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EL-05-1173 Miami Shores Village L] Building Department 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 DEC 0 9 2065 Tel:(305)795.2204 Fax:(305)756.8972 BUILDING 1° °0& I� Permit No. PERMIT LICATION Master Permit No. 05 Ff--f)- El FBC 2001 Permit Type(circles Building' IectricaT plutnbinp Mechanical Roofing Owner's Name(Fee Simple Titleholder) Phone# Owner's Address 57 City State �'L ZiP , °P II 3�1 Tenant/Lessee Name Phone# j Job Address where the�ork is bein( g done) 1 )7 nl AL !D 1ST 5M2T � City Miami Shores Village County Miami-Dade Zip 33( j3 i i Is Building Historically besignated YES NO �I Contractor's Company Name �� , A�I� �� -phone# Contractor's Address- `r0c� W • �] ST 9 City State L Zip 3 3t7/4 Qualifier State Certificate or Regis I tion No.i5d yoy f4 I 7• Certificate of Competency No. Architect/Engineer's N e(if applicable) Phone# $Value of Work For this Perini -4,Uo Square Footage Of Work: !Z77 I. Type of Work: Ad{iiti.. CIAlteration ❑New ❑ Repair/Replace ` ❑Demolition Describe Work: QD/� ' i . Submittal Fee AO Permit Fee$i/S}',S 6 CCF$-:K CEO CO/CC. Notary s ' Training/Education Fee$ 1, DO Technology Fee$ 3.93 Scanning Radon$ .Zoning Bond$ Code Enforcement$ Structural Plan Review.$ Total Fee Now Due$ f -73 3- (Continued on opposite i'de) i� " = I I 1w- 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 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$2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is Issued In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged Signature Signature Owner or Agent Contractor The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this day of ,20_,by day of D(L. .20 M by 0 rJ,0)4 V4 l who is personally known to me or who has produced who is identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Sign: Sign: s Print: Print p�ll� COMMISSION#DD 483 My Commission Expires My Commission Expi �f'" c :ate ftM— , u nYdr4rde,4ie4rk$rfelnintnY elnFsksYvTrsksYaYaYaRotrAr9eaYak4rir4rY t>'nY764edt4¢+Y�+k,tnirdrAruY 9rdraTrink,lr�rdrinkalnlr�¢##*4e&sY9r4aYdeIr*dr9rdrAnle,YYBa de lrir&vYirrktkir,raY9tF4rar ekalr3rinY[r3c di$ie8c9e� APPLICATION APPROVED BY• /ans�Examiner Engineer Chc 45/13/03 ' Zoning I • • ° ADDENDUM TO BUILDING PERMIT APPLICATION (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 UNIT FEE ITEM UNIT FEE ITEM MIT FEE BATH TlB SWITCH OUTLETS SPACE HEATERS BIDET LIGHT OUTLETS CENTRAL HEATING 9 1SHWASHER 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 mm TANKS LAUNDRY TRAY WATER HEATER U.F. PRESSURE VESSELS CLOTHES WASHER MOTORS 0— 1 HP STEAM BOILERS SHOWER MOTORS OVER 1— 3 If 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 HP VIOLATION INDIRECT WASTES A/C WINDOW REINSPECTION WATER SUPPLY TO: AIR CONDITIONERS A/C UNIT STRIP HEATER FIRE SPRINKLER GENERATORS TRANSFDRMERS 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 TRANSFORMIERS UTILITY—SEWER SIGN TIME CLOCK UTILITY—WATER FIXTRIRES 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 WEII AREA DRAIN ROOF INLET SOLAR WATER HEATER FIRE STANDPIPE POOL PIPING LAWN SPRINKLER SYSTEM N GAS RANGE c METER SET (GAS) GAS PIPIFZL t Miami Shores Village 10050 N.E.2nd Avenue Miami Shores, FL 33138-0000 _....��.,. Phone: (305)795-2204 Fax: (305)756-8972 Permit Permit Status:APPROVED Issue Date:3/9/2006 Expires: 12/09/2006 Permit Number: EL-12-05-1173 Owner's Name: JOHN AND ELAINE HAMLET one: Permit Type: Electrical-Residential Parcel#: 1132060133310 Work Classification: Addition/Alteration Block: Lot: Job Address: 117 91 Street NE Section: PB: Miami Shores Village, FL 33138- Contractor(s) Phone Primary Contractor Total Square Feet 280 ELECTRICAL POWER&SERVICE, I Yes Total Valuation: $4,500.00 ommen Re wired Ins tions ELECTRICAL FOR MASTER BP2005-873 Alteration Underground Rough WW Service Change Additional Information Meter Box Fire Alarm Type of Work: Additional Info: Relocation Classification:Residential Final 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 responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL, PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work. 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. Futhermore, I authorize the above-named contractor to do the work stated. Fees Due Amount Invoice Number Amt Due A Amt Paid CCF $3.00 EL-3-06-24080 $173.43 B , Education Surcharge $1.00 Total: Notary Fee $5.00 Permit Fee-Additions/Alterations $157.50 I®JUN 0 2 PS Scanning Fee $3.00 FA Technology Fee $3.93 Total: $173.43 Building Department File Copy NOTICE: In addition to the requirements of this permit, there may be additional restrictions applicable to this property that may be found in the public records of this county. AND THERE MAY BE ADDITIONAL PERMITS REQUIRED FROM OTHER GOVERNMENTAL ENTITIES SUCH AS WATER MANAGEMENT DISTRICTS,STATE AGENCIES,OR FEDERAL AGENCIES. Applicant Signature