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ELECTRICALPERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date 3 /3/ /CP Job Address / 2-1? "-I' b • 6 d 2;, Tax Folio Legal Description Historically Designated: Yes No Owner/Lessee / Tenant H Q- , - 44 04 "1 JIW1 S Master Permit # 1 7 1 2 , 5 --- 7 Owner's Address Phone Contracting Co. <)5* iE ie-ei b - 7-0•C'e' Address al- 9 lb S / 2i'7 /fib • / //�•/ 33/'j Qualifier / A'pe-eAc- () 61T1 SS# 30.1" .S7 State # Municipal # /9 / Competency # Ins. Co. Architect/Engineer Address Bonding Company Address Mortgagor Address Permit Type (circle one): BUILDIN ELECTRICA PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION 1eZ oe,c ti5 542 /Z Square Ft. Estimated Cost (value) /0 .5� WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO 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.) Application is hereby made to obtain a permit to do work and installation as indicated above, and on the attached addendum (if applicable). I 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, SIGNS, POOLS, ROOFING and MECHANICAL WORK. 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. Furthermore, I authorize the above -named contractor to do the work stated. Zoning er and/or Cond sident Date Notary as to Owner and/or Condo President Date My Commission Expires: 1 ✓efe,00 FEES: PERMIT �✓ / RADON PENALTY j1241_412 1 7 .00 APPROVED: Signature of Building Electrical tractor or Owner - Builder Notary as to Contractor or Owner - ° it er My Commission Expires: Notary Public, O l' St�:a of Ronda My Comm. expires July 2, 1g99 No.CC46S2i1 NOTARY — BOND Of Date TOTAL DUE 1 7 Date Plumbing Engineering ITEM BATH TUB UNIT FEE ITEM SWITCH OUTLETS ' ImJ FEE ITEM SPACE HEATERS UNIT FEE BIDET LIGHT OUTLETS 3 CENTRAL HEATING DISHWASHER RECEPTACLES 5 A/C (WIND) DISPOSAL SERVICE TEMPORARY A 1,50 A/C (CENTRAL) DRINKING FOUNTAIN SERVICE SIZE IN AAPS DUCT WORK FLOOR DRAIN SERVICE REPAIR/ METER CHANGE REFRIGERATION GREASE TRAP APPLIANCE OUTLETS PROCESS AND PRESS PIPING INTERCEPTOR RANGE TOP - UNDERGROUND TANKS LAVATORY OVEN ABOVE GROUND TANKS LAUNDRY TRAY WATER HEATER U.F. PRESSURE VESSELS CLOTHES WASHER MOTORS 0- 1 HP STEAM BOILERS SHOWER MOTORS OVER 1- 3 FP HOT WATER BOILERS SINK, POT /3 COMP. MDTCRS OVER 3- 5 I P MECHANICAL VENTILATION SINK, RESIDENCE MOTORS OVER 5- 8 HP TRANSPORTING ASSEMBLIES SINK, SLOP MOTCRS OVER 8- 10 FP ELEVATORS/ESCALATORS TEMPORARY WATER CLOSET MOTORS OVER 10- 25 FP FIRE SPRINKLER SYSTEMS URINAL MOTORS OVER 25-100 If COOLING TOWERS WATER CLOSET MOTORS OVER 100 FP VIOLATION INDIRECT WASTES A/C WINDOW f ''l°° REINSPECTION WATER SUPPLY TO: AIR CONDITIONERS • A/C UNIT STRIP HEATER FIRE SPRINKLER GENERATORS TRANSFORMERS • HEATER -NEW INST. GENERATORS TRANSFORMERS HEATER - REPLACE GENERATORS TRANSFORMERS LAWN SPRINKLER -WELL SPECIAL PURPOSE SWIMMING POOL OUTLETS COM4ERCIAL WATER SERVICE SIGN TUBES SEWER CONNECTIONS _ SIGN TRANSFORMERS UTILITY -SEWER SIGN TIME CLOCK UTILITY -WATER FIXTLRES SEPTIC TANK ANTENNA RELAY TELEVISION OUTLETS GRAINFIELD, 4' TILE/RES. VIOLATION PUMP & ABANDON SEPTIC TANK REINSPECTION SOAKAGE PIT CU. FT. CATCH BASIN DISCHARGE WELL DOMESTIC WELL AREA DRAIN ROOF INLET SOLAR WATER HEATER FIRE STANDPIPE POOL PIPING LAWN SPRINKLER SYSTEM GAS RANGE METER SET (GAS) GAS PIPING PLUMBING ADDENDUM TO BUILDING PERMIT APPLICATION (AN APPLICATION FOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. IF A MASTER PERMIT HAS BEEN OBTAINED, THE OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.) ELECTRICAL MECHANICAL rRICAL -1BG Irk PERMIT N? 10885 r of ng itect `rae - • Lot ri ptio Imp 'seas of ding Work to be performed under this Permit This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described id the application or in stria compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans, rugs, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit niay be revoked at any 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 ed is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations Ming to the work covered hereby whether shown on the plans or drawings or the statements .r specifications and that he assumes responsibility for work by his agents, servants or employees. In consideration of the issuance to me of this permit I agre perform the work covered hereunder in compliance with all ordinances and regulations ing thereto a d in strict conformity with the plans, drawing tements or specifications submitted to the proper authorities of Miami Shores Village. xptinqth�s y it I assume responsibility for all work don- ,y either, myself, my agent, servant or employee. MIAMI SHORES VILLAGE, FLORIDA DATE "" f i••••- 1951, Contractor's License No Signed: Subdi- vision BY BY AUTHORITY • ' V Permit No Owner's Name and Address . Registered Architect and /or Engineti MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT Street and Number where work is to be performed —No New Building Remodeling Addition. Repairs Service Overhead Size Feeders_,___... Conduit._ _ _ Main Sw./' �) Amps. u a d imessat i Type of Installation— Conduit Tubing B.X.L. Metal Moulding Amount of Permit S (Signed) (Signed Date_ Street 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. No_______ __________________ Street -- -- __________________ - ---- t - , �r i Employing Electrician's Name –'' ; a e- t _�:y _ No�� _ _______ Street___ Location and Legal Description Lot � Block_____ State work to be performed and purpose of building � __! �P 1_ �.... 4.1 g (By Floors) ____I! _ Main Fuses_ My Commission Expires Notary Public. State of Florida No. of Stories.. • Master Electrican. Amps. Electrical Inspector. 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 are licensed by Miami Shores Village. STATE OF FLORIDA, k 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, that he has carefully read the foregoing application, and that be did sign the same, and that all facts therein by him stated are true. 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 REFRIO. OUTLET IRON OUTLET RANGE OUTLET RANGE CONN. WATER HEATER W. HEAT. CONN. SPACE HEATER STRIP HEATER TOTAL C LST R / `� 1 2. J �.7 71. j 9 1 , / . Jcr� / . ` � 5 _ 2- Ii.�D CHECK ENT. SW. DIST. CAB. SERVICE TEMP. SERVICE PERM. MOTORS 0-1 HP MOTORS 1 -5 HP NEON TRANS. RADIO TOTAL CONTR. LIST CHECK A °'''l p� • ' V Permit No Owner's Name and Address . Registered Architect and /or Engineti MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT Street and Number where work is to be performed —No New Building Remodeling Addition. Repairs Service Overhead Size Feeders_,___... Conduit._ _ _ Main Sw./' �) Amps. u a d imessat i Type of Installation— Conduit Tubing B.X.L. Metal Moulding Amount of Permit S (Signed) (Signed Date_ Street 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. No_______ __________________ Street -- -- __________________ - ---- t - , �r i Employing Electrician's Name –'' ; a e- t _�:y _ No�� _ _______ Street___ Location and Legal Description Lot � Block_____ State work to be performed and purpose of building � __! �P 1_ �.... 4.1 g (By Floors) ____I! _ Main Fuses_ My Commission Expires Notary Public. State of Florida No. of Stories.. • Master Electrican. Amps. Electrical Inspector. 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 are licensed by Miami Shores Village. STATE OF FLORIDA, k 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, that he has carefully read the foregoing application, and that be did sign the same, and that all facts therein by him stated are true. 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. FINAL ALRAM Passed Inspector Comments Failed Correction Needed Re- Inspection Fee ($75) No Additional Inspections can be scheduled re- inspection fee is paid. until I nspection Number: INSP -19494 Inspection Date: 06/08/2006 Inspector: Devaney, Michael Owner: HENDERSON, REX AND GABRIELA Job Address: 1218 98 Street NE Project: <NONE> Contractor: BRINKS HOME SECURITY INC Building Department Comments Wednesday, June 7, 2006 Miami Shores Village, FL 33138- Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 0'9 Biro 1 .►.,. ,. Permit Number EL -5-05 -1294 Permit Type: Electrical - Residential Inspection Type: Final Work Classification: Addition /Alteration Block: Phone Number Parcel Number 1132050090350 Lot: Phone: 305 - 887 -8455 Page 2 of 2 ALARM Passed Inspector Comments Failed Correction Needed / / 001 .0r.„,, Re-Inspection Fee ($75) No Additional Inspections can be scheduled re-inspection fee is paid. until Inspection Date: 06/05/2006 Inspector: Devaney, Michael Owner: HENDERSON, REX AND GABRIELA Job Address: 1218 98 Street NE Miami Shores Village, FL 33138- Project: <NONE> Contractor: BRINKS HOME SECURITY INC Building Department Comments Friday, June 2, 2006 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 nspection Number: INSP-17673 JUN 0 o ENT Permit Number EL-5-06-1294 Permit Type: Electrical - Residential Inspection Type: Final Work Classification: Addition/Alteration Block: Phone Number Parcel Number 1132050090350 Lot: Phone: 305-887-8455 Page 2 of 2 Issue Date: 5/19/2006 Expires: 11/14/2006 Owner's Name: REX AND GABRIELA HENDERSON Permit Type: Electrical - Residential Work Classification: Addition /Alteration Job Address: Comments: BURGALR ALARM Additional Information 1218 98 Street NE Miami Shores Village, FL 33138- Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Fax: (305)756 -8972 Permit Contractor(s) BRINKS HOME SECURITY INC Phone 305 - 887 -8455 Primary Contractor Yes Type of Work: ALARM Additional Info: Classification: Residential 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. Building Department File Copy Applicant Signature Parcel #: Block: Section: Permit Status: APPROVED Permit Number: EL -5 -06 -1294 Phone: Total Square Feet: Total Valuation: Rewired Inspections 1132050090350 Lot: PB: 0 $ 900.00 Alteration Underground Rough WW Service Change Meter Box Fire Alarm Relocation Final Fees Due CCF Education Surcharge Permit Fee - Additions /Alterations Scanning Fee Technology Fee Total: Amount $0.60 $0.20 $100.00 $3.00 $2.50 $106.30 Invoice Number EL - 5 - 06 - 24879 Total: Amt Due $106.30 w< Amt Paid 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. Miami Shores Village 10050 N.E. a d : enue Ivfiami Shores, Florida 33138 Tel: ( i .( 756.8972 BUILDING �-� Permit Noy C 1 I , PERMIT APPLICATION BY:-- ............. Jvlaster Permit No. FBC 2001 Permit Type (circle): Building Owner's Name (Fee Simple Titleholder) Q g -A/6 (-R,SOIJ Phone # Owner's dress h2 /F 4E T e 0'77 City /4-si 1 es/ ' State ft Tenant/Lessee Name 5 Value of Work For this Permit Type of Work: ❑Addii Describe Work: Total Fee Now Due S (Continued on opposite side) Building Department K 3 / Electrical Plumbing Mechanical Roofing NO /0- ` J Zip ,33/30 Job Address (where the work is being done) ,4 E 91' �✓ City Miami Shores Village Is Building Historically Designated YES County Miami -Dade Phone # Zip f _ 'f7• f /1r5 Contractor's Company Name , 4 ° 0 1 )e-3 77 1/ __/ Phone # Contractor's Address 99 O r4) /11 Lay o1)' City '/ State Qualifier !_ - zip 35/7e Architect/Engineer's Name (if applicable) Phone # Square Footage Of Work: AlteratioJ ❑New ❑ Repair/Replace ❑ Demolition * * * * * * * * * * * * * * * * * * * * * * * * * * ** F ees * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Submittal Fee S Permit Fee S /00e 6 t' CCF 1 CO /CC Notary S Training/Education Fee S C7)• Technology Fee S Scanning S. `) • C)C; Radon $ Zoning Bond S Code Enforcement S Structural Plan Review. S p :71.:,`'s No -7 • .f ^, Ii -&.1F\ _ Bond -.r' iipany's Address _ City S7,t, Zip Mc 're (if ap; Mortgage Lender's Address City State 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 cons* ucton 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 '°T: I cer :'. '1:_ .:orc7 � _ ,r :i. : :, .. 7C71 a'id +r: 7'1 will be done in compliance with all applirible 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 PROPER ?. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDLNG 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 Owner or Agent The foregoi g instrument was ac •� : c'1 edred before me s I - The foregoing instrument was acknowle' ged bef day of �7 • , 20 a .4, by / 4444;42 ay of 20 o L, by APPLICATION APPROVED BY: Chc 12/15/03 As identification and who did take an oath. Signature Zip Contractor who is personally known to me or who has produced who is personally known to me or who has produced NOT • ' Y P : _ , */ NOTARY PUBL as identification and who did take an oath. Sign: /, '�,—°� , :,v - --a :.—._ Sign : _ -' -t -- .. : •'F a►Y•'+Jt l :...r,% Print: { { . , �3ilE t1,.: Print: :1 311E�. r1►1'a'n My Commission Expires: Gift =tr.tes • •'/ M9 My Commission Expi �� . sr,res • ./ c�09 (Certificate of Competency Holder) State Certificate or Registration No. Certificate of Competency No. ******************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** _ __ ******************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Plans Examiner Engineer Zoning 1 Primary Zone: 1400 SINGLE FAMILY RESIDENCE CLUC: 0001 RESIDENTIAL- SINGLE FAMILY Beds /Baths: 3/2 Floors: 1 Living Units: 1 Adj Sq Footage: 2,204 Lot Size: 8,175 SQ FT Year Built: 1950 Legal Description: EARLETON SHORES PB 43 -80 LOT 9 BLK 3 LOT SIZE 75.000 X 109 OR 21198 -0028 04 2003 1 Year: 2005 2004 Land Value: $187,069 $139,451 Building Value: $190,313 $214,557 Market Value: $377,382 $354,008 Assessed Value: $364,628 $354,008 Homestead Exemption: $25,000 $25,000 Total Exemptions: $25,000 $25,000 Taxable Value: $339,628 $329,008 Folio No.: 11- 3205 - 009 -0350 Property: 1218 NE 98 ST Mailing Address: REX HENDERSON &W GABRIELA 1218 NE 98 ST MIAMI SHORES FL 33138 -2561 Sale O /R: 21198 -0028 Sale Date: 4/2003 Sale Amount: $410,000 Miami -Dade My Home -Text My Home iamida • e.go Show Me: 'Property Information -Text j j Search By: (Select Item Address Search 'Enter the address and click "LOCATE ". Use the Tab key to switch between fields or click using the mouse. House Number: 11218 Direction: I Street Name: 198 Street Type: ,ST Unit (opt): 1 Zip Code I (opt): 1 Page 1 of 2 tGo to property map I' JProperty Appraiser Tax Estimator Summary Details: a Print friendly version Property Information: My Home 1 Property Information 1 Property Taxes 1 My Neighborhood 1 aoporty i4Rpraiser Home 1 Using Our Site 1 About 1 Phone Directory 1 Privacy 1 Disclaimer Sale Information: Assessment Information: :Q: We appreciate your feedback, please take a minute to complete our survey. If you experience technical difficulties with the Property Information application, please click here to let us know. E -mail your comments, questions and suggestions to Webmaster E httn• / /visims7. rn miami-darle fl nc /mvhnme /nrnntext acrOann= nnnek.hvtnnl= nnneRr.r.mr1 =F 5/1 R /7