1075 NE 96 St (3)PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date y /- Job Address /674 >' Tax Folio
Legal Description Historically Designated: Yes No
Owner/Lessee / Tenant
Owner's Address 10 7. IU 94', sr ("4f v714
Contracting Co. 14/ 4IN ! liuC
Qualifier J tAiW / C) S ✓0.4,0U F)0 6-c _ SS# / Phone 2(2s-- (NO
State # Municipal # Competency # Ins. Co.
Architect/En_i ea Address
Bonding Company Address
Mortgagor Address
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESC' tl. „'ON WV/ U ✓t�c - �.
Square Ft. Estimated Cost (value) 9S . 0 U
WARNING T OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY RESULT IN YOUR
PAYING TWICE FO IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER
OR AN ATTORNEY EFORE 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.
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.
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Signature Ol ►-- ........_' •
Notary as to Own
My Commission Expires:
APPROVED:
Zoning
/1140/i L-»
- 76 -ate
Master Permit # � ,'') p2J
330 3 5,7 Phone `J 9S 2S' « 5 Z 0
Address 10960 13 /g . G l -7'V 13 L
G 4, -- 16- 2 o0
Date
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1564�[,�0 g Nf).::rIININC `; A
L. ' Agee liL dP•
Signa
No
My Commission Expires:
RADON C.C.F. t k NOTARY • BOND
TOTAL DUE 7,
Date
Building Electrical
Mechanical Q 9oC ' (.17-02
. L 7.0 2 Plumbing Structural Engineer
Miami Shores
PER IT APPLICATION FOR MUNICIPALITIES OF
(OWNER TO RETAIN COPY)
Date Job Address 107"S 7"S N F q ( sj Tax Folio
.1/a Se
Legal Description .e T, = 4y „A ) ,td , Master
Owner / Lessee / Tenant MR. Lougr\iir)
Owner's Address \(cf " M c11 5}
Contracting Co. SE?a\ -S
Qualifier SS4# - Phone 3`'E -4-6/ j
state j) C, 33 63)
Architect /Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL PAVING FENCE SIGN
;1;� C�,��Ir�►��tvw,c�. Cwa11 ■t.n■i)
WORK DESCRIPTION
Square Ft.
WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TC
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 nd that all work
will be done comp ance with all applicable laws regulating const c ion and zoning.
Furthermore, / e the abo e -named contractor to do the work stated
Date:
Signature of 0 r and /or Con
No -ry
My C
PERMIT FEE:
as to Owner ar
ission Expired
* * *
APPROVED:
Zoning
*
Competency # Ins. Co.
• ' • r, ` r IiiYY
re dent
Y ANI ALFONSO
MISS'AN 1 CC 120511
natilyiRietnItnderArriters
*
*
Fire
Building
Address
Not
My
*
Estimated Cost
Signature o
Date:
as
ommiss
*
Other
Permit #
DADE COUNTY
Phone 7 5 ° 5 g a 8
D7O1 S_ p \avast -lain 'o2
no
7hru Notary Public Underwriters
••dactor or Owner-
der
*
1 f -�/q Electrical
Mechanical tit- ¢y tc
Plumbing ` Engineering
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) 0//v-
1
7 S
DISPOSAL
SERVICE TEMPORARY
A/C (CENTRAL)
DRINKING FOUNTAIN
SERVICE SIZE IN AMPS
DUCT WORK
FLOOR DRAIN
SERVICE REPAIR/METER 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 HP
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 HP
TRANSPORTING ASSEMBLIES
SINK, SLOP
MOTORS OVER 8- 10 HP
ELEVATORS /ESCALATORS
TEMPORARY WATER CLOSET
MOTORS OVER 10- 25 HP
•
FIRE SPRINKLER SYSTEMS
URINAL
MOTORS OVER 25-100 HP
COOLING TOWERS
WATER CLOSET
•
MOTORS OVER 100 HP
VIOLATION
INDIRECT WASTES
A/C WINDOW
REINSPECTION
WATER SUPPLY TO:
AIR CONDITIONERS
i, A '
,fp
A/C UNIT
STRIP HEATER
FIRE SPRINKLER
GENERATORS TRANSFORMERS
Z.TJ'
HEATER -NEW INST.
GENERATORS TRANSFORMERS
HEATER - REPLACE
GENERATORS TRANSFORMERS
LAWN SPRINKLER -WELL
SPECIAL PURPOSE
-
SWIMMING POOL
OUTLETS COMMERCIAL
WATER SERVICE
SIGN TUBES
SEWER CONNECTIONS
SIGN TRANSFORMERS
UTILITY -SEWER
SIGN TIME CLOCK
UTILITY -WATER
FIXTURES
SEPTIC TANK
ANTENNA
-
;ELAY
TELEVISION OUTLETS
IRAINFIELD, 4" TILE/RES.
VIOLATION
'UMP 8 ABANDON SEPTIC TANK
REINSPECTION
30AKAGE PIT CU. FT.
ATCH BASIN
1 I SCHARGE WELL
!OMESTIC WELL
TEA DRAIN
100F INLET
OLAR WATER HEATER
IRE STANDPIPE
'OOL PIPING
AWN SPRINKLER SYSTEM
;AS RANGE
ETER SET (GAS)
AS PIPING
, ADDENDUM TO BUILDING PERMIT APPLICATION
(AN APPLICATION FOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. IF A MASTER PERMIT HAS BEEN
OBTAINED, THE OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.)
PLUMBING
ELECTRICAL
MECHANICAL