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39815PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date P L J 9C Job Address 11366 Air' ()AJ.0 A tfj . Tax Folio Legal Description Historically Designated: Yes No Owner/Lessee / Tenant A , re 10/14J 1r -a' J M-49 / d e '_ _: Permit # q8 !, Owner's Address fi Phone Contracting Co. 6ee.c. Nfiif i2EG /C (JD . g" Address 7120 p.41VOAJ, £' j Qualifier 10 i& �U . 6/e ' //09# SS# , Phone 912- 6/29 State # E moo 8 2 / Municipal # Competency # Ins. Co. Architect/Engineer Address Bonding Company Address Mortgagor Address Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION 01J LJO,t.Tl/GdiE ,,l1/e ep Square Ft. Estimated Cost (value) 4 000 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. 22 eta .��/; Signature of owner and/or Condo President Date Siafure of Contractor Owner- Builder Date Notary as to Owner and/or Condo President Date as to Contractor or Owner- Builder Date My Commission Expires: My Co T_' _ i • _ N p',{� OFFICIAL NOTARY SEAL ;,1 �0' raAMPRA a ",ONTII:L T < ) lt3�9 1S^�I ®65fIr :. R 1, a? to ©4e 1eG T .. - `" V " " ' l F',1' > wlOW -AISO N •E::P. ���� FL a'� , I:EES: PERMIT ///-, '� RADON C.C.F. NOTARY APPROVED: Zoning Building Electrical Mechanical TOTAL DUE Plumbing Engineering ITEM BATH TUB UNIT FEE ITEM _ SWITCH OUTLETS UNIT FEE ITEM SPAN HEATERS UNIT FEE BIDET LIGHT OUTLETS CENTRAL HEATING DISHWASHER RECEPTACLES 43 A/C (WINO) DISPOSAL SERVICE TEMPORARY A/C (CENTRAL) DRINKING FOUNTAIN SERVICE SIZE IN AMPS DUCT WORK FLOOR GRAIN 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 If HOT WATER BOILERS SINK, POT /3 COMP. MOTCRS OVER 3- 5 HP MECHANICAL VENTILATION SINK, RESIDENCE MOTORS OVER 5- 8 HP TRANSPORTING ASSEMBLIES SINK, SLOP MOTORS OVER 8- 10 If ELEVATORS/ESCALATORS TEMPORARY WATER CLOSET MOTORS OVER 10- 25 if FIRE SPRINKLER SYSTEMS URINAL MOTORS OVER 25-100 FP COOLING TOWERS WATER CLOSET MOTORS OVER 100 If VIOLATION INDIRECT WASTES A/C WINDOW REINSPECTION WATER SUPPLY TO: _ AIR CONDITIONERS - A/C UNIT STRIP HEATER FIRE SPRINKLER GENERATORS TRANSFORMERS • HEATER -NEW INST. GENERATORS TRANSFORMERS HEATER - REPLACE GENERATORS TRANSFORMERS LAWN SPRINKLER -WELL SPECIAL PURPOSE SWIMMING POOL CUTLETS 00M ERCIAL WATER SERVICE SIGN TUBES SEWER CONNECTIONS SIGN TRANSFORMERS UTILITY-SEWER SIGN TIME MOCK UTILITY -WATER FIXTURES SEPTIC TANK ANTENNA • RELAY TELEVISION OUTLETS DRAINFIELD, 4' TILE/RES. VIOLATION • PUMP & ABANDON SEPTIC TANK - REINSPECTION . 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 . 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.) PLUMBING ELECTRICAL MECHANICAL