EL-05-327Miami Shores Village
10050 NE 2nd Avenue
Phone: 305 - 795 -2204
Printed: 9/19/2005
Applicant: THOMAS AND SANDRA
Owner: CHAILLE
JOB ADDRESS: 1480 NE 103
Contractor
Local Phone:
Parcel # 1132050310070
Electrical Permit
Permit Number: EL2005 -327
CHAI LLE
THOMAS AND SANDRA
ST
Contractor's Address:
Page 1 of 1
Legal Description: RE - PLAT OF TR C MIAMI SHORES BAY PARK ESTS
Permit Status: APPROVED Permit Expiration: 3/15/2006 Construction Value: $1,000.00
Work: INSTALL AN WIRE (LOW VOLTAGE) FOR STEREO, TV SPEAKERS
PB 64 -97 LOT 16
Fees:
FEE2005 -12609
FEE2005 -12610
FEE2005 -12611
FEE2005 -12612
FEE2005 -12613
FEE2005 -12614
Description
Building Fee
CCF
Notary Fee
Training and Education Fee
Technology Fee
Scanning Fee
Total Fees:
Amount
$150.00
$0.60
$5.00
$0.20
$2.50
$3.00
$161.30
Total Fees: $161.30
Total Receipts: $0.00
SE? 1 9 PAID
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 1 assume responisibility for all work
done by either myself, my agent, servants or employes.
REG C01 091.905 1450 lCkk01 030875 CHARGE $1161.30
Signed: (Contractor or Builder) BY:
MIAMI.SHO'? VILLAGES
BUILDING DEPARTMENT '(9�
305- 795 -2204 0��►
Building Inspection Request
Date "te *P P el-r- /14
Type Insp'n = !r .L6I/ l e7/ 1 44' /4i:0
Permit No.
Name ► / 4 2 .1•G e
Address / 4 46 ® ./(J, /.�
Company ® 4 — /'-- `PA Phone #
Inspection Date lEa C
Approved
Correction
Re- Insp'n Fee
Inspection Date: 04/17/2006
Inspector: Devaney, Michael
Owner: None, None
Job Address: 1480 103 ST
Project: <NONE>
Contractor.
Miami Shores Village, FL
Building Department Comments
Monday, April 17, 2006
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Block:
Permit Type: Imported Permit
Inspection Type: Electrical
Work Classification: <NONE>
Phone Number
Parcel Number 1132050310070
Lot:
Page 2 of 2
Passed Ea
Inspector Comments
('
0,6
Failed
Correction
Needed
Re- Inspection
Fee
($75)
No Additional Inspections can be scheduled
re- inspection fee is paid.
until
Inspection Date: 04/17/2006
Inspector: Devaney, Michael
Owner: None, None
Job Address: 1480 103 ST
Project: <NONE>
Contractor.
Miami Shores Village, FL
Building Department Comments
Monday, April 17, 2006
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Block:
Permit Type: Imported Permit
Inspection Type: Electrical
Work Classification: <NONE>
Phone Number
Parcel Number 1132050310070
Lot:
Page 2 of 2
BUILDING
PERMIT APPL
FBC 2001
Plumbing Mechanical Roofmg
Owner's Name (Fee Simple Titleholder) C 1 LLPhone # C l7 r S 3�
Owner's Address , \C t 1 ® C P
City \ ` 1 \ State
Permit Type (circle): Building
Job Address (where the work is being done)
City State
Total Fee Now Due $ ' b f
(Continued on opposite side)
Miami Shores Village
-E.2n
e:(30
TION
Electrical
mg Department
Avenue, Miami Shores, Florida 33138
) 795.2204 Fax: (305) 756.8972
Tenant/Lessee Name
Zip
Phone #
City Miami Shores Village County Miami -Dade
Is Building Historically Designated YES �NO�
Contractor's Company Name 9 4 A
Permit No.
Master Permit No.
Phone #
Zip 3513
Contractor's Address
Qualifier
State Certificate or Registration No. Certificate of Competency No.
Architect/Engineer's Name (if applicable) Phone #
$ Value of Work For this Permit 1 000 Square Footage Of Work:
Type of Work: ❑Addition ❑Alterat'on ew ❑ Repair/Replace ❑ Demolition
Describe Work: 4. 44. ev LLA t 1 _
/spe S
rees
Zip
Submittal Fee $ 1 Permit Fee $ / S ep e CCF $ 0 , CpC7 ,CO /CC
Notary $ e Training/Education Fee $ 0. 2C) Technology Fee $ 2_ • C ) .
Scanning $ 3 Radon $ Zoning Bond $
Code Enforcement $ Structural Plan Review. $
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. 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 A1414IDAVIT: 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 occur en (7) days after the building permit is issued In the absence of such posted notice, the
inspection will not be approved d a rei • ection fee will be charged
Signature
Contractor
The foregoin instrument was ac owledged bef e me this The foregoing instrument was acknowledged before me this
day of� 20 y) fif , day of , 20 , by
who is personally . o to me or who has produced who is personally known to me or who has produced
as identification and who did take an oath.
NOTA
Sign:
Print:
My Co i ission Expires:
* * * * * * * * * * * * * * * * * * * * * * * **
chc 05 /13/03
Owner or Agent
APPLICATION APPROVED BY:
As identification and who did take an oath.
********************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
Engineer
Zoning
NOTARY PUBLIC:
Sign:
Print:
My Commission Expires:
2j f
^it/anh C1 6 ,�.
CO., /rjc
********** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
.
/‘,4 2/ Examiner
ITEM
BATH TUR3
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 MAIN
SERVICE REPAIR/METER CHANGE
REFRIGERATION
GREASE TRAP
APPLIANCE OUTLETS
PROCESS AND PRESS PIPING
INTERCEPTOR
RANGE TOP
UNDERGROUND TANKS
LAVATORY
OVEN
ABOVE GROUND 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 HP
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 If
VIOLATION
INDIRECT WASTES
A/C WINDOW
REINSPECTION
WATER SUPPLY TO:
AIR CONDITIONERS
•
A/C UNIT
STRIP HEATER
FIRE SPRINKLER
GENERATORS TRANSFORMERS
i
'HEATER -NEW INST.
GENERATORS TRANSFORMERS
1
HEATER - REPLACE
GENERATORS TRANSFORMERS
LAWN SPRINKLER -WELL
SPECIAL PURPOSE
.
SWIMMING POOL
OUTLETS COMMERCIAL
WATER SERVICE
SIGN TUBES
SEWER CONNECTIONS
.SIGN TRANSFERS
UTILITY -SEWER
SIGN TIME CLOCK
UTILITY -WATER
FIXTLRES
SEPTIC TANK
ANTENNA
RELAY
TELEVISION OUTLETS
DRAINFIELD, 4' TILE/RES.
VIOLATION
PUMP 8 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)
GA. PIPING
Pk It.
ADDENDUM TO BUILDING PERMIT APPLICATION
(AN AZ bICATION FOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. IF A MASTER PERMIT HAS B.
OBTAINED, THE OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.)
PLUMBING
ELECTRICAL
MECHANICAL
VILLAGE OF MIAMI SHORES
r ' Y BUILDING DEPARTMENT
OWNER BUILDER DISCLOSURE .STATEMENT
�'�
I -� CY l bei ng the legal property owner, for the property
~� \ � �' I P P�h' � P P rty
Located at: `t ` o \,c::3 S�� ,
Legally described as
Do hereby petition the Village of Miami Shores to act as my own contractor pursuant to the laws of the
State of Florida, F.S. 489.103(7),And 1 have read and understand the following disclosure
Statement, which entitles me tci work as my own contractor, T further understand that T as the owner
must appear in person to complete all applications.
State law requires construction to be done by licensed contractors. You have applied for a permit under an
exemption to that law. The exemption allows you, as the owner of your property, to act as your own contractor
even though you do not have a license. You must supervise the construction yourself. You may build or
improve a one - family or two-family residence or a farm out - building. 1 You may also build or improve a
commercial building at a cost of 525,000.00 or less. The building must be for your own use and occupancy. It
may not be built for sale or lease. If you sell or lease a building you have built yourself within one year after the
construction is completed, the law will presume that you built it for sale or lease, which is a violation of this
exemption. You may not hire an unlicensed person as your contractor. It is your responsibility to make sure
that people employed by you have licenses required by state law and by county or municipal licensing
ordinances. Any person working on your building who is not Icensed must work under your supervision
and must be employed by you, which means that you must deduct F.I.C.A. and with - bolding tax and
provide workers' compensation for that employee, all as prescribed by law. Your construction must comply
with all applicable laws, ordinances, building codes and zoning regulations.
Proof of ownership provided ( ) initial of reviewing clerk. Tlie foregoing instrument
Was acknowledged before me this I, 4 day o
Produced 'r/ a •
Owner
Owner
DISCLOSURE STATEMENT
20 OS
who is personally known to me or who has
as identification
d who did take an oath..
Mabel Vargas
; Commission r)D23.) ,-
•
•
Atlantic, bonding Ca, Inc