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933 NE 99 St (12)08/03/2005 WED 8 _ FAx 3054605261 BUILDING & zOr tc\ Building Inspection Request Dace C-, Type Insp'n Permit No. 1' 11 CD 5 Z, Name E5C4 1 �(� 9 3 3Address it S÷ Company C� 1�0 Phone it � ,iV -- 7 C 121 Inspection Dare Approved Correction Re- Insp'n Fee Alb MIAMI : ' ES VILLAGE thi BUILDING DEPARTMEN 305- 795 -2204 i MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date ime Type Insp _ Permit No. 1d c D /0 Name Address Company Phone # For Inspector: 0 1 Name & Date Approved Correction Re- Insp'n Fee ❑ Village of Miami Shores 10050 NE 2nd Avenue Miami Shores, FL 33138 Phone: 305 - 795 -2204 Printed: 2/6 /2002 Applicant: MARK. Owner: Electrical Permit Permit Number: EL2002 -46 GALLO DARYL Contractor TRUE COOL AIR Address: 15481 SW 153 ST Local Phone: 305 - 232 -8708 Cellular: Permit Status: Approved Permit Expiration: 8/5/2002 Construction Value: Work: REPLACE 1 3 1/2 TON AIR HANDLER WITH 8KW HEAT Page 1 of 1 "If there is no permit package accessible on the job -site for inspectors to verify, there will be no inspections. Re- inspection fee is $50.00, which must be paid in advance before calling fc This Permit is granted to the contractor or builder named above to construct th ordinances pertaining thereto and with the understanding that the work will be pel and approved by the proper municipal authorities. This Permit may be revoked a authorization. A further condition upon which this permit is granted is the undersl ordinances and regulations pertaining to the work covered hereby whether showr by his agents, servants or employees. Signed: (INSPECTOR) In consideration of the issuance to me of this permit, I agree to perform the wo with the plans, drawings, statements or specifications submitted to the proper au myself, my agent, servants or employes. Signed: (Contractor ' Pe.A Mit (p_D)OD Total Fees: $0.00 Total Receipts: $0.00 9 Parcel # 1132060340250 Legal Description: 5 -6 53 40 MIAMI SHORES SEC 8 PB 14 -33 E9FT LOT 16 ALL LOT 17 & W16FT LOT Job Address: 933 NE 99 ST PAY r VI C/ TO THE I S ORDER OF L 1. A59 OF ' IA/1 M'l/�/l ( , `O V � 1 $ OC c A //c./ f eci rp .w1t4 r . ':06 700899 3.: 066 L00800111'06 FOR TRUE COOL AIR CONDITIONING SERVICE, INC. 13727 SW 152 ST. #264 MIAMI, FL 33177 PH. 305 - 232 -7575 G AP ex-3 7/0 COMMUNITY BANK P.O. BOX 900400 HOMESTEAD, FLORIDA 33090 DATE? l a a` 62 09 63- 899/670 DOLLARS 0991 are O... -m CONTRACTOR Name— COO 1 A « CUB. Seizo, lAi License No. C " c c 3 6 6 Address lingati /S rw if - 357`. / 1 11 ' A r F1' - 13 l e? Telephone 5— d3,. 7 J'7)..— Fax 3 o p q7 /' S476 Qualifier NffiiHrii it Al "ZV■k_4. 1 f ■ N9. PROPERTY OWNER New Construction Name ' k // ^ — a e o Address 1 // ,3-L Home Telephone Alteration Interior ■ Business Telephone Relocation of Structure Fax Shell Only Add'I Attachment TYPE OF MANAGEMENT (✓ ) New Construction Enclosure Alteration Exterior Re 1 air Alteration Interior ■ Demolish Relocation of Structure Shell Only Add'I Attachment Foundation Only Other Add'I Detachment Other 1 INSTRUCTIONS - The following steps must be taken to obtain a permit from the Miami 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: 13 3 N e g Ck S *� Address Apt. Folio Number i 3. 6(0 ©3 y d asp Lot Subdivision PB PG Zoning Linear Feet Current Use of Property Square Feet Units Floors Proposed Use of Property Value of Work Bldg Value Tenant Information Tax Assessed/Appraised Value Flood Zone PERMIT TYPE (✓ ) Building Electrical Mechanical Plumbing LPGX Roofing Fence Other Block Chg. Contractor Renewal Revision Extension Supplement Reinspection PERMIT CHANGE (✓ ) ARCHITECT Name License No. Address Telephone Fax 1M 1A■1t chDlei City R Description of Work R e p IA e..-€ I� \ c MA c IQ wa -\ State PERMIT APPLICATION Master Permit No. Subsidiary Permit No. D1/ ` - 33 t38 Zip Base Floor Elev. ENGINEER Name License No. Address Telephone Fax Page 2 Ii\1I'ORTAN'1' NOTICES 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. AFFI - 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 Sect' n 713 -35 of Florida Statutes. Review the brochure at Village Hall on Construction Lien Law and Choosing a Contracto STA OUNTY OF MIAMI -DADE Personally known Print Name ;L Sworn tQ and subscribed before me this 00 day of SAN `Z O O OFFICIAL NOTARY SEAL TERRY J ZARLING NOTARY PUBLIC STATE OF FLORIDA Signature of No MR5410g11905sk . FEB. 21,2005 SEAL: OR, Produced Identification Personally known Type of Identification Produced: STA Signature of Contr, ctor / Qualifier ar�y - Z tis> r\ Print Name i � I ' ■ blic V ' tate ,f Florida woR; O •. II subscribed before me • ��Tr ture of Nota SEAL: OF F PERMIT APPLICATION OUNTY OF MIAMI -DADE OFFICIAL NOTARY SEAL it PU 6e, ANGELA t BECKER (7r ( 1 COMaPUBOOW NUMBER % , c CC706697 O a SSION EXPIRES Ol7 ti6 " ce��¢�mtlBca n J)2., Type of Identification Produced: � S ' _� V ^ �j 1,-Q11, ELECTRICAL TypE QTY. Minimum Fee 0 a TYPE - Dryer QTY. TYPE Outlet, Appliance QTY. TYPE Service Repair QTY. A/C Central 1 -3 Ton WO j Fan - Paint Booth Outlet, Wall Air Handler, Tons Service, Temporary Piping, Flammable Liquid A/C Central 4 -7 Ton Barbecue Fire Pump Process/Pressure Piping Outlet, Switch Bath Fan - Vented, # Signs Pressure Vessel A/C Central 8 -15 Ton Pool Piping Fixture - Fluorescent Sprinkler Repair Oven Cap - Fixture Space Heater (kw) Fountain A/C Central 16-20 Ton Pump and Abandon Fixture Light Sprinkler System Parking Lot Lights Cap - Water Spas/Hot Tubs Gas - Appliance A/C Central 20+ Ton Pump, Domestic Flood Lights Supply, AC Well Plugmold/Strip Cap - Sewer Subfeeds, No. of Amps Gas - Natural A/C Window Pump, Fire Stand FPL - Load Central Temporary Toilet Posts Catch Basin Swim Pool, Commercial Gas - Propane Air Conditioners Pump, Re- circulate Garbage Disposal Temporary Water Closet Range/Range Top Clothes Washer Swim Pool, Residential Gas Piping Chiller Pump, Replace - Pool Generators, etc. Urinal Receptacles Dental Chair Switchboards Grease Trap Clear Violations Pump, Sprinkler Heat Recovery Utility - Sewer Refrigerator, Comm. (p/PH) Discharge Well Temp Serv., Construction Ice Maker Compactor Pump, Sump Low -volt, Burglar Utility - Water Refrigerator, Domestic Dishwasher Temp for Test - 30 days Indirect Wastes Deep Freezer Relay Repair Roof Inlet Low -volt, Fire Vacuum Pum Water Closet Renew - Temp Service 'Disposal Interceptor Demolition Low -volt, Intercom/Teleph. Repair Circuits Water Heater Dishwasher Low -volt, Television Service, Number of Amps Water Heater New MECHANICAL TYPE. QTY. Minimum Fee TYPE Condensate Drain QTY. TYPE Generator QTY. TYPE QTY. Refrigeration, Tons 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 Air Handler, Tons Ductwork, Cost of Piping, Flammable Liquid Periodic Inspections Barbecue Fire Sprinkler System Process/Pressure Piping Bath Fan - Vented, # Fireplaces, Number of Pressure Vessel PLUMBING TYPE QTY. ' QTy. .i.yp QTY. TYPE QTV A/C Condensate Drains, Roof Miscellaneous Fixture Soakage Pit 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 Roof Inlet Vacuum Pum Water Closet 'Disposal Interceptor 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 Water Service Drains, Floor Minimum Fee Shower 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:, G 0 — SECTION B DATE Zoning Electrical 7 1"A* Mechanical Plumbing Fire Public Works Structural Building Official Page 4 OFFICE USE ONLY CHECKLIST ❑ 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 $ $ G° (sq.ft. = x/1000 x 0.60) (¢.005 /sq.ft.) (¢.01 /sq.ft.) PERMIT APPLICATION ❑ CONDO ASSOCIATION APPROVAL (Attach) ❑ BPR APPROVAL (Restaurants) ❑ CONTRACTOR REGISTRATION (On File) TOTAL $ 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 ELECTRICAL TYPE Minimum Fee QTY TYPE Dryer QTY. TYPE Outlet, Appliance QTY. TYPE Service Repair QTY. A/C Central 1 -3 Ton th. Fan Outlet, Wall . Service, Temporary A/C Central 4 -7 Ton Fire Pump Outlet, Switch Signs A/C Central 8 -15 Ton Fixture - Fluorescent ( 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 Plugmold/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 !'I ECHA NI CA L TYPE, Minimum Fee QTY. TYPE Condensate Drain QTY. TYPE Generator QTY. "1'1'1'E Refrigeration, Tons QTY. A/C Central, Tons 3 th. Cooling Tower Heating Strips, each 1 = l0 is t✓ . Vent Hood, Cost A/C Wall/Win. Tons Dryer Vents, Number of Paint Booth Ventilation, Cost Air Handler, Tons Ductwork, Cost of 900, ' ( Piping, Flammable Liquid Periodic Inspections Barbecue Fire Sprinkler System Process/Pressure Piping Supply, AC Well Bath Fan - Vented, # Fireplaces, Number of Pressure Vessel Temporary Toilet PLUMBING TYI'E A/C Condensate Q'I'1' TYPE: Drains, Roof QT1' TYPE: Miscellaneous Fixture Q'I'1' TYI'E Soakage Pit 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 Heater Drainfield, 4" Tile/Res. Lavatory Septic Tank Water Heater New Drains, Area Meter Set (Gas) Sewer Connection Water Re -pipe Water Service Drains, Floor Minimum Fee Shower 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: Page 4 OFFICE USE ONLY CHECKLIST • OWNER - BUILDER FORM (Attach) ❑ FIRE DEPARTMENT APPROVAL (Commercial / multi - family) ❑ CONCURRENCY (New Construction) ❑ OTHER (Specify & Attach) ❑ PROOF OF OWNERSHIP (Attach) ❑ HRS / DERM APPROVAL (Septic / Sewer) ❑ IMPACT FEE (New Construction) ❑ OTHER (Specify & Attach) PERMIT FEES $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 $ 0 O /6 SO (sq.ft. = x/1000 x ¢.60) $ (¢.005 /sq.ft.) $ (¢.01 /sq.ft.) SECTION Zoning Electrical Mechanical Plumbing Fire Public Works Structural Building Official BY DATE PERMIT APPLICATION O CONDO ASSOCIATION APPROVAL (Attach) ❑ BPR APPROVAL (Restaurants) ❑ CONTRACTOR REGISTRATION (On File) TOTAL $ ° go r Za'' 10/4 ISSUING OFFICIAL REVIEWED AND PREPARED BY: 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 MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build- ing or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida. and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of the work. Date..._ Owner's Name and Address Willia D. Sulliva - ._ No January 15, 80 933 Street...... .. E ._ 9 9 St.. R egistered Architect and /or Engineer ,;,,,,,,,,,,,,,,,,, ,,,,,,,,, „,,..,,,.,,,, ,...... Name and address of licensed contractor Hill York Sales & Service 5150 N.W. 3 7 Ave. � Miami 3315 t Location and legal description of lot to be built on: Lot Block Subdivision Street and Number where work is to be done 933 N . E N.E. 99th 9th S t . — T State work to be done and purpose of building (by floors) Install new 3 — ton air conditioning system and for no other purpose. New Building Remodeling Addition 1 Repairs No. of Stories To be constructed of Kind of foundation Roof Covering Estimated Total cost of improvements $ r 5 0 0 s Amount of Permit $.3.4 5 Zone cubage required plan Cubage Distance to next nearest building Size of Building Lot Maximum live load to be borne by each floor I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may Hill York Sales & Service, 515Q N. W,.__. 37..A ve ,,__. Miami ___.3315 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 pennit, as are licensed by Miami Shores Village. Remarks ( Signed) _ .._......_N STATE OF FLORIDA, COUNTY OF DADE. j ss. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap- peared 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 1 1 Read, Sworn to and Subscribed before me. Disapproved C ate Notary Public, State of Florida (Signed) My Commission Expires Building Inspector to me well known, PLANNING BOARD DATE Chairman Member Member Member Member ...... _....._..._......._....._ Member Council Approved Date Disapproved Date NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has been obtained from the Planning Board. A re- inspection fee of 31.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and /or workmanship. Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build- ing or other structure herein described. This application. is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of the work. Date March 2 4� ,19 Owner's William D . Sullivan s Name and Address No Street Registered Architect and /or Engineer Shores Air Conditioning, Inc. 9730 -N E 2 Aye 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 933 E 99 St State work to be done,and purpose of building (by floors) _ Residence Room Air conditioner - 22,000 BTU installed through the wall and for no other purpose. New Building Remodeling Addition Repairs No. of Stories To be constructed of Kind of foundation Roof Covering Estimated Total cost of improvements $___ 45Q_ Amount of Permit $.__4,.00 Zone cubage required _Plan Cubage Distance to next nearest building Size of Building Lot Maximum live load to be borne by each floor I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may be sent to ---- •-- - - - - -- The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Pennanent 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 inspectio . thelite of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only sucF^su� ptra• rs, on ork to be performed under this permit, as are licensed by Miami Shores Village. Remarks._._ (Signed) STATE OF FLORIDA, COUNTY OF DADE. ss Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap- peared ----- - - - - -- - -- to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the of the above described 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 / Disapproved ( Signed) Chairman Member Member MIAMI SHORES VILLAGE APPLICATION FOR BUILDING PERMIT Date Building, nspector BUILDING INSPECTION DEPARTMENT ate 3 -2 Read, Sworn to and Subscribed before me. Notary Public, State of Florida My Commission Expires PLANNING BOARD DATE Member Member Member Council Approved Date Disapproved Date NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has been obtained from the Planning Board. A re- inspection fee of 51.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and /or workmanship. i 1 6) Service Permit No 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. Owner's Name and Address ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT Registered Architect and /or Engineer, Employing Electrician's Name..VO' Location and Legal Description Lot Block Street and Number where work is to be performed —No . State work to be performed and purpose of building (By Floors) New Building Remodeling Addition Repairs No. of Stories Overhead Underground Size Feeders T of Installation— Conduit Tubing B.X.L Metal Moulding r i 2 Electrical Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts hip/ l bligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Flo '8a Permanent Supplement, and has complied with the provisions thereof, and will require similar compliance from all contractors or sub•co t ctors 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 ork such public notice or notices as are required by the Act. The undersigned agrees to employ only such sub-contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. Amount of Permit $ SS. MIAMI SHORES VILLAGE No V Conduit Main Sw.. ° No (Signed) Amps... L� Date .... Street. Street v 1 .. Street..W ./ 1' K✓ ° Main Fuses Amps ,i ` C ' C (2 Master Electrician. ii STATE OF FLORIDA, l COUNTY OF DADE. I 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, and he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. My Commission Expires Notary Public, State of Florida NOTE: A re•in=pection 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 LIONT OUTLETS PLUG RECE'P'T'8 FIXTURES NO. LAMPS REFRIO. OUTLET IRON OUTLET RANGE OUTLET RANGE CONN. WATER HEATER W. HEAT. CONN. ACE HATER STRIP HEATER TOTAL CONTR. LIST CHECK ENT. SW. DIST. CAB. SERVICE TEMP. SERVICE PERM. MOTORS O•I HP MOTORS 1•8 HP NEON TRANS. RADIO TOTAL CONTR. LIST CHECK i 1 6) Service Permit No 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. Owner's Name and Address ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT Registered Architect and /or Engineer, Employing Electrician's Name..VO' Location and Legal Description Lot Block Street and Number where work is to be performed —No . State work to be performed and purpose of building (By Floors) New Building Remodeling Addition Repairs No. of Stories Overhead Underground Size Feeders T of Installation— Conduit Tubing B.X.L Metal Moulding r i 2 Electrical Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts hip/ l bligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Flo '8a Permanent Supplement, and has complied with the provisions thereof, and will require similar compliance from all contractors or sub•co t ctors 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 ork such public notice or notices as are required by the Act. The undersigned agrees to employ only such sub-contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. Amount of Permit $ SS. MIAMI SHORES VILLAGE No V Conduit Main Sw.. ° No (Signed) Amps... L� Date .... Street. Street v 1 .. Street..W ./ 1' K✓ ° Main Fuses Amps ,i ` C ' C (2 Master Electrician. ii STATE OF FLORIDA, l COUNTY OF DADE. I 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, and he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. My Commission Expires Notary Public, State of Florida NOTE: A re•in=pection 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. s Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build- ing or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of the work. Owner's Name and Address ... Registered Architect and /or Engineer.. Name and address of licensed contra Location and legal description of lot to he built on: Lot Block Subdivision Street and Number where work is to be done 9,9...4!E 99 State work be done r.nd urpose of building (by floors) - and for no other purpose. New Building Remodeling Addition Repairs No. of Stories To be constructed of Kind of foundation Roof Covering O Estimated Total cost of improvements $ O Amount of Permit $.. .l.P Zone cubage required Plan Cubage Distance to next nearest building Size of Building Lot Maximum live load to be borne by each floor I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may be sent to The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 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). STATE OF FLORIDA, COUNTY OF DADE. ss Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap- peared 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 Cr Date ' ' ( Read, Sworn to and Subscribed before me. Disapproved (Signed) APPLICATION FOR BUILDING PERMIT ate._ MIAMI S�-i10 ': V LLAGE BUILDING INSPECTION DEPARTMENT Date �eG O `. 3 /f li / , 19 93 3 No. Street__77 • - „ff.:2ff' to me well known, Notary Public, State of Florida uildin nspector My Commission Expires PLANNING BOARD DATE Chairman Member Member Member Member . Member Council Approved Date Disapproved Date NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has been obtained from the Planning Board. • A re- inspection fee of $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and /or worktnanship.