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453 NE 102 St (3)MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date g-,21-02. Time //f Type Insp'n �4J1 4 (1441;4) Permit No. i P1 ....2o0 2 `L Name J►r�I ill J tic Address 4 96 - 3 Ne t Company Approved Correction Re- Insp'n Fee Phone # 54L 7 L T ` 36o L l For Inspector: R--#2 7-0 2, Name & Date MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date Ti t 3 Time Type Insp'n VA t'`' Dave-7 3 Permit No. B P 'G © a" 1 / 3 Name ZL L i U �'`'` X5'3 S f Address Company Phone # For Inspector: Name & Date Approved Correction Re- Insp'n Fee ❑ AJ �? 7 L7 i UN C wt e eek MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date S A� Timee Type Insp' n `7 z .% Permit No. f,P -2,00z-//3f Name Address 453 3 N Company 4 a/B jq d Phone # For Inspector: iv (�, Approved Correction ❑ Re- Insp'n Fee ❑ Name & Date ) - AYZt piet 14,4.11,064 MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date Time Type Insp'n 0 L c:Qon c ). / q Permit No. Name Address Compa Phone #� For Inspector; Approved Correction ❑ Re- Insp'n Fee ❑ (op I ■ , I ref o 2003, )] PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date job Address N.g. I01ST,M1AP iliftaxFolio 1-o7' 19 / , 9Z,A nnD. "PLAT MIA.SFI.v1Li3 Legal Description s e • 4, 15 / ?ti 14- Historically Designated: Yes No Owner/Lessee / Tenan F P y �° 1 O1=j ,LP-TA L.LV Contracting Co. Owner's Address 4(3 E- 102 ,fit. MM M 1 -yO uTt -I.ot4y 4 9 Qualifier I Q .J A (9 �/1 (0S`9'S0 State # C Municipal # Architect/Engineer (9t) / y n M l C°.' j '4 ) Bonding Company Mortgagor Permit Type (circle one : BUILDING WORK . DESCRIPTION Square Ft. 325 r•�' Notary as to My Commissi �W 1 M M 11.? Cr- 'O 1___ ,WANTING 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 OF 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). l 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. OWNERS AFFIDAVIT: I certify that all the foregoing information is accurate and th work construction and zoning. Furthermore, I authorize the above -named contractor to • o the wo Signature of owner and/or Condo President UQ>s 4�P'1 fires i ah l . ($LB - r # CC885267 x. It?LS NOV 03. 2003 � Tyra 11 . ONOED THRAUGH Tr ` ADVAKIACA NOTARY FEES: PERMI3 )7) RADONS- 4 O APPROVED: 0 - 0 Zoningd 6/M�� ()%- Building Mechanical Plumbing Address 1 yvh.r J4.) • ► I l ST., M I4M � L ss# Phone 2,7 O l ga44 Competency # Ins. Co. LECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN sJ'• '3 . 0 to Address 4-1 10 g..) y - A vg.,M?# M, L 3 3 1 f( Address Address Estimated Cost (value) 2 d V 0 d Master Permit # ,6) Ir)O-1 • t(3 g Phone (3 0 .) 71a 3.11. 31.4-- Signal' of Contractor or Owner- Builder Notary as t orR61a ! t `` rd� =� ;, . My Comm si EXP r S,OMMISStON w CC885267 : S rs91.6;. !'= EX PINS NOV 03. 2003 erarr D. 0ONOED THCU ' RON H.CArT" � 4K i 1rb " '44b••AA• :/ , ✓ in compliance with all applicable laws regulating › ANANTAGE NOTARY Date J )3 •OY Date C.C.F. 6 � DC NOTARY' BOND 0 ( / TOTAL DUE1:4_M 0 Structural Engineer 6/1 i/o D 0 a 6. .10,1- t5 Printed: 6/24/2002 Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Applicant: JEFFREY CHARLES Owner: KELLUM JOB ADDRESS: 453 NE 102 Contractor Local Phone: 305 - 270 - 946 Building Permit Permit Number: BP2002 -1138 KELLUM JEFFREY CHARLES ST ANTHONY & SYLVAN POOL /SPA CONTRA ?Rractor's Address: 12245 SW 112 STREET Parcel # 1132060170810 Legal Description: MIAMI SHORES SEC 4 AMD PLAT Permit Status: Approved Permit Expiration: 12/21/2002 Construction Value: $20,000.00 Work: SWIMMING POOL 305 ?7v. —7 c31--/L/ : NTHONY AND SYLVAN POOLS CORP. DBA POOLS BY ANDREWS ,Qt INT 4077 123N 5 S&- 112 S rL p n anv 4449 r►-t i sr'-1 1 ) -1 Y 31 Xo gi a ki l r ' 5 101c -C I Diu r c� rT t�l - I�Wt r) -- SL t' - 00 Fees: FEE2002 -3527 FEE2002 -3528 FEE2002 -3529 FEE2002 -3532 First Union National Bank N' firstunion.com Org. 075 R/T 031000503 Description CCF Buildier's Bond Building Fee Radon Total Fees: Amount $12.00 $300.00 $310.00 $5.40 $627.40 DATE CO "0000 20 2 L11' ' :0 3 L000 SO 3l: 200000 3 3 26 . L9011 2L(02 2021 3- 50!310 1 $027. yv DOLLARS n =r muss Page 1 of 1 PB 15 -14 LOT 19 BLK 92 Total Fees: $627.40 Total Receipts: $0.00 :e- inspection ation herefor in strict compliance with all ications that may have been submitted to or if the plans are changed without onsibility for a thorough knowledge of the hat he assumes responsibility for work done. )S pertaining thereto and in strict conformity 9sponisibility for all work done by either State # t owv76 .) Municipal # Signature of owner and/or Condo President Notary as to Owner and/or Condo President My Commission Expires 00 2 79 PERMIT APPLICATION FOR MIAMI SHORES VILLAGE 10050 N.E. 2ni Avenue • Miami Shores, Florida 33138 • 305-795-2204 Date e Job Address 7 ,5 A t/ 0' J 7 Tax Folio Legal Description Historically Designated: Yes No Owner /Lessee/Tenet MI /M/rr. Owner's Address V,5 /VC Contracting Co. GJeite i'G7,UA C /eiti7/7 ('G/ Qualifier , efh Aiee 'LG Permit Type (circle one): BUILDING ELECTRICAL PLUMBING WORK DESCRIPTION: l�7PC� /��'G �-� Q� D' sw•� Square Ft. Estimated Cost (value) Date Signature of- Date FEES: PERMIT / ' 1190 RADON C. APPROVED: Zoning Building Electn Mechanical Plumbing Master Permit # I1/ cg — Phone c3UJ /ra • JJ/ Address /32c 2 j) /fr? ,.f j a SS# ■) 22,0 Competency # Ins. Co. IF THERE IS NO PERMIT PACKAGE ACCESSIBLE ON THE JOB SITE FOR INSPECTORS TO VERIFY, THERE WILL BE NO INSPECTION. RE- INSPECTION FEE IS $50.00 AND MUST BE PAID IN ADVANCE BEFORE CALLING FOR ANOTHER INSPECTION. MECHANICAL ROOFING c o 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 ANY 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 all disciplines. 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. Furthermore, I authorize the above named contractor to do the work stated. ractor or Owner uilde Date P ( 4'7 � 63 -O - O _____. .. .. 1, • k., A 9.1•- ,�!!�s o Con . ';nnr Builder . : D a� y Commission xpires `,` ,r;,,' NOTARY c Ci 0 BOND TOTAL DUE Structural Engineer ITEM BATH TUB UNIT FEE ITEM SWITCH OUTLETS UNIT FEE ITEM SPACE HEATERS UNIT FEE BIDET LIGHT OUTLETS CENTRAL HEATING DISHWASHER RECEPTACLES A/C (WIND) DISPOSAL SERVICE TEMPORARY A/C (CENTRAL) DRINKING FOUNTAIN SERVICE SIZE IN AMPS DUCT WORK FLOOR DRAIN SERVICE REPAIR/METER CHANGE REFRIGERATION GREASE TRAP APPLIANCE OUTLETS PROCESS AND PRESS PIPING INTERCEPTOR RANGE TOP UNDERGROUND TANKS LAVATORY OVEN ABOVE (MOUND TANKS LAUNDRY TRAY WATER HEATER U.F. PRESSURE VESSELS CLOTHES WASHER MOTORS 0- 1 HP STEAM BOILERS SHOWER MOTORS OVER 1- 3 HP 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 HP ELEVATORS/ESCALATORS TEMPORARY WATER CLOSET ' MOTORS 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 SUPPLY T0: '" AIR CONDITIONERS ' A/C UNIT - • _- = - STRIP HEATER FIRE SPRINKLER GENERATORS TRANSFORMERS i HEATER -NEW INST. GENERATORS TRANSFORMERS HEATER - REPLACE .- _ .. ' .... GENERATORS TRANSFORMERS _ LAWN SPRINKLER -WELL SPECIAL PURPOSE SWIMMING POOL OUTLETS COWERCIAL WATER SERVICE SIGN TUBES SEWER CONNECTIONS SIGN TRANSFORMERS UTILITY -SEWER - SIGN TIME CLOCK . UTILITY -WATER FIXTLRES SEPTIC TANK {HENNA RELAY TELEVISION OUTLETS DRAINFIELD, 4" TILE/RES. VIOLATION PUMP 8 ABANDON SEPTIC TANK REINSPECTION SOAKAGE PIT CU. FT. ..... (A) l ( h 111) &. PO d ( / CATCH BASIN '-1 DISCHARGE WELL DOMESTIC WELL AREA DRAIN ROOF INLET SOLAR WATER HEATER FIRE STANDPIPE POOL PIPING _AWN SPRINKLER SYSTEM 3AS RANGE WATER SET (GAS) 3AS PIPING PLUMBING ELECTRICAL ADDENDUM TO BUILDING PERMIT APPLICATION (AN APPLtATION 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 The Sunshine State LICENSE NURSER P626-673-63-022-0 PEDRO M PERIMCORDOVA 14781 8W 148 ST CIR MIAMI, FL 88188-0000 BMW DAM SEX 1.3T. REST. MIDORSE. 01-2243 M 5-08 A ISSUED EXPIRES DUPUCAIE 02-1509 01-22-08 maim SAFE DRIVER ORGAN DONOR MOTORCYCLE ALSO 110154 Operation of a motor wshicts constitutes consent to any sobriety test required by law 1 Miami Shores Village 10050 NE 2nd Avenue Phone: 305- 795 -2204 Permit Number: EL2002 -279 Printed: 8/27/2002 Page 1 of 1 Applicant: JEFFREY CHARLES KELLUM Owner: KELLUM JEFFREY CHARLES JOB ADDRESS: 453 NE 102 ST _ Contractor GENERATION ELECTRICAL SERVS CORP Contractor's Address: 13727 SW 152 ST #320 CJ Local Phone: 305 - 252 -7780 Parcel # 1132060170810 Permit Status: APPROVED Permit Expiration: 2/23 /2003 Work: ELEDCTRICAL CONDUIT AND WIRING FOR SWIMMING Sign Sign Electrical Permit Legal Description: MIAMI SHORES SEC 4 AMD PLAT - 00 5_0 Construction Value: $800.00 c s v Total Fees: �$0 00 Total Receipts: $0.00 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 Qr in the statements or specifications and that he assumes responsibility for work done by his agents, servants or employees. SPECTOR) BY: PB 15 -14 LOT 19 BLK 92 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. (Contractor or Builder) BY: GENERATION ELECTRICAL SERVICES CORP. PH. 305-252-7780/EC-#0001462 13727 SW 152ND ST., #320 MIAMI, FL 33177 PAY TO THE ORDER OF fly i SKares viOctge //,;(e-7) Fire' / • lea, MEMO 0-ctS YelifAr. • 00049 L310 '1:267084 L3 LI:a 3 L42 L L WASHINGTON MUTUAL, BANK, FA MIAMI/MIAMI LAKES FINANCIAL CENTER 1755 MIAMI LAKES, FL 33014 63-8413-2670 $ 95 • 4913 DOLLARS a NOTICE OF COMMENCEMENT A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF FIRST INSPECTION PERMIT NO. TAX FOLIO NO. STATE OF FLORIDA COUNTY OF DADE 0283734 -07 2002 JUN 17 13:31 THE UNDERSIGNED hereby gives notice that improvements will be made to certain real property, and in accordance with Chapter 713, Florida Statutes, the following information is provided in this Notice of Commencement. 1. Legal description of property and street addres 4r3 !JO- 1 02 SY MA A41 S •Lon.A,r (-or (cc ILL 12 -,Amb • ?c • 144D r � •d 13 1 S, P 2. Description of improvement: 1 MM t 3. Owner(s) name and address: ,4J IJI?_ 1 Interest in property: tGt Q-) /•-9 ft-11A Name and address of fee simple titleholder: 6. Lender's name and address: 123.01.112 7/94 PAGE 3 A IPIft 4. Contractor's name and address: / l' T1+iD,0 y k' ' yL V/ • It).— 5. `Surety: (Payment bond required by owner from contr -ctor, if any) Name and address: a! .: Amount of bond $ 1 HEREBY CERTIFY that this 1s a tru 7. Persons within the State of Florida designated by OwrOhlt gA 0 as provided by Section 713.13(1)(a)7., Florida Statutes By 'Name and address: 8. In addition to himself, Owner designates the following person(s) to receive a copy of the Lienor's Notice as pro - vidbd in Section 713.13(1)(b), Florida Statutes. Name and address: Signature of Owner Print Owner's Name r r7tr -a-T Sworn to and subscribed before me this day of 4— Notary Public ' ►/ � ...• tr- ..c:.�wac�,t�.1wq,T''t cak Print: Notary's Name , N0 . 03.2003 �icrav 30:40E0 !HP � 4 My Commission Expires: ' WAGE µpgARY % i �� 4-40 11.iK) original file . this office on TY OF DADE 9. Expiration date of this Notice of Commencement (the xpiration date is 1 year from the date of recording unless a different date in specified) Prepare (', f; P-T 00. IGo Address' I 1 ' 2 ' 4 V , LA-1 111. > T. I\A\AMI, -1- -33I6c JOB ADDRESS • /$ 3 /UE/ d?- $ /' APPLICANT k eu-tA. PHONE # APPLICATION .. e ®a �— DATE CRITIQUE SHEET SHEET MISCELLANEOUS moo oLi 5 PERMIT NO. ADDRESS: MIAMI SHORES VILLAGE BUILDING / ZONING DEPARTMENT' SECTION BY ZONING ELECTRICAL MECHANICAL PLUMBING FIRE PUBLIC WORKS STRUCTURAL BUILDING OFFICIAL I. Sub;ect to compliance wth et Federal, State. Co ly Ycitage t4'te s tad regulations. Wine mu ne no responsibility tor accuracy oUoc results tcoca these pans. 2. This copy of plans crust b• •yatltbie on tuctding site or no Inspection mitt be conducted. ZONING COMMENTS CIA-- 6U8V d®IT Ity ;e /t) s0 _ L C Ldgia -- d r • 9rf_tt, set 6-(o5 rr , 'elf toed INITIALS RESTRICTIVE COVENANTS PROTECTIVE POOL ENCLOSURE PREPARED BY: __DECLARATION OF RESTRICTIVE COVENANT KNOLL MEN BY THESE PRESENTS: WHEREAS, the undersigned 0b Ware the fee simple owner (s) of the following described property situate and being in the Vi i age 9 I ,> � Lot (s) Block 't c),_. of /4/11) Y 1 i ► Li (Subdivision), A.K.A. (address) S P1, E. 1 O'a, C -1> according to the plat thereof, as recorded In Plat Book I.S Page 1 y of the Public Records of Dade County, Florida, and Whereas, the undersigned owner (s) RD.6•P h /1"E" I / y rn desire to utilize said Lot (s) as • a single building site, and the undersigned owner (s) do (es) heteby declare and agree as follows: 1. That the property will not be used in violation of any ordinances of the Village or Dade County now in effect or hereinafter enacted. 2. That the purpose of this covenant•Is to Induce the Village *o Issue a permit for a pool where the required enclosure is not on the subject property where the pool is located. • 3. That if any of our adjoining neighbors remove any portion of their fence wall, or if our /my property shall fall to meet code requirements for pool barriers, we, as owners will immediately • install a protective enclosure to meet code requirements and will obtain a permit for such fence. • 4. That, we, as owners, hold the Village harmless for any negligence or injury that results from not having the enclosure FURTHER, the undersigned declares) that this covenant is intended and shall constitute a restrictive covenant concerning the use, enjoyment and title to the above property and shall constitute a covenant running with the land and shall be binding upon the undersigned, his/her successors and assigns and may only be released by the Village t , or its successors, in accordance of said Village then in effect. IN WITNESS WHEREOF, the undersigned has/have caused affixed hereto on this ) day of 3 1 i y1-P ' WITNESS(ES) Signature and Print Signature and Print STATE OF FLORIDA ): COUNTY OF DATE ): I HEREBY CERTIFY that on this day ersonally appea Imown to me or has produced that he/she executed the foregoing, freely and voluntarily, SWORN TO AND SUBSCRIBED before me on this MY commission expires: 1 o ono v.. 10 .' Pt/ M C =V i A O ' ANGELA I I Z •,) C cor.• ,pro:. i: ,:.:._ ; I ' I.! , a . cc ';',..i.:.:91 II ' 1 �� cos OF FA P mc' , Signature and Print Signature and Print PUBL ST TE hand (s) and seal {s) to be b fore e , r-6 kr ` le is personally f {611ca on) as identification and he/she acicoowiedge for purposes there in expressed. • !.I •FFLO• n (We) acknowledge that a new swimming pool, spa or hot tub will be constructed or stalled at 4[S /ov trr Miami shores,. Fl., and hereby affirm that one of e following methods will be used to meet the requirements of Chapter 515, Florida atutes. ease initial the method(s) to be used) All doors providing direct access from the home to the pool will be equipped with self- closing, self - latching devices with release mechanisms placed no lower than 54" above the floor or deck; derstand that not having one of the above installed at the time of final inspection, or n pool is completed for contract purposes, will constitute a violation of Chapter 515, and will co .idered as committing a misdemeanor of the second degree, punishable nes to $5 nd /or to 60 days in jail as established in Chapter 775, F.S. RACTOR'S SIGNATURE & DATE • • A . '4 • .DONNA D. (ALB COMMISSION # CC885267 EXPIRES NOV 93. BONDEDTHROUdN 4 ACTOR'S '.Y PUBLIC A 4111.14: cSelot, e4Tilia BUILDING DEPARTMENT 10050 N.E. SECOND AVENUE MIAMI SHORES. FLORIDA 3313E TELEPHONE (305) 795-2204 FAX (305) 756.6972 NOTICE OF REQUIREMENTS RESIDENTIAL SWIMMING POOL, SPA AND HOT TUB SAFTY ACT The pool will be isolated from access from the home by an enclosure that meets the pool barrier requirments of Florida Statute 515.29; The pool will be equipped with an approved safty cover that complies with ASTM F1346 -91; All doors and windows providing direct access from the home to the pool will be equiped with an exit alarm that has a minimum sound pressure rating of 85 decibels at 10 feet; WNER'S SIGNATURE & DATE .--- Z/31 1 /24/1 . I• OWNER'S NAM . rft . . �✓ . . __ NOT DONNA D. GI COMMISSION S CC9$5267 XPIRES NOV 03. 2003 EOHDEOTHR000H Date "II • oy Miami Shores Village Building and Zoning Department Attention: Building Official SWIMMING POOL OWNER'S CERTIFICATION I certify that I am the legal owner of the property described as L OT t � 1 7 L• Z, A....9,.•&A,A.siimuri A- 14714- , located at A .1 0.e . 10)-- S Mt t M I ,�--10 ;Ft-- • . In accordance with Section 33 -12(0, Code of Metropolitan Dade County, I certify that I understand and agree that the swimming pool to be constructed at the above address cannot be used or filled with water until <a - separate- permit -has_been -obtamed_for-an approved_safety_--- barrier - and - such - barrier - erected — inspected= and=approved. -2 [ further understand that this certification, however, does not eliminate the need for obtaining a permit and erecting an approved barrier prior to final inspection and use of the pool. Note: This certification is to be submitted with a swimming pool permit application in duplicate. STATE OF FLORIDA) COUNTY OF DADE) ( R. M The undersigned Afhant, gl�' / � t V , does hereby attest that the (property owner) attached survey, performed by + le-A∎10 2. 444 C4T, ( &c (name of surveyor's company) performed on 8 • ) 3 • $4'" , is an accurate representation of the existing conditions and (date of survey) locations of all structures on the property as of this date. The purpose of this Affidavit is to induce Miami Shores Village to issue a building permit for the property without first providing a survey less than : (6) months old. The fant, as property owner, further agrees to remove or obtain permits for any structures which now may exist on the property which are not permitted or which may violate zoning or building code regulations. The Affiant further understands that the existence of any such structures may affect final inspections as applicable to this or other permits.. Further, Affiant sayeth naught. AFFIDAVIT Vl -74 SWORN TO AND SUBSCRIBED before me this day of Affiant is personally known to me, produced as identification. Y�Y -4t rN� s aor' N f;t� >+�It!�ISS{ON • CC885267 1/4; • fx P! 'tiS NOV Q3 2003 - :i BONDED 1$ OUGH ADNAKTA.Of MOTARY Date do - 77- 0 Job Address VS3 � ,U /2 ,r7, T x Folio 5 / ✓ 07 — 1 7 ,e Ave M,_ 3i /0th. q2, Arn lol P /AS of • r!i Shovu "S LC�h y C� y Ea El / Legal Descriptiotrai en ,wi/,t0/ N P1A /5 • Histori Y No X Master Permit # �Cj0(9 a09 Owner/Lessee / Tenant /` e Owner's Address .VfJ /Vt /1. S7, 7 Contracting Co. Qualifier ,7/i4 /'� Awt (_ . /ed 'Wfi State # Municipal # Competency # Ins. Co. Architect/Engineer Bonding Company Mortgagor 'PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Address Address Address Phone , 30: 75. LJs7 Address /JZ79 34 7$ ? j,r y 7 d Phone Permit Type (circle one): BUILD G` LE PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION /f G(/ - D ll / �F�I��Fr/ /.2/A' 1,7(77x4717-741, /=-- ,vf(/ ,' ' . /1�A d / *Az�‘ Square Ft. Estimated Cost (value) 1 �'O- 76 WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY RESULT IN YOU PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDE 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 wo will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits are required for ELECTRICA 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 regulatii construction e►d zoning. Furthermore, I authorize the above -named contractor to do the work stated. Signature of owner and/or Condo President 4/ Notary as to Owner and/or C;j . , •• 'dent My Commission Expires: Ann Fugazzi p p • My Commission D0083828 i Expires March 29, 2008 FEES: PERMIT 6:0 ao RADON 2cO? Date Date Notary as to Contract or My Commission Expires: APPROVED: Zoning Building Mechanical Plumbing of Contractor or Owner- Builder Date Electrical Structural Engineer LIUJA M. PEREZCORDOVA pat .: MY COMMISSION # DD 001409 EXPIRES: March 14, 2005 Bonded Thnr Notary Public Underwriters BOND /� � TOTAL DUE ( V. D v ITEM BATH TUB UNIT FEE ITEM SWITCH OUTLETS UNIT FEE ITEM SPACE HEATERS UNIT FEE BIDET LIGIIT OUTLETS CENTRAL HEATING DISHWASHER RECEPTACLES A/C (WIND) DISPOSAL SERVICE TEMPORARY A/C (CENTRAL) DRINKING FOUNTAIN SERVICE SIZE IN AMPS DUCT WORK FLOOR DRAIN SERVICE REPAIMETER CHANGE / REFRIGERATION GREASE TRAP APPLI OUTLETS PROCESS AND PRESS PIPING INTERCEPTOR RANGE TOP UNDERGROUND TANKS LAVATORY OVEN ABOVE GROUAND TANKS LAUNDRY TRAY WATER HEATER U.F. PRESSURE VESSELS CLOTHES WASHER MOTORS 0- 1 If STEAM BOILERS SHOWER MOTORS OVER 1- 3 FP HOT WATER BOILERS SINK, POT/3 COP . MOTORS OVER 3- 5 HP MECHANICAL VENTILATION SINK, RESIDENCE MOTORS OVER 5- 8 If TRANSPORTING ASSEMBLIES SINK, SLOP MOTORS OVER 8- 10 1P ELEVATORS/ESCALATORS TEMPORARY WATER CLOSET MOTORS OVER 10- 25 FP F IRE SPRINKLER SYSTEMS URINAL MOTORS OVER 25-100 HP COOLING TOWERS WATER CLOSET MOTORS OVER 100 IP VIOLATION INDIRECT WASTES A/C WINDOW RE INSPECTION WATER SUPPLY TO: AIR CONDITIONERS A/C UNIT STRIP HEATER F IRE SPRINKLER GENERATORS TRANSFORMERS • HEATER -NEW INST. GENERATORS TRANSFORMERS HEATER - REPLACE GENERATORS TRANSFORMERS LAWN SPR I NKLER -WELL ^ SPEC I AL PLfiPOSE SWIMNING POOL OUTLETS COM,ERCIAL WATER SERV ICE _ S TUBES EWER CONNECTIONS SIGN TRANSFORMERS IT I L I TY- SETTER _ SIGN TIME CLOCK JT I L I TY-WATER FIXTLRES ;EPTIC TANK ANTENNA , RELAY TELEVISION OUTLETS RAINFIE10, 4' TILE/RES. VIOLATION UP & ABANDON SEPT IC TANK RE I NSPECT ION OAKAGE PIT CU. FT. j-/9L e/ / 7r :ATCH BASIN 11SCHARGE WELL _ WEST IC WELL AREA DRAIN ;OOF INLET ALAR WATER HEATER IRE STAMPIPE 001. PIPING AWN SPRINKLER SYSTEM - AS RAGE ETER SET (GAS) AS PIPING (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 ADDENDUM TO BUILDING PERMIT APPLICATION ELECTRICAL MECHANICAL • BUILDING AND ZONING DEPARTMENT 10050 N.E. SECONO AVENUE MIAMI SHORES. FLORIDA 33138 -2382 TELEPHONE 1305) 795.2204 FAX (305) 758-8972 TO: ELECTRICAL CONTRACTORS t e 4114 r FROM: MICHAEL DEVANEY, CHIEF ELECTRICAL INSPECTOR Two copies of the applicable requirements must accompany all permit applications. If not met, applications will not be accepted by the Building Department. Permit applications where a master permit is non- existent will need the following. Service change: Riser diagram showing meter size, disconnects, wire and conduit size, subfeed, grounding and panels. The Work With inspection can be scheduled after the permit has been obtained. A final inspection is required Air Conditioning Hook-up: Load calculations showing service size to determine if service is adequate for new load. Need the wire and conduit size for air handling unit and condensing unit. Kitchen Remodeling: Cabinet maker's layout will suffice showing location of outlets. In other situations where a master permit is not issued, I will need to have . a line diagram showing what's being done. DRIP LOOP ro BE a 0' '',FEI CHIN) • 1 200A HE 1 2' ADOVE ROOF 1 • • • . e 70ih11(1 minima a' PLAr1IC euci niia F111TS11ED GRAJIE •.1 HA]N cD PANEL • PVC SLCCV 1 1 • • U•U' ?11N 11EP711 • • 4--- ... • i MYM 41 ►4 fl#, ui*• t1.M J aw' x w fiRfl. t11 PM Q1110 «J • LU) • SUB C • PANEL PER S.F.II.C, 4506,2(B) CONT « U ' I ' QR.. " L . ..L E C"0a)7VI a • S 11i11ATl11lE P IC1:51:.K UI< ' MST • •I•Icloll•1:_ Conductor scat � �CV e1 • • Conclul•l• size � . 77 Coiith4t - L-ype: /h.. -n,ru cot YES .�x _ UU Ground wore :li:e %�_= :SL_ MACH. DISYOWIIECT Ro.tlnp =0 _AMpS Mull% _Anpa Sub Dr Gal cars Awra SUB FEEDER NowOt Exlrl'onp Typc1./�� i�ic e&.- fEd size j 3V M Mond SLsa•:.�,� WS [DE PArlEL . Ratlnp bU�d BUGS. LOC6'tion_ • • Nibs Yes X.x_I•1n Mad Tbni Notary Publtc Undarndters 1D • Printed: 7/2/2002 Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Applicant: JEFFREY CHARLES Owner: KELLUM JOB ADDRESS: 453 Contractor Local Phone: Parcel # 11320601 Permit Status: Approved Permit Expiration: 12/29/2002 Construction Value: $2,700.00 Work: RELOCATE OVERHEAD SERV DROP (METER/MAIN) TO PROVIDE CLEARANCE FOR NEW POOL 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 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 . -mployes. Sign 1 J NE 102 Electrical Permit Permit Number: EL2002 -209 KELLUM JEFFREY CHARLES ST Contractor's Address: 13727 SW 152 ST #320 Legal Description: MIAMI SHORES SEC 4 AMD PLAT Page 1 of 1 PB 15 -14 LOT 19 PECTOR) BY: (Contractor or Builder) e BY: BLK 92 GENERATION ELECTRICAL SERVICES CORP. PH. 305-252-7780/EC40001482 13727 SW 152ND ST., #320 PAY TO THE ORDER OF MEMO MIAMI, FL 33177 • JLreJ 01/afe • /ee/4 9531 -u-67- ac) filar WASHINGTON MUTUAL BANK, FA MIAMI/MIAMI LAKES FINANCIAL CENTER 1755 MIAMI LAKES, FL 33014 63-8413-2670 • 1000478 /0 1: 2 67084 L3 3 iso 2 1.4218thOui $ c7 4781 DOLLARS 8 to PERMIT APPLICATION FOR MIAMI SHORES VILLAGE job Adder 4f 3 1= I 0 2 ST ! ti( 1 I o ax Folio I-or 19 /St-. 9 z..,AAN D. AT MIA .S')4PT% -ws , Legal Description SFe • 1 4 , �R IS / 1)4- _ 14 Historically Designated: Yes No Owner/Lessee / Tenant Z F F �Y I X13 g R-T/J <:=" —t-- UM Master Permit # �i ' c�� )- ' 151 1 Date Qualifier Stat # Bonding Company Mortgagor Square Ft. Notary as t My Comm FEES: PERMIT APPROVED: Zoning Mechanical Owner's Address )3 $J a- 102 2.r MIAMI 4i0 1J Contrac Co. TI4.D y 4 S S . )P1.>IAL 9 -- 1 2 6 I/— C PC Municipal # Architect/Engineer/ ��AJ y 1..) n M 1e. % r D n l 4 I) p Address Permit Type (circle one): BUILDING ELECTRIC PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION W I M M I k9 er 43z Signature of owner and/or Condo President • • • '1":41111[4 • i ! ,aZ , T , i IjwideC8B5267 : CXPfI',`:S NOV 03 2003 a t<ONDED THROUGH ;.tWANTAGE NOTARY RADON Building Plumbing C.C.F. 'Y' •o ' Date ss# Phone W 2 -7 0 - 7q4 Competency # Ins. Co. 461 gCA) 7=2.AVg.,MIifMc L 33/.TJ' Address Address Estimated Cost (value) 4 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.) Phone (30i) 7.r 3(\[j C• 331 egG Address 17,-1,4r I I1 J7. MI elm ! L Application is hereby made to obtain a permit to do work and installation as indicated above, and on the attached addendum (if applicable). 1 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. OWNERS AFFIDAVIT: I certify that all the foregoing information is accurate and th. . work construction and zoning. Furthermore, I authorize the above -named contractor to • o the wo Signat of Contractor or Owner- Builder \:c.•••w' • • • .).1 • £.44 i i i ,: • • r orl 44.a• f•VirtiV7VMM t -B r ,.- L; .. a:MMISSION 1 CC885267 EXPII2€S NOV 03.2003 DONDED THROUON ADVArnAG NOTARY Notary as My Co NOTARY Electrical SOP 0 o a in compliance with all applicable laws regulating .l� Date .'•L3 .vv Date BOND /� TOTAL DUE O OD Structural Engineer Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Printed: 6/24/2002 Applicant: JEFFREY CHARLES KELLUM Owner: KELLUM JEFFREY CHARLES JOB ADDRESS: 453 NE 102 ST Contractor ANTHONY & SYLVAN POOL /SPA CONTRACT actor's Address: 12245 SW 112 STREET Local Phone: 305 -270 -946 Parcel # 1132060170810 Fees: Description Amount FEE2002 -3533 Building Fee $90.00 Total Fees: $90.00 Permit Status: Approved Permit Expiration: 12/18/2002 Work: SWIMMING POOL PIPING 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 pr- per 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 furthe 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 regulat „ns 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, servan •r employees. 1 ilk In consi . he ssuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining tt eto a i^ srr with the plan . awings, statements or specifications sub ted to the proper authorities of Miami Shores Village. In accepting this permit I assume responisibl y for ar .rrt ozre eiter myself, my agent, servants or employes. Signed: Plumbing Permit Permit Number: PL2002 -159 Legal Description: MIAMI SHORES SEC 4 AMD PLAT Construction Value: $2,000.00 Page 1 of 1 PB 15 -14 LOT 19 BLK 92 Total Fees: $90.00 Total Receipts: $0.00 (INSPECTOR) BY: (Contractor or Builder) BY: • PAY TO THE ORDER OF l'. _ ._ _ gas a.7U --7 S e/Ga ANTHONY AND SYLVAN POOLS CORP. DBA POOLS BY ANDREWS -ae+ PD. BOX t+ to 2Z�!S�sw /lZ S f- DOYlFCTZUIti rr% ; Q V' i 6 7 3•i142 a rYt / - .5 rZ f FOR First Union National Bank ° firstunion.com 10 . 075 R/T 031000503') H'0000 20 2 3n' jlir.w,nawtti}}we� DATE L000 50 31: 200000 3 3 26 L 9011' 1 �lr D DOLLARS LU 2023 3- 50/310 6 F••■•• Orb. Sl.w.wvl - ‘0.Wuu7111 .. __ 1..rovu..lu � n..ny PERMIT APPLICATION FOR MIAMI SHORES VILLAGE 1 1 Z 5 / o Job Address g - 5 . 3 /7 .e /0 Tax Folio .1 Description Historically Designated: Yes No • .. tier'/Lessee / Tenant Address fier SS# Municipal # — Competency # .,tt ct ingineer Address Company Address -, agor dress K.°(it`Type (circle one): BULLDING ELECTRICA PLUMBIN CIIANICAL ROOFING PAVING FENCE SIGN • .1K DESCRIPTION QQ- /oc&J ftv l tgui P.s f — Estimated Cost (value) , ►dINNG TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY RESULT IN YOUR :NG TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.) -tion 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 p rformed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits are required for ELECTRICAL :i13ING, SIGNS, POOLS, ROOFING and MECHANICAL WORK. AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating ction and zoning. Furthermore, I authorize the above -named contractor to do the work stated. as to : T er,fi •L•nuission Exp - . My Commission D0150048 " . or Expires November 15, 2006. Plumbing 74 d 6 : LC t1 M er Permit hone 0.9 --3s 1 1 My Commission Expires: Notary as to Contractor or Owner - Builder Date C.C.F. NOTAR ontra r or Owner Builder Date Electrical Structural Engineer O - ,.,,,co 3 o s _ y- Phon Ins. Co. BOND TOTAL DUE /V FROM :ANTHONY RNDSYLVAN POOLS PERMIT APPLICATION FOR MIAMI SHORES VILLAGE mem _Tai Yetis d iK►n.lMpe l Timms �C. C N M - •-- �-"""" N° 14.11 Mg "".`••'-. _ --�� — ! Pith ,r Phone Lica * ea. Adesse _^ - ..► &SA _ ....• •. �.... PI . • .+1x4 32 Add /It ' (clrek one): JJJI13.DDlfi trAtCTIRICAL PLCAWJgG ALC$ANICAL ROOFING JPAYID c PENCE SIGN • Ti Eetb2Red Cat (valu) 04INC TO O17411 YOU tart Mow A ? Vilai OF cOMMRNC>CNO RT AND Y vC Twin !ea ovsna fn TO Mgt PltorlE y (W YOu I'A . C N SO 1�Y lunar IN YOUR A'1" rosin sum 'Mealtime YOUN NOTICE or CoAtMt c 7U 0!?AJN lIIMAKCg1iC. Cotklt;LT �171(YOUR Lam P i4•1w'0br nede a Pra a eb *alt and in.411ie31 illatend govt. and en d • ;�afocroS To mat the s ai to * dal' 1i , I t1•de� voostruatiaa In this j Th:1km. 1 uddoi woe= pews an spplicA00). t�, that sit ..u., •i1�. SIGNS. RUA and hectiA�, wcXllC, roams ELECfRt('.A1. 'J'KSAh'F DAVIT; Nan* trot •a be beioing woe is wort. Mien ■d ate, rarthwt+ae, t atab rks it aktaot!Aed wan* Canenimi BETTY W. LAGRANGE ,:: • �r MY COMMISSION R CC 891856 T4 EXPIRES: April 27, 2004 �K11Q1' `„+ BodW TlwMalaryPub YcUndewngte TOTAL DM I rT 36 I0 39Vd FAX N0. :305 2549255 728d' eai.'£:Xd_ --- 3uTJJA ;.wN:;"(LIHTu: NVA1AS ANOHINti NOV. 25 2002 12:29PM P1 t3wrra1G11 d[� �e�li0er PA: I :'f r -7: TT 14, •r - n 7 SSZLLLZIb6 E0 :EI Z00Z /SZ /II PERMIT NO. ADDRESS: MIAMI SHORES VILLAGE BUILDING / ZONING DEPARTMENT.. SECTION BY DATE ZONING ELECTRICAL MECHANICAL PLUMBING FIRE ' PUBLIC WORKS STRUCTURAL BUILDING OFFICIAL 1. Subject to compliance with ett Federal, State. CowitX Vtiage rites and reputations. VHtage assumes no responsibility tot accuracy of /or resutts from these plans. 2. This copy of plans must be available on bugding site or no Inspection will be conducted. CRITIQUE SHEET JOB ADDRESS • sV /Q APPLICANT PHONE ft APPUCATION i(DvL SHEET OF MISCELLANEOUS DATE ZOJVINy . // i 14(41/ I s Qu (, 1c -1 7 COMMENTS INITIALS