PLUMBING PERMITS 725 NE 91 ST 4-DPERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date 95 Job Address l2 6 NE 1I 5i Tax Folio /7 ��C �� %`� 6://0
Legal Description Historically Designated: Yes No kr
Owner/Lessee / Tenant Ell "G bell) /113 Master Permit # W c 0 �lJ
Owner's Address 72 5 /Uir- / St *. / Phone /57 75
Contractin Co. �‘/S(2 ,?Z!/ grArC d. , / C'
Qualifier /l// � �0c/ ZY� SS# Phone 5 270- 6. , .
State # 7/67 0 2o)Oi Municipal #
_ ii/A ✓sue
Address
Competency # e G - �� Ins. Co. .0e/ c_ 4el/'
Architect/Engineer Address _
Bonding Company Address
Mortgagor Address
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION /t7,' /' Soirci`,, 0.al 7hie /f'
/ie''i Si n�C cd1✓"�/��.
Square Ft. Estimated Cost (value)
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 wil be done in compliance with all applicable
laws regulating construction and zoning. Furthermore, I authorize the above -named contractor to do work stated.
d,/a LOY
Sign a e of owner and/or Condo President Date
Notary as to Owner and/or Condo President Date
My Commission Expires:
FEES: PERMIT ° � RADON
APPROVED:
Zoning Building
Mechanical Plumbing
r /2c '4' r4$ E/ WGdre �'l ' /l 1 � {� hr C �<; � -
Signature of Contractor or i er- Builder
Alotary as to Contractor or Owner - Builder
My Commission Expires:
Pu :it
0 (. L
C.C.F. NOTARY BOND
Electrical
Date
TOTAL DUE
Date
Engineering
ITEM
BATH TUB dGo', Sie'rnoQ
f
IH
FEE
7 GJ /V/
ITEM �lse<,c,�.
SWITCH OUTLETS
fit,
4
7
/3/,o.
G//
l ' ' /, ' '4-
UNIT
FEE
B I CET
LIGHT CUTLETS G 4J 54(44:
5 r.
0 I SYIASHER
RECEPTACLES
OIS^?OSAL
SERVICE TEWOR
�
DRINKING FOUNTAIN
SERVICE SIZE IN AMPS
UK! mmic
FLOOR DRAIN
SERVICE REPAIR/METER CHANGE
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 If
HOT WATER BOILERS
SINK, POT /3 COMP.
MOTCRS OVER 3- 5 HP
MECHANICAL VENTILATION
SINK, RESIDENCE
MOTORS OVER 5- 8 HP
TRANS?CRTING ASSEMBLIES
SINK. SLOP
MIOTCRS OVER 8- 10 HP
ELEVATCRS/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 If
VIOLATION
INDIRECT WASTES
A/C WINDOW
REINSPECTION
WATER SUPPLY TO:
AIR CONDITIONERS
A/C UNIT
'Ir1
STRIP HEATER
FIRE SPRINKLER
GENERATORS TRANSFORMERS
HEATER-f- .
HEATER- REPLACE
GENERATORS TRANSFORMERS
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
FIXTLRES
SEPTIC TANK
_
ANTENNA
RELAY
TELEVISION OUTLETS
DRAINFIELO, 4' TILE/RES.
VIOLATION
PUMP & ABANDON SEPTIC TANK
REINSPECTION
SOAKAGE PIT CU. FT.
CATCH BASIN
D I SCiARGE WELL
DOMESTIC WELL
AREA DRAIN
ROOF INLET
SOLAR WATER HEATER
FIRE STANDPIPE
POOL PIPING
--
LAWN SPRINKLER SYSTEM
GAS RANGE
METER SET (GAS)
— � ••■"
GAS PIPING
i
•
9 ADDENDUM TO BUIL
(AN APPLICATION FOR BUILDING PERMIT MUST.
OBTAINED, THE OWNER'S NOTARIZED SIGNATUF
PLUMBING
ELE
Plys-fr
pi(A in(oi��
ON
R PERMIT HAS BEEN
APPLICATIONS.)
4NICAL