PL-15-155 (2) s- Miami Shores Village
JAN 2 2 nn
Building Department
10050 N.E.2nd Avenue,Miami Shores, Florida 33138 �—
Tel:(305)795-2204 Fax:(305)756-8972
INSPECTION LINE PHONE NUMBER:(305)762-4949
FBC 20 0
BUILDING Master Permit No.)?/
PERMIT APPLICATION Sub Permit No.
❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: CoL�o 14 e 1 ® I S-t
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#: 1�-'�Z - ('7 -'2®�® Is the Building Historically Designated:Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
C,o i n-fi e
OWNER:Name(Fee Simple Titleholder): io�ri Phone#: 86 8 L+L+
Address: (a 4® 0 F, (0 ( 5
City: Miaawn ShaseS state: zip:
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR:Company Name: C4 ( ► S Phone#:
Address: (3 Av&
City: Do or I StateZip:
.SLI'
Qualifier Name. 1fxfl Phone#:
State Certification or Registration#:��1"l�� r'26 2. Certificate of Competency#:
DESIGNER:Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit:$ uare/Linear Footage of Work: 7
Type of Work: ❑ Addition Alteration New Repair/Replace ❑ Demolition
Description of Work: q? �Q Ce -~ '_n
.e 100
Specify color of color thru tile:
Submittal Fee$ Permit Fee$ CCF$ CO/CC$
Scanning Fee$ Radon Fee$ DBPR$ Notary$
Technology Fee$ Training/Education Fee$ Double Fee$
Structural Reviews$ Bond$ 5w" W
TOTAL FEE NOW DUE$ ��
(Revised02/24/2014) ��� Q
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 ELECTRIC, PLUMBING, SIGNS, POOLS,
FURNACES,BOILERS, HEATERS,TANKS,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. /n the absence of such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
SignaturSignature
OWNER or AGENT CONTRACTOR
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
a day of 0 v� cl Q 2019 by day of 20 by
U f S W'e' crna ahs ,who is personally known to 0 P_✓-e�� � �� ,wh '_personally, kno n to
me or who has produced _�r,,4 dice,,p, as me or who has produced as
identification and who did take an oath. identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
Sign: QSign:
Print: e4k �� Qcn Print:
Seal: °. TERESA J SOLOMON public State of Flori a
Seal: Baa+ave Na'ary �zticlano
Joei�na M
•c MY COMMISSION#EE131935 �� e a,7;mirasinn FF 032753
n,r
EXPIRES November 08,2015 �r9fo� y�ir�s 01112i2o�8
5 F10MONOte rvice.00m 6m'trs+
APPROVED BY Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)
f
i
g� IZ
C.193 y P �A � ON
OV 2 1,; 2003
"" ""'� Master Permit No.
moi,_ seeo
o�A Subsidiary Permit No.
fINSTRUCTIONS - Th e following steps must be taken to obtain a permit from
I
Step 1. Complete the attached permit application which must be signed by the proWM owner and qualifier. Both signatures must be notarized Please
print or type to allow for a more accurate processing of your application. If roofing work will be done,a roofing application must be submitted
along with this permit application.
i
Step 2. Submit the completed application with all necessary documents to the Building,Planning and Zoning Department for processing. During the
processing of your application,you may be asked to submit additional information.
APPLICATION
` Job Address: ?U' I 'v ' C7 31104 V"l 1(_�I I 1 S/16 11. f L 3 i3e
Address Apt. City State Zip
Folio Number oj 3- Av�-70 Description of Work k }c�nr�-+ 4 L�.�w c��y esw� `F
Lot
AD Block ?J � Dv�51�t S-r, 1- to t' 13S
Subdivision PB PG ZoninamiJ ml l inear Feet
Current Use of Property n lJC Square Feet c;21'1!2+r Units Floors
Proposed Use of Property Value of Work 5'i 4Y,04 Ole'
Bldg Value
' Tenant Information Tax Assessed/Appraised Value
Flood Zone Base Floor Elev.
PERMIT TYPE (✓) PERMIT CHANGE (✓) TYPE OF MANAGEMENT (✓)
Building Chg.Contractor New Construction Enclosure
Electrical Renewal Alteration Exterior Repair
Mechanical Revision Alteration Interior Demolish
Plumbing Extension Relocation of Structure Shell Only
LPGX Supplement Foundation Only Add'1 Attachment
Roofing Reinspection Other Add'I Detachment
Fence Other
Other
ARCHITECT ENGINEER
Name Name
License No. (\j License No. t I 1
Address Address N 1
�) r- Nle
Telephone ft Telephone f
Fax Fax
PROPERTY OWNER CONTRACTOR
Name r . Name efy
_-M
Address License No. I' ^0�
1 S Address �,1(
Home Telephone r qM NV) S
Business Telephone J' Telephone — Fax i(_lQ
`TQC
Fax SU —
Qualifier Name p '
Page 2
PERMIT APPLICATION
I]NIPORTANT NOTICES
1. DO NOT BEGIN ANY WORK WITHOUT HAVING RECEIVED YOUR VALIDATED PERMIT AND PERMIT CARD. Applying for a permit does not grant
the right to begin construction. HOURS OF CONSTRUCTION are limited to: Monday through Friday from 7:30 a.m.to 6:00 p.m.,and Saturday from 8:00 a.m.
to 5:00 p.m. No inspections will be conducted on weekends or holidays.
2. All construction of demolition areas MUST BE MAINTAINED IN A CLEAN,NEAT AND SANITARY CONDITION free from construction debris.
3. STREETS AND NEIGHBORING PROPERTIES SHALL BE KEPT FREE FROM DIRT AND DEBRIS.
4. SWALES MUST BE PROTECTED FROM BEING DAMAGED BY EQUIPMENT OR VEHICLES,AND MAY NOT BE USED FOR STORAGE. A bond is
required for work in or near the street/sidewalk.
5. CONSTRUCTION TRAILERS ARE PROHIBITED ON SINGLE FAMILY RESIDENTIAL CONSTRUCTION SITES. Other construction may have a trailer
which requires a separate permit.
6. PORTABLE TOILETS for a construction site require a separate permit.
7. DO NOT DISCHARGE WATER INTO THE RIGHT OF WAY OR STORM DRAINS without approval from the Building,Planning and Zoning Department.
8. EQUIPMENT AND MATERIALS SHALL BE STORED at least 10 feet from the edge of pavement.
9. Department of Health and Rehabilitative Services(HRS)approval is required for applications involving septic tanks. Department of Environmental Resources
Management(DERM)and/or Miami-Dade Water and Sewer Department(MDWASD)approval is required for applications involving sewers.
AFFIDAVIT
Application is hereby made to obtain a permit to do work and installation as indicated. I,the OWNER of the property,certify that all
work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits
are required for ELECTRICAL, PLUMBING, POOL, EXTERIOR DOOR, MECHANICAL, WINDOW, FENCE, DRIVEWAY,
ROOFING and SIGNS and there may be additional permits required from other governmental agencies.
I, the OWNER of the property, have disclosed all information related to any work at the property performed in the prior twelve
months to the Building Official. Further,I am fully aware that if the cumulative cost of work to my home or business under this and
any other permit equals or exceeds fifty percent (50%) of the fair market value of the structure, the entire structure must meet the
present federal flood criteria for finished floor elevation. I am also fully aware that if the total cost of work to my home or business
under this and any other permit exceeds fifty percent (50%) of the replacement cost of the structure, then the entire structure must
conform to the current code requirements of the Building Code.
WARNING TO OWNER: Your failure to record a NOTICE OF COMMENCEMENT may result in you paying twice for
improvements to your property. If you are spending more than $2,500 or intend to obtain financing, you may wish to consult with
your attorney or lender before recording your Notice of Commencement. The Notice of Commencement must be recorded at:
22 N.W. 1st Street, 1,,Floor,(305)679-1078. Once recorded,the Notice of Commencement must be POSTED AT THE JOB SITE in
accordance with Section 713-35 of Florida Statutes. Review the brochure at Village Hall on Construction Lien Law and
Choosing a Contractor. r
S O ORID ,CO MIAMI-DADE ST OF A,COUNTY F -DADE
Si a of Owner Signature of Contractor/Qu6ther
�T2i,
Print NameAA Print Name / ,
Sworn to and subscribed before me this�day oflW✓M� Sworn to and subscribed before me thisy1� day of/V/0�
/:44 14w�
Sign f oK4MA KILPATRICK Signa o O P�Sta 'A*ILPATRICK
MY COMMISSION# DD 149162 y 1 i MY COMMISSION DD 149152
SEAL: or�o�� EXPIRES:September 27,2006 SEAL: ��or n%'
V EXPIRES:September 27,2(X16
1.6aXU MOTARY F'L Nc1arq Sw&9&Bw&g,Inc. 1.8Mt NOTARY FL Notary Semoe&Bordng.(-
Personally known OR,Produced Identification ✓ Personally known R,Produced Identification
Type of Identification Produced:r17-D2U.c F346 41506:54100 Type of Identification Produced:A
Page 3
PERMIT APPLICATION
INSTRUCTIONS: Please indicate the type of work being performed and quantity(ies)in the space provided below.
ELECTRICAL
TYPE QTY. TYPE QTY. TYPE QTY. TYPE /
Minimum Fa Dryer Outlet,Appliance I I Service Repair
A/C Central 1-3 Ton Fan Outlet,Wall Service,Temporary
A/C Central 4-7 Ton Fire Pump Outlet,Switch Signs
A/C Central 5-15 Ton Fixture-Fluorescent Oven Space Heater(kw)
A/C Central 16-20 Ton Fixture Light Parking Lot Lights Spas/Hot Tubs
A/C Central 20+Ton Flood Lights Plugmold/Strip Subfeeds,No.of Amps
A/C Window FPL-Load Central Posts Swim Pool,Commercial
Air Conditioners Garbage Disposal Range/Range Top Swim Pool,Residential
Chiller Generators,etc. Receptacles Switchboards
Clear Violations Heat Recovery Refrigerator,Comm.(p/PH) Temp Serv,Construction
Compactor Low-volt,Burglar Refrigerator,Domestic 1 Temp for Test-30 days
Deep Freezer Low-volt,Fire Renew-Temp Service w"e.
Demolition Low-volt,Intercom/Teleph. Repair Circuits
Dishwasher Low-volt,Television Service,Number of Amps
MECHANICAL
TYPE QTY. TYPE QTY. TYPE QTY. Typt-' 1
Minimum Fee Condensate Drain Generator Refrigeration,Tons
A/C Central,Tons Cooling Tower Heating Strips,each Vent Hood,Cost
A/C WaIUWm.Tons Dryer Vents,Number of Paint Booth Ventilation,Cost
Air Handler,Tons Ductwork,Cost of Piping,Flammable Liquid Periodic Inspections
Barbecue Fire Sprinkler System Process/Pressure Piping
Bath Fan-Vented,# Fireplaces,Number of Pressure Vessel
PLUMBING
TYPE Q-1-Y. TYPE Q'i-Y. Typu, QTY. TYPE QTY-
A/C Condensate Drains,Roof Miscellaneous Fixture Soakage Pit
Bath Tub Drinking Fountain Miscellaneous Repairs Solar Water Heater
Bidet Filter Replace Pool Piping Sprinkler Repair
Cap-Fixture Fountain Pump and Abandon Sprinkler System
Cap-Water Gas-Appliance Pump,Domestic Supply,AC Well
Cap-Sewer Gas-Natural Pump,Fire Stand Temporary Toilet
Catch Basin Gas-Propane Pump,Re-circulate Temporary Water Closet
Clothes Washer Gas Piping Pump,Replace-Pool Urinal
Dental Chair Grease Trap Pump,Sprinkler Utility-Sewer
Discharge Well Ice Maker Pump,Sump Utility-Water
Dishwasher Indirect Wastes Relay Repair Vacuum Pump
Disposal Interceptor Roof Inlet Water Closet
Domestic Well Laundry Tray Septic Connection Water Heater
Drainfield,4"Tile/Res. Lavatory Septic Tank Water Heater New
Drains,Area Meter Set(Gas) Sewer Connection Water Re-pipe
Drains,Floor Minimum Fee Shower Water Service
Drains,French Miscellaneous Equipment Sink Well,Supply
I
RECEIVED AND REVIEWED BY. DATE:
Page 4 u
PERMIT APPLICATION
OFFICE USE ONLY
3 . , • �-
i
❑ OWNER-BUILDER FORM ❑ PROOF OF OWNERSHIP ❑ CONDO ASSOCIATION APPROVAL
(Attach) (Attach) (Attach)
L1.FIRE DEPARTMENT ❑ HRS/DERM APPROVAL ❑ BPR APPROVAL(Restaurants)
APPROVAL(Commercial/ (Septic/Sewer)
multi-family) e
❑ CONCURRENCY ❑ IMPACT FEE ❑ CONTRACTOR REGISTRATION
(New Construction) (New Construction) (On File)
❑ OTHER ❑ OTHER
(Specify&Attach) (Specify&Attach)
$3.00 per page(Scanning Fee) $
Miami Shores Village $
Bond $
Metropolitan Dade County (C.C.R) $ 3, c) 1) (sq.ft.=x/1000
x¢.60)
Inspector State Educational Fund $ �� (¢.005/sq.ft.)
State DCA(Radon) $ (0.01/sq.tt.)
Code Enforcement Fine $
Zoning Review $
3 TOTAL $ �b I.
az
ISSUING OFFICIAL i At
nom:
REVIEWED AND PREPARED B DATE:
SECTION BY DATE
Zoning
Electrical
Mechanical
Plumbing
Fire
Public Works
Structural
Building Official
Revised July 2001
10050 N.E. 211D AVE., MIAMI SHORES,FL • (305) 795-2207 •FAX (305) 756-8972 • http://www.miamishoresvillage.com
I
1604
4;F77INC.
Broward CC#97-CME-1743-R
ELECTRICAL CONTRACTORS JOB: JOE FITZGERALD
Post Office Box 226317 - Miami, FL 33122-631 ADD: 261 NE 97 STREET
Tel: (305) 592-0534® (305) 2i4-1606 MIAMI SHORES
Fax: (305) 592-9462 FLORIDA 33138
NEW 1 POLE SW PHONE: 305-756-6118
FOR UNDER CABINET 2'MAX TYPICAL NEW G.F I SHEET: I OF 3
LIGHTS DUPLEX RECP DATE: 11r26t2003
TYPICAL
SS
D G.F.I. T
EXISTING G.F.I. 4'h4AX TYPICAL
RECESSED 0
LIGHTS(5)8 G.F.I.
DIMMER I S_
C) 0
PANTRY
DISPOSAL
Fs-1rjK Ila DhV
RECP.
KITCHEN G.F.I.
DNV NEV'-f LV Ui'-IDER
REF, 0 0 CABINET LIGHTS
(4)TYPICAL
L 0 {� RANGE
0 S NEW — -& MICRO-0-44VE
G.F.I. CEILING U
LIGHT&SW 0
G.F.I.
LAUNDRY S
EXISTING DRYER ROOM EXISTING PANTRY
-LL LIGHT AND SW TO Itt NEW YVALL
IF REMAIN RECP
ffT WASHER
�OPANTRYJ
2 NEW COUNTER
RECP&20A CIR
ALL NEW CIRCUITS ARE TO BE TIED INTO THE EXISTING 200A GE PANEL IN THE
GARAGE AND IS LARGE ENOUGH FOR THE LOADS.THE NEW KITCHEN
COUNTER RECP.WILL HAVE 2-20A 120V CIRCUITS AS REQUIRED.THE DAAf,
DISPOSAL,REF,WILL HAVE THERE OWN 20A 120V CIRCUITS.THE RANGE IS
50A 240V 9KVV AND WILL HAVE A-4 C -Y!T:.THE, EWUNDERCABINET
IRC
LIGHTS WILL BE 20W EACH(4)1 II TH t*TINGLIGHTING
CIRCUIT,
6
SNn�a. D'!t
MICHAEL A. DEVANEY, SR.
�RIDP CHIEF ELECTRICAL INSPECTOR
BUILDING DEPARTMENT
MIAMI SHORES VILLAGE
10050 N.E.SECOND AVE.
MIAMI SHORES,FLORIDA 33138-2382 Phone:(305)986-7028
:13B JOE FITZGERALD
04747 INC.
Broward CC#97-CME-1 743-R ADDRESS: 261 NE 97 STREET
ELECTRICAL CONTRACTORS hA SHORES
F'HOI'•lE: 305-756-6118
Post Office Boit 226317 9 Miami, Fl. 331122-631 7
Tel: (305) 592-0534 ® (305) 2741-1506 DATE: 11r26I2003
Fax: (305) 592-9462
SHEET 2 OF 3
NEW 2"E.M.T.RISER WITH 3-2N CU.THHN STR.
DRIP LOOP 10'MIN.FROM 2 OLD FUSE
GROUND PANELS
CONVERTED TO J
EXISTING 1"EMT TO BOXES EXISTING
EXISTING CENTRAL AIC
0 SYSTEM,W-2#4.REWORK EXISTING G.E
INTO METER MAIN AND MAIN BREAKER
INSTALL PROPER SIZE 40 CIRCUIT
NEW 200A BREAKER 120/240%/
8 CIRCUIT INDOOR SINGLE
METERIMAIN PHASE PANEL
SINGLE PHASE
REWORK 1-112"RIGID AND
SINGLE PANEL A.
NEW 1-112 EMT CONDUIT IN GARAGE
WITH 3-2/0 THHN CU.STR.
NEW#4THHN CU.STR.
IN A 112"P.V.0
I 2-10 FOOT X 518 GALV.GROUND RODS MIN (moi rg7ER
6'APART WITH A WATER GROUND
r
CC#16047 INC.
Broward CC#97-CME-1743-R JOB: JOE FITZGERALD
ELECTRICAL CONTRACTORS ADD: 261 P1E 97 AVE
Post Office Box 226317 , Miami, FL 33122-611 i MIAMI SHORES
Tel: (305) 592-0534- (305) 274-1606 � PHONE: 305-756-6118
Fax: (305) 592-9462
DATE: 11 16!1003
SHEET. 3 CIF 3
SQ FOOT 2100 X 3 6,300 VA
LAUNDRY 1,500 VA
SMALL APP. 3,000 VA
DRYER 5,000 VA
RANGE 9,000 VA
DISPOSAL 750 VA
DISHWASHER 975 VA
REF. 1,200 VA
MICROWAVE 1,300 VA
SPRINKLER PUMP 2,485'SIA
POOL PUMP 2,140 VA
TOTAL CONNECTED LOAD 33,650 VA
FIRST 10KW@ 100% 10,000VA
REMAINDER @ 40% 9,460 VA
DEMAND 19,460 VA
AIHJU 10KW @ 65%6,500VA
A/ClU @ 100% 3,864VA
DEMAND 19,460 VA
AIHN 6,500 VA
TOTAL LOAD 25,950 VA
25,950 VA 1230V=112.83 AMPS
i
jj �1 J�I�IiJ
4�
a
h
Miami Shores Village Dectrical Permit
10050 NE 2nd Avenue "'•
Phone: 305-795-2204 Permit Number: EL2003-350 *I;&
AR>l ►
Printed:12/1/2003 Page 1 of 1
Applicant: JOSEPH FITZGERALD
Owner: FITZGERALD JOSEPH
JOB ADDRESS: 261 NE 97 ST
Contractor G &T ELECTRIC COMPANY Contractor's Address: 9550 NW 12 ST 15
Local Phone:
Parcel # 1132060134270 Legal Description: MIAMI SHORES SEC 1 AMD PB 10-70 LOT 19&W1/2 OF LOT 20 BLK 31 LOT SIZE
Fees: Description Amount
FEE2003-7565 CCF $3.00 Total Fees: $161.85
FEE2003-7567 Technology Fee $3.85
FEE2003-7568 Training and Education Fee $1.00 Total Receipts: $0.00
FEE2003-7569 Building Fee $154.00
Total Fees: $161.85
Permit Status: APPROVED Permit Expiration: 5/24/2004 Construction Value: $4,400.00
Work: KITCHEN AND LAUNDRY ROOM AND OUTSIDE SERVICE REPAIR AS PER PLANS
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: