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MECHANICAL PERMITPERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date 3 n -CZ) Job Address Q $O N e. 97 Tax Folio Legal Description Historically Designated: Yes Owner/Lessee / Tenant C (-4 A R ( 1.�' F (4 T) E L y Owner's Address oC $ O N., C r '7 / c5,' - Contracting Co. l- V F N A:oc Cm o ro D i- i o m i to of Address / t{ ? 7 3 v .t.v . 6 s I V - Qualifier A L1) F P-4 A-C State # (' R c o 1. f a 6 Municipal # Competency # Ins. Co. Architect/Engineer Address Bonding Company Address Mortgagor Permit Type (circle one): BUILDING ELECTRICAL PLUMBIN t' MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION EZ F= 13 la-Ct;` a, S -(-0 tJ = �J 1LL f I _ • 111 Iu. Signa '. f owner an ondo �'" . 1 VILLA4ate NOTARY PUBLIC STATE OF FLORIDA COMMISSION NO. CC714v3 MY COMMSSION EXP. MAR 1 '� m Notary to Owner and/or My C6mmission Expires: FEES: PERMITA /qF RADON APPROVED: Zoning Mechanical or on do Presider a te 0 SS #„ Phone (�3n.) -01 a i Address No Master Permit # 'T (v 9y0 Phone G 3oS� - 1g g- 3(,.J Square Ft. Estimated Cost (value) V t,3, 6 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. F I ermore : 1 I a orize the above -named contractor to do the work stated. 3 - Signature of C • /, 3 �apg Notary ,: to Contrac My Commission Exp►r O A RYS EAL GLADY5 VILIAR NOTARY PUBLIC STATE OF FLORIDA COMMISSION NO. CC714103 MY COMMISSION EXP. MAR l 002 C.C.F: NOTARY BOND Date TOTAL DUE / 4E) Building Electrical ■ot , a I Plumbing Structural Engineer ITEM BATH MB UNIT FEE ITEM SWITCH OUTLETS UNIT FEE ITEM SPACE HEATERS UNIT FEE BIDET LIG-ff OUTLETS CENTRAL HEATING it k j DISHWASHER RECEPTACLES A/C (WIND) DISPOSAL SERVICE TEMPORARY A/C (CENTRAL) l DRINKING FOUNTAIN SERVICE SIZE IN AMPS A2 .,s4-01..)s DUCT WORK FLOOR DRAIN SERVICE REPAIR/ )TER CNANGE / REFRIGERATION GREASE TRAP APPLIANCE CUTLETS 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 IWP TRANSPORTING ASSEMBLIES SINK, SLOP MOTORS OVER 8— 10 HP ELEVATORS/ESCALATORS TEWCRARY WATER CLOSET MOTORS OVER 10- 25 HP FIRE SPRINKLER SYSTEMS URINAL MOTORS OVER 25-100 HP COOLING TOWERS WATER CLOSET MOTORS OVER 100 HP VIOLATION INDIRECT WASTES A/C WINDOW REINSPECTION LATER 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 SWR 4ING POOL CUTLETS COMMERCIAL WATER SERVICE SIGN TUBES :WER CONNECTIONS SIGN TRANSFORMERS iILITY— SEVER "ILITY SIGN TIME CLOCK —WATER FIXTLRES ?TIC TANK ANTENNA ' .LAY TELEVISION CUTLETS AINFIELD, 4' TILE/RES. VIOLATION W & ABANDON SEPTIC TANK REINSPECTION i AKAGE PIT CU. FT. TCH BASIN SCHARGE WELL MESTIC WELL EA DRAIN )F INLET .AR WATER HEATER lE STANDPIPE -L PIPING N SPRINKLER SYSTEM ; RANGE ER SET (GAS) 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 PERMIT APPLICATION FOR MUNICIPALITIES OF DADE COUNTY (OWNER TO RETAIN COPY) Date • 312 /' Z Job Address Zg0 &Jo Tax Folio Legal Description - 11- 32.64— C15 -04tv / CL J 1 {� Owner Lessee / Tenant r (� a 'e L y Owner's Address .2- SD Iv E q ( c1 Phone 7 S? 3 6' 33 fr i t i , rt ea� t 33/6 / Contracting Co. / - d/, q/11-- A is 1 i ' ( Address f 4)-7 o ■- < s .0 i t, -" (- /a4. . Qualifier I'L( II E / Sc/Y/: R SS# Phone Rg3e10.5 State # ca Co2; Y 3 ' iunicipal # Competency # / l& r 1 1 h Ins.Co. Architect /Engineer Address Bonding Company Address Mortgagor Address Permit Type(circle one): BUILDING ELECTRICAL PLUMBING WORK DESCRIPTION Il `Pp L Q c 1^ r S I/ A c_ i Square Ft. Estimated Cost(value) P027? L. - // Master Permit # 4 3 o'8f5f MECHANICAL ROOFING PAVING FENCE SIGN Rpero 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: be done 'n complian autho th abov i A a / Si Date: a ure of owner and e _ Signature of Date: pee Fire Zoning Buildin Mechanicaf \ �� umbing • yfr t y p e oc stamp name of Notary PuMIc '.y known ` J,,OR Produced LD.0 Cont tft`i 'li'l' 4ux1. ID take an oath, or e an oath. ary4as to Cont 9Ft?%17 C �reFt ,Sf ar h:\ Commission EAMM§IiSSION EXPIRES APRIL 16. 1992 BMW EJ U SIEM8LER ADAMS 8 SWEET NOTARY .7 t00 TOTAL DUE 35�" * ** Other Electrical Engineering MIAMI SHORE Building Inspector BUILDING INSPECTIO APPLICATION FOR BUILDING PERMIT Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build- ing or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida. and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of the work. ,19./_2 Owner's Name and Address • 24...t.!1. /..Al/.. /..G — No 8..D..— . StreetAZ.E Registered Architect and /or Engineer.... , cT�.M.e..s ...,._,, Name and address of licensed contractor.... ../.?f.. ??i S ao. t s..../5 t!'et...e a.....2 X E.,. 7 F ,Sr Location and legal description of lot to be built on: Lot Block Subdivision Street and Number where work is to be done. ' ! s.? _ s State work to be done and purpose of building (by floors).f8s 2_ ..f.Z.ovq ai�'.T.tt! en'c" !?Z .,f.L.t. .slGY.IG.. -/��� y ..5.�� z-te t ,.l �G.QkJ L2... �i and for no other purpose. New Budding Remodeling 1( Addition Repairs No. of Stories To be constructed of Kind of foundation vexing Estimated Total cost of improvements $ s??� Amount of Permit Zone cubage required _Plan Cubage Distance to next nearest building Size of Building Lot Maximum live load to be borne by each floor I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may be sent to The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Sup plenient, and has complied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such subcontractors, on work to be performed under this pennit, as are licensed by Miami Shores Village. (Signed).... letZ- i STATE OF FLORIDA, COUNTY OF DADE. ss Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap- peared - -- — -- - and who, being by me first duly sworn, upon oath deposes and says that he is the. of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stn tru3 f e . / ( Permit No.._____ �__ Date Read, Sworn to and Subscribed before me. Disapproved _......__ Date ____________ Notary Public, State of Florida ( Signed) •��� ILLAGE J EPARTMENT y Commission Expires to me well known, PLANN 'C BOARD _..- ._....DATE Chair :nan Member Member Member Member �-•_._... :Member ...... _._._......- -._.._ __.._ Council Approved _ Date Disapproved Date NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has been obtained from the Planning Board. A re fee of $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and /or workmanship. . - ■ , i o . SHORES VILLAGE f 5 APPLICATION FOR BUILDING PERMIT BUILDING INSPECTION DEPARTMENT Application is hereby wade for the approval of the detailed statement of the plans and specifications herewith submitted for the build- ing or other structure herein described. This application is madc in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida. and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of the work. Date..._..._... ✓__._ _ ..._._.�._ .. , 19� Owner's Name and Address ....... TA)/ 0 �G�� G I.. ? ._. No.. . &®.._ . Street_. E ... 9. P Registered Architect and /or Engineer ..... ..�� Name and address of licensed contrgctor , .. Location and legal description of lot to be built on: Lot Block Street and Number where work is to be done....sz Subdivision S to work to done and urpose f building (by floors)... __...._.... New Building Remodeling To be constructed of Kind of foundation Estimated Total cost of improvements $.. r ' 0 Amount of Permit S` Zone cubage required _Plan Cubage Permit No.. Disapproved (Signed) ate. Chairman Member Member Council Approved Date Akigi and for no other purpose. Addition Repairs No. of Stories Roof Covering Distance to next nearest building Size of Building Lot Maximum live load to be borne by each floor I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may be sent to The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the 'Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida. Permanent Supplement, and has complied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only su , ...tractors, wok to be performed under this pennit, as are licensed by Miami Shores Village. Remarks .__ _.__ (Signed) PLA 'INC BOARD STATE OF FLORIDA, COUNTY OF DADE. ss. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap- peared ------- - - - - - -- and who, being by me first duly sworn, upon oath deposes and says that he is the. of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. /9P /2 — 7 Date _ TRead, Sworn to and Subscribed before me. 6") Building I pector M y Commission Expires Notary Public, State of Florida .DATE Member Member Member - • - -._ .___ Disapproved Date NOTE: A ch.trge of $1.00 will be made for making corrections or changes to this application after approval has the Panning Board. A re-inspection fee of $1.00 will be charged when such re- inspection is made necessary by improper notice for materials and /or workmanship. • to me well known, been obtained from inspection or faulty MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT. APPLICATION FOR BUILDING PERMIT Application is hereby uinde for the approval of the detailed statement of the plans and specifications herewith submitted for the build- ing or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores village, Florida. and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of the work. Date.. .. J Ut•Y ,. . Owner's Name and Address .. OMINIG 1 V4 O .__. r . �Z .. 1. Registered Architect •• -• •••% ���••����•�� Name and address of licensed contractor 01 rNK New Building Remodeling Disapproved Date. (Signed) Building Inspector x Addition _Plan Cubage Size of Building Lot Location and legal description of lot to be built on: /� v isi io on. POtil r Lot Block � � QA .. .._ ... Street and Number where work is to be done.. so �� 91 .�.�{� / .• - . •_ State work to be done and u ose of built (b floors ...- .1��/!IJ `! 1.ON `� 1 IN NON. .;�► l .,.. ` NfU)... Al ��... 60' My Commission Expires trookftsti of epg.e/4 and for no other purpose. Repairs No. of Stories To be constructed of Kind of foundation Roof Covering — eEstirnated Total cost of improvements $. OO Amount of Permit S, $ Zone cubage required Distance to next nearest building Maximum live load to be borne by each floor I hereby submit all the plans and specifications for said building. All notices with reference to the building and 1 Notary Public, State of Florida its construction may be sent to The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the 'Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Supplement, and has complied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as arc required by the Act. The undersigned agrees to employ only such subcontractors, on work to . rformed under this perinit, as are licensed by Miami Shores Village. Remarks (Signed) lac STATE OF FLORIDA, COUNTY OF DADE. j ss Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap- peared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the. of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him s ted are true. Permit No.._._ C7 Date /- ZZ- 7 Read, Sworn to and Subscribed before me. PL N1NG BOARD DATE Chairman Member Mfcrnber Member Member ...... - - - - - Member Council Approved Date Disapproved Date NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has hecn obtained from the Planning Board. A re inspection fee of $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection at faulty materials and/or workmanship.