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EL-08-2074Project Address 295 GRAND CONCORSE Miami Shores Village, FL 33138- Owner Information NEIL HART Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Building Department Copy Address Fees Due CCF Education Surcharge Notary Fee Permit Fee - Additions/Alterations Scanning Fee Technology Fee Total: Amount $0.60 $0.20 $5.00 $100.00 $3.00 $2.50 $111.30 d on Parcel Number 1132060133600 Block: Lot: 295 GRAND CONCOURSE MIAMI SHORES FL 33138 -2852 Contractor(s) Phone CeII Phone ELECTRONIC CONTROL SYSTEMS IN (305)823 -1374 (305)962 -9547 Authorized Signature: Owner / Applicant / Contractor / Agent Phone (305)962 -4547 Type of Work: ELECTRICAL Additional Info: PANEL WIRING Classification: Residential Total 1 Amt Paid 1 Amt Due $ 0.00 $ 0.00 Payment Type: • , AR 0 5 PMMf Expiration: 06/03/2009 Applicant NEIL HART Valuation: Total Sq Feet: $ 1,000.00 0 Available Inspections : CeII Inspection Type: Alteration Fire Alarm Final Relocation Meter Box Service Change Underground Rough W. W. 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 responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL, PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work. OWNERS 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. Futhermore, I authorize the above -named contractor to do the work stated. December 08, 2008 Date Monday, December 8, 2008 1 I�l�sl�d Iqoacu- BUILDING PERMIT APPLICATION FBC 2004 Permit Type: Electrical Owner's Name (Fee Simple Titleholder) l� Owner's Address City Mr(),INA,;\ S1,t/b,r t) tate Tenant/Lessee Name E -MAIL: 'GCS &1-1 Qualifier Name Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 1-1-AfeA-- C®rvN, Job Address (where the work is being done) 2Ck City Miami Shores Village FOLIO / PARCEL # County Miami -Dade Is Building Historically Designated YES NO Contractor's Company Name L tE(° oote_ () S■* - phone # 3U� ' DZ�" �J tf Contractor's Address Co Vi ky(A7 u V , Are 6-9 city Mt CU'M State L. Zip 3.3 O C A --- ) & k Phone # 2/3 v39- , 4 �..., E -MAIL: err State Certificat or Registration No. S Architect/Engineer's Name (if applicable) Value of Work For this Permit $ Submittal Fee $ Notary $ Scanning $ Bond $ Structural Review. $ h k � 1 � Zip 23 ( Type of Work: ❑Addition ['Alteration [New Describe Work: 2C1S -\ r 4rS S Z W Nr N\- Permit Fee $ /® e Training /Education Fee $ (MO Radon $ DPBR $ Code Enforcement $ Permit No. Master Permit No. Phone # Phone # Certificate of Competency No. Double Fee $ f:: 0 1 288 BY: 1#.______ .606 C o c (' �►J CSC° zip 33 C3 Phone # Square / Linear Footage Of Work: Repair /Replace ❑ Demolition * ** * *B:oY**** *** ******* ** ****** *F ees**dr** *w * xxxxxxxxxxx*n4******** &feet ** ** ** **xxx CCF $ 040 CO /CC Technology Fee $ • Zoning $ Total Fee Now Due $ 117 •00 See Reverse side -4 Bonding Company's Name (if applicable) Bonding Company's Address City State Mortgage Lender's Name (if applicable) rale, Mortgage Lender's Address City State 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. NOTAR APPLICATION APPROVED BY: (Revised 02 /08/06) /l Owner or Agent Contractor The fore .,oing ' strument was ack owl dged befo me this day of !OAP , 20O� by The fore oing in trument was cknow edge. befo me t. is e Y T day of V 20 , by who is ersonally known to me or who has produceit I °LI who is p 3105 fo- 1 identification and who did y known to me or who has produced ■!t�� an oath. 3y � entification and who did take an oath. Y PUBLIC: O ° IUBLIC: °1q / I ii ' 't � ti \4 c�, v Sign: Print: God 6 My Commission Expires: ®`Sr° • • xxxxxxxx ,0xxxxxx 9exrxxxxx*x xde•' �\ *** xxxx x *x x x xxx** xx4: OTA Sign: Print: My Commission Expires: Zoning r.,Yx,Yxxxxxxxxxxxxrr. x acxnt 7rSe x�� '.�/ p p�y� •• ��✓, \ \CI ,�cb Examiner Engineer * *X•Y. 'x•Y. ADDENDUM TO BUILDING PERMIT APPLICATION AN APPLICATION FOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. IF A MASTER PERMIT HAS BEEN OBTAINED, THE OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS. PLEASE CIRCLE 0 DISCIPLINE APPLIED FOR: PLUMBING ELECTRICAL PERMIT # MECHANICAL ITEM BATH TUB DISHWASHER DISPOSAL FLOOR DRAIN GREASE TRAP INTERCEPTOR LAVATORY LAUNDRY TRAY CLOTHES WASHER SHOWER SINK. POT /3 COMP. SINK, RESIDENCE. SINK, SLOP. TEMPORARY WATER CLOSET URINAL WATER CLOSET INDIRECT WASTES WATER SUPPLY TO: A/C UNIT FIRE SPRINKLER HEATER -NEW INST. HEATER - REPLACE LAWN SPRINKLER -WELL SWIMMING POOL WATER SERVICE SEWER CONNECTIONS UTILITY -SEWER UTILITY -WATER SEPTIC TANK RELAY FAINFIELD, 4" TILE /RES. PUMP & ABANDON SEPTIC TANK 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 • UNIT FEE ITEM SWITCH OUTLETS LIGHT OUTLETS RECEPTACLES SERVICE TEMPORARY SERVICE SIZE IN AMPS SERVICE REPAIR/METER CHANGE APPLIANCE OUTLETS RANGE TOP OVEN WATER HEATER MOTORS 0 -1 HP MOTORS OVER 1 -3 HP MOTORS OVER 3 -5 HP MOTORS OVER 5 -8 HP MOTORS OVER 8 -10 HP MOTORS OVER 10 -25 HP MOTORS OVER 25 -100 HP MOTORS OVER 100 HP A/C WINDOW AIR CONDITIONERS STRIP HEATER GENERATORS TRANSFORMERS GENERATORS TRANSFORMERS GENERATORS TRANSFORMERS SPECIAL PURPOSE OUTLETS COMMERCIAL SIGN TUBES SIGN TRANSFORMERS SIGN TIME CLOCK FIXTURES ANTENNA TELEVISION OUTLETS VIOLATION REINSPECTION 0)1 h`1 UNIT FEE ITEM SPACE HEATERS CENTRAL HEATING A/C (WIND) A/C (CENTRAL) DUCT WORK REFRIGERATION PROCESS AND PRESS PIPING UNDERGROUND TANKS ABOVE GROUND TANKS U.F. PRESSURE VESSELS STEAM BOILERS HOT WATER BOILERS MECHANICAL VENTILATION TRANSPORTING ASSEMBLIES ELEVATORS /ESCALATORS FIRE SPRINKLER SYSTEMS COOLING TOWERS VIOLATION REINSPECTION UNIT FEE