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DS-07-1544Inspection Date: 08/14/2007 Inspector: Grande, Claudio Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Owner: WESENSTEN, JOHN Job Address: 1210 100 Street NE Miami Shores Village, FL Project: <NONE> Contractor: ALL QUALITY ELECTRICAL SERVICES, INC Permit Type: Driveways /Sidewalks /Slabs Inspection Type: Anal Work Classification: New Block: Phone Number (305)757 -1457 Parcel Number 1132050090070 Lot: Phone: (305)968 -7832 Building Department Comments PAD FOR 25 KW NEW GENERATOR l f7iL I15NM Passed '/ /Inspector Comments Failed Correction Needed Re- Inspection Fee ($75) No Additional Inspections can be scheduled re- inspection fee is paid . until Monday, August 13, 2007 Page 1 of 2 0 an-77,1 Miami Shores Village itt 2 No Building 1 ng Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 BY: ° °aoam °° Tel: (305) 795.2204 Fax: (305) 756.8972 BUILDING �� &Awe) PERMIT APPLICATION FBC 2004 Permit No. 0-1— /544 Master Permit No. Permit Type (circle): Building a► amoimmohierolv a Roofmg Owner's Name (Fee Simple Titleholder) yam' //?! t.ce 4,1SM-A,1 Phone # , 7S 7 /V5-"" 7 Owner's Address %2. /® JF /00 City //40.1 i SAWILS State A.Z. Tenant/Lessee Name )1/4% /09- - Zip 3g..r3 Phone # Job Address (where the work is being done) /210 NCB /0 sf City Miami Shores Vi11a2e County Miami -Dade ;Zip FOLIO / PARCEL # f/ 3)-- &i 00 — 9 , Is Building Historically Designated YES NO Y /it& c c)At,/ry 6 tecrizi e Contractor's Company Name Contractor's Address /%.5"O0 City //!j Qualifier Name 1,, Acv A CT State /r State Certificate or Registration No. 6 000 97 d Architect/Engineer's Name (if applicable) Value of Work For this Permit $ Type of Work: DAddition lmv'Y: r�'4 A Phone # - — eV) 7 Zip 33/g y Phone # 30s- 9682 7( 32- Certificate of Competency No. ("elp ❑Alteration Phone # Square / Linear Footage Of Work: El/New ❑ Repair/Replace ❑ Demolition Submittal Fee $ Permit Fee $ /a 6 - CCF $ 1 20 CO /CC Notary $ Training/Education Fee $ ,(40 Technology Fee $ ' Scanning $ YJ ` Radon $ DPBR $ Zoning $ Bond $ Code Enforcement $ Double Fee $ Structural Review. $ Total Fee Now Due $110 f 0 See Reverse side -* Bon Bon City Mo Mo City App com cons WE 0 appli "W PAY CO CO Noti prom whos fort inspection will not be approved and a reinspection fee will be charged ling company s i - - - =_ ��LL O 6:- W 5 W t IMPACT FEES HRS /DERM 0 � tgage Lender's N ication is hereb 6 I J R 6' 1 STRUCTURAL ,21j GA/40i ELECT 21C*L --.....„Z" `i/ MECHANICAL 1 Signature raa�.�,��� Signature Owner or Agent Contractor The foregoing instrument was acknowledged before me this /6 The foregoing instrument was acknowledged before me this / l Ilation has regulating G, SIGNS, ce with all IN YOUR ANCING, TICE OF bplicant must !o the person rt the job site d notice, the day of � 20 by who is person ly known to me or who hasproduced As identification and who did take'. oath. NOTARY PUBLIC: Sign: Print: day of 20 O7by who is personally known to me or who has produced as identification and who did take an oath. My Commission Expires: APPLICATION APPROVED BY: (Revised 02/08/06) _ , g Expires 12/7/2011 ' 1°, 0.0 Florid: 14:4n-- A.. -.. wnuSn.uIuoeeaeneautor.. e NOTARY PUBLIC: Sign: Print: My Commission Expires: We LACY Comm. 0008201108 *110 . Fbrtda NotaiyAssa, Inc Plans Examiner Engineer Zoning Man JUL24 BY: Ae P6444 413 t4ggi 1$}i' Survey of Lot 7 & the East 4 feet "EARLETON SHORES" recordecl in Plat Book 43 FO John Wesensl'en &T _ :/ of Lot 8, Block 1, at Pow 80 tgs•''7-62) . onoon No. 28328 • • ecr wiling to the Ptet ttwsoII most trAmirs711111111111 SUBJECT TO COMPLIAN . (WITH ALL FEDERAL STATE AND COUNTY RULES AND REGULATIONS • • ••• • • • • • • •• • ••• • • • • •• • •••• •• • • • • • • •••• • •• • • • ••• • •• •• •••• • • • • • • ••i• • • • • • • • •••• •i • ••• • • • •• • •• • • • • • • • • • • • • • J•H, MANUCY, INC PROFESSIONAL LAND SURVEYORS Ana Palm Avenue. Suite 263 o Hialeah, MAO& ro3i2 (300 621.1231 a 6 ) FI21.9220 ®ROWARD. 000) W. Wers UNDER MY RgCTlON; THAT IT MEETS THMINIMUM TECHNICAL STANDARDS FOR LAND G IN THE STATE OF FLORIDA CHAP LORIOAVADMINIST TIVE C� E) OR THE ;1 CHAPTER: OF S Y SHOWN HEREON AND BELIEF. AND CORRECT TO THE £)EE .�irw. • _. , . Menus to Land &armor 011213 t @. Job Address Job Description: Contractor Information 1210 NE Sao St Miami Shores, Ft. 33138 Pour Concrete Pad for 25kw NG fired Generator Pad weight = 3,200 Ibs or greater All Quality Electric 14500 NW 16 Ct Miami, FL 33167 305- 968 -7832 .:, Owner Information Residence of •Dt VVesensten Notes: Combined height of generator and slab will be 60" •••• •••, • .••••• 80" Long •••• • • • •••• • • •••• • • • • • • • •• • •• • • • • • • • •• hii�•• • • .• • • • • • • • • • ••• • • • • • •• 7/15/2007 Concrete Pad 80" Long X 37" Wide X 32" High 3000 PSI WI #5 Reinforcing Bars Each Way Sakrete 5000 Fiber Cement / Crack Proof Concrete Stained to Customer Specification k • • • • • • • • • • Stany d ,Powe.[, Rating • • 4. • 25 kW 60 Hi" • •• • • • •• • • • • •. • • • • • • ••••••• • STANDARD EQUIPMENT Liquid Cooled Gas Engine Generator Sets Model Numbers: 05324 (Tan ) 05324T (Tan - Steel) 05325 (Gray - Aluminum) WHISPER -TEST nM Low Speed Exercise 63 dB(A) at 23 feet GENERAC 1.6L ENGINE Naturally Aspirated Gaseous Fueled UL 2200 Listed Model 5324T is equipped with a 200 amp NEMA 3R Transfer Switch. Transfer Switches are available for Models 5324 and 5325 • All input connections in one single area • High coolant temperature shutdown • Low oil pressure shutdown • Low coolant level automatic shutdown • Overspeed automatic shutdown • Crank timer • Exercise timer • Oil drain extension • Cool flow radiator • Closed coolant recovery system FEATURES • Watertight state of the art electrical connectors • Mainline circuit breaker • Radiator drain extension • Battery charge alternator • 2 Amp static battery charger • Battery rack and battery cables • Fan and belt guards • Isochronous governor • UV/Ozone resistant hoses • Innovative design and fully prototype tested • UL2200 Listed • Solid state frequency compensated voltage regulator • Dynamic and static battery charger • Sound attenuated acoustically designed enclosure • Whisper- Testn"for low noise level exercise • Acoustically designed engine cooling system • High flow low noise factory engineered exhaust system • State of the art digital control system with R100 digital control panel • Watertight electrical connectors • Rodent proof construction • High efficiency, low distortion Generac designed alternator • Vibration isolated from mounting base • Matching Generac transfer switches engineered and tested to work as a system • All components easily accessible for maintenance • Electrostatically applied powder paint G vAR D IAN by Generac Power Systems, Inc. QUIET kIL E APPLICATION & ENGINEERING DATA .• • L: GENERATOR SPECfFfCATI0N3 ••• • • • • • • • • • • • •.• • • •• •• • • • • • • • • • • ••• • • • • Stantl14625 kW • 1 1 1 ••• • • • TYPE ••••••••••••• . ......Syrickronous• • ROTOR INSULATION • • ;•...;...;...:...:...:.�lass F• STATOR INSULATION TOTAL HARMONIC DISTORTION TELEPHONE INTERFERENCE FACTOR (11F) <50 ALTERNATOR OUTPUT LEADS 3 PHASE 4 wire BEARINGS Sealed Ball COUPLING Flexible Disc LOAD CAPACITY (STANDBY RATING) 25 kW EXCITATION SYSTEM Direct • • • • • •• • • �....�...� .....................•..Class F • •• • • • • • ••• 5a• NOTE: Generator rating and performance in accordance with IS08528 5, BS5514, SAE J1349, 1S03046, and DIN6271 standards. VOLTAGE REGULATOR OUARDIIAIIVa�.. UIETSOURCE ENGINE SPECIFICATIONS MAKE Generac MODEL In line CYLINDERS 4 DISPLACEMENT 1.6 Liter BORE 3.15 STROKE 3.13 COMPRESSION RATIO 9.75:1 INTAKE AIR SYSTEM Naturally Aspirated VALVE SEATS Replaceable LIFTER TYPE Hydraulic GOVERNOR SPECIFICATIONS TYPE Electronic FREQUENCY REGULATION Isochronous STEADY STATE REGULATION ± 0.25 TYPE Electronic SENSING ..SinglePh1% ENGINE LUBRICATION SYSTEM REGULATION t 1 % FEATURES V/F Adjustable Adjustable Voltage and Gain LED Indicators GENERATOR FEATURES O Revolving field heavy duty generator O Directly connected to the engine O Operating temperature rise 120 °C above a 40 °C ambient O Insulation is Class F rated at 130 °C rise O All models are fully prototyped tested CONTROL PANEL FEATURES O SEVEN LED INDICATOR LIGHTS O ADDITIONAL FUNCTIONS • System ready • Low fuel pressure • Low battery • Low oil pressure • High coolant temp/low coolant temp • Overspeed • Overcrank 0 INTERNAL FUNCTIONS: • 3 position switch (auto, off and manual) • Utility sensing • Delay on utility failure for engine start • Engine warm -up before transfer • Delay to retransfer to utility • Engine cooldown timer • Exerciser not set • 2 wire start for any transfer switch • Communicates with the Generac RTS transfer switch • Built -in 7 day exerciser • Selectable engine speed at exercise • Governor controller is built into the master control board • Temperature range -40 °C to 70 °C Rating definitions - Standby: Applicable for supplying emergency power for the duration of the utility power outage. No overload capability is available for this rating. (All ratings in accordance with BS5514, IS03046 and DIN6271). (All ratings in accordance with BS5514, IS03046, IS08528 and DIN6271). OIL PUMP Gear OIL FILTER Full flow spin -on cartridge CRANKCASE CAPACITY 4 Quarts ENGINE COOLING SYSTEM TYPE Closed WATER PUMP It driven FAN SPEED 2550 FAN DIAMETER 15 inches FAN MODE Pusher FUEL SYSTEM FUEL TYPE n.. Natural garopane vapor CARBURETOR Down Draft SECONDARY FUEL REGULATOR Standard FUEL SHUT OFF SOLENOID Standard OPERATING FUEL PRESSURE 5° - 14° H2O ELECTRICAL SYSTEM BATTERY CHARGE ALTERNATOR 12V 30 Amp STATIC BATTERY CHARGER 2 Amp RECOMMENDED BATTERY Group 26, 525CCA SYSTEM VOLTAGE 12 Volts STANDBY 25 kW • • ••• • • • ••• •• •• • • • •• •. • • • • • • • • • • • • • • ••• • • • • • • • • • • • ••• • • • • 000 • ••• • • • ••• • • •s• • • • • ®UJARDIAN. . ... UIE°TSOURCE -- --_ -- ___— T -_ -^i • rr• - ST NDBY25 kW 1(W- BATING . • • •• ••• •• x___25_ j •• ENGINE SIZE • • • • • •' • ' . 1.6 Liter 4 cyl. inline • • 60 • • • • ••• •• GENERATOR OUTPUT VOLTAGE/ItW - Hz 120/240V, 1-phase, 1.0 pf KW ' 25 AMP CB Size 125 GENERATOR LOCKED ROTOR KVA AVAILABLE € VOLTAGE DIP OF 35% Single phase 34 ENGINE FUEL CONSUMPTION (Natural Gas) (Propane -Vapor only) 60 Hz _Natural Gas ft3/hr) Propane ft3/hr (gal/hr - for reference only) Exercise Cycle- 25% - - - -- Load _ 50% 75% Load_ _ Load_ 100% Load .2 60 - 24 (0.65) -- 161_ 64 (1.76) 253 345 437 101 (2.77) 138 (3.79) 175 (4.81) ENGINE COOLING Air flow (inlet air including altemator and combustion air) ft3 /min. System coolant capacity US gal. Heat rejection to coolant BTU/hr. Max. operating air temp. on radiator °C ( °F) Max. ambient temperature °C ( °F) 1,528 2.0 110,000 60 (150) 50 (140) COMBUSTION AIR REQUIREMENTS Flow at rated power 60 Hz cfm 90 -SOUND- IUMIr -- In dB(A) at 23 feet with generator operating at low speed exercise In dB(A) at 23 feet with generator operating at electrical load 63 76 EXHAUST Exhaust flow at rated output 60 Hz cfm Exhaust temp. at muffler outlet °F 249 1015 ENGINE PARAMETERS Rated synchronous RPM 60 Hz HP at rated KW 60 Hz 3600 45 POWER ADJUSTMENT FOR AMBIENT CONDITIONS Temperature Deration 1.65% for every 10 °F above - °F Altitude Deration 3% for every 1000 ft. above - ft. 77 600 TRANSFER SWITCH SPECIFICATIONS If so equipped No. of Poles Current Rating Voltage Rating Utility Voltage Monitor (Fixed) Pick -up Dropout Enclosure - NEMA 3R Retum to Utility Exerciser 15 minute weekly UL 1008 Listed Dimensions (H' x W° x D') Weight 2 200 250 80% 60% Standard 15 seconds Standard Standard 20 x 15 x 7 35 lbs. RATING: All single phase units are rated at 1.0 power factor. STANDBY RATING: Standby ratings apply to installations served by a reliable utility source. The standby rating is applicable o varying loads for the duration of a power outage. There is no overload capability for this rating. Ratings are in accordance with ISO- 3046 -1. Design and specifications are subject to change without notice. KW rating is based on LPG Fuel and may deride with natural gas. Maximum wattage and current are subject to and limited by such factors as fuelBtu content, ambient temperature, altitude, engine power and condition, etc. INTERCONNEC;4I1S;1 Ground Level Concrete Slab Battery Charger Xfer Sw Input • • ••• • • • • • • • ��4RDIAN v.,� k • • • UIETSOURCE ••• • ••• • • • ••• •• • • ••• • •• • • • • • • • • • • ••• • ••• ••• • • • ••• • • ••• • •• Cl EIpcItmsure •2012.5 14414T.• • • • • • • • • • • • • • • • • ••• •• • • • • • • R 4040000 R100 CONTROL PANEL °- m ,>a I Flexible Conduit ►u9 Moult Brag 0 GENERATOR CONNECTION BOX NEUTRAL ENCLOSURE FRAME RAIL. INSTALLATION LAYOUT To Generator Control Panel CIRCUIT_ BREAKER— SIZEJ / AMPS LUG SIZE 25 240 10 -121 #6 to 300 mcm EXHAUST MUFFLERS ENCLOSED WITHIN 71 .• _ _ 37 �. in 0 FUEL LINE CONNECTION 3/4° NPT FEMALE COUPLING •p. LEFT SIDE VIEW 00 VISE ACTON LATCH, ONE PER DOOR,ONE UFT -OFF DOOR PER SIDE OF GENERATOR 35.7 Ref Dwg 0E7555 UNIT WEIGHT: Steel 794 lbs., Aluminum 704 lbs. Concrete Slab REARVIEW ©ENERAC0 POWER SYSTEMS, INC. • P.O. BOX 297 • WHITEWATER, WI 53190 WEBSITE: www.guardiangenerators.com GGS25kW1.6L 5.06 © 2006 Generac Power Systems, Inc. All rights reserved. All specifications are subject to change without notice. • ▪ -• • • • • • • 0•S ••• • • • • • • • • • • • • 0014- ,i 3 = szo "_ 2 - 5f4-11 Ii' 3/00 ., _ --- / - -Gcwwl —_/ s0o sluoto =ado oO .vet, 11, 75ava. d 1 E/4 c-�� (odI cue 00 � .� � p 1 -2 3 -- kJ.) b fOms - sywii Afg, s ",i! All. - i? e. /b rti 1 - (h eatrowevt, 6e.N 1•. to, /2, - W 1-i g2 13,: ,C ft (9 - Ge,t1 I fiZO "'- . _ pump . .2423 - L e1,0 Ai L24_ GW 1 . -� , 1. 1-? rI y S,) rigs/ !4 K"r/�1 = imo vim i5;':L? . G Flu Qe4INdc4 e ya717 2-42.? - - -- -- - . /z3va' 2f 31 /2 oil ash y® yB O 3042. 7126 "P3 Inspection Worksheet Miami Shores Village os 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Date: 08/08/2007 Inspector: Devaney, Michael Owner: WESENSTEN, JOHN Job Address: 1210 100 Street NE Miami Shores Village, FL 33138- Project: <NONE> Contractor: ALL QUALITY ELECTRICAL SERVICES, INC Block: Permit Type: Electrical - Residential Inspection Type: Final Work Classification: Generator Phone Number (305)757 -1457 Parcel Number 1132050090070 Lot: Phone: (305)968 -7832 Building Department Comments Tuesday, August 7, 2007 Page 2 of 2 AMA 1 0 2001 Passed Inspector Comments %, ,, 0 V/1-- 7"-difr"°:71 Failed Correction Needed Re- Inspection Fee ($75) No Additional Inspections can be scheduled re- inspection fee is paid . until Tuesday, August 7, 2007 Page 2 of 2 Miami Shores Village Building Department UL 2 J LP 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Cn1�1 BUILDING �� PERMIT APPLICATION SotiNd FBC 2004 Permit Type: Electrical Owner's Name (Fee Simple Titleholder) u,l'h-e- itiese/k.5 Owner's Address / 2 / /1 /06 100 S City itl/•i / SAO-AM State ct Tenant/Lessee Name N M E -MAIL: Job Address (where the work is being done) Permit No. 1 Master Permit No.a0-1- / 4.4 Phone # 3os- 7s-7 Ns-7 Zip 3338. Phone # City Miami Shores Village County Miami -Dade FOLIO / PARCEL # ,/— 3aos -°oo9 ®®070 Is Building Historically Designated YES NO V Contractor's Company Name ha ?tom, Contractor's Address pis-0 And / b %‘ C r Zip Phone # City / orine, 7 State /"L. Zip Qualifier Name Sffe/ &(_ (4 h 7L o t j,L Phone # ?o,5- q,8 7( ?L 33i 6 7 3 - 96 r 7 r .? z. State Certificate or Registration No. OS - rioo L7S' Certificate of Competency No. E -MAIL: Architect/Engineer's Name (if applicable) Value of Work For this Permit $ 3/ C ex) Type of Work: ❑Addition ❑Alteration Describe Work: 0s- del/ ,v &t4 af Phone # Square / Linear Footage Of Work: INew ❑ Repair /Replace ❑ Demolition /3TS *****'*** * * * * * * * * * * * ** * * * * * * * * * * * * * * * * ** Fees************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Submittal Fee $ Permit Fee $ d7,4,4 o o Notary $ Training /Education Fee $ Scanning $ • Bond $ Code Enforcement $ CCF $ 2.40 CO /CC Technology Fee $ 5 .CQ,�j Zoning $ Radon $ DPBR Double Fee $ Structural Review. $ Total Fee Now Due $ See Reverse side -+ 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. A. Signature /eat_.vzz Owner or Agent The foregoing instrument was acknowledged before me this / (,® day of ,204, by who is personally known to me or who has produced As identification and who did tak an oath. NOTARY PUBLIC: Sign: Print: Signature Contractor The foregoing instrument was acknowledged before me this /1 day of , 20 . by who is personally known to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: 4 My Commission Expires: Sign: Print: My Commission Expires: ** * * * * ** ** ** * * *** * * * * *** ** * * ** APPLICATION APPROVED BY: (Revised 02/08/06) * * * * *** * * * * * * * * * * * * * * * * ** 1VP12P10 OblaNitfirtAsst.bro Engineer Zoning Ha®He°ee9pi /h JUL 2 4 2007 BUILDING PERMIT APPLICATION FBC 2004 Miami Shores Village (31151')1 Building Department % 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Permit No. 1!: Q—)— 15 Master Permit NoO'l '744 Permit Type: Plumbing / Owner's Name (Fee Simple Titlehdlder) / rf.tl E 4 /e.r -e a vsk St- Owner's Address q0/0 -10 IJ E /00 City 4./ /rdT i �'13Gh(4 State Tenant /Lessee Name N- /A E- MAIL: Phone # 36 75 7 /t/3-7 Zip 33/36' Job Address (where the work is being done) /)– / 0 ,f\J /o O Phone # S/' City Miami Shores Village County Miami -Dade FOLIO / PARCEL # 1/ -32-05 _ do - 7o70 Zip Is Building Historically Designated YES NO V Contractor's Company Name /9 I f �- QL✓I,I Contractor's Address ?9 f d 5 City rr /tiff ';i / j State /Jl • Qualifier Name jie-P-/\ J /j0l'l76 8O19' State Certificate or Registration No Cb0O / 6/3 I E -MAIL: Phone #/ 6-911-6 7 2 Zip 3 c Phone# '7CU -7/ b % 2-0 Certificate of Competency No. Architect /Engineer's Name (if applicable) Phone # Value of Work For this Permit $ X8 60. Square / Linear Footage Of Work: 5-0 Type of Work: ['Addition ❑Alteration piNew ❑ Repair/Replace ID Demolition Describe Work: �V '' at /. ;1? pLe S fc` 1...) * * * *: * ** * * * * * ***** * * *** *** ** * ** .*** ** *Fees* * * *** rxxarwww* * *****x/f** *fix *xxxxxx,;x * * * * **** Submittal Fee $ Permit Fee $ / / A CCF $ CO /CC Notary $ Training /Education Fee $ Technology Fee $ A .'LS Scanning $ v Radon $ Bond $ Code Enforcement $ Double Fee $ Structural Review. $ Total Fee Now Due $ 11 5 . b<S DPBR $ Zoning $ See Reverse side --� Bonding Company's Name (if applicable) Bonding Company's Address City State Mortgage Lender's Name (if applicable) Mortgfge Lender's Address City Zip 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: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the .first inspection which occurs seven (7) days after the building permit is issued. In t bsence of such posted notice, the inspection will not be approved and a reinspection. fee will be charged. Signature 14.4432 //2t. .e4„ Owner or Agent The foregoing instrument was acknowledged before me this /1 day of fa/ l 20 a % by who is personally known to me or who has produced As identification and who did take an oath. NOTARY PUBLIC: Sign: Print: Signature Contractor The foregoing instrument was acknowledged before me this day of Ira f� 20 07 b Y /7 who is personally known to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: IA ELENA CEPERO MY COMMISSION # DD264598- My Commission Expires: *********** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** APPLICATION APPROVED BY 1I (Revised 02/ /06) s Sign: Print: My Commission Expires PATR1e1A ELENA CEPERO MY COMMISSION # DD264598 ****************,**************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** 67 Plans Examiner Engineer Zoning