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EL-05-87 Miami Shores Village BuildingDepartment - ( 2% �7 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 Tel: (305)795.2204 Fax: (305)756.8972 MAI 0 8 M5 BUILDING Permit Ivo.w PERMIT APPLICATION Master Permit No. ! 6 FBC 2001 Permit Type (circle): Building ')(Electrical Plumbing Mechanical Roofing Owner's Name(Fee Simple Titleholder) a tZ 1' A C� ' hone# 3©� ( jL Owner's Address 11,_, A/ E l S City li .S Il ` r . o K!,�State rEc o_ Zip 23 Tenant/Lessee Name Phone# 3O 10 7S Job Address(where the work is being done) ' j 7�5 City Miami Shores Village County Miami-Dade Zip 331 1 Is Building Historically Designated YES NO Contractor's Company Name { ra �G ��rv►C Phone# Contractor's Address 0.k1s-0 City /Il .�i Cf V;-, State F'-' C, Zip 3 I J Qualifier y Architect/Engineer's Name(if applicable) Phone# $Value of Work For this Permit g Sq uar�Foota a Of Work: Type of Work: ❑Addition ❑Alteration ❑New Re air/Re lace ❑Demolition YP p p Describe Work: z p o=c ig G T a u :Fe.T <o .S v i'44 C Y ( lav / � Submittal Fee$ Permit Fee$ /',S®�� CCF$ CO/CC Notary$ Training/Education Fee$ 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) 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 I! COMMENCEMENT." Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding$2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien*law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such pasted notice, the inspection will not be ap ro d and a reinspection fee will be charged. Signatur Signature Ow� Vcknowledged gent Contractor' The foregoi ' instrument wbefore me thiss.i�te foregoing instrument was acknowledged before me this b da of -dZ 20�' b da of 20a!` Y � �, Y Y by > who is personall k ho has produce who is personally known to me or who has produced As identification and who did take an oath. as identification and who did take an oath. NOTARY PUBLIC• NOTARY PUBLIC: —er' / G 4 Sign: C, Sign: Print: dl� Print:EtIDA Pt: Gi/1 0 0-/y S NOTA My Commission Expires: °OexP aM�?,1e 140TARY' My Commission Expires: My �`}�`§0&DA NOTA HAA PU LIC• TA E O BONDED i$SJO�N#DOI22133 (Certificate of Competency Holder) 9oNoEDTHRU+-Bea-NOTAR�1 State Certificate or Registration No. C O B df' Certificate of Competency No. APPLICATION APPROVED BY /t! Plans Examiner Engineer Zoning Chc 12/15/03 CEDED Miami Shores Village OCT o z �� Building Department BNY 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 BUILDING Master Permit No. ZZC�Z PERMIT APPLICATION Sub Permit No. ❑BUILDING 0 ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING ❑ MECHANICAL E]PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP ( 2J� C� ,r CONTRACTOR DRAWINGS JOB ADDRESS: J✓ 3 Q� ✓ `� `-rwr City: Miami Shores County: Miami Dade Zip: 3 Folio/Parcel#: Is the Building Historically Designated:Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER:Name(Fee Simple Titleholder): !�/ '�l�t ll� �/f1 Phone#: Address: She � A-.5 ill VE City: State: �� zip: Tenant/Lessee Name: Phone#: Email: CONTRACTOR:Company Name: `QlyZ�i.2Y' Phone#: Address: City: State: Zip: Qualifier Name: Phone#: State Certification or Registration#: Certificate of Competency#: DESIGNER:Architect/Engineer: Phone#: Address: ��ff City: State: Zip: Value of Work for this Permit:$ o-�"" Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition Description of Work: 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$ TOTAL FEE NOW DUE$ (Revised02/24/2014) 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 occ s seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved a reinsp ion fee will be charged. Signature _ Signature OWNEaknIedged CONTRACTOR The foreg ing instrument s before me this The foregoing instrument was acknowledged before me this �—day of 20 4� by day of 20 by r' M(ZS I X who is personally known to who is personally known to me or who has produced us. t" *Wvzv 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: 6 Sign: ` 'oi Sign: Print: � "w i. Print: Seal: �r. rip _ Seal: l4 . CP 69 r y''•.,�"�;a,,?sial,� ************************ * # *'* s * > * *************************************************************** j�ilf i1 APPROVED BY / Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) Miami Shores Village Electrical Permit 10050 NE 2nd Avenue Mf* Phone: 305-795-2204 Permit Number: EL2005-87 � ` ORit�` Printed:3/11/2005 Page 1 of 1 Applicant: MARTIN MEJIA Owner: MEJIA MARTIN JOB ADDRESS: 333 NE 91 ST Contractor METRO ELECTRIC SERVICE INC Contractor's Address: 15050 NE 20 AVE Local Phone: 305-945-1991 Parcel # 1132060136510 Legal Description: 1 53 41 6 53 42 MIAMI SHORES SEC 1 AMD PB 10-70 LOT 17 &W1/2 LOT 18 BLK Fees: Description Amount FEE2005-3198 Building Fee $150.00 Total Fees:$158.35 FEE2005-3199 CCF $1.20 FEE2005-3200 Training and Education Fee $0.40 Total Receipts: $0.00 FEE2005-3201 Technology Fee $3.75 FEE2005-3202 Scanning Fee $3.00 Total Fees: $158.35 "y Permit Status: APPROVED Permit Expiration: 9/4/2005 Construction Value: $2,000.00 Work: KIT OUTLETS REPLACE 18 LIGHTS AND HI HATS MAR 2 4 PAID Signed: (INSPECTOR) In consideration of the issuance to me of this permit,1 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: 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 UNIT FEE BATH TUB SWITCH OUTLETS 12 SPACE HEATERS BIDET LIGHT OUTLETS CENTRAL HEATING DISHWASHER RECEPTACLES o A/C (WIND) DISPOSAL SERVICE TEMPORARY A/C (CENTRAL) DRINKING FDUNTAIN SERVICE SIZE IN AMPS DUCT WORK FLOOR DRAIN SERVICE REPAIR/METER CHANGE REFRIGERATION GREASE TRAP APPLIANCE OUTLETS PROCESS AND PRESS PIPING INTERCEPTOR RANGE TOP c UNDERGROUND TANKS LAVATORY OVEN ABOVE GROUND 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 HEATER FIRE SPRINKLER GENERATORS TRANSFORMERS I 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 F IXTLRES 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 WELL AREA DRAIN ROOF INLET SOLAR WATER HEATER FIRE STANDPIPE POOL PIPING LAWN SPRINKLER SYSTEM GAS RANGE METER SET (GAS) GAS PIPING