1077 NE 91 Terr (6)1
Date £ _a - 01 Job Address (Cyr) L. E. 3 1 S' -t?_ Tax Folio
Legal Description Historically Designated: Ycs - No
Owner/Lessee / Tenant IN E L SON .T1) M A W 1 Master Permit # u ( go" V /3
Ownees Address 1077 N. E. 91 TERRACE Phone 30 5 759 Z
C o n t r a c t i n g Co. VAC. =% C) t G , Address 3Sc --7 1- 4-5+0. I 1r ,
Qualifier Z'u C..= O C. VA C ss30 •
State # C,Ac
Architect/Engineer
Bonding Company
Mortgagor Address
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING
WORK DESCRIPTION X_ 1.13.7-4e, JTSoto Or ivGTC,.XllaC .Qm ,,� � VN .V73' ,
Square Ft. Estimated Cost (value) 0 SCR.) - Cat, •
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 y work stated.
Sidmature of owner and/or Condo President
�• r��rr . @Nil nt
-7pr ION it CC 942151
of,o EXPIRES: June 5, 2004
miu Notary Public Undemdters
Notary a
My Co
FEES: PERMIT
Mechanical f a' Plumbing
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Municipal # Competency #
Address
Address
APPROVED:
Zoning Building Electrical
JULY -2O -200i
Date
Date
SS# Phone C3cs$) CIF- trio
Ins. Co.
ROOFING PAVING FENCE SIGN
My Commission Exp
2 1 dl ra sa
/'l
st. :dY is ]',0 E>0:4 �7. ::PIRk3
OF F'-O Gtr. is
r- Builder Date
RADON C.C. NOTARY S b 0 BOND
TOTAL DUE
Structural Engineer
ITEM
BATH TU3
UNIT
FEE
ITEM
SWITCH CURETS
UNIT
FEE
ITEM
SPACE HEATERS
UNIT
FEE
BIDET
LIGHT OUTLETS
CENTRAL HEATING I p k vJ
DIS;VZHER
RECEPTACLES
A/C (WIND)
DISPOSAL
SERVICE TEMPORARY
A/C (CENTRAL) a .J "TC,
DRINKING FOUNTAIN
SERVICE SIZE IN AMPS
DUCT WORK 9 c cc
•
•
FLOOR DRAIN
SERVICE REPAIR/YETER G1ANGE
REFRIGERATION
GREASE TRAP
APPLIANCE CURETS
PROCESS AND PRESS PIPING
INTERCEPTOR
RANGE TCP
UNDERGROUND TANKS
LAVATORY
OVEN
ABOVE GROUND TANKS
LAUNDRY TRAY
WATER HEATER
U.F. PRESSURE VESSELS
CLOTHES WASHER
MOTORS 0- 1 FP
STEAM BOILERS
SHOkR
MOTORS OVER 1- 3 FP
HOT WATER BOILERS
SINK, POT /3 COMP.
MOTORS OVER 3- 5 NP
MECHANICAL VENTILATION
SINK, RESIDENCE
MOTORS OVER 5- 8 FP
TRANSPORTING ASSEMBLIES
SINK, SLOP
MOTORS OVER 8- 10 FP
ELEVATORS/ESCALATORS
TEMPORARY WATER CLOSET
MOTORS OVER 10- 25 FP
FIRE SPRINKLER SYSTEMS
:,R I NAL
MOTORS OVER 25-100 FP
COOLING TOWERS
HATER CLOSET
MOTORS OVER 100 FP
VIOLATION
INDIRECT WASTES
A/C WINDOW
REINSPECTION
WATER SIPPLY 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
SNI4ING POOL
OUTLETS CONERCIAL
WATER SERVICE
SIGN TUBES
;EWER CONNECTIONS
SIGN TRANSFORMERS
rTILITY -SEWER
SIGN TIME CLOCK
TILITY -WATER
FIXTLRES
EPTIC TANK
ANTENNA
ELAY
TELEVISION CUTLETS
RAINFIELD, 4' TILE/RES.
VIOLATION
Ulf & ABANDON SEPTIC TANK
REINSPECTION
OAKAGE PIT CU. FT.
ATCH BASIN
I SG`IARGE WELL
:MESTIC WELL
;EA CRAIN
7OF INLET
7LAR WATER HEATER
IRE STANDPIPE
0L PIPING
VNN SPRINKLER SYSTEM
RAGE
.TER SET (GAS)
S PIPING
ADDENDUM TO BUILDING PERMIT APPLICATION
(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
BUILDING ❑
ELECTRICAL ❑
PLUMBING ❑ PERMIT
ROOFING ❑
•
MECH Work to be
Owner of YI f �'�'
Building
Architect
Contractor
or Builder
Legal
Description
ption
Address.of
Building
/9
Lot 1
,1()c ', f
CON ' ACTOR or-B t ILDER
MIAMI SHORES VILLAGE, FLORIDA
Date - P`— 20 7/
49613 Contractor's
License No.
1 1 1 1 V)1/ odse `
performed under this Permit 5, Q' 4, .1--'•' 1 r
rry
1
_
� j d, � Permit:
(
Subdl- ! „ f - 0
vision 1/
0 Notary: �'. ✓
S • /I
Bond:
II Bt.
Sq. Ft.: Radon: r j
D
Value of - Amount of r 7 jy�
Project $ .y / Permit:
This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the applica-
tion herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any
plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked
at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this.-
permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and
regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes respon-
sibility for work done by his agents, servants or employees.
t P -> > r�7. 7. c
Signed • (INSPECTOR) • BY
In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulation.'
pertainin ereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village.
In accep n this permit ssume responsibility for all work done by either, myself, my agent, servant or employee.
1502A200 08 /08i01TOTL 79.30
BY AUTHORITY
.r.....�:..,....,. �. a. �._. _.., _x........14_........ _s ^ ia��. .. ._._.W._�s::.._ .0 ..i .....ice..._ -..._ .. _...r....v -_, ..._. .a_�.....n,..- ..�..�_. •- ' ".:d......v'__.pL -. �.t G�� � � .
CCZE SECTION
. 77r s 71
1071 ME el 1 Tem_ 17 1=
me ci cad
PAGE LO=ON
C.7.7:c*mt"ES
4901.4(c)(Cont)
When the proposed work serves an occupant content of
total mechanical value of $25,000 or more or when the i
system capacity of more than 15 tons or for any structur
in area designed for public assembly, the plans shall
impress seal of a Professional Engineer, registered in the
When the estimated cost exceeds $5,000 for medical
toxic air filtration, or chemical, fire protection systems tl
be prepared by and bear the impress seal of a Professic
State of Florida, who is competent in this field of expert
All plans shall be prepared and submitted per the
Appendix "A ". The plans shall include a schedule sin
be filled by the Architect or Engineer of Record.
HVAC DESIGN REQUIRES:
YES
NO
DUCT SMOKE DETECTOR
FIRE DAMPER(S)
SMOKE DAMPER(S)
FIRE RATED ENCLOSURE
FIRE RATED ROOF /FLOOR
CEILING ASSEMBLY
FIRE STOPPING
SMOKE CONTROL
(d) PRECONTRACT EXAMINATION 0
may be submitted by the designer to the Chief Mechan
for the proposed work is entered into by the owner.
(e) EXAMINATION OF PLANS: The
Mechanical Plans Examiner shall examine all plans and
application or plans do not conform to the require
regulations, the Chief Mechanical Inspector shall reje
stating the reasons therefore. Plans that are rejected, a
returned for correction. Inked notations on mechanic
accepted only for minor corrections. If the application,
examination, are found to comply with the requiremen
plans shall be signed and marked as approved.
(f) PERMIT FEES : Shall be in accordance
4901.5 INSPECTIONS:
(a) SCHEDULE: The Chief Mechanical Insp
is issued, determine the mandatory incnecthnn en 1wl,,I. h
Supplement No. 3
49 -2 -2
100 or more persons, or has a
iechanical system(s) with a per
greater than 5,000 square feet
be prepared by and bear the
State of Florida.
gas, oxygen, steam, vacuum,
e plans and specifications shall
nal Engineer, registered in the
se.
iouth Florida Building Code,
ilar to the one shown below to
F PLANS: Preliminary plans
cal Inspector before a contract
C hief Mechanical Inspector or
applications for permits. If the
require] of all pertinent laws or
ct such application in writing,
as stated herein above, shall be
ally reproduced plans _may be
plans and specifications, upon
is of the Mechanical Code, the
with section 303 of this Code.
ector may, at the time the permit
ased upon the complexity of the