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EL-05-336 Miami Shores Village +> Building Department 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 Tel:(305)795.2204 Fax:(305)756.8972EH BUILDING � ` Permit No. �P'pE('RMIT APPLICATION aster Permit No. FBC 2001 w n --------- Permit ®wo ®®_Permit Type(circle): Building Electri Plumbing Mechanical Roofing Owner's Name(Fee Simple Titleholder) �Vjq 0S C— V#tzgz Phone# ®�5 7S&7/s Owner's Address ?& Il-CA) /® 54—• City 04-mi S 140AC_57 State e`Z Zip - {(ox Tenant/Lessee Name Phone# Job Address(where the work is being done) -5 47n-CF City Miami Shores Village County Miami-Dade Zip Is Building Historically Designated YES NO Contractor's Company Name J G Phone# Contractor's Address City State Zip- Qualifier State Certificate or Registration No. Certificate of Competenc No _ Architect/Engineer's Name(if applicable) Phone# $Value of Work For this Permit 4 1.2 ®®r 0 0 Square Footage Of Work: Type of Work: ❑Addition ❑Alteration ❑New ❑ Repair/Replace El Demolition DescribeWork: TI Lr C 13 t-ri r—r far 1K S go W G Submittal Fee$ Permit Fee$ t �4° CCF$ I' Zo CO/CC. Notary$ 5- Training/Education Fee$ Technology Fee$ 2.• Scanning$ 3• 00 Radon$ Zoning Bond$ Code Enforcement$ Structural Plan Review.$ Total Fee Now Due$ 112 - 10 (Continued on opposite side) Bonding Company's Name(if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name(if applicable)_ &I'l 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 Signature0� Signature O er.or Agent Contractor The foregoing in trument was acknowledged before me this Iq The foregoing instrument was acknowledged before me this day o��7 1Q5 by `/,t�c�� GI day of ,20_,by who ispersonallyknown to me who has produced who is personally known to me or who has produced ! J o As id e ifi ation and who did take an oath. as identification and who did take an oath. NOTARY PUBLIC: ;��,g�C?�e'% 1 Var aI NOTARY PUBLIC: ommissio $4 Sign: x ir- ,JU ➢ 7 Sign: Print: j is Bondina Ca far Print: My Commission Expire : My Commission Expires: APPLICATION APPROVED BY: ye �/ -O-$tans Examiner Engineer chc 05!13/03 Zoning ADDENDUM TO BUILDING PERMIT APPLICATION (AN A£PLICATION 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 SPACE HEATERS BIDET LIGHT OUTLETS CENTRAL HEATING DISHWASHER RECEPTACLES A/C (WINO) DIAL SERVICE TEMPORARY 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 UNDERGROUND TANKS LAVATORY OVEN ABOVE GROUND TANKS LAUNDRY TRAY WATER HEATER U.F. PRESSURE VESSELS CLOTHES WASHER MOTORS D- 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 LAINAL 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 M 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 ORA INFIELD, 4' TILE/RES. VIOLATION PUMP 8 ABANDON SEPTIC TANK REINSPECTION SOAKAGE PIT CU. FT. CATCH BASIN DISCHARGE WELL DOMESTIC WELL AREA ORA I N ROOF INLET SOLAR WATER HEATER FIRE STANDPIPE POOL PIPI% LAWN SPRINKLER SYSTEM GAS RANGE ! METER SET (GAS) GAS PIPIIC- Miami Shores Village Electrical Permit N 10050 NE 2nd Avenue Phone: 305-795-2204 Permit Number: EL2005-336 Printed:9/22/2005 Page 1 of 1 Applicant: YVROSE VALDES Owner: VALDES YVROSE JOB ADDRESS: 86 NW 108 ST SUPPLIES INC Contractor's Address: Contractor RAY'S ELECTRICAL SU2023 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 FEE2005-12713 Building Fee $100.00 Total Fees:$112.10 FEE2005-12714 CCF $1.20 il Rts: Total Receipts:FEE2005-12715 Notary Fee $5.00 Top $0.00 FEE2005-12716 Training and Education Fee $0.40 FEE2005-12717 Technology Fee $2.50 FEE2005-12718 Scanning Fee $3.00 Total Fees: $112.10 Permit Status: APPROVED Permit Expiration: 3/21/2006 Construction Value: $1,500.00 Work: CHANGE TILE, CABINET,TOILET AND SHOWER IN BATHROOM 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: