275 NE 94 St (4)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.
Date. 17" , 19.r a
cede-VW No - Z5. Street!! ..9
Owner's Name and Address._. - ..
Registered Architect and /or Engineer .___
Name and address of licensed contractor_ , .-.�. � 15 - .cg 'V01
Location and legal description of lot to be built on:
Lot Block Subdivision
Street and Number where work is to be done f
State work to bed e a purpose of building (by floors) <- / - �
and for no other purpose.
New Building Remodeling Addition Repairs No. of Stories
To be constructed of Kind of foundation Roof Covering
Estimated Total cost of improvements $ ...... /79 Amount of Permit $
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 pblic notice
or notices as are required by the Act. The undersigned agrees to employ only such s}tbcontractprs, y rk - .� performed under this
permit, as are licensed by Miami Shores Village. -�
Remarks ( Signed )j
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
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 carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
Permit No ` �� Date `� ° ' Read, Sworn to and Subscribed before me.
Disapproved /� Date °_
i' Notary Public, State of Florida
( Signed) (4.-' 'd ° O - -.:47 ' 4
Building Inspector My Commission Expires
/
PLANNING BOARD DATE
Chainnan 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 Board.
A re- inspection 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.
•
7 / rf
SWITCH
OUTLETS
LIGHT
OUTLETS
PLUG
RECE'T'S
FIXTURES
NO. LAMPS
REFRIG.
OUTLET
IRON
OUTLET
RANGE
OUTLET
RANGE
CONN.
WATER
HEATER
W. HEAT.
CONN.
S CALE
H ATER
STRIP
HEATER
TOTAL
ONTR.
FIST
!'
/ '
• %
ENT.
SW.
DIST.
CAB.
SERVICE
TEMP.
SERVICE
PERM.
J
1 �
` / L_ ->
MOTORS
04 HP
MOTORS
1.5 HP
NEON
TRANS.
RADIO
TOTAL
CDx R.
UST
/7
CHECK
Permit No
Owner's Name and Address
Amount of Permit $
STATE OF FLORIDA, , l
COUNTY OF DADE. j
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
Date l�
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building 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 work.
ss.
Registered Architect and /or neer n
Employing Electrician's Name / ' No
Street /
Location and Legal Description Lot Block Subdivision
Street and Number where work is to be performed —No Street
State work to be performed and purpose of building (By Floors)
New Building Remodeling Addition Repairs No. of Stories
Service Overhead Size Feeders Conduit Main Sw Amps Main Fuses Amps
Underground
Type of Installation— Cond�pit Tobin 13.X L Metal Mouldin g r
_�
�- / /�� �
L /
My Commission Expires
s a
No
,
(Signed)
}
•
The undersigned applicant for this building permit does hereby certify that he understands and a
labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws
has complied with the provisions thereof, and will require similar compliance from all contractors or
work to be performed under this permit; and will post or cause to be posted for inspection on the site
as are required by the Act. The undersigned agrees to employ only such subcontractors, on work to
licensed by Miami Shores Village.
Street.
Notary Public, State of Florida
I
Electrical Inspector.
ccepts his obligatio as an employer of
of Florida Per a nt Supplement, and
sub•contracto ployed by him in the
of the work such public notice or notices
be performed under this permit, as are
Master Electricia
7/
(YL ...
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally
appeared
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, and he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
NOTE: A re•inspection fee of $1.00 will be made when such re•inspection is made necessary by improper notice for inspection, or faulty
materials and /or workmanship.
Owner's Name and Address
Registered Architect and /or Engineer
BUILDING INSPECTION DEPARTMENT
MIAMI SHORES VILLAGE
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 ie°" 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 . - , 19 '
No._ Street
Name and address of licensed contractor u = _4- _ w_ ___y_
Location and legal description of lot to be built on:
Lot Block ___, n $ubdivision _..
j 9 ; r / i
Street and Number where work is to be done „_ �� - _- %` " �" / _
State work to be done and purpose of building (by floo {)_ ,� I,
and for no other purpose.
New Building Remodelifig ' Addition Repairs No of Stories
To be constructed of K' undatio 13.o Covering
Estimated Total cost of improvements $ F' �' Amount of Permit $ L '<c). ^ }" ''
Zone cubage required 7 .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 to be performed under this
permit, as are licensed by Miami Shores Village.
Remarks
(Signed) � � .
fi- -� - -=
STATE OF FLORIDA,
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 hhs carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
Permit No. Date �� � ��; /' Read, Sworn to and Subscribed before me.
Disapproved Date —
( Signed)
Building Inspector My Commission Expires
Notary Public, State of Florida
PLANNING BOARD DATE
Chairman 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 Board.
A re- inspection 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.
BUILDING
ELECTRICAL
PLUMBING
ROOFING
Owner of
Building
Architect
Contractor �"'
or Builder "1 M ,
Legal
Description
Address of
Building
Lot
PERMIT IT? 12725
n Work to be performed under this Permit
CONTRACTOR OR BUILDER
MIAMI SHORES VILLAGE, FLORIDA --"''
Value of
Project $
This permit is nted to the contractor or builderinam!>tf above to c jstruct the building or to install the equipment or device described in the app on
herefor in strict comp ante with all ordinances pertaining thereto and wit the understanding that the work will be performed in compliance with any plans,
drawings, statements or specifications that may have been submitted to anIt appsdved by the proper municipal authorities. This Permit may be revoked at any
time if the work is not done in compliance with such ordinances or if the p ns are changed without authorization. A further condition upon which this permit is
granted is the understanding that the contractor or builder named above alsumts the responsibility for a thorou• knowledge of the ordinances and re:ulati• .s
pertaining to the work covered hereby whether shown on the plans or drawing{ or in the statemejts or umes responsibility . or rk
done by his agents, servants or employees.
BY
i
DATF ' 195_
Contractor's
License No.
Amt. of
Permit
Signed: INItt454 ► c$ ti .. ; s—
In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance wi ordinances aid 40gulations
pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper orities of Miami S�orda Village.
In accepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee.
AUTHORITY
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-
u ing or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami
,, `•Jhores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and
ibgulations 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 •
Registered Architect and /or Engineer
Name and address of licensed contractor.
CC) Location and legal description of lot to be built on:
t Block
Street and Number where work is to be done
Date_.__ , 19
. 2 .0. kzaga r sscAL cc, z40 (45, c2
Subdivision
2.
State work to be done and purpose of building (by floors) t __�
and for no other purpose.
New Building Remodeling Addition
To be constructed of Kind of foundation Roof Covering
0
Estimated Total cost of improvements $ Q 00 Amount of Permit $
Zone cubage required .Plan Cubage
DIstance to next nearest building. g ��� _ 4 _ 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, Pennanent 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 subcon.:ctors, n to be .erformed under this
permit, as are licensed by Miami Shores Village.
Remarks
STATE OF FLORIDA, i
COUNTY OF DADE. ss
PLANNI
My Commission Expires__
OARD __ . DATE
No Z7 5 Street.._ - r c?4
Repairs No. of Stories
Chairman Member
Member _..__.___.__ Member
Member ._ - -_- -•_ _ --- .. Member -
Council Approved Date Disapproved
Read, Sworn to and Subscribed before me.
Notary Public, State of Florida
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.
Permit No._____J/ � Date
Disapproved _._ _ _.. _�_ Date_
( Signed) %� 0
Building Inspector
to me well known,
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 Board.
A re- inspection 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.
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building 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 72 Z
To be constructed of
Registered Architect and /or Engineer p� 7 5 Y i �y � i ,� p
Name and address of licensed contractor E g , 6 / - 7 3 �/ 1/� G✓ 7 5 71 ,aE .-r / . 3
Location and legalescription of lot to be built on: A� ` 6 �� iy ( In g Subdivision / �4 AMP 1 1 .� 0' / 3 J 97
APPLICATION FOR BUILDING PERMIT
Lot J2 ii/ Block -p
Street and Number where work is to be done d -5- ?c ev 99
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
be done an purpose of building (by floors). state ex for colors (submit mples)
000- 0
Amount of Permit 3 X/
Date
No. 2 j'_5
19 k1
Street i V5+
No of Stories
•
and for no other purpose.
New Building Remodeling Addition Repairs
Kind of foundation of Covering
Estimated Total cost of improvements
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 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 obligatons 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 : - a" ploy only su ubcontractors. on work to be performed
under this permit. 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 appeared
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 carefully read the foregoing application, and that he did sign the same. and that all facts therein by him stated are true.
0101Z9
Date l I 1 0 i41 Read, Sworn to and Subscribed before me.
Permit No.
Disapproved Date
Notary Public. State of Florida
(Signed)
Building Inspector My Commission Expires
PLANNING BOARD DATE
Chairman Member
Member Member
Member Member
Council Approved late Disapproved Date
NOTE: A charge of 825.00 will be made for making corrections or changes to this application after approval has been obtained from the Planning Board.
A re- inspection fee of 825.00 will be charged when such re-inspection is made necessary by improper notice for inspection or faulty materials and/or workmanship.
o= ffcc) ��,��-/
BUILDING
ELECTRICAL
PLUMBING
ROOFING
Owner of
Building
Architect
Contractor
or Builder
Legal Lot
Description
CONTRACTOR OR BUILDER
MIAMI SHORES VILLAGE, FLORIDA
PERMIT
Work to be performed under this Permit
B1
N° 4130
DATE 19
Contractor's
License No.
Subdi-
vision
Address of Value of II Amount of
Building Project $_ > I Permit $
This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the applica-
tion herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any
plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked
at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this
permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and
regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes respon-
sibility for work done by his agents, servants or employees.
Signed. INSPECTOR
In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations
pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In as
cepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee.
BY AUTHORITY
1V11d1T11 ►Ji1UrC5 v 111agc
Building Department
• 10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
BL
PE
Fs( eau alat0
Perm
Ownt
Owne
City_
Tenn
Contractor's Address 7351 NW 7th ST. "R"
Qualifier RICHARD ARNETTE
$ Value of Work For this Permit $4000.
Total Fee Now Due $
(Continued on opposite side)
/ 9. 9°
Permit No. W1
Master Permit No.
;al Plumbing ' Mechanical Roofing
r TED & DONNA Phone # 305- 754 -0200
(AMI SHORFS, Fl 33138
zip 33138
Phone #
Job A / j/ NE 94 STREET
City _ ty ami -Dade Zip 33138
Is Building Historically Designated YES NO
Contractor's Company Name R.E.A. AIR COND. INC. Phone # 305 - 266 -6627
City MIAMI state FL zip 33126
Architect/Engineer's Name (if applicable) Phone #
Square Footage Of Work:
Type of Work: ❑Addition ❑ Alteration CI New ® Repair/Replace
Describe Work: A/C CHANGE OUT 4 TON COND/ AHU 10KW
* * * * * * * * * * * * * * * * * * * * * * * * ** * s * * * * * * * * * * * * * * * * * * * * * * * * * **
Submittal Fee $ Permit Fee $ \ l V e CCF $ p V 0 --�1
Notary Training/Education Fee $ t Technology Fee $ 3 • s `�
Scanning $ Radon $ Bond $
Code Enforcement $ Structural Plan Review. $
❑ Demolition
Bonding Company's Name (if applicable)
Bonding Company's Address
City
Mortgage Lender's Name (if appli bit)
Mortgage Lender's Ad
City State Zip
Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has
commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating
construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS,
WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDmONERS, ETC
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.
"WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT 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."
Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the
inspection will not be approved and a rein , -ction fee will be. charged.
Signa
State Zip
The fore / oing instalment was ac ..w1ed;;ed before me this
day of ti 1, . , 20 05, by _ E/
who is personally known to me or who has produced who is : rsonally kno to me or who has produced
4 4,, PATRICIA S. HA
N Wili my mMMt4S10N # /30371403
w EXPIRES: December 07.NOS
As identification and who did take an oath.
A •
Print:
My Commission Expires:
***************************************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
State Certificate or Registration No. Certificate of Competency No.
***************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** * * * * * * * * ** * * * * * * * ** * * * * * ** * * * * * * * * * * * * * * * * * * * * * * * * * * **
APPLICATION APPROVED BY: ( Plans Examiner
Engineer
Zoning
Chc 10/14/03
UBLIC:
Owner or Agent
as identification and who did take an oath.
NOTARY
Si
(Certificate of Competency Holder)
Signature
Contractor
The fore •'ng instrument was
day ofi,' 20Q5b
Print:
My Commission Exp
dged before me thisj(1
Page 3
PERMIT APPLICATION
I INSTRUCTIONS: Please indicate the type of work being performed and quantity(ies) in the space provided below. II
ELECTRICAL
TYPE
QTY. TYPE
QTY. TYPE QTY.
TYPE QTY.
Minimum Fee
A/C Central 1 -3 Ton
A/C Central 4-7 Ton
A/C Central 5 -15 Ton
A/C Central 16-20 Ton
A/C Central 20+ Ton
A/C Window
Air Conditioners
Chiller
Clear Violations
Compactor
Deep Freezer
Demolition
Dishwasher
Dryer
Fan
Fire Pump
Fixture - Fluorescent
Fixture Light
Flood Lights
FPL - Load Central
Garbage Disposal
Generators, etc.
Heat Recovery
Low -volt, Burglar
Low -volt, Fire
Low -volt, Intercom/Teleph.
Low -volt, Television
Outlet, Appliance
Outlet, Wall
Outlet, Switch
Oven
Parking Lot Lights
Plugmold/Strip
Posts
Range/Range Top
Receptacles
Refrigerator, Comm. (p/PH)
Refrigerator, Domestic
Renew - Temp Service
Repair Circuits
Service, Number of Amps
Service Repair
Service, Temporary
Signs
Space Heater (kw)
Spas/Hot Tubs
Subfeeds, No. of Amps
Swim Pool, Commercial
Swim Pool, Residential
Switchboards
Temp Sere, Construction
Temp for Test - 30 days
MECHANICAL
TV1'!
Minimum Fee
QTY. TYPI'.
QTY. TYPE
QTY. TYPE
QTY.
A/C Central, Tons
A/C Wall/Win. Tons
Air Handler, Tons
Barbecue
Bath Fan - Vented, #
Condensate Drain
Cooling Tower
Dryer Vents, Number of
Ductwork, Cost of
Fire Sprinkler System
Fireplaces, Number of
Generator
Heating Strips, each
Paint Booth
Piping, Flammable Liquid
Process/Pressure Piping
Pressure Vessel
Refrigeration, Tons
Vent Hood, Cost
Ventilation, Cost
Periodic Inspections
PLUMBING
T1'1'1.:
QT1'. T1'11F.
Q1'1'. TYPE
QTY. TYPE
Drains, Roof
Drinking Fountain
Miscellaneous Fixture
MTlscellaneous Re . . irs
Soakage Pit
Solar Water Heater
QTY
A/C Condensate
Bath Tub
Bidet
Cap - Fixture
Filter Replace
Fountain
Pool Piping
Pump and Abandon
Pump, Domestic
Pump, Fire Stand
Pump, Re- circulate
Pump, Replace - Pool
Pump, Sprinkler
Pura Sum
Relay Repair
Roof Inlet
Septic Connection
Septic Tank
Sewer Connection
Shower
Gas - Appliance
Gas - Natural
Gas - Propane
Gas Piping
Grease Trap
Ice Maker
Indirect Wastes
Interceptor
Laundry Tray
Lavatory
Meter Set (Gas)
Minimum Fee
Cap - Water
Cap - Sewer
Catch Basin
Clothes Washer
Dental Chair
Discha : e Well
Dishwasher
Disposal
Domestic Well
Drainfield, 4" Tile/Res.
Drains, Area
Drains, Floor
Drains, French
Miscellaneous Equipment
Sink
Sprinkler Repair
Sprinkler System
Supply, AC Well
Temporary Toilet
Temporary Water Closet
Urinal
Utility - Sewer
Utilit - Water
Vacuum Pump
Water Closet
Water Heater
Water Heater New
Water Re -pipe
Water Service
Well, Supply
RECEIVED AND REVIEWED BY:
DATE:
Page 4
• .OFFICE USE ONLY
CHECKLIST
❑ OWNER - BUILDER FORM
(Attach)
❑ FIRE DEPARTMENT
APPROVAL (Commercial /
multi- family)
O CONCURRENCY
(New Construction)
❑ OTHER
(Specify & Attach)
$3.00 per page (Scanning Fee)
Miami Shores Village
Bond
Metropolitan Dade County (C.C.F.) $
Inspector State Educational Fund $
State DCA (Radon) $
Code Enforcement Fine r
Zoning Review
❑ PROOF OF OWNERSHIP
(Attach)
❑ HRS / DERM APPROVAL
(Septic / Sewer)
❑ IMPACT FEE
(New Construction)
❑ OTHER
(Specify & Attach)
SECTION
Zoning
Electrical
Mechanical
Plumbing
Fire
Public Works
Structural
Building Official
BY
DATE
(sq.ft. = x/1000
x 0.60)
(0.005 / sq.ft.)
(0.01 / sq.ft)
PERMIT APPLICATION
O CONDO ASSOCIATION APPROVAL
(Attach)
❑ BPR APPROVAL (Restaurants)
❑ CONTRACTOR REGISTRATION
(On File)
PERIIIIT FEES
TOTAL $
ISSUING OFFICIAL
REVIEWED AND PREPARED BY: DATE:
CONDITION OF APPROVAL
Revised July 2001
10050 N.E. 2'''D AVE., MIAMI SHORES, FL • (305) 795 -2207 • FAX (305) 756 -8972 • http : / /www.miamishoresvillage.com
Miami Shores Village
10050 NE 2nd Avenue
Phone: 305 - 795 -2204
Printed: 4/18/2005
Applicant: DONNA
Owner: NEUWEILER
JOB ADDRESS: 275 NE 94
Mechanical Permit
Permit Number: MC2005 -46
NEUWEILER
DONNA
ST
Contractor R E A AIR CONDITIONING INC Contractor's Address: 7351 NW 7 STREET SUITE R
Local Phone: 305 - 266 -6627
Parcel # 1132060133830
Legal Description: MIAMI SHORES SEC 1 AMD PB 10 -70 LOT 22 & W1/2 LOT 23 BLK 28 LOT SIZE
Fees: Description Amount
FEE2005 -4930 Building Fee $140.00
FEE2005 -4931 CCF $2.40
FEE2005 -4932 Training and Education Fee $0.80
FEE2005 -4933 Technology Fee $3.50
FEE2005 -4934 Scanning Fee $3.00
Total Fees: $149.70
Total Fees: $149.70
Total Receipts: $0.00
Permit Status: APPROVED Permit Expiration: 10/10/2005 Construction Value: $4,000.00
Work: A/C CHANGE OUT 4 TON AIR CONDITIONER / AHU 10 KW
Signed: (INSPECTOR)
Page 1 of 1
Vs
In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict
conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responisibility for all work
done by either myself, my agent, servants or employes.
Signed: (Contractor or Builder) BY:
4
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305 -795 -2204
Building Inspection Request
Date d1 I IO5
Type Insp'n V1AtiN,A,1 •
Permit No. ' 2005 1 16
Narne rria !Jd{JW ?tiff
Address 275 ijE c 4 ST
Company
Phone #
011105
4
Inspection Date
Approved
Correction
Re- Insp'n Fee
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