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EL-06-211Issue Date: 1/27/2006 Expires: 01/26/2007 Owner's Name: ST ROSE OF LIMA CATHOLIC CHURCH Permit Type: Electrical - Commercial Work Classification: Addition /Alteration Job Address: 415 105 Street NE Miami Shores Village, FL Contractor(s) MOODY ELECTRIC INC Phone (305)758 -2000 Primary Contractor Yes Comments: ELECTRIC FOR CARNIVAL BOOTHS Additional Information Type of Work: BOOTHS Additional Info: Classification: Commercial 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. Fees Due CCF Education Surcharge Miscellaneous Fee Permit Fee - Additions /Alterations Scanning Fee Technology Fee Total: Amount $0.60 $0.20 $1,000.00 $100.00 $3.00 $27.50 $1,131.30 Building Department File Copy Applicant Signature Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Fax: (305)756 -8972 Permit Parcel #: Block: Section: Permit Status: APPROVED Permit Number: ELC-1 -06-211 Phone: (305)758 -0539 1122310430010 Lot: PB: Total Square Feet: 0 Total Valuation: $ 1,000.00 Required Inspections Alteration Underground Rough WW Service Change Meter Box Fire Alarm Relocation Final Invoice Number ELC - 1 - 06 - 23628 Total: 'JAN 2 7 PAID CIL-# 19(72. Amt Due $1,131.30 Amt Paid 41 131.3C) 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. BUILDING PERMIT APPLICATION FBC 2001 Permit Type (circle): Building Tenant/Lessee Name Job Address (where the work is being done) Miami Shores Village Building Department 10050 N.E.2nd Avenue s, Florida 33138 Te 756.8972 Owner's Name (Fee Simple Titleholder) 4 -fLegi c . zctfA,. Phone # Owner's Address e ( 1 / 4 (® k G rZ City \N►.1 - State -lc� i erc.1c1/4. City Miami Shores Villa • e County Miami -Dade Is Building Historically Designated YES NO Nzok, acickc- kr Contractor's Address Contractor's Company Name City Zc- Qualifier �� $ Value of Work For this Permit Submittal Fee $ Notary $ Scanning $ 3 - OCJ Code Enforcement $ \Nr°• Architect/Engineer's Name (if applicable) * * * * * * * * * * * * * * * * * * * * * * ** Total Fee Now Due $ 1 1 .3 1 • (Continued on opposite side) State Structural Plan.Review. $ Permit No. £L Z 1 I aster Permit No. Plumbing Mechanical Zip ' Phone # r--US i' E !OS Ez - Zip Phone # — — 1ST — Zip \ SCE Phone # 33‘2S Roofing State Certificate or Registration No.�C C ('h (\ q Certificate of Competency No. Square Footage Of Work: Type of Work: DAddition DAlteration ❑New ❑ Repair/Replace Describe Work: atzefi.c . CC-4 \c> ®S ❑ Demolition ** F ees * * * * * * * * * * * * * * * * * * * * * * * * * *, * ** Permit Fee $ /l161 e CCF $ 7Q CO /CC Training/Education Fee $ © . 2 -0 Technology Fee $ 2 - 7 - S O Radon $ Zoning Bond $ Bonding Company's Name (if applicable) Bonding Company's Address City Mortgage Lender's Name (if applicable) chc 05/13/03 State NOTAR PUB . C: Sign ***************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** APPLICATION APPROVED BY Mortgage Lender's Address Y\ I � ll DA Serg .. F LSS City State ' v 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 $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued In the absence of such posted notice, the inspection will not be a_' a reinspection fee will be charged Owner or Age The foregoin instrument was ackn • wledged before me this c�C day of c2 e 1 20 d , by Seam 1,15 .VO y I e- , who is personally known to me or who has produced As identification and who did take an oath. NOTARY PUBLIC: IR r Print: De I NI, ar r( ��e� My Commission Expires 0 Dell Marie Springer Ai . :,t_ MY COMMISSION# DD129398 EXPIRES • " ............ BONDED THRU TROY FAIN INSURANCE, INC Sign: Print My Co Special Palrol Bureau Special Events Unit POLL • A BERGERT ,A, • i ISSION # DD 441715 t�,� Bonded Tim Notary P Undermost DFariss@mdpd.com Phone (305) 468 -1204 Pager (305) 583 -6807 Fax (305) 468 -1211 3v• 9$e 3Zv21 ENT Plans Examiner Engineer Zoning 1519 NW 79 Avenue Miami, FL 33126 Contractor The foregoing instrument was acknowledged before me this day of , e 4 , 200S , by c‘ who is per personallyown to me or who has produced as identification and who did take an oath. *************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** AN AI:PLI - 'ION 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.) ADDENDUM I U IJUi LUIN.i ranmi 1 , ? r r L vr'' PLUMBING ELECTRICAL MECHANICAL UNIT FEE ITE1 SPACE HEATERS UNIT FEE TE61 ATH T 3 UNIT FEE ITEM SWITCH OUTLETS IDET LIGHT CUTLETS -_ CENTRAL HEATING I SHAVER RECEPTACLES -_ A/C mWIND) IISPOSAL SERVICE TEMPORARY _ A/C (CENTRAL) SERVICE SIZE 1N AM'S DUCT WORK IRINKIIC FOUNTAIN -_ SERVICE REPAIR/METER CHANGE REFRIGERATION LDOt DRAIN TRAP __ APPLIAICE OUTLETS PROCESS AND PRESS P1PI% ;EASE TANKS !NTERCEPTDR RANGE TCF UNDERGROUND OVEN ABOVE GROUND TANKS _AVATDRY TRAY WATER HEATER _ U.F. PRESSURE VESSELS _AUNDRY WASHER -_ MOTORS 0- 1 FP STEAM BOILERS :LOTHES ;HONER MiOTCRS OVER 1- 3 1-P HOT WATER BOILERS SINK, POT /3 COME. MJTDRS OVER 3- 5 HP MECHANICAL VENTILATION 31NK, RESIDENCE 1 MOTORS OVER 5- B hP TRANSPORTING ASSEMBLIES , INK, SLOP MOTORS OVER 8- 10 1•P ELEVATORS/ESCALATORS TEMPORARY WATER CLOSET __ MOTORS OVER 10- 25 HP F IRE SPRINKLER SYSTE} URINAL MOTORS OVER 25-100 1P COOLING TOWERS WATER CLOSET MOTORS OVER 100 If -_ VIOLATION I1 .0 IRECT WASTES { A/C WINDOW { REINSP,ECTJON WATER SUPPLY TO: { AIR CONDITIONERS A/C UNIT STRIP HEATER I F IRE SPRINKLER { GENERATORS TRANSFORMERS _ I HEATER -NEW I UST . GENERATORS . TRANSFORMERS -_ I HEATER - REPLACE __ GENERATORS TRANSFORMERS LAWN SPRINKLER -WELL SPECIAL PURPOSE I SWIINING POOL __ OUTLETS COM+ERCIAL WATER SERVICE SIGN 7116ES SEWER CONNECTIONS `SIGN TRANSFORMERS UTILITY -SEWER SIGN TIM€ CLOCK UT IL ITY -WATER F IXTI,RES SEPTIC TANK I ANTENNA RELAY I TELEVISION OUTLETS I ORAINFIELD, 4 TILE/RES. VIDLATION �= _ _ PUMP 8 ABANDON SEPTIC TANK RE INSPECT ION SOAKAGE P IT CU. - F7. CATCH BASIN l/>y - I ,.�.,Ir DISCHARGE WELL - �0 DOM'EST IC WELL AREA DRAIN I 1 ROOF INLET SOLAR WATER HEATER FIRE STANDPIPE POOL PIPING I I LAWN SPRINKLER SYSTEM GAS RANGE METER SET (GAS) 1 l 1 1 1 I I AN AI:PLI - 'ION 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.) ADDENDUM I U IJUi LUIN.i ranmi 1 , ? r r L vr'' PLUMBING ELECTRICAL MECHANICAL