916 NE 96 St (2)ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
Permit No....... 3 3
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith se,bmitted 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 kept at
building during progress of work.
Owner's Name and Address
Registered Architect and /or Engineer
Employing Electrician's Name H✓ feD . �F° @ �� p N l) s �� y �� � '
Location and Legal Description Lot Block Subdivision
Street and Number where work is to be performed— No. ..��'
State work to be performed and purpose of building (By Floors)
New Building Remodeling X. Addition Repairs No. of Stories
Amount of Permit $
STATE OF FLORIDA, }
COUNTY OF DADE.
ss.
MIAMI SHORES VILLAGE
,e7y c
No....d" / 47 /- 1 '
(Signed)... ':'
(Signed)_
Date h 1�
Street
C..
Street (z 7 ' d l
Street. _..//.. ':/ i
Service Berg- nd Size Feeders. .Conduit.i Main Sw Amps Main Fuses Amps
Type of Installation — Conduit �� Tubing.... B.X.L Metal Moulding..
lectrical Inspector.
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 subcontractors 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.
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, a,,d he has carefully read the foregoing application, and that he did sign the same, and that all facts
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 faulty
materials and /or workmanship.
SWITCH
OUTLETS
LIGHT
OUTLETS
PLUG
RECE'P'T'S
FIXTURES
NO. LAMPS
REFRIO.
OUTLEY
IRON
OUTLET
RANGE
OUTLET
RANGE
CONN.
WATER
HEATER
W. H EAT.
CONN.
SPACE
HE!. 'ER
STRIP
HEATER
TOTAL
CONTR
LIST
CHECK
ENT.
SW.
DIST.
CAB.
SERVICE
Tr-; "P.
SERVICE
PERM.
M OTOP0
0.1 HP
t. :OTORS
1.3 HP
N EON
TRANS.
RADIO
TOTAL
CON': R.
LIST
°'
�.,. -» ! 3'
: \.i
C L
CHECK
v
g..•
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
Permit No....... 3 3
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith se,bmitted 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 kept at
building during progress of work.
Owner's Name and Address
Registered Architect and /or Engineer
Employing Electrician's Name H✓ feD . �F° @ �� p N l) s �� y �� � '
Location and Legal Description Lot Block Subdivision
Street and Number where work is to be performed— No. ..��'
State work to be performed and purpose of building (By Floors)
New Building Remodeling X. Addition Repairs No. of Stories
Amount of Permit $
STATE OF FLORIDA, }
COUNTY OF DADE.
ss.
MIAMI SHORES VILLAGE
,e7y c
No....d" / 47 /- 1 '
(Signed)... ':'
(Signed)_
Date h 1�
Street
C..
Street (z 7 ' d l
Street. _..//.. ':/ i
Service Berg- nd Size Feeders. .Conduit.i Main Sw Amps Main Fuses Amps
Type of Installation — Conduit �� Tubing.... B.X.L Metal Moulding..
lectrical Inspector.
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 subcontractors 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.
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, a,,d he has carefully read the foregoing application, and that he did sign the same, and that all facts
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 faulty
materials and /or workmanship.
Permit No
Owner's Name and Address
Registered Architect and /or Engineer
Employing Electrician's Name
Location and Legal Description Lot / . F"
Street and Number where work is to be performed —No
STATE OF FLORIDA, }
COUNTY OF DADE.
ss.
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
24/
(Signed)
/37
Date SEA 17 /-
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith sub 1 fitted 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 ani specifications must be kept at
building during progress of work.
No teP Y / Street.. • 6
No ,dr._4 e Street. Le
Block /...(Q Subdivision
Street
State work to be performed and purpose of building (By Floors)
New Building V
Remodeling Addition Repairs No. of Stories
Service Overhead Site Feeders Conduit Main Sw Amps Main Fuses Amps
Underground
Type of Installation— Conduit Tubing B.X.L Metal Moulding
Amount of Permit $ (Signed)
Electrical Inspector.
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 subcontractors 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 sub - contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village.
PP
•
L Il I-. e- -e
ter 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 facts
therein by him stated are true.
My Commission Expires Notary Public, Sate of Florida
NOTE: A re- inspection fee of $1.00 will be made when such re-inspection is made necessary by improper notice for inspection, or faulty
materials .4nd /or workmanship.
SWITCH
OUTLETS
LIGHT
OUTLETS
PLUG
RECE'P'T'S
FIXTURES
NO. LAMPS
REFRIG.
OUTLET
IRON
OUTLET
RANGE
OUTLET
RANG[
CONN.
WATER
H
W. HEAT.
CONN.
SP /■CE
HEATER
STRIP
H
TOTAL
CONTR.
LIST
CHECK
ENT.
SW.
DI$T.
CAS.
IC
TEMP.
ERVICE
ERM.
MOTORS
0.1 HP
MOTORS
t -f HP
NEON
TRANS.
RADIO
TOTAL
CONTR.
LIST
CHECK
Permit No
Owner's Name and Address
Registered Architect and /or Engineer
Employing Electrician's Name
Location and Legal Description Lot / . F"
Street and Number where work is to be performed —No
STATE OF FLORIDA, }
COUNTY OF DADE.
ss.
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
24/
(Signed)
/37
Date SEA 17 /-
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith sub 1 fitted 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 ani specifications must be kept at
building during progress of work.
No teP Y / Street.. • 6
No ,dr._4 e Street. Le
Block /...(Q Subdivision
Street
State work to be performed and purpose of building (By Floors)
New Building V
Remodeling Addition Repairs No. of Stories
Service Overhead Site Feeders Conduit Main Sw Amps Main Fuses Amps
Underground
Type of Installation— Conduit Tubing B.X.L Metal Moulding
Amount of Permit $ (Signed)
Electrical Inspector.
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 subcontractors 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 sub - contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village.
PP
•
L Il I-. e- -e
ter 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 facts
therein by him stated are true.
My Commission Expires Notary Public, Sate 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 faulty
materials .4nd /or workmanship.
Permit No 1.
Amount of Permit $
APPLICATION FOR ELECTRICAL PERMIT
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 kept at
building during progress of work.
Owner's Name and Address ' • X • No
Street and Number where work is to be performed —No
State work to be performed and purpose of building (By Floors)
STATE OF FLORIDA, 5
COUNTY OF DADE. } Z
Q
Before me, the undersigned authority, a
appeared
My Commission Exp
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
0.
(Signed)
Date
Street.....: a • E i i !
Registered Architect and /or Ehdineer ` :t •�- : ... ..,: •
> //- '
Employing Electrician's Name ( , ( r r � . ° t. r
•�
Street «.:.�/
Location and Legal Description Lot ! ...I . { . _... . . (,,`■ snbd;r
S treet. .. .,4.'..._. 7r......1......_,::.L' ..
New Building Remodeling Addition Repairs No. of Stories
f
Service Overheads/ Size Feeders
U
Conduit. A. Main Sw Amps Iviain Fuses Amps
nderground
Type of Installation — Conduit Tubing B.X.L tal Moulding
Electrical Inspector.
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 subcontractors 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 agregs o employ only such sub - contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village. �/ag e
/ S S
1 0 0
(Signed) j �� `
Master / ectrician.
ry public, duly authorized to administer oaths and take acknowledgments, personally
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 facts
therein by him stated are true.
Notary Public, State of Florida
NOTE: A reins ection fee of $1. 0 �1 ill be made when such re-inspection is made necessary by improper notice for inspection, or fault
P 9 P Y
terials and /or workmanship. 1
SWITCH
OUTLETS
LIGHT
OUTLETS
PLUG
RECEE'P•T'S
FIXTURES
NO. LAMPS
REFRI6.
OUTLET
IRON
OUTLET
RANGE
OUTLET
RANGE
CONN.
WATER
HEATER
W. HEAT.
CONN.
SPACE
HEATER
STRIP
HEATER
TOTAL
CONTR.
LIST
�J /1
v U
°� `7
. " J ��
!I/
'
/
/
/
/
/
PO
/
4
1
l
ENT.
SW.
DIST.
CAS.
SERVICE
TEMP.
SERVICE
PERM.
MOTORS
0.1 HP
MOTORS
1.S NP
NEON
TRANS.
RADIO
TOTAL
CONTR.
LIST
J
/
/
/
f...`
CHECK
Permit No 1.
Amount of Permit $
APPLICATION FOR ELECTRICAL PERMIT
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 kept at
building during progress of work.
Owner's Name and Address ' • X • No
Street and Number where work is to be performed —No
State work to be performed and purpose of building (By Floors)
STATE OF FLORIDA, 5
COUNTY OF DADE. } Z
Q
Before me, the undersigned authority, a
appeared
My Commission Exp
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
0.
(Signed)
Date
Street.....: a • E i i !
Registered Architect and /or Ehdineer ` :t •�- : ... ..,: •
> //- '
Employing Electrician's Name ( , ( r r � . ° t. r
•�
Street «.:.�/
Location and Legal Description Lot ! ...I . { . _... . . (,,`■ snbd;r
S treet. .. .,4.'..._. 7r......1......_,::.L' ..
New Building Remodeling Addition Repairs No. of Stories
f
Service Overheads/ Size Feeders
U
Conduit. A. Main Sw Amps Iviain Fuses Amps
nderground
Type of Installation — Conduit Tubing B.X.L tal Moulding
Electrical Inspector.
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 subcontractors 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 agregs o employ only such sub - contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village. �/ag e
/ S S
1 0 0
(Signed) j �� `
Master / ectrician.
ry public, duly authorized to administer oaths and take acknowledgments, personally
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 facts
therein by him stated are true.
Notary Public, State of Florida
NOTE: A reins ection fee of $1. 0 �1 ill be made when such re-inspection is made necessary by improper notice for inspection, or fault
P 9 P Y
terials and /or workmanship. 1
BUILDING
ELECTRICAL
PLUMBING -
ROOFING
Owner of
Building
Architect
Contractor
or Builder
Legal
Description.
Address of
Building
Lot
1
CONTRACTOR OR BUILDER
MIAMI SHORES VILLAGE, FLORIDA
t -
DA TE_.
Cotatrocioe's
rogyPERMIT iN? 13380
❑ Work to be performed under this Permit
Subdi-
vision
Value of Amt. of
Project $ 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
herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in cotaphiutce
drawings, statements or specifications that may have been submitted to and approved by the proper munidpal authorities. This Permit may
time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upce N
granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the orb' att�ta:�l
pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or spedfications and that he asntmes r
done by his agents, servants or emp yap.
Signed. By% *olk 0,41260. .
In consideration of the issuance to me of this permit I agree to pee&iii the work covered hereunder in compliance with all ordinancN smtd
pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Mimi Sens
In accepting this permit I assume responsibility for all work done by either, myself, my ages, servant or employee.
BY
Ff
AUTHOR=
BUILDING
ELECTRICAL
PLUMBING
ROOFING
Owner of
Building
Architect
Contractor
or Builder
Legal Lot
Description
Address of
Building •
PERMIT N9 7733
MIAMI SHORES VILLAGE, FLORIDA
B1
Value of
Project $
DATE
Contractor's
License No
Work to be performed under this Permit `'
Subdi-
vision
Amount 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 applica-
tion 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 specificatione, and tha he assumes respon-
sibility for work done by his agents, servants or employees. — -,
Signed. � INSPECTOR
In consideration of the issuance to me of this permit I agree to perform the work covered hereunde in compliance with all ord ances 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 as
cepting this permit I assume responsibility for ell work done by either, myself, my agent, servant or employee.
CONTRACTOR OR BUILDER BY AUTHORITY MOT ''
allt
2 �Q o / f
Date 3 '�6' C, v Job Address / � tD A' E 5 e v' s Tax Folio
Legal Description lea i JO t ili 0 ' 5 Bal 7 ( Historically Designated: Yes No
Owner/Lessee / Tenant 0 C e C7 ./d /..S' iJ Master Permit # ( � Z l Y ) ei y
Owner's Address 5/ 6 N - < . "4"' , S' ,-- Phone 7-' 7 C 6 cc'
Contracting Co. F fi/'�t/li r,s 7 C',,t /./ t i 4 1 t Address E 2 7% S' c ti 1 f/
Qualifier 4Ztd/ a/4 Cam 7 .4e/ C SS# Phone 3') 3 6 ES di.i "5'
State # Ft aQ v fl 7 L 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 ; 2C'c l
Square Ft. a3 Estimated Cost (value) ig Vet 40
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 INTENT) 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 ce_tify 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 .'undo President Date
Notary as to Owner and/or Condo President Date
" Commission Expires:
FEES: I ERMIT y� / d" RADON
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
c 0
Signature of Contractor or Owner- Builder
Notary as to Contractor or Owner - Builder
My C P' �XJ ;ikli.. !' C T AI ;°r S'-',;:
• O 1 �.� _, riANDRA t! Iii OW
( : * t�VE1l4i�iSlt1'� :J1R'��::'
2.: : Fly °
c3—/ PS'
Date
Date
�
C.C.F. , VC NOTARY ✓` BOND
TOTAL DUE
APPROVED:
Zoning Building Electrical /,VII— fr#
Mechanical Plumbing Engineering
ITEM
BATH TUB
UNIT
FEE
ITEM
SWITCH OUTLETS
UNIT
FEE
ITEM
SPACE HEATERS
UNIT
FEE
BIDET
LIGHT OUTLETS
CENTRAL HEATING
DISHWASHER
RECEPTACLES
A/C (WINO)
DISPOSAL
SERVICE TEMPORARY
A/C (CENTRAL)
DRINKING FOUNTAIN
_
SERVICE SIZE IN AAPS
DUCT WORK
FLOOR DRAIN
SERVICE REPAIR/METER CHAFE
REFRIGERATION
GREASE TRAP
APPLIANCE OUTLETS
PROCESS AND PRESS PIPING
INTERCEPTOR
RANGE TCP
UNDERGROUND TANKS
LAVATORY
OVEN
ABOVE CADUNO TANKS
LAUNDRY TRAY
WATER HEATER
U.F. PRESSURE VESSELS
CLOTHES WASHER
CTS 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
A/C UNIT
STRIP HEATER
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
ORAINFIELO, 4' TILE/RES.
VIOLATION
PUMP & ABANDON SEPTIC TANK
REINSPECTION
SOAKAGE PIT CU. FT.
CATCH BASIN
C l ArM / /V
DISCHARGE WELL
(..-00 €19p•,4
/
4 -J'
DOMESTIC WELL
AREA GRAIN
ROOF INLET
SOLAR WATER HEATER
FIRE STANDPIPE
-
POOL PIPING
LAWN SPRINKLER SYSTEM
GAS RANGE
METER SET (GAS)
GAS PIPING
ENDUM TO BUILDING PERMIT APPLICATION
1 •
(AN APPLICATION FOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. IF A MASTER PERMIT HAS BEEN
OBTAINED, TIE OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.)
PLUMBING
ELECTRICAL
MECHANICAL
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date Job Address 9/4 ,44 A; 5T Tax Folio
Legal Description
Owner / Lessee / Tenant 0. -I Master Permit # ..?h/e2/
Owner's Address 14 4/ f 57T 53/3J Phone
Contracting Co. / L/1 'J /me Address -5 /di /S 3
Qualifier i /Q,li'e SS# /�. - - Phone •,
State #E # Competency # Ins.Co.
Architect /Engineer Address
Bonding Company Address
Mortgagor ' Address
Permit Type(circle one): BUILDING E E RI«. PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION �f �/ 4t7/.
""/ /, C !'' 1
Square Ft. Estimated Cost(value
/7/
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, ROOPING and MECHANICAL WORK.
OWNER'S AFFI +AVIT: I certify that all the foregoing information is accur :te and that all work will
be done in c4mpliance with all applicable laws regulating construction - d zoning. Furthermore, I
auth• • e th ab. -named contractor to do the work stated.
g ature
Date:
•
Notary as o ()Alb*
My Commission Expires:
APPROVED:
oeo (mu). HRP 2664tAt
Fire
Zoning Build
Mechanical Plumbing,
do President Signature of C�pm gpctor
Date:
FFICIAL SEAL `" "'"` '
0 ROBLES
mission Expires
Notary as
My Commission E#'i
** * * * * * * * * * * * * * * * **
# a
FEES: PERMIT 3a RADON C.C.F. e5 NOTARY TOTAL DUE 3 d s
4.lder
OBLES
Ion Expires
1Q96
oeo rem . Own Ce -159 fid e r
Other
Electrical
Engineering_
Date `'b -ko `
State # G— C Li i 73
PERMIT APPLICATION FOR MIAMI SHORES VILLAG�
Job Address c,1' (, IV (_; <I Tax Folio 2 o (aL 1
Legal Description l L \- AU ,,{{�� �, \ \c, \C ( -
Owner/�..essee / Tenant `�-�Q
Owner's Address ( 'k.1(o N < (--1
Contracting Co. _ k -r 1 e l 6;1 r Kr t r r (• (C`') y(� S.r,, c T Address r � ) \Twc^n 6 ,�' L
Qualifier In ! C\ .c) ,A.k (p\ - y Q_-v1 z SS# - C 5 `� // - 9g 3 -e 7 C23
Municipal # Competency # (G,•-GNl i -ICe727 s. Co.
Address
Address
Architect/Engineer
Bonding Company
Mortgagor Address
Permit Type (circle one): BUILDIN ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WO ' DESCRIPTION k,m \ sc=- Q S
1 4A'
Signature of owner and/or Condo President Date
Notary as to Owner and/or Condo President Date
My Commission Expires:
FEES: PERMIT ; RADON
S /
Historically Designated: Yes ��To
Master P- t #(
Phone
e e. v 3 F7:
Square Ft. Estimated Cost (value) C
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.
APPROVED:
Zoning Building Electric
Mechanical
Signature of Co actor or Owner ilder Date
A ../Y)
Not as to Contractor or Owner - Builder
My Commission Expires:
14 IF atliN
*',3l *i' g690 eaKel
49, ROM .41N8.,2902
Plumbing Engineering
TOTAL DUE
ate
C.C.F. NOTARY BOND
ITEM
BATH TLB
UNIT
1 11 '
ITER
SWITG4 OUTLETS
UNIT
FEE
ITEM
SPACE HEATERS
UNIT
FEE
BIDET
LIGHT OUTLETS
S I
CENTRAL HEATING
DISHWASHER
REC2TACLES
Ci
A/C (WIND)
_
DISPOSAL
SERVICE TEMPORARY
A/C (CENTRAL)
DRINKING FOUNTAIN
SERVICE SIZE IN AMPS
DUCT WORK
FLOCK DRAIN
SERVICE REPA1R/I€TER CHANGE
REFRIGERATION
GREASE TRAP
_
_
APPLIANCE OUTLETS
PROCESS AND PRESS PIPING
INTERCEPTOR
RANGE TOP
UNDERGROUIO TAMS
LAVATORY
OVEN
ABOVE max O TANKS
LAUNDRY TRAY
WATER DATER
U.F. PRESSURE VESSELS
CLOTHES WASHER
MQTCRS 0- 1 HP
STEAM BOILERS
SHOWER
MOTGRS OVER 1- 3 HP
HOT WATER BOILERS
SINK. POT /3 COMP.
MOTCRS OVER 3- 5 HP
MECHANICAL VENTILATION
SINK, RESIOENCE
MOTORS OVER 5- 8 HP
TRANSPORTING ASSEIELIES
SINK. SLCP
MUTCRS OVER 8- 10 HP
ELEVATCRS/ESCALATCRS
TEMPORARY WATER CLOSET
/ AS OVER 10- 25 HP
FIRE SPRINKLER SYSTEMS
URINAL
MCTCRS OVER 25-100 H)
COOLING TOWERS
WATER CLOSET
MflTCRS OVER 100 FP
VIOLATION
INDIRECT WASTES
A/C WINDOW
REINSPECTION
WATER SUPPLY TO:
AIR CONDITIONERS
•
A/C UNIT
STRIP HEATER
F IRE SPRINKLER
GE'WERATORS TRAtSFORIERS
HEATER -NEW INST.
GENERATORS TRANSFORMERS
HEATER - REPLACE
GENERATORS TRANSFORIERS
LAWN SPRINKLER -WELL
SPECIAL PURPOSE
SWIMMING POOL
CUTLETS CIAL
WATER SERVICE
SIGN TUBES
SEWER CONNECTIONS
SIGN TRANSFORMERS
UTILITY -SEWER
SIGN TIME aDGK
UTILITY -WATER
FIXTURES
SEPTIC TANK
ANTENNA .
RELAY
TELEVISION OUTLETS
ORAIHFIELD, 4 TlLE/RES.
VIOLATION
PUMP & ABANDON SEPTIC TANK
REINSPECTION
SOAKAGE PIT CU. FT.
CATCH BASIN
0ISCMARGE WELL
ODMEST IC WELL
AREA GRAIN
ROOF INLET
SOLAR WATER HEATER
FIRE STANDPIPE
POOL PIPING
LAWN SPRINKLER SYSTEM
GAS RANGE
METER SET (GAS)
GAS PIPING
ADDENDUM TO BUILDING PERMIT 12,PLICATION
MA6TEre O4-
(AN APPLICATION FOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. IF A MASTER PERMIT HAS B.
OBTAINEED, THE OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.)
PLUMBING
mca 9'c.
ELECTRICAL MECHANICAL
•
El k,‘/ " G,1 G
PROJECT NAME : 0'2 et, /9/20‘,/ ' '
PROJECT ADDRESS 9/6 Ne 5 /
PLAN REVIEW COMMENTS
DATE:
REVIEWER: fj /L��G � �L1/��i19L� f
SHEET NUMBER:
e3 89 3
3/ y , -F
COMMENTS fo ic N/ /$ t2 n
6 /oc -o' 14-dQ ' e7 - G 72i s (5.?z e .
Y •
n ceiz e)z-
2, S e � UGC Gr /52. e i t vii s'
9 4 � ' ti e 4o Ar,e"i S .
I ?A Zile 4 e4.: 1DN/ dat IffARK, ,b';D 4 V ehida4f y
Ill Oka,
JM /Ma CH» )) eA1414 /xh
49-4/07,_‹‘, ,getv 4/o
ignature of Inspector
Date Signed
t
//,(K ). /A-
Title
Total Number of Hours
(PLEASE TURN IN A COPY OF THIS FORM AS YOUR TIME SHEET: FOR ALL PLAN REVIEW)
t , 4 , lei
r
, , ', ,