1 '7 g 517 4) v _ ----e j City Y " ` <(— ` . State eL Zip S 3 [ 1 '2 Qualifier Name 01 � \ 4 6 Phone # State Certificate or Registration No. CIA-C..() q 4� Certificate of Competency No. ['New XRepair/Replace ❑ Demolition CCF $ 3 .`tJO CO /CC Technology Fee $ 5 •,9 Zoning $ .225.05 l See Reverse side — � \--P1 '] � �� L Bonding Company's Name (if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name (if applicable) Mortgage Lender's Address o 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 Sign: Print: (Revised 02/08/06) Q �r cLatc, Owner or Agent The foreq,6l`ng ins i ment was ackno�� w�l dged f e thi e day of I /,/ , 2 04, by KoiA :. ' `Q-2-L. , who is pers natty known to me or who has produced c( NOTARY PUBLIC: APPLICATION APPROVED BY: As identification and who did take an oath. * '?9:f P i% BM ? u c 9KIS t `VJ n tYCOMOSS1o' 11 33148899 OAT 0 (407) 398.0163 • • Florida Notary Scrvloo.com My Commission Expires: *************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Zoning Signature The fore day of who is sonally known -tome or who has pr Contractor oing in trument was acknowledged) before me , 200 s/ , by NOTARY PUBLIC: Sign: _ Ar • as identification and who did take an oath. Print: tip: Plt9 Amy ► ►rrpIKlg My Commission ; xp @Q coMMlssloN # nD448899 �Of h� EXPIRES: Oct. 14, 2009 * * * * * * * * * * * * * * ** * *, 09t **i *** * t *t $atvc*da * *- * Plans Examiner Engineer ADDENDUM TO BUILDING PERMIT APPLICATION T APPLICATION FOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. IF A MASTER PERMIT HAS B. STAINED, THE OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.) • PLUMBING ELECTRICAL MECHANICAL 4 i TUB UNIT FEE ITEM SWITCH OUTLETS UNIT FEE ITEM UNIT SPACE HEATERS FEE ET LIGHT OUTLETS CENTRAL HEATING 10 KW / ;R RECEPTACLES A/C (WIND) SERVICE TEMPORARY A/C (CENTRAL) 5 POSAL NKING FOUNTAIN SERVICE SIZE IN AMPS DUCT WORK OR DRAIN SERVICE REPAIR/VETER CHANGE REFRIGERATION APPLIANCE OUTLETS PROCESS AND PRESS PIPING TRAP .'SE RCEPTOR RANGE TO P UNDERGROUtO TANKS 'ATORY OVEN ABOVE GROUND TANKS `1RY TRAY WATER HEATER U.F. PRESSURE VESSELS :TEES WASHER MOTORS 0- 1 FP STEAM BOILERS R MOTORS OVER 1- 3 HP HOT WATER BOILERS :n MOTORS OVER 3- 5 FP MECHANICAL VENTILATION IK, POT /3 COMP. ;K. RESIDENCE MOTORS OVER 5- 8 HP TRANSPORTING ASSEMBLIES .K, SLOP MOTCRS OVER 8- 10 HP ELEVATORS/ESCALATORS - PCRARY WATER CLOSET MOTORS OVER 10- 25 HP FIRE SPRINKLER SYSTEMS. INAL MOTORS OVER 25-100 FP COOLING TOWERS TER CLOSET MOTORS OVER 100 NP VIOLATION )IRECT•WASTES A/C WINDOW REINSPECTION TER SUPPLY TO: AIR CONDITIONERS STRIP HEATER AJC UNIT FIRE SPRINKLER GENERATORS TRANSFORMERS • GENERATORS TRANSFCRMERS HEATER -HEW INST. HEATER - REPLACE GENERATORS TRANSFORMERS • LAWN SPRINKLER -WELL SPECIAL PURPOSE SrfIAUNG POOL OUTLETS COMI.€RCIAL SIGN TUBES WATER SERVICE WER CONNECTIONS SIGN TRANSFORMERS ILITY -SEWER SIGN TIME CLOCK ILITY - WATER FIXTURES ?TIC TANK ANTENNA LAY TELEVISION OUTLETS AIRFIELD, 4' TILE/RES. VIOLATION MP & ABANDON SEPTIC TANK REINSPECTION AKAGE PIT CU. FT. TCH BASIN SaMARGE WELL MESTIC WELL :EA DRAIN OF INLET 1 :UAR WATER HEATER ` . RE STANDPIPE _ = - _ OL PIPING ;WN SPRINKLER SYSTEM - _ S RANGE - � =_ :TER SET (GAS) S PIPING ADDENDUM TO BUILDING PERMIT APPLICATION T APPLICATION FOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. IF A MASTER PERMIT HAS B. STAINED, THE OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.) • PLUMBING ELECTRICAL MECHANICAL