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MECHANICAL PERMITApproved Correction MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date Type Insp'n Permit ►L� Name Address I96' o q) `�` ?& A `• Comp y CC ^� Phone # C kj —_ L O— 4 1 ' l D Inspection Date q 0 Re- Insp'n Fee ❑ BUILDING PERMIT APPLICATION FBC 2001 Miami Shores Village Building Department Permit Type (circle): Building Electrical Plumbing Master Permit No. Mechanical Permit No. c )0 0 3 .1c04 Phone # Roofing rior) `f9/ - 2 Sys' Owner's Name (Fee Simple Titleholder) ieen4e/1 8E'- c /C Owner's Address /0 9 0 J/6/1; 4 7 2 S.S.1.-- e e / Ci ty /Ai-k / 5 O s' ej State E Zip 7? /7 Tenant/Lessee Name Phone # Job Address (where the work is being done) / U f 0 Z ,--e E' City Miami Shores Village County Miami -Dade Zip i? ( ?ff Is Building Historically Designated YES NO '..-- 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Contractor's Company Name 14 ��'"1 ems/ %T� ` f %B.� S Phone # ( V/ - t 7 O / Contractor's Address 99' 6 S / a v ,`may 57e j City f?? t'a /s'►-(r //,, ice/ / C Zip .33 0 Qualifier /(e ' '` h �/ Ch ain/ /G t_ Architect/Engineer's Name (if applicable) - Phone # Architect/Engineer's Address City State Zip $ Value of Work For this Permit Square Footage Of Work: Number of: Bays Stories Families Bedrooms Baths Type of Work: ['Addition ['Alteration EiNew ❑ Repair/Replace ❑ Demolition Describe Work: 1/ O /�' c p #.9 * * * * * * * * * * * * *•,► * * * * * * * * * * * ** F ees * * *,► * *.. * * * * * * * * * * * * * * * * * * * * ** County Escrow Fee $ Permit Fee $ `b Notary $ Education/Training Fee $ Tech $ Scanning $ Radon $ Code Enforcement $ Bond $ Struct. $ Minus Plans Check Fee $ Total Fee Now Due $ (Continued on opposite side) PPP. Fee. • $ 30.00 C heCki 1150 Bonding Company's Name (if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State Zip Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC 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. "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT 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." Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the .building permit is issued. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature Signature 49. Own or Agent The foregoing instrument was acknowledged before me this it day of /� , 20 07, by R i t° ,q.,r e / !'1 ,ae who is personally known to me or who has produced As identification and who did take an oath. NOTARY PUBLI Sign: Print: chc717103 APPLICATION APPROVED BY: Contractor The foregoing instrument was acknowledged before me this "8 day of 'ivy 200), by .i,' . CIG 1 '4 who is personally known to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: / , GARY KILGORE ., » Commission # DD0103451 Sign : , Expires 4/8/2006 c Anvlarl thrnu0h Print: .. 4 OF FN. • Bonded through My Commission Expires: : (800-432-4254) Florida Notary Assn., Inc. My Commission Expum:. 0 -432 -4254) ORE # DD0103451 mmission ' 4 i S 7 69 (/i c l Florida Notary ASS TI., Inv. (Certificate of Competency Holder) State Certificate or Registration No. Certificate of Competency No. •***************** s************ ********************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Plans Examiner Engineer Zoning 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/) TER 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 If' 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 If' ELEVATORS/ESCALATORS TEMPORARY 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 WATER SUPPLY TO: AIR CONDITIONERS A/C UNIT STRIP HEATER FIRE SPRINKLER GENERATORS TRANSFORMERS • HEATER -NEW INST. GENERATORS TRANSFORMERS I HEATER - REPLACE GENERATORS TRANSFORMERS _ LAWN SPRINKLER -WELL SPECIAL PURPOSE SWIMMING POOL OUTLETS COMMERCIAL WATER SERVICE SIGN TUBES SEWER CONNECTIONS SIGN TRANSFORMERS UTILITY -SEWER SIGN TIME CLOCK UTILITY -WATER FIXTURES SEPTIC TANK ANTENNA RELAY TELEVISION OUTLETS DRAINFIELD, 4' TILE/RES. VIOLATION PUMP & ABANDON SEPTIC TANK REINSPECTION SOAKAGE PIT CU. FT. /4 ea I Ail l 1 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 BUILDI 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 Date BIZ / - ©p Job Address /a e ) V E `j 4 a Tax Folio 1t' — 3 .1 e - /' ,?) /I c '/ Legal Description Owner/Lessee / Tenant 1) . h. 4 p,t 16/f onie Master Permit # Y7 Owner's Address 7i 9 0 0 G a Phone (�'° r) ? 3 v ©o 2 a Contracting Co. & 4P /.7s Qualifier /4 ,0)14 State # Municipal # Architect/Engineer Bonding Company Mortgagor Permit Type (circle one): BUILDIN ECTRICAL 7 WORK DESCRIPTION gnature of er and/or Condo President V SEAL xpires: CARLENE VERRILL' NOTARY OMMISSION NO. CC674619 MY COMMISSION EXP. SEPT 18 2001 ,r.-.•. �1 N. as to Own My Commission FEES: PERMIT APPROVED: Zoning Mechanical PERMIT APPLICATION FOR MIAMI SHORES VILLAGE ,t9/54 P/AL v//9 RADON W IA.-{, 502 Historically Designated: Yes No (62-9-P &f ,! 2r C v v 49 Address SC6/' p ' o y ' ge- Phone Or/ ) b26 / . - C? e7 Competency # Address Address Address C.C.F. ,J' ©2 0 NOTARY Building Ins. Co. PLUMBING ECHANICAL ROOFING PAVING FENCE SIGN Signature of Contractor or Owner- Notary as t My Commi Electrical 0u � Square Ft. Estimated Cost (value) jj / 9 -3-i) ,. ea 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 an d zoning. + ore, I authorize the above -named contractor to do the work stated. // Z( i Date ion ExpiCtLENE VE ' NOTARY PUBLIC SPATE OF FLORIDA COMMISSION NO. CC674619 MY COMMISSION EXP. SEPT 18,2 'lder Date at /ice X,/ / /a / %, yr'' Date `� Plumbing Structural Engineer To Whom It May Concern: I hereby certify that 1 am the owner (or owners) representative for the property located at i d 9 0 N E 9). s rt and 1" hereby authorize Gables Air Conditioning, Inc. to act in my behalf in obtaining a permit to do the work and installation as indicated by our contract dated 1 . t o •a c) , 2000. I certify that all work will be performed to meet the standards of all laws regulating air conditioning construction and the relevant mechanical permit being applied for in this document, pertaining to the municipality of lv� %q . 1 understand that Gables Air Conditioning, Inc. is only authorized to make application for mechanical permits. Electrical, plumbing, etc. are the responsibility of others trades. • With all these facts known, 1 authorize Gables Air Conditioning, Inc. and their Agent, , to do the work so contracted and to sign my name to the applicable permit application form and Notice of Commencement form. Signature of Owner Notary Signature 4600 S.W. 75 AVENUE MIAMI, FLORIDA 33155 TELEPHONE (305) 264 -2020 POWER OF ATTORNEY * * *. 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. GABLES AIR CONDITIONING, INC. (onlinenlal'antnte4ciai �itaidcon ,J(ianti tritoted .wit reo4t[ diOn6t, gave olfGt Wontlilionin$ Folio # 1 (— 32,0 S . Z 2 a qt() Social Security # I v�l�S is c3- ytt-