860 NE 92 St (7)PERMIT APPLICATION FOR MIAMI[ SHORES VILLAGE
D a t e ' � g o o ? S Tax Folio -- 39 O 0Q / O
Legal DescriptiorL L.› 4r1a= fob( w 5 4 9 Historically Designated: Yes No
Owner/Lessee / Tenant WI /a / ( E
Owner's Address q ,00 9�_ per
Alit 14 4,f; //4d Address 7 (a �e /9d ‘V - 3 k/ ,
! ce_e SS# Phone 9 c/o - 777
�
mob
Contracting Co.
Qualifier
State #
Architect/Engineer
Bonding Company
Mortgagor Address
Permit Type (circle one): BUILDING ELECTRICAL PLUMBIN MECHAN ROOFING PAV t G FENCE SIGN
WORK D cRiPTION
i
Notary as to Owner and/ ?r C9nd Prestdelrf bat
My Commission Expires w
FEES: PERMIT
Address
RADON
Municipal #
Square Ft. Estimated Cost (value) r )" y
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 do the work stated.
Signatur c yowrier and/or Cot 10 President Date
s
APPROVED:
Zoning
Mechanical Plumbing
Building
Master Permit #
Phone __„____7 7
Competency # l , ',� o`C: tom/ vt.� /6Iis. Co.
Address
Address
Signa .` of pop` a%tor or Owner- Builder
Notary as to Contractor or
My Commission Expires:
C.C.F. / fC) NOTARY
Electrical
TOTAL DUE 7 V (r
Engineering
!� SERVICE REPAIR/IETER CHANGE
APPLIANCE OUTLETS
RANEE TOP
OVEN
HATER DATER
M4TCRS 0- 1 HP
MOTORS OVER 1- 3 HP
REFRIGERATION
_ PROCESS AND PRESS PIPING
UNOERGRW O TANKS
ABOVE GROUND TANKS
U.P. PRESS RE VESSELS
STEAM BOILERS
NUT WATER BOILERS
kOTORS OVER 8- 10 FP
MJTCRS OVER 10- 25 FP
MOTORS OVER 25-100 FP
MOTCRS OVER 100 FP
A/C NIN00N
AIR CONDITIONERs
STRIP HEATER
GENERATORS TRAGSFORSERS
GENERATORS TRANSFClis
GENERATORS TRANSFOR,,ERS
SPECIAL PURPOSE
OUTLETS CON ERCIAL
SIGN TISES
SIGN TRAWWFURME RS
SIGN T III CLOCK
FIXTURES
ANTENNA
TELEVISION OUTLETS
VIOLATION
RE RESPECT IoN
MECHANICAL VENTILATION
TRANtSPCART I NG ASSEMBLIES
ELEVATORS/ESCALATORS
F IRE SPRINKLER SYSTEMS
COOLING TONERS
VIOLATION
RE I RESPECT I ON
LAUCtY TRAY
CLOTIfS US1EA
POT /3 COW.
SINK, RESIDENCE
SINK, SLOP
TEMPORARY WATER CLOSET
u I NAL
INDIRECT WASTES
LAM SPRINKLER -WELL
SWIMMING Po0.
METER SET (GAS
GAS PIPING
ITEM
SNITCH OUTLETS
LIGHT OUTLETS
RECEPTACLES
SERVICE TEWcWRY
SERVICE SIZE IN AMPS
FEE ITEM
SPACE HEATERS
- It L KAYOS.
A/C (NM)
ItlIT FEE
ITEM
BATH 1U3
13 WET
El ISMUISI#R
DISPOSAL
DRINKING FOUNTAIN
FLOOR GRAIN
GREASE TRAP
INTERCEPTOR
LAVATORY
SMOWER
S INK
WATER CLOSET
WATER SLPPLY TO:
WATER SERVICE
SEWER CdFWCTIONS
UT IL ITT -SE1ER
UTILITY -MATER
SEPTIC TANK
RELAY
D
ADDENDUM TO BUILDING PERMIT.APPLICATION
(AN APPLICATION FOR BUILDING PERMIT MUST ACCOMFANT THIS ADDENDUM. IF A MASTER PERMIT HAS BEEN
OBTAINED, THE OWNER'S NOTARIZED SIGNATVRE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.)
MECHANI
ELECTRICAL
al
C RA Uf IELD, 4' T ILE/RES.
PUN' E ABAIOON SEPTIC TAM(
SCAKAGE PIT W. FT.
CATCH BASIN
DISCHARGE
DOMESTIC
AREA DRAIN
ROOF KEY
SOLAR PATER IfATER
FIRE STANDPIPE
POOL PIPIFC •
PLUMBING
LAM SPRINKLER SYSTEM
GAS RANGE
03/0
15:24 MSV
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004