725 NE 96 St (10)Date
Legal Description
Owner/Lessee / Tenant
Owner's Address
Contracting Co. / 4 ( I IN
Qualifier 1,-51 1
Square Ft.
Signature of owner and/or Condo President Date
FEES: PERMIT
PERMIT APPLICATION 'FIR MIAMI SHORES VILLAGE
Job Address 7,3 ,c /;,fir 77 Tax Folio
Notary as to Owner and/or Condo President Date Notary a o Contractor
My Commission Expires: My Commission Expires:
RADON C.C.F.
Historically Designated: Yes No
? j;
Master Permit #
Phone
Address /r _ /A
SS# : Phone ✓ ,r3 .j'f
State # er b J 0 v 7` / Municipal # Competency # Ins. Co.
Architect/Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION re...
,)
7
r
42‘e, r (-))%
Estimated Cost (value)
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 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 applicable
laws regulating construction and zoning. Furthermore, I authorize the above -nam actor to do the work stated.
NOTARY BOND
APPROVED:
Zoning Building Electrical `�1:17,1- 6- i - 47 "'K - z`` -
Mechanical Plumbing Engineering
TOTAL DUE 3
ITEM
BATH TUB
UNIT
FEE
ITEM
SWITCH OUTLET'S
UNIT
FEE
ITEM
SPACE HEATERS
UNIT
FEE
BIDET
LIGHT OUTLETS
CENTRAL HEATING
DISHWASHER
RECEPTACLES
A/C (WIND)
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 GROUH3 TANKS
LAUNDRY TRAY
WATER HEATER
U.F. PRESSURE VESSELS
CLOTHES WASHER
, MOTORS 0- 1 HP
STEAM BOILERS
SHOWER
MOTC1 S OVER 1- 3 HP
HOT WATER BOILERS
SINK, POT /3 COMP.
MDTCRS OVER 3- 5 If
MECHANICAL VENTILATION
SINK, RESIDENCE
MOTORS OVER 5- 8 HP
TRANSPORTING ASSE1y8LIES
SINK, SLOP
MOTORS OVER 8- 10 HP
ELEVATORS/ESCALATORS
TEMPORARY WATER CLOSET
MTTCRS OVER i0- 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
REINS?ECTION
WATER SUPPLY TO:
AIR CONDITIONERS
A/C UNIT
STRIP HEATER
FIRE SPRINKLER
_GENERATORS TRANSFORMERS
.
'HEATER -NEW INST.
GENERATORS TRANSFORMERS
HEATER - REPLAN
GENERATORS TRANSFORMERS
LAWN SPRINKLER -WELL
SPECIAL PURPOSE
SWIMAGING POOL
•
CUTLETS COMERCIAL
_
WATER SERVICE
•
•
SIGN TUBES
SEWER CONNECTIONS
_
SIGN TRANSFORMERS
UTILITY-SEWER
SIGN TIME CLOCK
_
UTILITY-WATER
FIXTLRES
SEPTIC TANK
ANTENNA
RELAY
TELEVISION OUTLETS
`
ORAINFIELD, 4' TILE/RES.
VIOLATION
PUMP & ABANDON SEPTIC TANK
RE I NSOCT ION
SOAKAGE PIT CU. FT.
/ 4, /f3/j
CATCH BASIN
D I SCt IARfE WELL
_ 1� . m
0 ,
DOMESTIC WELL
AREA DRAIN
e--;-- -
r
.
100F INLET
AAR WATER HEATER
- IRE STANDPIPE
COL PIPING
AWN SPRINKLER SYSTEM
.
AS RANGE
_
ETER SET (GAS)
S PIPING
ADDENDUM TO BUILDINtG PERMIT APPLICATION
5Ho
(AN APPLICATION FOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. IF A MASTER PERMIT HAS B.
OBTAINED, THE OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.)
PLUMBING
ELECTRICAL
MECHANICAL