725 NE 93 St (13)e7 �
Permit No
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building of other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Fiu :Ida,
and all provisions of the Lawa 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.
Owner's Name and Address.�.L.A4 „
Registered Architect and /or En g neer
Employing Electrician's NameS . f..eze- 4 16....i., . - �G�°I C ..4..c. No._0 J Street,5'. 9b /` Ti' - .
Location and Legal Description Lot .- '3 v 3 a Block.... 9 Subdivision../U ..6 .. ,(.hotreY...I 3
nn ,, _ p �
Street and Number where work is to be performed— No.. .7 J Street.... /.�i!. .. / ` • 6 3 Y/ 1
t
State work to be performed and purpose of building (By Ploors)Q.�f1./ 1e�'..�0a /,94'19' - hl. G /14 i ar "4.S
Repairs No. of Stories d
New Building
4
Service ergro Site Feeders /0 Conduit.. . Main Sw //45 C9.4
Amount of Permit $
APPLICATION FOR ELECTRICAL PERMIT
Type of Installatio — Conduit 1 Tubing....1 ...........B.X.L
0 ' 4/ as .d "4.. .� /
licensed by Miami Shores Village.
Remodeling Addition.
es.
My Commission Expires
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
No ... 24" Street (/ g3
A mps /J f/4
Metal Mou
Date
1 >—
f — Js2 r..7cA'LJ
Main Fuses.. Z Amps
(Signed)
Electric
.,�� y,;�:,: `.;� - .;�. : :.-- �� �•.
In pector.
(Signed)
The undersigned applicant for this building permit does hereby certify that he understands and accepts his o)1 gations 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 work such public notice or notices
as are required by the Act. The undersigned agrees to employ only such subcontractors, I work to be performed under this permit, as are
Notary Public, State of Florida
Master Electrician.
STATE OF FLORIDA,
COUNTY OF DADE. j
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, and he has carefully read the foregoing 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.
SWITCH
OUTLETS
LIGHT
OUTLETS
PLUG
RECE'P'T'8
FIXTURES
NO. LAMPS
REFRIO.
OUTLET
IRON
OUTLET
RANGE
OUTLET
RANGE
CONN.
WATER
HEATER
W. HEAT.
CONN.
SPACE
H
STRIP
HEATER
TOTAL
CONTR.
LIeT
/
`
2
6
z
71 �
�---
1
—
—
_
._.
_
.--
_
CHECK
ENT.
SW.
DIST.
CAB.
SERVICE
TEMP.
SERVICE
PERM.
MOTORS
0.1 HP
MOTORS
1.8 HP
N EON
TRANS.
RADIO
TOTAL
CONTR.
LIST
—
--
.�
O/•�
_ & —I--
d. .?
CHECK
� ° }
d
e7 �
Permit No
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building of other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Fiu :Ida,
and all provisions of the Lawa 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.
Owner's Name and Address.�.L.A4 „
Registered Architect and /or En g neer
Employing Electrician's NameS . f..eze- 4 16....i., . - �G�°I C ..4..c. No._0 J Street,5'. 9b /` Ti' - .
Location and Legal Description Lot .- '3 v 3 a Block.... 9 Subdivision../U ..6 .. ,(.hotreY...I 3
nn ,, _ p �
Street and Number where work is to be performed— No.. .7 J Street.... /.�i!. .. / ` • 6 3 Y/ 1
t
State work to be performed and purpose of building (By Ploors)Q.�f1./ 1e�'..�0a /,94'19' - hl. G /14 i ar "4.S
Repairs No. of Stories d
New Building
4
Service ergro Site Feeders /0 Conduit.. . Main Sw //45 C9.4
Amount of Permit $
APPLICATION FOR ELECTRICAL PERMIT
Type of Installatio — Conduit 1 Tubing....1 ...........B.X.L
0 ' 4/ as .d "4.. .� /
licensed by Miami Shores Village.
Remodeling Addition.
es.
My Commission Expires
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
No ... 24" Street (/ g3
A mps /J f/4
Metal Mou
Date
1 >—
f — Js2 r..7cA'LJ
Main Fuses.. Z Amps
(Signed)
Electric
.,�� y,;�:,: `.;� - .;�. : :.-- �� �•.
In pector.
(Signed)
The undersigned applicant for this building permit does hereby certify that he understands and accepts his o)1 gations 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 work such public notice or notices
as are required by the Act. The undersigned agrees to employ only such subcontractors, I work to be performed under this permit, as are
Notary Public, State of Florida
Master Electrician.
STATE OF FLORIDA,
COUNTY OF DADE. j
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, and he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty
materials and /or workmanship.
Permit No
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building oc other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Fiv:lda,
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at
b;:: ildi during progress of work
Name and Address .. r�,/ l . 7/74: /
Registered Architect and /or Engineer
Employing Electrician's Name 546.1"„1. /.C. / - /G ) ht C..No.Q..3 /$ 5 ' V 944 ..... -/ •
Location and Legal Description Lot Block - Subdivision
Street and Number where work is to be performed— No ..... 2 Street
State work to be performed and purpose of building (By Floors) / h C r ,S'e/.'1/.1. (-,e
New Building Remodeling Addition
Overhead 3 71.4-z;
se.",,_ Under round Size Feeders ,..�G.J
Amount of Permit $
appeared
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
Date
Main Sw 200
No 72 >S Street.. , �' 9 3 '5 <
L- Repairs No. of Stories
A 210
"1 g
�p Type of Installation— Conduit Tubing B.X.L Metal Moulding
(Signed)
•
The undersigned applicant for this building permit dots hereby eel tify that he understands and accepts his obi
labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida
has complied with the provisions thereof, and will require similar compliance from all contractors or subcontract
work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work s
as are required by the Act. The undersigned agrees to employ only such subcontractors, on work to be performed
licensed by Miami Shores Village.
(Signed)
Main Fuses ..... — Amps
Iectric4I Inspector.
tions as an employer of
anent Supplement, and
employed by him in the
uch public notice or notices
under this permit, as are
aster Electrician.
STATE OF FLORIDA,
COUNTY OF DADE. j
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments,
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, and he has carefully read the foregoing application, and that he did sign the same, and
therein by him stated are true.
personally
that all facts
My Commission Expires Notary Public, State of Florida
NOTE: A re-inspection fee of $1.00 will be made when such re-inspection is made necessary by improper notice for inspection, or faulty
materials and /or workmanship.
SWITCH
OUTLETS
LIGHT
OUTLETS
PLUG
RECE'►'T'S
FIXTURES
NO. LAMPS
REFRIO.
OUTLET
IRON
OUTLET
RANGE
OUTLET
RANGE
CONN.
WATER
HEATER
W. HEAT.
CONN.
SPACE
HEATER
STRIP
HEATER
TOTAL
CONTR.
LIST
CHECK
ENT.
SW.
DIST.
CAD.
SERVICE
TEMP.
SERVICE
PERM.
MOTORS MOTORS
0.1 HP 1•5 HP
NEON
TRANS.
RADIO
TOTAL
CONTR.
LIST
4 ((77 ��
1 -9� /'1 /G� 4 _
�� OD ! gyp
CHECK
Permit No
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building oc other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Fiv:lda,
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at
b;:: ildi during progress of work
Name and Address .. r�,/ l . 7/74: /
Registered Architect and /or Engineer
Employing Electrician's Name 546.1"„1. /.C. / - /G ) ht C..No.Q..3 /$ 5 ' V 944 ..... -/ •
Location and Legal Description Lot Block - Subdivision
Street and Number where work is to be performed— No ..... 2 Street
State work to be performed and purpose of building (By Floors) / h C r ,S'e/.'1/.1. (-,e
New Building Remodeling Addition
Overhead 3 71.4-z;
se.",,_ Under round Size Feeders ,..�G.J
Amount of Permit $
appeared
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
Date
Main Sw 200
No 72 >S Street.. , �' 9 3 '5 <
L- Repairs No. of Stories
A 210
"1 g
�p Type of Installation— Conduit Tubing B.X.L Metal Moulding
(Signed)
•
The undersigned applicant for this building permit dots hereby eel tify that he understands and accepts his obi
labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida
has complied with the provisions thereof, and will require similar compliance from all contractors or subcontract
work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work s
as are required by the Act. The undersigned agrees to employ only such subcontractors, on work to be performed
licensed by Miami Shores Village.
(Signed)
Main Fuses ..... — Amps
Iectric4I Inspector.
tions as an employer of
anent Supplement, and
employed by him in the
uch public notice or notices
under this permit, as are
aster Electrician.
STATE OF FLORIDA,
COUNTY OF DADE. j
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments,
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, and he has carefully read the foregoing application, and that he did sign the same, and
therein by him stated are true.
personally
that all facts
My Commission Expires Notary Public, State of Florida
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.
Permit No
ci
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted 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 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.
Owner's Name and Address
STATE OF FLORIDA,
COUNTY OF DADE. I
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
Date 1
SS.
sin . rrt
Registered Architect and /or En ineer
Employing Electrician's Name Gy � �' No ' 1 o a'
Location and Legal Description Lot Block Subdivision
Street and Number where work is to be performed —No Street
State work to be performed and purpose of building (By Floors)
New Building Remodeling Addition Repairs No. of Stories
J =
Service Overhead Size Feeders Conduit Main Sw Amps Main Fuses, Amps
Underground
Type of Installation — Conduit Tubing B.X.L Metal Moulding
Amount of Permit $ `t (Signed)
No... .A. xs" �� Street P 3 -f Y
The undersigned applicant for this building permit does hereby certify that he understands and a
labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws
has complied with the provisions thereof, and will require similar compliance from all contractors or
work to be performed under this permit; and will post or cause to be posted for inspection on the site
as are required by the Act. The undersigned agrees to employ only such sub - contractors, on work to
licensed by Miami Shores Village.
treet
7
Eleal Inspector.
ccepts his obligati,. s / as an employer of
of Florida Permanent Supplement, and
sub - contractors Lemployed by him in the
of the work such public notice or notices
be performed under this permit, as are
Master Electrician.
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, and 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
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.
SWITCH
OUTLETS
LIGHT
OUTLETS
PLUG
RECE'P'T'S
FIXTURES
NO. LAMPS
REFRIO.
OUTLET
IRON
OUTLET
RANGE
OUTLET
RANGE
CONN.
WATER
HEATER
W. HEAT.
CONN.
SPACE
HEATER
STRIP
HEATER
TOTAL
CONTR.
LIST
CHECK
ENT.
SW.
DIST.
CAB.
SERVICE
TCMP.
SERVICE
PERM. �TT
73-0—
LT
G�y_�'�/
/5 $
MOTORS
0.1 HP
MOTORS
1.5 HP
NEON
TRANS.
RADIO
TOTAL
CL
LIuST sr
' //TO`" 1
/7'
'
`/
F1 �-
CHECK
Permit No
ci
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted 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 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.
Owner's Name and Address
STATE OF FLORIDA,
COUNTY OF DADE. I
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
Date 1
SS.
sin . rrt
Registered Architect and /or En ineer
Employing Electrician's Name Gy � �' No ' 1 o a'
Location and Legal Description Lot Block Subdivision
Street and Number where work is to be performed —No Street
State work to be performed and purpose of building (By Floors)
New Building Remodeling Addition Repairs No. of Stories
J =
Service Overhead Size Feeders Conduit Main Sw Amps Main Fuses, Amps
Underground
Type of Installation — Conduit Tubing B.X.L Metal Moulding
Amount of Permit $ `t (Signed)
No... .A. xs" �� Street P 3 -f Y
The undersigned applicant for this building permit does hereby certify that he understands and a
labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws
has complied with the provisions thereof, and will require similar compliance from all contractors or
work to be performed under this permit; and will post or cause to be posted for inspection on the site
as are required by the Act. The undersigned agrees to employ only such sub - contractors, on work to
licensed by Miami Shores Village.
treet
7
Eleal Inspector.
ccepts his obligati,. s / as an employer of
of Florida Permanent Supplement, and
sub - contractors Lemployed by him in the
of the work such public notice or notices
be performed under this permit, as are
Master Electrician.
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, and 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
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.
APPLICATION FOR ELECTRICAL PERMIT
Permit No ®s
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted 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 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. /
Owner's Name and Address (.�./ /9iQlr 1 S i4j. . No 7 .,j`� Street... 7.1/47
Registered Architect and /or Engineer , /L
Employing Electrician's Name (9 617 , 1 W No Street
Location and Legal Description Lot Block Subdivision _
Street and Number where work is to be performed —No !. Street /V6 4 73 `r,'
State work to be performed and purpose of building (By Floors) f'i1.. ...........Q X ..1.:
New Building Remodeling , Addition Repairs No. of Stories
Service Overhead Size Feeders Conduit Main Sw
Underground
Type of Installation— Conduit Tubing B.X.L
Amount of Permit $
58.
My Commission Expires
MIAMI SHORES VILLAGE
ELECTR ICAL INSPECTION DEPARTMENT
Amps Main Fuses Amps
Metal Moulding
(Signed) W
The undersigned applicant for this building permit does hereby certify that he understands and ac
labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws
has complied with the provisions thereof, and will require similar compliance from all contractor
work to be performed under this permit; and will post or cause to be posted for inspection
as are required by the Act. The undersigned agrees to employ only such subcontractors
licensed by Miami Shores Village.
Date
Electrice •Spector.
his obligations as an employer of
Florida Permanent Supplement, and
r sub-contractors employed by him in the
of the work such public notice or notices
formed under this perm
STATE OP FLORIDA, 1
COUNTY OF DADE. j
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and ta.�cknowledgments, 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, and he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
Notary Public, State of Florida
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.
SWITCH
OUTLETS
LIGHT
OUTLETS
PLUG
RECE•P'T'S
FIXTURES
NO. LAMPS
REFRIO.
OUTLET
IRON
OUTLET
RANGE
OUTLET
RANGE
CONN.
WATER
HEATER
W. H EAT.
CONN.
ACE
H ATER
STRIP
HEATER
TOTAL
CONTR.
LIST
1
`
`
J
t
'7
CHECK
1
ENT.
SW.
DIST.
CAB.
SERVICE
TEMP.
SERVICE
PERM.
�9 h�
15,.....
MOTORS
0.1 HP
MOTORS
1.5 HP
N EON
TRANS.
RADIO
TOTAL
CONTR.
LIST
L
11
Q VG'
CHECK
a.. .,.-
3O'
•
APPLICATION FOR ELECTRICAL PERMIT
Permit No ®s
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted 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 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. /
Owner's Name and Address (.�./ /9iQlr 1 S i4j. . No 7 .,j`� Street... 7.1/47
Registered Architect and /or Engineer , /L
Employing Electrician's Name (9 617 , 1 W No Street
Location and Legal Description Lot Block Subdivision _
Street and Number where work is to be performed —No !. Street /V6 4 73 `r,'
State work to be performed and purpose of building (By Floors) f'i1.. ...........Q X ..1.:
New Building Remodeling , Addition Repairs No. of Stories
Service Overhead Size Feeders Conduit Main Sw
Underground
Type of Installation— Conduit Tubing B.X.L
Amount of Permit $
58.
My Commission Expires
MIAMI SHORES VILLAGE
ELECTR ICAL INSPECTION DEPARTMENT
Amps Main Fuses Amps
Metal Moulding
(Signed) W
The undersigned applicant for this building permit does hereby certify that he understands and ac
labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws
has complied with the provisions thereof, and will require similar compliance from all contractor
work to be performed under this permit; and will post or cause to be posted for inspection
as are required by the Act. The undersigned agrees to employ only such subcontractors
licensed by Miami Shores Village.
Date
Electrice •Spector.
his obligations as an employer of
Florida Permanent Supplement, and
r sub-contractors employed by him in the
of the work such public notice or notices
formed under this perm
STATE OP FLORIDA, 1
COUNTY OF DADE. j
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and ta.�cknowledgments, 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, and he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
Notary Public, State of Florida
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.
1
Legal Description Historically Designated: Yes No
Owner/Lessee / Tenant 6 da /y r) Ai3 ro W r7 Master Permit #(4,A o a.0 .4' 1 1 25.)
Owner's Address 7a a /t/,E 73 5f' /y /4 fir .5 ho re s. Phone
C o n t r a c t i n g Co. A /74 � • ' G . A d d r e s s //780 5 Gt) /85t .-ea/ M/aer/ -X /75
Qualifier / ' 7 / ' 7 / SS # Phone ✓r'✓r 4- 48 ,ar)
State # A R. co /. /.a 8 Municipal # Competency # 97A %78 Ins. Co.
Architect/Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type (circle one): BUILDING LECTRICAJ PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION
Square Ft. 48
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Job Address 701.5/(.f/4 .517 Tax Folio
,
C////, -r7fro ry /error •
Signature of owner and/or Condo President Date
Notary as to Owner and/or Condo President Date
My Commission Expires:
FEES: PERMIT 3 RADON C.C.F.
Estimated Cost (value) ,F,A. °°
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.
f Contractor
Signatur
Notary as to Contractor or Owner - Builder
My Commission Expires:
Luis Fernandez
Notary Public, State of Florida
. °; ? Commission No. CC 599619
e. OF Fe My Commission Exp. 11/07/2000
t- 800.3- NOTARY - Fla. Notary S:Nio & Bonding Co.
NOTARY
BOND
Owner - Builder Date
TOTAL DUE
0 97
a te
APPROVED:
Zoning Building Electrical / r ✓ rJ""
Mechanical Plumbing Engineering
ITEM
BATH TUB
UNIT
FEE
ITEM
SWITCH OUTLETS
I 'i•
' FEE
ITEM
SPACE HEATERS
UNIT
FEE
BIDET
LIGHT OUTLETS
/
CENTRAL HEATING
DISHWASHER
RECEPTACLES
/
A/C (WIND)
DISPOSAL
SERVICE TEMPORARY
A/C (CENTRAL)
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
MOTCRS OVER 1- 3 HP
HOT WATER BOILERS
SINK, POT /3 COMP.
MOTORS OVER 3- 5 If
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
SWIMMING POOL
OUTLETS COMMERCIAL
WATER SERVICE
SIGN TUBES
SEWER CONNECTIONS
SIGN TRANSFORMERS
UTILITY -SEWER j
SIGN TIME CLOCK
UTILITY -WATER
FIXTLRES
SEPTIC TANK
ANTENNA
RELAY
TELEVISION OUTLETS
ORAINFIELO, 4' TILE/RES.
VIOLATION
PUMP & ABANDON SEPTIC TANK
REINSPECTION
.
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
r
ADDENDUM TO BUILDING PERMIT APPLICATION
(AN APPLICATION 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