44227 (3)Date ► °Ij 4 19 Job Address 02 .9V e 9 6 -44— Tax Folio
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Owner's Address t t" 7 N C Atik ,
Contracting Co. A 1 R R PO '4 C
C".r,
Address
SS# 'hone ,qn c 4Z S7 73 Sy
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State # I4 ':fl 1 1 Al 1 Municipal # Competency # Ins. CoT12r_amiitrASARAf
Architect/Engineer - 11 c(1 4 12. C3EAdi Act C,o Q G.9 Le S
Bonding Company Address
Mortgagor Address
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
/Tenant des Presl y°fer w .'4
Square Ft Estimated Cost (value) 146 it li
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 W1TH 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
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 Condo President Date
Notary as to Owner and/or Condo President
My Commission Expires:
FEES: PERMIT RADON C.C.F.
APPROVED:
Zoning Building
Historically Designated: Yes NO
/
Master Permit #(I42 7
� 117 , C
Phone
NOTARY BOND
TOTAL DUE
Electrical f'
4- 9f Plumbing Structural Engineer
ITEM
BATH TLB
UNIT
•
FEE ITEM
SWITCH CURETS
WILT
FEE
ITEM
SPACE HEATERS
WILT
FEE
8I0ET
LIGHT CUTLETS
CENTRAL DATING
otShOSHER
RECEPTACLES
A/C (KIND)
DISPOSAL
SERVICE TEWORARY
A/C (CENTRAL)
,,j'
DRINKING FOUNTAIN
SERVICE SIZE IN AMPS
DUCT WOO(
FLOOR CRAIN
SERVICE REPAIRWER CHOSE
REFRIGERATION
GREASE TRAP
APPLIANCE CUTLETS
PROCESS AND PRESS PIPING
INTERCEPTER
RANGE TOP
Ut TAMS
LAVATORY
OVEN
ABOVE GREW
LAY TRAY
_
WATER HEATER
U.F. PRESSURE VESSELS
CLOTHES WASHER
-
MOTORS 0- 1 If
STEAM BOILERS
SHOWER
MOTCRLS OVER 1- 3 FP
HOT WATER BOILERS
SINK, POT/3 COMP.
MOTORS OVER 3- 5 iP
MECHANICAL VENTILATION
SINK. RESIDENCE
MOTERS OVER 5- 8 HP
TRANSPORTING AMELIES
S INK. SLOP
_
MDTCRS OVER 8- 10 FP
ELEVATORS/ESCALATORS
TE}PCRARY WATER CLOSET
MOTERS OVER 10- 25 MP
FIRE SPRINKLER SYSTEMS
URINAL
MOTE RS OVER 25-100 FP
COOLING TOWERS
WATER CLOSET
MOTORS OVER 100 FP
VIOLATION
INDIRECT WASTES
A/C WDOOI
REINSPECTION
WATER SVPII.Y TO:
AIR COIOITIONERS
'
A/C UNIT
STRIP HEATER
FIRE SPRINKLER
GENER.&T3 S TRANSFD RS
.
DATER -NEW INST.
GENERATE TRIOSRMIERS
HEM-REPLACE
GENERATORS TRA RS
•
LAWN SPPRINKLER -HELL
SPECIAL PURPOSE
SWIMMING PCCL
' OUTLETS COKERCIAL
WATER SERVICE
• SIGN TUBES
SEWER CONNECTIONS
SIGN TRANSFORMERS •
UTILITY-40ER
SIGN TIME CLOCK
UTILITY -WATER
FIXILRES
SEPTIC TANK
ANTEM(A
RELAY
TELEVISION OUTLETS
_
ORAINFIELD. 4' TILE/RES.
VIOLATION'
MA' & ABANDON SEPTIC TANK
REINSPECTION
SOAKAGE PIT CU. FT.
CATCH BASIN
DISCHARGE WELL
DOMESTIC WELL
AREA CRAIN
REEF INLET
SOLAR WATER HEATER
FIRE STANDPIPE
POOL PIPING
,
LAWN SPRINKLER SYSTEM
GAS ROI
_
METER SET (GAS)
I
GAS PIPING _
—.
(AN APPLICATION FOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. IF A MASTER PERMIT SAS B.
OBTAINED, TF2 OVUM'S S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.)
PLUMBING
ADDENDUM TO BUILDING PERMIT APPLICATION
ELECTRICAL
MECHANICAL