2000 KITCHEN REMODELING PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date 9 1 100 Job Address 11-7 3 M£. 1 W4 .5-1-, Tax Folio 11 - 2 23 2-O 3 14.- 00 'Z A
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PWIDUC. MLO s •F DodsCev �¢tovida. ��n
Own6 ware/Tenant D;a„ne rf7i $C�-2✓' Master Permit#
Owner's Address 1177?, N.E . • 103"t Phone 3 OS -'7 S 8- 47o 8 2
Contcading Co. •r v*11-0•v-A a c..atyNA-u Address EA u
Qualifier SS# hon 9S 0$9- ®I�O —
State#L r,C D A N inlam—Municipal# Competency# Ins.Co.
Architect/Engineer Address
Bonding Company Address
Mortgagor _oR�c�r,Address
r
Permit Type(circle one): BUII.DIN ISLE&CAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION J-k ( .(�L�-��-ccx�rtQ��r.�]c� eu� � ;�s,- �G�r:h a� QUA-
0K
rk
0 M�(2T;�r Idtilf.��1 1L{�i�'li
Square Ft .0 ' � Estimated Cost(value)
WARNING TO OWNER YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY RESULT IN YOUR
PAYING TWICE FOR EMPROVEMENTS TO YOUR PROPERTY(IIF YOU VaM TO OBTAIN FINANCING,CONSULT WITH YOUR LENDER
OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.)
Application is hereby made to obtain a permit to do waak and installation as indicated above,and on the attached addendum(if applicable). I certify that all work
will be performed to meet the suds of all laws regulating construction in this jurisdiction. I understand that separate permits are required for ELECTRICAL
PLUMBING,SIGNS,POOLS,ROOFING and MECHANICAL WORK
OWNERS AFFIDAVIT: I certify that all the fotegoing information is accurate and that all work will be done in compliance with all applicable laws regulating
construction and zoning. Furthermore,I authorize the above-named contractor to do the work stated
naoq,de
'140
14A - �
''.Notary as to Owner and/or C oPhsident Date r� Bail Date
M�+Commission D y roa
00
KATHERINE M.0TER0 �r a� TAMMY ROBINSON OLIVENCIA
,s MY COMMISSION#M CC 825420 $ Notary Public. State of Florida
EXPIRES:April 12,2003 My comm.expires Mar. 13,2004
•.18;, T MNGWy! nUWW No. CC918244
FEES: PERMIT ! RADON C.C.F. v NOTARY BOND
APPROVED: TOTAL DUE
Zoning Building � Electrical
Mechanical PlumbingStructural
Engineer
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job site and adjustment to fit job applicable fee has been paid or job DAK
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VILLAGE
Date
nn PERMIT APPLICATION FOR MIAMI SHORES VI
Date /90_ � -®U Job Address M.E. 0 b35*---Tax Folio
Legal Description IZorioally Designated: Yes No
Owner/Lessee/Tenarmt �s � Master Permit#
Owner's Address C S-Vtrc C _ Phone
Contacting Co.�4y(=I� i; ® Address IVV mZ
Qualifier ✓0& SS# INNEPhone 3 o5 � ri 0 5
1b
__NW
State# Municipal# Comply# 7Coovo 31 Ins.Co. C®�D
Architect/Engi�er Address
Bonding Company Address
Mortmar Address
Permit Type(drde one): BUII.DIN jLECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTIONP��_j t�
Square Ft. Estimated Cost(value) gt?0
WARNING TO OWNER YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY RESULT IN YOUR
PAYING TWICE FOR 01pROVEMENTS TO YOUR PROPERTY(IF YOU INTEND TO OBTAIN FINANCING,CONSULT WITH YOUR LENDER
OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.)
Application is hereby made to obtain a permit to do wa&and installation as indicated above,and on the attached addendum(if applicable). I certify that all work
will be performed to meet the standards of all lawn;regulating construction in this jurisdiction. I understand that separate permits are required for ELECTRICAL
PLUMBING,SIGNS,POOLS,ROOFING and MECHANICAL WORK.
OWNERS AFFIDAVff: 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. Furthermore,I authorize the above-named contractor to do the work stated.
ignature of owner and/or Condo President Date of Contractor or Owner-Builder Date
D L A 3 a®-PD 4a-) b^ v
Notary as to Owner and/or Condo President Date as Con orTD
My Commission Expires: My Commi c,n< MOTawr s
Z�PR l/B�ir ANGEE1 bum
C*)
CC78607
o W
Off O 16.Z0 R�
FEES: PERWr AP � RADON C.CX_ NOTARY S_ QQ BOND
APPROVED: TOTAL DUE—
Zoning Building Electrical
Mechanical dumbing Structural Engineer
I �
.. � ��-i+
FFR�� �ts:
a..�� �y�
-• .-
ADDENDUM TO BUILDING PERMIT APPLICATION
r
(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 �( SPACE HEATERS
BIDET LIGHT OUTLETS CENTRAL HEATING
01SMASHER RECEPTACLES A/C (WINO)
DISPOSAL. SERVICE TEMPORARY A/C (CENTRAL)
DRINKING FOUNTAIN SERVICE SIZE IN AMPS DUCT WORK
FLOOR DRAIN SERVICE REPAIRACTER OW&E REFRIGERATION
GREASE TRAP APPLIANCE OUTLETS PROCESS AND PRESS PIPING
INTERCEPTOR RANGE TOP UNDUGM ND TANKS
LAVATORY OVEN ABOVE GROUNDI TANKS
LAUNDRY TRAY WATER HEATER U.F. PRESSURE VESSELS
.LOTHES WASHER MOTORS 0- 1 HP STEAM BOILERS
MOWER MOTORS OVER 1- 3 W 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
JRINAL MOTORS OVER 25-100 HP COOLING TOWERS
NATER CLOSET MOTORS OVER 100 HP VIOLATION
INOIRECT WASTES A/C WINDOW REINSPECTION
VATER SUPPLY TO: AIR CONDITIONERS
A/C UNIT STRIP HEATER
FIRE SPRINKLER GENERATORS TRANSFORIERS
HEATER-NEW INST. GENERATORS TRANSFORMERS
HEATER-REPLACE GENERATORS TRANSFORMERS
LAWN SPRINKLER-WELL SPECIAL PURPOSE
SWIMMING POOL OUTLETS COlAaCIAL
WATER SERVICE SIGN TUBES
,EWER CONNECTIONS SIGN TRANSFORMERS
TILITY-SEWER SIGN TIME CLOCK
UTILITY-WATER FIXTURES
EPTIC TANK ANTENNA
ELAY TELEVISION OUTLETS
RAIIFIELD, 4" TILE/RES. VIOLATION
UMP & ABANDON SEPTIC TANK REINSPECTION
OAKAGE PIT CU. FT.
ATCH BASIN
ISCHARGE WELL
OMESTIC WELL
REA DRAIN
OOF INLET
OLAR WATER HEATER
IRE STANDPIPE
OOL PIPING
4WN SPRINKLER SYSTEM
4 RADE
:TER SET (GAS)
%S PIPING