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705 NE 92 St (4)/ PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date& 2( Q Job Address ✓ �BJ /U� 2 f Tax Folio f(•' ;2 06 d /y"' (r6 Legal Description / ac 3 98 (0-37 Historically Designated: Yes j No > / Tenant (' ' 6 ODdt/A /ch ?' L� / Master Permit # 6 X► Owner's Address 7 D ,\' /t' g � L 57 'Phone �� J 3^ ? 7 d V My Commission Ex APPROVED: Zoning Mechanical 4 As fre 1 " / CP • � Address 207- s'(/► U 7 7T V M'+ 3! (£( Contracting Co. ,+� Qualifier / 4 c G 2 kC 4t - �Phoneel�) "`` � D 3u) 2 State # / - 4/) /• .: as t Owner : 174+?Nfr}f- Architect/Engineer Bonding Company Mortgagor Address Permit Type (circle one): BUILDING ELECTRICAL PLUMBIN s MECHANIC ROOFING PAVING FENCE SIGN WORK DESCRIPTION sr 3 Ac (,)oft- G v•v"( *c. 1 - Square Ft. Estimated Cost (value) 9 ') 0 0 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. d/or Condo President ate� s st a ate ermore, I authorize the above -named contractor to do the work stated. �w PU B � AM1GE c' r 'M OF F■O 5_ Municipal # Competency # Address Address Building &it G�. ature of Contractor or Owner- Builder Notary as to Contractor or My Commission Expires: - Builder FEES: PERMIT G RADON C.C.F .. Z �U NOTARY 5 O 0 BOND Electrical T ;IL/AL N r, Y A JVii -LAR 'VARY I 1 1• ,> ,r,� 1 JUE c �^ ri' CCNf'+ 4^ i._l'Y 7.1114 .1 '11.A..P. l ? 2 tZ, d I Plumbing Structural Engineer ITEM BATH TUB UNIT FEE ITEM SWITCH OUTLETS UNIT FEE UNIT FEE ITEM SPACE HEATERS 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 FP STEAM BOILERS SHOWER MOTORS OVER 1- 3 FP HOT WATER BOILERS SINK, POT /3 COMP. MOTORS OVER 3- 5 HP MECHANICAL VENTILATION SINK, RESIDENCE MOTORS OVER 5- 8 FP TRANSPORTING ASSEMBLIES SINK, SLOP MOTCRS OVER 8- 10 FP 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 FP VIOLATION INDIRECT WASTES A/C WINDOW REINSPECTION WATER SUPPLY TO: AIR CONDITIONERS A/C UNIT STRIP HEATER FIRE SPRINKLER GENERATORS TRANSFORMERS g 7 HEATER -NEW INST. GENERATORS TRANSFORMERS .F6-. D 6 � (� ` HEATER - REPLACE GENERATORS TRANSFORMERS LAWN SPRINKLER -WELL SPECIAL PURPOSE 9 A-6 I ' b SWIM1ING POOL OUTLETS COMMERCIAL �/" WATER SERVICE SIGN TUBES - SEWER CONNECTIONS SIGN TRANSFORMERS l t �� / UTILITY -SEWER SIGN TIME CLOCK UTILITY -WATER FIXTURES `J( SEPTIC TANK ANTENNA E NA / ,C�,(" RELAY TELEVISION OUTLETS DRAINFIELD, 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 Do4/4-4.(0A/ 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 ELECTRICAL MECHANIC Applicat on is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build- ing o. other stru ture he ein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Vrltag', F onda, and all previsions of the Laws of the State of Florida, all ord'nances of Miami Shores Village and Al rules and regulations of the Building Division of Miam Shores Village sh 11 be con plied with whether her in specified cr not. A cop of approv d plans and specifications must be kept at budding during progress of the work. Owner s Name and Address Registered Architect and ' or Engineer __ C_4(./,' .. A ,J11 ii 2k Name and address of licensed contractor _ _ __ ^ '% ' ' _' ' —a_ ! _ _V o n Location -nd legal description of I t to be built on: � . /�� _' 6v � '. '% c ' < �' c" e Lot ___4.1. 7 6' B " - lock �O Subdiv� ion_ / y Street and Number where work is to be done_ rh =- � s J_ .. _ _ .- k- State work to be done and purpose of building (by floors)____ _- _ .. .. .1 . __ ___ _ . _1 2a____k__ i (S �= - / Q'270 4/ _'' t' t ' fiJ_` L i' , and for no other purpose. New Building _ __ ___ Remodeling _ ___ _ .. _ Additim. _ . _ Repairs.__ __ _ _ _ _ No. of Stories .. _ .. To be constructed of _ Per it No. _. _ Disapp co ed ( Signed) APPLICATION FOR BUILDING PERMIT ' Buildi:;g Inspector MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT Kind of foundation Date tom ', Date_ _ __ __ _ __ __ _ _ Roo` Covering Estimated Total cost of improvements $ ___ _Amo r-S: c - Permit $ _ . _ _ Zone cubage required_ _ _ __._ _ _ .._. - __ _ _Plan Cubage _ _ __ _ _ Distance to next nearest building_ _ __ . _ __ _ _ _Size of Building Lot____ _ Maximum live load to be me by each floor I hereby submit all the plans ,, .d specifications 'o sa'd :gilding. All polices with re::erence to the building and its conrtr ction may be sent to - -- -- -� -- Y • / , < f. ; 0 � 9 G %)) -- > ^ ! 4 ) ( 3 . . The undersigned 1.pp:'cant for this building permit does hereby certify that h - understands and acct pts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Supph..nent, and has complied with the p.• -v'sions thereof, and will require similar compliance from all contractors or sub - contractors cmplo) cd b him m the work to be perform• d u der this rermit; and will post or cause to be po -ied for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agree. to ploy oily such sub cpi tracto:cs, on work 'o be pe formed under th's permit, -r are licensed by Miai. S'.'o e, Village. Remarks (Sign ) � .>=0. r .. _ STATE 05' FLORIDA, COUNTY OF DADE. ss ' Before me, he undersigned authority, a notary pubk. duly uthorized to administer oaths and take acknowledgments, personally ap- peared __ and who, being by m: fist duly swo r upon oath _:poses and says that he is the _ _ _ of he above described const.0 tion than ie has carefully read the or -going - - cation, and that he did sign the same, and that all facts therein b him sated are true . Date. - ' _ � � ' - _ Read, Sworn to and Subscribed before me. Notary Pubhc, S : to of Florida My Commiss'on Expires I t , 17 r � 196,s No. /__4'._ Street__ __ to me well known, PLANNIN9� BOARD _ DATE Chairman _ . - Member _ _ - Member __ Member Member _ _ .. M ber _ _ Co..' Al Approved Da.e D sapp: oved .. Date NOTE: A charge of $1 00 will be made for making corrections or changes to this appl cation after appr.val has been obtained from the Planning Board A r -i, _pe ' c fec of $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and /or workmanship.