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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.