790 NE 97 St (4)PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date a� 1 t Job Address 79'0 Z? / � /. Tax Folio
al S7ii2� r�G� D�f ��
Legal Description LOT // c 0 , (e 6 Historicall 6 esi g nated. Yes No
/ o
Owner/Lessee / Tenant \/ I i d� c�
`� (,) Master Permit # ) 93`
Signature/
or Condo President
Notary as to ownerand/or Condo President
My Conunission Expires:
rIS: PERMIT `/X ��' RADON
Owner's Address 2 ,// 7 ,VrePT 7i Phone 7 -
Contractin Co. gee7k Address 7 ez2r
Q ualifier 30,e7 (/q v / SS# - � yo —0/7_?)
State # L r (X'()// L40 Municipal # Competency # Ins. Co.
Architect/Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type (circle one): BUILDING ELECTRICAL PLUMB G MECHANICAL RO FING PAVING FENCE SIGN
WORK DESCRIPTION ' � `� fJA+t 6 67 i 31,2 To/ 4 6 ci
/r/ r iex' rEia cka /�/ erre
Square Ft. Estimated Cost (value). C cr
C.C.F.
lag
Date 3 i s ig
Date 31,
c -5 s& -_ ?
,•%7
Signature of
NOTARY
Building
WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY
RESULT IN YOUR PAYING TWICE FOR LMPROVEMENTS 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 and that all work will be done in compliance with all c.pplicable
laws regulating construction and zoning. Furthermore, I authorize the above -named coctor to d the wor stated.
i L
Notary:is t• Contractor or Owner - Builder ` T = _ , s D
3 --ate
My Commission E �•=�_ r ,, ,
7 :.,:.,d �.."�:e.;:�s3 art =.
�;�4^. 92, Sal
Electric
br or • er- Builder
TOTAL DUE 0;
APPROVED:
Zoning
Mechanical Plumbing Engineering
Date jr ';,'
ITEM
BATH 'RS
B IOET
PLUMBING
81SINIASHER
DISPOSAL
DRINKING FOUNTAIN
FLOOR [RAIN
GREASE TRAP
INTERCEPTKR
LAVATORY
UMW TRAY
CLOTHES WASHER
SHIER
SINK POT/3 COIN'.
SINK, RESIDENCE
SINK, SLOP
TEMII'QiARY WATER CLOSET
IRINAL
WATER CLOSET
INDIRECT WASTES
WATER SUPPLY TO:
A/C UNIT
FIRE SPRINKLER
HEATER-1€w IHST.
HEATER - REPLACE
LAWN SPRINKLER -/ELI
_ SWIMMING POOL
WATER SERVICE
SEWER CONNECTIONS
UTILITY -WATER
PUMP
CH BASIN
DISCIWIGE WELL
DOMESTIC WELL
AREA DRAIN
ROOF INLET
SOLAR WATER HEATER
FIRE STAINPIPE
POOL PIPING
LAWN SPRINKLER SYSTEM
GAS BARGE
METER SET (GAS
CAS PIPING
03/
■
FEE
MINIM
1�
MEM
15:24
M
• ADDENDUM TO BUILDING PERMIT. APPLICATION
(AN APPLICATION FOR BUILDING PERHIT HUST ACCOMPANT THIS ADDENDUM. IF A MASTER PERMIT HAS BEEN OBTAINED, THE OWNER'S NOTARIZED SIGNATURE EED N NOT BE PRESENT on SUBSEQUENT APPLICATIONS.)
MECHANICAL
ELECTRICAL
ITEM
SWITCH CUTLETS
LIGHT OUTLETS •
RECEPTACLES
SERVICE TEWORARY
SERVICE SIZE IN RAPS
SERVICE REPAIR/►ETER CHANGE
APPLIANCE OUTLETS
RANGE TOP
OVEN
WATER HEATER
MOTORS 0- 1 if
MOTORS OVER 1- 3 HP
MITERS OVER 3- 5 FP
LETERS OVER 5 8 HP
IAOTCRS OVER 8- 10 HP
MOTORS OVER 10 - 25 HD
MOTORS OVER 25-100 NP
MOTORS OVER
A/C WINDOW
100 HP
AIR COO I T IONERS
STRIP HEATER
GENERATORS MUMMERS
GENERATORS TRANSFCRIERS
UNIT
PURP
■
SPECIAL PURPOSE SE
Cpf(RCML
FEE
TELEVISION CUTLETS 1111111111 ITEM
VIOLATION
SPACE HEATIRS
CENTRAL HEATING
A/C RIM)
-- A/C (CENTRAL)
-- DUCT WORT(
11111 — PROCESS PRESS TAMS
-_ 1 • r•u • 1
AB GROUND TANKS
U.F. PRESSURE VESSELS
STEAM BOILERS
HN7T WATER BOILERS
MECHANICAL VENTILATION F I
TRANSPC TING ASSES
MI
Mil
--
-NM COOLING TOWERS
U VIOLATION
RE INSPECTION
1'
11
ELEVATORS/ESCALATK S
FIRE SPRINKLER SYSTEM
004
UNIT
IMMO MI
MI NI � r
MUM
WEAKEN SEPTIC TANK � '
SOAKAGE
MIN
INN
PIT W. FT. El
CAT / `
��''
BUILDING
ELECTRICAL
PLUMBING
Owner of
Building
Architect
Contractor
or Builder
Legal Lot
Description
Address of
Building
CONTRACTOR OR BUILDER
MIAMI SHORES VILLAGE. FLORIDA
PERMIT N° 9665
Work to be performed under this Permit
Bl.
Subdi-
vision
Value of
Project $
DATE 195
Contractor's
License No
Amt. of
Permit $
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 an / 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.
Signed • 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 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.
BY AUTHORITY
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
Permit No 4 J Date
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building 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 cept at
building during progress of work.
Owner's Name and Address No Street....
Registered Architect and /or Engineer
Employing Electrician's Name No . Street
Location and Legal Description Lot Block Subdivision
Street and Number where work is to b: performed —No Street
State work to be performed and purpose of building (By Floors)
New Building Remodeling Addition Repairs No. of Stories
Service Overhead Size Feeders Conduit Main Sw Amps Main Fuses Amps
Underground
Type of Installation— Conduit Tubing B.X.L .Metal Moulding
Amount of Permit $ l
The undersigned applicant for this building permit does hereby certify that he understands and a
labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws
has complied with the provisions thereof, and will require similar compliance from all contractors or
work to be performed under this permit; and will post or cause to be posted for inspection on the site
as are required by the Act. The undersigned agrees to employ only such sub - contractors, on work to
licensed by Miami Shores Village.
STATE OF FLORIDA, l
COUNTY OF DADE. I
ss.
(Signed)
Electrical Inspector.
ccepts his obligations as an employer of
of Florida Permanent Supplement, and
subcontractors employed by him in the
of the work such public notice or notices
be performed under this permit, a are
(Signed)
Master Electrician.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally
appeared
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, and he has carefully read the foregoing application, and that he did sign the same, and that all fact:
therein by him stated are true.
My Commission Expires Notary Public, State of Florida
NOTE: A re-inspection fee of $1.00 will be made when such re-inspection is made necessary by improper notice for inspection, or faalty
materials and /or workmanship.
SWITCH
OUTLETS
LIGHT
OUTLETS
PLUG
RECE'P'T'S
FIXTURES
NO. LAMPS
REFRIO.
OUTLET
IRON
OUTLET
RANGE
OUTLET
RANGE
CONN.
WATER
HEATER
W. HEAT.
CONN.
SPACE
HEATER
STRIP
HEATER
TOTAL
CONTR.
LIST
CHECK
ENT.
SW.
DIST.
CAB.
SERVICE
TEMP.
SERVICE
PERM.
MOTORS
0.1 HP
MOTORS
1.5 HP
NEON
TRANS.
RADIO
TOTAL
CONTR.
LIST
CHECK
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
Permit No 4 J Date
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building 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 cept at
building during progress of work.
Owner's Name and Address No Street....
Registered Architect and /or Engineer
Employing Electrician's Name No . Street
Location and Legal Description Lot Block Subdivision
Street and Number where work is to b: performed —No Street
State work to be performed and purpose of building (By Floors)
New Building Remodeling Addition Repairs No. of Stories
Service Overhead Size Feeders Conduit Main Sw Amps Main Fuses Amps
Underground
Type of Installation— Conduit Tubing B.X.L .Metal Moulding
Amount of Permit $ l
The undersigned applicant for this building permit does hereby certify that he understands and a
labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws
has complied with the provisions thereof, and will require similar compliance from all contractors or
work to be performed under this permit; and will post or cause to be posted for inspection on the site
as are required by the Act. The undersigned agrees to employ only such sub - contractors, on work to
licensed by Miami Shores Village.
STATE OF FLORIDA, l
COUNTY OF DADE. I
ss.
(Signed)
Electrical Inspector.
ccepts his obligations as an employer of
of Florida Permanent Supplement, and
subcontractors employed by him in the
of the work such public notice or notices
be performed under this permit, a are
(Signed)
Master Electrician.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally
appeared
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, and he has carefully read the foregoing application, and that he did sign the same, and that all fact:
therein by him stated are true.
My Commission Expires Notary Public, State of Florida
NOTE: A re-inspection fee of $1.00 will be made when such re-inspection is made necessary by improper notice for inspection, or faalty
materials and /or workmanship.