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822 NE 96 St (8)Date Legal Description /AT Architect /Engineer Bonding Company Mortgagor PERMIT APPLICATION FOR MIAMI SHORES VILLAGE 2 2-.. NLgC i,.pef� Job Address 9 Ta x Folio �r � Lessee / Tenant / HoP469 flu s' S r Owner's Address g Z 2 N 9C 57 a Contracting Co. ,a fu y ( eo(.r,u C ht) ` Address 13 3-S? Al' 7,4jg Qualifier i?t f L. �aLfo� q / C� 5 (R ( P Master Permit # j X7 Address Phone '7 .57`^ s lc? I ss# Phone 655 State # of C g5 ; Municipal # Competency # Ins.Co. Address Address Permit Type(circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING ^ PAVING PENCE SIGN WORK DESCRIPTION r��'f'C if e E ir1 E /JT © i 4 o Pd -r- i- e 2 ,)) r o� Square Ft. 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 -named contractor to do the work stated. Signature of owner and /or Condo President Signatur of Co fra or or Owner-Bu f r Date: Date: 9 20 / Cf3 E4 'f'. kb! L cam Notary as to Owner and /or Condo President Not y as to Contactor or Owner-Builder My Commission Expires: My Commission Expires: j, j o1,2 pidle NOTARY PUBLIC, STATE OF FLORIDA. MY COMMISSION EXPIRES: April 1, 1995. ** * * * * * * * * * * BONDED THRINOTARY !'AJBLIC UNDIRWRITER* ** FEES: PERMIT J "J 1 RADON C.C.F. )'�� NOTARY TOTAL DUE /J W APPROVED: Fire Other Zoning Buildi _ ?' Electrical Mechanical Plumbing Engineering r 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) DISPOSAL SERVICE TEMPORARY A/C (CENTRAL) 41)1- DRINKING FOUNTAIN SERVICE SIZE IN AMPS DUCT WORK FLOOR DRAIN SERVICE REPAIR/IETER 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 k (A.) 57'Q T- r-P Kepf A/C UNIT STRIP HEATER /& /4- /-C U FIRE SPRINKLER GENERATORS TRANSFORMERS 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 RELAY TELEVISION OUTLETS DRAINFIELD, 4" TILE/RES. VIOLATION 1 PUMP 8 ABANDON SEPTIC TANK REINSPECTION SOAKAGE PIT CU. FT. CATCH BASIN DISCHARGE WELL DOMESTIC WELL I AREA DRAIN ROOF INLET SOLAR WATER HEATER FIRE STANDPIPE POOL PIPING LAWN SPRINKLER SYSTEM GAS RANGE METER SET (GAS) GAS PIPING I Ir 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