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Legal Description
Owner / Lessee / Tenant
Contracting / Co.
Qualifier
Permit Type(circle one)
WORK DESCR
APPROVED:
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
/ r
Owner's Address //306 /Y,g
ss#
State # Municipal #
: BUILDING ELECTRICAL PL
Square Ft. Estimated Cost(value)
Signature of owner and /or Condo President
Date:
Notary as to Owner and /or Condo President
My Commission Expires:
c F,
Mechanical Plumbing
Sign
Da
** * * * * * * * * *
FEES: PERMIT K5Ag RADON C.C.F. F NOTARY
tary`as to Cont
Commission Exp
Master Permit #
Phone
Address 32 ( 4/ t )
c 4 f /Ca ,� �%C�.a✓ Jr��2� 'L ,
Phone ''\
' ac 79
Competency # Ins.Co.—
Architect /Engineer Address
Bonding Company Address
Mortgagor Address
NN' MECHANICAL ROOFING PAVING FENCE \SIGN
WARNING TO OWNER: YOU MUST RECORD A NOTICE OF 'COMMENCEMENT AND YOUR FAILURE TO DO
SONNY 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 ac orate and at all work will
be done in compliance with all applicable laws regulating •• structio a zoni \Furthermore, I
authorize the above -named contractor to do the work stat -•�
Fire Other
Zoning Building Electrical ' 1)
**
Engineering
ITEM
BATH TUB
UNIT
FEE
ITEM
SWITCH OUTLETS
UNIT
FEE
ITEM
SPACE HEATERS
UNIT
FEE
BIDET
_
LIGHT OUTLETS
CENTRAL HEATING
DISHWASHER
RECEPTACLES
A/C (WIND)
DISPOSAL
_
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 0- 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
IN I NAL
MOTORS OVER 25-100 HP
COOL I NG TOWERS
WATER CLOSET
MOTORS OVER 100 HP
VIOLATION
INDIRECT WASTES
A/C WINDOW
RE INSPECT ION
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
OUTLETS COMMERCIAL
WATER SERVICE
SIGN TUBES
SEWER CONNECTIONS
SIGN TRANSF-8R Th-
UTILITY -SEWER
- CLOCK
UTILITY -WATER
� 1°Tlfil�
,FFIXTURES
SEPTIC TANK
RELAY
TELEVISION OUTLETS
GRAINFIELD, 4" TILE/RES.
VIOLATION
PUMP & ABANDON SEPTIC TANK
REINSPECT ION
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.)
MECHANICAL
PLUMBING
ELECTRICAL