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MECHANICAL
, PERMIT APPLICATION FOR MUNICIPALITIES OF DADE COUNTY � j (OWNER TO RETAIN COPY) Job Address o2 ? 41. j � S /7 j c t�dee_s Tax Folio /A 3.7e66/341 f Legal Description � /� 5' / / 473? Master Permit # �' ! / q e Tenant)(7� r � /S /4 ) ° b / 44 41' 41 /S OU / d dl,Yl �0 - 7/ /z .�v7-mio el 7- .Fsr ram � . 4 (/� tic ,execf$ phone Owner / Owner's Address Contracting Co. die/P/C Q QualifierGF/ 4 b1 ,t) & l7 n State# Ctwo 36 .26 Architect /Engineer Bonding Company Mortgagor Permit Type (circle one): BUILDING ELECTRICAL PLUMBING WORK DESCRIPTION /Sfcz,// a eiori a ©N2 S�slP.r.. � � eP.4efjI AcFe 648060 TA- S /41-6 20 /D g s - S %,1 s - -Seeds 144-r- �o Uku r Square Ft. Estimated Cost g2S0p 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. 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 d e in compliance with all applicable laws regulating construction and zoning. Furthermore, I authorize the above -named contractor to do 'e work stated. Signature o Date: O Notary as t My * Commission Expire9; ;TAlr PUBLIC STATE OF FLORIDA * * D *COMISSIGN*AP. UOV.27*991 BONDED TURD GIJERAL INS. UND. APPROVED: PERMIT FEE: Owner or Condo President 'rand /or Condo President c f Competency # phone Ins. Co. AI1IP.RleRit) �i eG * Fire Building Plumbing Sig Da Address a?/9/ 4Itd .76 e- /1/4447J r'/444jj` �L Address Address Address e: Electrical Engineering 3 3 - PAVING FENCE SIGN ture of Contractor or Owner - Builder Notary as t Contractor or Owner - Builder My Commission Expires: VOTARY PUBLIC STATE JF FLORIDA* * * * * .IY CO;; I*SIO EXP. V.27,1991 BONDED IHRU GEUERAL IUS. UUD. Other 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. Owner's Name and Addres APPLICATION FOR BUILDING PERMIT Registered Architect and /or Engineer Name and address of licensed contracto Location and legal description of lot to be built on: Lot Block Street and Number where work is to be done. State work to e done and p rpose, of building (by Building I 'spector MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT q Subdivision floors).. l Chainnan Member Member .. Council Approved Date NOTE: A charge of $1.00 will be made for making corrections the Planning Board. A re- inspection fee of $1.00 will be charged materials and /or workmanship. Date. ,3 123a. 44- . Read, Sworn to and Subscribed before me. , 19 c3 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 e ° $_tom Amount of Permit $ S'° 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 to be performed under this permit, as are licensed by Miami Shores Village. Remarks (Signed) =° �c �,.,.f�- __,,,_„ 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 76 7 3 Date Disapproved (Signed) Notary Public, State of Florida My Commission Expires PLANNING BOARD DATE Member Member Member Disapproved Date or changes to this application after approval has been obtained from when such re- inspection is made necessary by improper notice for inspection or faulty BUILDING ❑ ELECTRICAL CI DATE PLUMBING ❑ PERMIT N? 7673 ROOFING ❑ w ❑ Owner of Building Architect Contracto or Builder Legal Descripti Address Building 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. In consideration of the issuance to me of this permit I agree to perform the work covered:.lereunder 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 responsibility for all work done by either, myself, my agent, servant or employee. CONTRACTOR OR BUILDER MIAMI SHORES VILLAGE. FLORIDA Work to be performed under this Permit Signed • f .; • j, INSPECTOR Contractor's License No 4 BY AUTHORITY 195 7 � 4 ., { ; 4 i, L- ' :f t t . _ I } r t / t r ( n Lot gl Subdi- vision If , !` : "" Sq. Ft Amt. of Permit $ Value of Project $ . r ,x BUILDING ❑ ELECTRICAL CI DATE PLUMBING ❑ PERMIT N? 7673 ROOFING ❑ w ❑ Owner of Building Architect Contracto or Builder Legal Descripti Address Building 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. In consideration of the issuance to me of this permit I agree to perform the work covered:.lereunder 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 responsibility for all work done by either, myself, my agent, servant or employee. CONTRACTOR OR BUILDER MIAMI SHORES VILLAGE. FLORIDA Work to be performed under this Permit Signed • f .; • j, INSPECTOR Contractor's License No 4 BY AUTHORITY 195 7 Printed: 11/5/2004 Applicant: MADELEINE Owner: ROMANELLO JOB ADDRESS: 29 NE 96 Contractor Local Phone: Parcel # 1132060130830 AIRWAY AIR CONDITIONING INC Signed: (INSPECTOR) Mechanical Permit Miami Shores Village 10050 NE 2nd Avenue Phone: 305- 795 -2204 Permit Number: MC2004 -192 ROMANELLO MADELEINE ST Permit Status: APPROVED Permit Expiration: 4/30/2005 Construction Value: $4,250.00 Work: REPLACE A/C 5 TON Page 1 of 1 Contractor's Address: 3930 N. 38 AVE Legal Description: MIAMI SHORES SEC 1 AMD PB 10 -70 LOTS 15 & 16 BLK 6 LOT SIZE 100.000 Fees: Description Amount FEE2004 -10870 Building Fee $148.00 FEE2004 -10871 CCF $3.00 FEE2004 -10872 Notary Fee $5.00 FEE2004 -10873 Training and Education Fee $1.00 FEE2004 -10874 Technology Fee $3.70 Total Fees: $160.70 Total Fees: $16k70 Total Receipts: $0.00 C � II0.7U .N0V05PAID 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: 353 mit • 0. 1CG- te -- Omni. dress ...- P CIO rtipanv 1 4_4 t 1, )ne # pection Date Proved irrection -Imp' n Fee do_ .... • - 0 171 Mil — • i C his 'n Na Ad Co Ph LT A c MIAMI SHOR.ES VILLAGE BUILDING DEPARTMENT . Buil g Inspection Request Dxc e 1 • 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 BUILDING PERMIT APPLICATION FBC 2001 Permit Type (circle): Building Electrical Plumbing (Mechanical Roofing Owner's Name (Fee Simple Titleholder) RO ((AI Ale" L Phone # 5- -2 g.2 - 2- /.3 Owner's Address 2 9 ‘ Y 7 Cit g , State r L Tenant/Lessee Name Phone # Job Address (where the work is being done) .2 9 II) F 96 sr City Miami Shores Village Is Building Historically Designated YES NO Contractor's Company Name * \ V Contra or s Address Z C'� � _ ,r 1 % f' e > ��. � d � Z. PIIL'e- City \S\\/(' c—k, State L- Qualifier L fV\ R 0-V'Y! -) v ✓n c4 Total Fee Now Due $ (Continued on opposite side) Miami Shores Village Building Department Scanning $ Radon $ Zoning Code Enforcement $ Structural Plan Review. $ �l ? Permit No. tC Ou — 1 C I Z Master Permit No. 8 0 4' � 3 7 Zip 3 County Miami -Dade Zip Phone # 47 LI Zip Architect/Engineer's Name (if appli a ble Phone # $ Value of Work For this Perna .. f i Square Footage Of Work: ❑NewRepair/Replace Type of Work: ['Addition ❑Alteration Describe Work: �=�i .�4`' t� rNJ 1 /4_ 0- ,M Mfl G O6b 7 c cc. Submittal Fee $ •CU Permit Fee $ t � 1 rt CCF $ Notary $ .6 Training/Education Fee $ Technology Fee $ Bond $ ! CtE VEn I NO 1 20 / ❑ Demolition Bonding Company's Name (if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name (if applicable) Mortgage Lender's Address 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 installatio commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regul construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIt 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 FINANC G, 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 estimaJeerv�lue exceeding $2500, the applicant > ust promise in good faith that a copy of the notice of commencement and construction li n law rochure will be delivered to the pe son whose property is subject to attachment. Also, a certified copy of the recorded nottr of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is i ssued. /n the absence of such posted notice, the inspection will not be appr•ved an reinspection fee will be charged. 1 7 s „ , ,,,, �i� Steve 4vi ; Signature Owner or Agent The foregoing instrument was acknowledged before me this day of .e'v " , 20 O � ! by / ► /€0 h tiVC L. O who is perso P A own to me or who has produced J CX . NOTAR Sign: Print: My Com ssion Expires: As identificatio�p. o e li e an oath. mission MD23198 : Jul 13, 2007 Signature NOTARY PUBLIC: Sign: Print: My Commission Expires: (07 (Certificate of Competency Holder) State Certificate or Registration No. Certificate of Competency No. *********************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** * * * * * ** * * * * * * * * * * * * * * * * * * * ** * * * * ** G Plans xaminer APPLICATION APPROVED BY: Cho 12/15/03 Engineer Zoning has ting NS, I (, >L' :r ° . e � =, Commissi#DDI7572 � 7 -..,*,.. .::_ Expires: J�n 06, 2007 ,, , ".oF F�c Bond d Thru Contractor Atlantic Bo ding Co., Inc The foregoing 11 insst�trument was acknowledged before me this day of <1 Uv 20 dy, by who is personally known to me or who has produced S't'�� : C 1CeA-152Sas identification and who did take an oa * *