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PL-05-286BUILDING PERMIT AP FBC 2001 Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (3 as; • ; ega +; 5; .8972 LICATION Permit NoF j 2-6 ster Permit No.— CIS 714. Permit Type (circle): Building ® Electrica Plumbing Mechanical Roofing � Owner's Name (Fee Simple Titleholder) V l cm a if- Phone # 3 or ---m A o0 % . Owner's Address / f// 30 ) 3 City / /4"1 / b O ',State # Zip 3'5 j 3 Tenant/Lessee Name Phone # 3o Ail- 3 Job Address (where the work is being done) J City Miami Shores Village County Miami -Dade Zip ' 13 Is Building Historically Designated YES Contractor's Company Name NO 7LO /C 6"S Contractor's Address ' / 6,4 City fe,i4 wok /% -i/ State Qualifier 4-14-'-y k/ i/v Phone # Zip State Certificate or Registration No. ,1 6x73 Y1 - Certificate of Competency No. Architect/Engineer's Nan:e (if applicable) Phone # $ Value of Work For this Permit Type of Work: ❑Addition Describe Work: Square Footage Of Work:° iteration ❑New ❑ Repair/Replace ❑ Demolition XT-11-t-1- pcl e yt 54175445-6. Lci-enr6f---y Submittal Fee $ Notary $ r - Scanning $ • CO Code Enforcement $ ****************************W**************************** Permit Fee $ /3Q CCF $ 0 . rob CO /CC. Training/Education Fee $ C7.2 Technology Fee $ 2 • SO Radon $ Zoning Bond $ Structural Plan Review. $ Total Fee Now Due $ 141.3D (Continued on opposite side) 10 -14-05PO4 :0 7 P A IL 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 Ali 14 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 the absence of such posted notice, the inspection will not b as + a d a reinspection fee will be charged Signature Owner or Agent The foregoing instrument was acknowledged before me this 24 day S of - - 5T. , 200a by V t C1?C72 L .1 who is personally known to me or who has produced 1 b As identification and who did take an oath. NOTARY PUBLIC: Sign: Print: MALtL. V VAlta owledged before me this �, l may ° , 20 j' by who i ersonally known tome or who h d , as identification NOTARY PUBLIC: Sign: Print: • My Commission Expires My Commission Expires: ********************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** ********* * ***** * **** * ** ***** * **** * ****** APPLICATION APPROVED BY: Clic 05/13/03 * * * D108114 March 30, 2007 3 13o ) aot 7 *********************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** *********************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** fob Q Plans Examiner Engineer Zoning • ADDENDUM TO BUILDING PERMIT APPLICATION . 1 (AN A£PLICATION 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 ITEM BATH TUB UNIT i` FEE ITEM SWITCH OUTLETS UNIT FEE ITEM SPACE HEATERS UNIT FEE BIDET LIGHT OUTLETS CENTRAL HEATING DISHWASHER RECEPTACLES A/C (WINO) 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 (ROUND TANKS LAUNDRY TRAY WATER HEATER U.F. PRESSURE VESSELS CLOTHES WASHER MOTORS 0- 1 H? STEAM BOILERS SHOWER Je MOTORS OVER 1- 3 FP HOT WATER BOILERS SINK, POT /3 COMP. MOTORS OVER 3- 5 If MECHANICAL VENTILATION SINK, RESIDENCE X MOTORS OVER 5- 8 HP TRANSPORTING ASSEMBLIES SINK, SLOP MOTORS OVER 8- 10 HP _ ELEVATORS/ESCALATORS TEMPORARY WATER CLOSET MOTC RS OVER 10- 25 HP FIRE SPRINKLER SYSTEMRS URINAL MOTORS OVER 25-100 HP COOL I NG TOWERS WATER CLOSET MI'7TCRS OVER 1OX) HP VIOLATION INDIRECT WASTES A/C WINDOW REINSPECTION WATER SUPPLY 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 WATER,SERVI,GE ,; OUTLETS COMMERCIAL SIGN TUBES SEWER CONNECTIONS SIGN TRANSFERS UTILITY -SEWER SIGN TIME CLOCK 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 P!PINL Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Printed: 9/22/2005 Applicant: RENE Owner: LEONI JOB ADDRESS: 10430 NE 3 Contractor GRAHAM SERVICES, INC. Local Phone: 954 -442 -9358 Parcel # 1121360130450 Plumbing Permit Permit Number: PL2005 -286 Page 1 of 1 LEONI RENE AVE Contractor's Address: 8910 Miramar Parkway, Suite 307 Legal Description: MIAMI SHORES SEC 5 PB 10-47 LOT 1 & E1/2 OF LOT 2 BLK 120 LOT SIZE Fees: FEE2005 -12684 FEE2005 -12685 FEE2005 -12686 FEE2005 -12687 FEE2005 -12688 FEE2005 -12689 Description Building Fee CCF Notary Fee Training and Education Fee Technology Fee Scanning Fee Total Fees: Amount $130.00 $0.60 $5.00 $0.20 $2.50 $3.00 $141.30 Total Fees: $141.30 Total Receipts: $0.00 Permit Status: APPROVED Permit Expiration: 3/20/2006 Construction Value: $500.00 Work: INSTALL NEW SHOWER DIVERTER AND BATHROOM LAVATORY 10 -14- 051304 :07 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 I assume responisibility for all work done by either myself, my agent, servants or employes. Signed: (Contractor or Builder) BY: