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402 NE 93 St (8)® CLOiETB BATH TUBS SHOWERS LAVA- TORIES SINKS SLOP SINKS{ LAUNDRY TUBE UR CATCH BABIN FLOOR DRAIN DRINKING FOUNT' NB TOTAL FIXTURE6 CONTR. LIST CHECK SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SW IM'G POOL CONTR. LIST • 0 � � � ` -- CHECK _ ^ - Permit N Street State work to be performed and purpose of building (By Floore) _______ _,A4X_ New Building ___._ --- Remodeling------ -....- -- -___ _ Additior__•- -- -._` Repairs . Employing Plumber's Name No._ Location and Legal Description Lot Street and Number where work is to be performed —No Amount of Permit $ STATE OF FLORIDA, 1 COUNTY OF DADE. j MIAMI SHOR[;S VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR FLUMBING PERMIT lick Street__ (Oigned) �% Dat Application is hereby made for the approval of the detailed statement of fle plans and specifications herewith submitte for the building 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 Misr ii Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified not. A copy of approved plans and specifications must be kept at building during progress of work. Owner's Name and Address Subdivision____ __________ c 6 No. of Stories. .... ............. ....... e/ Size Septic Tank Type of Tank_____ Feet of Drain Tile____.__ ........... - -- -_- .... ___-__.-_Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: City — Well._____ _.--_- __- ______- ___________ She of Soakage Pit Capacity Gals Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that lie 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 com- plied 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 sub- contractors, on work to be 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 appeared 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. My Commission Expires Notary Public, State of Florida Master Plumber. NOTE: A re- inspection fee of $$1.00 will be made when st ch re•insix etion is made' necessary by improper notice for inspection, or faulty materials and /or workmanship. [27 Amount of Permit $____ STATE OF FLORIDA, t COUNTY OF DADE. SS. ) Permit No. t Application is hereby made for the approval of the detailed statement of the structure herein described. This application is made in compliance and confor and all provisions of the Laws of the State of Florida, all ordinances of Miami of Miami Shores Village shall be complied with, whether herein specified or building during progress of work. MIAMI SHORE; VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT , r Street and Number where work is to be performed—No State work to be performed and purpose of building (By Floors) New Building Remodeling Addition Size Septic Tank Feet of DraM Tile ./ „ Date \ 7 .•*• - . C'; plans and specifications herewith submitted for the building or other pity with the Building Ordinance of Miami Shores Village, Florida, Shores Village and all rules and regulations of the Building Division not. A copy of approved plans and specifications must be kept at Owner's Name and Address • 7 No. Registered Architect and/or Engineer_ Employing Plumber's Name 1 No Location and Legal Description Lot Blot k Subdivision Repairs Type of Tank__ Dist. Feet of Tank or Drain I ield from Well. 00 Nature of Water Supply: City—We — Sizt of Soakage Pit Street Capacity Gals. ----- ------ ---- Street Street No. of Stories ( S .gned ) Plumbing Inspector. The undersigned applicant for this building permit does hereby certify t hat he mhderstands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Comp led General Laws of Florida Permanent Supplement, and has com- plied with the provisions thereof, and will require similar compliance from :11 contractors or sub-contractors employed by him in the work to he 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 sub-c mtractors, on work to be performed under this permit, as are licensed by Miami Shores Village. ( igned ) Master Plumber. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared 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 fore l. oing application, and that he did sign the same, and that all facts therein by him stated are true. My Commission Expires Notary Public, State of Florida NOTE: A re-inspection fee of $1.00 will be made when such re-inspi ction is made necessary by improper notice for inspection, or faulty materials and/or workmanship. CLOSETS BATH TUBS SHOWERS LAVA- TORIES SINKS SLOP SINKS LAUNDRY TUBS URINALS CATCH BASIN FLOOR DRAIN DRINKING FOU NT• NS At s k TOTAL FIXTURES CONTR. LIST "2. ../ ( ,..-. , , i t CHECK 2 0 1 — c c' I '-- •': 1 '.rf /.--, 3 SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SW I M 'G POOL 1..Y0 CONTR. LIST . ..; CHECK .- [27 Amount of Permit $____ STATE OF FLORIDA, t COUNTY OF DADE. SS. ) Permit No. t Application is hereby made for the approval of the detailed statement of the structure herein described. This application is made in compliance and confor and all provisions of the Laws of the State of Florida, all ordinances of Miami of Miami Shores Village shall be complied with, whether herein specified or building during progress of work. MIAMI SHORE; VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT , r Street and Number where work is to be performed—No State work to be performed and purpose of building (By Floors) New Building Remodeling Addition Size Septic Tank Feet of DraM Tile ./ „ Date \ 7 .•*• - . C'; plans and specifications herewith submitted for the building or other pity with the Building Ordinance of Miami Shores Village, Florida, Shores Village and all rules and regulations of the Building Division not. A copy of approved plans and specifications must be kept at Owner's Name and Address • 7 No. Registered Architect and/or Engineer_ Employing Plumber's Name 1 No Location and Legal Description Lot Blot k Subdivision Repairs Type of Tank__ Dist. Feet of Tank or Drain I ield from Well. 00 Nature of Water Supply: City—We — Sizt of Soakage Pit Street Capacity Gals. ----- ------ ---- Street Street No. of Stories ( S .gned ) Plumbing Inspector. The undersigned applicant for this building permit does hereby certify t hat he mhderstands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Comp led General Laws of Florida Permanent Supplement, and has com- plied with the provisions thereof, and will require similar compliance from :11 contractors or sub-contractors employed by him in the work to he 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 sub-c mtractors, on work to be performed under this permit, as are licensed by Miami Shores Village. ( igned ) Master Plumber. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared 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 fore l. oing application, and that he did sign the same, and that all facts therein by him stated are true. My Commission Expires Notary Public, State of Florida NOTE: A re-inspection fee of $1.00 will be made when such re-inspi ction is made necessary by improper notice for inspection, or faulty materials and/or workmanship. BUILDING ELECTRICAL PLUMBING ROOFING Owner of -� Building Address of Building n MIAMI SHORES VILLAGE, FLORIDA DATR PERMIT N? 11164 n Work to be performed under this Permit Architect "ontractor or Builder. . :j a� �' • j _ i ,.� ; • 4"_ i Legal Lot I Bi. Description 1 t ) N4AC O OR BUILDER S, tbdi . t ision `\ ' • VI due of PrDject $ i ' :L. 1 s r This permit is granted to the contractor or builder named above to construct he building or to install the equipment or device described in the application herefor in strict compliance with all ordinances pertaining thereto and with the un lerstanding that the work will be performed in compliance with any plans, drawings, statements or specifications that may have been submitted to and approver 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 ch inged 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 i1. the statements or specifications and that! tt: es responsibility for work done by his agents, servants or employees. r' � } Signed ' " � , ,, .. 'Li BY ; '.1 k SPE In consideration of the issuance to me of this permit I agree to erform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or si ecifications submitted to the proper authorities of Miami Shores Village. l accepting this permit I assume responsibility for all work done by ether, myself my agent, servant or employee. Contractor's License No Amt, of ' # , - Permit BY AUTHORITY 1 95 MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR ' LUMBING PERMIT /emit No. -. ..._ ��� - -- -- Date Application is hereby made for the approval of the detailed statement of he plans and specifications herewith submitted for the building or other structure herein described. This application is made in compliance and con:'ormity 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 work. Corner's Name and Address - ! % f / _ / '{ / / - / -_- - - - -- -- -- -- •---- .------ .- - - - - -- Registered Architect and /or Engine Employing Plumber's Name - Street. Location and Legal Description _ B. ock Subdivision Street and Number where work is to be performed —No State work to be performed and purpose of building (By Floors)_4 4. New $uilding____.-- _- .- _.-- ..... -. Remodeling_-_ -_ - Addition Repairs No. of Stories Amount of Permit $- STATE OF FLORIDA, } COUNTY OF DADE. (S. Strad)._ Str Street 7 Size Septic Tank Feet of Drain Tile_ f r- list. eet o ank or Drain :Field from Well Nature of Water Supply: City — Well.-----_---_-- .-- .- .._. ..... of Soakage Pit Capacity Gals Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Comp'_•led General Laws of Florida Pennanent Supplement, and has com- plied with the provisions thereof, and will require similar compliance from a ll 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 sub - contractors, on work to be performed under this permit, as are lid by Miami Shores Village. My Commission Expires Notary Public, State of Florida _1 Master Plumber. Before me, the undersigned authority, a notary public, duly authorized '.o administer oaths and take acknowledgments, personally appeared 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 foregt ing application, and that he did sign the same, and that all facts therein by him stated are true. NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty materials and /or workmanship. CLoorrei OATH TUBS SHOWERS LAVA• TORIES SINKS SLOP SINKS LAUNDRY TUBS URINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT' NS TOTAL FIXTURES LICr .11.1gC:S SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR H EATER DEEP WELL SPRKLR. SYSTEM SW IN •G POOL C6RiTW. tin CHECK CHECK MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR ' LUMBING PERMIT /emit No. -. ..._ ��� - -- -- Date Application is hereby made for the approval of the detailed statement of he plans and specifications herewith submitted for the building or other structure herein described. This application is made in compliance and con:'ormity 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 work. Corner's Name and Address - ! % f / _ / '{ / / - / -_- - - - -- -- -- -- •---- .------ .- - - - - -- Registered Architect and /or Engine Employing Plumber's Name - Street. Location and Legal Description _ B. ock Subdivision Street and Number where work is to be performed —No State work to be performed and purpose of building (By Floors)_4 4. New $uilding____.-- _- .- _.-- ..... -. Remodeling_-_ -_ - Addition Repairs No. of Stories Amount of Permit $- STATE OF FLORIDA, } COUNTY OF DADE. (S. Strad)._ Str Street 7 Size Septic Tank Feet of Drain Tile_ f r- list. eet o ank or Drain :Field from Well Nature of Water Supply: City — Well.-----_---_-- .-- .- .._. ..... of Soakage Pit Capacity Gals Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Comp'_•led General Laws of Florida Pennanent Supplement, and has com- plied with the provisions thereof, and will require similar compliance from a ll 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 sub - contractors, on work to be performed under this permit, as are lid by Miami Shores Village. My Commission Expires Notary Public, State of Florida _1 Master Plumber. Before me, the undersigned authority, a notary public, duly authorized '.o administer oaths and take acknowledgments, personally appeared 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 foregt ing application, and that he did sign the same, and that all facts therein by him stated are true. NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty materials and /or workmanship. lUILDING LECTRICAL 'LUMBING )wner of 3uilding u chitect - -- -: ontractor nr Builder .egal Lot B� Description =iddress of ,.Ar ; uilding_ _ This permit is granted to the contractor or builder named above to construct t ,ation herefor in strict compliance with all ordinances pertaining thereto and with th( clans, drawings, statements or specifications that may have been submitted to and ap t any time if the work is not done in compliance with such ordinances or if the plan .ermit is granted is the understanding that the contractor or builder named above as egulations pertaining to the work covered hereby whether shown on the plans or d, ibility for work done by his agents, servants or employees. CONTRACTOR OR BUILDER MIAMI SHORES VILLAGE, FLORIDA PERMIT ■2 4339 Work to be performed under this Permit Sul: di- visi >n Val ie of Pro:ect DATE Contractor's License No. Amt. of Permit 194 le building or to install the equipment or device described in the appli- understanding that the work will be performed in compliance with an iroved by the proper m authorities. This Permit may be revok are changed without authorization. A further condition upon which is ;times the responsibility for a thorough knowledge of the ordinances d awings or in the statements or specifications and that he assaw. re on- , 1 Y AUTHORITY Signed: By INSPOR • In consideration of the issuance to me of this permit I agree to perform the w irk covered hereunder in compliance with all ordinances and regulations )ertaining thereto and in strict conformity with the plans, drawings, statements or pecifications submitted to the proper authorities of Miami Shores Village. n accepting this permit I assume responsibility for all work done by either myself, n y agent, servant or employee. Page 2 IMPORTANT NOTICES 1. DO NOT BEGIN ANY WORK WITHOUT HAVING RECEIVED YOUR VALIDATED PERMIT AND PERMIT CARD. Applying for a permit does not grant the right to begin construction. HOURS OF CONSTRUCTION are limited tc: Monday through Friday from 7:30 a.m. to 6:00 p.m., and Saturday from 8:00 a.m. to 5:00 p.m. No inspections will be conducted on weekends or holidays. 2. All construction of demolition areas MUST BE MAINTAINED IN A CLEAN, NEAT AND SANITARY CONDITION free from construction debris. 3. STREETS AND NEIGHBORING PROPERTIES SHALL BE KEPT FREE F 2OM DIRT AND DEBRIS. 4. SWALES MUST BE PROTECTED FROM BEING DAMAGED BY EQUIFMENT OR VEHICLES, AND MAY NOT BE USED FOR STORAGE. A bond is required for work in or near the street/sidewalk. 5. CONSTRUCTION TRAILERS ARE PROHIBITED ON SINGLE FAMILY RESIDENTIAL CONSTRUCTION SITES. Other construction may have a trailer 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 without approval from the Building, Planning and Zoning Department. 8. EQUIPMENT AND MATERIALS SHALL BE STORED at least 10 feet fron- the edge of pavement. 9. Department of Health and Rehabilitative Services (HRS) approval is required for applications involving septic tanks. Department of Environmental Resources Management (DERM) and/or Miami -Dade Water and Sewer Department (MDWASD) approval is required for applications involving sewers. AFFIDAVIT - Please read carefully. Application is hereby made to obtain a permit to do work and instz.11ation as indicated. I, the OWNER of the property, 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, POOL, EXTERIOR DOOR, MECHANICAL, WINDOW, FENCE, DRIVEWAY, ROOFING and SIGNS and there may be additional permits required from other governmental agencies. I, the OWNER of the property, have disclosed all information related to any work at the property performed in the prior twelve months to the Building Official. Further, I am fully aware that if fie cumulative cost of work to my home or business under this and any other permit equals or exceeds fifty percent (50 %) of the fair market value of the structure, the entire structure must meet the present federal flood criteria for finished floor elevation. I am also fully aware that if the total cost of work to my home or business under this and any other permit exceeds fifty percent (50 %) of th.: replacement cost of the structure, then the entire structure must conform to the current code requirements of the Building Code. WARNING TO OWNER: Your failure to record a NOTICE OF COMMENCEMENT may result in you paying twice for improvements to your property. If you are spending more than $2,500 or intend to obtain financing, you may wish to consult with your attorney or lender before recording your Notice of Commencement. The Notice of Commencement must be recorded at: 22 N.W. 1st Street, Pt Floor, (305) 679 -1078. Once recorded, the Notice of Commencement must be POSTED AT THE JOB SITE in accordance with Section 713 -35 of Florida Statutes. Review the brochure at Village Hall on Construction Lien Law and Choosing a Contractor. ST T FLORID O Y OF MI y I DARE STATE O1 ORI , ' O 7FMIAMIDADE 9 r Signature of Owner Print Name ' 7)�,, Sjo and subscribed before me this ' of DZ�� ..l1 ,17U� B Lit Signs e t1ir - Gc -,State of Florida SEAL: 2 111 ter Ae �� Fly LESTER ER E. CROCKErT MY C *IM SSION # DD 014762 EXPIRES: May 20, 2005 Bonded lin Budget Notary Services Personally known OR, Produced Identification Type of Identification Produced: Sil;aCctorTalifier — �L� E koC,/'L - Print Name S and subscribed before me this / Avit 1.A _ �. nature of Pry Public - tate of ' on SEAL: ` 4: re, !, f , l PERMIT APPLICATION Per O y � Old; Prod ced Identification c. te e• ._.� . ,y Type of Identification4Produced: PROPERTY OWNER New Construction Name e/✓LV al,-)71„ Address $ ca. A '935 Home Telephonee T ^7 . S1 1 j'D J [/ Business Telephone Fax ENGINEER New Construction _ Name . i � , A . License No. Repair Address Demolish Telephone Relocation of Structure Fax Foundation Only TYPE OF MANAGEMENT (✓ ) New Construction Enclosure Alteration Exterior Repair Alteration Interior Demolish Relocation of Structure Shell Only Foundation Only Add'l Attachment Other Add'l Detachment Other INSTRUCTIONS - The following steps must be taken to obtain a permit from the Miami Shores Village: Step 1. Step 2. 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. Job Address: 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. APPLICATION Folio Number 1/ Lot / 1, / - Block 3 Subdivision /4//111n/ 9/00Z PB PG Zoning Linear Feet Current Use of Property R CS /DtWee- Square Feet Proposed Use of Property XZ 1( Value of Work 42 0 0 • 00 Tenant Information PERMIT TYPE (✓ ) Building Electrical Mechanical Plumbing LPGX Roofing Fence Other Address Apt. Chg. Contractor Renewal Revision Extension Supplement Reinspection PERMIT CHANGE (✓ ) ARCHITECT Name License No. Address Telephone Fax Description of Work l City PERMIT APPLICATION Master Permit No. -5 0 / 3 , Subsidiary Permit No. Flood Zone State Zip Pza-e-e- Units Floors Bldg Value Tax Assessed/Appraised Value Base Floor Elev. CONTRACTO License No. Address Telephone Qualifier Name PAY TO THE ORDER OF FOR lt�) LLOYD NORTH DADE SEPTIC 750 NW 107TH ST. MIAMI, R. 33168 V,_g_ c-21 ( 044S Washington Mutual Washington Mutual Bank, FA North Miami/7th Avenue Financial Center 1746 12600 NW. 7 Avenue 1.800- 788 -7000 North Miami_ Ft iA168 44 hmu Custmier Senna ,,, r+c gas, „c ,,,Msb3 +3��Z u'00 2 L04u' 1:26 7084 L 3 LI: L9 3111 200 9 2 3111 E0' DATE -d/ DOLLARS 210. 63- 8413/267 6 ELECTRICAL TI'1'E Minimum Fee QTY. 'TYPE Dryer QTY. TYPE. Outlet, Appliance QTY. TYPE Service Repair QTY. A/C Central 1 -3 Ton A/C Central, Tons 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 1 Posts Gas - Propane Swim Pool, Commercial Pump, Re- circulate Air Conditioners Temporary Water Closet Garbage Disposal Range/Range Top Swim Pool, Residential Pump, Replace - Pool Generators, etc. Receptacles Dental Chair Switchboards Grease Trap _Chiller Clear Violations Pump, Sprinkler Pump, Sump Heat Recovery Refrigerator, Comm. (p/PH) Temp Serv., Construction Compactor Dishwasher Low -volt, Burglar Refrigerator, Domestic Temp for Test - 30 days Deep Freezer Low -volt, Fire Renew - Temp Service Interceptor hoof Inlet Demolition Low -volt, Intercom/Teleph. f Repair Circuits Water Heater Dishwasher Low -volt, Television f Service, Number of Amps Water Heater New Water Re -pipe Water Service MECHANICAL TY Minimum Fee QTY. TYPE Condensate Drain QTY. TYPE Generator QTY. TYI'I': Refrigeration, Tons QTY. A/C Central, Tons Cooling Tower Heating Strips, each Vent Hood, Cost A/C Wallin. Tons Dryer Vents, Number of Paint Booth Ventilation, Cost Air Handler, Tons Ductwork, Cost of Piping, Flammable Liquid Periodic Inspections Barbecue Fire Sprinkler System Process/Pressure Piping Supply, AC Well Bath Fan - Vented, # Fireplaces, Number of Pressure Vessel Temporary Toilet PLUMBING TYPE: A/C Condensate QTY TYPE Drains, Roof QTY 'TY Miscellaneous Fixture Q TYPE Soakage Pit TI Bath Tub Drinking Fountain :Miscellaneous Repairs Solar Water Heater Bidet Filter Replace Pool Piping Sprinkler Repair Cap - Fixture Fountain :'ump and Abandon Sprinkler System Cap - Water Gas - Appliance :'ump, 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 Pump, Sump Utility - Sewer Utility - Water Discharge Well Ice Maker Dishwasher Indirect Wastes 1lelay Repair Vacuum Pump Water Closet Disposal Interceptor hoof Inlet Domestic Well Laundry Tray Septic Connection Water Heater Drainfield, 4" Tile/Res. Lavatory Meter Set (Gas) Septic Tank Sewer Connection Water Heater New Water Re -pipe Water Service Drains, Area Drains, Floor Minimum Fee Shower Drains, French Miscellaneous Equipment S nk 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: Page 4 OFFICE USE ONLY CHECKLIST ❑ OWNER - BUILDER FORM (Attach) ❑ FIRE DEPARTMENT APPROVAL (Commercial / multi- family) ❑ CONCURRENCY (New Construction) ❑ OTHER (Specify & Attach) $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 ❑ PROOF OF OWNERSHIP (Attach) ❑ HRS / DERM APPROVAL (Septic / Sewer) ❑ IMPACT FEE (New Construction) ❑ OTHER (Specify & Attach) ‘ o (sq.ft. = x/1000 x0.60) $ (¢.005 / sq.ft.) $ (¢.01 /sq.ft.) �1 vV REVIEWED AND PREPARED BY: SECTION Zoning Electrical Mechanical Plumbing Fire Public Works Structural Building Official BY DATE PERMIT APPLICATION ❑ CONDO ASSOCIATION APPROVAL (Attach) ❑ BPR APPROVAL (Restaurants) ❑ CONTRACTOR REGISTRATION (On File) PERMIT FEES TOTAL $ 3,14 4 ISSUING OFFICIAL DATE: CONDITION OF APPROVAL Revised July 2001 10050 N.E. 2ND AVE., MIAMI SHORES, FL • (305) 795 -2207 • FAX (305) 756 -8972 • http : / /www.miamishoresvillage.com