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432 NE 100 St (9)Inspection Date: 06/21/2006 Inspector: Perez, JanPierre Owner: STRUSE, CHARLES AND SORAYA Job Address: 432 100 Street NE Project: <NONE> Contractor: DUCTMASTERS USA INC Building Department Comments Monday, June 19, 2006 Miami Shores Village, FL 33138- Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Block: Permit Type: Mechanical - Residential Inspection Type: Final Work Classification: Addition /Alteration Phone Number (305)756 -1030 Parcel Number 1132060170370 Lot: Phone: (954)791 -4111 Page 2 of 2 Passed Inspector Co nts 6,240/0,6 Failed Correction Needed Re- Inspection Fee ($75) No Additional Inspections can be scheduled re- inspection fee is paid . until Inspection Date: 06/21/2006 Inspector: Perez, JanPierre Owner: STRUSE, CHARLES AND SORAYA Job Address: 432 100 Street NE Project: <NONE> Contractor: DUCTMASTERS USA INC Building Department Comments Monday, June 19, 2006 Miami Shores Village, FL 33138- Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Block: Permit Type: Mechanical - Residential Inspection Type: Final Work Classification: Addition /Alteration Phone Number (305)756 -1030 Parcel Number 1132060170370 Lot: Phone: (954)791 -4111 Page 2 of 2 Date 04/21/2006 Permit Receipt Permit Number: MC -4 -06 -967 Invoice Number: MC -4 -06 -24506 Applicant: CHARLES AND SORAYA STRUSE Company Name: Payment Type CheckNum Check 8113 Friday, April 21, 2006 Page 1 of 1 Amount $111.24 Total Payment: $111.24 o • 4I 1° 14 AM BUILDING PERMIT APPLICATION FBC 2004 Permit Type (circle): Building Electrical Owner's Name (Fee Simple Titleholder) / � „.� / 00 JJ Sr. Owner's Address 43 a City M IA • NGttE S State Tenant/Lessee Name ,it/ /A Job Address (where the work is being done) City Miami Shores Village County Miami -Dade / Zip FOLIO / PARCEL # Is Building,Historically Designated YES Contractor's Company N N ame U C.7m14-S �j�`L12S VA. uc X Phone # q s9 ----) 9 j ^ (1 (( t Contractor's Address 34, y y ,i 1a , ! 6 sr / City Fr, Leg tIAE/L i)4 LC State F(. . Zip 333 / Qualifier Name l c ©q r2 / M 1 Hs. R D c Z Phone # State Certificate or Registration No. .0/1<0 5 6 '75 Certificate of Competency No. Architect/Engineer's Name (if applicable) Value of Work For this Permit $ ( Type of Work: EAddition Describe Work: R 01 pV `- Submittal Fee $ *********** * * * * * * * * * * * * * * * * * * * * * * * ** * *� *F es * * * ** **,**** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *. Permit Fee $ 1 (J y CCF $ ( - ® 0 CO /CC Training/Education Fee $ O , . Technology Fee $ 2..;G DPBR $ Zoning $ Notary $ Scanning $3 Bond $ Structural Review. $ Radon $ Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Plumbing 4 Avg, f (). .c7 NO Zip Phone # Square / Linear Footage Of Work: ❑Alteration ❑New IA-Repair/Replace f- 47LJ4CE /9 -C IJ UC'7` cvoKt 1< Code Enforcement $ Double Fee $ Master Permit No. Phone # Phone # al Fee Now Due $ Al* 1 PAID la APR 1 3 2006 B Y: Permit No. N., 406 ^ l� 2313 echanical J Roofing (o3o ca.Liit - 72G- Z$1- 17 33(32 95'/- 75 / -4I 1 I 1 .z4- See Reverse side —> ❑ Demolition 1 . 4 9 GAMc, Bonding Company's Name (if applicable) Bonding Company's Address City State 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. Signature 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 an oath. NOTARY PUBLIC: Sign: Print: My Commission Expires: Zip Signature Contractor The foregoing instrument was acknowledged before me this day of ,20 who is personally known to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: Sign: Print: My Commission Expires: ***************************************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** APPLICATION APPROVED BY: (Revised 02/08/06) Plans Examiner Engineer Zoning PROPERTY OWNER Name ,2,‘/Crit-41Sreetsr License No. CAC 5 05 61 Name AW44 - 55`2el0S E Telephone * 171 I /J // 1 Fax Iry 5 Qi T C5O 1 Qualifier Name .065,_ Ad �� . Addre y h -+ ` E / (.7O SiL. Pt 1ad;4 Shoe -e f it Repair Home Telephones 75'zo / 0 Demolish B ne l (+7 � e.)�1p 7g ( , D / � 7 Fax Foundation Only CONTRACTOR Name ,2,‘/Crit-41Sreetsr License No. CAC 5 05 61 Address CEO ,T ,/N /6 s i0`i FT idit0, Gt 333/ / Telephone * 171 I /J // 1 Fax Iry 5 Qi T C5O 1 Qualifier Name .065,_ Ad �� . TYPE OF MANAGEMENT (✓ ) New Construction Enclosure Alteration Exterior Repair Alteration Interior Demolish Relocation of Structure Shell Only Foundation Only Add'I Attachment Other Add'I Detachment Other Master Permit No. Subsidiary Permit No. Step 1. PERMIT APPLICATION INSTRUCTIONS - The following steps must be taken to obtain a permit from the Miami Shores Village: 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 submit- ted along with this permit application. Step 2. Submit e c thompleted applicatin o 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: I/32 NG mOSTiQ. r ,Li q'/L/ /4 2 FL 33 /3, Address Apt. City State Zip Folio Number Description of Work R PL4 C .C7 %S 7 L 1 //u 47 L .e___ Lot Block Subdivision PB PG Zoning Linear Feet Current Use of Property Square Feet .,... Floors p Proposed Use of Property Value of Work 2- -- -- Bldg Value Tenant Information Tax Assessed /Appraised Value Flood Zone PERMIT TYPE (✓ ) Building Electrical Mechanical Plumbing LPGX Roofmg Fence Other PERMIT CHANGE (✓ ) Chg. Contractor Renewal Revision Extension Supplement Reinspection ARCHITECT Name License No. Address Telephone Fax Base Floor Elev. ENGINEER Name License No. Address Telephone Fax Page 2 IMPORTANT NOTICES 1. DO NOT BEGIN ANY WORK WITHOUT HAVING RECEIVED YOUR VALIDATED PERMIT AND PERMIT CARD. Applying for a permit does not grant the right to begin construction. HOURS OF CONSTRUCTION are limited to: Monday through Friday from 7:30 a.m. to 6:00 p.m., and Saturday from 8:00 a.m. to 5:00 p.m. No inspections will be conducted on weekends or holidays. 2. All construction of demolition areas MUST BE MAINTAINED IN A CLEAN, NEAT AND SANITARY CONDITION free from construction debris. 3. STREETS AND NEIGHBORING PROPERTIES SHALL BE KEPT FREE FROM DIRT AND DEBRIS. 4. SWALES MUST BE PROTECTED FROM BEING DAMAGED BY EQUIPMENT OR VEHICLES, AND MAY NOT BE USED FOR STORAGE. A bond is required for work in or near the street/sidewalk. 5. CONSTRUCTION TRAILERS ARE PROHIBITED ON SINGLE FAMILY RESIDENTIAL CONSTRUCTION SITES. Other construction may have a trailer which requires a separate permit. 6. PORTABLE TOILETS for a construction site require a separate permit. 7. DO NOT DISCHARGE WATER INTO THE RIGHT OF WAY OR STORM DRAINS without approval from the Building, Planning and Zoning Department. 8. EQUIPMENT AND MATERIALS SHALL BE STORED at least 10 feet from the edge of pavement. 9. Department of Health and Rehabilitative Services (HRS) approval is required for applications involving septic tanks. Department of Environmental Resources Management (DERM) and/or Miami -Dade Water and Sewer Department (MDWASD) approval is required for applications involving sewers. AFFIDAVIT - Please read carefully. Application is hereby made to obtain a permit to do work and installation as indicated. I, the OWNER of the property, certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits are required for ELECTRICAL, PLUMBING, POOL, EXTERIOR DOOR, MECHANICAL, WINDOW, FENCE, DRIVEWAY, ROOFING and SIGNS and there may be additional permits required from other governmental agencies. I, the OWNER of the property, have disclosed all information related to any work at the property performed in the prior twelve months to the Building Official. Further, I am fully aware that if the cumulative cost of work to my home or business under this and any other permit equals or exceeds fifty percent (50 %) of the fair market value of the structure, the entire structure must meet the present federal flood criteria for finished floor elevation. I am also fully aware that if the total cost of work to my home or business under this and any other permit exceeds fifty percent (50 %) of the replacement cost of the structure, then the entire structure must conform to the current code requirements of the Building Code. WARNING TO OWNER: Your failure to record a NOTICE OF COMMENCEMENT may result in you paying twice for improvements to your property. If you are spending more than $2,500 or intend to obtain financing, you may wish to consult with your attorney or lender before recording your Notice of Commencement. The Notice of Commencement must be recorded at: 22 N.W. 1st Street, is Floor, (305) 679 -1078. Once recorded, the Notice of Commencement must be POSTED AT THE JOB SITE in accordance : ith Section 713 -35 of Florida Statutes. Choosing ontractor. STATE O;i ORIDA r. 1 Y OF Signa Print Name So ® or subscribed before me this I .7 day of -,a4_, 1!1 3: Ya% KIMBERLY R. BUTLER MY COMMISSION # DD290785 a� EXPIRES: 01, 2008 �orn.`FSR Prod March . �@ UiY Signa SEAL: Personally known of Notary Public - State of Type of Identification Produced: Signa of Notary Public - State of SEAL: Personally known PERMIT APPLICATION Review the brochure at Village Hall on Construction Lien Law and 100 is 1 a Si: of Con... • r / Qualifier - eti A, COUNTY OF MIAMI -DADE Print Name 2 Sworn to and subscribed before me this / day of 7.0 . ui "'_ KIMBERLY R. BUTLER MY COMMISSION # DD290785 EXPIRES: March 01, 2008 0' B, Discount Assoc. CO. 1800.3 "11. Type of Identification Produced: ITEM 3ATH TUB UNIT FEE ITEM SWITCH CUTLETS UNIT FEE ITEM SPACE HEATERS UNIT FEE 3IDET LIGHT CUTLETS CENTRAL HEATING )ISHWASHER RECEPTACLES A/C (WINO) DISPOSAL SERVICE TEMPORARY A/C (CENTRAL) DRINKING FOUNTAIN SERVICE SIZE IN AMPS DUCT WORK / :LOOK DRAIN SERVICE REPAIRA€ETER CHANGE REFRIGERATION (/ GREASE TRAP APPLIANCE CUTLETS PROCESS AND PRESS PIPING INTERCEPTOR RANGE TOP UNDERGROUND TANKS LAVATORY OVEN ABOVE GROUND TANKS LAUNDRY TRAY WATER HEATER U.F. PRESSURE VESSELS CLOTHES WASHER MOTORS D- 1 FP STEAM BOILERS SHOWER MOTORS OVER 1- 3 NP HOT WATER BOILERS SINK, POT /3 COMP. MOTORS OVER 3- 5 FP MECHANICAL VENTILATION SINK, RESIDENCE MOTCRS OVER 5- 8 HP TRANSPORTING ASSEMBLIES SINK, SLOP MOTCRS OVER 8- 10 I-P ELEVATORS/ESCALATORS TEMPORARY WATER CLOSET MOTORS OVER 10- 25 NP FIRE SPRINKLER SYSTEMIS UR I - MOTORS OVER 25-100 NP COOLING TOWERS WATER CLOSET MOTORS OVER 100 FP VIOLATION INDIRECT WASTES 1 A/C WINDOW REIRSPECTJON WATER SUPPLY T0: 1 AIR CONDITIONERS A/C UNIT STRIP HEATER FIRE SPRINKLER . GENERATORS TRANSFORMERS HEATER -NEW INST. GENERATORS' TRANSFORMERS HEATER - REPLACE GENERATORS TRANSFORMERS LAWN SPRINKLER -WELL SPECIAL PURPOSE SWIMAING POOL OUTLETS COM4ERCIAL WATER. SERVICE SIGN TUBES SEWER CONNECTIONS ,'.SIGN TRANSFORMERS UTILITY -SEWER UTILITY SIGN TIME CLOCK -WATER SEPTIC FIXTURES TANK RELAY 'ANTENNA TELEVISION OUTLETS DRAINFIELD, 4' TILE/RES. VIOLATION PUMA & ABANDON SEPTIC TANK SOAKAGE REINFECTION PIT CU. FT. CATCH BASIN DISCHARGE WELL DOMESTIC WELL AREA DRAIN • 1 100F INLET ;OLAR WATER HEATER :IRE STANDPIPE TOOL I 1 PIPING AWN i SPRINKLER SYSTEM' ;AS I RANG_ IETEP, 1 ( I I SET (GAS) AS PI °IM. I i AN APPLICATION FOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. IF A MASTER PERMIT HAS B. OBTAINED, T, OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.) PLUMBING ELECTRICAL MECHANICAL Issue Date: 4/18/2006 Expires: 04/13/2007 Owner's Name: CHARLES AND SORAYA STRUSE Permit Type: Mechanical - Residential Work Classification: Addition /Alteration Job Address: 432 100 Street NE Additional Information Miami Shores Village, FL 33138- Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Fax: (305)756 -8972 Comments: REMOVE AND REPLACE NC DUCT WORK WITH SAME Permit Contractor(s) Phone DUCTMASTERS USA INC (954)791 -4111 Primary Contractor Yes Tons: Classification: Residential Additional Info: 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. Parcel #: Block: Section: Permit Status: APPROVED Permit Number: MC -4 -06 -967 Phone: (305)756 -1030 1132060170370 Lot: PB: Total Square Feet: 2900 Total Valuation: $ 2,950.00 Required Inspections Rough Rough Duct Ventilation Smoke Test Hood Smoke Det Test Final Fees Due CCF Education Surcharge Permit Fee - Additions /Alterations Scanning Fee Technology Fee Total: Amount $1.80 $0.60 $103.25 $3.00 $2.59 $111.24 Invoice Number Amt Due MC - 4 - 06 - 24506 $111.24 Total: CK Amt Paid Building Department File Copy Applicant Signature NOTICE: In addition to the requirements of this permit, there may be additional restrictions applicable to this property that may be found in the public records of this county. AND THERE MAY BE ADDITIONAL PERMITS REQUIRED FROM OTHER GOVERNMENTAL ENTITIES SUCH AS WATER MANAGEMENT DISTRICTS, STATE AGENCIES, OR FEDERAL AGENCIES. Customer: Strouse, Soraya 432 NE 100 Street Miami Shores, FL 33138 786 2 -799 Existing 5 ton Air Handler Kitchen Ong m Attic duct system replacement Room APR 1 32006 ID Living Room Bathroom #3 4 DUCTMASTERS, INC. CACO56953 Roger M. Herde' 3644 NW 16 Street Fort Lauderdale, FL 33166 (954) 791 -4111, (800) 506 -2551 Bedroom #2 Bathroom #2 Office b O Master Bathroom Master Bedroom • • • •• • •••• • • •••• •••• • • • • ;4 J •� • • • • • • • • • siz 't'ffn _ 1 Bedroom'�t4•" 6� '�10 2 Kitchen . ••.• • ±•t 3 Dining Rggrr „ 6i. 11Q 4 Fla Room. b'. i4 5 Fla Roon 6 1.10 6 Living Roen 1 Ql• �L5 7 Bathroom #3. 4i e 0 8 Bedroom 13'�• s „h7 9 Bedroom #2 8 170 1 Bathroom #2 41 50 Office 81 170 12 Master bathroom 6; 110 13 Master bedroom 8f 170 14 Master bedroom 8 170 Total ( 2000 Customer: Strouse, Soraya 432 NE 100 Street Miami Shores, FL 33138 786 2 -799 Existing 5 ton Air Handler Kitchen Ong m Attic duct system replacement Room APR 1 32006 ID Living Room Bathroom #3 4 DUCTMASTERS, INC. CACO56953 Roger M. Herde' 3644 NW 16 Street Fort Lauderdale, FL 33166 (954) 791 -4111, (800) 506 -2551 Bedroom #2 Bathroom #2 Office b O Master Bathroom Master Bedroom • • • •• • •••• • • •••• •••• • • • • ;4 J •� • • • • • • • • • 00 00 'I�pe Insp'n 4.3473 MIAIVII SHORES VILLAGE BUILDING DEPARTMENT - 305- 795 -2204 Building Inspection Request Date 4 2 ! 5 Permit No. ,IC. Z (x) -//4 Name l a Id 3 t. • Address 43Z WE /OAST Company 1i f f / S {0. • 4 y 1,h C.,- Phone# 1?t . .' 34 ?lea se ra 05 ,,.- ...i* • Inspection Date Approved Correction Re- Insp'n Fee Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Permit Number: MC2005 -114 Printed: 8/12/2005 Applicant: DONALD SHOCKEY Owner: SHOCKEY DONALD JOB ADDRESS: 432 NE 100 ST Contractor ALFRESCO AIR INC Local Phone: Parcel # 1132060170370 Mechanical Permit Contractor's Address: 1442 NW 2 STREET Legal Description: AMD PL OF MIAMI SHORES SEC 4 Permit Status: APPROVED Permit Expiration: 2/5 /2006 Construction Value: $4,250.00 Work: REPLACE CENTRAL AIR CONDITIONING UNIT Page 1 of 1 PB 15 -14 LOT 7 & 8 BLK 89 Fees: Description Amount FEE2005 -11108 Building Fee $148.75 FEE2005 -11109 CCF $3.00 FEE2005 -11110 Training and Education Fee $1.00 FEE2005 -11111 Technology Fee $3.80 FEE2005 -11112 Scanning Fee $3.00 Total Fees: $159.55 Total Fees: $159.55 Total Receipts: $0.00 AUG 2 3 PAID d= Z I i Signed: (INSPECTOR) 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: BUILDING PERMIT APPLICATION FBC 2001 O e s Address City, i O r iS1,O(P5 State L Tenant/Lessee Name Job Address (where the work is being done) City Miami Shores Village County Miami -Dade Is Building Historically Designated YES NO Qualifier Contractor's Company Name �C�.e6s C� ,4 /, - Contractor's Address /y9Z ,t/6.1 ,t/6.1 2 �T City /f /PIZ State /47 S a Submittal Fee $_ Notary $ �---- Scanning $ 3 • 00 Code Enforcement $ (Continued on opposite side) Radon $ Total Fee Now Due $ C( ' Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Permit No. kC Z00 5 114 3'� N&loo+k S}. Structural Plan Review. $ Master Permit No. Permit Type (circle): Building Electric Plumbing Owner's Name (Fee Simple Titleholder) � 0 S1' \Pd( y Phone # Ow r' 3 ,1, 1 v-e aJ Y -ert Zip 3.3 13 y Phone # Zip RED E8 'E® AUG p �9 1 314 5 3313 Zip 33 /ZS • Roofing Phone # — s: �— 3F2 State Certificate or Registration No. CACjef/,.i Certificate of Competency No. Architect/Engineer's Name (if applica Phone # $ Value of Work For this Permit Type of Word Ic--- tion ❑Alteration ['New Describe Work: e, /�1 CL C .eo G L1 /.€ Square Footage Of Work: ZSO a'` • .Repair/Replace ❑ Demolition * * * * * * * * * * * * * * * * * * * * * * * * * * ** F ees * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Permit Fee $ 1 `'1/� (, �� CCF $ 3 . 00 CO /CC Training /Education Fee $ - DO Technology Fee $ 3 • BO Zoning Bond $ O di • (i4 Bonding Company's Name (if applicable) Bonding Company's' Address City 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. l 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 r ns.` ction fee will be charged. Signature Owner or Agent The foregoing instrument was acknowledged before thisAc/.5 day of % , 200,�by 7);1,01 , who is personally known to m- or who has produced A, SZOO /9.S5t /JSOA ' deitification and who did take an oath. NOTARY PUBL Sign: Print: My Com ' ission Expires: Abraham Amador Commission D0163562 * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * APPLICATION APPROVED BY: chc 05/13/03 State Zip Signature Contrac#or The foregoing instrum t was acknowledged before me this day of ,t/6e/.3 / 20a-S by ,e6c)- 7, -✓ ,q'!/i, S, who is persona y known to me or who has produced as identifica on and who did take an oath. NOTARY PUBLIC: Sign: Print: My Com 'ssion Expires: Abraham Amador Commission D018358Z 23, 2008 * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * Plans Examiner Engineer Zoning * ITEM BATH 1l8 UNIT FEE ITEM SWITCH OUTLETS UNIT FEE ITEM SPACE HEATERS UNIT FEE BIDET LIGHT OUTLETS CENTRAL HEATING DISHWASHER RECEPTACLES A/C (WIND) DISPOSAL SERVICE TEMPORARY A/C (CENTRAL) S TON S . 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 TOP 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 FP 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 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 FIXTLRES SEPTIC TANK - ANTENNA RELAY TELEVISION OUTLETS DRAINFIELO, 4 TILE/RES. VIOLATION PUMP & ABANDON SEPTIC TANK REINSPECTION SOAKAGE PIT CU. FT. CATCH BASIN _ DISCHARGE WELL DOMESTIC WELL AREA DRAIN ROOF INLET SOLAR WATER HEATER FIRE STANDPIPE POOL PIPING LAWN SPRINKLER SYSTEM 1 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. 0BTAINED, THE OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.) PLUMBING ELECTRICAL MECHANICAL 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. Owner's Name and Address._. Registered Architect and /or Engineer. `C LL Name and address of licensed contractor_St5e 'O@ .C__ C f '/Y.05%_ ie_ 7 Location and legal description of lot to be built on: Lot_. Block Disapproved _ (Signed) Chairman - _____. . . . Member Member Council Approved MIAMI SHORES VILLAGE Street and Number where work is to be done :.? -e - _ State work to be done and purpose of building (by floors )__s -. Date Subdivision Building Inspector J My Commission Expires_ PLANN/ G BOARD__ __ . DATE Member Member Member . _._.... _Date Disapproved .:_..._. 6 n, La-to Date . , 19 e- No._ 2-. .... ___ Street /4EL/ t O _... cr, 440 d and for no other purpose. New Building Remodeling Addition Repairs No. of Stories To be constructed of Kind of foundation__.. Covering__ Estimated Total cost of improvements $__ .a/.® ®v . 0 d Amount of Permit $ ` 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 foi said building. All notices with reference to the building and its construction may be sent to___._ The undersigned applicant for this building permit dot 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 upder 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 stat d are true. �$ . =-6 Permit No / 1 Date .2 Read, Sworn to and Subscribed before me. Notary Public, State of Florida 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 workmanship.