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MECHANICAL
Owner's Name and Address Registered Architect and /or Engineer_ _ � �.._ Name and address of licensed contractor / 1/4 Location and legal description of lot to be built on: Lot Block Subdivision Street and Number where work is to be done MIAMI SHORES VI BUILDING INSPECTION DEPARTMENT GE 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 Law 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. elL1D - � , cL n �i Date. 11 _ _ .2 I Id 9 3 Si ii State wo to be do and purpos of building (. y floors) L pd 1 3 i 14 6 -e F and for no other purpose. New Building y i Remodeling Addition _ Repairs No. of Stories To be constructed of Kind of foundation Roo Covering Estimated Total cost of improvements $___!! 3 ®x— Amount of Permit $ 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 ork such public notice or notices as are required by the Act. The undersigned agrees to employ only suck subcontractors, on work to be rformed under this permit, as are licensed by Miami Shores Village. Remarks (Signed) _.- _C - 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. / r Permit No 7. 3__41 Date 3 11 tGb Read, Sworn to and Subscribed before me. Disapproved Dat Notary Public, State of Florida (Signed) - 1 — ms s' �/ Building Inspecto a My Commission Expires PLA NING 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. PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date Job Address 355 /' . ' q3 7'1 Legal Description / Lessee / Tenant /641,6 Master Permit # Owner's Address 35 /v • f 3 S'' Phone 7 -5- ? - (2 Contracting Co. g I L Address 3662c /giari/ / Qualifier odinie( V V d � ss# Phone g / b - + 4' State 11:41A�0/33o/DMunicipal # Competency # Ins.Co. Architect /Engineer I Address Bonding Company Address. Mortgagor Address Permit Type(circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL )ROOFING PAVING FENCE SIG WORK DESCRIPTION -Q � 6 4 k <v'l Olvd 404/4e'l 6'4 Square Ft. Estimated Cost(value) WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO D SO MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTEN TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOU NOTICE OF COMMENCEMENT). Application is hereby made to obtain a permit to do work and installation as indicated above, ar on the attached addendum (if applicable). I certify that all work will be performed to meet tt standards of all laws regulating construction in this jurisdiction. I understand that separat permits are required for ELECTRICAL, PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK. OWNER'S AFFIDAVIT: I ce tify that all the foregoing information is e in compliance h all applicable laws regulating construe ze t �'a�ove d contractor to do the work stated. Signature of owner and /or Condo President • I•;<•. Date: Notary a to Owner and My Commission Expires: ** * * FEES: PERMIT APPROVED: Zonin Mechanical 40 HARRY R. HAWKINS iT `�� i � ''s;: ,; on actor or Owner- Builder _ � y Coy s oza. =E . r � yo, t c�•1.: 9e/ -� 8�� + �Pj �� t�Tr * * * * * * * j n x + � ,;'� B „9„ -,. vok RADON C.C.F. NOTARY T Fire Other Building Electrical Plumbing Engineering o Prakftga Bonded mm notfy PubIic undenerRera Tax Folio </ - 3$ ) /o kV, to an a all work wil Furthermore, Owner- Builder ** ITEM BATH TUB UNIT FEE ITEM SWITCH OUTLETS UNIT FEE ITEM SPACE HEATERS UNIT FEE BIDET LIGHT OUTLETS CENTRAL HEATING I49 cid . I DISHWASHER RECEPTACLES A/C (WIND) DISPOSAL SERVICE TEMPORARY A/C (CENTRAL) 3tesil DRINKING FOUNTAIN SERVICE SIZE IN AMPS DUCT WORK FLOOR DRAIN SERVICE REPAIR/METER CHANGE REFRIGERATION GREASE TRAP APPLIANCE OUTLETS 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 HP 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 hCTORS 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 • SWIMMING POOL OUTLETS COMMERCIAL WATER SERVICE SIGN TUBES SEWER CONNECTIONS SIGN TRANSFORMERS UTILITY -SEWER SIGN TIME CLOCK UTILITY -WATER . FIXTURES SEPTIC TANK ANTENNA • 3ELAY TELEVISION OUTLETS )RAINFIELD, 4" TILE/RES. VIOLATION 'UhP S ABANDON SEPTIC TANK REINSPECTION SOAKAGE PIT CU. FT. :ATCH BASIN )ISCHARGE WELL )OMESTIC WELL 1REA DRAIN 100F INLET >OLAR WATER HEATER 'IRE STANDPIPE 'OOL PIPING .AWN SPRINKLER SYSTEM 1AS RANGE DETER SET (GAS) AS PIPING ADDENDUM BUILDING PERMIT APPLICATION (AN APPL /7ATION FOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. IF A MASTER PERMIT HAS BEEN OBTAINED, THE OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.) PLUMBING ELECTRICAL MECHANICAL PERMIT NO. STATE OF FLORIDA: COUNTY OF DADE: THE UNDERSIGNED hereby gives notice that improvements will be made to certain real property, and in accordance with Chapter 713, Florida Statutes, the following information is provided in this Notice of Commencement. 1. Legal description of property and street address: 3.j , /I. g, 93 sY, 2. Description of improvement: 3. Owner(s) name and address: ai ` J sfi as 3,S,Jf . • 7.3 . V .931.38 Interest in property: l/ Name and address of fee simple titleholder: 4. Contractor's name and address: 5. Surety:(Payment bond required by owner from tractor, if any) Name and address: Amount of bond $ 6. Lender's name and address: 7. Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as provider by Section 713.13(1)(a)7., Florida Statutes, Name and address: 8. In addition to himself, Owner designate the following person(s) to receive a copy of the, Lienor's Notice as provided tion 713.13(1)(b), Florida Statutes. Name and address: 9. Expiration date of this Notice of Commencement: (the expiration da rent date is s.ecifiied) NOTICE OF COMMENCEMENT TAX FOLIO NO. /1 3 ©/3' 60.io /r) Notary Public My Commission Expires: ki+:ry , HARRY R. HA S" 11 A ` IA MY COMMISSION R CC 308381 1 :6 ; :t "111 „tip . ' B anded EXPIRES: August 12, 1997 Thru N otary PhhUo tlnde rwrflsrs S Signature of Ow Sworn to and subscribed before me this 4:4 of 7�fi�J , 19 / 57 PS AT: VF 871..,1 iTyr, tt:It�JIUJ04111r T?F mvty bin *is Wier) , twi M'NED�D trtvInurt ?mar :Mis As •o e4q3tc aA t y t A.O. 19 e; • N ✓ /'SSrnyh nil nn ;dot Sear. 9 r • T J' IJV f t � o, bean ondCounly Courts O.C. - dew oao vs rtss� Address: 9R039 180 1995 JAN 31 09:06 CENTRAL INSTAI I ATION OFFICE Sears, Roebuck and Co. (5596) 3825 Forsyth Rd. • Winter Park, FL 32792 1 year from the date of recording unless a in Se Prepared by: CENTRAL nv5 I ALLA [ION OFFICE Sears, Roebuck and co. (bb96) 3825 Forsyth Rd. Winter Park, FL 32792 C IILDING ECTRICAL UMBING 3OFING ner of ling itect trtor ' under al =cription MIAMI SHORES VILLAGE, FLORIDA DATE 19 6 PERMIT Lot CONTRACTOR OR BUILDER Work to be performed under this Permit B1 ;Tess of 11 - r �� Value of Amount of / ding 1 J , f Project $ / / t I 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 applica- herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any s, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked +y 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 Alit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and !ulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes respon- ility for work done by his agents, servants or employees. Signed. L-''L INSPECTOR In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in ccmpliance all ordinances and regulations taining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorfties of Miami Shores Village. In as .ling this permit I assume responsibility for ell work done by either, myself, my agent, servant or employee. N9 7341 NI 1'• L • Contractor's ,,. .► License No ' r , Subdi- vision BY AUTHORITY , r • AIUOT