210 NE 102 St (3)MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
Building Inspection Request
4 .:2 � Date , Time
Type Insp'n "h
Permit No. \ J? — 33 9
Name i-� r neon
Address 2 to IJE. ,
Company
Phone #
For Inspector: 3 j.Narn8cDate
Approved
Correction
Re- Insp'n Fee
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
Building Inspection Request
Date Time
Type Insp'n �� LC i 6'
Permit No. L ' c71 333
x • Name c ) N ( , 5
Address (9 / 0 1 ry ` C
V
Company O-t' --, Q
Name &Date
Correction
Phone
For Inspector:
Approved
Re- Insp'n Fee ❑
f 1 b
Date Time
Type Insp'n
Permit No.
Name
Company
Phone #
For ` Inspec r:
/ ygns Approvel
Correction
Re-Insp'n Fee
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
Building Inspection Request
' "i- fr 4 /;b Leh• P4- �—
./ 9L 5 i® 79e
77a fi2aee
35 '/ e
P112 _
ELECTRICAL
TYPE;
Minimum Fee
QTY.
TYPE
Dryer
QTY.
TYPE
Outlet, Appliance
QTY.
TYPE
Service Repair
QTY.
1
A/C Central 1 -3 Ton
Dryer Vents, Number of
Fan
Ventilation, Cost
Outlet, Wall
Ductwork, Cost of
Service, Temporary
Periodic Inspections
A/C Central 4 -7 Ton
Fire Sprinkler System
Fire Pump
Outlet, Switch
Fireplaces, Number of
Signs
A/C Central 8 -15 Ton
Fixture - Fluorescent
Oven
Space Heater (kw)
A/C Central 16-20 Ton
Fixture Light
Parking Lot Lights
Spas/Hot Tubs
A/C Central 20+ Ton
Flood Lights
Plugmold/Strip
Subfeeds, No. of Amps
A/C Window
FPL - Load Central
Posts
Swim Pool, Commercial
Air Conditioners
Garbage Disposal
Range/Range Top
Swim Pool, Residential
Chiller
Generators, etc.
Receptacles
Switchboards
Clear Violations
Heat Recovery
Refrigerator, Comm. (p/PH)
Temp Serv., Construction
Compactor
Low -volt, Burglar
Refrigerator, Domestic
Temp for Test - 30 days
Deep Freezer
Low -volt, Fire
Renew - Temp Service
Water Closet
Demolition
Low -volt, Intercom/Teleph.
Repair Circuits
Water Heater
Dishwasher
Low -volt, Television
Service, Number of Amps
Water Heater New
MECHANICAL
TYPE QTY.
Minimum Fee
TYPE
Condensate Drain
QTY. TYPE
Generator
QTY. TYPE QTY.
Refrigeration, Tons
A/C Central, Tons
Cooling Tower
- Heating Strips, each
Vent Hood, Cost
A/C Wall/Win. Tons
Dryer Vents, Number of
- Paint Booth
Ventilation, Cost
Air Handler, Tons
Ductwork, Cost of
Piping, Flammable Liquid
Periodic Inspections
Barbecue
Fire Sprinkler System
- Process/Pressure Piping
Bath Fan - Vented, #
Fireplaces, Number of
- Pressure Vessel
PLUMBING
TYPE
A/C Condensate
QTY.
TYPE
Drains, Roof
QTY.
TYPE
Miscellaneous Fixture
QTY.
TYPE
Soakage Pit
QTY.
Bath Tub
Drinking Fountain
Miscellaneous Repairs
Solar Water Heater
Bidet
Filter Replace
Pool Piping
Sprinkler Repair
Cap - Fixture
Fountain
Pump and Abandon
Sprinkler System
Cap - Water
Gas - Appliance
Pump, Domestic
Supply, AC Well
Cap - Sewer
Gas - Natural
Pump, Fire Stand
Temporary Toilet
Catch Basin
Gas - Propane
Pump, Re- circulate
Temporary Water Closet
Clothes Washer
Gas Piping
Pump, Replace - Pool
Urinal
Dental Chair
Grease Trap
Pump, Sprinkler
Utility - Sewer
Discharge Well
Ice Maker
Pump, Sump
Utility - Water
Dishwasher
Indirect Wastes
Relay Repair
Vacuum Pump
Disposal
Interceptor
Roof Inlet
Water Closet
Domestic Well
Laundry Tray
Septic Connection
Water Heater
Drainfield, 4" Tile/Res.
Lavatory
Septic Tank
Water Heater New
Drains, Area
Meter Set (Gas)
Sewer Connection
Water Re -pipe
Drains, Floor
Minimum Fee
Shower
Water Service
Drains, French
Miscellaneous Equipment
Sink
Well, Supply
Page 3
PERMIT APPLICATION
INSTRUCTIONS: Please indicate the type of work being performed and quantity(ies) in the space provided below.
RECEIVED AND REVIEWED BY: DATE:
Page 4
OFFICE USE ONLY
CHECKLIST
0 OWNER - BUILDER FORM
(Attach)
❑ FIRE DEPARTMENT
APPROVAL (Commercial / .
multi- family)
❑ CONCURRENCY
(New Construction)
❑ OTHER
(Specify & Attach)
$3.00 per page (Scanning Fee)
Miami Shores Village
Bond
Metropolitan Dade County (C.C.F.) $
Inspector State Educational Fund $
State DCA (Radon) $
Code Enforcement Fine
Zoning Review
❑ PROOF OF OWNERSHIP
(Attach)
❑ HRS / DERM APPROVAL
(Septic / Sewer)
❑ IMPACT FEE
(New Construction)
❑ OTHER
(Specify & Attach)
PERMIT FEES
$
(sq.ft. = x/1000
x0.60)
(¢.005 /sq.ft.)
(0.01 /sq.ft.)
PERMIT APPLICATION
❑ CONDO ASSOCIATION APPROVAL
(Attach)
❑ BPR APPROVAL (Restaurants)
❑ CONTRACTOR REGISTRATION
(On File)
TOTAL $
ISSUING OFFICIAL
REVIEWED AND PREPARED BYz��. ��i� - - -1 _
SECTION
Zoning
Electrical
Mechanical
Plumbing
Fire
Public Works
Structural
Building Official
BY
DATE
DATE: G O
CONDITION OF APPROVAL
Revised July 2001
10050 N.E. 2' AVE., MIAMI SHORES, FL • (305) 795 -2207 • FAX (305) 756 -8972 • http : / /www.miamishoresvillage.com
CONTRACTOR
Name,ari fan E....C. , 2 Inc.
License No. E.0 000 2e,
Address 1Cg7s sw 5G 8k._
M \O►w11 1 L. 33t6:
Telephone 3V5 276 6084 Fax 5 2756084
Qualifier Name ^ 0\ii r P 1:20kQJ
PROPERTY OWNER
Name tiny p i Ai
Address
ZI 0 N e • /OZ_ ST - ReET'
Home Telephone (305) iz5 -1 33-7
1
Business Telephone
Fax
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
INSTRUCTIONS - The following steps must be taken to obtain a permit from the Miami Shores Village:
Step 1.
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 submitted
along with this permit application.
Step 2. Submit the completed application 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
K Job Address:
PERMIT TYPE (✓ )
Building
Electrical
Mechanical
Plumbing
LPGX
Roofing
Fence
Other
ZIO Ng /OZ 51 T •
Address Apt.
Folio Number "Description of Work
Lot Block
Subdivision PB PG Zoning Linear Feet
Current Use of Property Square Feet Units Floors
Proposed Use of Property Value of Work 4
Tenant Information
PERMIT CHANGE (✓ )
Chg. Contractor
Renewal
Revision
Extension
Supplement
Reinspection
ARCHITECT
Name
License No.
Address
Telephone
Fax
Master Permit No.
Subsidiary Permit No.
11000.00
Tax Assessed/Appraised Value
PERMIT APPLICATION
M/fr 5/11, 4-a 35138
City
State Zip
R - cavagzT iMi" J ThaAK
Bldg Value
Flood Zone Base Floor Elev.
ENGINEER
Name
License No.
Address
Telephone
Fax
Page 2
II\•IPORTANT NOTICES
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.
1.
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, 1" Floor, (305) 679 -1078. Once recorded, the Notice of Commencement must be POSTED AT THE JOB SITE in
accordance with Section 713 -35 of Florida Statutes. Review the brochure at Village Hall on Construction Lien Law and
Choosing a Contractor.
STATE O11LORIDA \COUNTY OF MIAMI -DADE
Signature of 0 e
Print Name
Sworn to and subscribed before me this day of
Signature of Notary Public - State of Florida
SEAL:
STATE OF FLORID ADE
Signature of Contractor /
Print Name
day of 1'"'
O 2
Sworn to and subscribed before me this 17
PERMIT APPLICATION
/ S�
Signature of
SEAL:
MAIRA ROJAS
•_ Notary Public - State of Florida
.,rte :tC ' My Comm ionas:il:skirl
%A N` Commission a 00052597
Personally known OR, Produced Identification Personally known OR Produce dent' rcation
Type of Identification Produced: Type of Identification Produced:
Miami Shores Village
10050 NE 2nd Avenue
Phone: 305 - 795 -2204 Permit Number: EL2002 -339
Printed: 10 /18/2002
Applicant: GEORGE ORLANDO
Owner: ORLANDO GEORGE
JOB ADDRESS: 210 NE 102 ST
Contractor
Local Phone:
Parcel # 1132060480010
BRINCO ELECTRICAL CONTRACTOR INC Contractor's Address: 10975 SW 56 ST
Total Fees: $0.00
Total Receipts: $0.00
Permit Status: Approved Permit Expiration: 4/16/2003 Construction Value: $1,000.00
Work: RE CONNECT MAIN POWERS
If there is no permit package accessible on the job -site for inspectors to verify, there will be no inspections. Re- inspection
fee is $50.00, which must be paid in advance before calling for another inspection.
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 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 specifications and that he assumes responsibility for work done
by his agents, servants or employees.
Signed:
In consideration of the issuance to me of this permit, I agree to
with the plans, drawings, statem , s or specifications submitt
myself, my agent, servants or r• ployes.
Electrical Permit
Page 1 of 1
Legal Description: VAZQUEZ SUB PB 115 -23 LOT 1 BLK 1 LOT SIZE 81.68 X 130 OR 18346 -1589 0998 1
INSPECTOR) BY:
rform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity
o the proper authorities of Miami Shores Village. In accepting this permit I assume responisibility for all work done by either
Signed: i/ (Contractor or Builder) BY:
•
ANDES CUSTOM REMODELING, INC.
1620 N.W. 114TH AVENUE
PEMBROKE PINES, FL 33026
(954) 430 -7141
Fib fintunion.com
N Org. 003 R/T 067006432
ID 2
':06700643 2':2185300001 2411' 3760
DATE
3760
63- 843/670
sRMICH 13093
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Permit No
ELECTRICAL INSPECTION DEPARTMENT
/� APPLICATION FOR ELECTRICAL PER
NOS 1 � r/ 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, Fiv:ida,
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...
Registered Architect and /or Engineer
MIAMI SHORES VILLAGE
Employing ElectriciaA's Name..0 .irJ... eheileeei ... .. .
Location and Legal Description Lot Q
Street and Number where work is to be performed —No
State work to be performed and purpose of building (By Floors) R . . ..
New Building Remodeling Addition
Street
IT
No Street
Block Sabdfitsion...TF.� '�
/t • a.
Repairs No. of Stories
Service Overhead Site Feeders Conduit Main Sw Amps Main Fuses Amps
Underground
Type of Installation — Conduit Tubing B.X.L .Metal Moulding
Amount of Permit $
STATE OF FLORIDA, I
t
COUNTY OP DADE.
(Signed) 61 e .. ei1T N Q
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 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 under this permit, as arc
licensed by Miami Shores Village.
(Signed) `/ T.. (4 e9f /
Master Ele . rician.
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
OUTT
PLUG
RECC
FIXTURES
NO. L
REFRIO.
OUTLET
IRON
OUTLET
RANGE
OUTLET
RANGE
CONN.
WATER
NEATER
W. HEAT.
CONN.
SPACE
H
STRIP
H
TOTAL
CLISY
OS y
c /
10
✓ Si/
�"5
—
^ 3(0
�J
/(O
. ,fur
/10
CHECK
ENT.
SW.
DIST.
CAS.
SERVICE
TEMP.
SERVICE
PERM.
�I t��f1
UgA.,54b�P 01
'
' / /
&. .d. MOTORS
HP
/
z.
MOTORS
1•e HP
NEON
TRANS.
/^^
I � V
f f]
l o / V
RADIO
..
TOTAL
CONTR.
LIST
CHECK
tif
IV, $ t ,'6
Permit No
ELECTRICAL INSPECTION DEPARTMENT
/� APPLICATION FOR ELECTRICAL PER
NOS 1 � r/ 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, Fiv:ida,
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...
Registered Architect and /or Engineer
MIAMI SHORES VILLAGE
Employing ElectriciaA's Name..0 .irJ... eheileeei ... .. .
Location and Legal Description Lot Q
Street and Number where work is to be performed —No
State work to be performed and purpose of building (By Floors) R . . ..
New Building Remodeling Addition
Street
IT
No Street
Block Sabdfitsion...TF.� '�
/t • a.
Repairs No. of Stories
Service Overhead Site Feeders Conduit Main Sw Amps Main Fuses Amps
Underground
Type of Installation — Conduit Tubing B.X.L .Metal Moulding
Amount of Permit $
STATE OF FLORIDA, I
t
COUNTY OP DADE.
(Signed) 61 e .. ei1T N Q
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 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 under this permit, as arc
licensed by Miami Shores Village.
(Signed) `/ T.. (4 e9f /
Master Ele . rician.
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.