MECHANICALPERMIT APPLICATION FOR MIAMI SHORES VILLAGE
10050 N.E. 2nd Avenue • Miami Shores, Florida 33138 • Phone: 305 - 795 -2204 • Fax: 305- 756 -8972
Date 1 26 ' Job Address 190 ! _ E Tax Folio
Legal Description
Owner /Lessee/Tenet
Owner's Address
Contracting Co. C+ r CO . W .
R Obe ✓ — F �S . 01( yJT
Qualifier /�
state # CA-6 L / I Municipal #
IF THERE IS NO PERMIT PACKAGE ACCESSIBLE ON THE JOB SITE FOR INSPECTORS TO VERIFY,
THERE WILL BE NO INSPECTION. RE- INSPECTION FEE IS $50.00 AND MUST BE PAID IN ADVANCE
BEFORE CALLING FOR ANOTHER INSPECTION.
Permit Type (circle one):
WORK DESCRIPTION:
I 0 of S s - t -
Square Ft. Estimated Cost (value) 3 C i 6 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 ANY 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). 1 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 all disciplines.
OWNERS 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 wner and/or Condo President D /' /
Not y s to Owner and/or Condo Pre t 9ent Date
My Commission ExpiT; O:Y '•., v Janet Kranz
MY COMMISSION # DD174033 EXPIRES
° December 26, 2006
BONDED THRU TROY FAIN INSURANCE INC.
FEES: PERMIT 75 RADON
BUILDING ELECTRICAL
t -x8.03
C.C.F
Historically Designated: Yes No
Master Permit # o 03 r V
Phone 3 0S 7 - 9 7 �
SS#
Address Q0. b( 6 v 1 ( 4 IQr►1r ri. o3 /6e
Phone ` 5 0 ' V 6 es r l
Competency # Ins. Co. Ci ^ •'h0 t`C'
PLUMBING C MECHANICAL ROOFING
#50
Signature o
Not as to Contractor or Owner B
My Commission E ������"
r • wner Builder
dr
I anet Kranz
+r ' IA MY COM ION# DD174033 r:Xoi .
"'' December 26, 2006
BONDED THRU TROY FAIN INSURANCE, IN.
I .gt• °J
Date
1 ..0 3
Date
NOTARY BOND
APPROVED: TOTAL DUE
Zoning Building Electrical
Mechanical l ' �l ' 3 Plumbing Structural Engineer
ITEM
BATH TU8
UNIT
FEE
ITEM
SWITCH OUTLETS
UNIT
FEE
ITEM
SPACE HEATERS
UNIT
q f
FEE
BIDET
L I Gi•iT OUTLETS
CENTRAL HEAT I IG G= /V ,
DISHWASHER
RECEPTACLES
SERVICE TEMPORARY
A/C (WIND)
A/C (CENTRAL) = on FACE
DISPOSAL
DRINKING FOUNTAIN
SERVICE SIZE IN AWPS
DUCT WORK
9
FLOOR DRAIN
SERVICE REPAIRNETER CHANGE
REFRIGERATION
GREASE TRAP
APPLIANCE OUTLETS
PROCESS AND PRESS PIPING
INTERCEPTCR
RANGE TOP
UNDERGROUND TANKS
LAVATORY
OVEN
ABOVE GROUND TANKS
LAUNDRY TRAY
WATER HEATER
U.F. PRESSURE VESSELS
CLOTHES WASHER
MOTORS 0- 1 HP
hOTORS OVER 1- 3 HP
STEAM BOILERS
HOT WATER BOILERS
SHOWER
SINK, POT /3 COMP-
MOTORS OVER 3- 5 HP
MECHANICAL VENTILATION
SINK, RESIDENCE
MOTCRS OVER 5- 8 HP
MOTCRS OVER 8- 10 HP
MOTORS OVER 10- 25 HP
TRANSPORTING ASSEMBLIES
ELEVATORS/ESCALATORS
FIRE SPRINKLER SYSTEMS
SINK, SLOP
TEMPORARY WATER CLOSET
2RINAL
MOTORS OVER 25-100 HP
COOLING TOWERS
iATER CLOSET. - •
..
MOTCRS OVER 100 HP
VIOLATION
INDIRECT WASTES
A/C WINDOW
REINSPECTION
CATER SUPPLY TO: .
AIR CONDITIONERS
A/C UNIT "
..
• -•
STRIP HEATER
FIRE SPRINKLER
GENERATORS TRANSFORMERS
HEATER -NEW INST. '
GENERATORS TRANSFORMERS
HEATER - REPLACE %....:-.:-
GENERATORS TRANSFORMERS
1
LAWN SPRINKLER-WELL.
SPECIAL PURPOSE
-
- -�
SWIMMING POOL
OUTLETS COM,€RCIAL
WATER SERV ICE
SIGN TUBES
EWER CONNECTIONS
SIGN TRANSFORMERS
TILITY - SEWER
SIGN TIME CLOCK
TILITY -WATER
_PTIC TANK
FIXTLRES
ANTENNA
_LAY •
zAINFIELD,
TELEVISION OUTLETS
4' TILE/RES.
VIOLATION
AP S ABANDON SEPTIC TANK •:
)AKAGE PIT CU. FT.
•
REINSPECTION
.
■TCH BASIN
'SCHARGE
WELL
1MESTIC WELL
.EA DRAIN
OF
INLET
LAR WATER
HEATER
RE
STANDPIPE
OL PIPING
4
NN
SPRINKLER SYSTEM
S RANGE
TER
SET (GAS)
3 PIPING
(AN APPLICATION FOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. IF A RASTER PERMIT HAS B.
OBTAINED, THE OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.)
PLUMBING
ADDENDUM TO BUILDING PERMIT APPLICATION
ELECTRICAL
MECHANICAL
Miami Shores Village
10050 NE 2nd Avenue
Phone: 305 - 795 -2204
Printed:1 /30/2003
Applicant: MARY
Owner: NEWMAN
JOB ADDRESS: 140 NE 95
Contractor C & R AIR CONDITIONING CO
Local Phone: 305 - 685 - 6394
Parcel # 1132060132850
Permit Status: Approved Permit Expiration: 7/29/2003 Construction Value: $3,995.00
Work: EXACT REPLACEMENT OF 3 TON PACKAGE
If there i
fee is $50.1
This Permit
ordinances pe
and approved
authorization. 20
ordinances al
by his agents
Signed
In conside
-with the plat
myself, my
Signet
AIR CONDITIONING CO.
6 P.O. BOX 681330 • MIAMI, FL 33168 -1330
. 10 PHONE: (305) 685 -6394
18
C y _ ' - 22
26
- 20
30
- 32
11.0.-
(le- •6
42
\
PAY TO THE
ORDER OF `"'� .7�"'V}—
AkA dU 1L st era
MEMO
�s ,DO
c›?
Mechanical Permit
Permit Number: ME2003 -10
NEWMAN
MARY
ST
Contractor's Address: 2121 NW 139 ST #10
Page 1 of 1
Legal Description: MIAMI SHORES SEC 1 AMD PB 10 -70 LOTS 10 TO 12 INC BLK 21 LOT SIZE
11'004 3 2611' 4 :06 700 24 3 61: 40 1 309 10 6011'
Total Fees: $1:0073"
Total Receipts: $0.00 , e
BANK OF AMERICA
FLORIDA
63- 243/670
SIGNATURE
D 4326
2 -3 -0
m • l
• r
(-JD C ..
DOLLARS n
r•
"I
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT.
APPLICATION FOR BUILDING PERMIT
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build-
ing 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 the work.
Owner's Name and Address .... EWMA zE. //JEli GE _. No r ¢ d ... Street er 95 5 T.
Registered Architect and/or Engineer ,:,.. .,,,,,,;,,,,,,, , ,,,,,....,: ,.......
Name and address of licensed contrgctotf'1 � 2L.S.Q....f1. �2 _ � N� + 74 c o IC./. E . 4 eoc.)47'
Location and legal description of lot to be built on:
Lot Block Subdivision _... — ..__....._._...._...._
Street and Number where work is to be done 1 4 t)_ N ` E - �. S
State work to be done and purpose of building (by floors) / E pL.A GE , 7D v P G/L U U l T ,. l7i -
1!1... � /7- O
me-14 i 7146 sd1!2c Lo c. -f of-) , _ _....._._
and for no other purpose.
New Building Remodeling ) Addition Repairs No. of Stories
To be constructed of Kind of foundation Roof Covering
m
Estimated Total cost of improvements $ 1 40 C Amount of Permit $.. cz
Zone cubage required plan Cubage
Distance to next nearest building. Size of Building Lot
Maximum live load to be borne by each floor
I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may
be sent to
The undersigned applicant for this building permit does hereby certify that he 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 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 woe such public notice
or notices as are required by the Act. The undersigned agrees to employ only such subco • . rs, _ work ormed under this
pennit, as are licensed by Miami Shores Village.
Remarks (Signed)
STATE OF FLORIDA, 1
COUNTY OF DADE. J ss.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap-
peared _.__._ .__._..__....
___ 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 carefplly read the foregoing application, and that he did sign the same, and that all facts
therein by him s t are true.
Permit No.__ ._ ,2Q_._ Date 7 (Q 0/7.x..._._ Read, Sworn to and Subscribed before me.
Disapproved Daatte. n j
(Signed) 4� 1C Com - t LGC 7 Notary Public, State of Florida
Bui ding Ins or L My Commission Expires _
E2 AftD
PLANNING BOARD DATE
Chairinan Member
Member Member
Member Member
Council Approved Date Disapproved Date
NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has been obtained from
the Planning hoard.
A re -in pcction fee of $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty
materials and /or workmanship.