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PL-04-46 Miami Shores Village ' [ C�Zf Er�* . Building Department F V, X004 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 Tel:(305)795.2204 Fax:(305)756.8972 m s B ING Permit Nof. PERMIT APPLICATION Master Permit No. FBC 2001 Permit Type(circle): Building Electrical Plumbin t1 Mechanical Roofing Owner's Name(Fee Simple Titleholder) 4,tA 20ud1 CLUd3 V1`I-` dJ�� W 0 rnone# Owner's Address 1 X-4 b N r 05"" '5"1-. favi o it t 12'Y'500 r3 0-x-4 o City m i diol � E s State Jt_- Zip `31`713 r Tenant/Lessee Name Phone# Job Address(where the work is being done) 1(et r 1J 1 O 5,r; City Miami Shores Village County Miami-Dade Zip Is Building Historically Designated YES NO -541�&, rj1V^b/A-,6 Contractor's Company Name-rff� G C©Mrl NG-WA-t- Cft U,P L.TJ?> Phone# 303- 67 2 f�`� Contractor's Address 'V1-YO . �F' 11--Xk t City �D t.L4 Wl9.9I.-) State FL, , IRA Qualifier t-1E 0N wttArt�i Architect/Engineer's Name(if applicable) Phone# $Value of Work For this Permit Square Footage Of Work: Type of Work: ❑Addition ❑Alteration ❑New R RepairMMAase- ❑Demolition Describe Work: -7'14aNEZ VNOt-ALytJt T 'i-o ez"o tit_ efoKG--,.) --> - ttA- -y L I N�e Cj Eli Submittal Fee$ ® Permit Fee$ 13 ® CCF$ CO/CC Notary$ Training/Education Fee$ 6 ® Technology Fee Scanning$ Radon$ Zoning Bond$ Code Enforcement$ Structural Plan Review. $ Total Fee Now Due$ (Continued on opposite side) Bonding Company's Name(if applicable) a Bonding Company's Address T 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.• Asa condition to the issuance of a building pe-mmit 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 VOwneror Agent Contractor The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this CI—L, day of VtA 208 _q_,by t- R,2eI t-4V4Pr1 Y day of FEBOU40kOOLby A ---�+1 who known to me or who has produced FL-A who(p o y ,own to me or who has produced .*2. LX CC�MCA As iden' cation and who did take an oath. as identification and who di take an oath NOTAR IC: NOTARY PUBL Sign: ( RHONDA P.FREDER Si Print. My Comm Exp.7/21/04 Print: to HONDA P.FREDERICK PUBUC a My Commission Expires 4n�I.D. My Co Sion EXplres N0•CC 985419 ' Pe—wly mown I I omm I,D. (Certificate of Competency Holder) State Certificate or Registration No.LF L ®S--10 7 (® Certificate of Competency No. APPLICATION APPROVED BY: Plans Examiner Engineer Zoning Chc 12/15/03 ADDENDUM TO BUILDING PERMIT APPLICATION (AN APPLICATION 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 TUB SWITCH OUTLETS SPACE HEATERS BIDET LIGHT OUTLETS CENTRAL HEATING DISHWASHER RECEPTACLES A/C (WIN) DISPOSAL SERVICE TEMPORARY A/C (CENTRAL) DRINKING FOUNTAIN SERVICE SIZE IN AMPS DUCT WORK FLOOR FAIN SERVICE REPAIR/METER CHANE REFRIGERATION GREASE TRAP APPLIANCE OUTLETS PROCESS AND PRESS PIPING INTERCEPTOR RANGE TOP UNERMOUND TANKS LAVATORY OVEN ABOVE GRDUND 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. 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 MATER FIRE SPRINKLER GENERATORS TRANSFORMERS HEATER-NEW INST. GENERATORS TRANSFORMERS HEATER-REPLACE GENERATORS TRANSFORMERS LAWN SPRINKLER-WELL SPECIAL PURPOSE SW I MM I N POOL OUTLETS COMMERCIAL WATER SERVICE SIGN TUBES SEWER SIGN TRANSFORMERS UTILITY-SEWER SIGN TIME CLOCK UTILITY-WATER FIXTURES SEPTIC TANK ANTENNA RELAY TELEVISION OUTLETS DRAINFIELD, 4" TILE/RES. VIOLATION PUMP 8 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 PIPING Miami Shores Village Plumbing ' 10050 NE 2nd Avenue Phone: 305-795-2204 Permit Number: L2004-46 Printed:2/18/2004 Page 1 of 1 Applicant: HARBOUR CLUB VILLAS Owner: CLUB VILLAS HARBOUR JOB ADDRESS: 1530 N. E. 105 ST. Contractor CONTINENTAL GROUP LTD(THE) Contractor's Address: 2950 N 28 TERR Local Phone: 305-672-1741 Parcel # PARC2003-22 Legal Description: Fees: Description Amount FEE2004-1654 Building Fee $130.00 Total Fees: $135.65 FEE2004-1655 CCF FEE2004-1656 Training and Education Fee $0.60 Total Receipts: $0.00 FEE2004-1657 Technology Fee $3.25 Total Fees: $135.65 Permit Status: APPROVED Permit Expiration: 8/8/2004 Construction Value: $2,300.00 Work: TUNNEL UNDER UNIT TO REPAIR BROKEN SANITORY UNIT QP\O D5. 2 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: