The URL can be used to link to this page

PL-05-1178 tr i Miami Shores Village Building Department 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 Tel• (305)756.8972 �E EppQ�ll V BUILDING 05 Permit No. co 9 20 DE I� PERMIT APP ICATI N _____ Master Permit No., FBC 2001 Permit Type(circle): Building . Electrical Plumbing Mechanical Roofing I' LMLIaT Owner's Name(Fee Simple Titleholder) t Phone k Owner's Address F. Cl I S7 City State L— Zip �a Tenant/Lessee Name Phone# ---- i Job Address(where the work is being donee ('� �.� , °J j sT S City Miami Shoj es Villa e County Miami-Dade Zip ,.,,�� Is Building Historically D ignated YES NO Contractor's Company NamejIUMPj Ma AQLMQNj Phone# _-3r Contractor's Address City State Zip a Qualifier i�Ac (Phtl ap 5 State Certificate or Registra 1on No. Certificate of Competency No. Architect/Engineer's Nam (if applicable) Phone# $Value of Work For this ermit h Square Footage Of Work: a 21S / Type of Work: /Addii,I on []Alteration ❑New ❑ Repair/Replace 0 Demolition Describe Work: T I4 C.VN L.., I..t. a - 0 Q Submittal Fee$ Permit.Fee$ 4K CCF$ CO/CC Notary$ TrainingfEduca tion Fee$ Technology Fee$ S • ZS Scanning$3. 00 • Radon$ Zoning Bond$ Code Enforcement$ Structural Plan Review.'$ Total Fee Now Due$ Z 3 •C (Continued on opposite 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. 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 .20_,by who is personally known to me or who has produced who is personally known to me or who has produced As identification and who did take an oath. as identification and who did take an oath. NOTARY PU13LIC: NOTARY PUBLIC:, Sign: Sign: Print: Print: My Commission Expires: My Commission Expires: �*�>k��**�kk+kk**kkkk#kkkk*�kkkk>k>Kk�k>kkkk�k*k* kk>k h** *N>kkkkk*k*k****�kkk*N**kk*+kk �k�kk*>k*�kkk+kk�>K�kx'***kk APPLICATION APPROVED BY: ��l �.� Plans Exam. xaminer Engineer Zoning chc 05/13/03 ADDENDUM TO BUILDING PERMIT APPLICATION IA£PLICATION FOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM- IF A MASTER PERMIT HAS B. OBTAINED, THE OWNERS NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.) PLUMBING ELECTRICAL MECHANICAL ITEM UNIT FEE ITEM UNIT FEE ITEM UNIT FEE BATH TUB SWITCH OUTLETS SPAN HEATERS BIDET LIGHT OUTLETS CENTRAL HEATING 01SHWAM RECEPTACLES A/C (WIND) DISPOSAL SERVICE TEIrIGMY A/C (CENTRAL) DRINKING FOUNTAIN SERVICE SIZE IN AMPS DUCT WORK FLOOR MAIN SERVICE REPAIR/hM CHANGE REFRIGERATION GREASE TRAP APPLIANCE OUTLETS PROCESS AND PRESS PIPING INTERCEPTOR RANGE TOP UNDERGROUND TANKS LAVATORY OVEN ABOVE GROUND TANKS L9 MY TRAY WATER HEATER U.F. PRESSURE VESSELS CLOTHES WASHER MOTORS D- 1 HP STEAM BOILERS SHOWER MOTCRS OVER 1- 3 HP HOT WATER BOILERS SINK, POT/3 COW. MOTORS OVER 3- 5 HP MECHANICAL VENTILATION SINK, RESIDENCE MOTORS OVER 5- 8 HP TRANSPORTING ASSEM3LIES SINK, SLOP M3TCRS OVER 8- 10 HP ELEVATORS/ESCALATORS TEMIDWY WATER CLOSET MOTORS OVER 10- 25 HP FIRE SPRINKLER SYSTEMS R&RINAL MOTORS OVER 25-100 If COOLING TOWERS WATER CLOSET MOTORS OVER 100 w 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 SWIWING POOL OUTLETS COMMERCIAL WATER SERVICE SIGN TUBES SEWER CMCTIONS SIGN TRANSFORMERS UTILITY-SEWER SIGN TIME CLOG( UTILITY-WATER F IXTI.RES SEPTIC TANK ANTENNA RELAY TELEVISION OUTLETS DRAINFIELD, 4` TILE/RES. VIOLATION PUMP & ABANDON SEPTIC TANK REINSPECTION SOAKAGE PIT CU. FT. CATCH BASIN DISCHARGE WELL WhESTIC WELL AREA DRAIN � ROOF INLET I . SOLAR WATER HEATER P FIRE STANDPIPE E POOL PIP IQ f 1 LAWN SPRINKLER SYSTEW. f E 1 GAS RANGE METER SET (GAS) I I I GAS PI?Ifr, 1 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:3/912006 Expires:06/1012006 Permit Number: PL-12-05-1178 Owner's Name: JOHN AND ELAINE HAMLET one: Permit Type: Plumbing-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: 0 PLUMBING BY SALOMON 305-935-9214 Yes Total Valuation: $ 6,000.00 Comments: R uired Ins actions ENLARGE BEDROOM W/NEW BATH Underground Rough Water Main Top Out Main Drain Additional Information Lavatory Water Service Type of Work: Type of Piping: Re Pipe Additional Info: Bond Retum: Heater 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 Amt Paid CCF $3.60 PL-3-06-24081 $223.05 .� Education Surcharge $1.20 Total• .� Permit Fee-Additions/Alterations $210.00 Scanning Fee $3 JUN 0 2 PAID Technology Fee $5.25 Total: $223.05 (—,=I 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