EL-03-316Miami Shores Village
10050 NE 2nd Avenue
Phone: 305 - 795 -2204
Printed: 10 /23/2003
Applicant: DONALD KLINGNER
Owner: KLINGNER DONALD
JOB ADDRESS: 122 NE 101 ST
Contractor SANDERS ELECTRIC INC
Local Phone: 305 - 624 -1003
Parcel # 1132060132010
Signed: (INSPECTOR)
Electrical Permit
Permit Number: EL2003 -316
Page 1 of 1
Contractor's Address: 3915 NW 164 ST
Legal Description: 1 53 41 6 53 42 MIAMI SHORES SEC 1 AMD PB 10 -70 LOTS 11 & 12 BLK 15
A-'
Fees: Description Amount
FEE2003 -6383 Building Fee $100.00
FEE2003 -6384 CCF $0.60
FEE2003 -6385 Notary Fee $5.00
FEE2003 -6388 Training and Education Fee $0.20
FEE2003 -6389 Technology Fee $2.50
Total Fees: $108.30
Total Fees: $108.30 AA, p
Total Receipts $ 0 . 00
sE,3
NOV 1 PM
Permit Status: APPROVED Permit Expiration: 4/19/2004 Construction Value: $500.00
Work: REPLACE CABINETS IN KITCHEN- FIXTURES
t V
In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict
conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responisibility for all work
done by either myself, my agent, servants or employes.
Signed: (Contractor or Builder) BY:
RECEIVED
n IC 2 2 2003
BUILDING
PERMIT APPLICATION
FBC 2001
Architect/Engineer's Name (if applicable)
Architect/Engineer's Address
$ Value of Work For this Permit
Miami Shores Village
Building Department
Permit Type (circle): Buildin •
Owner's Name (Fee Simple Titleholder) Phone # 367 7s -.6 6 T
Owner's Address /2 v Ai( /6 / li
City i rlinetb it iarl. State /�� Zip Ty6'_ e
Tenant/Lessee Name Phone # Jar ?— ?OP
Job Address (where the work is being done) 42 a ,, C A9 / S1
City Ivlami Shores Village County Ivliami-Dade
Is Building Historically Designated YES NO
Contractor's Company Name a1,Ub S t G, .UG, Phone # 5OS 6Z4- 1 003
Contractor's Address Z9 is 1,1 ik! I Get �T�
Cit L,Litomi State FL.
Qualifier V` RW)LU D0 Mt ZS
Plumbing Mechanical Roofmg
. zip ziLlf
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
Permit No. EEL X03 /63
Master Permit No.
Zip 3406;4-
. Phone #
Square Footage Of Work:
Number of: Bays Stories Families Bedrooms Baths
Type of Work: DAddition ['Alteration ['New 435 Repair/Replace ❑ Demolition
Describe Work: 2/e �®�''61 O 0/ 04
County Escrow Fee $ a (6 0 Permit Fee $ ,/��
" G% Notary $ 6 f DU
Education/Training Fee $ ° LC) Tech $ 2 , c5 0 Scanning $ Radon $
Code Enforcement $ Bond $ Struct. $
Minus Plans Check Fee $ 5 0 .(XO Total Fee Now Due $ (Continued on opposite side)
Bonding Company's Name (if applicable)
Bonding Company's Address
City State Zip
Mortgage Lender's Name (if applicable) I 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 FLRCTRICAL 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 oceurs seven (7) days after the building permit is issued In the absence of such posted notice, the
inspection will not be a proved and a reinspectiion fee will be charged
Signature
APPLICATION APPROVED BY:
Chc 10/02/03
Signature
Owner or Age
f o r e g o i n g instrument was a c k n o w l e d g e d b e f o r e me this 2 0/. •• The foregoing instrument was acknowledged before me this 1 '
day of 1" , 20 03, by \C rflICA l . 0 \� )8 tc. day of gm) , 20 03, by }t2YYYi i •
who is personally known to me or who has produced' who is personally known to me or who has produced
As identifigion and a YIefr'S
i�jen . ' d take an oath.
4 . - ConanNt'on #DD231984 C on D 1 - . . 4
NOTAR ' P IC Expires: Jul 13, 2007 NOTARY PUB I
p
• Sign: % . I L- i �. ; Sign: .� s ; 0 Bond' 4
Print: a�i l� `.
_0111191l I Print: y
My Commission Expires: My Commission Expires:
Contractor
(Certificate of Competency Holder)
State Certificate or Registration No. `®O 1 Z. k qt) Certificate of Competency No. r 1 3 S 1
************************************************_********************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
e .7 Examiner
Engineer
Zoning
PLUMBING
ADDENDUM TO BUILDING PERMIT APPLICATION
APPLICATION FOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. IF A MASTER PERMIT HAS
TAINED, THE OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIO
ELECTRICAL
MECHANICAL
UNIT
•
FEE
ITEM
SWITCH OUTLETS
UNIT
FEE
ITEM
SPACE HEATERS
UNIT
T
LIGHT OUTLETS
CENTRAL HEATING
WASHER
RECEPTACLES
A/C (WIND)
OSAL
KING FOUNTAIN
R DRAIN
SE TRAP
RCEPTOR
,tORY
SERVICE TEMPORARY
SERVICE SIZE IN AMPS
SERVICE-REPAIR/METER CHANGE
APPLIANCE OUTLETS
RANGE TOP
OVEN.
5
A/C (CENTRAL)
DUCT WORK
REFRIGERATION
PROCESS AND PRESS PIPING
UNDERGROUND TANKS
ABOVE G I0UND TANKS
lill
M
CRY TRAY
WATER HEATER
U.F. PRESSURE VESSELS
III
;HES WASHER
MOTORS 0- 1 IP
STEAM BOILERS
ER
MOTORS OVER 1- 3 HP
HOT WATER BOILERS
(, POT /3 COMP.
(, RESIDENCE
(, SLOP
MOTORS OVER 3- 5 HP
MOTORS OVER 5- 8 HP
MIOTCRS OVER 8- 10 HP
MECHANICAL VENTILATION
TRANSPORTING ASSEMBLIES
ELEVATORS/ESCALATORS
N
IIII
'WRY WATER CLOSET
NAL
ER CLOSET
MOTORS OVER 10- 25 FP
MOTORS OVER 25-100 HP
MOTORS OVER 100 HP
FIRE SPRINKLER SYSTEMS
COOLING TOWERS
VIOLATION
U
IRECT-WASTES
A/C WINDOW
REINSPECTION
ER SUPPLY TO:
AIR CONDITIONERS
U
/C UNIT
IRE SPRINKLER
EATER -NEW INST.
STRIP HEATER
GENERATORS TRANSFORMERS
GENERATORS TRANSFORMERS
•
EATER- REPLACE
GENERATORS TRANSFORMERS
AWN SPRINKLER -WELL
SPECIAL PURPOSE
:W POOL
OUTLETS CCOIERCIAL
-
ATER SERVICE
SIGN TUBES
ER CONNECTIONS
SIGN TRANSFORMERS
LITY- SEWER
SIGN TIME CLOCK
LITY -WATER
FIXTLRES
TIC TAM(
•
ANTENNA
AY
TELEVISION OUTLETS
,INFIELD, 4' TILE/RES.
VIOLATION
P S ABANDON SEPTIC TANK
REINSPECTION
,KALE PIT CU. FT.
•
01 BASIN
ZHARGE WELL
ESTIC WELL •
:A DRAIN
•
•
)F INLET i
•
.
JR WATER HEATER
.
IE STANDPIPE
X. PIPING
•
'RI SPRINKLER SYSTEM
fER SET (GAS)
PIPING
MI
PLUMBING
ADDENDUM TO BUILDING PERMIT APPLICATION
APPLICATION FOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. IF A MASTER PERMIT HAS
TAINED, THE OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIO
ELECTRICAL
MECHANICAL