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1235 NE 100 StMiami Shores Village Building Department BUILDING PERMIT APPLICATION FBC 2001 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Permit No. H X63 -- ` 1 Master Permit No. 'B? Z aj" BSO Permit Type (circle): Buildin DE Mechanical Roofing Own er's Name (Fee Simple Titleholder) 0 U tS D 7 o ,PI Phone # 3 Or --'75 9 Owner's Address / Z 3 r Li • E • / D O / , ' n d ft F State 7 L - Zip City Al r a 2 3 0 T - '7 5' /— `J G r / If Phone # Tenant/Lessee essee Name ,U L Job Address (where the work is being done) City Miami Shores Village County Miami -Dade Zip Is Building Historically Designated YES NO �/ . .5A(. 1 s 6 elec(1 / rh Contractor's Company Name ± Contractor's Address 36 q) -S' - ° State Zip City_ tom—"- ----. � /y 0- `'`��'v • Qualifier (---------D __ 0 0-'0 Architect /Engineer's Name (if applicable) 11 a r' ou 6 - /V rd Q at S c/ LfRllohe # � Architect/Engineer's Address S 7 4"5" `I' `�`' j N L- City -- f I-/ u Pcii 04 ZI c� State P- L' Zip $ Value of Work For this Permit County Escrow Fee $ Education/Training Fee $_ Code Enforcement $ Minus Plans Check Fee $ Phone APT! 443 `6 0 g /3 4 Square Footage Of Work: Number of: Bays Stories Families Bedrooms Baths ❑ ['New ❑ Repair/Replace ❑ Demolition Type of Work: ['Addition alteration Describe Work: P-) ) 2 /c C * * * * * * * * * * * * * * * * * * * * * * * * * * * Fee * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Permit Fee $ 4c:'t ee' Notary $ Tech $ Scanning $ Bond $ Strict. $ Total Fee Now Due $ Radon $ (/ a e. l2� Co i11l� (Continued on opposite side) eC. � 2SS "PGia Bonding Company's Name (if applicable) Bonding Company's Address City Mortgage Lender's Name (if applicable) Mortgage Lender's Address City Signature State State Owner or Agent The foregoing instrument was acknowledged before me this day of 20 by who is personally known to me or who has produced As identification and who did take aona oath. NOTARY PUBLIC: Sign: Tint: Ay Commission Expires: PPLICATION APPROVED BY: :717/03 Zip Zip Application is hereby made to obtain a permit to do the work and installations as indicated. I certify 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 ELE that no work or installation has WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, E CAL WORK, PLUMBING, SIGNS, OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance wi th all applicable laws regulating construction and zoning. mP "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN Y OUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE COMMENCEMENT." O OF F Notice to Applicant: As a condition to the issuance of a of posted notice, the buildin g 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 for the first inspection which occurs seven (7) days after the building permit is issued. In the absence o such p inspection will not be approved and a reinspection fee will be charged. job site Signatures Contractor The foregoing instrument was acknowledged before me this I Z day of A t . S 20 c3 , by ? who is personally known to me or who has produced as identification and who did take an oath. NOTARY P Sign: Print: My (Certificate of Competency Holder) * * * * * * ** tate Certificate or Registration No. Certificate of Competency No. ******************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Plans Examiner Engineer Zoning ITEM BATH TUB UNIT FEE ITEM SWITCH OUTLETS UNIT FEE ITEM SPACE HEATERS UNIT FEE BIDET LIGHT OUTLETS CENTRAL HEATING DISHWASHER RECEPTACLES A/C (WINO) DISPOSAL SERVICE TEMPORARY A/C (CENTRAL) DRINKING FOUNTAIN SERVICE SIZE IN AMPS DUCT WORK FLOOR DRAIN SERVICE REPAIR/METER CHANGE REFRIGERATION GREASE TRAP APPLIANCE OUTLETS PROCESS AND PRESS PIPING INTERCEPTOR RANGE TCP UNDERGROUND TANKS LAVATORY OVEN ABOVE GROUND TANKS LAUNDRY TRAY WATER HEATER U.F. PRESSURE VESSELS CLOTHES WASHER MOTORS 0- 1 HP STEAM BOILERS SHOWER MOTORS OVER 1- 3 HP HOT WATER BOILERS SINK, POT /3 COMP. MOTORS OVER 3- 5 HP MECHANICAL VENTILATION SINK, RESIDENCE MOTORS OVER 5- 8 HP TRANSPORTING ASSEMBLIES SINK, SLOP MOTORS OVER 8- 10 HP ELEVATORS/ESCALATORS TEMPORARY WATER CLOSET MOTORS OVER 10- 25 HP FIRE SPRINKLER SYSTEMS URINAL MOTORS OVER 25-100 HP COOLING TOWERS WATER CLOSET MOTORS OVER 100 HP VIOLATION INDIRECT WASTES .. A/C WINDOW REINSPECTION WATER SUPPLY TO: AIR CONDITIONERS A/C UNIT STRIP HEATER FIRE SPRINKLER GENERATORS TRANSFORMERS 'HEATER - NEW INST. GENERATORS TRANSFORMERS I HEATER - REPLACE GENERATORS TRANSFORMERS LAWN SPRINKLER -WELL SPECIAL PURPOSE SWIMMING POOL OUTLETS COMMERCIAL WATER SERVICE SIGN TUBES SEWER CONNECTIONS SIGN TRANSFORMERS UTILITY -SEWER SIGN TIME CLOCK UTILITY -WATER FIXTURES SEPTIC TANK ANTENNA RELAY TELEVISION OUTLETS DRAINFIELD, 4' TILE/RES. VIOLATION PUMP & ABANDON SEPTIC TANK REINSPECTION SOAKAGE PIT CU. FT. • .. Si lmYh1N6 Pool, (.14tAJ1C} CATCH BASIN PIooL PVVUI f • DISCHARGE WELL DOMESTIC WELL AREA DRAIN ROOF INLET SOLAR WATER HEATER FIRE STANDPIPE POOL PIPING LAWN SPRINKLER SYSTEM GAS RANGE METER SET (GAS) GAS PIPING ADDENDUM TO BUILDING PERMIT APPLICATION (AN APPLICATION FOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. IF A MASTER PERMIT HAS B. OBTAINED, THE OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.) PLUMBING C MECHANICAL MIAMI SHOES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT Permit No / €2 Date 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 'y�) Owner's Name and Address No 1 r .3 Je . N E Street I. e') STATE OF FLORIDA, 1 COUNTY OF DADE. I �'' Amount of Permit $ ® (Signed) (Signed) to administer oaths and take i Registered Architect and /or En eer �an - Employing Electrician's Name...` S3k� C No .....).2 .o Street C Location and Legal Description Lot Block Subdivision Street and Number where work is to be performed —No Street State work to be performed and purpose of building (By Floors) New Building Remodeling Addition Repairs No. of Stories Service Overhead Amps Size Feeders Conduit Main Sw Amps Main Fuses Am Underground p p Type of Installation — Conduit Tubing B.X.L .Metal Moulding Electrical Inspector. 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 ntractors or sub-contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspec ono the site the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such sub•contracto , nor to b performed under this permit, as are licensed by Miami Shores Village. Master Electrician. Before me, the undersigned authority, a notary public, duly authorized 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. acknowledgments, personally My Commission Expires 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 OUTLETS LIGHT OUTLETS PLUG RECE'P'T'S FIXTURES NO. LAMPS REFRIG. OUTLET IRON OUTLET RANGE OUTLET RANGE CONN. WATER HEATER W. H EAT. CONN. SPACE HEATER STRIP HEATER TOTAL CONTR. LIST /0 ) 0 0 / /N ) /96 CHECK ENT. SW. DIET. CAB. SERVICE TEMP. SERVICE PERM. vJ E f C ` I MOTORS 0.1 HP / MOTORS 1.5 HP / N EON TRANS. RADIO TOTAL q,00 CONTR. LIST A /pD CHECK M 77 PS' I MIAMI SHOES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT Permit No / €2 Date 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 'y�) Owner's Name and Address No 1 r .3 Je . N E Street I. e') STATE OF FLORIDA, 1 COUNTY OF DADE. I �'' Amount of Permit $ ® (Signed) (Signed) to administer oaths and take i Registered Architect and /or En eer �an - Employing Electrician's Name...` S3k� C No .....).2 .o Street C Location and Legal Description Lot Block Subdivision Street and Number where work is to be performed —No Street State work to be performed and purpose of building (By Floors) New Building Remodeling Addition Repairs No. of Stories Service Overhead Amps Size Feeders Conduit Main Sw Amps Main Fuses Am Underground p p Type of Installation — Conduit Tubing B.X.L .Metal Moulding Electrical Inspector. 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 ntractors or sub-contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspec ono the site the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such sub•contracto , nor to b performed under this permit, as are licensed by Miami Shores Village. Master Electrician. Before me, the undersigned authority, a notary public, duly authorized 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. acknowledgments, personally My Commission Expires 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. Permit No Amount of Permit $ -2, STATE OF FLORIDA, 1 COUNTY OF DADE. 11 MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT 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 L/ ... . No /2 ... Street / �s Registered Architect and /or Engineer Employing Electrician's Name.. NO. .. 2 C Street Location and Legal Description Lot Block Subdivision Street and Number where work is to be performed —No Street State work to be performed and purpose of building (By Floors) New Building Remodeling Addition Repairs No. of Stories Service Overhead Size Feeders Conduit Main Sw Amps Main Fuses Amps Underground p P Type of Installation— Conduit Tubing B.X.L Metal Moulding The undersigned applicant for this building permit does hereby certify that he understands and accepts Is ' bligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of o ' a Permanent Supplement, and has complied with the provisions thereof, and will require similar compliance from all contractors or b•oontractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspectio n the sit • work such public notice or notices as are required by the Act. The undersigned agrees to employ only such sub-contractors, on v4Ork donned under this permit, as are licensed by Miami Shores Village. II'I t ss. (Signed) (Signed) Date a Electrical Inspector. M. ter Electrician. 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-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 OUTLETS LIGHT OUTLETS PLUG RECE'P'T'S FIXTURES NO. LAMPS REFRIO. OUTLET IRON OUTLET RANGE OUTLET RANGE CONN. WATER H EATER W. H EAT. CONN. SPACE HEATER STRIP HEATER TOTAL CONTR. LIST CHECK ENT. SW. DIST. CAB. SERVICE TEMP. SERVICE PERM. MOTORS 0.1 HP MOTORS 1.5 HP N EON TRANS. RADIO TOTAL CONTR. LIST CHECK Permit No Amount of Permit $ -2, STATE OF FLORIDA, 1 COUNTY OF DADE. 11 MIAMI SHORES VILLAGE ELECTRICAL INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT 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 L/ ... . No /2 ... Street / �s Registered Architect and /or Engineer Employing Electrician's Name.. NO. .. 2 C Street Location and Legal Description Lot Block Subdivision Street and Number where work is to be performed —No Street State work to be performed and purpose of building (By Floors) New Building Remodeling Addition Repairs No. of Stories Service Overhead Size Feeders Conduit Main Sw Amps Main Fuses Amps Underground p P Type of Installation— Conduit Tubing B.X.L Metal Moulding The undersigned applicant for this building permit does hereby certify that he understands and accepts Is ' bligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of o ' a Permanent Supplement, and has complied with the provisions thereof, and will require similar compliance from all contractors or b•oontractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspectio n the sit • work such public notice or notices as are required by the Act. The undersigned agrees to employ only such sub-contractors, on v4Ork donned under this permit, as are licensed by Miami Shores Village. II'I t ss. (Signed) (Signed) Date a Electrical Inspector. M. ter Electrician. 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-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.