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785 NE 94 St (2)MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date Time Type Insp'�tl' 9a Permit No. f o " /` if Name Address Company Phone # For Inspector: 0 e l Name & Date Approved P ) ,°).z7 CA- Correction Re- Insp'n Fee ❑ t Date PERMIT APPLICATION FOR MIAMI SHORES VILLAGE 10050 N.E. 2nd Avenue • Miami Shores, Florida 33138.305- 795 -2204 ' 7 ' 3a '02 Job Address 1 0 E �( t'►'u /� Tax Folio Legal Description �Gdc wvvIla L _. Historically Designated: Yes No Owner /Lessee/Tenet &Z. � Master Permit # !✓ t'U -.' ' l Owner's Address 7 C) J +" E c h4 Contracting Co. CI k -Air C ©h Q . Lo. Address 1'. ©. 130 x 6 &l 330 Miciol, / R. / 63 Qualifier ?6oe•1 5. C.L r yir SS# Phone J6 E8S"6 State # C K C0:6 L l L4 Municipal # Competency # Ins. Co. "^�irn i.1;1 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): BUILDING WORK DESCRIPTION: Square Ft. Estimated Cost (value) - 4 CO . 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). 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 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 owner and/or Cot!.o'President D ate „4 3oyce MY COMMISSION # 50,� XPIRES APPROVED: Notary as to owner FEES: PERMIT , � d/or C ` adp President Joyc My Commis ion Ex res 43• Y kf, ; Y _ *: � •� : * MY COMMISSION - " Februu y RADON BONDED THRU TROY FAIN INSURANCE, INC ELECTRICAL PLUMBING Phone WS. SS 7. ( -" KO Signature of Cot ctor or O er Builder D to Not as ontr• tor or Ov / + per Build Joyc Kranz E PIRES My om ssion Expires:' ,;� COMMISSION CC808950 EXPIRES Febr 14, 2003 TROY FAIN INSURANCE, INC ROOFING 7'30 .a2. Date C.C.F ) ( 0 NOTARY BOND 1111 TOTAL DUE f . (1 V Zoning Building Electrical Mechanical S '` `z- 2 .'• L Plumbing Structural Engineer, ITEM - : BATH TUB UNIT FEE ITEM SWITCH OUTLETS UNIT : FEE." ITEM :.: SPACE HEA /0 f;4/ UNIT FEE BIDET LIGHT OUTLETS CENTRAL HEATING y 4, DISHWASHER RECEPTACLES A/C (WIN)) 1(4, Q # 4 /,5-f DISPOSAL SERVICE TEMPORARY A/C (CENTRAL) DRINKING FOUNTAIN SERVICE SIZE IN AMPS DUCT WORK FLOOR DRAIN SERVICE REPAIR/6€TER CHANGE REFRIGERATION GREASE TRAP APPLIANCE OUTLETS PROCESS AND PRESS PIPING INTERCEPTOR RANGE TOP UNDERGROUND TANKS LAVATORY OVEN ABOVE GROUNW TANKS LAUNDRY TRAY WATER HEATER _ U.F. PRE E VESSELS CLOTHES WASHER MOTORS 0- 1 W STEAM BOI SHOWER MOTORS OVER 1- 3 If HOT WATER ILERS SINK, POT/3 co*. MOTCRS OVER 3- 5 HP MECHANICAL VENTILATION SINK, RESIDENCE MOTORS OVER 5- 8 HP TRANSPORTING ASSEMBLIES . SINK, SLOP MOTORS OVER 8- 10 HP ELEVATORS/ESFALATORS TEMPORARY WATER CLOSET MOTCRS OVER 10- 25 HP FIRE SPRINKLER SYSTEMS URINAL MOTORS OVER 25-100 HP COOLING TOWERS WATER a.OSET MOTORS OVER 100 FP VIOLATION INDIRECT WASTES • A/C WINDOW REINSPECTION4 WATER SUPPLY TO: AIR CONDITIONERS - A/C UNIT STRIP HEATER FIRE SPRINKLER GENERATORS TRANSFORMERS • • i I HEATER -NEW INST. GENERATORS TRANSFORMERS HEATER - REPLACE GENERATORS TRANORMERS LAWN SPRINKLER -WELL SPECIAL PURPOSE SWIMMING POOL OUTLETS COMMERCIAL WATER SERVICE SIGN TUBES ;EWER CONNECTIONS SIGN TRANSFORMERS ITILITY-SEWER SIGN TIME CLOCK ITILITY -WATER FIXTLRES :EPTIC TANK ANTENNA ELAY TELEVISION OUTLETS RAINFIELD, 4' TILE/RES. VIOLATION UMP & ABANDON SEPTIC TANK RE I NSPECT ION OAKAGE PIT CU. FT. 11 ��� 4 AM ATCH BASIN + / ISCHARGE WELL 1 OMESTIC WELL REA DRAIN . OOF INLET CLAR WATER HEATER IRE STANDPIPE )OL PIPING - AWN SPRINKLER SYSTEM AS RANGE :TER SET (GAS) LS PIPING PLUMBING ADDENDUM TO BUILDING PERMIT APPLICATION (AN AP €LICATION FOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. IF A MASTER PERMIT HAS B. OBTAINED, THE OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBS I QUENT APPLICATIONS.) 1 ELECTRICAL MECHANICAL - - - e D- ,0 -12 - u - 18 - 1e ' 20 24 - - 26 -� 30 - - 32 - 34 - 36 - 38 -40 - 42 AIR CONDITIONING CO. P.O. BOX 681330 • MIAMI, FL 33168 -1330 PHONE: (305) 685 -6394 PAY TO THE ORDER OF MEMO BANK OF AMERICA FLORIDA 63- 243/670 11'00400311' 1:06 700 24 361: 40 L309 L0600 4003. Contractor C & R AIR CONDITIONING CO Local Phone: 305 - 685 -6394 Parcel # 1132060142030 JOB ADDRESS: 785 NE 94 ST Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Printed: 8/1/2002 Applicant: MARY Owner: BRLGGS Permit Status: Approved Permit Expiration: 1/27/2003 Work: EXACT CHANGE OUT OF 4 TON SPLIT SYSTEM Mechanical Permit Permit Number: ME2002 -111 BRIGGS MARY Contractor's Address: 2121 NW 139 ST #10 Construction Value: $3,450.00 Page 1 of 1 Legal Description: MIAMI SHORES SEC 3 PB 10 -37 E1/2 OF LOT 24 & ALL LOTS 25 & 26 LESS E15FT j2 ��s o0 — 77.4 0 Total Fees: W90 Total Receipts: $0.00 If there is no permit package accessible on the job -site for inspectors to verify, there will be no inspections. Re- inspection fee is $50.00, which must be paid in advance before calling for another inspection. 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 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 or in the statements or specifications and that he assumes responsibility for work done by his agents, servants or employees. Sign `'signed: 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 ag _ t, servants or employes. (INSPECTOR) BY: (Contractor or Builder) BY: