490 NE 101 St (10)MIAMI SH 4 ORES VILLAGE �iy
BUILDING DEPARTMENT
305- 795 -2204
Building Inspection Request
Date C7J
Type Insp'n
Permit No. ELCD - I89
Inspection Date
Approved
Correction
Re- Insp'n Fee
Name Irvr>
Address 490 N1. 101 S r
Company ( Y1Y�e-H- ICC4 -- vs C .
Phone # (186) 2.53 7.55Z.
❑ 2 }" JGrlr.Of
'ifs' - 25y-
33 24 A t b
% MIAMI SHORES VILLAGE Raba
ti
BUILDING DEPARTMENT
305- 795 -2204
Bu`(ii g Inspection Request
Date /'� r
Type Insp'n h( 1Q \ `� 6 ec
Permit No. e1 -eC L O — 1 361
Name I`i/ I l •
Address 400 • Ic{
Company
rbeYJ/ , / 0
Phone #
Inspection Date
Approved
Correction
Re- Insp'n Fee
Electrical Permit
Miami Shores Village
10050 NE 2nd Avenue
Phone: 305 - 795 -2204 Permit Number: EL2005 -189
Printed: 6/13/2005
Applicant: MARK BLOOM
Owner: BLOOM MARK
JOB ADDRESS: 490 NE 101 ST
Contractor BENNETT ELECTRIC SERVICES CO Contractor's Address: 6900 NE 4TH COURT
Local Phone: 305/759 -1665
Parcel # 1132060170430
Permit Status: APPROVED Permit Expiration: 12/6/2005 Construction Value: $1,000.00
Work: INSTALL 3 RECEPTABLES FOR A NEW KITCHEN RENOVATION
Signed: (INSPECTOR)
Legal Description: 6 53 42
Page 1 of 1
PB 15 -14 AMD PL OF MIAMI SHORES SEC 4 LOT 1 BLK 90
JUN 3 0 PAID
Fees: Description Amount
FEE2005 -8077 Building Fee $150.00
FEE2005 -8078 CCF $0.60
FEE2005 -8079 Training and Education Fee $0.20
FEE2005 -8080 Technology Fee $3.75
FEE2005 -8081 Scanning Fee $3.00
Total Fees: $157.55
Total Fees: $157.55
Total Receipts: $0.00
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 APPLICATIO JUN II 9 2015
FBC 2001 _
Permit Type (circle): Building
Owner's Name (Fee Simple Titleholder) fri A e
Owner's Address
ht C i 0 N >;. o l s+
City Kt .Owe • S('+bee- State F1
Tenant/Lessee Name
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
Job Address (where the work is being done) L.(.q 0 isp E ( 0-4
City Miami Shores Villa.e County Miami -Dade
Is Building Historically Designated YES NO
Contractor's Company Name C (¢�, -rr..i � e,e 1 cR. Phone # 3 o r' 7 S'ej 6 �J
Contractor's Address 1, 0 0 t F 4 $q.. L — t
City State V.-1 Zip 3 3 /3 '
Qualifier LA,
State Certificate or Registration No.EC G 000 1 . ---5
Architect /Engineer's Name (if applicable) Phone #
$ Value of Work For this Permit
Total Fee Now Due $ 6 3 • 55.
(Continued on opposite side)
r f ,,0.4.
Permit No.ELZ J$
Master Permit No.
Plumbing Mechanical Roofing
Phone 1/ '7g S8 d `�
Zip "33 tze
Phone /t
Zip
Certificate of Competency No.
Square Footage Of Work:
Type of Work: ❑Addition AA,, ❑V�Alteration 1 New ❑ Repair /Replace ❑ Demolition
Describe Work: fP' ail 3 1`e c.` -Q`� Qa - t FLe,
* * * * * * * * * * * * * * * * * * * * * * * * * * ** F ees * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
Submittal Fee $ Permit Fee $ /.6 ,— CCF $ CO /CC
Notary $ Training /Education Fee $ Technology Fee $ F• 7
Scanning $ Radon $ Zoning Bond $
Code Enforcement $ Structural Plan Review. $
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 o curs s n (7) days after the building permit is issued. In the absence of such posted notice, the
inspection will not be approved .'nsp •ction fee will be charged.
Signature
The foregoing instrument was acknowledged before me this
day of Q, 20 05 by
who is . sonally know to me or who has produced
As identification and who did take an oath.
NOTAR PUB IC:
Sign:
Print:
chc 05/13/03
Owner or Agent
My Commission Expires:
My Com ssio — • _ ----- . °1�
D ek Za itee�lplo
** * * * *** * * * * * * * * ** * * * **A0Mil $* oo * * * **, 1ppph v, t, t*****************************, t * *,t * * * * * * * * * * * * * * * * * * * * * *,t **
=UMW
F Expires: Jan 17, 2009
; ,;` DV I�Ri�
* * * * * * * * * * * * * * * * * * * * * * * *4 *4 * * *1PR4 #'* * * * * **
APPLICATION APPROVED BY:
******* ********** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
.rLi 12 0 `Plans Examiner
Engineer
Zoning
NOTARY PUBL
Sign:
Print:
The foregoing instrument was acknowledged before me this
, day of - To,,, 2 , 20°5 , by d p✓ e i j ► r��
who is personally known to me or who has produced"
entific lion and who did take an oath.
ITEM
BATH TUB
UNIT
FEE
ITEM
SWITCH OUTLETS
UNIT
FEE
ITEM
SPACE HEATERS
UNIT
FEE
BIDET
LIGHT OUTLETS
CENTRAL HEATING I i
DISHWASHER
I
RECEPTACLES
3 I
A/C (WIND)
DISPOSAL
SERVICE TEMPORARY
A/C (CENTRAL)
DRINKING FOUNTAIN
SERVICE SIZE IN AMPS
DUCT WORK
FLOOR DRAIN
SERVICE REPAIR/10ER CHANGE
REFRIGERATION
GREASE TRAP
APPLIANCE OUTLETS
PROCESS AND PRESS PIPING
INTERCEPTOR
RATE TOP
UNDERGROUND TANKS
LAVATORY
OVEN
ABOVE GROUND TANKS
LAUNDRY TRAY
WATER HEATER
U.F. PRESSURE VESSELS
CLOTHES WASHER
MOTORS C- 1 If
STEAM BOILERS
SHOWER
MOTORS OVER 1- 3 FP
HOT WATER BOILERS
SINK, POT /3 COMP.
MOTORS OVER 3- 5 If
MECHANICAL VENTILATION
SINK, RESIDENCE
MOTORS OVER 5- 8 HP
TRANSPORTING ASSEMBLIES
SINK, SLOP
MOTORS OVER 8- 10 If
ELEVATORS/ESCALATORS
TEMPORARY WATER CLOSET
MOTORS OVER 10- 25 If
FIRE SPRINKLER SYSTEMS
URINAL
MOTORS OVER 2E -100 HP
COOLING TOWERS
WATER CLOSET
MOTORS OVER 100 HP
VIOLATION
INDIRECT WASTES-
A/C WINDOW
RE I NSPECT I ON I
I
WATER SUPPLY TO:
I
AIR CONDITIONERS
A/C UNIT
I
I STRIP HEATER
FIRE SPRINKLER
I
I GENERATORS TRANSFORMERS
I I I
I
'HEATER -NEW INST.
I
I GENERATORS TRANSFORMERS
I
I
I I I
HEATER - REPLACE
I
I GENERATORS TRANSFORMERS
I
I
LAWN SPRINKLER -WELL
I
SPECIAL PURPOSE
I
SW I MA I NG POOL
OUTLETS COI1I,ERC I AL
I
I I I
WATER SERVICE
SIGN TUBES
I i
SEWER CONNECTIONS
SIGN TRANSFORMERS
I I
UTILITY -SEWER
I
SIGN TIME CLOCK
I I
r
UTILITY -WATER
I
FIXTURES
I I
I
SEPTIC TANK
ANTENNA
RELAY
I TELEVISION CUTLETS
I I
DRAINFIELD, -' TILE/RES.
VIOLATION
PUMP & ABANDON SEPTIC TANK
REINSPECTION
SOAKAGE PIT CU. FT.
CATCH BASIN
DISCHARGE WELL
DOMESTIC WELL
I
AREA DRAIN
I
I I I
ROOF INLET
SOLAR WATER HEATER
FIRE STANDPIPE
POOL PINK":
LAWN SPRINKLER SYSTEM
GAS RANGE
METE. SET (GAS
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.)
PIPINC
PLUMBING
ELECTRICAL
MECHANICAL
:e
Is/MI SHORES VILLAGE, FLA.
:•-••
JOB le . / 3 f
•
,
ADDRESS ." • '
INSPECTION
TIME READY ? 71 C • I I
REMARKS'
—
Go4L ga-n; 0 E
_
-.
•
A
I —
INSPECTOR
C -
■•■•:,-,
N9 5302
• .
DATE
M I MI SHORES VILLAGE, FLA.
N9 5021
JOB r e .� , �= v i'/ ct•a ,o s
ADDRESS / o A- 112 / -VI' S A
INSPECTION
TIME READY FR. ,sI _ .0.K. -1 2,5
REMARKS.
'SPECTOR DATE p- z X--)
Villa f'e of Miami Shores
JOB � ' 5 : tDaJ C
ADDRESS r 52 6 d �,
INSPECTION i '.::- N'
TIME READY A! " I
REMARKS
`milt
/K P
N? 4804
INSPECTOR DATE
Permit No
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.. Ei...5.7.o r> F
Registered Architect and /or Engineer
Employing Electrician's Name
Location and Legal Description Lot Block
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
55.
& vc: C01eS No 4 7
C.'- No... ".4
Amount of Permit $ / 2 . ac, (Signed) CJ
Addition Repairs No. of Stories
Service Underground Size Feeders Conduit. .' , . .Main Sw / 0 Amps Main Fuses....l 4 6 Amps
Type of Installation— Conduit Tubing `' B.X.L .Metal Moulding
The undersigned applicant for this building permit does hereby certify that he understands and
labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws
has complied with the provisions thereof, and will require similar compliance from all contractors or
work to be performed under this permit; and will post or cause to be posted for inspection on the site
as are required by the Act. The undersigned agrees to employ only such subcontractors, on work to
licensed by Miami Shores Village.
(Signed) .�,(/'r� %�`e
STATE OF FLORIDA, t
COUNTY OF DADE. I
Before me, the undersigned authority, a notary public, duly authorized to administer oaths
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
therein by him stated are true.
Date f 2 — JC-°
Street.. C - I O e/
�. /2- ,�' h '
Street
Subdivision
Electrical Inspector.
cepts his obligations as an employer of
of Florida Permanent Supplement, and
sub-contractors employed by him in the
of the work such public notice or notices
be performed under this permit, as are
and take acknowledgments, personally
did sign the same, and that all facts
Notary Public, State of Florida
Muter Electrician.
My Commission Expires
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
HEATER
W. HEAT.
CONN.
SYACE
WATER
STRIP
HEATER
TOTAL
CO
LIST
/ L
/ 3
/ 7 /,�
/ 3
/
/
'
CHECK
ENT.
SW.
DIST.
CAS.
SERVICE
TEMP.
SERVICE
PERM.
MOTORS
0.1 HP
MOTORS
1.5 HP
NEON
TRANS.
RADIO
TOTAL
CONTR.
LIST
i
1
/
CHECK
Permit No
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.. Ei...5.7.o r> F
Registered Architect and /or Engineer
Employing Electrician's Name
Location and Legal Description Lot Block
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
55.
& vc: C01eS No 4 7
C.'- No... ".4
Amount of Permit $ / 2 . ac, (Signed) CJ
Addition Repairs No. of Stories
Service Underground Size Feeders Conduit. .' , . .Main Sw / 0 Amps Main Fuses....l 4 6 Amps
Type of Installation— Conduit Tubing `' B.X.L .Metal Moulding
The undersigned applicant for this building permit does hereby certify that he understands and
labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws
has complied with the provisions thereof, and will require similar compliance from all contractors or
work to be performed under this permit; and will post or cause to be posted for inspection on the site
as are required by the Act. The undersigned agrees to employ only such subcontractors, on work to
licensed by Miami Shores Village.
(Signed) .�,(/'r� %�`e
STATE OF FLORIDA, t
COUNTY OF DADE. I
Before me, the undersigned authority, a notary public, duly authorized to administer oaths
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
therein by him stated are true.
Date f 2 — JC-°
Street.. C - I O e/
�. /2- ,�' h '
Street
Subdivision
Electrical Inspector.
cepts his obligations as an employer of
of Florida Permanent Supplement, and
sub-contractors employed by him in the
of the work such public notice or notices
be performed under this permit, as are
and take acknowledgments, personally
did sign the same, and that all facts
Notary Public, State of Florida
Muter Electrician.
My Commission Expires
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.
BUILDING
ELECTRICAL
PLUMBING
ROOFING
Owner of
Building
Architect
Contractor
or Builder
Legal
Description
Address of
Building
Lot
MIAMI SHORES VILLAGE, FLORIDA
❑ DATE 7—
n PERMIT N° 5557 Contractor's
❑ License No.� t v—
❑ Work to be performed under this
`CONTRACTOR OR BUILDER
/' :/
u
Subdi-
vision
Value of
Project $
v •
/j I
Amount of
Permit $
This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the applica-
tion herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any
plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked
at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this
permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and
regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes respon-
sibility for work done by his agents, servants or employees.
Signed. `'` 1 _ 4 . ; , % ✓ ' ef . INS,CTOR
In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and 'a gulations
pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In ao
cepting this petassume responsibility for all work done by either, myself, my agent, servant or employee.
BY AUTHORITY •aeoT
BUILDING
ELECTRICAL
PLUMBING
ROOFING
Owner of
Building
Architect
Contractor
or Builder <:' r;
Legal Lot
Description
Address of Building 1 D 7 c
❑ {
O DATF f - 2 "7 195
❑ PERMIT N? _ 4387 Contractors 3
License No. rS
0
❑ Work to be performed under this Permit
r
MIAMI SHORES VILLAGE. FLORIDA L/
CONTRACTOR OR BUILDER
d -
B1
/ 44
Subdi-
vision
Value of
Project $
Amount of
Permit $ it ' ,
This permit is granted to the contractor or builder named above to construc the building or to install the equipment or device described in the application
herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans,
drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any
time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is
granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations
pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specificgtf and-Mat-he assumes responsibility for work
done by his agents, servants or employees.
Signed (. t j % i . tt...,..w -
INSPECTOR
In consideration' of the issuance to me of this permit I agree to perform the work covered hereunder in compliance wit 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 ac-
cepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee.
t
t �
BY AUTHORITY e