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MECHANICALQualifier State # C lt`I. Municipal # Permit Type (circle one): WORK DESCRIPTION Job Address otary as to Owner artior Cond President My Commission Expires PERMIT APPLICATION FOR MIAMI SHORES VILLAGE 10050 N.E. 2nd Avenue • Miami Shores, Florida 33138 • 305-795-2204 a/4 ) 6 q ) v S4.Tax Folio Date Legal Description Owner/Lessee/Tenet ^ <%"lJ Owner's Address ac �� • 9S Contracting Co. Historically Designated: - roc - c -- (c3 IF THERE IS NO PERMIT PACKAGE ACCESSIBLE ON THE JOB SITE FOR INSPECTORS TO VERIFY, THERE WILL BE NO INSPECTION. RE- INSPECTION FEE IS 850.00 AND MUST BE PAID IN ADVANCE BEFORE CALLING FOR ANOTHER INSPECTION. BUILDING 7 ELECTRICAL 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 ANY 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 all disciplines. OW RS AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be do, e in compliance with all applicable laws reg lacing construction and zoning. Furthermore, I authorize the above , med contractor to do the work stag . 441111110 gda mature of 4` Si d/or ondo President �� ti v° 3- '/ o_o (7b_ t7 Si_ )iature of r ) or .4_t► AAA 0 r or 1 Yes �r p� No Master Permit # ° ��1�( � J/ Phone @A / 5 05 °Ce) Address l' D W ,O 61-r N SS# Phone . aDS — gCOS - ( 7,7,0 Competency # Ins. Co. PLUMBING otary as t slContract I My Commission Expiresn ROOFING 0 ner Builder Date o•sso• �a -osa. c7 Owner Builder ate FEES: PERMIT 7c 1n RADON C.C.F 1 . NOTARY S . 0 0 BOND APPROVED: TOTAL DUE Zoning /, Building Electrical Mechanical � (�✓h I O 0 ,0, C ? Plumbing Structural Engineer fE.M kTH TUB UNIT FEE ITEM SWITCH CURETS UNIT FEE ITEM SPACE HEATERS UNIT FEE IOET LIGHT OUTLETS CENTRAL HEATING ISHWASHER RECEPTACLES A/C (WIM3) r/ IS?OSAL SERVICE TEMPORARY A/C ( CENTRAL) v 7 DUNKING FOUNTAIN SERVICE SIZE IN AMPS DUCT WCAK ._OCR CRAIN SERVICE REPAIR/METER CHANGE REFRIGERATION lEASE TRAP APPLIANCE CUTLETS PROCESS AND PRESS PIPING VTERCEPTOR RANGE TOP UNDERGROUND TANKS AVATCRY OVEN ABOVE GROUND TANKS .UNDRY TRAY - 0 WATER HEATER U.F. PRESSLRE VESSELS LOTHES WASHER MOTORS 0- 1 FP STEAM BOILERS -OWER MOTORS OVER 1- 3 FP HOT WATER BOILERS INK. POT /3 COMP. MOTCRS OVER 3- 5 If MECHANICAL VENTILATION INK, RESIDENCE MOTORS OVER 5- 8 EP TRANSPORTING ASSEMELIES INK, SLOP MOTCRS OVER 8- 10 HP ELEVATORS/ESCALATORS _MPORARY WATER CLOSET MOTORS OVER 10- 25 FP FIRE SPRINKLER SYSTEMS RINAL MOTORS OVER 25-100 FP COOLING TOWERS ATER CLOSET MOTORS OVER 100 FP VIOLATION ~DIRECT WASTES A/C WINDOW REINSPECTION ATER SLPPLY TO: AIR CONDITIONERS • A/C UNIT STRIP HEATER FIRE SPRINKLER GENERATORS TRANSFORMERS HEATER -NEW INST. GENERATORS TRANSFORMERS HEATER - REPLACE GENERATORS TRANSFORMtERS LAWN SPRINKLER -WELL SPECIAL PURPOSE SWIMMING POOL OUTLETS COWERCIAL WATER SERVICE • SIGN TUBES - - ~- EWER CONNECTIONS SIGN TRd1SFORM€RS TILITY -SEWER SIGN TIME CLOCK fILITY -WATER FIXTLRES EPTIC TANK ANTENNA :LAY TELEVISION CURETS UINFIELO, 4' TILE/RES. VIOLATION JMP & ABANDON SEPTIC TANK REINS?ECTION )AKAGE PIT CU. FT. ATCH BASIN ISCHARGE WELL )SST IC WELL IEA DRAIN )OF INLET JLAR WATER HEATER 0 IRE STAN;PIPE 3101. PIPING MNN SPRINKLER SYSTEM LS RANGE :TER SET (GAS) IS PIPING AN APPLICATION FOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. Ii A MASTER PERMIT HAS B. 1OBTAINED, THE OWNER'S'NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.) PLUMBING ELECTRICAL MECHANICAL simoalsoorio Operation of a motor vehicle constftutes *meant to any sobriety test required by law. The Sunshine State °°••••"" • • LICENSE SUMER . G650-293-70-096-0 GARY MARK GREEN 246 NE 93RD STREET MIAMI SHORES, FL 33138-3119 BIRTH DATE SEX T. REST. MORSE. 03-18-70 M 6-07 ISSUED EXPIRES 044849 03-1844 DUPLICATE 08-16-01 k'. Miami Shores Village 10050 NE 2nd Avenue \Phone: 305 - 795 -2204 Permit Number: ME2002 -141 ` Printed: 10 /10/2002 Page 1 of 1 Applicant: CRISTINA PERALTA Owner: PERALTA CRISTINA JOB ADDRESS: 245 NE 93 ST Contractor BLUE BREEZE AC Local Phone: 305 - 865 -1220 Parcel # 1132060133660 G Permit Status: APPROVE Permit Expiration: 4/8/2003 Work: CHANGE OUT A TON Signed: `� l 70. a 2 Mechanical Permit Contractor's Address: 736 NW 107 ST Legal Description: 1 53 41 6 53 42 MIAMI SHORES SEC 1 AMD PB 10 -70 LOT 12 & BEG AT SW COR Construction Value: $2,100.00 Total Fees: -$0;03375 Total Receipts: $0.00 If there is no permit package accessible on the job -site for inspectors to verify, there will be no inspections. Re- inspection fee is $50.00, which must be paid in advance before calling for another inspection. 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 application 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 responsibility for work done by his agents, servants or employees. (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 regulations pertaining thereto and in strict conformity with the plans, drawings, statements o 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 empl (Contractor or Builder) BY: Name and address of licensed contractor Disapproved �, (Signed) d""' Building I ector MAM0S ; a G'_ VOLLA E BUILDING INS" N DEPARTMENT APPLO CATO N FE3 t J O LE EMMET Application is hereby made for the approval of the detailed statemen 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 ��� Owner's Name and Address. -_4P # d WLen..... No Street-- P• ' , Registered Architect and /or Engineer Location and legal description of lot to be built on: Lot Block Subdivision pp Street and Number where work is to be done s°*; /,)_ ,2"-' 93 /i a, State work t be done and purpose of building floors) - -- -' -'3 .� ' a-a �� , ..--- �• v v and for no other purpose. New Building Remodeling Addition Repairs. -. No. of Stories To be constructed of Kind of foundation Roof Covering Estimated Total cost of improvements $ Z. (cQ ._ Amount of Permit $ l 3 • s:aca 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 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 such s euPtractors, on `,. k be p ; ' ol� ed under this permit, as are licensed by Miami Shores Village. Remarks (Signed) 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 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 stated are true. / Permit No L7' 6 3 r , Date � - Read, Sworn to and Subscribed before me. Notary Public, State of Florida My Commission Expires PLANNING BOARD DATE Chairman 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 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 or faulty materials and /or workmanship.