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1270 NE 98 St (3)• • • • • ..w ••■ 4•••• •• • *I l•• • ...■■•••••••• • V &IA eet,L& Date I Tvpelncp'n Permit No. MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305-795-2204 Bt. i1ding Inspection Request Neme Address 12, 0 Company _ ..� / y� Phone N Inspection Date 2 — 1, Approved ) Correction ❑ Re- lnsp'n Fee ❑ VWA MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 B ilding Inspection Request Dater Type Insp'n + 1 Permit No. 00 1 L43 Name ( inuLair- . Address 1210 N F Q 3 Company -t CCc 1 Phone # Inspection Date 1 1 1 Z Approved ❑ Correction ❑ Re- Insp'n Fee ❑ Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Printed: 8/6/2004 Parcel # 1132050090310 Signed: (INSPECTOR) Mechanical Permit Permit Number: MC2004 -143 Applicant: LUCIE ROGENSDORF Owner: ROGENSDORF LUCIE JOB ADDRESS: 1270 NE 98 ST Contractor TRUE COOL AIR CONDITIONING INC Contractor's Address: 13727 SW 152 ST #264 Local Phone: 305 - 232 -7575 Page 1 of 1 Legal Description: 5 53 42 EARLETON SHORES PB 43 -80 LOT 3 LESS E12.5FT & E5OFT LOT 4 Fees: Description Amount FEE2004 -7969 Building Fee $100.00 FEE2004 -7970 CCF $1.80 FEE2004 -7971 Notary Fee $5.00 FEE2004 -7972 Training and Education Fee $0.60 FEE2004 -7973 Technology Fee $2.50 FEE2004 -7974 Scanning Fee $3.00 Total Fees: $112.90 Total Fees $112.90 Total Receipts: - 13:So o\Lo Permit Status: APPROVED Permit Expiration: 1/30/2005 Construction Value: $2,390.00 Work: REPLACE EXISTING 5 TON A/C SYSTEM 'ALE2 OPAID 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: City Qualifier BUILDING PERMIT APPLICATION FBC 2001 Permit Type (circle): Building Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.221 Fax: (305) 756.8972 Permit - O W — ! 11 Electrical PI u bing Phone Owner's Address lawn ;e City iAn, 1.9 r S ' h cis State Tenant/Lessee Name Phone if Job Address (where the work is being done) City Miami Shores Village Is Building Historically Designated YES Contractor's Company Name - tit Lre Contractor's Address - 1 3/ Sc.) QB s t - P l A State ' re Z44 � COC( A l /r sr- V a�r'o S• State Certificate or Registration No. C 4-Co 3 66 Certificate of Competency No. Architect/Engineer's Name (if applicable) Phone # S Value of Work F Permit a- 3 4 d� Type of Work: ©Addition DAlteration ❑New Describe Work: . 12I - e plAc -e -e ?ceSi-11Ny taCiL Total Fee Now Due $ (Continued on opposite side) * * * * * * * * * * * ** * * * * * * * * * * * * * ** F ees * * * * * * * * * * * * * ** * * * * * ** * ** * * * ** qD t7 /v-e 9,8 Sr County Miami -Dade NO ,to Master Permit No. Zip 33 t �F1' Square Footage Of Zip 3 31(3 RECEIV WS , 3 2004 ---- - - - - -- Phone # 3 S Z- 3a - 7 S' - 74.f — Zip 33/ 7 [ Repair/Replace 0 Demolition 4f r. £tiov`pl- Srfbmittal Fee $ (.50 400 Permit Fee $ 490 c.-- CCF $ I , 4 0 CO /CC Notary 1;5/ 0 © Training/Education Fee $ 6 a Technology Fee $ a ,S Z Scanning $ 3 , O 6 Radon S Zoning Bond Code Enforcement $ Structural Plan Review. $ Bonding Company's Name (if applicable) Bonding Company's Address City State 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 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 ved and a reinspection fee will be charged. Signature Owner or Ag The foregoing instrument was acknowledged before me this by ; n �1 � . ' • who is per ally known to me or who has produced As identifiratinn and who did take an oath. OFFICIAL NOTARY SEAL NOTARY ) UBLIC: TERRY J ZARLUNG NOTARY PUBLIC STATE OF FLORIDA Sign: COMMISSION NO IInon3433 Print: My Commission Expires: APPLICATION APPROVED BY: Chc 05/13/03 MY COMMISSION EXP. FEB. 21 Signature The foregoing instrument was acknowledged before me this tP l [ UIlh/ nom/ day of who is personal] known to me or who has pr uced a C.LS Sign: Print: My Commission Expir \ Contractor NOTARY PUBLIC AiIE:4mo v"6„ �. k. C < f c: - Plans Examiner Engineer Zoning • Zip identification and who did take an oath. v i 9`` p'dc■ U'., ^ 1�t11551UT1 •-) 9f ***************************************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** ITEM BATH TUB UNIT FEE ITEM SWITCH OUTLETS UNIT FEE ITEM SPACE HEATERS UNIT FEE BIDET LIGHT OUTLETS J CENTRAL HEATING /- (OW DISHWASHER RECEPTACLES A/C (WIND) DISPOSAL SERVICE TEMPORARY A/C (CENTRAL) 1- 5-tat-/ DRINKING FOUNTAIN SERVICE SIZE IN AMPS DUCT WORK FLOOR DRAIN SERVICE REPAIR/I€TER 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 HP HOT WATER BOILERS SINK, POT /3 COMP. MOTORS OVER 3- 5 HP MECHANICAL VENTILATION SINK, RESIDENCE MOTORS OVER 5- 8 HP TRANSPORTING ASSEMBLIES SINK, SLOP MOTORS OVER 8- 10 HP ELEVATORS/ESCALATORS TEMPORARY WATER CLOSET MOTORS OVER 10- 25 HP FIRE SPRINKLER SYSTEMS URINAL MOTORS OVER 25-100 HP COOLING TOWERS WATER CLOSET MOTORS OVER 100 HP VIOLATION IO IRECT WASTES - A/C WINDOW 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 COMMERCIAL WATER SERVICE SIGN TUBES SEWER CONNECTIONS SIGN TRANSFORMERS UTILITY -SEWER SIGN TIME CLOCK UTILITY -WATER FIXTURES SEPTIC TANK ANTENNA RELAY TELEVISION OUTLETS DRAINFIELD, 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 _ (AN APPLICATION FOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. IF A MASTER PERMIT HAS B. OBTAINED, THE OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.) PLUMBING ADDENDUM TO BUILDING PERMIT APPLICATION ELECTRICAL MECHANICAL Chairman Member Member . .. - _.. Council Approved STATE OF FLORIDA, COUNTY OF DADE. j ss • Building Inspector NOTE: A charge of $1.00 will be made for the Planning Board. A re- inspection fee of $1.00 will be charged materials and /or workmanship. / \.\ MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Application is hereby made for the approya1 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 and specifications must be kept at building during progress of the work. Owner's Name and Address... Registered Architect and /or Engine Name and address of licensed contractor...- ,/�'(, Location and legal description of lot to be built on: Lot Block Subdivision Street and Number where work is to be done State to be ne pose of ' ildin (by floors) ) . ido xleo -e_e and for no other purpose. New Building Remodeling Addition Repairs No. of Stories To be constructed of Kind of foundation Roof hovering Estimated Total cost of improvements $ ZO i Amount of Permit $.. Zone cubage required _Plan Cubage Distance to next nearest building Size of Building Lot Notary Public, State of Florida Maximum live load to be borne by each floor I hereby submit all the plans and specifications foetal& 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 5966, 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 subcontractors, on work to be performed under this permit, as are licensed by Miami Shores Village. Remarks (Signed / /L-frz ,:c - --- -d :77/ . 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 construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. Permit No Date Read, Sworn to and Subscribed before me. Disapproved Date (Signed) My Commission Expires PLANNING BOARD DATE Member Member Member Date Disapproved Date making corrections or changes to this application after approval has been obtained from when such re - inspection is made necessary by improper notice for inspection or faulty ING ELECTRICAL ROOFING Owner of Architect Contractor I or Builder Legal Description Address of ',lading This p herefor in strict c mp I dsawngs, statements or spe cif? lame if the work is not done panted is the understanding pertalining to the work covarod one by his aged, servant or In consideration of the 3ss aano in thereto and in strict. conform pting this permit I assume : resgo CONTRACTOR OR BOLD _ � 1 M IAMI p