MECHANICALMIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Application is hereby wade 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.
Date
Mr. Donald Baile ...�N eb L 1284 Stre J: E. 94th?Street
Owner's Name and Address Y - -F.-Or
Registered Architect and /or Engineer
Bu Refrigeration, Inc., 651 �1.t. '(L16 h 'Street -
Name and address of licensed contractor
Location and legal description of lot to be built on:
Lot Block Subdivision
Street and Number when: work is to be done
State work to be done and purpose of building (by floors..._
Installation of central air conditioning system FoT "5 " t — ---
- --------- - - - - --
and for no other purpose.
New Building Remodeling Addition X Repairs No. of Stories
To be constructed of Kind of foundation Roof Covering
Zoo r
Estimated Total cost of improvements $ 3 410.00 Arnount of Permit $�....1 � "
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 work such public notice
or notices as are required by the Act. The undersigned agrees to employ only such subcontractors, on work ` . be perform d under this
pennit, as are licensed by Miami Shores Village.
Remarks... (Signed)
STATE OF FLORIDA,
COUNTY OF DADE. ss.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap-
peared
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 carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true. )04/U Permit No._ —_Vq 5 Date ma Read, Sworn to and Subscribed before me.
Disapproved
(Signed) Wt2� L
1285 N.E. 94th Street
Notary Public, State of Florida
to me well known,
B ding Inspector My Commission Expires
PLANNING BOARD DATE
Chairman Member
Member Member
Member ...... Member
Council Approved Date Disapproved Date
NOTE: A ch.rrgc of $1.00 will be made for making corrections or changes to this application after approval has been obtained from
the Planning )io:ird.
A re- irir.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.
Date Job Address /c2 ° r / 'J v Tax Folio
Legal Description /jai 74
Owner / Lessee / Tenant Master Permit # �/ �(
Owner's Address
Phone
Contracting Co. �/ ~�°c�� / ar � �L.o Address —2„/Z-2 di. 4/Z=
Qualifier SS4� Phone
State # Municipal # Competency # Ins.Co.
Architect /Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type(circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION li'���Ci Da -
Square Ft. Estimated Cost(value) c 1335
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 owner and /or C9nd
Date:
APPROVED:
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Notary as to Owne 'F nd /or Condo President
My Commission Expi es:
** *
FEES: PERMIT lr ''RADON
e'sident
Signature of Contractor or • er- Builder
i
Date:
Notary as to Contractor or Owner-Builder
My Commission Expires:
* * * * * * *
C.C.F. j cl, NOTARY TOTAL DUE
Fire Other
Building
bing
**
Electrical
Engineering
Date
Legal. Description S.cleKc
Notary as to
My Commission
ISS I 4
Job Address
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
** *
ik -2z/54
Tax Folio
0
Owner / Lessee / Tenant Master Permit # 3'599
Owner's Address Phone
Contracting Co. A Alc Address al (.2 2 - in l S'
Qualifier (406 eDtpais Phone 9/Q d 4 7 q
State #04(04w municip # Competency # Ins.Co. -49
Architect/Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type(circle one): BUIPING ELECTRICAL PLUMBING (FiCHANICA0 ROOFING PAVING FENCE SIGN
WORK DESCRIPTION (1.A E 4,1e1 4e)c 444 0 es1 e"S
Square Ft. 4tiMatnd cent(vol4e)Sv
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 UNDER OR AN ATTORNEY BEFORE RECORDING YOUR
NOTICE Of COMMENCEMENT).
Application i§ hereby 41400. to? Obtain a PerMit to do work and installation on indicated above, and
on the attnoh@d 4444en4m (if aPPlicable). 1 certify that all Worit will be performed to meet the
standards of all Laws regulating construction in this juriSdiction. I understand that separate
permits are recitare0 for PAPTRNA, nuM4ING, SIGNS, POOLS, ROOFING and MECHANICAL WORK.
OWNER'S AFFIDAVIT; T qortifY 00'41 the foregoing information is accurate and that all work will
be done in coMPli with 441 #PPli cable laWf regulating conatruc jon an mling, Furthermore,
authoriz the above to do the work 6,ated.
A ii,i i#ii
4/or Condo President Signature of Concilactor or Owner-Builder
Date:
WaRent Notary at
My Commia*
* *
FEES: PERMIT RADON C.C.P. NOTARY TOTAo DUE
APPROVED: Fire Other
Zoning Blinding Electrical
Mechanical Plumbing Engineering
AMMMOOMMUOUilder
WTROY FAmvaccnc
*.
* *
Date
Legal Description Historically Designated: Yes . No
Owner/Lessee / Tenant ___/e:),`/ eZ /,V (7CJ (V ? T y u .
Owner's Address
Contracting Co.
Qualifier
State #
l� Job Address o S IV `'t % Tax Folio / / 32OS — / 0 _ 0
/ JQ6 ALE ' /
77 mil)/" Address
P )hee. ss#
Phoneoe6) 05 - ?6 . v
ee/ 5 i ns Co.
PLUMBING CH.ANICA ' OOFING PAVING FENCE SIGN
NOTARY
BOND
/Aggialb
i e
• f Contractor or -Build
"I
No : ao Contract
My Commission Exp s: GLADYS 1 VILLAR
NOTARY PU3LIC STATE OF FLORIDA
COMMISSION NO. CC714103
MY COMMISSION F.XP. MAR. 10002
TOTAL DUE
Date
Electrical -J ---to
Plumbing Structural Engineer
ITEM
BATH TUB
UNIT
FEE
ITEM
SWITCH OUTLETS
UNIT
FEE
ITEM
SPACE HEATERS
UNIT
FEE
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/ETER 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 If
STEAM BOILERS
SHOWER
MOTORS OVER 1- 3 HP
HOT WATER BOILERS
SINK, POT /3 COMP.
MOTORS OVER 3- 5 HP
MECHANICAL VENTILATION
SINK, RESIDENCE
MOTORS OVER 5- 8 If
TRANSPORTING ASSEMBLIES
SINK, SLOP
MOTORS OVER 8- 10 HP
ELEVATORS/ESCALATORS
TEMPORARY WATER CLOSET
MOTORS OVER 10- 25 HP
FIRE SPRINKLER SYSTEMS
URINAL
MDTCRS OVER 25-100 HP
COOLING TOWERS
WATER CLOSET
MOTORS OVER 100 HP
VIOLATION
INDIRECT WASTES
A/C WINDOW
REINSPECTION
MATER 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
SWIMMING POOL
OUTLETS COMMERCIAL
WATER SERVICE
SIGN TUBES
;EWER CONNECTIONS
SIGN TRANSFORMERS
UTILITY- SEWER
SIGN TIME CLOCK
T I L I TY -WATER
FIXTURES
EPTIC TANK
ANTENNA
ELAY
TELEVISION OUTLETS
RAINFIELO, 4' TILE/RES. -.
VIOLATION
U1+' & ABANDON SEPTIC TANK
REINSPECTION
JAKAGE PIT CU. FT.
ATOM BASIN
ISCNARGE WELL
JMESTIC WELL
TEA DRAIN
JCF INLET
JLAR WATER HEATER
IRE STANDPIPE
JOL PIPING
1MN SPRINKLER SYSTEM
S RANGE
:TER SET (GAS)
S PIPING
PLUMBING
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.)
ELECTRICAL
MECHANICAL
Date t/ O Job Address /. ff-S/l/ L''7 9_ Tax Folio // 3 d {` 0/0 - €
Legal Description / z-/ 6 e a� i��ZL i ,�! � /� l/,- -,�..�
0 17 ∎97 N'/ /,
Owner / Lessee / Tenant � 3' `T / /� r - y Master Permit # % 70 3 7
Owner's Address / 2 8 /t/,e 9' 4/ ,.e. pFione -- 7c -- 6- ' 9 7
Contracting Co. e 0 L0 /V /9/C Address 5 7 // ,G- 4
Qualifier/PA/map-A!) it.-1?h=7/40-A--Z2 SS# ?. � / - � Phone 3 c2f o - • r7
C '' s
State # / Municipal # Competency # Ins.Co.
Architect /Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type(circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING PENCE SIGN
WORK DE SCR 1 PT 1 ON 4) ION /1-7 E !/zi. -, 7 y` T /
(i)e / 5 7 / s'T
//ea
Square Ft.
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.
Sig
Date:
No *y as to Own
M " ommissi
** *
FEES: PERMIT 5
APPROVED:
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
ly Veott. 2000
or Condo President
and /or Condo President
Si ure of Contractor or Owner- Builder
D: e:
i �
Notary ash r.' t rte"`" •i � � ilder
My Commi s 4 ii'i bsion Exp. 08/ 27/2001 > .
r +oo- 3•NoTARY. Pb, bleary Se+reoe&
* * * * * * * • * * **
RADON C.C.F. ( • g NOTARY
TOTAL DUE,i/
Fire Other
Zoning Building Electrical
Mechanical � ' ' Engineering