1250 NE 94 St (5)PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date jp 9— i I —o / Job Address l Z J v rt/' c 5 ti 57-
Tax Folio
Legal Description Historically Designated: Yes No
Owner/Lessee / Tenant Gam- C r to R „p�jl a / C q Master Permit #
Owner's Address l L � O" 6 Q <-v
Contracting Co. ( -4.5 S 6" ' — ( Ar ' Address ?go 6 Al . , ' e , `��• 5/ /a-
)E' / /- /c4 6).9.4.0) e . -S
Qualifier k ,4 Si / a— c_ ®4.1 • SS# h o n e 55-8 1/4 P+ 4' Lt
State # C fJ C e' 49-C '7 / Municipal # Competency # Ins. Co.
Architect/Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type (circle one): BUILDING ELECTRICAL PLUMBINGCHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION , 2.� p.Qar ` to t✓c T ce' /L C
Square Ft Estimated Cost (value)
Date
FEES: PERMIT - 2 2 '1 O RADON
(Z.I/ iD ,e1442 4/97YS)
9// //0
do President Date
Phone
Z—s,
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.
Signature of Contractor or Owner- Builder
®p- / / —e/
Date
My Commission Expires:
C.C.F. NOTARY BOND
TOTAL DUE
APPROVED:
Zoning / Building Electrical
Mechanical (Cpl ‘, ( (q r. '3. 6/ Plumbing Engineering
ti
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date 0 k 21 Job Address 1 230 N6 94e ST, Mt /j Tax Folio
Legal Description Historically Designated: Yes No
Owner/Lessee / Tenant a&ui)I10 S ' p.to D -G Z Master Permit #
Owner's A d d r e s s l - S ° 4 . ) . 6 - 7 , - / .57
Contracting Co. rig -JS 44/ i — ca2t., • Address 18D 6 A) r✓ o 4 5 ' %` i2- —
1.1i',a't4 ("4.4.d e-^ 9 f e:1
Qualifier A rt A fr1 ohot 0S4: SS# Phone °3-- S `f`I `E'`f
State # C 4- c n LF S' 7 / Municipal # Competency # Ins. Co.
Architect/Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING CH
ME ANIC ) ROOFING PAVING FENCE SIGN
WORK DESCRIPTION / ®-- -9- vN vow —
.() p 7 � f proc. cve)— ,
1
Square Ft. Estimated Cost (value) 3 y. o • `° a
WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY RESULT IIN 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 regul
construction nnd zoning. Furthermore, I authorize the above -named contractor to do the work stated.
Z - 21 -0!
o f owner an or Condo Signature Presiden t
%r % l,_'
tary : to d/or Condo President
My Commission Expires:
FEES: PERMIT
APPROVED:
Date
UO
RADON
M/,CM, 5)m�{ I= X931
C.C.F.
■
Phone
Signs Contractor or Owner - Builder
tor or Owner- Builder
xpires:
NOTARY ^"0 — BOND
1 /q 1 7Ns'
3 0 - 7 - 7
^-� 1O
TOTAL DUE / � .�
084/46
Date
06 / /2_'0
Zoning Building Electrical
Mechanical e,4) D ' L - I Plumbing Structural Engineer
ITEM
BATH TUB
UNIT
FEE
ITEM
SWITCH OUTLETS
UNIT
FEE
ITEM
SPACE HEATERS
UNIT
FEE
BIOET
LIGHT OUTLETS
CENTRAL HEATING 7. Y P
DISHWASHER
RECEPTACLES
A/C (WIND)
DISPOSAL
SERVICE TEMPORARY
A/C (CENTRAL) ✓ gr
DRINKING FOUNTAIN
SERVICE SIZE I N AMPS
DUCT WORK Q¢ p.Q�y -- y 1 1 i3 v4
T w
04:
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
MOTORS OVER 1- 3 FP
HOT WATER BOILERS
SINK, POT /3 COMP.
MOTCRS OVER 3- 5 FP
_
MECHANICAL VENTILATION
SINK, RESIDENCE
MOTORS OVER 5- 8 FP
TRANSPORTING ASSEMBLIES
SINK, SLOP
MOTCRS OVER 8- 10 FP
ELEVATORS/ESCALATORS
TE)Q0RARY WATER CLOSET
MOTCRS OVER 10- 25 FP
FIRE SPRINKLER SYSTEMS
URINAL
MOTORS OVER 25-100 FP
C00LING 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
'HEATER -NEW INST.
GENERATORS TRANSFORMERS
HEATER - REPLACE
GENERATORS TRANSFORMERS
LAWN SPRINKLER -WELL
SPECIAL PURPOSE
SWIM,IING POOL
OUTLETS COMAERCIAL
WATER SERVICE
SIGN TUBES
SEWER CONNECTIONS
SIGN TRANSFORMERS
UTILITY -SEWER
SIGN TIME CLOCK
UTILITY -WATER
FIXTURES
SEPTIC TANK
ANTENNA
RELAY
-
TELEVISION OUTLETS
]RAINFIELO, 4' TILE/RES.
VIOLATION
'UMP & ABANDON SEPTIC TANK
REINS?ECTION
SOAKAGE PIT CU. FT.
:ATCH BASIN
T
IISCHARGE WELL
)OMESTIC WELL
AREA DRAIN
100F INLET
)OLAR WATER HEATER
'IRE STANDPIPE
'001 PIPING
.AWN SPRINKLER SYSTEM
;AS RANGE
ETER SET (GAS)
AS PIPING
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
MECHANICAL