MC2004-21BUILDING
PERMIT APPLICATION
FBC 2001
Permit Type (circle): Building Electrical Plumbing Mechanical
Owner's Name (Fee Simple Titleholder) v G / 5/'I r7 Phone
Owner's Address 4 • . q l >-'--- City��t /f/1i 56 State
Tenant/Lessee Name
, � //v # 1/ —.1G'— C.20 — °6);24'" Job Address (where the work is being done) ‘ g ii .61
City Miami Shores Village County Miami -Dade
Is Building Historically Designated YES NO
Contractor's Company Name t/R/14/9 .ef
$ Value of Work For this Permit /
Type of Work: ['Addition ❑Alteration ❑New
Submittal Fee $ S V
Notary $
Scanning $
Radon $
Miami Shores Village
Building Department \v% L 11 )1
10050 N.E.2nd Avenue, Miami Shores, Florida 33138 H . t i ?O 4
Tel: (305) 795.2204 Fax: (305) 756.8972
Permit No. 11 r a �Q
Master Permit No.
Contractor's Address - /4Z 57"
City e >'4 ,),/ 1 State ,�' Zip -?.?/
Qualifier ec7 _ .� 2//9/2h4
Architect/Engineer's Name (if applicable) Phone it
Repair/Replace ❑ Demolition
Describe Work: 2 t � .r ,F3?!'�'�ir tS � .,i T�J�/l� ✓ /6-.5 Se�71
* * * * * * * * * * * * * * * * * * * * * * * *** F ees * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** `
ermit Fee $ 1(.'
Training/Education Fee $
Zoning
Zip f
Phone #
7-S:2,Tdi
Phone Q2s) 2 7/2/
Square Footage Of Work: 2 c ....
CCF $ CO /CC
Technology Fee $ 5 , 2S
Bond $
Code Enforcement $ Structural Plan Review. $
Total Fee Now Due $
(Continued on opposite side)
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 and a reinspection fee will be charged.
Signature!/
Owner or Agent
The foregoing instrument was acknowledged before me this (37
day of1-J' , 200 7, by
who is personally known to me or who has produced
As identification and who did take an oath.
My Commission Expires:
APPLICATION APPROVED BY:
Chc 12/15/03
n
cAl/ Signature � /�' e � �Ote.
Contractor
The foregoing instrument was acknowledged before me thiseS e
day of , 20(2, by /10 6'_.�
who is personally known to me or who has produced
as identification and who did take an oath.
NOTARY PUBLIC:
NOTARY PUBLIC: 0, 641
Sign: 1
Prin • Mizabel Bas
My Commission D13034iF'.
or a Expires June 30. 2005
(Certificate of Competency Holder)
State Certificate or Registration No. Certificate of Competency No.
***************************************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
Z 4vu
Sign:
Print / /Z/1j7
My Commission Expires:
Mizabel Bascoy
My Commission DD034365
Expires June 30, 2005
t r ( 1 Plans Examiner
Engineer
Zoning
Sec. 6 -3 Air Conditioning Regulations.
(a) All individual air conditioning units installed in walls or windows shall be securely anchored
to the walls by approved methods. Units installed over public property, paths of egress or more
than ten (10) feet above grade shall be secured to the structure by bolts or screws to resist horizontal
wind loads. Such units cantilevering more than eight (8) inches on the exterior of a building shall
be supported by steel angle brackets secured by bolting. Bolts to masonry shall be set in lead shields
or similarly rot - resistant fastenings.
(b) The following special requirements shall apply to the control and regulation of noise nuisance
from air conditioning machinery.
(1) All equipment, existing or hereafter installed, regardless of location, shall be
maintained in good working order. Equipment so located that normal operating
noises create a nuisance to adjacent owners or occupants shall be provided with
soundproofing, or sound- absorbing baffels, or enclosures, as apprbved'to insure
maintenance of a reasonable noise level.
(2) All equipment on outer walls, on roofs, or in the other exposed locations, which are
unduly noisy, and which causes valid complaints from adjoining property owners or
occupants may be required to be relocated, redesigned and/or enclosed in noise-
retarding materials when, in the opinion of the building official, such enclosure is
necessary or would be effective.
(3)
owner /signature
Miami Shores Village
Special consideration shall be given to the planning of all future installations to
minimize the noise nuisance to adjoining property owners or occupants and the
building official shall have authority to reject or require the redesign of any system
which, in his opinion, would cause such a noise nuisance.
(c) Violation of this section shall be punished as is now or may hereafter be provided by law
(Ord. No. 299, Sec. 1 -3, 2- 21 -61).
I have �read the above ordinance and will comply with the regulations thereof.
114
Contractor Signature
I have read the above ordinance and will comply with the regulations thereof.
ITEM
BATH TUB
UNIT
FEE
ITEM
SWITCH OUTLETS
UNIT
FEE
ITEM
SPACE HEATERS
UNIT
/Os sz)
FEE
BIDET
LIGHT OUTLETS
CENTRAL HEATING
cr
DISHWASHER
RECEPTACLES
A/C (WIND)
DISPOSAL
SERVICE TEMPORARY
A/C (CENTRAL) , $
]7A)
DRINKING FOUNTAIN
SERVICE SIZE IN AMPS
DUCT WORK
FLOOR DRAIN
SERVICE REPAIR/IETER CHANGE
REFRIGERATION
GREASE TRAP
APPLIANCE OUTLETS
PROCESS AND PRESS PIPING
INTERCEPTOR
RANGE TOP
UNDERGROUND TANKS
LAVATORY
OVEN
ABOVE ROUND TANKS
LAUNDRY TRAY
WATER HEATER
U.F. PRESSURE VESSELS
CLOTHES WASHER
MOTORS 0- 1 IP
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
URINAL
MOTORS OVER 25-100 HP
COOLING TOWERS
WATER CLOSET
MOTCRS 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
HEATER - REPLACE
GENERATORS TRANSFORMERS
LAWN SPRINKLER -WELL
SPECIAL PURPOSE
SWIMAING POOL
OUTLETS COM+ERCIAL
WATER SERVICE
SIGN TUBES
SEWER CONNECTIONS
SIGN TRANSFORMERS
UTILITY -SEWER
_
SIGN TIME CLOCK
UTILITY -WATER
F I XTI.RES
SEPTIC TANK
ANTENNA
RELAY
TELEVISION OUTLETS
ORAINFIELD, 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 B.
OBTAINED, THE OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.)
PLUMBING
ELECTRICAL
MECHANICAL
NOTICE OF COMMENCEMENT 1 11 1111 1 1111 1 1111 11111 11111 11111 111 11 1111 1111
A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF FIRST INSPECTION
PERMIT NO.
STATE OF FLORIDA:
COUNTY OF MIAMI -DADE:
THE UNDERSIGNED hereby gives notice that improvements will be made to certain real
property, and in accordance with Chapter 713, Florida Statutes, the following information
is provided in this Notice of Commencement.
1. L gal description of property and street/a dress: 4 /-62r/ SGT etee 9 /Kg
pr 2 ft// ,227c- 3 Y �" 5 4
2. Description of improvement:
3. Owner(s) name and address: APR i n-
S' A/-6< ' / 3t 407//tii/7f 5X4-26 , 3.x/3%
Interest in property:
Name and address of fee simple titleholder:
4. Contractor's name and address:
5. Surety: (Payment bond required by owner from contractor, if any)
Name and address:
Amount of bond $
6. Lender's name and address:
TAX FOLIO NO//- - 3/D/- '20 -Z2v
/5
c:FN 20048008622°
OR Bk 22028 Ps 3706; (1p9)
RECORDED 02/06/2004 12 :2021
HARVEY RUVIN► CLERK OF COURT
MIAMI -DADE COUNTY? FLORIDA
LAST F'AGE
7. Persons within the state of Florida designated by Owner upon whom notices or other documents may be served as
provided by Section 713.13(1)(a)7., Florida Statutes.
Miami Shores Village
10050 NE 2nd Avenue
Phone: 305 - 795 -2204 Permit Number: MC2004 -21
Printed: 2/5/2004
Applicant: LAURAINE
Owner: GLISPIN
JOB ADDRESS: 68
Local Phone:
Parcel # 1131010200020
NE 91
Signed: (INSPECTOR)
Mechanical Permit
GLISPIN
LAURAINE
ST
Contractor RAMA AIR CONDITIONING INC Contractor's Address: 7462 NW 8 STREET
Page 1 of 1
Legal Description: 1 53 41 EL PORTAL SEC 3 PB 9 -148 W1/2 LOT 2 ALL LOTS 3 & 4 & E1/2 LOT 5
Fees: Description Amount
FEE2004 -1164 Building Fee $210.00
FEE2004 -1165 CCF $4.80
FEE2004 -1166 Training and Education Fee $1.60
FEE2004 -1167 Technology Fee $5.25
Total Fees: $221.65
Total Fees: $221.65 cc
Total Receipts: — $ O.0t
Permit Status: APPROVED Permit Expiration: 8/2/2004 Construction Value: $7,737.00
Work: REPLACEMENT OF 5 TON TRANE 16.50 SEER
at god
FEB 10 PAID
In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict
conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responisibility for all work
done by either myself, my agent, servants or employes.
Signed: (Contractor or Builder) BY: