390 NE 93 St (3)PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date Job Address A 9 0 X.)C 3 S Tax Folio
A.49
Legal Description 104 1 °F L � k c_ k 7 & 9 / f _Se' f Historically Designated: Yes No
Owner/Lessee / Tenant e be,- 4 06 u^ _c Master Permit # 43:3 pg
Owner's Address ? CJ "j , s Phone 3 O �" 7s �90
3b'Vo x�k) 6 Cf
Contractin Co. .s t A l o,4.) 4 cry ! [Grp - i-� Address
36 c- ?‘17-'
Qualifier ?Atv 1
State # (AC o 1 SY 5 Municipal #
Architect/Engineer
Bonding Company
Mortgagor Address
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING a S • " OWING PAVING FENCE SIGN
WORK DESCRIPTION oCo,
4 r
va(< < cr 47
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 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.
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. Furthermore, I authorize the above -named contractor to do the work stated
7(
nature of Contractor or caner- Builder Dat
:. .3� 6 ,7..
Signature of owner and/or Condo President Date
% 5/ 92
Notary as to Owner and/or Condo President Date „ • t : o C I F tra 4 : r � er- : ui der
My Commission Expires: �41, My Commis on
(292 a",11-..1
FEES: PERMIT c/v a RADON C.C.F.
SS#
Competency # Ins. Co.
Address
Address
FFFICIALNOTAR SEAL
GLADYS J V1LLAR
NOTARY PUBLIC STATE OF IFIORIDA
COMMISSION NO. CC714103
MY COMMISSION EXP. MAR.1
NOTARY
41, Sov
BOND
TOTAL DUE
Date
APPROVED:
Zoning o , f Building Electrical
Mechanical
Plumbing Engineering
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.)
PLUMBING
BATH 1.8
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
URINAL
WATER CLOSET
INDIRECT WASTES
WATER SUPPLY TO:
A/C UNIT
FIRE SPRINKLER
HEATER -NEW INST.
HEATER - REPLACE
LAWN SPRINKLER -WELL
SWIMMING POOL
WATER SERVICE
SEWER CONNECTIONS
UTILITY - SEWER
UTILITY -WATER
SEPTIC TANK
RELAY
ORAINFIELO, 4' TILE/RES.
PUMP & ABANDON SEPTIC TANK
SOAKAGE PIT CU. FT.
CATCH BASIN
DISCHARGE WELL
DOMESTIC WELL
AREA DRAIN
ROOF INLET
SOLAR WATER HEATER
FIRE STANDPIPE
POOL PIPING
LAWN SPRINKLER SYSTEM
GAS RANGE
METER SET (GAS)
GAS PIPING
ITEM
ELECTRICAL
UNIT
FEE
ITEM
SNITCH OUTLETS
LIGHT OUTLETS
RECEPTACLES
SERVICE TEMPORARY
SERVICE SIZE IN AMPS
SERVICE REPAIR/METER CHANGE
APPLIANCE OUTLETS
RANGE TOP
OVER
WATER HEATER
MOTORS 0- 1 HP
MOTORS OVER 1- 31f
MOTCRS OVER 3- 5 hP.
MOTORS OVER 5- 8 HP
MOTORS OVER 8 10 HP
ANTENNA
MOTCRS OVER 10- 25 hP
%MRS OVER 25-100 HP
%OTCPS OVER 100 hP
A/C WINDOW
AIR CONDITIONERS
STRIP HEATER
C-NERATORS TRANSFORMERS
GENERATORS TRANSFORMERS
GNERATORS TRANSFORMERS
SPECIAL PURPOSE
• 1 OUTLETS COWERCIAL
1 SIGN TUBES
SIGN TRANSFORMERS
SIGN TIME CLOCK
FIXTURES
TELEVISION OUTLETS
VIOLATION
REINSPECTION
UNIT I FEE
ITEM
SPACE HEATERS
CENTRAL HEATING
A/C (WIND)
A/C (CENTRAL)
DUCT WORK
REFRIGERATION
PROCESS AND PRESS PIPING
I1h0ERGROUND TANKS
ABOVE GROUND TANKS
U.F. PRESSURE VESSELS
STEAM BOILERS
HOT WATER BOILERS
MECHANICAL VENTILATION
TRANSPORTING ASSEMBLIES
ELEVATORS/ESCALATORS
FIRE SPRINKLER SYSTEMS
COOLING TOWERS
VIOLATION
REINSPECTION
�Q.
i f
UNIT
New c/nte
E && ile1 8 e)
FEE