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600 NE 98 St (6)Issue Date: 10/23/2006 Owner's Name: EILEEN SAMMONS Permit Type: Mechanical - Residential Work Classification: Repair Job Address: 600 98 Street NE Additional Information Miami Shores, FL 33138 - 2472 Contractor(s) Phone BRANDON AIR CONDITIONING SEF 305 - 819 -2669 Yes Primary Contractor 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 $2.40 Education Surcharge $0.80 Permit Fee - Additions /Alterations $120.00 Scanning Fee $3.00 Technology Fee $3.00 Total: $129.20 Building Department File Copy Applicant Signature Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Fax: (305)756 -8972 Permit Expires: 04/21/2007 Invoice Number MC -10 -06 -26495 Total: Parcel #: Block: Section: Permit Status: APPROVED Permit Number: MC -10 -06 -2606 Phone: Total Square Feet: 0 Total Valuation: $ 3,250.00 Required Inspections Final Amt Due $129.20 1132060171840 Lot: PB: Amt Paid OCT 2 6 21116 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. CHANGE OUT OF ONE 5 TON AIR HANDLER UNIT j t s 1 1 2001 Passed Inspector Comments PO L (Mk Failed Correction Needed Re- Inspection Fee ($75) No Additional Inspections can be scheduled re- inspection fee is paid. until Inspection Date: 01/08/2007 Inspector: Perez, JanPierre Owner: SAMMONS, EILEEN Job Address: 600 98 Street NE Miami Shores, FL 33138 -2472 Project: <NONE> Building Department Comments Thursday, January 4, 2007 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 inspection Number: IN P-30250 er mit Number: MC -10-06 -2606 Contractor: BRANDON AIR CONDITIONING SERVICE CORP Block: Permit Type: Mechanical - Residential Inspection Type: Final Work Classification: Repair Phone Number Parcel Number 1132060171840 Lot: Phone: 305- 819 -2669 Page 1 of 1 J 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 BUILDING (J 2 (1 Permit No. G(V PERMIT APPLICATION c . - 2°N `Master Permit No. FBC 2004 Owner's Name (Fee Simple Titleholder) Owner's Address 4DQ /)4 9'8 • City 772t..esp -A tate Tenant/Lessee Name FOLIO / PARCEL # 1/302 D 4 / 7 /8 +'8 City State 1 Qualifier Name State Certificate or Registration No.(: /9 C.03 (0 ? / Type of Work: ❑Addition Describe Work: Bond $ Code Enforcement $ Miami Shores Village Building Department Submittal Fee $ Permit Fee $ Notary $ Training/Education Fee $ Scanning $?)00 Radon $ DPBR $ Permit Type (circle): Building Electrical Plumbing Mechanical Roofing Phone #.3D -e- Job Address (where the work is being done) COO ,Ale y 3,CZ‘ • Zip 33/.38 City Miami Shores Village County Miami -Dade Zip 33/38 Is Building Historically Designated YES NO Contractor's Company Name 6 Contractor's Address 6/ 7 .$ 4 CA) /(o 7 Architect/Engineer's Name (if applicable) Phone # Double Fee $ Phone # " phone #30S —6/ -.266 y Zip 33 /S Phone #3 5- 1/9 - c2 66F Certificate of Competency No. C.. /9 C. 0 3 6 7, / Value of Work For this Permit $ 2$'®, © 0 Square? Linear Footage Of Work: ['Alteration [New [df ❑ Demolition ******** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** F * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** V i 0 D� CCF $ 2 CO /CC Technology Fee $ 5a) Zoning $ Structural Review. $ Total Fee Now Due $ I - . 02 See Reverse side —> 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 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 % (.� .?(�i /c J li'-Pt.-4/0 t� Owner or Agent The foregoing instrument was acknowledged before me this/ — day of 200 4, by c who is personally known to me or who has produced As identification and who did take an oath. i•...... .STiEN p ............ t ( ` _ 4/24/2009 Sign: 7' 8 V)dS ftli (8°° ) 43 2.4254 Li .... .. Assn. Inc • Print: Si u c ,i, ?, w f+ C7 . -r_16"/ 2 - • • . ... . .. •• •i My Commission Expires: d. -.24 -e `r ******************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** NOTARY PUBLIC: APPLICATION APPROVED BY: (Revised 02/08/06) Signature NOTARY PUBLIC: Sign: Print: r r = STE Contractor The foregoing instrument was acknowledged before me this/9 day ofCaitoc- 2006, by , , who is personally known to me or who has produced as identification and who did take an oath. GNER in Monde Notary Man Inc My Commission expires: J' _ d * * * * * * * * * * * * * * * * * *, * * * * * * * * * * ** * * * * * * * * * * * * * * * * * * * * * ** Plans Examiner Engineer Zoning ITEM UNIT FEE ITEM UNIT FEE ITEM UNIT FEE BATH TUB SWITCH OUTLETS SPACE HEATERS DISHWASHER LIGHT OUTLETS CENTRAL HEATING DISPOSAL RECEPTACLES A/C (WIND) FLOOR DRAIN SERVICE TEMPORARY NC (CENTRAL) GREASE TRAP SERVICE SIZE IN AMPS DUCT WORK INTERCEPTOR SERVICE REPAIR/METER CHANGE REFRIGERATION LAVATORY APPLIANCE OUTLETS PROCESS AND PRESS PIPING LAUNDRY TRAY RANGE TOP UNDERGROUND TANKS CLOTHES WASHER OVEN ABOVE GROUND TANKS SHOWER WATER HEATER U.F. PRESSURE VESSELS SINK. POT /3 COMP. MOTORS 0 -1 HP STEAM BOILERS SINK, RESIDENCE. MOTORS OVER 1 -3 HP HOT WATER BOILERS SINK, SLOP. MOTORS OVER 3 -5 HP MECHANICAL VENTILATION TEMPORARY WATER CLOSET MOTORS OVER 5 -8 HP TRANSPORTING ASSEMBLIES URINAL MOTORS OVER 8 -10 HP ELEVATORS /ESCALATORS WATER CLOSET MOTORS OVER 10 -25 HP FIRE SPRINKLER SYSTEMS INDIRECT WASTES MOTORS OVER 25 -100 HP COOLING TOWERS WATER SUPPLY TO: MOTORS OVER 100 HP VIOLATION A/C UNIT NC WINDOW REINSPECTION FIRE SPRINKLER AIR CONDITIONERS HEATER -NEW INST. STRIP HEATER HEATER - REPLACE GENERATORS TRANSFORMERS LAWN SPRINKLER -WELL GENERATORS TRANSFORMERS SWIMMING POOL GENERATORS TRANSFORMERS WATER SERVICE SPECIAL PURPOSE SEWER CONNECTIONS OUTLETS COMMERCIAL UTILITY -SEWER SIGN TUBES UTILITY -WATER SIGN TRANSFORMERS SEPTIC TANK SIGN TIME CLOCK RELAY FIXTURES FAINFIELD, 4" TILE /RES. ANTENNA PUMP & ABANDON SEPTIC TANK TELEVISION OUTLETS SOAKAGE PIT CU. FT. VIOLATION CATCH BASIN REINSPECTION 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. PLEASE CIRCLE 0 DISCIPLINE APPLIED FOR: ELECTRICAL PERMIT # MECHANICAL PROPOSAL & SALES AGREEMENT PACKAGE UNIT CONDENSING SECTION BLOWER COIL AIR HANDLER FURNACE COIL VENTILATION QUANTITY rJ re, e BRAND / ? Gt 72 E MODEL 277( 3 ' (,0%r I )0O/ SIZE 5 iort HEATING / / / QUANTITY BRAND MODEL SIZE HEATING PROPOSAL & SALES AGREEMENT PURCHASER: c rC>.Et.. ,l( mmo n.,d 600 A' , !.7. 98 SIz. ADDRESS: ^j a r: .,.,, -, ,'/, 4. , .6, ? 3 37 3�;' JOB: SITE: PERMIT III EQUIPMENT SCHEDULE DATE: 3058193469 10/19/2006 08:17 3058193469 AIR DISTRIBUTION: WILL BE INSTALLED ACCORDING TO. OUR PLAN * SUBJECT TO MODIFICATION ACCORDING TO STRUCTURAL OR OTHER REQUIREMENTS. DUCTS: WILL BE GALVANIZED INSULATED GLASS FIBER ALL MATERIAL WILL BE NEW. FIRST QUALITY, DESIGNED, FABRICATED AND INSTALLED ACCORDING TO ACCEPTED ENGINEERING PRACTICE AND IN COMPLIANCE WITH ALL APPLICABLE BUILDING CODES IN FORCE ON ABOVE DATE GRILLES: w1LL BE AS SHOWN SUBJECT TO JOB -SITE REQUIREMENTS CONTROLS: PARTS WARRANTY: MANUFACTURER'S YEAR WARRANTY ON COMPRESSOR, MANUFACTURER'S J YEAR WARRANTY ON ALL OTHER COMPONENTS. SERVICE: BRANDON AIR CONDITIONING CORPORATION WILL PROVIDE FREE SERVICE LABOR FOR A PERIOD OF • FROM DATE OF START -UP. START -UP IS PART OF FREE SERVICE LABOR. SERVICE WILL BE PERFORMED DURING NORMAL WORKING DAYS AND HOURS ONLY UNLESS AUTHORIZED BY PURCHASER AT ADDITIONAL CHARGE. RESPONSIBILITY SHALL BE ASSUMED AS INDICATED BELOW: BRANDON INSTALLATION OF EQUIPMENT DRAIN PIPING REFRIGERANT PIPING .... .. . ... .. .... INSTALL DUCTS AND GRILLES STRUCTURAL SUPPORTS FOR EQUIPMENT . BATH EXHAUST FAN SCHEDULE OF PAYMENTS WITH ORDER UPON COMPLETION PURCHASER TITLE (A ) 30 5- 757 -59 30 5- 773 -8 EOVIPMENT WILL CONTAIN. AS SUPPLIED BY THE MANUFACTURER, HIGH- LOW PRESSURE SAFETY SHUT OFF SWITCHES. AUTOMATIC TRIP OVERLOAD. FOR FULL PROTECTION OF THE COMPRESSOR AND SEALED SYSTEM. $ COMPL ETION OF UNDERGROUND PIPING 5 WHEN DUCT IS ROUGHED IN S DELIVERY OF MAJOR EQUIPMENT S $ 3.254.00 l � u. , 7. 17 ALL CONDITIONS READ AND ACCEPTED BRANDON AIR SALES ENGINEER 2 R. 1.1 C'!? 1 l./7. Fl. rj. (� F (JCL 7'o2a. .r/ (7 a JL /i OC7aS BRANDON AIR CONDITIONING CORP. TITLE PAGE 01 SERVICE CORPORATION SINCE 1952 6175 N,W. 167 STREET, G -25 MIAMI, FLORIDA 33015 PHONE: (305) 819 -2669 FAX: (305) 819 -3469 PRICE: $ 3 , 54 ( : 0 BRANDON THERMOSTAT V /(RING THERMOSTAT INSTALLP1IQN CUTTING OF H01 F FOR PIPES, (DUCTS. ETC ACCCESS & CLEARANCE FOR DU::Tti, 3HIL 1 ES 1 EQUIP' ELECTRIC BV OTHERS' Tnr_G:.tc /c I 1.4 if C/ ,r/ CA /7.Oifl /7(20. (2) ,' ' r - t,/ f Dorm`. CONDITIONS OF SALE: P urchaser is r•spon•Ibl• for all equipment and material delivered 10 toD tote De.rpoed f •br is atett and • • ccortiono 10 steepled •r10.1,••111-1.2 pr•etre• end ,n 0Omp1,•nc• w.lh all applicable bu,I(i n(J contra ,n d•t• Any.Il.r. tion or d•..ntion from above spec rfICat,on• involving arty CO(1.. ...Flit,. e.ecv ■ed only upon orders and oe10 0•00rn• •n ••ll• ch.r0.. Th• w•rr•ntl•• p100Idad herein • e ••pleas ly In 11•u Of all Other w•rrsnIre• o • obbget.on• e•O'e5(011 (1 n and .r n•Ith.r •••Urn•. 001 OUthOIIZ•• •ny Om•I parson t0 •••Vme 1pr it •ny h•brti,y In connec,,Ort w,,r, tho sal* 0, 10.0 •qul per. Ove •r.hip of tn. stow, .qul pm•nt and mat•ri•l• •11•1 r•0•In in elle• a a •nd irtle rs •e0, r n n• ,.I *sm.: .5 fully paid In •CCOId•nC• Wlt0 Ih• •Cn•dvl• of paym•nt• •• 5., torch .boy. In the euent payment s n0l m.00 v.. ,. time end manner a a31 forth above, the ..liar. et Is option. m•v r mow• .•10 •gv.Dmsnt •nd mefer.els end e1ske p0 ion wh•th.r or of a • hay ba•n palm n11y •t/•c." Or *Maned , the •pr l P.1•c.ese e , 1. pay •.I1.r re••On•bl• •ttOrn•y'• I••• •nd00•l• if n.c••••ry f0 •Olorce any of the term• of in sspree men, All sere.._• snail Oa • uap.nd•d On punt due SCC000I•. It ,• •pre•d 1,1•1 the purch•aa• rat the •.l1.• from and th•t th• • r a s 0 h r0s no Ib.lity en s of be a, respon•Ibl.10, any ided.m•p.Orc•I C•u••d0y tic tit k.. Of Qovsrnm•nO .I loCk•outs I, esPlJ..nn 1•n. 110011s •10. water 0.10.9.. 7,01 t,vil commotion. war, nuclear ds•.1• m*lbC mlath pocket Iln•s. Acts Of 130110. 0 ,- a • u•• beyond ,1'• control and In any •••nt 10 COn••0U•nt1•I d•m.g••. v Punch••and his aalgn.•gfe• to hold •. 11•rh.rml... and r.lsa••aeii•rhOm •ny•n0 •ncle , ms for d Des vO.ng w1 d•rn.0., r••w /Pons the w•• •nd/O1 rna1a11.e,On 01 •ny •qu duct wort,. Or d..rn ape t•c■l ■,,01 s00C. .n 1M. Droop••(. That In (n0 •••nt M• Pwlch•Nl fSfudiel•• 104 COftfSCI she ••000LOn and retu•as to allow .•Iler ,O comets ^Le unO•r COnleaC• prOVSlOna. than and In that oven( lh• purehaer shall Pay t0 and b• r•epOn•.nla to the •ell*..« the sun- of 10% of (he tonlr•ct pr,c. .a and for I,quld.l•• •nd •pr••d d.m•g•• •n0 not •5 • pen•lty Th,• proposal may ba wllhdr•wn by S.11.r 0 not • c•pl.d ...thin 90 day of In.• 0•t• Tn• COnlreCr may b. 00,0•0 •I tn• Option of the •011er. .1 work ha. not Commenced w,tn,n 90 ad., V of CeCty"he Purchaser •Or••• 10 00y inter* /I Of 116 0.• month on ell peat due amount. r•9•101... 0 SsluI yr Jc.b CHANGE OUT ON 5 TON CONDENSING UNIT ,,AN 1 1 200 Inspector Comments Clicl Failed \., \ 5 0 J / ll Passed If Correction Needed Re- Inspection Fee ($75) No Additional Inspections can be scheduled re- inspection fee is paid. until Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP - 31047 Permit Number: MC -10-06 -2681 Inspection Date: 01/08/2007 Inspector: Perez, JanPierre Owner: SAMMONS, EILEEN Job Address: 600 98 Street NE Miami Shores, FL 33138 -2472 Project: <NONE> Contractor: BRANDON AIR CONDITIONING SERVICE CORP Building Department Comments Thursday, January 4, 2007 Block: Permit Type: Mechanical - Residential Inspection Type: Final Work Classification: New Phone Number Parcel Number 1132060171840 Lot: Phone: 305 - 819 -2669 Page 1 of 1 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 -10 -06 -2681 Invoice Number: MC -11 -06 -26605 Applicant: EILEEN SAMMONS Company Name: Owner Address: 600 NE 98 ST MIAMI, FL 33138 -2472 Job Address: 600 98 Street. NE Miami Shores, FL 33138 -2472 Date Monday, November 6, 2006 11/06/2006 Credit Card Payment Type Check Number Amount $169.85 Change $0.00 Total Payment: $169.85 Page 1 of 1 Issue Date: 11/1/2006 Owner's Name: EILEEN SAMMONS Permit Type: Mechanical - Residential Work Classification: New Job Address: 600 98 Street NE Contractor(s) Phone BRANDON AIR CONDITIONING SEF 305 - 819 -2669 Yes Primary Contractor Additional Information Tons: Classification: Residential Miami Shores, FL 33138 -2472 Expires: 04/30/2007 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 $3.00 Education Surcharge $1.00 Notary Fee $5.00 Permit Fee - Additions /Alterations $154.00 Scanning Fee $3.00 Technology Fee $3.85 Total: $169.85 Building Department File Copy Applicant Signature Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Fax: (305)756 -8972 Permit Permit Status: APPROVED Permit Number: MC -10 -06 -2681 Phone: Parcel #: 1132060171840 Block: Lot: Section: PB: Total Square Feet: 0 Total Valuation: $ 4,400.00 Required Inspections Rough Rough Duct Ventilation Smoke Test Hood Smoke Det Test Final Invoice Number MC - 11 - 06 - 26605 Total: tclv aid 0 s NJ Amt Due $169.85 Amt Paid NOTICE: In addition to the requirements of this permit, there may be additional restrictions applicable to this property that may be found in the public records of this county. AND THERE MAY BE ADDITIONAL PERMITS REQUIRED FROM OTHER GOVERNMENTAL ENTITIES SUCH AS WATER MANAGEMENT DISTRICTS, STATE AGENCIES, OR FEDERAL AGENCIES. FBC 2004 Permit Type (circle): Tenant/Lessee Name — 6 — Is Building Historically Designated YES NO Contractor's Address In / '7$ A) LJ / 6 9.. . G S" City 7/2.4...;0-77. 7 • Qualifier Name / C State Certificate or Registration No.0 /}G ® 3 i '76 / Type of Work: ['Addition Describe Work: a. Miami Shores Village Building Department BUILDING r PERMIT APPLICATI 0 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Permit No. Building Electrical Plumbing State Job Address (where the work is being done) to 4)6 qg .,/�• City Miami Shores Village County Miami -Dade FOLIO / PARCEL # 1 / 3;? c 6o / 9 / g v o Owner's Name (Fee Simple Titleholder) ' Phone 30S 7.r' ' 5 Owner's Address lv co City .2-. .0. State 7',..12rei C54v bath Master Permit No. Zip 33/38 Phone # Architect/Engineer's Name (if applicable) Phone # Mechanical Roofing Zip Contractor's Company Name Aj Q ,,_, ,9 f Phone # Jps ' 1/9 6 C 9' Zip 330/x' Phone #,,,3e). 5 - / 9 ° c ,2 6 5 Certificate of Competency No. C f}G p a 6 7 8/ Value of Work For this Permit $ 1 -1 1 1 41406 o a Square / Linear Footage Of Work: ['Alteration ['New Repair/Replace ❑ Demolition ******** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** F i ** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Submittal Fee $ Permit Fee $ ii 5 k �/ CCF $ S 00 CO /CC Notary $ Training/Education Fee $ 1'(90 Technology Fee $ S Scanning $ 03 Radon $ DPBR $ Zoning $ Bond $ Code Enforcement $ Double Fee $ Structural Review. $ Total Fee Now Due $ ' l l2 ?.n See Reverse side -> c-27J50 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 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. ..L��✓ Signature Owner or Agent Contractor f. The foregoing instrument was acknowledged before me this ' The foregoing instrument was acknowledged before me this -3 day oferk., , 20 0 ri by Er. 1,. -rn .mow¢., day of «t. , 20 04; by r e who is personally known to me or who has produced who is personally known to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: As identification and who did take an oath. STEVEN WA GNER OOO 111 / / 00 0425/115 � ""' • "_ s • : ... 0 / 2 4/2008 Print: t'c' tie > � • ; " ; J� (000141 »2 •,••• ................................ Aasn.. .... . My Commission Expires: 6 _. ,2 y.- 0e; Sign: (Revised 02/08/06) Signature ****,****************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** * * * * * * * * * * * * ** * * * * * ** * * * * * * * * * * * * * * * * * * * * * * * * * * * ** APPLICATION APPROVED BY: Plans Examiner IL /1 NOTARY PUBLIC: Sign: y , : o o4[pt l5 Print: TEV _* _ 62 3 My Commission a rVitn: - '6. 4 :r.':'2'^ O"O Engineer Zoning ITEM UNIT FEE ITEM UNIT FEE ITEM UNIT FEE BATH TUB SWITCH OUTLETS SPACE HEATERS DISHWASHER LIGHT OUTLETS CENTRAL HEATING DISPOSAL RECEPTACLES A/C (WIND) FLOOR DRAIN SERVICE TEMPORARY A/C (CENTRAL) 5,./1 GREASE TRAP SERVICE SIZE IN AMPS DUCT WORK INTERCEPTOR SERVICE REPAIR /METER CHANGE REFRIGERATION LAVATORY APPLIANCE OUTLETS PROCESS AND PRESS PIPING LAUNDRY TRAY RANGE TOP UNDERGROUND TANKS CLOTHES WASHER OVEN ABOVE GROUND TANKS SHOWER WATER HEATER U.F. PRESSURE VESSELS SINK. POT /3 COMP. MOTORS 0 -1 HP STEAM BOILERS SINK, RESIDENCE. MOTORS OVER 1 -3 HP HOT WATER BOILERS SINK, SLOP. MOTORS OVER 3 -5 HP MECHANICAL VENTILATION TEMPORARY WATER CLOSET MOTORS OVER 5 -8 HP TRANSPORTING ASSEMBLIES URINAL MOTORS OVER 8 -10 HP ELEVATORS /ESCALATORS WATER CLOSET MOTORS OVER 10 -25 HP FIRE SPRINKLER SYSTEMS INDIRECT WASTES MOTORS OVER 25 -100 HP COOLING TOWERS WATER SUPPLY TO: MOTORS OVER 100 HP VIOLATION A/C UNIT A/C WINDOW REINSPECTION FIRE SPRINKLER AIR CONDITIONERS HEATER -NEW INST. STRIP HEATER HEATER - REPLACE GENERATORS TRANSFORMERS LAWN SPRINKLER -WELL GENERATORS TRANSFORMERS SWIMMING POOL GENERATORS TRANSFORMERS WATER SERVICE SPECIAL PURPOSE SEWER CONNECTIONS OUTLETS COMMERCIAL UTILITY -SEWER SIGN TUBES UTILITY -WATER SIGN TRANSFORMERS SEPTIC TANK SIGN TIME CLOCK RELAY FIXTURES FAINFIELD, 4" TILE /RES. ANTENNA PUMP & ABANDON SEPTIC TANK TELEVISION OUTLETS SOAKAGE PIT CU. FT. VIOLATION CATCH BASIN REINSPECTION 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. PLEASE CIRCLE 0 DISCIPLINE APPLIED FOR: ELECTRICAL PERMIT # MECHANICAL PROPOSAL & SALES AGREEMENT PACKAGE UNIT CONDENSING SECTION BLOWER COIL AIR HANDLER FURNACE COIL VENTILATION QUANTITY One BRAND 72,lnP MODEL 277123060410004' 64231 ?D!'% 17 SIZE 5 Inn HEATING Sll QUANTITY BRAND MODEL SIZE HEATING PROPOSAL & SALES AGREEMENT PURCHASER: E4.ieen Sammons 600 NE 98 S.f2eet ADDRESS: 1 ?41a172.c Sho2e 7Pon.LcIa 33138 JOB: SITE: PERMIT # EQUIPMENT SCHEDULE DATE: 305 -- 757 - -5934 AIR DISTRIBUTION: WILL BE INSTALLED ACCORDING TO: OUR PLAN # SUBJECT TO MODIFICATION ACCORDING TO STRUCTURAL OR OTHER REQUIREMENTS. DUCTS: WILL BE: GALVANIZED INSULATED GLASS FIBER ALL MATERIAL WILL BE NEW, FIRST QUALITY, DESIGNED, FABRICATED AND INSTALLED ACCORDING TO ACCEPTED ENGINEERING PRACTICE AND IN COMPLIANCE WITH ALL APPLICABLE BUILDING CODES IN FORCE ON ABOVE DATE. GRILLES: WILL BE AS SHOWN SUBJECT TO JOB -SITE REQUIREMENTS. CONTROLS: EQUIPMENT WILL CONTAIN, AS SUPPLIED BY THE MANUFACTURER, HIGH - LOW PRESSURE SAFETY SHUT OFF SWITCHES, AUTOMATIC TRIP OVERLOAD, FOR FULL PROTECTION OF THE COMPRESSOR AND SEALED SYSTEM. BRANDON SERVICE CORPORATION SINCE 1952 6175 N.W. 167 STREET, G -25 MIAMI, FLORIDA 33015 PHONE: (305) 819 -2669 FAX: (305) 819 -3469 PARTS WARRANTY: MANUFACTURER'S 7 0 YEAR WARRANTY ON COMPRESSOR. MANUFACTURER'S 5 YEAR WARRANTY ON ALL OTHER COMPONENTS. one �ea SERVICE: BRANDON AIR CONDITIONING CORPORATION WILL PROVIDE FREE SERVICE LABOR FOR A PERIOD OF FROM DATE OF START -UP. START -UP IS PART OF FREE SERVICE LABOR. SERVICE WILL BE PERFORMED DURING NORMAL WORKING DAYS AND HOURS ONLY UNLESS AUTHORIZED BY PURCHASER AT ADDITIONAL CHARGE. RESPONSIBILITY SHALL BE ASSUMED AS INDICATED BELOW: 13.5 Seel PRICE: $ 4, 4 00.00 BRANDON JOB DATA I HEREBY MAKE APPLICATION FOR A PERMIT TO COVER INSTALLATION OF: BUILDING M ECHANICAL g 1,46 PERMIT NO. P ERMIT NO /�/ ;,! /�f TYPE Number SPECIFICAT. FEE SPACE HEATERS CONTRACTING FIRM Sc d T r . 5:„.1. i rIt C 6 9,e 4 / g f r C- t o " Cr: CONTRACTOR'S ADDRESS PHONE ?8 crGS CENTRAL HEATING x I. PI V✓ 11,50 AIR CONDITIONING (WIND) AIR CONDITIONING (CENTRAL) X y ro.v 2. 3,73 OWNER'S NAME CFAA eLtsf D, M . fr zoA%f DUCT WORK ONLY REFRIGERATION JOB ADDRESS 6 � / E 7 '� S ri?4-tr PROCESS AND PRESS. PIPING CITY l,1 ,4f S f O , 2 � s PHONE 7 s 7- J z / UNDERGROUND TANKS ABOVE GROUND TANKS LOT BLOCK .U.F. PRESSURE VESSELS SUBDIVISION STEAM BOILERS HOT WATER BOILERS Application is hereby made to obtain o permit to do the work and in- stallations as hereon indicated. I certify that no work or installation has been effected prior to the issuance of said permit and that all work will be performed to meet the standards of all laws regulating con- struction in Dade County. I further certify that I hove checked and am responsible for the adequacy of any existing systems to which the work de ribed in this pe it adds extension or makes changes. 47 *� MECHANICAL VENTILATION TRANSPORTING ASSEMBLIES ELEVATORS — ESCALATORS FIRE SPRINKLER SYSTEMS COOLING TOWERS SIt • ATURE sF MASTER OR OWNER BUI s ER: TOTAL FEE 1> t, I3 5,2j Proposed use of Building (Describe in Detail) This permit does not become valid until signed by on authorized repre- sentative of the Director, Metropolitan Dade County Building and Zon- ing Department and all fees are paid and receipt acknowledged in the space provided. When making remittance by mail, send check for exact amount payable to: METROPOLITAN DADE COUNTY BUILDING AND ZONING DEPARTMENT 1351 N. W. 12th ST. BOX 52 -655 MIAMI 52, FLORIDA VIOLATIONS CHECK: CHECKED BY DATE Will There be Spray or Dip Painting Operations CONTR. CERT. NUMBER CLASS CHECKED BY in This Building? (Yes or No) ISSUED BY • DATE Will There be Woodworking or Other Operations in This Building which WHERE APPLICABLE, APPLICATION APPROVED BY: ZONING BY • %1■. \ DATE will produce Flammable Particles or Dust? (Yes or No) Will Flammable or Hazardous Chemicals be Used or Stored in This �j� CONSTRUCTION BY • ∎ �� DATE 'BEVEL Building? (Yes or No) REQ 0 d' c c c a G o Refrig- eration Tank oiler. & ...are Ye..•I. Vent- ilation Misc. List 123.03 -4 DING AND ZONING MECHANICAL PERMIT APPLICATION MECHANICAL INSPECTION RECORD INSPECTOR'S COPY UIRED INSPECTIONS ROUGH —UNIT & FLUE FINAL —UNIT & FLUE ROUGH —DUCTS FINAL —DUCTS ROUGH —UNIT FINAL —UNIT ROUGH —DUCT FINAL —DUCT ROUGH FINAL ROUGH FINAL ROUGH FINAL ROUGH FINAL ROUGH FINAL INSPECTOR'S NAME Dora Approved Dote Disapproved Other Inspections (LIST TYPE, EXTENT or UNITS CHECKED) REMARKS Inspector's Name Dore Approved List here: Reasons for all Disapprovals, Date 8 Type of all Notices left, all Verbal Instructions to Contractor and Any Other Information Pertinent to the Inspection of This Job. Dee Di .appr o..4 PERMIT APPLICATION FOR MUNICIPALITIES OF DADE COUNTY (OWNER TO RETAIN COPY) Date Job Address ff' . // d / (O /1 3 � I / / to ?0 (D� � .� /��'�i Tax Folio Legal Description /11/1g /0/ Wilk/pi/ NI�Master Permit ifr 0 Owner// Lessee / Tenant Owner's Address State # Signature Date: 2- ' �?� Square Ft. / Contracting Co. �x'd� /� , ON0//7oir/i4E.-Tt/ Address C��� �t O' A/ Qualifier 6jG/P /Z G Z 6{ /6 L SSii Phone Architect /Engineer Address Bonding Company Address Mortgagor Address Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL, PAVING FENCE SIGN WORK DESCRIPTION 1.779�L � (le: r(C /cr /jcr / O /c 13;P-5 �� � /C. dd 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. of Owner and /or Conti President Competency# q 'D/' ary as to Owner and OA PIIRig tTDA. y Commission Expires.CY COMMISSION EXPIRES: FEB. 4. 1994a / * y BROSD THRU *TARY PUBIC UNDERWR*Rdi PERMIT FEE: APPROVED: Fire q ,o, 75 Zoning Building Signa Date: Phone U Ins. Co. 6 / %/' �� � /? 3 Td /d !� /' j C> Estimated Cost 3o& re of Cont act .• o , jowl - Builder = ary as to Contractor or Owner -B der 1ARY PUBLIC: ST TE OF FLORIDA. * Hy Commission Expires:MY MI EX'REES .: 4994, J. .60NDED COM THR* NOTA RY PI Pt* UNDE R ITE RGa Other Electrical Mechanical mik, 0)10h) Plumbing Engineering 6fd 0 901 e 04 f '5 G ee'a pro/ 9 ,95 Fy e Ae.//4 aUT e -Y; 3/8 efi (A0 Ham 5J 7/ 9900 Ofcrae "he ZA/PiT?QtfiNc, 6,5440 ZW /41 Ads bolo , rfE- 9 / Sr: I A1- PE ,73'/4 Date ' ; -a/ Job Address 6 d O "_)6 99 , Tax Folio i / — -a G to 0 / 7 / z ? 1 / O Legal Description h. Owner/Lessee / Tenant Owner's Address C 'C A- 9 0--� Contracting Co. 9 G Qualifier dt state #G 176a 36 7$ / Municipal # Architect/Engineer WORK DESCRIPTION oeL,t4.c.1t Q iL cez.a....4" ary as to 'i wner an or Con goP a� �c . i My Commission Expires:iaf ;i_O'g u m n Poe 1 AN A rA s a aea , 11 •` a a CC76669 oC _1cs15?„OO FEES: PERMIT RADON PERMIT APPLICATION FOR MIAMI SHORES VILLAGE 04 c Historically Designated: Yes Address J 7 S' ,Q Gc.) / 7 �e " G 2. s SS # thhone, -g / 9 -a 6 6 9' Competency # Address Address Master Permit # Square Ft. Estimated Cost (value) '/, ‘FSD Notary as to Contractor or My Commission Expires: Ins. Co. No 1 . - *" -. Phone 3 es- 7s' 7_ S 9 3 Bonding Company Mortgagor Address Permit Type (circle one): BUILDING ELECTRICAL PLUMB 1 ECHANIC ROOFING PAVING FENCE SIGN 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 constru tion and zoning. Furthermore, I authorize the above -named contractor to do the work stated. /0( _,,,,t...e.,4__ 0 ( Si ature of o er and/or Condo Form DlJ e ature of Contractor or 0 r- Builder Y . to S �1S a �1 �l �► / ate STEVEN P. WAGNER My ecmm Exp. 6/24/05 No. DO 019759 Priersonally Known 11 Dour 1.0. C.C.F. 1 , jD NOTARY S%. 0 0 BOND TOTAL DUE a/ a APPROVED: Zoning Building Electrical Mechanical V' 5 7 , 1 , 0 / Plumbing Engineering ITEM BATH TL8 UNIT FEE ITEM SWITCH OUTLETS UNIT FEE ITEM SPACE HEATERS UNIT FEE BIDET LIGHT OUTLETS CENTRAL HEATING DISHWASHER RECEPTACLES A/C (WIND) 0IS^?OSAL SERVICE TEMPORARY A/C (CENTRAL) 2 1 /2,-.., / DRINKING FOUNTAIN SERVICE SIZE IN AMPS OLCT WORK FLOOR CRAIN SERVICE REPAIR ETER G'iANGE REFRIGERATION GREASE TRAP APPLIANCE OUTLETS PROCESS Mil PRESS PIPING INTERCEPTOR RANGE TOP UNDERGROLM) TANKS LAVATORY OVEN ABOVE GROUND TANKS LAUNCRY TRAY WATER HEATER U.F. PRESSLRE VESSELS CLOTHES WASHER MCTCRS 0- 1 HP STEAM BOILERS SHOWER 6OTCRS OVER 1- 3 HP HOT WATER BOILERS SINK. POT /3 COMP. MATCRS OVER 3- 5 HP MECHANICAL VENTILATION SINK, RESIDENCE MOTORS OVER 5- 8 HP TRANSPORTING ASSEMBLIES SINK. SLOP MOTCRS 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 I VIOLATION INDIRECT WASTES I A/C 'WINDOW REINSPECTION WATER SUPPLY TO: 1 AIR CONDITIONERS A/C UNIT STRIP HEATER FIRE SPRINKLER GENERATORS TRANSFORMERS HEATER -NEW INST. GENERATORS TRANSFORMERS HEATER- REPLACE GENERATORS TRANSFORMERS 1 1 LAWN SPRINKLER -WELL SPECIAL PURPOSE SW I WA I NG POOL CUTLETS COM€RC I AL 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 ?LW & ABANDON SEPTIC TANK REINSPECTION SOAKAGE PIT CU. FT. CATCH BASIN DISOiARGE WELL DOMESTIC WELL AREA DRAIN ROOF INLET SOLAR WATER HEATER FIRE STMcPIPE POOL PIPING LAWN SPRINKLER SYSTEM GAS RANGE METER SET (GAS) GAS PIPING 1' .r 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.) PLUMBING ELECTRICAL MECHANICAL Date Time Type Insp=H —� )/12.&) 46®d- . /2g Na Address / 0C2 NE 9g 5 L o Company Phone # L3D5 • Sig ‘Pq Permit No. MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request For Inspector: ' 0 Name & Date Approved/ U 0 Sc U `1 ; ( 0 • 0 . cti Correction ❑ Re- Insp'n Fee ❑ MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date ))c? ) a Type Insp'n Permit No. Name Address by 00 Kif/ C E St Compan ii O_C Time Phone # 305 'SP ` °`- `'` ' � I For Inspector: 15° *me llat '" �� 1 - Approved Correction Re- Insp'n Fee ❑ %t .c; r c/ Type Insp'n Permit No. Name Address Company Phone # MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 // Building Inspection Request Date( • Time For Inspector:l Approved Correction Re- Insp'n Fee Z2 MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date Type Insp Permit No Name f� Address /' APO Company Phone # $.5 44.' eP For Inspector: ame & D 0 , Approve/ Correction Re- Insp'n Fee cl 09,e- '/2 /ei ( SS c � — .ro `wQ Re,,04 Jzd. cAtyi /9-4_ CONTRACTOR New Construction ''Name e f me License No. c Ac 03 ‘11 2 ✓ n �t 9 ".^', � j 1 A. 3 3 i- 3 g Home Telephone 3 ps- a Address. . 42..... e- G _ , 7 • -.70 i s. Business Telephone . J 7:,-,-/- • 7 do -V r� r l j � g p � = J / -,2CQ� 5 f F ,` 0.s - - 8 / ?- 3 C 9 Qualifier Name // „/� ¢e Foundation Only TYPE OF MANAGEMENT (✓ ) New Construction Enclosure me Address �L �r ) d� EEO „ 1` % n �t 9 ".^', � j 1 A. 3 3 i- 3 g Home Telephone 3 ps- a Alteration Interior Business Telephone . J 7:,-,-/- • 7 do -V r� Fax Relocation of Structure 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 111111 4 1111 111 .liltllill I 1 J I �i fU lll (Y mit 'Hail: ,� INSTRUCTIONS - 'G vi he follo ng steps must be taken �to� obtatn�a� per from the �NIi Shores Village: Step 1. 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. A PPLICATION II'I Job Address: PERMIT TYPE (✓ ) Building Electrical Mechanical Plumbing LPGX Roofing Fence Other Address Apt. City Folio Number /1 6 (9/ Lot Block Subdivision PB PG Current Use of Property Proposed Use of Property Tenant Information PERMIT CHANGE (✓ ) Chg. Contractor Renewal Revision Extension Supplement Reinspection ARCHITECT Name License No. Address Telephone Fax Master Permit No. Flood Zone Subsidiary Permit No.2 (7 PERMIT APPLICATION State Zip Description of Work /'L4 _t 2-1 .. °/ Zoning Linear Feet Square Feet Units Floors Value of Work t¢ b0 a Bldg Value Tax Assessed/Appraised Value Base Floor Elev. ENGINEER Name License No. Address Telephone Fax Page 2 INIPOR'I'ANT NO'T'I 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 13E 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. AFFtDAVIT - 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. STATy OF FLORIDA, OUNTY OF MIAMI -DADE Signature of Owner S/9/14/v/o Print Name Sworn to and subscribed before me this /3 day of .;reett. 14) on Signature of Notary Public - State o da SEAL: Personally known Type of Identification Produced: STEVEN P. WPGNER My Comm Exp. 4/24/05 N entificatign 00 019759 11 Personalty wrown 11 other I.D. PERMIT APPLICATION STA�� FL ��' (MIAMI -DADE $kgi / �� ct� Ce Print Name Sworn to and subscribed before me this /3 day of Y C Signature of Notary Public - State of Flonda SEAL: Personally known Type of Identification Produced: ELECTRICAL TYPE Minimum Fee QrY.j TYPE Dryer II QTY. 1 1 1'}'PI?. Outlet, Appliance 1 QI'Y. I'YPI: Service Repair QTY. A/C Central 1 -3 Ton A/C Central, Tons Fan Cooling Tower Outlet, Wall Heating Strips, each Service, Temporary Vent Hood, Cost A/C Central 4 -7 Ton A/C Wall/Win. Tons Fire Pump Dryer Vents, Number of Outlet, Switch Paint Booth Signs Ventilation, Cost A/C Central 8 -15 Ton Air Handler, Tons Z Fixture - Fluorescent Ductwork, Cost of Oven Piping, Flammable Liquid Space Heater (kw) Periodic Inspections A/C Central 16 -20 Ton Barbecue Fixture Light Fire Sprinkler System Parking Lot Lights Process/Pressure Piping Spas/Hot Tubs 1 -A/C Central 20+ Ton Bath Fan - Vented, # Flood Lights Fireplaces, Number of Plugmold/Strip Pressure Vessel Subfeeds, No. of Amps A/C Window FPL - Load Central Posts Swim Pool, Commercial Air Conditioners Garbage Disposal Range/Range Top Swim Pool, Residential Chiller Generators, etc. Receptacles Switchboards Clear Violations Heat Recovery Refrigerator, Comm. (p/PH) Temp Serv., Construction • Compactor Low -volt, Burglar Refrigerator, Domestic Temp for Test - 30 days Freezer Low -volt, Fire Renew - Temp Service Water Closet k Deep Demolition Low -volt, Intercom/Teleph. Repair Circuits Water Ileater Dishwasher Low -volt, Television Service, Number of Amps Water Heater New PLUMBING TYPE I A/C Condensate QTY. QTY. I , TYPE Q'I'Y. • 10PE I I Generator QTY. TYPE. QTY. MX HA NI SUM AU Minimum Fee I Condensate Drain I I Refrigeration, Tons A/C Central, Tons Drinking Fountain Cooling Tower Miscellaneous Repairs Heating Strips, each 1 Vent Hood, Cost Bidet A/C Wall/Win. Tons Filter Replace Dryer Vents, Number of Pool Piping Paint Booth Sprinkler Repair Ventilation, Cost Cap - Fixture Air Handler, Tons Z yy Ductwork, Cost of Pump and Abandon Piping, Flammable Liquid Sprinkler System Periodic Inspections Cap - Water Barbecue Gas - Appliance Fire Sprinkler System Pump, Domestic Process/Pressure Piping Supply, AC Well Cap - Sewer Bath Fan - Vented, # Gas - Natural Fireplaces, Number of Pump, Fire Stand Pressure Vessel Temporary Toilet Catch Basin PLUMBING TYPE I A/C Condensate QTY. ,TYPE • 1 }' Drains, Roof �� �� Q , i'�')'1' 1 '• Miscellaneous Fixture QTY. • Q TYPE . Soakage Pit • 1 . } Q 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 Ileater 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: SECTION BY DATE Zoning Electrical Mechanical -6 f. (©.c, Z Plumbing Fire Public Works Structural Building Official Page 4 OFFICE USE ONLY CHECKLIST O OWNER - BUILDER FORM (Attach) ❑ FIRE DEPARTMENT APPROVAL (Commercial / multi - family) ❑ CONCURRENCY (New Construction) ❑ OTHER (Specify & Attach) $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 ❑ PROOF OF OWNERSHIP (Attach) ❑ HRS / DERM APPROVAL (Septic / Sewer) ❑ IMPACT FEE (New Construction) ❑ OTHER (Specify & Attach) PERMIT FEES ( sq.ft. = x/1000 x ¢.60) $ (¢.005 / sq.ft.) $ (¢.01 /sq.ft.) REVIEWED AND PREPARED BY: PERMIT APPLICATION ❑ CONDO ASSOCIATION APPROVAL (Attach) ❑ BPR APPROVAL (Restaurants) ❑ CONTRACTOR REGISTRATION (On File) TOTAL $ ISSUING OFFICIAL DATE: CONDITION OF APPROVAL Revised July 2001 10050 N.E. 2ND AVE., MIAMI SHORES, FL • (305) 795 -2207 • FAX (305) 756 -8972 • http : / /www.miamishoresvillage.com S.W.. bahrtw Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Printed: 9/18/2002 Applicant: CHARLES Owner: SAMMONS JOB ADDRESS: 600 NE 98 Electrical Permit Permit Number: EL2002 -300 SAMMONS CHARLES ST Contractor BRANDON AC Contractor's Address: Local Phone: Parcel # 1132060171840 Legal Description: MIAMI SHORES SEC 4 AMD PB 15 -14 LOTS 11 & 12 BLK 101 LOT SIZE Permit Status: Approved Permit Expiration: 3/17/2003 Construction Value: Work: DISONNECT AND RE- CONNECT ELECTRICITY BRANDON AIR CONDITIONING SERVICE CORP. 6175 N.W. 167 STREET, G -25 MIAMI, FL 33015 (305) 819 -2669 e—C� S v�sv Z - C r' •rte r;rf SunTnut Bank/Miami, N.A. MIAMI WEST OFFICE 702 • MIAMI, FLORIDA 33155 DATE INVOICE AMOUNT y It'O L L 2001 1:0 070 2000895503 11200 63 -60 660 CHECK AMOUNT TO THE ORDER OF PAY CHECK NO. /1, ©a sgo-2.0 - a.ti .Lede „ ake._, DATE • c1 -�a -oy GROSS AMOUNT DISCOUNT -2 77 Page 1 of 1 0. °101 Total Fees: $1:00 Total Receipts: $0.00 spections. Re- inspection •ibed in the application herefor in strict compliance with all DOLLARS tements or specifications that may have been submitted to such ordinances or if the plans are changed without y � s sumes the responsibility for a thorough knowledge of the ecifications and that he assumes responsibility for work done es and regulations pertaining thereto and in strict conformity ermit I assume responisibility for all work done by either