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DS-07-2080
gas for generatot spec or Comments Passed Failed Correction Needed Re- Inspection Fee ($75) No Additional Inspections can be scheduled until re- inspection fee is paid . SA 1 : Inspection Date: 12/04/2007 Inspector: Levrock, James Owner: RUFENER, JANN & DAVID Job Address: 1234101 Street NE Miami Shores Village, FL Project: <NONE> Contractor: DIAL PLUMBING CORP Building Department Comments Monday, December 3, 2007 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, F Phone: (305)795 -2204 Fax: (305)756 -897 ' Block: 01-.20g0 Permit Type: Plumbing - Residential Inspection Type: Final Work Classification: Gas Mop Phone Number arcel Number 1132050080030 Lot: Phone: (305)221 -8569 Page 1 of 2 INSTALLATION OF 16 KW CUSTOMER PROVIDED GENERATOR NATURAL GAS GENERATOR WITH16 CKT AUTOMATIC TRANSFER SWITCH Passed Inspector Comments p , plilzi %-to Op 7.414/e, A/ 8 ,.>'• Allt-,ec er --, Failed Correction Needed Re-Inspection Fee ($75) No Additional Inspections can be scheduled re-inspection fee is paid . until • • • • • • , , • Inspection Date: 12/04/2007 Inspector: Devaney, Michael Owner: RUFENER, JANN & DAVID Job Address: 1234 101 Street NE Project: <NONE> Miami Shores Village, FL Contractor: ALL QUALITY ELECTRICAL SERVICES, INC Building Department Comments Monday, December 3, 2007 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Block: o s ono go Permit Type: Electrical - Residential Inspection Type: Final Work Classification: Generator u ....00 Phone Number Parcel Number 1132050080030 Lot: Phone: (305)968-7832 Page 2 of 2 gas for generatot 3, / 1 ,..: Passed Insp • ,, o ments , CC Failed Correction Needed Re- Inspection Fee ($75) No Additional Inspections can be scheduled re- inspection fee is paid. until Inspection Date: 11/13/2007 Inspector: Levrock, James Owner: RUFENER, JANN Job Address: 1234 101 Street NE Project: <NONE> Miami Shores Village, FL Contractor: DIAL PLUMBING CORP Building Department Comments Friday, November 9, 2007 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Block: Permit Type: Plumbing - Residential Inspection Type: Rough Work Classification: Gas Phone Number Parcel Number 1132050080030 Lot: Phone: (305)221 -8569 Page 2 of 2 CONCRETE PAD FOR 16 KW HG GENERATOR. POURD TO INTERIOR FLOOR LEVEL HEIGHT. 4 INCHES OOTPR NND EACH SINGLE THAN GEN UNIT ®� ®�� Passed Inspector Comments cc d p 07 / 07 Failed Correction Needed Re- Inspection Fee ($75) No Additional Inspections can be scheduled re- inspection fee is paid. until Inspection Date: 11/0.12007 Inspector:�Ti Owner: RUFENER, JANN Job Address: 1234 101 Street NE Project: <NONE> Miami Shores Village, FL Contractor ALL QUALITY ELECTRICAL SERVICES, INC Building Department Comments Monday, November 5, 2007 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Permit Type: Driveways /Sidewalks/Slabs Inspection Type: Slab Work Classification: New Block: Phone Number Parcel Number 1132050080030 Lot: Phone: (305)968 -7832 Page 2 of 2 BUILDING Permit No. 17LOI'Mg PERMIT APPLICATION FBC 2004 )012,1 Permit Type: Plumbing Owner's Name (Fee Simple Titleholder) AA) it.J f f,al _ Phone # 7 .? Roo l Owner's Address /c ?4 s<26 /0 / ` 1 3 62- City f1�� / 3 1 1 (' d State d Zi Tenant/Lessee Name E -MAIL: 4,13 (I 6 90 City Miami Shores Village County Miami -Dade Zip .? J / 3 2 oo Is Building Historically Designated YES NO NO ke Job Address (where the work is being done) FOLIO / PARCEL # Contractor's Company Name J )=3 i>' ' / �S 4- Phone # 7S / Z v 7,2_0 Contractor's Address q9/(7,1 Stu � City Ail 4114 ) State FJ L • Zip 7 3 3 16 Qualifier Name C Aiii , t ° To, 7 Z0 6 ,9 Phone # 7g 6 V/ Z 6 7�0 State Certificate or Registration No. Certificate of Competency No. 0000 / C /Z3 f E -MAIL: ? Phone # Architect/Engineer's Name (if applicable) Value of Work For this Permit $ 9.32'. Type of Work: Describe Work: ['Addition ['Alteration Submittal Fee $ Permit Foe $ * Notary $ Training /Education Fee $ Scanning $ Bond $ Structura Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 dew Master Permit No. Phone # CCF$ J Square / Linear Footage Of Work: ******* Fpps******* * ** * ** * * * * * *** * * ** * * **x * * *xxr. OCT 1 0 &0l ❑ Repair /Replace ❑ Demolition 14 A-0 / /C cJ ** See Reverse side -� MIAMI SHORES V I LLAGE ja-65-'2 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 Zi 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 properly 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 t > ence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Sign: Print: My Commission Expires: (Revised 02/08/06) tn, 209°7 Signature ontractor The foregom instrument was acknowledged before me this , A2 The foregoing instrument was acknowledged be fore me thisa,6 day of t,20 by day of 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. as identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: , 20 O 'by « r P4f te, PATRICIA ELENA CEPERO MY COMMIISSION # DD264598 MY COMMISSION # DD2643g8 Sign: Print: My Commission Expires: *war** xxxxxxxxxxxxx xxxxxx xxxxxx 1 w edrxxxxxxxxx9exx** xxxxxxxxx xxxx *s *** *********xxxxxxxxxxx *xxxnY4eaY* . APPLICATION APPROVED BY: -/ � / . /'` 7 Plans Examiner Engineer Zoning Bill To I JANN RUFENER 1234 NE 101 ST MIAMI SHORES, FL 33138 -2609 Return to: Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Invoice Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Fax: (305)756 -8972 Invoice Number: PL -10-07 -30114 Invoice Date: October 22, 2007 Permit Number: PL -10 -07 -2081 Permit Type: Plumbing - Residential / Work Classification: Gas Date Fee Name 10/22/2007 Change of Contractor Fee Monday, October 22, 2007 Fee Type Fixed OCT 3 1 2007 CKZ6 MIAMI SNORES VILLAGE Fee Amount $75.00 Total Fees Due: $75.00 E .H ®Wm Wednesday, August 29, 2007 Miami Shores Village 10050 Northeast 2nd Avenue Miami Shores, FL 33138 Re: PL -8 -07 -1650 1234 NE 101 Street Miami Shores, FL 33138 Via Certified Mail 7005- 1820 - 0005 -4117 -2966 To whom it may concern: Please cancel the above referenced permit for gas piping that was to have been installed at the address shown. At this time, E.H. Whitson will not be performing any work. If in the future, our customer wishes to go through with the installation, we will at that time reapply for a permit. /AI S. ipka esident cc: Mr & Mrs Rufener certified #7006 -0100- 0001 - 7558 -5724 PHONE: (954) 929 -3599 FAX: (954) 921 -5050 E.H. WHITSON PLUVIBING 421 South 21st Avenue Hollywood, Florida 33020 � g�gII�� O SEA 0 5 X001 CFC041711 CACO39635 EC0001583 own 2e will bn✓x Yob Uat)PeY ger -go) ahory, ewl -I-O paI perm/4 nee new PLEASE INQUIRE ABOUT OUR AIR CONDITIONING & ELECTRICAL SERVICES E-Mail Address: info@ehwhitson.com Web Site: www.ehwhitson.com Project Address Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 1234 NE 101 Street Miami Shores Village, FL Owner Information DAVID RUFENER Contractor(s) EH WHITSON AIC & PLUMBING Phone Cell Phone (954)923 -6505 Type of Work: GAS Type of Piping: Additional Info: GENERATOR Bond Retum : Classification: Residential Fees Due CCF Education Surcharge Permit Fee - Additions/Alterations Scanning Fee Technology Fee Total: Amount $1.80 $0.60 $170.00 $3.00 $4.25 $179.65 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. Authorized Signature: Owner / Applicant / Contractor / Agent Building Department Copy Address Reside 817/2007, PROVED Expiration: 02/031200 Parcel Number 1234 NE 101 ST MIAMI SHORES FL 33138 -2609 Phone Total $ 0.00 $ 0.00 Payment Type: Amt Paid Amt Due $ 0.00 Applicant Valuation: Total Sq Feet: Available Inspections: Inspection Type: Final ROW Press Test August 07, 2007 Date CeII $ 2,646.00 0 Tuesday, August 7, 2007 1 Description of Work: .H. Whitson Plurretimp 21 South 2 Lst Nieniltt? Hollywood, FL 33020 CFC141:2 •:' • • • ••• • • • ••• •• .. • • • •• •• • • • • • • — • • • • • • • • ••• • • • • • • • • • • • • • ••• • • • • ••• • • • • • • • • • 6 • • • • • • • • • • Survey Sheets 1 'hp s Customer Name: , /-4 ietn Address: city 5.1-ate, Zip: :04;9047/1„12/1"eir, AM 0 6 70(11 BY: ---------------- --- Phone #: All Work to Comply With N.F.P.A. C.00. #: gew60 nick Estimated Job Cost: Ji g -z49e.rep ri #% JENNIFER STAMENKOVIC MY COMMISSION # DD320I82 % EXPIRES: August 14, 2008 1,800. a Notary Discotmt Assoc. SUBJECT TO COMP WITH AU_ FEDERAL TA COU RULE AND REGULATION Surve Sheets Customer Name: Address: City, State, Zip: :'COIFER.S o A pp 3�o�s2 Nei coMM ta,2oo RXPIRES: pugs Veal Pla Phone #: All Work to Comply With N.F.P.A. Code #: Estimated Job Cost: Description of Work: f tic 4f piping IS • • •• •• •• • • • • • • • • • • • • • • •• • • • • • • •• lurratxir� :: • E.H.- Whitson P • . • 421 South 21st Aven 4 ,, • . Hollywood, FL 330.2 . CFC1 425789 •• • . • •• • •• •• g‘l -r •• • • • • • • r 1/ ' 1 /06 6 0.-07fgh9i9A v,b4"14 pI 7 ,ao ••• •- • •• • • • • • 44 / 9-404 1 ‘/)? • • • • • • • • /t� e .p//57kos• TRENCH FOR GAS LINE 00 0 6 Passed A Ins . = ctor Comments Failed Correction Needed Re- Inspection Fee ($75) No Additional Inspections can be scheduled re- inspection fee is paid. until Inspection Number: INSP -53886 Permit Number: PL - -d7- Inspection Date: 10/02/2007 Inspector: Levrock, James Owner: RUFENER, JANN Job Address: 1234 101 Street NE Project: <NONE> Miami Shores Village, FL Contractor: TECO PEOPLES GAS SYSTEM ent Comments Inspection Worksheet Miami Shores Village Li 19 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Block: Permit Type: Plumbing - Residential Inspection Type: Final Work Classification: Gas Phone Number Parcel Number 1132050080030 Lot: Phone: (305)957 -3857 Tuesday, October 2, 2007 Page 2 of 2 3 • ...... • ••• Continuum • • • .. • . . • • • . :,... . • • • • • • • • • Rover Rvn O,vl 01 Hal Water ARVIn • • • ... • • • • • • • . go • � ..: :.:.. • • ••• • • • • ••• Power Supply Safety devices Remote control Remote control cable Clearances from combustibles Clearances from non - combustibles Clearance from Eaves, Porches, Overhangs Minimum and Maximum gas supply pressure Manifold Gas Pressure Natural Gas Warranty V2020W • ••• • • • Appliance - AC 120 Vol'- t 6§I4. • • • ••• • • • Remote control DC 12 Volts (Digital) Flame failure - Boiling protection - Remaining flame (OHS) - Fusible link - Automatic frost protection Combustion fan rpm check Over current MC- 45-4US BC- 45-4US BSC- 45-4US Non - polarized two core cable Top of heater Front of heater Sides of heater Back of heater Ground Top of heater Front of heater Sides of heater Back of heater Bottom of heater • • • . . •• • • ••• • • • • • • • • • •. • . .._ • • S Flame rod 203 °F lockout thermistor 194 °F bi -metal switch 264 °F thermal fuse Bi metal sensor & anti -frost heaters Integrated circuit system Glass fuse (3 amp) Main control Kitchen / Laundry Bathroom control Second bathroom control 12" 24" 6" 0" 12" 2 " 24" 1/2" 0" ••• ... • • • •• V1 61 6W Maximum 10.5" W. C. Maximum 13.5" W. C. 3.5" W.C. high fire /0.73" W.C. low fire 3.3" W.C. high fire /0.72" W.C. low fire 2" Installations within Recess Box: Clearances from combustibles to recess box top, bottom, back and sides = 0" Top of heater 36" Natural Gas (NAT.) : Minimum 6 ,t W. C. Propane Gas (LPG) : Minimum 10" W. C 3.7" W.C. high fire /0.74" W.C. low fire 3.5" W.C. high fire /0.74" W.C. low fire Residential: Ten years heat exchanger / five years parts (see unit's warranty for details) Commercial or Space Heating: No Warranty — Use V2020WCN1616WC Water Heater NOTE: Rinnai is continually updating and improving products. Therefore, specifications are subject to change without prior notice. Continuum www.rinnaLus 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 BUILDING PERMIT APPLICATI9N FBC 2004 E -MAIL: a q/ Job Address (where the work is being done) Jt1 y Jd' 6 Jo/ 'CC-. City Miami Shores Village County Miami -Dade FOLIO / PARCEL # // 3,k 6-00g- (2o3 Contractor's Address u pp /(ecl Notary $ Scanning $ 3.00 Structural Review. $ Radon $ Miami Shores Village Building Department Type of Work: ❑Addition ZAtteration Describe Work: DPBR $ Bond $ Code Enforcement $ Double Fee $ Permit No. Master Permit No. Permit Type: Plumbing ,/ Owner's Name (Fee Simple Titleholder) Aj 1)1 CC Qi ,» FNair Phone # .305 959 - '7/Q Owner ddress J3 A/c , /0/ � '� �/p Cityvl'/ t fi'u C )7U �� State r0, Zip 33)3 Tenant/Lessee Name Phone # Is Building Historically Designated YES NO 0( Contractor's Company Name 14. h . afibbol -ill ° i City J 11 State IL Qualifier Name (J 7 , ,�g � L ,O I( , State Certificate or ' egistration No.l.,d," L c ) gq E- MAIL�1 � (,I7�B�(.. C.cD � 1 ov> Architect/Engineer's Name (if applicable) ,(X Phone # Certificate of Competency No. Zip�JI,�� Phone # 95-4 q 2 3- Cos ? \ Zip 356w 0 ) l' 0 Value of Work For this Permit $o �(/ 4 �') ' r' Square / Linear Footage Of Work: Total Fee Now Due $ � •('05 See Reverse side —> 7C-: 711 i , AUG 0 6 ' 2001 M BY: - -- P10 Ic0sd Phone #q'5,L) _qaq -. 5q9 DNew D Repair /Replace ❑ Demolition ( CLt ) h )l® WO A (9) j () CU5 1,„ **************** * **skk3rdc**4**** ***** F Submittal Fee $ Permit Fee $ /?4 CCF $ 1.3 CO /CC Training /Education Fee $ 0 Technology Fee $ Zoning $ 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. 1 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: l 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 properly 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. regoi Owner or Agent Signature. The instrument was acknowledged before me this day o �, UL( , 20-9 , by 371-clr V { C 0 -PQn S who is ppolallylurrnap to me or who has produced As identification and who did take an oath. NOTARY PUBLIC: Print: My Commission Expires: x* w www wwwwwwww*wwwwxx ww w ******* APPLICATION APPROVED BY: (Revised 02/08/06) 1 Signature Contractor The foregoing instrument was acknowledged before me this eT day of :R , 20 IR, by ) k) S . L d P I—! l , who is nally knov;ri to me or who has produced as identification and w o did r e an oath. Sign: Print: My Co www***wwwwww w ww*wwwwwwwwr.wwwr. ww Plans Examiner Engineer Zoning EH. E.H. Whitson Air Conditioning 423 South 21st Avenue • Hollywood, FL 33020 33I.38$2392 r_C1S 1 1 1 1 1 1 7005 1820 0005 4117 2966 V La act 0 OLitu Shores, 53)3S I,, li„, I1, 1,.l I., IL1, 1l,,,l rl .,Il,11113$,I,)1,I,.I,1►,1,I,,I les SAP P0 H * 1 190 2736 $ 03,06 AUG- 2S 5 6 1 5 HOLLYWOOD. FL 3 Project Address 1234 NE 101 Street Miami Shores Village, FL Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Owner Information JANN RUFENER Address 1234 NE 101 ST MIAMI SHORES FL 33138 -2609 Parcel Number 1132050080030 Block: Lot: Contractor(s) Phone Cell Phone ALL QUALITY ELECTRICAL SERVICE (305)968 - 7832 Approved: Yes Comments: Date Approved: 10/10/2007: Yes Date Denied: Type of Work: CONCRETE SLAB Bond Retum : fo ERATOR ntial OCT 3 2-( �?,�07 MIAMI SHORES VILLAGE Fees Due CCF Education Surcharge Permit Fee Scanning Fee Technology Fee Total: Amount $0.60 $0.20 $100.00 $6.00 $2.50 $109.30 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 1 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 Authorized Signature: Owner / Applicant / Contractor / Agent Building Department Copy Monday, October 22, 2007 Permit NO. DS -10 -07 -2080 Permit Type: Driveways/Sidewalks /Slabs Perm' Work Classification: New Permit Status: APPROVED Issue Date: 10 /22/2007 Expiration: 0411912008 Phone Valuation: Applicant JANN RUFENER Cell $ 1,000.00 Total Sq Feet: 45 Available Inspections: Final Landscaping Foundation Sidewalk Inspection Type: October 22, 2007 Date 1 MUMEWEI Miami Shores Village OCT i 0 200? B Y: BUILDING tOI 101 PERMIT APPLICATION FBC 2004 Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Permit Type (circle): Electrical Plumbing Mechanical Roofing Owner's Name (Fee Simple Titleholder) Zi$,U A) p, 7 M Can_ Phone # r 2 5I S ciao 0 Owner's A d d r e s s / . 3 v ,(J6 /0/ S City ® ??�l / J E14' State re Zip 3 31 3 2 Tenant/Lessee Name `/f Phone # Job Address (where the work is being done) /o 3 V AI E /0 0 City Miami Shores Village County Miami -Dade FOLIO /PARCEL# 1/ — 3 c 0o? - 0 o J6 Is Building Historically Designated YES NO V Contractor's Company Name ,4 t - t + U I LI fl Ct' / C. Phone # 303 96 - 7? 3 2 Contractor's Address Pi-SO 0 Permit No. 0S O WE0 Master Permit No. 5A City / ?»7 / State T Z . Zip 5 3 / ej 7 Qualifier Name 1/4�eCYY/ U e_., L ei Phone # �� a j ( � � - 78' S 2_ State Certificate or Registration No. Certificate of Competency No .a2.5 01 (6 7C' ON It Architec Submittal Fee $ Value of Work For`this°Peknit Notary $ Training/Education Fee $ e �Q Scanning $ (L) CO Radon $ DPBR $ Bond $ Code Enforcement $ Structural Review. $ Permit Fee $ /b oI) rirmgr Z1We'L. 01/196.11 Square / Linear Footage Of Wa Type of Work: ['Addition ['Alteration EKew ❑ Repair/Replace ❑ Demolition Describe Work: a) d_,0_X P . I(& 47 . /K ,e E't) A2 e ,/L � y / / * * * * * * * * * * * * * * * * * ** ar; * *, * , ,r, *, , ,t *,r *, *****F ,r * *, *,r,� *,r * *,� *,�,r * * *,� * *** *,t * * * * *** * ****** • CCF $ ` �llt Double Fee $ Technology F Zo Total Fee Now D Zip ee ' e'erse side - 5Q Fr ,GE 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 (Revised 02/08/06) - f /1 er or Agent The foregoin was acknowledged before me this day of Sr . 0 07, by Taw who is personally known to me or who has produced As identifi NOTARY PUBLIC: Sign: Print: My Commission Expires: APPLICATION APPROVED BY: Contractor The foregoing instrument was acknowledged before me this day of ©C/Ikler, 20 07 by Sam ve• / who is personally known to t ol own as iden NOTARY PUBLI( Sign: Print My Commission Expires: Plans Examiner Engineer Zoning PERMIT # O1-- tog() CONTRACTOR: A(L oucr'' 'et/MC-) SUBMITTAL DATE: Oct 1 0 ,Q1 ADDRESS: 11,3z1 Ne [01 NAME: 3 1041,1 rUfe 4e - a) R--e RESUBMITAL DATES: PROJECT TYPE: ( / (6 6 / ZON1NG STRUCTURAL ELECTRICAL ere; ) PL MECHANICAL FIRE IMPACT FEES HRS /DERM NOC 111 ;ill in Owner's Name: JANN RUFENER Planning and Zoning Criteria and Comments Approved: Yes Comments: Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138-0000 Phone: (305)795-2204 Fax: (305)756-8972 Date Approved: 10/10/2007 : Yes Issue Date: Not Issued Job Address. 1234 101 Street NE Miami Shores Village, FL Total Job Valuation: Total Square Feet: Expires:Not Issued Folio Number:1132050080030 Owner's Phone: .............. ........ . ......... Contractor(s) Phone Primary Contractor ALL QUALITY ELECTRICAL SERVICES, INC (305)968-7832 Yes .• .:::.. .:: ii ..., 45 ii $ 1,000.00 1 -e4 :j 30° 5c /e / =30 Lot 3, Block 1, Book 45 at Page Order No. 89931 Order No. N. N. e F. B. No. 1477/4 /00 -3.965 22.5.5* 06.7 /00' /00' d • /0C 5 5 ' p', e �wo /o /iPe /Gb 77/ /-97 - o 'Y 046. ■ 2 0' 506e/7 er77 6 ST /00 • 7 Scales Shown • • • •— ••• •• ....�. : Damao • • •••• •• • •••• • • •••• • . • • .1.• •• ••• • • • • • •• • •• •• • ST • •••• •. •••• ••• • •• •• SKETCH OF SURVEY GORDON SHORES, according to the plat thereof, as recorded in Plat 8 of the Public Records of Dade County, Florida. Date :Hay 15, 1968 R E V I S I O N S Date Field Book :;,guature • •1.•• • • /?, , S i G te pi 4 I HEREBY CERTIFY: That the attached "SKETCH OF SUF(VEY' (.,r" a.bove described roperty is true and correct to the be: -t of my knowiedt.y• .o,:i ief as T. er't,nt- ly surveyed and platted under ry direct. -�r;. !_ _,�. .., ...• _ V. ` Pre . R g 1.' tE?rod !.and Sui vF'v - 'r 9 St at ,•.!. of , t r.r 1;Ja H _ • �t�i�e • 51' - F.l a. ;, -t a tt` ts7 Fla . Re' :7;31 S ui= iicyOr *__ - _ . _ . t: : Z - F1a. Rei. ry or a ` I'a PE ,1M IT T #:03,0 - )— Mtami Shores VH n APPROVED EY DATE ZONING DEPT I BLDG DEPT /�� 0 AS 0 SUBJECT TO COMPLIAN E WITH ALL FE ^EL' L STATE�IA D OUNTY RULES AND REG'ULAT'O •• • •• • •• • • • • • • • • •••• • • • • • • •••• • • • • • • • •• •• •••• • • • • •••• • • • •••• • • •••• • • • • • • •• • •••• • • • • • 0 • •; aob Address Job Description: Contractor Information -• • ' 12, - III mi esy F1. Pour Concrete Pad for 16kw NG fired Generator Pad wei = 1 Ibs or greater All Quality Electric 14500 NW 16 Ct Miami, FI. 33167 305 - 968 -7832 :Qwrier.lnformation hisidaenVe o# tannue Notes: * * * ** *Combined height of generator and slab will be 42" • • ••• •• •• • • • • • • • • • • • • • • ••• • • •• • • • • • • • • • • • •• ••• • •• • • • • • •• • •• • • 32" Wide 9/18/2007 • • • • • •• • • • • • • ••• •• •• • • • • • • • • • • • • • • ••• 18" height (or poured to interior living space floor level, whichever greater) 60" long \\ o 0 0 Concrete Pad 3000 PSI W/ #5 Reinforcing Bars Each Way Sakrete 5000 Fiber Cement / Crack Proof Concrete Stained to Customer Specification • /a/.5' . a /00' ' 22.55' r• °'t - /505• o . • /0/6'1 a . 2G.? 1 - ,1 , N ., ..: 4 `Ca ? tHo // 5'Eosemenf ,P,oe-� /GYM' 9 •Avv// A //!e Order No. F. B. No. 1477/4 N. E. 33. 20.55 2 //.6 / /,5 I• HEREBY CERTIFY; That the attached "SKEFCII OF SURVEY ' c,t 4t e above deser ibed roperty is true and correct to the bet-;t of my knowied ' • .1.a4:9 aael ief as z er•o»t - ly surveyed and platted under try (l i.re:. t. i on. „0/9/ 0 4, '"" ' 1 - v. M1 r,•.:. . SKETCH OF SURVEY Lot 3, Block 1, GORDON SHORES, according to the plat thereof, as recorded in Plat Book 45 at Page 8 of the Public Records of Dade County, Florida. Order No. 89931 ST R E V I S I O N S Dat£ °________ TField Boole r Signature t l-teg. i,anf.i :.urveyor* -Stale . of Fla. i? Or:1. 1171 13 i ^V_ ?` %5 t• -_._ __ ;. t a tis - °ts7 - 1 a 000000 .. .... • . •. • • • . • • Scales Shown • . ...... • •••• . • . . . • • I • • ••• • • • • i ... •... • • •... • .• • lmTU in— C.195 6-3c504/ .t,►r�e • /; /I &i0/ AIIZe 4 iL L.CP ig ® 6/6 c, /G NAY / CON * 3v Ps . .3 ili-jtizebi_ Date:May 15, 1968 • • ••• • u Lan(: Su.. vf'vrr � j ' 7 L S t F 1 !1 Y• 1 •1••• I' I) fl ey Yi i , - _._ T e Re — a and ST1r ?11T e o ,T.7I Home Standby - 16kW Whisper-Test TM Low Speed Exercise 59 dB(A) at 23 feet INCLUDES: ( Aut i nsfer gency Load=Ceer r • Electronic Governor • Pre -wired External Connection Box • Flexible Fuel Line • Composite Mounting Pad • Pre -wired conduits or LP Gas Operation • UL 2200 Listed FEATURES 0 INNOVATIVE DESIGN & PROTOTYPE TESTING are key components of GENERAC'S success in "IMPROVING POWER BY DESIGN." But it doesn't stop there. Total commitment to component testing, reliability testing, environmental testing, destruction and fife testing, plus testing to applicable CSA, NEMA, EGSA, and other standards, allows you to choose GENERAC POWER SYSTEMS with the confidence that these systems will provide superior performance. O TEST CRITERIA: ✓ PROTOTYPE TESTED ✓ SYSTEM TORSIONALTESTED ✓ NEMA MG1 -22 EVALUATION ✓ MOTOR STARTING ABILITY UI ETh Air-Cooled Gas Engine Generator Sets Continuous Standby Power Ratifo — f gkir60Ha.. •. Models: ...... 05244 (! tinum - Gray) • • • • •••• ...... • •.•. • . • • • ..... 4Ir• • • GUAR DIAIV by Generac Power Systems, Inc • • • • • • •• • ••. • • • ••• • • ••• • • •• s • • Or ailr 46 -- 1 UIETS°'JRC O SOLID- STATE, FREQUENCY COMPENSATED VOLTAGE REGULATION. This state- of- the-art power maximizing regulation system is standard on all Generac models. It provides optimized FAST RESPONSE to changing Toad conditions and MAXIMUM MOTOR STARTING CAPABILITY by electronically torque - matching the surge Toads to the engine. O SINGLE SOURCE SERVICE RESPONSE from Generac's dealer network provides parts and service know -how for the entire unit, from the engine to the smallest electronic component. You are never on your own when you own a GENERAC POWER SYSTEM. O GENERAC TRANSFER SWITCHES. Long life and reliability are synonymous with GENERAC POWER SYSTEMS. One reason for this confidence is that the GENERAC product line includes its own transfer systems and controls for total system compatibility. V7C7 • • ...... • ...... • • •Generac (OHVI) Design •°Spiny -lok' cast iron cylinder walls W Z •Electronic ignition, spark advance and Z compression release W •Full pressure lubrication system •Low oil pressure shutdown system •High temperature shutdown Maximizes engine "breathing" for increased fuel efficiency. Cylinder walls run cooler, regucing oil consumption. Because heat is the primary cause of engine wear, thp OHVJ has a siniftearily longer life than competitive engines. ' • • •••••• '' Rigid construction and added durability provide long engine life. •••• e. • . . • • •••• These features combine to assure smooth, quick starting every time. • • , , , • I • • • • Superior lubrication to all vital bearings means better performance, less maintenance ar�SR�flificantly longer engine life. • • • �• • • • •••• • • Superior shutdown protection prevents catastrophic engine damage Le to II w oil. • • • • I •• • ••• • • • • Prevents damage due to overheating. • • *Revolving field Q p •Skewed stator a W • Displaced phase excitation 2 •Automatic voltage regulation •UL 2200 Listed Allows for smaller, light weight unit that operates 25% more efficiently than a revolving armature generator. Produces a smooth output waveform for compatibility with electronic equipment. Maximizes motor starting capability. Provides more surge capability than brushless generator designs. Regulates the output voltage to ±2% prevents damaging voltage spikes. For your safety CC W = •Fully Automatic LL V 2 H 'Remote Mounting at H •UL Listed Transfers your vital electrical loads to the energized source of power. Mounts near your existing distribution panel for simple, low cost installation. For your safety MICROPROCESSOR CONTROL •Manual/Auto /Off switch *Utility voltage sensing *Utility interrupt delay *Engine warm -up •Engine cool -down •Seven day exerciser *Timed Trickle Battery charger •Main Line Circuit Breaker Selects the operating mode. Constantly monitors utility voltage, setpoints 60% dropout, 70% pick -up, of standard voltage. Prevents nuisance start-ups of the engine, set point approximately 10 seconds. Ensures engine is ready to assume the load, setpoint approximately 10 seconds. Allows engine to cool prior to shutdown, setpoint approximately 1 minute. Operates engine to prevent oil seal drying and damage between power outages. Maintains battery amperage to insure starting. Protects generator from overload. llNn •Weather protective enclosure •Enclosed critical grade muffler *Small, compact, attractive Ensures protection against mother nature. Hinged key locking roof panel for security. Lift -out front for easy access to all routine maintenance items. Electrostatically applied textured epoxy paint for added durability. Aluminum enclosure available - (Model 05244) Quiet, critical grade muffler is mounted inside the unit to prevent injuries. Makes for an easy, eye appealing installation. INSTALLATION SYSTEM •Pre -wired External Connection Box •1' Flexible Fuel Line •Composite Mounting Pad •Pre -wired conduits •UL Listed wire nuts Easy Installation - Virtually all hardware included, plus step -by -step photographed Installation Guide. • HOME STANDBY SPECIFICATIONS Home Standby -16kW •••••• • • • ••••• •• • ••••• • • • •••• • • Home Standby - 16kW GENERATOR Rated Maximum Continuous Power Capacity (LP) Rated Maximum Continuous Power Capacity (NG) a s' Rated Voltage 120/240 Rated Maximum Continuous Load Current 120 Volts 240 Volts 66.6 LP /62.5 NG Main Line Circuit Breaker t Phase 1 Number of Rotor Poles 2 • Rated AC Frequency •••• • Power Factor 1 • Battery Requirement (not included) Group 26,12 Volt Netgative Ground and 525 Cold-crap ng:4mperesPinimum ••• • Unit Weight 445 Pounds • • • • Dimensions L° x W° 48 x 24 x 28-1/4 • • • • •••• •• • ••• • illgatiF • • •• ENGINE Type of Engine GENERAC OHVI V TWIN Number of Cylinders. 2 Rated Horsepower 30 @ 3,600 rpm Displacement 992cc Cylinder Block. Aluminum w/Cast Iron Sleeve Valve Arrangement. Overhead Valve Ignition System Solid -state w/Magneto Govemor System Electronic Compression Ratio 9.5:1 Starter 12Vdc Oil Capacity Including Filter Approx. 1.7 Qts. Standby Operating RPM 3,600 Exercise RPM 2400 Fuel Consumption CONTROLS Mode Switch -Auto Automatic Start on Utility failure 7 day exerciser -Off Stops unit. Power is removed Control and charger still operate - Manual/Test (start) Start with starter control, unit stays on. If utility fails, transfer to load takes place. Cyclic cranking: 7 sec. on, 7 rest (90 sec. maximum duration) Engine Warm -up 10 seconds Engine Cool -Down 1 minute Starter Lock -out Starter cannot re- engage until 5 sec. after engine has stopped. 2.5 Amp Timed Trickle Battery Charger Standard Automatic Voltage Regulator w /Overvoltage Protection Standard Automatic Low Oil Pressure Shutdown Standard Overspeed Shutdown Standard, 72Hz High Temperature Shutdown Standard Overcrank Protection Standard Safety Fuse Standard Engine Start Sequence Model 05243 - Steel, Model 05244 - Aluminum Model 05243 - Steel, Model 05244 - Aluminum • • • • • •• • • • •• • 1/2 Load . Full Load - Liquid Propane ftlhr (galhr) 1/2 Load 59 (1.59) Full Load 92 (2.51) Required fuel pressure to generator fuel inlet at all load ranges - 5 to 7 inches of water column for natural gas, 10 to 12 Inches of water column for LP gas • • • ••• • • • • • •••• • •••• • • • • • •••• • Rating detlnitions - Standby: Appfcable for supplying emergency power for the duration of the utility power outage. No overload capability is available for this rating. (All ratings in accordance with B85514,1603046 and DIN6271). ` Maximum wattage and current are subject to and limited by such factors as fuel Btu content, ambient temperature, altitude, engine power and condition, etc. Maximum power decreases about 3.5 percent for each 1,000 feet above sea level; and also will decrease about 1 percent for each 12° C (10° F) above 15.5° C (609. 000000 • • • •••••• • • •••••• • • ••••• • • 00000 •••••• • • • • 00000 • Mechanical Dimensions (In Inches) Current Rating No. of Poles Height Width Depth H1 H2 W1 W2 7 100 UL Listed 2 26.5 29.25 8.14 12.5 Terminal Wire Ran es ATS Rated Amps Switch Terminal Neutral Lug/Stud Ground Lug 100A 2 -Pole UL 1 x 1/0-12 1 x 3/8.16 Stud 1 x2/0 -14 Home Standby -16kW Models: 05243 & 05244 No. of Poles 2 Current Rating (amps) 100 Voltage Rating (VAC) 250 Utility Voltage Monitor (fixed) -Pick -up 70% -Dropout 60% Retum to Utility approx. 13 sec. Exerciser weekly for 12 minutes Standard UL Listed Standard Dimensions (H° x W x Cr) 26.5 x 12.5 x7 Total of Pre -wired Circuits 16 No. 15A 120V 5 No. 20A 120V 5 No. 20A 240V 1 No.40A 240V 1 No. 50A 240V 1 Circuit Breaker Protected Available RMS Symmetrical Fault Current @ 250 Volts 10,000 "QUIETSOURCE Transfer SwitcD Features • , •••••• • EIIeatricalt operates • meohesieally -held eoj aact� 4or fast, pose connections. • Nail Soh all das esrof fold, 1 rated, • both isdutva 9nd resistive. •••••• $2 pdfe, X50 VAC coat • c ors. • • • 410•millisecon , me. • Dual coil design. • • • Main contacts are silver plated or silver alloy to resist welding and sticking. • NEMA 1 (Indoor rated) enclosure is standard on the 100 amp switch. I II -- r 1l � '� I`?) 7\•C ,11111,11n■,.. i. 411 w2 —� f WI. GuardianQuletSourceACl6kW H1 aIEwou,IIIIED 0.14[101111010M TROMEROWCICI CONE13711710POBEIWOR m127REMnaw®manua MOM EL= MN GENERAC POWER SYSTEMS, INC. • P.O. BOX 297 • WHITEWATER, WI 53190 WEBSITE: www.guardiangenerators. 1.07 @ 2007 Generac Power Systems, Inc. AO rights reserved.AB specifications are subject to change without notice. • • • • • •••••• • • •••••• • • ••••• • • ••••• •••••• • •••••• • • •••••• • • K k e4 ro-i-lr+ 100 am p 16 coci- ea,ne. 1 1 6 Kw• 3 cotrotot 344 be /tjr • 2-(5O4 )( 3soo ve Wa,4-eid-k4ta. 3 () 00 v D;shwkskeit.- • j ct Fig-5 /9 KIM & 10070 — I 6, 0004 a. tmov Matti 40 7o 2_ 5oove, 7f373■7 / Kv4 oP 1 (6 4 7, 9 zi L 12,24 S; 7 I. 2 " 44y,, 4,1 - totreern Gtirole 1 etv It . i 3, if (4 11 1100 2.1 25 • • • • • •• • • • •• •• • • • • • • • • • • •• • (3 utreo m A C 6 e41/1 t. • 1 •OOOOO • •••• • • •••• • • • •••••11 • •••• • 41 •••• • • •S$. • 1S .s ••• • • • •• co-1 PaismA A 1(4 amp_ 1 • 501A-1 A-pp . 511101 APP. - ed.roolvi FAA, m . 6;7 • ki4-cketv etc. OO O 00 • • • •*_•1110._ • • •*•*** • • Project Address 1234 NE 101 Street Miami Shores Village, FL Owner Information JANN RUFENER Monday, October 22, 2007 Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Address Fees Due CCF Education Surcharge Permit Fee - Additions /Alterations Scanning Fee Technology Fee Total: Amount $1.20 $0.40 $225.00 $3.00 $5.63 $235.23 Building Department Copy Permit Issue Da : 10/22/2007 Permit NO. EL -10 -07 -2082 Permit Type: Electrical - Residential Work Classification: Generator Permit Status: APPROVED Expiration: 04/19/2008 Parcel Number 1132050080030 Block: Lot: 1234 NE 101 ST MIAMI SHORES FL 33138 -2609 Contractor(s) Phone CeII Phone ALL QUALITY ELECTRICAL SERVICE: (305)968 -7832 Authorized Signature: Owner / Applicant / Contractor / Agent Phone Applicant Valuation: Total Sq Feet: Type of Work: ELECTRICAL Additional Info: GENERATOR Classification: Residential Et 1) ?OCT 3 1 2007 c:' MIAMI SHORES VILLAGE Total $ 0.0 $ 0.00 $ 0 .00 Payment Type: Amt Paid I Amt Due JANN RUFENER October 22, 2007 Date CeII $ 2,000.00 Available Inspections: 85 Inspection Type: Final 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. 1 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. 1 INSTALLATION OF 16 KW CUSTOMER PROVIDED GENERATOR NATURAL GAS GENERATOR WITH 16 CKT AUTOMATIC TRANSFER SWITCH �Q® Passed Inspector Comments cc f/g 2 -' / /�/ 6v/ 1P" Failed Correction Needed Re- Inspection Fee ($75) No Additional Inspections can be scheduled re- inspection fee is paid. until Inspection Date: 11/15/2007 Inspector: Devaney, Michael Owner: RUFENER, JANN & DAVID Job Address: 1234 101 Street NE Project: <NONE> Miami Shores Village, FL Contractor. ALL QUALITY ELECTRICAL SERVICES, INC Building Department Comments Inspection Worksheet Miami Shores Village 0 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Block: Permit Type: Electrical - Residential Inspection Type: Rough Work Classification: Generator Phone Number Parcel Number 1132050080030 Lot: Phone: (305)968 -7832 Wednesday, November 14, 2007 Page 2 of 2 BUILDING PERMIT APPLICATION FBC 2004 Tenant/Lessee Name E -MAIL: Job Address (where the work is being done) /2_3 V ,&J6 )6 / City Miami Shores Village County Miami -Dade FOLIO / PARCEL # 1/ 3 8 —Co 3 Is Building Historically Designated YES NO V Architect/Engineer's Name (if applicable) Value of Work For this Permit $ /TO Type of Work: Describe Work: Bond $ Code Enforcement $ IVilami Shores Village Building Department L1005 0 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (30595.2204 Fax: (305) 756.8972 Double Fee $ Structural Review. $ Total Fee Now Due OCT MO METR it 1 0 zC10 BY: Permit No. EL - 7,Q(Z. Master Permit No. Permit Type: Electrical /+ Owner's Name (Fee Simple Titleholder) J.L?J 7`f � A)tIZ Phone # 3o s" 3 �i / R'00 Owner's Address / 2 3 L( JU9 City/W, /QM/ Shiet2(A State PL, Zip J 3 / 3a Phone # Phone # Square / Linear Footage Of Work: Zip 303 7s3 Z. Contractor's Company Name ( g o /3 L T 6Le C7 /C. Phone # Contractor's Address f/) O) l\J tc) / / (? 114 C r Cit /L / I m I State Zip 3 3 / 6 _ Qualifier Name SAi)' -Y[OTC �/9 j/)Z,,,� Phone# 303 — 4 11( 733 State Certificate or Registration No. Certificate of Competency No.0, t(,r V 7 E -MAIL: N/ ❑Addition ❑Alterationlew ❑ Repair/Replace 0 Demolition .ZnS1Lx?IL 97/0,k) ®f /6 ,c& (Gees neizt pzervIcild C T 4U ; , * *** ** ** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** F ees* ** *** ** *** ** ** * * * * *x * * * * * * * * * * * * * * * * * * Submittal Fee $ Permit Fee $ i elPe, CCF $ ` 2 CO /CC Notary $ 4 /?� Training /Education Fee $ 1 v Technology Fee $ Scanning $ 5 . Radon $ DPBR $ i See Reverse side -� MIAMI SHORES VILLAGE Mai 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. Owner or Agent Contracto The foregoing instrument was acknowledged before me this / The foregoing instrument was acknowle before me this / day of IYC4iee, 2(W 7, by Q NN , day of pcfcber , 20 07 by coi l / who is personally known to me or who has produced who is personally known to me or who has produced as ides As identifi • • , , 'd take an oath. My Commission Expires: APPLICATION APPROVED BY: (Revised 02 /08/06) NOTARY PUBLI Plans Examiner Engineer Zoning Sign: Print: 4/64 , d1 My Commission Expires: ***************************************************` u***** * * ** ** * * * * * * * * * * * * * ******* * *** *Pest * ** * * * * * * * * * * ** * **