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 .
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Master Permit # ° ��1�( � J/
Phone @A / 5 05 °Ce)
Address l' D W ,O 61-r N
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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.