EL-05-305L 17
BUILDD
PERMIT
FBC 2001
Permit Type (
Owner's Name (
Owner's Address
City
Tenant/Lessee Na
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: 756.8972
xF
.n VELD;
s IPermit No.��J-' 305
VPPLICATION AUG
aster Permit No.
ao�w`17-
rcle): Building Electrical Plumbing Mechanical ---moo mg
Simple Titleholder) ELSIP I,P QBE (;A/tV1e #AICAi •�
f 95
Statep 3�/ SO
Zi �-
Phone #
Job Address (whea the work is being done) C/ MJ 10, �5- 7-1
City Mi Shores Villaize County Miami -Dade Zip
Is Building Historically Designated YES NO t/
Contractor's C
Contractor's Ad
City rj .
Qualifier �
Name O"'] —C 4-ci12d C Phone # 30Y �I' Y9 6 3 %3
N
State
Zip 3-3/All
State Certificate or �istration No. C< �e Certificate of Competency No
Architect/Engineer s Name (if applicable) Phone #
$ Value of Work 0or this Permit 6-6 Square Footage Of Work:
Type of Work: Addition []Alteration []Newepair/Replace [] Demolition
Describe Work: /1-t r'4 A4.,j 04��/2 OU G
9
Submittal Fee $
Notary $ 5 -
Scanning $ 3.
Code Enforcemen T.
Permit Fee $__ �� �d CCF $ 10 • I - 2C7 CO/CC
Training/Education Fee $ Technology Fee $
Radon $ Zoning_ Bond $
Structural Plan Review. $
Total Fee Now Dui $ `j r , �✓ ��
(Continued on opp Dsite side)
Bonding Company's Name (if applicable)
Bonding Company's Address
City
State
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
City
State
Zip
Zip
h
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.
ji Signature +
/ Owner or Agent
The foregoing instrument was acknowledged before me this
day of 20 QS`by _ r1'CJ W
who is personAy—own to me or who has produced
As identification and who did take an oath.
NOT
PUB C: ".;R.belVar1
Mission 01M)Slgn: s g ,' ,• �:1 X r,
®9� o rnq
Print: e, ° ttbondiaC
My Cofinmission Expires:
X Signature S� �
®J Contractor
The foregoing instrument was acknowledged before me this I
day of
who is personally known to me or who has produced
ARY PUBLIC:
11 Sign:
q.tion o i take an oathil .
0- i ommissioj,
Inc. Print:
My Commission Expires:
Ca., Inc
APPLICATION APPROVED
"Plans Examiner
Engineer
Zoning
chc 05/13/03
ADDENDUM TO BUILDING PERMIT APPLICATION
(AN A]:PLICATION:�VOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. IF A MASTER PERMIT HAS B.
OBTAINED, THS OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.)
PLUMBING ELECTRICAL MECHANICAL
ITEM
BATH TUB
BIDET
UNIT FEE ITEM
SWITCH OUTLETS
LIGHT OURETS
UNIT FEE ITEM UNIT FEE
SPACE HEATERS
CENTRAL HEATING
DISHWASHER
DISPOSAL
RECEPTACLES
SERVICE TEMPORARY
A/C (WINO)
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
UNDERmax TANKS
LAVATORY
OVEN
ABOVE (ROUND 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.
SINK, RESIDENCE
MOTORS OVER 3- 5 HP
MOTORS OVER 5- 8 HP
MECHANICAL VENTILATION
TRANSPORTING ASSEMBLIES
SINK, SLOP
TEMPORARY WATER CLOSET
MOTORS OVER 8- 10 HP
MOTORS OVER 10- 25 HP
ELEVATORS/ESCALATORS
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 TRANSFORMERS
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 TRANSFORMERS
UTILITY -SEWER
SIGN TIME CLOCK
UTILITY -WATER
FIXTURES
SEPTIC TANK
ANTENNA
RELAY
TELEVISION OUTLETS
ORAINFIELD, 4" TILE/RES.
VIOLATION
PUMP 8 ABANDON SEPTIC TANK
REINSPECTION
SOAKAGE PIT CU. FT.
rATrw RAQIN
DISCHARGE WELL
DOMESTIC WELL
AREA DRAIN
ROOF INLET
SOLAR WATER HEATER
FIRE STANDPIPE
POOL PIPItG
LAWN SPRINKLER SYSTEW.
GAS RANGE
METER SET (GAS)
GAS PIPIN-
Miami Shores Village tPermit
10050 N E Avenue
r 306-795-2204
za 0 5
Printed:9/1/2005 Page 1 of 1
Applicant: ELSA
Owner: RODRIGUEZ
JOS ADDRESS: 149 NW 105
Contractor P & M ELECTRIC INC
Local Phone: 305-949-6373
RODRIGUEZ
ELSA
ST
Contractor's Address: 1936 NE 148 ST
Parcel # 1121360080120 Legal Description: RUNNINGS MIAMI SHORES EXT 4
Fees:
Description
Amount
FEE2005-11983
Building Fee
$100.00
FEE2005-11984
CCF
$1.20
FEE2005-11985
Notary Fee
$5.00
FEE2005-11986
Training and Education Fee
$0.40
FEE2005-11987
Technology Fee
$2.50
FEE2005-11988
Scanning Fee
$3.00
Total Fees:
$112.10
Permit Status: APPROVED Permit Expiration: 2/27/2006 Construction Value: $1,2110.00
Work: MATER MAIN REPAIR DUE TO STORM
Signed: (INSPECTOR)
PB 48-20 LOT 12
Total Fees: $112.10
Total Receipts: $0.00
BLK 204
In consideration of the issuance to me of this permit, I a to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and In strict conformity
with the plan, drawings, statements or speclfk atlons 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.
Signed: (Contractor or Builder) BY:
Miami Shores Village
10050 NE 2nd Avenue
Phone: 305-795-2204
Permit Number:EL2005-305
Printed: 9/1 /2005 Page 1 of 1
Applicant: ELSA
Owner: RODRIGUEZ
JOB ADDRESS: 149 NW 105
Contractor P & M ELECTRIC INC
Local Phone: 305-949-6373
Parcel # 1121360080120
RODRIGUEZ
ELSA
ST
Contractor's Address: 1936 NE 148 ST
Legal Description: DUNNINGS MIAMI SHORES EXT 4
PB 48-20 LOT 12
Fees:
Description
Amount
FEE2005-11983
Building Fee
$100.00
Total Fees: $112.10
FEE2005-11984
CCF
$1.20
FEE2005-11985
Notary Fee
$5.00 Total Receipts: $0.00
FEE2005-11988
Training and Education Fee
$0.40
FEE2005-11987
Technology Fee
$2.50
FEE2005-11988
Scanning Fee
$3.00
Total Fees:
$112.10
Permit Status: APPROVED Permit Expiration: 2/27/2008 Construction Value: $1,200.00
Work: MATER MAIN REPAIR DUE TO STORM
Sigma:
(INSPECTOR)
:1
In considwation of the Nuance 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 speof8cations submitted to the proper authorities of Miami Shores Village. in accepting this permit I assume responisibil#y, for all work done by either myself,
my agent, servants or employes.
Signed: (Contractor or Builder) BY:
Miami Shores Village
Electrical
§
;WOM050 NE 2nd Avenue
Phone:2 : nX
Printed: 9/1/2005 Page 1 of 1
Applicant: ELSA
Owner: RODRIGUEZ
JOY ADDRESS. 149 NW 106
Contractor P 8• M ELECTRIC INC
Local Phone: 305-94&6373
Parcel# 1121360080120
RODRIGUEZ
ELSA
ST
Contractor's Address: 1936 NE 148 ST
Legal Description: DUNNINGS MIAMI SHORES EXT 4
PB 48-20 LOT 12
FEE2005-11983
Building Fee
$100.00 Total Fees: $112.10
FEE2005-11984
FEE2005-11985
CCF
Notary Fee
$1.20
$5,00 Total Receipts: $0.00
FEE2005-11986
Training and Education Fee
$0.40
FEE2005-11987
Technology Fee
$2.50
FEE2005-11988
Scanning Fee
$3.00
Total Fees:
$112.10
Permit Status: APPROVED Permit Expiration: 2127/2006 Construction Value: $1,200.00
Work: MATER MAIN REPAIR DUE TO STORM
Signed:
(INSPECTOR)
BLK 204
In Consideration of the lsm a to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pe laming 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 responisibift for d work done by either myself,
my agent, servants or employes.
Signed: (contractor or Builder) BY:
Miami Shores Village Electrical Permit
10050NE 2nd Avenue
't•1_ 305-796-2204
Permit Number: EL2006-305
Printed:9/1/2005 Page 1 of 1
Applicant: ELSA
Owner: , RODRIGUEZ
RODRIGUEZ
ELSA
JOB ADDRESS: 149 NW 105 ST
Contractor P & M ELECTRIC INC Contractor's Address: 1936 NE 148 ST
Local Phone: 305-949-6373
Parcel # 1121360080120 Legal Description: DUNNINGS MIAMI SHORES EXT 4
PB 48-20 LOT 12
Fees:
Description
Amount
FEE2005-11983
Building Fee
$100.00 Total Fees: $112.10
FEE2005-11984
CCF
$120
Total Receipts: $0.00
FEE2005-11985
Notary Fee
$5.00
FEE2005-11986
Training and Education Fee
$0.40
FEE2005-11987
Technology Fee
$2.50
FEE2005-11988
Scanning Fee
$3.00
Total Fees:
$112.10
Permit Status: APPROVED Permit Expiration: 2/27/2006 Construction Value: $1,200.00
Work: MATER MAIN REPAIR DUE TO STORM
Signed: (INSPECTOR)
BLK 204
In corralderation of the I.-suanos to mo of this permit, I agree to perform the work coves hereunder in compliance with all ordinances and regulatkms 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 responisiblilty, for all work done by either myself,
my agent, servants or employes.
Signed: (Contractor or Builder) BY: