EL-05-294 Miami Shores Village
Building Department
10050 N.E.2nd A imi Shores,Florida 33138
�r'q Tel: (305)7 5
t
]BUILDING `AUG 2 2 ZOOS Permit No.
PERMIT APPLICATION ------------ �t r Permit_No. ash g
FBC 2001 -
Permit Type(circle): Building Electrical Plumbing Mechanical Roofing
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Owner's Name(Fee Simple Titleholder) — v# p #
Owner's Address 6 AIlitJ LB .11777
City /N_ � ��._@C��State (= L 14 Zip C �'
Tenant/Lessee Name Phone#
Job Address(where the work is being done) Q <9' !jC�"
City Miami Shores Village County Miami-Dade Zip
Is Building Historically Designated YES NO
Contractor's Company Name V Phone# ZRAa Z A M 7
17
Contractor's Address_2 Z 3 6 L4 c-JEA
City_ ' ,�eLtt*j "m State
Qualifier
State Certificate or Registration No. "0071-77 Certificate of Competency No. fid®
C
Architect/Engineer's Name(if applicable) Phone#
$Value of Work For this Permit 20® C7 Square Footage Of Work:
Type of Work: ❑Addition ❑Alteration ❑New ❑ lace Re air/Re
p p El Demolition
Describe Work: l�q D� ?-"AMR? IJ6 tx- an �
90N 't�rXh UAAC. (24006:L
Submittal Fee$ Permit Fee CCF$ ( 20 CO/CC
Notary$ Training/Education Fee$ . 40 Technology Fee$ -!5-cc ,
Scanning$ 3 CO Radon$ Zoning Bond$
Code Enforcement$ Structural Plan Review.$
Total Fee Now Due$ 20q . GO
(Continued on opposite side)
Bonding Company's Name(if applicable)
Bonding Company's Address
City State Zip
t
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 -2—Q The foregoing instrument was acknowledged before me this;Z—_Z
day of c�w.rt_<6�20 ,by day of 20,0.r 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 PUBLIC: NOTARY PUBLIC:
Sign: < Sign:
Print: Print:
My Commission Apires.,
M commis
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VALTYRAYMORE
den''6XA�9bJIdl��ry � i�; '�V�fi'17 .�f. 1�1f9°#°81�3964fiY�� *�*�
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EXPIRES.June 19,21109
Bor�+ed 7hro Notary Pubtla Undeiwritae
IL
APPLICATION APPROVED BY: 5kG� plans Examiner
Engineer
Zoning
Chc 05/13/03
Miami Shores Village Electrical Permit
10050 NE 2nd Avenue twit sun
,
Phone: 305-795-2204 Permit Number: EL2005-294
Printed:8/31/2005 Page 1 of 1
Applicant: YVROSE VALDES
Owner: VALDES YVROSE
JOB ADDRESS: 86 NW 108 ST
Contractor RAY'S ELECTRICAL SUPPLIES INC Contractor's Address: 2023 OPA LOCKA BLVD
Local Phone: 305-688-7133
Parcel# 1121360110160 Legal Description: DUNNINGS MIAMI SHORES EXT NO 7 PB 52-33 LOT 8 BLK
Fees: Description Amount
FEE2005-11605 Building Fee $200.00
FEE2005-11606 CCF $1.20 Total Fees:$209.60
FEE2005-11607 Training and Education Fee $0.40 Total Receipts: $0.00
FEE2005-11608 Technology Fee $5.00
FEE2005-11609 Scanning Fee $3.00
Total Fees: $209.60
Permit Status: APPROVED Permit Expiration: 2/18/2006 Construction Value: $2,000.00
Work: SERVICE UPGRADE 200 AMPS 10 120 VOLTS KIT C�
� , ® 1 Pal®
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:
ADDENDUM TO BUILDING PERMIT APPLICATION
(AN A£PLICATION FOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. IF A MASTER PERMIT HAS B.
OBTAI=, THE OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.)
A,
' PLUMBING ELECTRICA MECHANICAL
ITEM UNIT FEE ITEM UNIT FEE ITEM UNIT FEE
BATH TUB SWITCH OUTLETS SPACE HEATERS
BIOET LIGHT OUTLETS CENTRAL HEATING
01SHWASfim RECEPTACLES A/C (WIND)
DISPOSAL SERVICE TEMPORARY A/C (CENTRAL)
DRINKING FOUNTAIN SERVICE SIZE IN AhPS DUCT WORK
FLOOR MAIN SERVICE REPAIR/METER CHANGE '` REFRIGERATION
GREASE TRAP APPLIANCE OUTLETS PROCESS AND PRESS PIPING
INTERCEPTOR RANGE TOP 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 FP ELEVATORS/ESCALATORS
TEMPARY WATER CLOSET MOTORS OVER 10- 25 FP FIRE SPRINKLER SYSTEMS
URINAL MOTORS OVER 25-100 FP COOLING TOWERS
WATER CLOSET MOTORS OVER 100 FP VIOLATION
INDIRECT WASTES A/C WINDOW REINSPECTION
WATER SUPPLY TO: AIR CONDITIONERS
A/C UNIT STRIP HEATER
FIRE SPRINKLER GENERATORS TRANSFORhERS I
HEATER-NEW INST. GENERATORS TRANSFORMERS
HEATER-REPLACE GENERATORS TRANSFORMERS
LAWN SPRINKLER-WELL SPECIAL KJRPOSE
SWIMMING POOL OUTLETS COMMERCIAL
WATER SERVICE SIGN TUBES
SEWER CONNECTIONS SIGN TRANSFORMERS
UTILITY-SEWER SIGN TIME CLOCK
UTILITY-WATER FIXTLFIES
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 PIPIWG
LAWN SPRINKLER SYSTEM?
GAS RANGE
METER SET (GAS)
GAS PIPIN-
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MIAMI S �LLAGE
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BUILDING DEPARTMENT
305-795-22Oz6EP 3 0
Building Inspection Request
Date C=� ZB CS
Type Insp'n 'N
Permit No.o.
Name Y\-IQ—
Address CSC-1 Q Lk ) D-9 ST
Compan� 5 ��
Phone#
Inspection Date a f ZC I os
Approved LTJ'
Correction ❑ ��60 ®S
Re-Insp'n Fee ❑
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