Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
MECHANICAL
CONTRACTOR Name C - E A , 0 ^G • © . /' License No. A /^ c3 2 , 6 i 4/ C� l'1l_ Address P 6 V i 1 3 3 0 �(1 ,�+, r i t s2.1 t 6g 3oSL&S639Lf 30s% K ?I -- Telephone Fax (�" Qualifier Name R. Li S C L r f V E PROPERTY OWNER Name Pc / %\ !'`ct1SO Address aJS, A) e G9 34, Ilome Telephone Business Telephone Fax TYPE OF MANAGEMENT (✓ ) New Construction Enclosure Alteration Exterior Repair Alteration Interior Demolish Relocation of Structure Shell Only Foundation Only Add'I Attachment Other Add'I Detachment Other NI.. unolso INSTRUCTIONS - The following steps must be taken to obtain a permit from the )Miami Shores Village: Step 1. Job Address: Complete the attached permit application which must be signed by the property owner and qualifier. Both signatures must be notarized. Please print or type to allow for a more accurate processing of your application. If roofing work will be done, a roofing application must be submitted along with this permit application. Step 2. Submit the completed application with all necessary documents to the Building, Planning and Zoning Department for processing. During the processing of your application, you may be asked to submit additional information. t1 PPLICATION Ale 93 Address PERMIT TYPE (✓ ) Building Electrical Mechanical Plumbing I.PGX Roofing Fence Other Apt. PERMIT - CHANGE (✓ ) Chg. Contractor Renewal Revision Extension Supplement Reinspection ARCHITECT Name License No. Address Telephone Fax Master Permit No. Subsidiary Permit No. City F1. State PERMIT APPLICATION Zip tn„ 4 /ff Folio Number Description of Work Cad Lot Block Subdivision PB PG Zoning Linear Feet Current Use of Property Square Feet p� Units Floors Proposed Use of Property )(Value of Work i 50 0 ' 00 Bldg Value Tenant Information Tax Assessed/Appraised Value Flood Zone Base Floor Elev. ENGINEER Name License No. Address Telephone Fax IMPORTANT NOTICES AFFIDAVIT - Please read carefully. A ature Page 2 1. DO NOT BEGIN ANY WORK WITHOUT HAVING RECEIVED YOUR VALIDAT the right to begin construction. HOURS OF CONSTRUCTION are limited to: Mon to 5:00 p.m. No inspections will be conducted on weekends or holidays. 2. All construction of demolition areas MUST 13E MAINTAINED IN A CLEAN, NEAT 3. STREETS AND NEIGHBORING PROPERTIES SHALL BE KEPT FREE FROM DI 4. SWALES MUST BE PROTECTED FROM BEING DAMAGED BY EQUIPMENT required for work in or near the street/sidewalk. 5. CONSTRUCTION TRAILERS ARE PROHIBITED ON SINGLE FAMILY RESIDE which requires a separate permit. 6. PORTABLE TOILETS for a construction site require a separate permit. 7. DO NOT DISCHARGE WATER INTO THE RIGHT OF WAY OR STORM DRAINS 8. EQUIPMENT AND MATERIALS SHALL BE STORED at least 10 feet from the edg 9. Department of Health and Rehabilitative Services (HRS) approval is required for ap Management (DERM) and/or Miami -Dade Water and Sewer Department (MDWASD) Application is hereby made to obtain a permit to do work and installation work will be performed to meet the standards of all laws regulating constr are required for ELECTRICAL, PLUMBING, POOL, EXTERIOR D ROOFING and SIGNS and there may be additional permits required fro I, the OWNER of the property, have disclosed all information related months to the Building Official. Further, I am fully aware that if the cu any other permit equals or exceeds fifty percent (50 %) of the fair mark present federal flood criteria for finished floor elevation. I am also fully under this and any other permit exceeds fifty percent (50 %) of the repl conform to the current code requirements of the Building Code. WARNING TO OWNER: Your failure to record a NOTICE OF improvements to your property. If you are spending more than $2,500 your attorney or lender before recording your Notice of Commencem 22 N.W. 1st Street, 1' Floor, (305) 679 -1078. Once recorded, the Notice accordance with Section 713 -35 of Florida Statutes. Review the Choosing a Contractor. STATE OF FLORIDA, COUNTY OF MIAMI -DADE S Signature of Owner 'Dcb r J DS Print Name n(� Sworn to and subscribed before me this .L- l day of • SEAL: Personally known otary Public - State of F1 Si - , k :_ MY COMMISSION # CC808950 EXPIRES • FAT • February 14, 2003 DONDED THRU TROY FAIN INSURANCE, INC OR, Produced Identification Type of Identification Produced: P PERMIT APPLICATION D PERMIT AND PERMIT CARD. Applying for a permit does not grant through Friday from 7:30 a.m. to 6:00 p.m., and Saturday from 8:00 a.m. ND SANITARY CONDITION free from construction debris. T AND DEBRIS. R VEHICLES, AND MAY NOT BE USED FOR STORAGE. A bond is TIAL CONSTRUCTION SITES. Other construction may have a trailer without approval from the Building, Planning and Zoning Department. of pavement. lications involving septic tanks. Department of Environmental Resources pproval is required for applications involving sewers. as indicated. I, the OWNER of the property, certify that all ction in this jurisdiction. I understand that separate permits OR, MECHANICAL, WINDOW, FENCE, DRIVEWAY, other governmental agencies. o any work at the property performed in the prior twelve ulative cost of work to my home or business under this and t value of the structure, the entire structure must meet the aware that if the total cost of work to my home or business cement cost of the structure, then the entire structure must OMMENCEMENT may result in you paying twice for r intend to obtain financing, you may wish to consult with nt. The Notice of Commencement must be recorded at: � f Commencement must be POSTED AT THE JOB SITE in rochure at Village Hall on Construction Lien Law and Of Si at e of Contr ct r / Quali ier 0 P 0e r `-T J. Cs 7 nt Name p� S orn to and subscribed before me this 2 ` AL: OF MIAMI -DADE day of Public - State of r ol'da ,o�rtt :Pk Joyce Kranz MY COMMISSION # CC808950 EXPIRES . February 14, 2003 BONDED THRU TROY FAIN INSURANCE INC rsonally known OR, Produced Identification pe of Identification Produced: Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Printed: 5/2/2002 Applicant: DEBORAH `` MADSEN Owner: MADSEN DEBORAH JOB ADDRESS: 335 6NE 93 ST aC /. ao Permit Status: Approved Permit Expiration: 10/27/2002 Work: RECONNECT 4 TON A/H Mechanical Permit Permit Number: ME2002 -58 Contractor C & R AIR CONDITIONING CO Contractor's Address: 2121 NW 139 ST #10 Local Phone: 305- 685 -6394 Parcel # 1132060136260 Legal Description: MIAMI SHORES SEC 1 AMD PB 10 -70 LOT 21 & 22 - BLK 46 LOT SIZE Construction Value: Signed. (Contractor or Builder) BY $100.00 L• ' _ S��ned: �1 �� l ' � " v (JNSPECTOR) BY: _ 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. Page 1 of 1 Total Fees: $0.00 Total Receipts: $0.00 -9- (o . v This Permit is granted to the contractor or builder named above to construct (he budding 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 tnat 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 !unher 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 whetner shown on the plans or drawings or in the statements or specifications and (hat he assurnes responsibility for work done by his agents, servants or employees. In co:,sideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with alt ordinances and 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 raesponisibility for all work done by either myself, my agent, servants or employes. — — 8 ra il) — 12 14 — 18 -- 18 — 20 — 24 20 —20 _ 30 32 34 _ 38 _ 36 — 40 42 AIR CONDITIONING CO. P.O. BOX 681330 • MIAMI, FL 33168 -1330 PHONE: (305) 685 -6394 PAY TO THE ORDER OF $ 136.ao datAlLq BANK OF AMERICA FLORIDA 63-243/670 MEMO Q g 11 ':0 6 700 2 4 3 61: 40 /309 L0 601I' AUTHO a SIGNATURE 4563 DOLLARS T d j r u O v N III nr u 1 ITEM • BATH TUB UNIT FEE i ITEM ' SWITCH OUTLETS UNIT .FEE • ITEM . SPACE HEATERS I ; 10 KW UNIT FEE BIDET LIGHT OUTLETS CENTRAL HEATING DIShYIASHER RECEPTACLES A/C (WIND) DISPOSAL SERVICE TEMPORARY A/C (CENTRAL) I= LI 16 n A // DRINKING FOUNTAIN SERVICE SIZE IN AMPS DUCT WORK FLOOR DRAIN SERVICE REPAIR/METER CHANGE REFRIGERATION GREASE TRAP APPLIANCE OUTLETS PROCESS AM) PRESS PIPING INTERCEPTOR RANGE TOP UNDERGROU D TANKS LAVATORY OVEN ABOVE GROUND TANKS LAUNDRY TRAY WATER HEATER U.F. PRESSURE VESSELS CLOTHES WASHER MOTORS 0- 1 FP STEAM BOILERS SHOWER MOTORS OVER 1- 3 If 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 MOTORS 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 OUTLETS COMMERCIAL + SWIMMING POOL WATER SERVICE SIGN TUBES ;EWER CONNECTIONS - SIGN TRANSFORMERS ITILITY -SEWER SIGN TIME CLOCK 'DUTY-WATER FIXTURES :EPTIC TANK —� — ANTENNA • ELAY TELEVISION OUTLETS _ RIINFIELO, 4' TILE/RES. VIOLATION UMP & ABANDON SEPTIC TANK REINSPECTION OAKAGE PIT CU. FT. ATOM BASIN ISCHARGE WELL OMESTIC WELL REA DRAIN OOF INLET OLAR WATER HEATER IRE STANDPIPE JOL PIPING AWN SPRINKLER SYSTEM AS RANGE :TER SET (GAS) LS PIPING _ IF PLUMBING (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.) ADDENDUM TO BUILDING PERMIT APPLICATION ELECTRICAL MECHANICAL ELECTRICAL TYPE Minimum Fee QTY. TYPE Dryer QTY. TYPE. Outlet, Appliance QTV. TYPE Service Repair QTY. A/C Central 1 -3 Ton W Fan Outlet, Wall Service, Temporary A/C Central 4 -7 Ton Fire Pump Outlet, Switch Signs A/C Central 8 -15 Ton Fixture - Fluorescent Oven Space Heater (kw) A/C Central 16-20 Ton Fixture Light Parking Lot Lights Spas/Hot Tubs A/C Central 20+ Ton Flood Lights Plugmold/Strip Subfeeds, No. of Amps A/C Window FPL - Load Central Posts Swim Pool, Commercial Air Conditioners Garbage Disposal Range/Range Top Swim Pool, Residential Chiller Generators, etc. Receptacles Switchboards Clear Violations Heat Recovery Refrigerator, Comm. (p/PH) Temp Serv., Construction Compactor Low -volt, Burglar Disposal Refrigerator, Domestic Interceptor Temp for Test - 30 days Roof Inlet Deep Freezer Water Closet Low -volt, Fire Domestic Well Renew - Temp Service Laundry Tray Septic Connection Demolition Water IIIeater Low -volt, Intercom/Teleph. Drainfield, 4" Tile/Res. Repair Circuits Lavatory Septic Tank Dishwasher Water Heater New Low -volt, Television Drains, Area Service, Number of Amps Meter Set (Gas) Sewer Connection MECHANICAL TYPE QTY. TYPE Minimum Fee ME Condensate Drain QTY. TYPE. Generator QTY. TYPE Refrigeration, Tons QTY. A/C Central, Ton ' __ — : - - M'' r - I oling Tower QTY. Heating Strips, each ) = ( K W Vent Hood, Cost A/C Wall/Win. Tons Dryer Vents, Number of Paint Booth Ventilation, Cost Air Handler, Tons _ I o Ductwork, Cost of Piping, Flammable Liquid Periodic Inspections Barbecue Fire Sprinkler System Process/Pressure Piping Pump and Abandon Bath Fan - Vented, # Fireplaces, Number of Pressure Vessel Gas - Appliance PLUMBING TYPE A/C Condensate QTY. TYPE Drains, Roof QTY. TYPE Miscellaneous Fixture QTY. TYPE Soakage Pit QTY. Bath Tub Drinking Fountain Miscellaneous Repairs Solar Water Heater Bidet Filter Replace Pool Piping Sprinkler Repair Cap - Fixture Fountain Pump and Abandon Sprinkler System Cap - Water Gas - Appliance Pump, Domestic Supply, AC Well Cap - Sewer Gas - Natural Pump, Fire Stand Temporary Toilet Catch Basin Gas - Propane Pump, Re- circulate Temporary Water Closet Clothes Washer Gas Piping Pump, Replace - Pool Urinal Dental Chair Grease Trap Pump, Sprinkler Utility - Sewer Discharge Well Ice Maker Pump, Sump Relay Repair Utilit, - Water Vacuum Pump Dishwasher Indirect Wastes Disposal Interceptor Roof Inlet Water Closet Domestic Well Laundry Tray Septic Connection Water IIIeater Drainfield, 4" Tile/Res. Lavatory Septic Tank Water Heater New Drains, Area Meter Set (Gas) Sewer Connection Water Ike -pipe • Drains, Floor Minimum Fee Shower Water Service Drains, Drench Miscellaneous Equipment Sink Well, Supply Page 3 PERMIT APPLICATION INSTRUCTIONS: Please indicate the type of work being performed and quantity(ies) in the space provided below. RECEIVED AND REVIEWED BY: DATE: SECTION BY DATE Zoning Electrical Mechanical (i, ) , :- ..' L Plumbing Fire Public Works Structural Building Official Page 4 OFFICE USE ONLY CHECKLIST ❑ OWNER - BUILDER FORM (Attach) ❑ FIRE DEPARTMENT APPROVAL (Commercial / multi- family) ❑ CONCURRENCY (New Construction) Cl OTHER (Specify & Attach) ❑ PROOF OF OWNERSHIP (Attach) ❑ HRS / DERM APPROVAL (Septic / Sewer) Cl IMPACT FEE (New Construction) ❑ OTHER (Specify & Attach) PERMIT FEES $3.00 per page (Scanning Fee) $ Miami Shores Village Bond $ Metropolitan Dade County (C.C.F.) $ Inspector State Educational Fund $ State DCA (Radon) $ Code Enforcement Fine $ Zoning Review REVIEWED AND PREPARED BY: $ ISSUING OFFICIAL (¢.005 / sq.ft.) (¢.01 /sc 10050 N.E. 2' AVE., MIAMI SHORES, FL • (305) 795 - 2207 • FAX (sq.ft. = x/1000 x ¢.60) .ft.) PERMIT APPLICATION ❑ CONDO ASSOCIATION APPROVAL (Attach) ❑ BPR APPROVAL (Restaurants) Cl CONTRACTOR REGISTRATION (On File) TOTAL $ DATE: CONDITION OF APPROVAL Revised July 2001 (305) 756 -8972 • http : / /www.miamishoresvillage.com PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date 7" 16' 1 Job Address 33,C ME E Legal Description S 1 ? 2 f 9 M i e CS Lessee / Tenant ct ( Mgd @'1 Owner's Address Sc C (� Phone � (p S C � `\ nc C ( � � � ( o�t ►Jc-0( f' F to 3ios(-I Contracting Co. t Oh , �1 vt i n q o., Address P %:OX (7.3R (,�I ; fYl IO i 33311::$3 a Qualifier 1C r-i- J (P v' PSI Phone &35 -6.039Li State #CACb2(S-41 # Competency #0 Ins.Co. rl.)( 64 Architect /Engineer OA" U� Bonding Company Address Mortgagor Address Permit Type(circle one): BUILDING ELECTRICAL PLUMBING MEC IC ROOFING PAVING FENCE SIGN WORK DESCRIPTION 2 1 ' �+ i Square Ft. Estimated Cost(value) f -2 Z 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). Appliwcion 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 standardslof 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 info be done compliance with all applicable laws regulating aut iz the above -named contractor to do the work stat Signature o Date: 7�If� 1 9 9/ Lia.,4;441,_/ owner /Fondo President MY COMMISSION N CC438959 February 14, 1999 BODED MU TROY FA'A e9SURA Cb Notary as to Owner and /or Con o President My Commission Expires: Q(fq Tax Folio Address Master Permit # 6400 q 7 accurate and that all work will ion]: zo ing. Furthermore, I Signature •£ Contractor or Owner- Builder Da e : 4;,� , Pd�11"�l.A .9. �" - 0 '. a= MY C0Nn1HISSRIU D CIUMIC 4 `1 ��• 0:.::.mlu. nwr WaW lta Notary as to Contractor o, r % r- Builder/ My Commission Expires: cZ 1r ** * * * * * * * * * * * * * * * ** C. FEES: PERMIT 4(0 RADON C.C.F. NOTARY TOTAL DUE APPROVED: Zonin Mechanical Fire Other Building Electrical Plumbing Engineering