MECHANICALMIAMISH&RES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
Building Inspection Request
Date
Type Insp'n RildACCMCDA FV',1110
Permit No. KC L3o5 -
Name " f f iN ilk1 -0
Address 1 N� 1J
Company ?0 NV EAC
Phone # '3osI d s 8 - 15145
Inspection Date 011011 b5
Approved
Correction
Re- Insp'n Fee
MIAMI-SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
Building Inspection Request
Date Ci' \b(9 U)S
Type Insp'n RciklavActl,
Permit No. K(, 5 - O
Name Cf fiN tiitTov
Address 11 �Z - - -1- g
Company /NA J( t rm.,
Phone # 'S/1S3- 1545
Inspection Date 01 toil 65
Approved
Correction
Re- Insp'n Fee
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305 -795 -2204
Building Inspection Request
Date 01\06
Sob
Type Insp'n )kQ A 1(„i'
Permit No. I&L 2 - 0115' '8S
Name t ff t t ` 1
Address 1 tit ( 15 J t
Company / NM AWY rAG
r Phone# 11S8" 154 5
Inspection Date DI 1011 65
Approved - f lsell /
Correction a
Re- Insp'n Pee 0
BUILDING
ELECTRICAL
PLUMBING
ROOFING
Architect
Contractor
or Builder
Legal Lot
Description
Address of
Building
of PERMIT
MIAMI SHORES VILLAGE. FLORIDA
Owner of
Building ). >� • -_�. �.
'1
t
CONTRACTOR OR BUILDER
. l l • YJ +�- � i
N° 615
DATE4 -
Contractor s
License No.
195
Work to be performed under this Permit
B 1
This permit is granted to the contractor or builder named above to construc the building or to install the equipment or device described in the application
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 cr in the statements or specifications and that he assumes rjesp9ibility for work
done by his agents, servants or employees.
Signed ..• Lr BY
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 confonnity with the plans, drawings }. statements or specifications submitted to the proper authorities of Miami Shores Village. In ac-
cepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee.
Subdi-
vision
Value of
Project $
Amount of
Permit $
BY AUTHORITY 5 .
MIAMI SHORES VILLAGE °? $; 1 4,„
BUILDING DEPARTMENT
305-795-2204
:Building Inspection Request
Date \4:1
Type inSP'n
Permit No. 1" gq
Name t LteNi.
Address TJ ±-16 q.3
Company \YLIn
Phone ft
Inspection Date
Approved
Correction
Re.-Insp'n Fee
r �
BUILDING
PERMIT APPLICATION
FBC 2001
Permit Type (circle): Building Electrical Plumbing Mechanical Roofing
C Owner's Name (Fee Simple Titleholder) 'Tear \ ` Ji / Phone # 36 9 5-,-ig65.
$ Value of Work For this Permit
Type of Work: ❑Addition
Describe Work:
Total Fee Now Due $ " I
(Continued on opposite side)
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
Owner's Address - 7 `7 /V 9 r..5 /~ p-
City_�-�'� 7/4 / 5 JS,t � State ie- Zip � /gT
Tenant/Lessee Name Phone #
Job Address (where the work is being done) 7 7 At T r ?.s 5-r
City Miami Shores Village County Miami -Dade Zip 33 138
Is Building Historically Designated YES NO X-
Contractor's Company Name ?1 LI Y 1 ,4l/ < t / Phone # ' 7 SE ZS-KC-
�z�
Contractor's Address (� �l y u,. W. / • 5 3 ,.S 'T.��7' 7
Cit - -� r L4 /Q Sttattez� Zip
Qualifier ` C � � g� f � � U �l
Architect/Engineer's Name (if applicable) Phone #
d
�/'� * * * * * * * * * * * * * * * * * * * * * * * * * * * * Fee * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
Submittal Fee $ �L/ Permit Fee $ \ (fit) CCF $ 1 ' 2 CO /CC
Notary $ 5- CD Training/Education Fee $ 0-40 Technology Fee $ c) - a✓
Scanning $ 3 Radon $ Zoning Bond $
Code Enforcement $ Structural Plan Review. $
Permit No. ?tcZS 8g
Master Permit No.
Square Footage Of Work:
Bonding Company's Name (if applicable) N
Bonding Company's Address
City State Zip •
TiStgek 3
licable)
Mortgage Lender's Address
City State Zip
who is perso
NOT
Sign:
Print:
My C
Chc 12/15/03
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 CONDITIONERS, 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 reinspection fee will be charged.
C
l
✓
! / �0wner i/r, D il Contractor
Th. reg oing ins t was wledged before me this The foregoing instrument was acknowledged before me this
day of , 20 , by , day of , 20 , by
PUBLI
s areo�� My Commi ion Expires:
* * * ** *************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
mmission Expires:
State Certificate or Registration No.
Si
to me or who has produced who is personally kn a to e or who has produced
As identification and who did take an oath. ' as identification • • did take an oath.
• a'' *TARP PUBLIC:
os`
Sign:
Print:
(Certificate of Competency Holder)
C X7 ' .3
�'C � 3 Certificate of Competency No.
********************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** * * * * * * * * * * * * * ** * * * * * * * * *. * * * * * * * * * * * * * * * * * * * * * * **
APPLICATION APPROVED BY: Plans Examiner
Engineer
Zoning
ADDENDUM TO BUILDING PERMIT APPLICATION
APPLICATION FOUR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. IF A MASTER PERMIT F.AS B.
AIMED, THE• WNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.)
PLUMBING
ELECTRICAL
MECHANICAL
UNIT
•
FEE
ITEM _ UNIT
SWITCH OUTLETS
FEE
ITEM
SPACE HEATERS
UNIT
FEE
LIGHT OUTLETS
CENTRAL HEATING
ASR
RECEPTACLES
A/C (WIND) _ , . r,.
SAL
SERVICE TEMPORARY
A/C (CENTRAL) r ,)i .y i IJ
:II.G FOUNTAIN
SERVICE SIZE IN »fS
DUCT WORK
' DRAIN
SERVICE REPAIR/METER CHASE
REFRIGERATION
;E TRAP
APPLIANCE OUTLETS
PROCESS AND PRESS PIPING
;CEPTOR
RANGE TOP
UNDERGROUND TANKS
iORY
OVEN
ABOVE GROUND TANKS
DIY TRAY
WATER HEATER
U.F. PRESSURE VESSELS
-ES WASHER
MOTORS 0- 1 FP
STEAM BOILERS
_R
•
MOTORS OVER 1- 3 HP
HOT WATER BOILERS
POT /3 COMP.
MOTORS OVER 3- 5 If
MECHANICAL VENTILATION
,
RESIDENCE
MOTORS OVER 5- 8 HP
TRANSPORTING ASSEMBLIES
,
SLOP
MOTORS OVER 8- 10 HP
ELEVATORS/ESCALATORS
,
CRARY WATER CLOSET
MOTORS OVER 10- 25 11'
FIRE SPRINKLER SYSTEMS
jai
MOTORS OVER 25-100 HP
COOLING TOWERS
R CLOSET
MOTORS OVER 100 If
VIOLATION
RECT•WASTES
A/C WINDOW
REINSPECTION
:R SUPPLY T0:
AIR CONDITIONERS
'C UNIT
STRIP HEATER
!RE SPRINKLER
GENERATORS TRANSFCf ERS
:ATER -NEW INST.
GENERATORS TRANSFCRVERS
:ATER - REPLACE
GENERATORS TRANSFORRS
1'KN SPRINKLER -WELL
SPECIAL PURPOSE
.
11Mfi4lNG POOL
OUTLETS COMIdERCIAL
-
4TER SERVICE
SIGN TUBES
1
:R CONNECTIONS
SIGN TRANSFORMERS
.ITY -SEWER
SIGN TIME CLOCK
.ITY -WATER
FIXTURES
iIC TANK
ANTENNA
kY
TELEVISION OUTLETS
INFIELD. 4' TILE/RES.
VIOLATION
' & ABANDON SEPTIC TANK
REINSPECTION
{AGE PIT CU. FT.
)I BASIN
OOZE WELL
ESTIC WELL
A DRAIN •
F INLET
AR WATER HEATER I .
E STANDPIPE
L PIPING
-
N SPRINKLER SYSTEM
RANGE
ER SET (GAS)
' PIPING
ADDENDUM TO BUILDING PERMIT APPLICATION
APPLICATION FOUR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. IF A MASTER PERMIT F.AS B.
AIMED, THE• WNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.)
PLUMBING
ELECTRICAL
MECHANICAL
Mechanical Permit
Miami Shores Village
10050 NE 2nd Avenue
Phone: 305 - 795 -2204 Permit Number: MC2005 -89
Printed: 6/24/2005
Applicant: JEFFREY
Owner: HILTON
JOB ADDRESS: 77 NE 95
Contractor PALM AIR INC
Local Phone: 305 - 758 -7545
Parcel # 1132060130720
Signed:
(INSPECTOR)
HILTON
JEFFREY
ST
Contractor's Address: 6010 NW 153 STREET
Permit Status: APPROVED Permit Expiration: 12/12/2005 Construction Value: $1,900.00
Work: REPLACEMENT OF CONDENSING UNIT ONLY!
Page 1 of 1
Legal Description: MIAMI SHORES SEC 1 AMD PB 10 -70 E3OFT LOT 21 & LOT 22 BLK 5 LOT SIZE
Fees: Description Amount
FEE2005 -8754 Building Fee $100.00
FEE2005 -8755 CCF $1.20
FEE2005 -8756 Notary Fee $5.00
FEE2005 -8757 Training and Education Fee $0.40
FEE2005 -8758 Technology Fee $2.50
FEE2005 -8759 Scanning Fee $3.00
Total Fees: $112.10
Total Fees: $112.10
Total Receipts: $0.00
JUO 2 8 PAID
JUN 2 8 PAID 4(59$
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 responisibiiity for all work
done by either myself, my agent, servants or employes.
Signed: (Contractor or Builder) BY:
DIVISION WORKKE RS C PENS1Pi E
0
'' REVISSUANCE OF CONSTRUCTION INDUSTRY FIC E Off' EXEMPTION *'
This certificate exempts the Officer of the Corporation t •er of the Limited LisbWity Company
listed below from the provision of Florida Workers' ' ' • ; tion Law for the period indicated below .
EFFECTIVE GATE: 01/01/2004 �
" TION DATE 09/03/2005
CORPORATE OFFICER/ ICRUSOTH
LLC MEMBER NAME:
FEIN 5927763
TOM GALLAGHER
CHIEF FINANCIAL OFFICER
BUSINESS NAME AND AIR INC
ADDRESS: ,,�► NB 103RD ST
IAMT
RE- 1SSUAN .'t
ROBERT
FL 33138
Q1-U5-'lOU4
SCOPE OF BUSU SS OR TRADE: HEATING & AIR CONDITION/NO
IMPORTANT: Pursuant to Chapter 440.05(14) . F . S . , an officer of a corporation who elects
exemption from this chapter by filing a certificate of election under this section may not recover
benefits or compensation under this chapter QUESTIONS? 185W 419.2133
OWC.2E3 RE-ISSUANCE OF CONSTRUCTION INDUSTRY CERTIFICATE OF EXEMPTION REVISED 11 -03