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321 NE 93 St (4)BUILDING PERMIT APPLICATION FBC 2001 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Job Address (where the work is being done) JoZ ` . C . J S $ Value of Work For this Permit Miami Shores Village Building Department Permit No. IdCQL1 — k go . Master Permit No. Permit Type (circle): Building Electrical Plumbing Mechanical Roofing Owner's Name (Fee Simple Titleholder) L, I .S Ebc� p N Phone # c —7 ( 42 — 19,0? Owner's Address c ad, I n( . , 3 s T, City 1v! t Awl S} D e&3 State Fl_. Zip 33 Tenant/Lessee Name Phone # City Miami Shores Village County Miami -Dade Zip 33 3 '4 RECENED OCT 2 6 2004 Is Building Historically Designated YES NO Contractor's Company Name El k_ ) Phone # 3(0T- 7( 1 Contractor's Address 7 3 Co N.6 1 0 - 1 s %,, City Y v t 1 -r.' 1 State l— Zip 3 3 1 (p Q Qualifier I(.A'T1 ffib {,(Q ) l� ►� Architect/Engineer's Name (if applicable) Phone # 7 . 00 Square Footage Of Work: Type of Work: Addition ❑Alteration ['New [epair/Replace ❑ Demolition Describe Work: C. ; /tt ('-( 0011 ( 0� a \I R C._ S ( L �`) 14'1 _ 7 - -��v� l � c.a� o e 1. * * * * * * * * * * * * * * * * * * * * * * * * * * 4,61 **F * * * * * * * * * * * * * * * * * * ** * * * ** * * ** Submittal / Fee Permit Fee $ CCF $ CO /CC Notary $ Training/Education Fee $ it D 0 Technology Fee $ . 47 (D Scanning $ Radon $ Zoning Code Enforcement $ Structural Plan Review. $ Total Fee Now Due $ /5 I (Continued on opposite side) Bond $ 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 ch posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature Chc 12/15/03 My Commission Expires: Owner 8r Agent The foregoing instrument was acknowledged before me this ' 5 day of t!�e7ober', 20(2'(, by L S d '?'v4 who is personally known to me or who has produced f/ ,i' r.4 L .., As identification and who did take an oath. NOTARY PUBLI Sign:' Print: C ORLANDO OLIVO, JR. NOTARY PUBLIC - STATE OF FLORIDA COMMISSION # uuzutzwa D 0/ 4) EXPIRES 02/03/2008 APPLICATION APPROVED BY: tlUNUtU 1 HHU 1- 8M- NOTAR "" Signature The foregoing instrument was acknowledged before me thisy' day of (Z '/aI r , 20 f , by A Tore- »je.�- , who is personally known to me or who has produced A rcarw, /lr Attbwnas identification and who did take an oath. , JR. NOTARY PUBLIC: - � tIO STATE O COMMISSION # DD287299 Sign: EXPIRES 02/03/2008 NDED THRU 1. 888- NOTARY1 rll;�t�v 2 :fry C Print: My Commission Expires: r (Certificate of Competency Holder) State Certificate or Registration No. Certificate of Competency No. ************************************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** ******** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Plans Examiner Engineer Zoning l Year: 1100 SINGLE FAMILY RESIDENCE 2003 r001 RESIDENTIAL- SINGLE FAMILY Beds/Baths: '/2 Floors: 1 Livin• Units: 1 d' S. Foote e: 1 802 Assessed Value: •,525 SO FT ear Built: 1950 Legal Description: MIAMI SHORES SEC 1 AMD PB 10- 0 LOT 18 W1/2 LOT 19 BLK 46 LOT IZE 75.000 X 127 OR 21299 - 1156 -57 • 2003 1 Year: 2004 2003 Land Value: $135,217 $103,868 Building Value: $131,263 $128,272 M arket Value: $266,480 $232,140 Assessed Value: $266,480 $189,087 Homestead Exemption: $25,000 $25,000 Total Exemptions: $25,000 $25,000 Taxable Value: _ $241,480 $164,087 Folio No.: 11- 3206 - 013_6240 Property: 321 NE 93 ST Mailing Address: LISA EDGERTON 321 NE 93 ST MIAMI SHORES FL 33138.2854 Miami -Dade My Home iamida • e.g Show Me: Property Information Search By: Select Item My Home Text only `M' Color Aerial Photogr phy_ Use a for Black & White Summary Details: Property Information: Sale Information: 1299 -1156 /2003 335,000 Assessment Information: ACTIVE TOOL: SELECT itqclarytikEllE Aerial Photography - AirPhoto USA 2004 c l We appreciate your feedback, please take a minute to complete our survey. My Home I Property Information 1 Property Taxes My Neighborhood 1 Property Appraiser 0 Home 1 Using Our Site 1 About 1 Phone Directory 1 Privacy I Disclaimer If you experience technical difficulties with the Property Information application, please click here to let us know. E -mail your comments, questions and suggestions to Webmaster Web Site © 2002 Miami -Dade County. All rights reserved. Page 1 of 2 113 ft http: / /gisims2.co.miami -dade. fl.us /myhome /propmap. asp ?app= none &bytool =0 WNER &... 10/25/2004 Miami -Dade County. Real Estate Tax Information to Real Estate Tax Information rniamida de. go Show Me: Property Taxes Search By: Select Item Detail Tax Information: Real Estate Tax Info 2004 Prior Years Taxes Due 2004 Ad Valorem 2004 Non -Ad Valorem 2004 Back Assessments 2004 Enterprise Folio 2004 Historical Abatements 2005 Quarterly Payments 2004 Tax Notice /Memorandum © 2002 Miami -Dade County. All rights reserved. Real Estate Tax Information Today's Date: 10/25/2004 Last Update: 10/08/2004 Year: 2004 Folio Number: 11 32060136240 MIAMI SHORES Owner's Name: LISA EDGERTON Property Address: 321 NE 93 ST Mailing Information : LISA EDGERTON 321 NE 93 ST MIAMI SHORES FL 331382854 To view 2004 Tax Notice/Memorandum click here Amounts due if paid by 10/2512004 in U.S. funds 2004 Taxes 1 $ 6519.451 If payment is not received or postmarked by the specified date the total amount due is subject to change. Amounts due are subject to change without notice. Property Tax Home I Real Estate Tax Info 1 2004 Taxes I Prior Years 1 2004 Non -Ad V 2004 Back Assessments 1 2004 Enterprise Folio 1 2004 Historical Abatements 1 2005 Quarter/ 2004 Tax Notice /Memorandum Miami -Dade Home I Using Our Site 1 About I Phone Directory 1 Privacy I Disclain Legal Description : MIAMI SHORES SEC 1 AMD PB 10 -70 LOT 18 W1/2 LOT 19 BLK 46 LOT SIZE 75.000 X 127 OR 21299 - 1156 -57 04 2003 1 E -mail your comments, questions and suggestions to Webmaster Page 1 of 1 MI? Conte( miai (30E Dowr 140 V R Mian South 1071( R Mian Off 8:00 Rely To Prop( Florid; Rt http: / /egvsys.miamidade.gov :1608 /wwwserv/ggvt/txcaw01.dia ?folio = 1132060136240 10/25/2004 0 Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Printed: 11/1/2004 Applicant: CHRISTINE Owner: WAGNER JOB ADDRESS: 321 Contractor BLUE BREEZE AC Local Phone: 305 - 865 -1220 Parcel # 1132060136240 NE 93 Signed: (INSPECTOR) Mechanical Permit Permit Number: MC2004 -190 WAGNER CHRISTINE ST Contractor's Address: 736 NW 107 ST Page 1 of 1 Legal Description: MIAMI SHORES SEC 1 AMD PB 10 -70 LOT 18 W1/2 LOT 19 BLK 46 LOT SIZE Fees: FEE2004 -10741 FEE2004 -10744 FEE2004 -10745 FEE2004 -10746 Description Building Fee CCF Training and Education Fee Technology Fee Total Fees: Amount $146.28 $3.00 $1.00 $3.66 $153.94 Total Fees: $153.94 Total Receipts: $0.00 ( 1a - `‘ Permit Status: APPROVED Permit Expiration: 4/20/2005 Construction Value: $4,867.00 Work: CHANGE OUT OF HVAC NOV 02PAID 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: . 6 . 4 MIAMI SHORES VILLAQE BUILDING DEPARTMENT 305-795-2204 Building Inspection Request J,.il±4,.‘.41‘FAP Date Type Insp'n Permit No Adt, 0 0 Name ,A) Address )9t. Company Phone # Appro., /417 4494, crot At 4/ I ( 7 4 L 0 speetion Date Correction Re-Insp'n Fee •••11110 - ••" 4 -^•••■•■••••■•••---.-„,,,,. •••.+•••■•■••••■■••■•■,,,,.. Id Wdt7S:TO POOE 80 '^oN EP8LSEES02 : 'ON XUA g • 4'7 / Et782.,SEES02 'DNI 01J1 : 1.10d • / / s `9d ess `F -Ph $ �� �� �sp od e 1 �� 0 �� � e0.,$\. `s r �1ti • 1�SQ OP .97:0CN:v 1 '6'4,, ''F+C‘; ess • o�\ C°rc`pa ee:\O o./ 0 BUILDING ❑ ELECTRICAL ❑ PLUMBING ❑ ROOFING y ❑ Owner of Building Architect Contractor or Builder Legal Description Lot k {- t> CONTRACTOR OR BUILDER MIAMI SHORES VILLAGE, FLORIDA DATE 195 PERMIT N? 6780 Address of Building Work to be performed under this Permit Bi. , Value of , jf — Project $ r° Contractors License No. = BY AUTHORITY rt . Subdi- vision ;w? Amount of Permit $ 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 thg statements or specifications and that he assumes responsibility for work done by his agents, servants or employees. Signed. INSPECTOR , In consideration of the issuance to me of this permit I agree to perform the work coverg'ci 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 ac. cepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Application is hereby made for the approval of the detailed statement 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. - O ARL. i Owner's Name and Address.. ". //1. � 'i 0 Registered Architect and /or Engineer Name and address of licensed contractor. Remarks (Signe STATE OF FLORIDA, COUNTY OF DADE. j ss MIAMI SHORES VILLAGE Date J e//4N L- A `r Ge L _S No. J; Street.Ng 9.3 .5.% /Y/( /,Z4'✓_= Location and legal description of lot to be built on: Lot Block Subdivision Street and Number where work is to be done State work to be done and purpose of building (by floors) / R < o N i a A /Y._ 71 / T 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 $ , 0 Amount rmit $ Zone cubage required .Plan C Distance to next nearest building Size of ng Lot Maximum live load to be borne by each floor I hereby submit all the plans and specifications for said building. All notices ith 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 ins -ctio .n the ite of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such ub tr: t. , .n w ; performed under this permit, as are licensed by Miami Shores Village. 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 Date Read, Sworn to and Subscribed before me. Disapproved Date. Notary Public, State of Florida (Signed) Building Inspector 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 been 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. PHONE g PL 1 -7 16d2tEMECCA1 /31:8kV toio maaminaana coo XMAXAX XSXX X * * MIAMI #11, FLORIDA 5907 N. W. 2nd Avenue February 20, 1958 Miami Shores Village Department of Building & Inspection Gentlemen; In the event the (3) three Ton Air Conditioning Unit we propose to install for Mr. Roger Carley at, 32l N. E. 93rd Street, Miami Shores Village, becomes a nuisance we will move the unit to a new location with- out any cost to the owner or the Village of Miami Shores. LR /br: Very truly yours, Mechanical Heat & Cold uis Radoi PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date (a ` t4 0 ( Job Address . 1 PE '1 -> Tax Folio t ` E)Io - D I3 ' 4 .9 D4C Legal Description 1 - 7 >+ st 0.1 loZ a 14 L bIac Historically Designated: Yes No Owner/Lessee / Tenant Cjtif .5`h D 1 V/A ( Master Permit # Owner's A d d r e s s 7 5 a . k "t,� , C s � • Phone 3O • ' « 3Oq Contracting Co. pW h Pve Qualifier SS# Phone State # Municipal # Competency # Ins. Co. Architect/Engineer Address Bonding Company Mortgagor Address WORK DESCRIPTION ____f11 DA tAx66.tke, hom--k Signature of owner and/or Condo President Date My Commission Expires: Mechanical Address Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING ( PAVING ' FENCE SIGN Square Ft. Estimated Cost (value) M OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all construction and zoning. Furthermore, I authorize the above -named contractor to do the Address c. a mac; aie Sty. - r 'G £V 4 A k tte_ 1 VA rk '11 be done ted. 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. gna ' e f ontractor or Notary as to Owner and/or Condo President Date No as to 1 ontract 4 Lt My Commiss> e k :I f' Ji1LIC STATE OF FLORIDA tl , � %Il CCMM1 SiON NC. Ca14103 My, COUmblissiON EXP. MAR. 1,2002 pliance with all applicable laws regulating er- Buiylokr �._ Date ./Salt Date FEES: PERMIT l f ✓ O RADON C.C.F. i 6151 2 NOTARY 5 BOND 7 O O APPROVED: � TOTAL DUE 3 (a S - Zoning /.� Building GA n ( Electrical Plumbing Structural Engineer Cz cAe PERMIT NO. • ADDRESS: • MIAMI SHORES BUILDING / ZON VILLAGE NG DEPARTMENT SECTION BY DATE ZONING • ELECTRICAL MECHANICAL PLUMBING FIRE " PUBLIC WORKS STRUCTURAL BUILDING OFFICIAL t. Subject to cacaptianc. vat eft Federal, State, Coady. Village rules &Id re p.'.at: Wtag•e muck= no responsibility for accvrtcy oflor resetts (cam these plans. 2. This copy of plans nwst bi rallabIt ca bW ding site or no Inspection *VI ba condoled. JOB ADDRESS CRITIQUE SHEET 3a/ /1 q3sJ APPLICANT PHONE f# APPLICATION Ur SHEET OF MISCELLANEOUS DATE COMMENTS INITIALS / NA' , filc" siks‘-e_v 4. 1 (4 0 , : r 10,0a: ? i .1..N41 ( 7 .............."- i CL1 _........:, 4 1 1 ...:.] W'■ i , ATETCH OF �UAy URVEY 0 SCALE I 2o' titoe-p; r 1 10 T) 15.60 7•1'- . ‘:•"' C s _ t d • "! 4:4)Ase. •-• 260.1E4 LiVE, /3 'uor tet3 oat Fe* 00 • • ''2.2.1 8,40' 1144N3S HEREON OF ANY) ARE REFERRED TO AN ASSUMED VALUE OF FOR 11-1E ..,... •• ; 00 ' - 51-SfaStA1144-&" • i. • . - • : . ., Zonihg App oved , k"< V i : s t ..., :.,:: : : ' . „, • ri ' V - ,,,,4,_) i ' , 1.4 ■ SAID BEARtNq IngilTICAL wrm TVIE RAT 6F rit.t.trt",:t :0Pgril0 TO INC N.RI.P. THU atet.iCT PROPERTY FALLS WITHiN FI nrin L G 4 %. DEDCROPT1ON LOT 13 t. 416 SUBDIVISION: 64 t PL.K o 1.46,t..4i 5 0,0 5 ACCORDING TO ME PLAT THEREOF AS RECORDED IN RAT BOOK 1 C) OF THE PUBLIC RECORDS OF Lit)C TION SKETCH SCALE F.B, NO, SURVEY CE •-6L:r t ". h1 44Ktzt-,- ftft.t ha:* fri6 Fyla of2oe.ft. towFtwe.: epoPi it1/414 THE ATTACHED SKETCH OF BOUNDARY SURVEY OF THE 400vE DESCRBED PROPERTY IS A TRUE AND CORRECT REPRESENTATION OF A FIELD SURVEY MADE UNDER MY DIRECTION AND MEETS THE MINIMUM TECHNICAL STANDARDS AS SET FORTH BY THE FLORIDA BOARD OF PROFESSIONAL SURVEYORS AND MAPPERS IN CHAPTER 61o17-6 FLORIDA ADMINISTRATIVE cops, PURSUANT TO SECTION 47 FLONDA STATUTES. Sa.,14.,R,, OP JC)P-L1 1-10t.r r A ‘i714).fLci:, 11.4 a A IA JOB NUMBER 4;9- DRAWN Sr CHECKED SY: • A. DATE OF THE FIELD SURVEY l 20 REVISION DATE: SURVEYOR'S NOTES: LEG. A WV FLOXI oY cupfr, t9:DER9ROLOYD:iNISTNAAROms e,-,FRoy HAW, sEEK Lox', ExcEPT AS born/. rriER2 r 7,<c?wErfTS OTRZR TH.A/a 'NOSE 9-60.4.1* EXAMIOT or THE ABSTRACT 9F tiE love Yo PE 60,0€ TO DETE/Vdti.lE. RECORDED NSTRLNENT, V ANY AFFEc TKO r,•431. f'ETCE Cr.t•P BY VIS0,41. IAEANiS O. r perr), LEopd. loya.gfemP act Oft LEGAL CEECRiPTiOn sirscr TO At7f OEDCATIC tillITATtOx5, RESTRK.75004, REsEAvArtvis OR EASE • 6 ec ri r) “164 fL EOOFtn.. • =4:4•EAR a4,4c, vio,:onr—n.9.1 cA,S. -YE ittOOK te,4" .6 .01 DMZ, MAXIENAkZe mar. t=s74 EX KOLE 0 4*.n e99alromtIesi tprt zc mmc,Emxia tit rje Ece .ord ett u '=ktritirY El4a,IENT «.:VALC..t1,74T. acswori :,44pLT F =i;:lvtat.4 caa toRA2ieitilitNy !Awl. --,zfeeleir F,F.a =fotjxo RZ•GAR =*1T WILK= • ok2.9, =90, • /2F 9pme et tr11.3.TYPICAl 00 I • COUNTY, FLORIDA, AT PAGE 1 BLOCK E, LTRAN SOaATE 12533 S.W. 30th STREET MIAMI, FLOSIDI-V3175 PHONE: (305) 552-7450 CERTIFICATE OF AUTHORIZATION Numessi IS , . • 4.1...1. ERNR57r 1 1,% C STaie..OFfi,..opp.A. f/ NOTE: :IOTA. va.10 suotEr 07.,61fr , Th tye A otwil rAtec-sp.otei - 0.45N '6 ••il 00T 0 • PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date `/ d /Job Address :522/ /t) /E 93 Tax Folio Legal Description Historically Designated: Yes No ( r, tie W c„ Owner /Lessee / Tenant Owner's Address Contracting Co. Qualifier State # d D D // 9 # Architect/Engineer Bonding Company Mortgagor Square Ft. OWNER'S construction Signature e i' ioel SS# Phone Notary as to / er and/or My Commission Expires: VIT: I certify tha g. Furth o President FEES PERMIT 4' 'PO RADON APPROVED: Zoning Building Mechanical A 0 C D to i/// 0 ' • FFICIAL NOT / tFR SEAL 9 e, MARY P BRIGGS COMMISSION NUMBER CC7411160 0 t MY CCIAMISS1011 EXPIRES c,- r'"w 11,2002 C.C.F. Address Competency # Address Address Address NOTARY Phone �oS - 3331 '59' Master Permit # Permit Type (circle one): BUILDING ELECTRICAL PLU KING ECHANICAL � WORK DESC ON ()Z4/4 �7 Signature of Contractor or Owner -Build Ins. Co. ROOFING PAVING Estimated Cost (value) 2,04 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. the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating authorize the above -named contractor to do the work stated. Notary as to Co tra for or 0 �6 ilder My Commission Ex irY P4,6 2 ^t- (ie o F Or -, 0 OFFICIAL NOTARY SEAL MARY P BRIGGS COMMISSION NUMBER CC741860 IS; l CCMMISSION EXPIRES • 5 .2002 BOND TOTAL DUE Electrical 4? /}',6 U� 29/--/.3? /GG / FENCE SIGN 44/ Date Da e Plumbing Structural Engineer PLUMBING ITEM BATH TUB BIDET DISHWASHER DISPOSAL DRINKING FOUNTAIN FLOOR DRAIN GREASE TRAP INTERCEPTOR LAVATORY LAUNDRY TRAY CLOTHES WASHER SHOWER SINK, POT /3 COMP. SINK, RESIDENCE SINK, SLOP TEMPORARY WATER CLOSET UR I NAL HATER CLOSET INDIRECT WASTES HATER SUPPLY TO: A/C UNIT FIRE SPRINKLER HEATER —NEW INST. HEATER — REPLACE LAWN SPRINKLER —WELL SWIMMING POOL WATER SERVICE EWER CONNECTIONS TILITY —SEWER TILITY —WATER EPTIC TANK :LAY iAINFIELO, 4' TILE/RES. �1P b ABANDON SEPTIC TANK )AXAGE PIT CU. FT. \TCH BASIN SCHARGE WELL )MESTIC WELL ,EA DRAIN OF INLET LAR WATER HEATER RE STANDPIPE JL PIPING WN SPRINKLER SYSTEM S RANGE TER SET (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.) ELECTRICAL MECHANICAL SERVICE TEMPORARY SERVICE SIZE IN MPS SERVICE REPAIR/METER CHANGE APPLIANCE OUTLETS RANGE TOP OVEN WATER HEATER MOTORS 0— 1 FP MOTORS OVER 1— 3 FP MOTORS OVER 3— 5 FP MOTORS OVER 5— 8 FP MOTORS OVER 8— 10 FP MOTORS OVER 10— 25 FP MOTORS OVER 25-100 FP MOTORS OVER 100 FP A/C WINDOW AIR CONDITIONERS STRIP HEATER GENERATORS TRANSFORMERS GENERATORS TRANSFORMERS GENERATORS TRANSFORMERS SPECIAL PURPOSE OUTLETS COMdERCIAL SIGN TUBES SIGN TRANSFORMERS SIGN TIME CLOCK F I XTI. ES ANTENNA TELEVISION OUTLETS VIOLATION REINSPECTION UNIT FEE ITEM SPACE HEATERS CENTRAL HEATING A/C (WIND) A/C (CENTRAL) DUCTWORK REFRIGERATION UNIT FEE PROCESS AND PRESS PIPING ABOVE GROUND TANKS UNDERGROUND TANKS U.F. PRESSURE VESSELS STEAM BOILERS HOT WATER BOILERS MECHANICAL VENTILATION TRANSPORTING ASSEMBLIES ELEVATORS/ESCALATORS FIRE SPRINKLER SYSTEMS COOLING TOWERS VIOLATION REINSPECTION J ?Zit) ITEM SWITCH OUTLETS LIGHT OUTLETS RECEPTACLES