38241PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date 8 -7 -95 Job Address 11,300 N.E. SECOND AVENUE Tax Folio # 11-2136-000-0040
Legal Description 11300 N.E. SECOND AVENUE
Owner / Lessee / Tenant BARRY UNIVERSITY)''& 45 /q2a T/0 1 ( Master Permit # 3g2 ( # I
Owner's Address
11300 N.E. SECOND AVENUE Phone
Contracting Co. SAM BLOOM PLUMBERS, INC. Address 900 N.W. 144 STREET
Qualifier BONNIE BLOOM
ssi0 ph 6.88 -9668
State # CFC 05331 iunicipal # Competency # Ins.Co. LIBERTY MUTUAL
Architect /Engineer N/A Address
Bonding Company N /A Address
Mortgagor N/A Address
Permit Type(circle one): BUILDING ELECTRICAL LUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION 1) ADD _ "A COMPLETE DEIONIZED SYSTEM, 2) RELOCATE MECHANICAL ROOM
Square Ft. Estimated Cost(value) $ 19,000.00
WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO
SO 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).
Application is hereby made to obtain a permit to do work 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 laws regulating construction in this jurisdiction. I understand that separate
permits are required for ELECTRICAL, PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK.
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. Furthermore, I
authorize the above -named contractor to do the work stated.
Signature of owner and /or Condo President
Date:
Notary as to Owner and /or Condo President
My Commission Expires:
*
Signature of Contractor or Owner- Builder
Date: 8_7_95
AL
Notary as to Conjacto or 1
My Commission Ex res:
** * * * * * *
FEES: PERMIT Z5%0
RADON C.C.F.
APPROVED: Fire Other
Zoning Buildin
Mechanical Plumbin
4.V P4/ SHARON GIANNINY
,, ,i, , COMMISSION # CC 463776
* 44 EXPIFS MAY 2f), 1999 * **
4F Fk ATLANTI ONDING CO., INC.
NOTARY TOTAL DUE /7
Electrical
Engineering
er- Builder
ITEM
BATH TUB
UNIT
-
FEE
ITEM
SWITCH OUTLETS
UNIT
FEE
ITEM
SPACE HEATERS
UNIT
FEE
BIDET
LIGHT OUTLETS
CENTRAL HEATING
DISHWASHER
RECEPTACLES
A/C (WINO)
DISPOSAL
SERVICE TEMPORARY
A/C (CENTRAL)
DRINKING FOUNTAIN
SERVICE SIZE IN AMPS
DUCT WORK
FLOOR GRAIN
/
AI
SERVICE REPAIR/METER CHANGE
REFRIGERATION
GREASE TRAP
_
APPLIANCE OUTLETS
PROCESS AND PRESS PIPING
INTERCEPTOR
RANGE TOP
UNDERGROUND TANKS
LAVATGRY
—
OVEN
_
ABOVE GROUND TAMS
LAUNDRY TRAY
WATER HEATER
U.F. PRESSURE VESSELS
CLOTHES WASHER
MOTORS 0- 1 FP
STEAM BOILERS
SHOWER
MOTORS OVER 1- 3 FP -
HOT WATER BOILERS
SINK, POT /3 COMP.
MOTORS OVER 3- 5 HP
MECHANICAL VENTILATION
SINK, =NM LAB
/
Ile
MOTORS OVER 5- 8 HP
TRANSPORTING ASSEMBLIES
SINK, SLOP
MOTORS OVER 8- 10 HP
ELEVATORS/ESCALATORS
TEMPORARY WATER CLOSET
MOTORS OVER 10- 25 FP
FIRE SPRINKLER SYSTEMS
URINAL
MOTORS OVER 25-100 HP
COOLING TOWERS
WATER CLOSET
.
MOTORS OVER 100 HP
`_ VIOLATION
INDIRECT WASTES
L/
A/C WINDOW
REINSPECTION
WATER SUPPLY TO:
AIR CONDITIONERS
V A-C U V evi 1'» "N. P
1
foi
A/C UNIT
STRIP HEATER
V f }C UV rn O u t 1.e f
S
-
FIRE SPRINKLER
GENERATORS TRAN SFORM RS
Al ta 0 ti .7-1.-e. TS
S
501 J
HEATER -NEW INST.
GENERATORS TRANSFORMERS
,
/9-/A2 C o mpr esso t
/
>
HEATER— Relacu412,
/
p
GENERATORS TRANSFORMERS
LAWN SPRINKLER -WELL
SPECIAL PURPOSE
SWIMMING POOL
OUTLETS COMMERCIAL
WATER SERVICE
SIGN TUBES
SEWER CONNECTIONS
SIGN TRANSFORMERS
UTILITY -SEWER
SIGN TIME COCK
UTILITY -WATER
F IXT1PES
SEPTIC TANK
ANTENNA
RELAY
TELEVISION OUTLETS
DRAINfIELO, 4' TILE/RES.
_
VIOLATION
PUMP & ABANDON SEPTIC TANK
REINSPECTION
SOAKAGE PIT CU. FT.
CATCH BASIN
DISCHARGE WELL
DOMESTIC WELL
:Del' bA )2.4 tAokee- o u+li is
.
pe DN J248 F'il+e FFeeY-uf,
SOLAR WATER HEATER &
5404 By n 1-ke As
_
FIRE STANDPIPE
POOL PIPIM3
LAWN SPRINKLER SYSTEM
GAS RANGE
-
METER SET (GAS)
GAS PIPING -ouTLF rg .
S'
rfrF .�;,r ,
PLUMBING
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.)
ELECTRICAL
MECHANICAL