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ELECTRICALAPPROVED: PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date '/ Job Addressjo .v g98 �`�r Tax Folio 1/ Jc2t If * Legal Description &' ' 9 ',Make' er Lessee / Tenant /U - -- t a D/LT(Gio Zr4- Master Permit 4Rl % r. Owner's Address To L 98 S'( Phone 7S / Contracting Co. X../(00 2 - 6 G- EG / Ac-C- Address /D6/ ,U cJ 90' ST: - Phone c?' 9/ - 7 - 3 7.-/ State # EC--. /(99Municipal # Competency 4P Ins.Co. e RJ/ fa c-4ff- Architect /Engineer / 4 -( 14r- Address Bonding Company Address Mortgagor Address Permit Type(circle one): BUILDIN ELECTRI PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION - ..2-- d iG --- g Square Ft. Estimated Cost(value) 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. Signature of owner and /or Condo President ignatV� � of Contractor or Owner ilder '? Date: Date: / Notary as to Owner and /or Condo President My Commission Expires: * * * * * * * * * * * Zoning Buildin Mechanical Plumbing, - I", L N ary / s to M Commissio Engineering ** FEES: PERMIT D RADON C.C.F. 1 f P NOTARY .c, 00 TOTAL DUB. Permit No /// t2 O 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 St to of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall b c ith, het hr,�' herein specified or not. A copy of approved plans and specifications must be kept at building during progress of w Owner's Name and Addre Service Overhead Size Feeders Underground Type of Installation — Conduit Amount of Permit $ STATE OF FLORIDA, COUNTY OP DADE Il appeared ss. MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT Registered Architect an ' or Engineer Employing Electrician's Name 7tr""'" Location and Legal Description Lot Street and Number where work is to be performed —No My Commission Expires Block Street Street Subsion Date .f No Street State work to be performed and purpose of building (By Floors) New Building Remodeling Addition Repairs No. of Stories Main Sw. Amps Main Fuses .40 Amps B.X.L Metal Moulding (Signed) Electrical Inspector The undersigned applicant for this building perinit 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 subcontractors 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 undecsjgn4grees to employ only such sub-contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. , _ / V / (Si d'O CrO Before me, the undersigned authotya notary public, duly authorized to administer oaths and take acknowledgments, personally Master Electrician. to me well known, and who, being b$(fI t dai'y sworn, upon oath deposes and says that he is the of the above described constr c��t'pn,arid.•h... " TI'ly read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. ; Notary Public, State of Florida 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 OUTLET 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 CONTR. LIST /7 / li s J / 7 `// /,/ b T / I^U � ,/ /� t . V ' �( / L/ � r� ` / .i � ,i % r� t _.... / ✓ CHECK ENT. SW. MIST. ' CAB. SERVICE TEMP. SERVICE PERM. MOTORS 0.1 HP MOTORS 1.5 HP NEON TRANS. RADIO TOTAL CONTR. LIST CHECK / / /� ` �,I ,/ Permit No /// t2 O 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 St to of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall b c ith, het hr,�' herein specified or not. A copy of approved plans and specifications must be kept at building during progress of w Owner's Name and Addre Service Overhead Size Feeders Underground Type of Installation — Conduit Amount of Permit $ STATE OF FLORIDA, COUNTY OP DADE Il appeared ss. MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT Registered Architect an ' or Engineer Employing Electrician's Name 7tr""'" Location and Legal Description Lot Street and Number where work is to be performed —No My Commission Expires Block Street Street Subsion Date .f No Street State work to be performed and purpose of building (By Floors) New Building Remodeling Addition Repairs No. of Stories Main Sw. Amps Main Fuses .40 Amps B.X.L Metal Moulding (Signed) Electrical Inspector The undersigned applicant for this building perinit 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 subcontractors 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 undecsjgn4grees to employ only such sub-contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. , _ / V / (Si d'O CrO Before me, the undersigned authotya notary public, duly authorized to administer oaths and take acknowledgments, personally Master Electrician. to me well known, and who, being b$(fI t dai'y sworn, upon oath deposes and says that he is the of the above described constr c��t'pn,arid.•h... " TI'ly read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. ; Notary Public, State of Florida 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. 4 iILDING 'CTRICAL _MBING OFING ner of !ding hite V ractor •ilder iption Tess of MIAMI SHORES VILLAGE, FLORIDA RMIT N° 11050 Work to be performed under this Permit > t J ling � CONTRACTOR OR BUILDER Signed: Volpe of Project $ DATR ,111 air Contractor's License No Amt. of Permit $ f l� This ermit is granted to the contract° or builder named above to construct the building or to install the equipment or device describeJin . far iik t compliance with all ordinances peatai ing thereto and with the understanding that the work will be performed in compliance with nyaav gs nts or specifications that may have bin submitted to and approved by the proper municipal authorities. This Permit may b e°° tht is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon whiff d is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and ing to the work covered hereby whether shown on the plans or drawings or • the statements or specifications and that he assumes responsibility donenzby his agents, servants or employees. BY Y, Aid AUTHORITY 95 fieaition ans, any t is ations work In consideration of the issuance to me of .permit I a 1 . perform the work covered hereunder in compliance with an ordinances ant' regulations pertaiping thereto and in strict conformity with the. plans, draws statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work d y by either, myself, agent, servant or employee. CONTRACTOR Name �� y� � n . / n rn eo aec g 4J ` U License N o. 1 / / Address 106q Nw 909 r /7 I/A-in 1 Pt 3 3i 0 Telephone QCi 1_ i 3 ' 7 L Fax /7 t - 00 -7 b C�C/CJ tN Qualifier Name J »l _,i_ DO ' PROPERTY OWNER New Construction 1 Name 7/:' if �� R/V t y Gi' Enclosure Address 90,0698 Alteration Exterior Home Telephone '7, ' 5 ! q ' • / � Business Telephone - 7 s.( , 7 6 7O h j Fax ice, 8i v3 me TYPE OF MANAGEMENT (✓ ) New Construction Enclosure Alteration Exterior Repair Alteration Interior Demolish Relocation of Structure Shell Only Foundation Only Add'l Attachment Other Add'I Detachment Other INSTRUCTIONS - The following steps must be taken to obtain a permit from the Aliami 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. APPLICATION Job Address: D Address PERMIT TYPE (✓ ) Building Electrical Mechanical Plumbing LPGX Roofing Fence Other Apt. I 3kDb0(303(0 Folio Number Lot Subdivision PB PG Current Use of Property Proposed Use of Property Tenant Information Block Zoning Linear Feet Square Feet Old D • Units Floors Value of Work / 8 0 6 . 60 Bldg Value Tax Assessed/Appraised Value Flood Zone Base Floor Elev. PERMIT CHANGE (✓ ) Chg. Contractor Renewal Revision Extension Supplement Reinspection ARCHITECT Name License No. iJ Address Telephone Fax Description of Work Master Permit No. Subsidiary Permit No. S'C7 City PERMIT APPLICATION 33/3' State Zip 5ei_v ,, ,e.'E'_.ocm-rt'o / OA ENGINEER Name i License No. Address Telephone Fax Page 2 IMPORTANT NOTICES 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 BE 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. AFFIDAVIT - 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, P' 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. STATE FLORID COUNTY AMI -DARE Signature of of • er #4n !)n2ne Print Name . Sworn to nd subscribed before me this day of Z.07 I. Signature of Notary SEAL: Personally known ffacEL._ OR, Produced Identification LESLIE RACK L MY COMMISSION # DD 005946 EXPIRES: March 4, 2005 Bondsd Thai Notary Public Undanrdters PERMIT APPLICATION RIDA, CO OF MIAMI -DADE Signature of Contractor / Qualifier J om j /flooA- y Print Name /^ Swntoan subscribed before me this (Q day of . T 4'P j '�[orida ��• Signature of No MISSION NUMBER CC741880 COMMISSION EXPIRES uF F�" MAY 11,2002 Personally 'mown OR, Produced Identification Type of Identification Produced: Type of Identification Produced: ELECTRICAL TYPE Minimum Fee QTY. TYPE Dryer QTY. TypE Outlet, Appliance QTY. TY Service Repair QTY. A/C Central 1 -3 Ton Fan Dryer Vents, Number of Outlet, Wall Ventilation, Cost Service, Temporary Air Handler, Tons A/C Central 4 -7 Ton Piping, Flammable Liquid Fire Pump Outlet, Switch Fire Sprinkler System Signs A/C Central 8 -15 Ton Bath Fan - Vented, # Fixture - Fluorescent - Pressure Vessel Oven Space Heater (kw) A/C Central 16-20 Ton Fixture Light Parking Lot Lights Spas/Hot Tubs A/C Central 20+ Ton Flood Lights Plugniold/Strip 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 Deep Freezer Low -volt, Fire Renew - Temp Service Water Closet Demolition Low -volt, Intercom/Teleph. Repair Circuits Water Heater Dishwasher Low -volt, Television Service, Number of Amps Water Heater New MECHANICAL TYPE Minimum Fee QTY. TYPE Condensate Drain QTY. TY Generator QTY. TYPE Refrigeration, Tons QTY. A/C Central, Tons Cooling Tower Heating Strips, each Vent Hood, Cost A/C Wall/Win. Tons Dryer Vents, Number of Paint Booth Ventilation, Cost Solar Water Heater Air Handler, Tons Ductwork, Cost of Piping, Flammable Liquid Periodic Inspections Barbecue Fire Sprinkler System Process/Pressure Piping Cap - Fixture Bath Fan - Vented, # Fireplaces, Number of - Pressure Vessel Pump and Abandon PLUMBING TYI'I, A/C Condensate QTY. TYPE Drains, Roof QTY. TYI'1'. Miscellaneous Fixture QTY. TYPE Soakage Pit QTY. 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 Heater 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 INSTRUCTIONS: Please indicate the type of work being performed and quantity(ies) in the space provided below. RECEIVED AND REVIEWED BY: DATE: PERMIT APPLICATION SECTION BY DATE Zoning Electrical `, %: ..'" Mechanical Plumbing Fire Public Works Structural Building Official Page 4 OFFICE USE ONLY CIIECKLIST ❑ 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) PERNIIT FEES $ 6;19, Gvc, $ (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