565 NE 101 St (9)MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204 ��
Builr�in: Inspection Requ-st -
•
Date
Type Insp'n
Permit No.
Name
Address J5 to 5 ( G 1
Company Eiec
Phone #
Inspection Date
r
q
Approved Z/
Correction ❑ / •�‘ a'9
Re- Insp'n Fee ❑
IAMI SHORES VILLAGE
J UILDING DEPARTMF
l 305- 795 -2204
Building Inspection Reque
Date //
2/ 10(
Type [nsp' n .�it.e(./ /S6a4-
C ? - Z4'
Permit No.
Name
Address -
Company
Phone #
Inspection Date
Approved
Correction
Re- Insp'n Fee
/
S a 4A Lit
7E 6 - 5 s ' -y72f
/ - z�oy
Air/ l7' �G io/I f�C / 69 / !"
C e —
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RECEPVED
JAN A R 2004
BUILDING
PERMIT APPLICATION
FBC 2001
Owner's Name (Fee Simple Titleholder)
Owner's Address :5(05 s
$ Value of Work For this Permit
Number of: Bays Stories Families
['Addition
Eta).
Miami Shores Village
Building Department
Permit Type (circle): Buildin Plumbing Mechanical Roofing
v l ° Let Phone #
❑Alteration
:New
o O Ck-cu
Permit No. e I OCC `i
Master Permit No. fop o"-d
Zip 33
City ✓lA l j - Z State
Tenant/Lessee Name
7 D0 � / v-� Cil� Phone #
(3 '
gok-
Job Address (where the work is being done) 6 < A-I/E: 1 0 ( 5 r ,
City Miami Shores Village County Miami -Dade Zip 3. 3 ! I
Is Building Historically Designated YES NO t /
Contractor's Company Name .S09 W So It' � G-e ,tcce_ 1�l�.S Phone # 3 o S - 1-04 3 V 6 V
Contractor's Address 3?9S 4 - 4 - 4 -- Cf SJ` c @f ge S'1
City / �4fvr (i State Fl• Zip ....v/34
Qualifier Cb Mttoy iS® -4 e4 i4 FL, t��
Architect/Engineer's Name (if applicable) . Phone #
Architect/Engineer's Address
City State Zip
Square Footage Of Work:
Bedrooms
❑ Repair/Replace
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
Baths
❑ Demolition
Si-
Type of Work:
Describe Work:
* * * * * * * * * * * * * * * * * * * * * * * * * * ** F ees * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
County Escrow Fee $ JJ Permit Fee $ ZJ- A k o A k Notar $
Education/Training Fee $ ` b o Tech $ I 1 , ! J Scanning $
Code Enforcement $ 100 —' Bond $ Struct. $
Radon $
Minus Plans Check Fee $ SCE . Total Fee Now Due $ S 0 (.. oa 3 (Continued on opposite side)
Bonding Company's Name (if applicable) �� ' S t7 G7(ge7c / r '
Bonding Company's Address
City M S Y r( t
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 indicate . 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 E ECTRICAL 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 $2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
Signature
Owner Kr Aent)
The foregoing instrument was acknowledged before me this
day of ` 754^- , 20 O4-, by U6 U(
who is personally known to me or who has produced
As identification and who did take an oath.
NOTARY UBLIC:
Sign: _ =w
Print:
Chc7/7 /03
*************•** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
APPLICATION APPROVED BY:
My Commt sibn Expires:
3x$ SzC—
State el OP
Signature
Contractor
The foregoing instrument was acknowledged before me this
day of v'- , 20 03, by C f /' - c,
who is personally known to me or who has produced
* * * * * * * ** **************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
(Certificate of Competency Holder)
State Certificate or Registration No. f
Zip 371)
as identification and who did take an oath.
NOTARY PUBLIC: ,,,l• ,
Sign: N
Print:
My Co
* * * * * * * * * * * * * * * * * * * * * * * * **
Certificate of Competency No. 94 Eq
** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
L ✓,"y Plans Examiner
Engineer
Zoning
IEMI
4TH TUB
UNIT
FEE
ITEM
SWITCH OUTLETS
UNIT
/-
FEE
ITEM
SPACE HEATERS
UNIT
FEE
IOET
LIGHT OUTLETS
NO
CENTRAL HEATING
ISHWASHER
RECEPTACLES
A/C (WIND)
ISPOSAL
SERVICE TEMI?ORARY
A/C (CENTRAL)
;INKING FOUNTAIN
SERVICE SIZE IN AWS
I w s
DUCT WORK
LOOR DRAIN
SERVICE REPAIR/IkTER CHA}E
REFRIGERATION
REASE TRAP
APPLIANCE CUTLETS
PROCESS AND PRESS PIPING
NTERCEPTOR
RANGE TOP •
(
UNDERGROUND TANKS
AVATORY
OVEN
f
ABOVE GROUND TANKS
AUNDRY TRAY
WATER HEATER
I
U.F. PRESSURE VESSELS
LOTHES WASHER
MOTORS 0- :`1::FP
STEAM BOILERS
.HOWER
MOTORS OVER 1- 3 FP
HOT WATER BOILERS
:INK, POT /3 COMP.
MOTORS OVER 3 5, ND '.
MECHANICAL VENTILATION
:INK, RESIDENCE
MOTORS OVER 5- :8 FtA ;,: -'
'
TRANSPORTING ASSEMBLIES
.INK, SLOP
MOTORS OVER 8 - 10 H y':
ELEVATORS/ESCALATORS
'EMFORARY WATER CLOSET
MOTORS OVER 10- 25 hP
FIRE SPRINKLER SYSTEMS.
JRINAL
MOTORS OVER 25-100 FP
COOLING TOWERS
;ATER CLOSET
MOTORS OVER 100 ID
VIOLATION
'IDIRECT
A/C WINDOW
RE INSPECTION
IATER 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 CO14, RCIAL
WATER SERVICE
SIGN TUBES
;EWER CONNECTIONS
SIGN TRANSFORMERS
JTILITY -SEWER
SIGN TIME CLOCK
JT I L I TY -WATER
FIXTURES
;EPTIC TANK
ANTENNA
ILAY
TELEVISION OUTLETS
)RAINFIELO, 4" TILE/RES.
VIOLATION
'UMP & ABANDON SEPTIC TANK
RE INSPECTION
IMAGE PIT CU. FT.
CL-
a'
;ATCH BASIN
)ISCHARGE WELL
)OMESTIC WELL
AREA DRAIN
100F INLET
SOLAR WATER HEATER `,
=IRE STANDPIPE
'OOL PIPING
_AWN SPRINKLER SYSTEM
3AS RANGE
DETER SET (GAS)
3AS 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
ELECTRICAL
MECHANICAL
1
DRIP LOOP
ire BE 30'
AFG CHIN)
( 200A
METER
2' ABOVE ROOF
• •
•
• FII ITSI IF D GRATIS
i
r
r" 10 lttEK1
auaaia
}
e' Pt/41C eu�*uiu r t
�•• -.
•
• PVC
MAIN CT3
PANEL
WO' /UN UEl' TI 1
vacs •4 wo-13
anti z U
c;Uix»4n
nun v+un
S
SUB C
. PANEL
SUB FEEDER
Neu __,,__ •
Type • .g7T.
PER S.F.D.C,
k1 LK UI■ '
'I- Ic�pl� L .-..J.SIT` _ ti-
Conclhactor sue
• Condul•t stzc - • ,�.
MAIN. DIS YONNECT
Rattnp
Hata
Sub Breakers
INS EDE PANEL
4505,2.(R)
Conduit . iy p�'
Thru roof YES
G round wtrc c
Size . .
Bond :s1ze • -
Rntuip ' . 2 -A. ,��s
Bond Buss .„_ i' e s _1•ln
. L occ-tio n
•
3.o ArIpS
-2-0 d _ An (p s
_„_, Amps
•
I
Miami Shores Village
10050 NE 2nd Avenue
Phone: 305 - 795 -2204 Permit Number: EL2004 -4
Printed: 1 /8/2004
Applicant: VIOLET CAUZA
Owner: CAUZA VIOLET
JOB ADDRESS: 565 NE 101 ST
Contractor SANSON ELECTRICAL PLUS INC Contractor's Address: 3995 SW 4 ST
Local Phone: 305 -443 -8808
Parcel # 1132060171140
Fees: Description Amount
FEE2004 -183 Training and Education Fee $0.60
FEE2004 -184 Technology Fee $11.13
FEE2004 -185 Code Enforcement Fine $100.00
FEE2004 -196 Building Fee $222.75
FEE2004 -197 Building Fee $222.75
Total Fees: $557.23
Total Fees: $7.
Total Receipts: $0.0
jp,
Permit Status: APPROVED Permit Expiration: 7/4/2004 Construction Value: $2,500.00
Work: INCREASE SERVICE100 AMP.
Signed: (INSPECTOR)
Electrical Permit
Page 1 of 1
Legal Description: MIAMI SHORES SEC 4 AMD PB 15 -14 LOT 21 & 22 BLK 94 LOT SIZE 100.000
JAN 0 9 E
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:
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
Date ,, ^ 7 .0
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.
Permit No I 1 4 3
Owner's Name and Address c '/ v; A No.... j. 4 5 Street./"/"/ S I
Registered Architect and /or Engineer
Employing Electrician's Name 4 v . C /3 I 44 .—: No. .i T U Street 'h ../ d,�...� . 1 .
Location and Legal Description Lot ^^ Block Subdivision
Street and Number where work is to be performed—No \7. - 6 LS Street �' /a7 I 1
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
Type of Installation — Conduit Tubing B.X.L Metal Moulding
Q
Amount of Permit $ � �
STATE OF FLORIDA, }
COUNTY OF DADE.
ss.
MIAMI SHORES VILLAGE
(Signed)
ectrical In ector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obi' ' ions as an employer of
labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida )/rmanent Supplement, and
has complied with the provisions thereof, and will require similar compliance from all contractors or sub- contr.. -ors 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 sub-contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village.
aster 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
HEATER
W. HEAT.
CONN.
SPACE
HEATER
STRIP
HEATER•
TOTAL
CONTR.
LIST
/
CHECK
ENT.
SW.
DIST.
CAB.
SERVICE
TEMP.
SERVICE
PERM.
MOTORS
O -I HP
MOTORS
I•5 HP
NEON
TRANS.
RADIO
TOTAL
CONTR.
LIST
CHECK
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
Date ,, ^ 7 .0
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.
Permit No I 1 4 3
Owner's Name and Address c '/ v; A No.... j. 4 5 Street./"/"/ S I
Registered Architect and /or Engineer
Employing Electrician's Name 4 v . C /3 I 44 .—: No. .i T U Street 'h ../ d,�...� . 1 .
Location and Legal Description Lot ^^ Block Subdivision
Street and Number where work is to be performed—No \7. - 6 LS Street �' /a7 I 1
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
Type of Installation — Conduit Tubing B.X.L Metal Moulding
Q
Amount of Permit $ � �
STATE OF FLORIDA, }
COUNTY OF DADE.
ss.
MIAMI SHORES VILLAGE
(Signed)
ectrical In ector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obi' ' ions as an employer of
labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida )/rmanent Supplement, and
has complied with the provisions thereof, and will require similar compliance from all contractors or sub- contr.. -ors 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 sub-contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village.
aster 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.
NO.
r oc.!
Mettars
STREET
C•E °S ^`
ators
PART OF LOT
LOT
BL'K
Other Apparatus
SUBDIVISION a
/r p
Er
. ..:°^
/t✓'
/
'
G , /," +K
r•
moo'
.,
'
"` c g
}
Outlets
r oc.!
Mettars
Receptacles
C•E °S ^`
ators
Stoves
Water Heaters
Signs
Billboards
Other Apparatus
Permit -
-<
/r p
;
J
/
p.
ELECTRICAL PERMIT
N. B. —This Permit must be on display on the premises during
the construction.
Owner of Building
Clikactor or Electrician_
th�Department.
Dated
,19
7liami fhores9 llage
F 1. O A I D A
OFFICE OF ELECTRICAL DEPARTMENT
19
Miami Shores Village, Fla ,
LO CATION
r,.
DESCRIPTION OF WORK
NUMBER OF
N° 752
This Permit is granted upon the express condition that all facts stated in the Application are true d that the construction complies strictly with
the plans and specifications submitted and are in accordance with the Electrical Laws of the State of Florida and with the Electrical Ordinances and Code
of Miami Shores Village and the rules and'regulations of the Electrical Department of Miami Shores Village. , This Permit may be revoked at any time
upon the violation of any provisions of said laws, ordinances, or rules and regulations, or upon an� chge in floe plans and specifications unauthorized by
, Electrical Inspector.
In consideration of the issuance to me of the foregoing Electrical Permit, I hereby agree to do the proposed construction in strict conformity with
the Application and t - plans and specifications thereof heretofore by me submitted, and in compliance with all provisions of all Electrical Laws of the
State of Florida, all - Electrical Ordinances and Codes of Miami Shores Village, and all rules and regulations of the Electrical Department of Miami
Shores Village.
(Seal)
by
Size of Service
Range �.�.. ~t..
Power: Connected load
Other Apparatus �[
MIAMI SHORES VILLAGE PERMIT
Office of Electrical Inspector r .
N o. / _ 0 �,
CERTIFICATE OF INSPECTION
r.s
THIS CERTIFIES THAT the wiring and apparatus installed at t ? t:- ': j-
j ' : + -A',. °
f . -v., f ,,► y wlr .r
for , /1 ' ''� t. ` - •• e- owner, and occupied as
Address
watts. Water Heater
Number of Lighting Circuits
,r-
° 1,„o
has been inspected and current is authorized to be turned on, until otherwise notified, for:
hi
H. P. Space Heaters /TO
ELECTRICAL INSPECTOR.
watts
watts
OUTLETS
e, ...‘,
RECEPTACLES
Lam.....•..`
01011.1111013
STOVES
WATER H'TERS
SIGNS
BILLBOARDS
OTHER APPARATUS
MAIN
' SUB
BRANCH
Basement
First
°% /
It I
FLOOR.
NUMBER OF
SIZES OF
INSULATION
I
OPEN OR
O
CONCEAL•D
NUMBER OF
CIRCUITS
OUTLETS
MOTOR
GEN.
MAIN
' SUB
BRANCH
Basement
First
°% /
It I
Second
Third
Fourth
7
Oth
Floors
•
IIIVirir
Owner
Electrical Contractor
Building Contractor
tame jhorerialage
F L O A I D A
APPLICATION FOR ELECTRICAL PERMIT
Application is hereby made for issuance of permit for electrical installation as described below, and for
inspection of same after installation:
Address
f{
Location of proposed work: Lot I , Block � " Subdivision ms 's r '
f
Description of proposed work !' ` - A r
CJ
Building: Old or new Number of stories
Details of proposed work:
Number of Mot2rs l , H R ._ i Volts
Date 193
<< <
4 ,c Z`,
Used as
Amps Phase
Additional Information
Signature of Applicant V 2 ) / tt
g pp � ' } � 1
Address (if other than owner or contractor) / s-�t� I I - / t- -' - � ► j � f
(SPACE BELOW FOR INSPECTOR'S U8 NL t ' . l u )Y { 17 "
Work begun Inspected _
fi'
Work finished Final inspection 2(
�' °�' � r�ii � � /
.,,,;,ti lofty
_ ;14 X01
etk
.,
75'