29 NE 102 St (9)Type Insp'n r c' 1 Cen-+ro 1 At
Permit No. -42 mil •
Tower CI'rcc.
Name J C ' +h Ar-r- f'rc n9
Address
Z17J 0 )1
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
Building Inspection Request
Date0 '/2& /05
Company �J • IeCfiy! CG7 I ( -f p
Phone # (305) Z/6 - 4850
Inspection Date
Approved
Correction
Re- Insp'n Fee
Z 9 NE I OZ ST
06 / 2 05
o
BUILDING - '
PERMIT 4P11t
FBC 2001 L
Permit Type (circle): Bui ding
Owner's Address .L q NE 10 2 ST
City ,97it,,,,,' S!i or e.S State //
Tenant/Lessee Name
Contractor's Company Name
City A7/o.0.2 i • State pl
Qualifier
State Certificate or Registration No.
Total Fee Now Due $
(Continued on opposite side)
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
Electrical
Owner's Name (Fee Simple Titleholder) J y Arm s + ro n Phone # (j.:; 7S8- 860?
Job Address (where the work is being done) • 2„ ci N E 1 0 ,2. ST
City Miami Shores Village County Miami -Dade Zip
Is Building Historically Designated YES NO ✓"
Lam, E jicIri cQl Corp.
Contractor's Address G, .22 0 $ W .3 0 ST
Re7r7Ql4o 1/9n Ioi.ng s
Permit No. EL o5_ 1 /g
Master Permit No.
Architect /Engineer's Name (if applicable) Phone #
Plumbing Mechanical Roofing
Zip 33
Phone #
Phone #
qo) 2 /6 -'-lS So
Zip 33 /3S
ER 1 3 0 1 ;Z_1 8 Certificate of Competency No. 0 0 00 1 4 16 7
$ Value of Work For this Permit 6 ]s, 00 Square Footage Of Work:
Type of Work: ❑Addition ❑Alteration. [New // (Repair /Replace ❑ Demolition
Describe Work: R e Ia c G p'7 1 � .� � ro r X/ S f%^ \ y
($ 0 min ,O CC/7 /i 9/ Aif fl.at.Pi - l % P Cv/
*6 *************************F
Submittal Fee $ 5 Permit Fee $ /' ' m CCF $ CO /CC
Notary $ Training /Education Fee $ , Technology Fee $ j•50
Scanning $ Radon $ Zoning Bond $
Code Enforcement $ Structural Plan Review. $
A /4 D3r1
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. 1 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: 1 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.
IBY PVB
e
C
I
.
Sign:
L. -err.
ch „Ar
1
Mny
11 11
J
Ala
Signatur \Atoll iimAkamL
The foregoing instrument was acknowledged
day of
NOTARY
Si
P►
***** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
Owner or Agent
APPLICATION APPROVED BY
chc 05/13/03
who has produced
Signature
Contractor
The foregoing instrument was acknowledged before me this Ine
o f l0 ,20b , by
o is personally known to me or who has produced
As identification and who did take an oath. as identification and who did take an oath.
NOTARY PUBLI
Sign:
Print:Man
onell
323870
My Commission Ex Tres: ,
Y p �(0(�/� Bonded Thrt
O „ Expires: May 26 2008 My Commission Expi
Te&
;' February 11 2009
r, Bonded Thru Notary Public Underwriters
*********************** * * * * * * * * * * * * * * * * * * * * *.t * * * * ** ,, ** iFP.******* * * * ** *r * ** * * * * * * * * * * * *** * * * * * **
*** **** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *
Z. NG ,Vtej Plans Examiner
Engineer
Zoning
ITEM
BATH T.E
UNIT
FEE
ITEM
SWITCH OUTLETS
UNIT
FEE
ITEM
SPACE HEATERS
UNIT
FEE
BIDET
LIGHT OUTLETS
CENTRAL HEATING
DISHWASHER
RECEPTACLES
A/C (WIND)
DISPOSAL
I
SERVICE TEMPORARY I
A/C (CENTRAL)
DRINKING FOUNTAIN
SERVICE SIZE IN AMPS I
DUCT WORK
FLOOR DRAIN
SERVICE REPAIR/METER CHANGE
REFRIGERATION
GREASE TRAP
1
APPLIANCE OUTLETS
PROCESS AND PRESS PIPING
INTERCEPTER
RAJE TOP
UNDERGROUND TANKS
LAVATORY
OVEN
ABOVE (MOUND TANKS
LAUNDRY TRAY
WATER HEATER
U.F. PRESSURE VESSELS
CLOTHES WASHER
MDTCRS C- 1 if
STEAM BOILERS
SHOWER
MOTORS OVER 1- 3 If
HOT WATER BOILERS
SINK, POT /3 COMP.
MOTCRS OVER 5 H°
MECHANICAL VENTILATION
SINK, RESIDENCE
MOTORS OVER 5- 8 If
TRANSPORTING ASSEMBLIES
SINK, SLOP
MOTORS OVER 8- 10 If
ELEVATORS/ESCALATORS
TEMPORARY WATER CLOSET
MOTCRS OVER 10- 25 H
FIRE SPRINKLER SYSTEMS
I
•
URINAL
MIOTCRS OVER 25-100 NP
COOLING TOWERS
WATER CLOSET
MOTORS OVER 100 HP
VIOLATION
INDIRECT WASTES
(
I
A/C WINDOW
REINSPECTION.
I I
WATER SUPPLY TO:
I AIR CONDITIONERS
A/C UNIT
I STRIP HEATER
I
FIRE SPRINKLER
I
I GENERATORS TRANSFORMERS
'HEATER -NEW INST.
I
1 GENERATORS TRANSFORMERS
I
I I
HEATER - REPLACE
I
I GENERATORS TRANSFORMERS
LAWN SPRINKLER -WELL
I
SPECIAL PURPOSE
I
I
I
i
SWIMMING POOL
OUTLETS COMMERCIAL
I
I
I 1
WATER SERVICE
SIGN TIKES
SEWER CONNECTIONS SS
SIGN TRANSFORMERS
UTILITY -SEWER
SIGN TIME CLOCK
UTILITY -WATER
I
FIXTURES
SEPTIC TANK
ANTENNA
RELAY
TELEVISION OUTLETS
DRAINFIELD, 4' TILE/RES.
VIOLATION
1
I
PUMP 8 ABANDON SEPTIC TAN} ,
REINS ECTION
SOAKAGE PIT CU . FT.
CATCH BASIN
DISCHARGE WELL
DOMESTIC WELL
1
AREA DRAIN
t
ROOF INLET
I
SOLAR WATER HEATER
FIRE STANDPIPE
POOL PIPING I
I
LAWN SPRINKLER SYSTEM I
GAS RANG.
PETE. 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.)
MECHANICAL
G PIPIN';
PLUMBING
ELECTRICAL
Owner
rC4
3/1 � Conduif wi a #4 111140
anal 1 #t' 10t(rroon
R epkce E x;n Cen¢ra1 ; C cu i /C E it
E. I 0 z. s r
/1 iqm i S Jores FL 3l
N ni civ ,rt f ron
Eu.s4in 1SOA
C rcu Breq C''r
F- . te r':.
Circui
New 4 TON 10 k W
Air 4cmdi'r Next
■ V 5 Ar^P,
1
it (+3- Ccni'rci I - A /C
New 4 TON ag�+r+r
Co t/ pressor'
3
3/y C o n
Sa Y
fito
to Disconn
uit virfn 2 #$ TINN
1 tIOTNNIJ-
Ground
(� ey \/4ncJ4wcis
El Electric. Corp.
/flit. F1. 331St/
y � yos
:-� r
It t
1 qnd 1 *lot 6-rO0nel
EVIS4'in ISO)
C ftu 11' Breglter
t. IoZ. sr
/)1 harn i Sores F;. 33131
N c tive Al \ .r.tro
Owner , GJ
New 4 ToN O ) / W
�! Megt
pir ttgndttr
;,rJ:r -- -)1 f 1
}
Circui.k t 4-3 - C` n1'r4i_. A/c
Safer
1 A P ‹— Disconnect
New 4 TON12.1,Anp
corn 13 resso/' {
�4 Cona ,1;f
Set tor Y
WO
A QisconnecT
wre
#`8 THF9
I to T wHhJ-
Ground
Rey Va ncc4rV4S
E1JI: Electric Corp.
p ✓1 W,W. P " w C
pit gm; F/. 33 1 - 5-,5
•
Contractor E. J. ELECTRICAL
Local Phone:
Parcel # 1132060131650
Electrical Permit
Miami Shores Village
10050 NE 2nd Avenue
Phone: 305 - 795 -2204 Permit Number: EL2005 -172
Printed: 6/7/2005
Applicant: JUDITH ARMSTRONG
Owner: ARMSTRONG JUDITH
JOB ADDRESS: 29 NE 102 ST
Contractor's Address: 6220 SW 20 ST
Page 1 of 1
Legal Description: MIAMI SHORES SEC 1 AMD PB 10 -70 LOT 15 & LOT 16 BLK 12 LOT SIZE
Fees: Description Amount
FEE2005 -7547 Building Fee $100.00
FEE2005 -7548 CCF $0.60
FEE2005 -7549 Training and Education Fee $0.20
FEE2005 -7550 Technology Fee $2.50
FEE2005 -7551 Scanning Fee $3.00
FEE2005 -7552 Submittal Fee ($50.00)
Total Fees: $56.30
Total Fees: $56.30
Total Receipts: $0.00
Permit Status: APPROVED Permit Expiration: 11/21/2005 Construction Value: $675.00
Work: REPLACE AND RELOCATE EXISTING 50 AMP CENTRAL AIR POWER CIRCUIT
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:
A CORD
PRODUCER G:l 8 As84C1es
9787 S.W, 72nd
Miami, FL 3317
, (G05)279 -7665
- 06/08/05 WED 10:1
INSURED Ray E . J Electrical
5220 SW 20 Sr
Miami, FL 33155-
COVERAGES
THE 'OLICIES Or- INSURANCE
ANY RI5CIUIREMENT• TERM OR
MAY PER I AIN_ THE INSU_-SAND
P0L'C1ES• AGGREGATE LIMIT:
IInsR: AGO'L
S?'12: TYPE OF INS • GENERAL LIABILI:
' : COMMERCIAL G
•
MAO
A
I
•
•
•
•
GENII. AGGREGATE
. POIJC'Y I PR+
I AUTOMOBILE LIABI
I ' ANY Air
I,,,,j ALL OWNED A
1 , '
i '
GARAGE L[ASILnTY
I ANY AUTO
i..
•
I
I; ,
SCHEDULED A
HIRED AUTOS
N0N OWNED UTOS
, EXCESS LIABILITY
r • OCCUR
DEDUCTIBLE
, RETENTION
WORKERS COMPENSATIO AND
EMPLOYERS' LIABILITY
'• ANY PROPRIETOR/ PAWN
OFFICER 1 MEMBER EXCLU
If yea, describe under
( - PROVISIONS bel
r ?TREK — ^ - - -•
DESCRIPTION OF OPERATIONS LOCATIONS I VET -HOLES 1 EXCLUSIONS ADC BY EN0ORSEMENT / SPECIAL PROVISIONS
CERTIFICATE HOLDER
CITY OF MIAM
ACOR0 25 (20oiios)
ITV
708
1TOS
186 —d 100/100'd 9Z8 -1
FAX 3052799705
ERT1FICATE OF LIABILITY INSURANCE
THIS CERTIFICATE IS ISSUED AS A
ONLY AND CONFERS NO RIGHTS UP
HOLDER. TI»IS CERTIFICATE DOES Is
ALTER TiiE COVERAGE AFFORDED
INSURERS _AFFORDING COVERAGE
INSURER A: Naticnal Insurance
In 5L :raanc
1ST7.0 NAVE BEEN ISSUED TO Th E INSLJ F-D NAML3 ABOVE FOR THE POLICY , ERIOD INDICAT
CONDITION OF ANY CONTRACT OR OTHER DOCUMEN1 WITH RESPECT TO WHICH THIS CERTIF
AFFORD:iD BY Tait POLICIES DESCRldRD 4aRCIN IS SUBJECT TO ALL THE TERMS_ EXC_USIO
ShONN MAY HAVE •E° REDUCED BY PAID CLAUS__ _
POL'CY LP}rECT1VEI Poi ICY EXPIRAT ON
TRANCE POLICYNUMBP -R DATE{MM /Doy - 1 O DIYl
ATS rgutuOf_ LIMITS
� EACH OGC RRENCE I
NEWRAL LIABILITY Cc(
OCCUR
IM IT APPLIES PCR'
ECT LOC
CLAIMS MADE
R / E)(PCIJTIVE
ED?
S V E
696E- 9ZE -90E
I.OIL AND ASSOCIATES
INSURER R_
INSURER C.
INSURER D!
-.-
INSURER E. -
CANCELLATION
•
AUTHORIZED REPRESEN V
RSEINA SEADE
DAMAGE T RENTED •
05/21/06 PREMISES r a occurenob} _ _
bl ED ExP ( y one person)
PERSONAL': ADV INJURY •500,000
PRODUCTS; COMP /OP AGG • 600.000
FIRE DAM GE 100.000
• COMBINED;'INGLE LIMIT
;E0 occiden 1
BODILY INJ. RY
(Per aerson
BODILY LNJ RY
(Per scalds 1)
PROPER? DAMAGE
SHOULD ANY OF THE ABOVE DESCRIBED POI CIES BE CANCELLED BEFORE THE
ExP:RAT10N DATETNERI5O1 , THE ISSUING IN RER WILL ENDEAVOR TO MAIL
DAYS WRITTEN NOTICE TO THE CE'" {FICATE HOLDER NAMED TO
THE LSFT, BUT FAILURE TO DO SO SHALL IMP SE NO OBLIGATION OR LIABILITY
OF ANY KIND UPON THE IN$.L RER, ITS A - , • OR REPRESENTATIVES.
6562 SE2 932
(Per a: ide D _
AUTO ONL - EA ACCIDENT
• OTHER TH N EA ACC I
AUTO ONL
• EACH OCC
I AGGREGA
W C S ! ATU. •- rr 0T H-
_
' TORY I MITS ..__FR I ,,,
E.L. EACH CCIDENT
E.L DIS E- EA EMPLOYE!~!
EL. D1SLA' E - POLICY LIMIT
nOOS dY030 —word
el 001
DATE (MM;DD/YY)
35/24/05
ArrER OF INFORMATION
N THE CERTIFICATE
DT AMEND, EXTEND OR
Y THE POLICIES 8E<LOW.
NAIC
RRENCL-
D. NOTWITASTANDING
CATE MAY BE ISSUFD OR
$ AND CONDITIONS oi= SUCH
•
CORPORATION 1988
we9l :Ol 9002- 80 —unf
Mia ni Shores Village
10050 NE 2nd Avenue
Phone: 305 -795 -2204
Printed: 61712005
Applicant: JUDITH
Owner: ARMSTRONG
JOB ADDRESS: 29
Parcel N. 1132060131650
NE 102
Mechanical Permit
Permit Number: MC2005 -85
ARMSTRONG
JUDITH
ST
Conliactor A 1.24 HOUR SERVICE Contractor's Address: 18424 SW 293 TERR
Local Phone:
Page 1 ol 1
Legal Description: MIAMI SHORES SEC 1 AMD PB 10-70 LOT 15 & LOT 16 BLK 12 LOT SIZE
Fees: Description Amount
FEE2005 -7254 Building Fee $142.62
FEE2i105 -7255 CCF $3.00
FEE2005 -7256 Training and Education Fee $1.00
FEE2005 -7257 Technology Fee $3,57
FEE2005 -7258 Scanning Fee $3,00
Total Fees: $153.19
Total frees: $153.19
Total Receipts: $0.00
Permit Status: APPROVED Permit Expiration: 1//2012005 Construction Value: S4,O75.00
Work: REPLACE EXSISTING 4 TON HVAC SYSTEM AND MOVE CONDENSING UNIT AS SHOWN ON ATTACHED PLANS. ALL HAS 10
6 3
Signed:
os
(INSPECA'OR)
In consideration of the issuance to me of Ibis permit, I agree to perform the work covered hereunder in compliance with ali ordinances and regulations pertaining thereto and in strict
conk rmity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit 1 assume responisiblllty for all work
done by either mysell, my agent, servants or employes.
Signed: (Contractor orBailderrj SY:
Miami Shores Village
10050 NE 2nd Avenue
Phone: 305 - 795 -2204
Printed: 6/7/2005
Applicant: JUDITH
Owner: ARMSTRONG
JOB ADDRESS: 29
Contractor A 1 24 HOUR SERVICE
Local Phone:
Parcel # 1132060131650
NE 102
Signed: (INSPECTOR)
Signed: (Contractor or Builder)
Mechanical Permit
Permit Number: MC2005 -85
ARMSTRONG
JUDITH
ST
Contractor's Address: 18424 SW 293 TERR
BY:
Page 1 of 1
Legal Description: MIAMI SHORES SEC 1 AMD PB 10 -70 LOT 15 & LOT 16 BLK 12 LOT SIZE
Fees:
FEE2005 -7254
FEE2005 -7255
FEE2005 -7256
FEE2005 -7257
FEE2005 -7258
Description
Building Fee
CCF
Training and Education Fee
Technology Fee
Scanning Fee
Total Fees:
Amount
$142.62
$3.00
$1.00
$3.57
$3.00
$153.19
Total Fees: $153.19
Total Receipts: $0.00
Permit Status: APPROVED Permit Expiration: 11/20/2005 Construction Value: $4,075.00
Work: REPLACE EXSISTING 4 TON HVAC SYSTEM AND MOVE CONDENSING UNIT AS SHOWN ON ATTACHED PLANS. ALL HAS 10
: :i1
EN 1 PAID
In consideration of the issuance to me of this permit, 1 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.
BUILDING
PERMIT APPLICATION
FBC 2001
Permit Type (circle): Building Electrical
Owner's Name (Fee Simple Titleholder) Tc.Ari r ft/ km-7 S No .4 y
Owner's Address act A/ (- St ,11 q r-, : 5
City ta•idvt4: StIctiO_S State C C
Tenant/Lessee Name Phone #
Job Address (where the work is being done) a` q N & 0 06/
S rt
City Miami Shores Village County Miami -Dade
Is Building Historically Designated YES NO
Contractor's Company Name A-1 r ) 4 How/ .0 ell/ c e Zi Phone # OS a 5 5 s
Contractor's Address I f 9 ?3 S $ B" S-r
City di e tread State F(,
Qualifier To Sep Pa +ems a ,q fQ
Architect/Engineer's Name (if applicable) Phone #
$ Value of Work For this Permit 40 1 S. 0 c
Type of Work: ['Addition ['Alteration
Describe Work: J e p (ar e. X sr : -77
c e P . 1 S i -i L(.4 ; r 4 S t 6r
Submittal Fee $ L_ Permit Fee $
r V Training/Education Fee $
Notary $
Scanning $
Code Enforcement $ / Structural Plan Review. $ f 1
Total Fee Now Due $
(Continued on opposite side)
****************************F
i t hr CCF$ J
CAD Technology Fee $ .5f1
Radon $ / Bond $ /
163 ri
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8'72
Egg =�
2 4 260 M as
Plumbing
Zip
V
Permit No. E kO S--P
er Permit No.
(Mechanica Roofing
Phone # 30 7Si /60
33i ��r
)3 Oa
Zip 331
Z 3 3o 3
Square Footage Of Work:
❑New pair /Replace ❑ Demolition
i t to H SY5re -«. 4 -rod
d /1 rCttr c6ac /'pf 1 ' C .4 /1-1 irRf
Bonding Company's Name (if applicable)
Bonding Company's Address
City State
Mortgage Lender's Name (if applicable) °''i
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 NO'T'ICE 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 he delivered to the person
whose property is subject to attachment. Also, a certified copy of the recorded notice of cormnencentent must be pasted 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 he approved and a reinspection fee will he charged
Ct:c 1()/14/03
Zip
• , •
Owner or Agent
Contractor
The foregoing instrument was acknowledged before is 17 The foregoing instrument was acknowledged before me this
day of Ma/ , 20 05 by T„ `
7 y — •�' r f► 4 l�� . •.�, day of _s
_-1– , 20 OS , by 70./ ,t r -
who is personally known to me or who has produced FG O G c- t. '
p who is personally known to me or who has pro I
416 S. l SSZVoAs identification and , • - 'td ke an oath.
as identification ���� e an oath.
NOT Y�I)f3 IC . NOTARY
Sign:
Sign
Print:
Print: = „�
My Commission Expii d,,
'/y 2oo7 My Comtnissio
* *A** ** * * * * * *fi *ate *k* • * ************':*****: * *** * * ** * *at* * *a: * * ** * * * ** * * * ** a.** * * * * * * *** *v.a ** *** ** *r
(Certificate of Competency Holder)
State Certificate or Registration No. CAC 05- 0. ,3 Certi licate of Competency No.
APPLICATION APPROVED BY:
Plans Examiner
Engineer
— _ Zoning
May 24, 2005
Miami Shores Village
10050 NE 2 Ave
Miami Shores, FL 33138
Dear Mechanical Inspector,
A -1 24 HOUR SERVICE, INC.
AIR CONDITIONING
18995 S.W. 288 Street • Homestead, Florida 33030
(305) 235 -5855
We will be replacing the existing 4 ton condensing unit and air handler (10 kw heat). The
homeowner is contemplating doing some renovations to the back of her home so she
would like the condensing unit moved to the side of the home as shown on the plans. The
air handler will remain the same. I have written down the distances from the property line
to the condensing unit for zoning.
If you have any questions please contact me on my cell phone 321 -508 -8895.
Sincerely,
Allen Patenaude
Office Manager
A -1 24 Hour Service
305 - 235 -5855
CAC 058293
r Ou FeiO rcd ,:
SA/ Cendoir i fk 1 I TWO
g nti 1 it 10- C r ro clna
150A
CircV tireq frr
FAnri. j
N.E. 1o41 s
/Y? lava i $sores F {, 3
New Li TON 10 K V/
Air Uanei Hegf`
utt;t,_t 45 Awl
CitGd #s W 1 + -C nt riI-•Aic
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ss E— Oiaconnecr
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StarefY
AriP
4a DiicOrinecT
;eit wi4 n
e VG helamgs
=J' Electric Corp.
r
/71iami FL 33
2-- #lr r � Grovnd
(4) 1/4" CONCRETE. SCREWS SNUG TO BASE PAN- LENG1'H
T PENEjRATO BE PLACED THE MINIMUM.
BASE SCREWS HAVE SHOWN
(NECtta) STANDARD TOLERANCE
UNI.ESS OTHE9W ISE SPEC IF 1ED
a> nonaEa .PAC 1IDNA( ±1i)2
- ANGULAR • 1 °
RC An. EOM. -OE( IMAL ±.0
- DIMENSIONS IN I I REF. DI:LY
_r
,MaDEL NUMBER
;AKA -018/- 024/030, ALB - 018/024, AMB - 018/024
AKA- 037/042, ALB- 0.130/036, AMS -•030, AML- I24 413@, ANB• -024
APA -024. PKA - 019/025/031. PLA••019/02S/031, PMC -018, PN.1- 019;37.625
PPA -019
AMB- 036/042448/060, AML - 036/042448/060, Ak(A- 048/060
ALB - 042/048460. ANB- 030/036/042/049 /061,
APA - 030/036/042/049 /061, PKA - 035/043/049/061.
PI.4- 037/0 43/049461, PMC- 024/030/036/042/048/060,
PML- 1324/030/036/0424 68/460, PNJ- 025/031/037/043 /04.9/061,
: !SPA -0 25/0 31/0 37 /0 43/049/061
01
ADDED INFO ARIIUT SCREW
RHEEM /RUUD HURR l C ANE PROOF
SCREW. LOCATIONS
ca •'l ' �'ISr'2� (4 4 :
de to I
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32.625 22.2163
41.5
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25.938 15 34 3 !i 22.5
1
29.813 15 i 3V• 1 3 5 j 26.5
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MODELED OT TWC � I � .NOTE: ALI. PARES ART 90p
RESEARCH T �
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TTES 01 ON
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JESPECVER
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PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date 5 -a ASJob Address we 10204 Tax Folio
Legal Description
Owner/Lessee / Tenant S L P L e J `L0 Master Permit # 78,5 /
aR 10 V - ` + M l'Ai4lehoR Q� Phone
Owner's Address
J of k 13 LAC.(-- Pik t
Qualifier <Tas `V k R L oc .lt— SS# at,
State # C Acc 0-3 Z7 Municipal # Competency #
Architect/Engineer Address
Bonding Company Address
Mortgagor Address
Contracting Co.
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIP'T'ION T c h pdV S CA 1 2 4-o U N r lR
4 11, (r, Oee
i2 kke w; �� 5 1L l)J U 4e4 cvy G z _Ls
0
Square Ft. Estimated Cost (value) D-0 0 0��
WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO 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.)
Application is hereby made to obtain a permit to do work and installation as indicated above, and on the attached addendum (if applicable). I
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, SIGNS, POOLS, ROOFING and MECHANICAL WORK.
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. Furthermore, I authorize the above -named contractor to do the work stated.
igna
e of owner and/
APPROVED:
Zoning
Mechanical Cr
ondo President
Notary to Owner and/or Condo President Date
My C
4 9 1 -2- at
ssion Expir /1 - l ' a
OFFICIAL O rARY SEAL
MOHAMMAD I HAQ
NOTARY PUBLIC STATE OF FLORIDA
COMMISSION NO CC428170 MY COMMISSION EXP DEC. 20,1998
I EES: PERMIT hi .0 RADON C.C.F.
Historically Designated: Yes No
Address
L bOg 0 Ldlt CoSt-A- �r . (Avde
- - 24Phone 3 ' - V 7 lG �u
30
Ins. Co.
Signature Contractor or Owner- Builder
Not
My C
NOTARY 2 5 l
11
k,,,, CIAL NOTARY SEAL
o �� 6 SANDRA M MONTIEL
^ » COMMISSION NUMBER
., :I, � � C C 4 012 61
yr� MY COMMISSION EXP.
Or p� AUG. 17 1 09a
TOTAL DUE I4 a�
5-n- - s
Date
SV
Date
•
Building Electrical
al'orcittf Plumbing Engineering
ITEM
BATH TIE
UNIT
•
FEE
ITEM
SWITCH OUTLETS
UNIT
FEE
ITEM
SPACE HEATERS
UNIT
FEE
BIDET
LIGHT OUTLETS
CENTRAL HEATING
SKf,
_
DISMASFER
RECEPTACLES
A/C (WIND)
DISPOSAL
SERVICE TEMPORARY
A/C (CENTRAL) ThAto
DRINKING FOUNTAIN
SERVICE SIZE IN AMPS
DUCT WORK
FLOOR DRAIN
SERVICE REPAIRA(TER 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
MDTCCS 0- 1 HP
STEAM BOILERS
SHOWER
MOTORS OVER 1- 3 HP
HOT WATER BOILERS
SINK, POT /3 COMP.
IOTCRS OVER 3- 5 HP
MECHANICAL VENTILATION
SINK, RESIDENCE
MOTORS OVER 5- 8 If
TRANSPORTING ASSEMBLIES
SINK, SLCP
MOTORS OVER 8- 10 HP
ELEVATORS/ESCALATORS
TEMPORARY WATER CLOSET
MOTCRS 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 SLPPLY 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 CLOCX
UTILITY -WATER
FIXTURES
.
SEPTIC TANK
ANTENNA
RELAY
TELEVISION OUTLETS
DRAINFIELD, 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
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 BEEN
OBTAINED, THE OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.)
PLUMBING
ELECTRICAL
MECHANICAL
BUILDING
ELECTRICAL
PLUMBING
ROOFING
Owner of a ry ,5
Building `A
PERMIT N9 5405
Architect
Contractor
or Builder t •
Legal Lot
Description BI
CONTRACTOR Oft BUILDER
MIAMI SHORES VILLAGE, FLORIDA
s.f?.• A -
Work to be performed under this Permit
Address of
Building
Subdi-
vision
Value of Y 0.s I Amount of
Project $ II Permit $
This permit is gtranted 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. \ 1; ,
Signed . . .. —.. , -. --
, r 'i IN P`EGTOR
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 as
cepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. ,;%vf
r e . r
DATE
Contractor's
License No.
.. G
BY AUTHORITY
ABBOT
1 9 45'4
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 ,, L
Name and address of licensed contractor
Location and legal description of lot to be built on:
Lot
Street and Number where work is to be done
State work to work be done purpose o building y oors d f b ld' (by floors).
Block
Building Inspe
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
or
Council Approved
Ca Ca Ca 1 11I -1l1
Subdivision
9
Date
No
- 71 P. 1 O 2 °T
' 19 C 4l
Street '1 C• / 0 Z
i 3
an d
, SIAACC-cLA-4
1 — I lrt P - / =s - e 1 . S t w a-eJQ
_ — and for no other purpose.
New Building Remodeling Addition _ Repairs No. of Stories
To be constructed of Kind of foundation Roof Covering
c,tc. ° ° _
Estimated Total cost of improvements $ -�.,t0 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 for said building. All notices with reference to the building and its construction may
be sent to
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 contrac : s or sub- contracto 'employed by him
in the work to be performed under this permit; and will post or cause to be posted for inspectio . on e site of the wo such public notic
or notices as are required by the Act. The undersigned agrees to employ only such subco to be /p rf6rmed under t1
permit, as are licensed by Miami Shores Village.
Remarks (Signed
STATE OF FLORIDA,
COUNTY OF DADE. j 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 state are true. t /�
Permit No � Date Z T Read, Sworn to and Subscribed before me.
Disapproved
D. d'
` r Notary Public, State of Florida
(Signed)
My Commission Expires
LANNING BOARD DATE
Chairman Member
Member Member
Member Member
Disapproved 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.