Loading...
POOLMIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request LL Date '7 ` 3 — Z / Time Typelnsp'n I �9 Permit No. PL 2 Oa; 1 - (S — C Name RC 307;tz G Address /0 76 /{/t / p s7t Pew Company 7 p Phone f aP r / O For Inspector: y_ 9.O Na Date Approved Correction Re- Insp'n Fee /? Type Insp'n Permit No. Name Address Company Phone # Correction Date 7 3.� , 0'� Time „eze7/kowe eao02 gg, Re- Insp'n Fee MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request /074 s* , i /) Ainei 7 ' 3o g9g5 For Inspector: 7...3/...D1. Name Approved ❑ Er 9i)2/Iyerg MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date 5 f Qit Time �J Type Insp'n 1741G .(1X Permit No. E L 2 dd Z- 6 l Co Name 0/ Address Company Phone For Inspector: J _/O d 2 Name & Date Approved LN" Correction ❑ /n'' //o Z Re- Insp'n Fee ❑ — Name Address I Company Phone # �� C � 7 , E 78 ,2 For Inspect• ,; Name & Da e 1 13j2; Date Type Insp'n , / 2O ' Permit No. - 6? . c;C/GG" • 4 Approved Correction Re- Insp'n Fee MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date r�� Time — Type Insp'n a �/ Permit No. Name Address v 7cp /v6 'I 8 (5 - 1 2 i Company 2p�..,, Q" Phone #(L ' ) 7555-8 ? �� For Inspector: / / Approved Correction Re- Insp'n Fee ■MI SHORES VILLAGE U DING DEPARTMENT 305- 795 -2204 Building Inspection Request Name ate 1 el. .6, 11GWAA4- � {C / V 7 o) Date 745-02) Approved Correction Re- Insp'n Fee MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Time Type Insp'n 4 Permit No. P.200g0 Name + c �G- iy/7l/`71L— Address / 0 76 ‘ T g s� ✓ Company 7 C 43' 7006 Phone# 30C o ds - / "Sdy/9 For Inspector: 7• /6-0 .?J Nam & ate 0 (Ft ,_0000.- MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date 3-/f-,02 Time Type Insp'n r ,(24.frpehe .rsil Permit No. p 20Oz 5Z Name „(� 1 r /4d Address / 9 7`j l! /r ! gs9 51 Compan r 6-,7? Phone # ���” �` g‘ 9 For Inspector:3 - Approved Correction ❑ Re- Insp'n Fee & l ate MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date 3 a -112, Time Type Insp'n . S(�P./ Permit No. - .2 2J -7 / Name /v!C �lhJ Address Company Phone`#" For Inspector. / 7 Tao/ s q9 Name & Date / h5 MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date Time Type Insp'n ,l PdA Permit No. es'U g Name 7/ f it Q Address /0 Yt 98 Cr Company 2 p e z o Phone # 3 dj 191,?" For Inspector: Name & Date Approved Correction ❑ Re- Insp'n Fee ❑ S �3 NOTICE OF COMMENCEMENT A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF FIRST INSPECTION PERMIT NO. TAX FOLIO NO. STATE OF FLORIDA: COUNTY OF DADE: 02R 131798 2002 11AR 05 11:30 THE UNDERSIGNED hereby gives notice that improvements will be made to certain real property. and In accordance with Chapter 713. Florida Statutes. the following information is provided in this Notice of Commencement. 1. Legal description of property and street address: /076 9? Sr' 1 9 i AM ; ,Sao 4 s, FL. 3 3437 2. Description of improvement: 3. Owner(s) name and address: Interest in property: Name and address of fee simple titleholder: 4. Contractor's name and address: S. Surety:(Payment bond required by owner from contractor, if tiny) Name and address: Amount of bond $ 6. Lender's name and address: 7. Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as provided by Section 713.13(1)(a)7., Florida Statutes, Name and address: 8. In addition to himself, Owner designates the following person(s) to receive a copy of the Lienor's Notice as provided in Section 713.13(1)(b), Florida Statutes. Name and address: 9. Expiration date of this Notice of Commencement: (the expiration date is: year from the date of recording unless a different date is specified) Wc Signature of Own Print Owner's Name Notary Public Print Notary's Name My ertmmiccinn Fxnires Sworn to and subscribed before me this 1 i Iui1c ivu. • JYJJ GJ1 0by4 4ao / '76, NC 78 Sr M r AK : - eG 1. 3/3g C.2 Poo Ls, , ...�, Q /S J /y7 ST ay of STATE OF FLORIDA, COUNTY OF DADE 1 HEREBY CERTIFY that this is a tru of the original tiled in this office on 'J day of , A D 20 _a WITNESS my hand and Official Seal. HARVEY RUVIN, , = f cup! and County Courts By 1)1 . / D.C. Isar. 01 2002 04:14PM P2 J 6...33's'j Prepared by &arm 20 d . OFFICIAL NOTARY SEAL Andress: I (P ‘ _DJ /' 7S)- LAURA G KELLY �^ 3 � piptrAgvmmt, STATE OF FLORIDA N vq �, 1) t'L— COMMESION NO. CC929364 MY oMMIS$le1'i•ECP. APR. 18,2004 1 • C.O.R = 7.98 FEET 92- 0000598 LATITUDE/LONGITUDE (OPTIONAL) ( ## - ## - ##.##" or ##.###F#) FEMA Form 81 -31, FEDERAL EMERGENCY MANAGEMENT AGENCY NATIONAL FLOOD INSURANCE PROGRAM ELEVATION CERTIFICATE Impnrtant• Read the incfructinnt nn pagpa 1 - 7 SECTION A - PROPERTY OWNER INFORMATION BUILDING OWNER'S NAME EDWARD MC INTYRE BUILDING STREET ADDRESS (Including ApI, Unit, Suite and /or Bldg. Number) OR P.O. ROUTE AND BOX NO. 1076 NE 98 ST CITY MIAMI SHORES PROPERTY DESCRIPTION (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) Lot 17 Block 180 of REVISED PLAT OF MIAMI SHORES, SECTION 8 according to the plat thereof as recorded in Plat Book 43 at Page 69 of the public records of MIAMI -DADE County, Florida. BUILDING USE (e.g. Residential, Non - residential, Addition, Accessory, etc. Use Comments section if necessary.) RES IDENTIAL L_I NAD 1927 I_I NAD 1983 STATE FL SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION Does the elevation reference mark used appear on the FIRM? 1 .42 O.M.B. No. 3067 -0077 Expires July 31, 2002 ZIP CODE 33138 HORIZONTAL DATUM: SOURCE: 1_I GPS (Type): L_I USGS Quad Map IX 1 Other: NGVD 1929 B1. NFIP COMMUNITY NAME & COMMUNITY NUMBER MIAMI SHORES 125098 B2. COUNTY NAME MIAMI -DADE B3. STATE FL B4. MAP AND PANEL NUMBER 12025C0093 B5. SUFFIX 3 B6. FIRM INDEX DATE 07/17/1995 B7. FIRM PANEL EFFECTIVE/REVISED DATE 03/02/1994 88. FLOOD ZONE(S) AE B9. BASE FLOOD ELEVATION(S) (Zone AO, use depth of flooding) 8 FT B10.Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in B9. 1_1 FIS Profile I XI FIRM 1 1 Community Determined 1 I Other (Describe): _ 611.Indicate the elevation datum used for the BFE in B9: 1 x 1 NGVD 1929 I NAVD 1988 1 10ther Describe : (Describe): B12.Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? 1 1 Yes I 1 No Designation Date: SECTION C - BUILDING ELEVATION INFORMATION C1. Building elevations are based on: 1_1 Construction Drawings* 1_1 Building Under Construction* 1x1 Finished Construction 'A new Elevation Certificate will be required when construction of the building is complete. C2. Building Diagram Number 8 (Select the building diagram most similar to the building for which this certificate is being completed - see pages 6 and 7. If no diagram accurately represents the building, provide a sketch or photograph.) C3. Elevations - Zones A1-A30, AE, AH, A (with BFE), VE, V1 -V30, V (with BFE), AR, AR/A, AR/AE, AR/A1 -A30, AR/AH, AR/AO Complete Items C3a -i below according to the building diagram specified in Item C2. State the datum used. If the datum is different from the datum used for the BFE in Section B, convert the datum to that used for the BFE. Show field measurements and datum conversion calculation. Use the space provided or the Comments area of Section D or Section G, as appropriate, to document the datum conversion. Datum Conversion /Comments Elevation reference mark used 90 ❑ a) Top of bottom floor (including basement or enclosure) ❑ b) Top of next higher floor ❑ c) Bottom of lowest horizontal structural member (V zones only) ❑ d) Attached garage (top of slab) ❑ e) Lowest elevation of machinery and /or equipment servicing the building 9.03 ft. • ❑ f) Lowest adjacent grade (LAG) 8.94 ❑ g) Highest adjacent grade (HAG) 9.38 ❑ h) No. of permanent openings (flood vents) within 1 ft. above adjacent grade 8 ❑ i Total area of all • ermanent o•enin•s flood vents in C3h 1 206.00 s • INC 1X1 Yes 1 -1 No License Number, Embossed Seal, Si nature, and Date SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION This certification is to be signed and sealed by a land surveyor, engineer, or architect authorized by law to certify elevation information. I certify that the information in Sections A, B, and C on this certificate represents my best efforts to interpret the data available. I understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001. CERTIFIER'S NAME LICENSE NUMBER John Ibarra 5204 TITLE COMPANY NAME Professional Land Surveyor NOVA SURVEYORS, INC. ADDRESS CITY STATE ZIP CODE 5582 N.W. 7TH �� SUI 02 MIAMI FL 33126 SIGNATURE / s DATE TELEPHONE 111/07 (305) 264 -2660 SEE REVERSE SIDE FOR CONTINUATION REPLACES ALL PREVIOUS EDITIONS IMPQRTANT: In these spaces, copy the corresponding information from Section A 92- 0000598 BUILDING STREET ADDRESS (Including Apt., Unit, Suite and /or Bldg. Number) OR P.O. ROUTE AND BOX NO. 1076 NE 98 ST OiTY STATE ZIP CODE MIAMI SHORES FL 33138 SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED) Copy both sides of this Elevation Certificate for (1) community official, (2) insurance agent/company, and (3) building owner. COMMENTS HIGHEST CROWN OF ROAD ELEVATION = 7.98 FEET LOWEST CROWN OF ROAD ELEVATION = 7.91 FEET NOTE: ALL ADDITIONS WERE CONSIDERED TO DETERMINE LOWEST FLOOR ELEVATION. I Check here if attachments SECTION E - BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE) For Zone AO and Zone A (without BFE), complete Items El through E4. If the Elevation Certificate is intended for use as supporting information for a LOMA or LOMR -F, Section C must be completed. El. Building Diagram Number (Select the building diagram most similar to the building for which this certificate is being completed - see pages 6 and 7. If no diagram accurately represents the building, provide a sketch or photograph.) E2. The top of the bottom floor (including basement or enclosure) of the building is 1 -1 —I ft. 1 -1 -1 in. II above or 1J below (check one) the highest adjacent grade. E3. For Building Diagrams 6 -8 with openings (see page 7), the next higher floor or elevated floor (elevation b) of the building is 1 1 1 ft. 1 I 1 in. above the highest adjacent grade. E4. For Zone AO only: If no flood depth number is available, is the top of the bottom floor elevated in accordance with the community's floodplain management ordinance? I I Yes I I No I I Unknown. The local official must certify this information in Section G. SECTION F - PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION The property owner or owner's authorized representative who completes Sections A, B, and E for Zone A (without a FEMA- issued or community- issued BFE) or Zone AO must sign here. PROPERTY OWNER'S OR OWNER'S AUTHORIZED REPRESENTATIVE'S NAME EDWARD MC INTYRE ADDRESS CITY STATE ZIP CODE 1076 NE 98 ST MIAMI SHORES FL 33138 SIGNATURE DATE TELEPHONE COMMENTS SECTION G - COMMUNITY INFORMATION (OPTIONAL) The local official who is authorized by law or ordinance to administer the community's floodplain management ordinance can complete Sections A, B, C (or E) and G of this Elevation Certificate. Complete the applicable item(s) and sign below. G1. 1J The information in Section C was taken from other documentation that has been signed and embossed by a licensed surveyor, engineer, or architect who is authorized by state or local law to certify elevation information. (Indicate the source and date of the elevation data in the Comments area below.) G2. 1 I A community official completed Section E for a building located in Zone A (without a FEMA- issued or community- issued BFE) or Zone AO. G3. I I The following information (Items G4 -G9) is provided for community floodplain management purposes. G6. DATE CERTIFICATE OR COMPLIANCE/OCCUPANCY G4. PERMIT NUMBER G5. DATE PERMIT ISSUED ISSUED G7. This permit has been issued for: 1 1 New Construction 1_1 Substantial Improvement X38. Elevation of as -built lowest floor (including basement) of the building is: (39. BFE or (in ZONE AO) depth of flooding at the building site is: LOCAL OFFICIAL'S NAME TITLE COMMUNITY NAME SIGNATURE COMMENTS FEMA Form 81 -31, AUG 99 TELEPHONE DATE --ji:.,...,,, ., ft. Datum: 11 Check here if attachments ft. Datum: Check here if attachments REPLACES ALL PREVIOUS EDITIONS : 7 LCC•EG N. Z. A-'T tE (?OS', 7 5 -rG. F?:: (23c) --_, EUI DING _�i /cr ? aA RE R- IST2?TIC•_`t ;11E , . 1 C:py cf STATE CF FLCRIDA ICZCTEI=ON (DEER) ._ Ste'":' cREGISMATION AbD DADE CCUNrY CC HPE NCX LD:CSSE Czpy of a nrnnt CCOJPATIONAL LICENSE from count _ or :ill_nic__a1itl wh rra .`.mess is '_ocat_ed. - - Certificate of Insurance for LIABILITY (add -ems_ to Miami Sbc_ =s Village). Certificate of Insurance for WORKER'S CCU (addressed to Miami S::oresVillage) or if exempt. State of Florida LES Form BCMH204, Construction lndustry Notice of Election to be Exempt. PLEASE SUBMIT r�G rtzFri D OFF Pe. it Application (signed by person performing the work, license cvnu. actor and the property owner, both signatures notarized). Two sets of plus /dra sided and sewed by registered architect or engineer -. Occiczncies by Group Classification rniist be on plans and cermit application. All plans must inclose folio number and property address. Amended plats, in addition to the above, rrtust also include the permit number. 42) Stzuctiral Calculations signer and sealed by _&it_c engineer o. e_Rgi. ^.e when applicable. / u.rrent survey of the property. Y J of Elevation signed and sealed by Surveyor. k2J3 Sz±bn tial Imra Checklist (contractor c= owner) . `-` 14 sets of energy calculations, signed and sealed /021 To sets Of signed & sealed Truss Plans (Engineer). N DADE County or State of Florida Pr. ». Approvals for roof materials, sheds, windows, exterior /garage doers, aluminum carports, screen enclosures, shutters awnings, skylights, f - -enc: doors and etc. Approvals from EELS, DADE County Impact Fee Section, Fire Department a Health Department (when applicable). DEM Warranty Deed or Other Proof of Ownership if necessary. Struc.tuLd1 Review fee 513 1)4 4 r)r?" Notice of Commencement I 7 rY)E qa,1- cit-et{ cett-c( • • ••• • • • ••• • • • • • • • • • • • • • • • • • • • • • • • • • • • ••• • • • • • • • • • • • • • • ••• • • y •_••• • • • • BU1 QrN4 1 0050 N.E. SECOND AVENUE MIAMI SHORES`gLQR+DA 4 •• TELEPNOI.E (30 19tl- 244•. •• FAX (300) : ; .C.8"" • • • • • • • • • • • • • • •• • • • • • ••• •• NOTICE OF REQUIREMENTS RESIDENTIAL SWIMMING POOL, SPA AND HOT TUB SAFTy ACT (We) acknowledge that a new swimming pool, spa or hot tub will be constructed or stalled at _C2?G 4 { Miami Shores,, Fl., and hereby affirm that one of following methods will be used to meet the requirements of Chapter 515, Florida itutes. ease initial the method(s) to be used) The pool will be isolated from access from the home by an enclosure that meets the pool barrier requirments of Florida Statute 515.29; The pool will be equipped with an approved salty cover that complies with ASTM F1346 -91; All doors and windows providing direct access from the home to the pool will be equiped with an exit alarm that has a minimum sound pressure rating of 85 decibels at 10 feet; sL All doors providing direct access from the home to equipped with self - closing, self - latching devices with release will be mechanisms placed no lower than 54" above the floor or deck; !erstand that not having one of the above installed at the time of final inspection, or t pool is completed for contract purposes, will constitute a violation of Chapter 515, ind will be considered as committing a misdemeanor of the second degree, punishable aes up to $500 and /or up to 60 days in jail as established in Chapter 775, F.S. ZACTOR'S SIGNATURE & D 1"/ • OR'S NAME (PLEASE P `P (2 & OFACIAI . Y SZAL ' .. NGELA M :• CKER N` MY d'aMMISSION EXPIRES OF F\. NOV. 15,2002 Y P� Date Miami Shores Village Building and Zoning Depart Attention: ,Building Oct I understand and agr be used or lled with w barrier, and such barrier I further nnde obtaining a permit and I certify that In accordance wF s :. poi posit ` , located at ved b a No ' hire ' fication is to be h a •• •. ■ • i• 4 • • • • • r., • s • • . 4 -4 .4 • . .•• • • • I •1. • • • •.. • • •. • • • • 6 • • . • • • 1 4 • • • . • • ■ ••.• of the prop Code o ool to pea • 6 • • ■ • • • • ,• g r n • •,�: • :• SECTION - BY DATE Zonin: ��.I.V. FWATI Electrical Riii0 Ni --" Mechanical Plumbin: I vim= Fire ,a l Public Works Structural j_ Z / et- p Building Official 1'rOL Page 4 OFFICE USE ONLY CIIECKLIST ❑ OWNER - BUILDER FORM (Attach) ❑ FIRE DEPARTMENT APPROVAL (Commercial / multi- family) ❑ CONCURRENCY (New Construction) ❑ OTHER (Specify & Attach) ❑ PROOF OF OWNERSHIP (Attach) ❑ HRS / DERM APPROVAL (Septic / Sewer) PERMIT FEES $3.00 per page (Scanning Fee) Miami Shores Village Bond Metropolitan Dade County (C.C.F.) Inspector State Educational Fund State DCA (Radon) Code Enforcement Fine Zoning Review di ❑ IMPACT FEE (New Construction) ❑ OTHER (Specify & Attach) $ $ S �� (¢.01 /sq.ft.) 5-0 o a�.,s 0s O a ISSUING OFFICIAL REVIEWED AND PREPARED BY: (sq.ft. = x/1000 x 0.60) (¢.005 /sq.ft.) PERMIT APPLICATION ❑ CONDO ASSOCIATION APPROVAL (Attach) ❑ BPR APPROVAL (Restaurants) ❑ CONTRACTOR REGISTRATION (On File) TOTA $ (b I - 1) C �� DATE: CONDITION OF APPROVAL Revised July 2001 10050 N.E. 2" AVE., MIAMI SHORES, FL • (305) 795 -2207 • FAX (305) 756 -8972 • http:/ /www.miamishoresvillage.com ELECTRICAL TYPE Minimum Fee QTY. 'TYPE Dryer QT\'. TYPE. Outlet, Appliance QTY. 'TYPE Service Repair QTY. A/C Central 1 -3 Ton Heating Strips, each Fan Outlet, Wall . Service, Temporary - Paint Booth A/C Central 4 -7 Ton Fire Pump Outlet, Switch Piping, Flammable Liquid Signs A/C Central 8 -15 Ton Fixture - Fluorescent - Process/Pressure Piping Oven Space Heater (kw) A/C Central 16-20 Ton Pressure Vessel Fixture Light Parking Lot Lights Spas/Hot Tubs A/C Central 20+ Ton Flood Lights Plugmold/Strip Subfeeds, No. of Amps A/C Window FPL - Load Central Posts Swim Pool, Commercial Air Conditioners Garbage Disposal Range/Range Top Swim Pool, Residential Chiller Generators, etc. Receptacles Switchboards Clear Violations Heat Recovery Refrigerator, Comm. (p/PH) Temp Serv., Construction Compactor Low -volt, Burglar Refrigerator, Domestic Temp for Test - 30 days Deep Freezer Low -volt, Fire Renew - Temp Service Water Closet Demolition Low -volt, Intercom/Teleph. Repair Circuits Water Heater Dishwasher Low -volt, Television Service, Number of Amps Water Heater New MECHANICAL TYPE Minimum Fee QTY. TYPE Condensate Drain QTY. TYPE Generator QTY. 'TYPE Refrigeration, Tons QTY. A/C Central, Tons QTY. Cooling Tower Heating Strips, each Vent Hood, Cost A/C Wall/Win. Tons Dryer Vents, Number of - Paint Booth Ventilation, Cost Air Handler, Tons Ductwork, Cost of Piping, Flammable Liquid Periodic Inspections Barbecue Fire Sprinkler System - Process/Pressure Piping Pump and Abandon Bath Fan - Vented, # Fireplaces, Number of Pressure Vessel Gas - Appliance PLUMBING TYPI A/C Condensate QTY. 'I'YI'E Drains, Roof QTY. TYPE Miscellaneous Fixture QTY. TYPI? Soakage Pit QTY. Bath Tub Drinking Fountain Miscellaneous Repairs Solar Water Heater Bidet Filter Replace Pool Piping Sprinkler Repair Cap - Fixture Fountain Pump and Abandon Sprinkler System Cap - Water Gas - Appliance Pump, Domestic Supply, AC Well Cap - Sewer Gas - Natural Pump, Fire Stand Temporary Toilet Catch Basin Gas - Propane Pump, Re- circulate Temporary Water Closet Clothes Washer Gas Piping Pump, Replace - Pool Urinal Dental Chair Grease Trap Pump, Sprinkler Utility - Sewer Discharge Well Ice Maker Pump, Sump Utility - Water Dishwasher Indirect Wastes Relay Repair Vacuum Pump Disposal Interceptor Roof Inlet o Water Closet Domestic Well Laundry Tray Septic Connection Water Heater Drainfield, 4" Tile/Res. Lavatory Septic Tank Water Heater New Drains, Area Meter Set (Gas) Sewer Connection Water Re -pipe Drains, Floor Minimum Fee Shower Water Service Drains, French Miscellaneous Equipment Sink Well, Supply Page 3 PERMIT APPLICATION INSTRUCTIONS: Please indicate the type of work being performed and quantity(ies) in the space provided below. RECEIVED AND REVIEWED BY: DATE: Page 2 IMPORTANT NOTICES 1. DO NOT BEGIN ANY WORK WITHOUT HAVING RECEIVED YOUR VALIDATED PERMIT AND PERMIT CARD. Applying for a permit does not grant the right to begin construction. HOURS OF CONSTRUCTION are limited to: Monday through Friday from 7:30 a.m. to 6:00 p.m., and Saturday from 8:00 a.m. to 5:00 p.m. No inspections will be conducted on weekends or holidays. 2. All construction of demolition areas MUST BE MAINTAINED IN A CLEAN, NEAT AND SANITARY CONDITION free from construction debris. 3. STREETS AND NEIGHBORING PROPERTIES SHALL BE KEPT FREE FROM DIRT AND DEBRIS. 4. SWALES MUST BE PROTECTED FROM BEING DAMAGED BY EQUIPMENT OR VEHICLES, AND MAY NOT BE USED FOR STORAGE. A bond is required for work in or near the street/sidewalk. 5. CONSTRUCTION TRAILERS ARE PROHIBITED ON SINGLE FAMILY RESIDENTIAL CONSTRUCTION SITES. Other construction may have a trailer which requires a separate permit. 6. PORTABLE TOILETS for a construction site require a separate permit. 7. DO NOT DISCHARGE WATER INTO THE RIGHT OF WAY OR STORM DRAINS without approval from the Building, Planning and Zoning Department. 8. EQUIPMENT AND MATERIALS SHALL BE STORED at least 10 feet from the edge of pavement. 9. Department of Health and Rehabilitative Services (HRS) approval is required for applications involving septic tanks. Department of Environmental Resources Management (DERM) and/or Miami -Dade Water and Sewer Department (MDWASD) approval is required for applications involving sewers. AFFIDAVIT - Please read carefully. Application is hereby made to obtain a permit to do work and installation as indicated. I, the OWNER of the property, 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, POOL, EXTERIOR DOOR, MECHANICAL, WINDOW, FENCE, DRIVEWAY, ROOFING and SIGNS and there may be additional permits required from other governmental agencies. I, the OWNER of the property, have disclosed all information related to any work at the property performed in the prior twelve months to the Building Official. Further, I am fully aware that if the cumulative cost of work to my home or business under this and any other permit equals or exceeds fifty percent (50 %) of the fair market value of the structure, the entire structure must meet the present federal flood criteria for finished floor elevation. I am also fully aware that if the total cost of work to my home or business under this and any other permit exceeds fifty percent (50 %) of the replacement cost of the structure, then the entire structure must conform to the current code requirements of the Building Code. WARNING TO OWNER: Your failure to record a NOTICE OF COMMENCEMENT may result in you paying twice for improvements to your property. If you are spending more than $2,500 or intend to obtain financing, you may wish to consult with your attorney or lender before recording your Notice of Commencement. The Notice of Commencement must be recorded at: 22 N.W. 1st Street, Is' Floor, (305) 679 -1078. Once recorded, the Notice of Commencement must be POSTED AT THE JOB SITE in accordance with Section 713 -35 of Florida Statutes. Review the brochure at Village Hall on Construction Lien Law and Choosing a Contractor. STATE Signatur of Owner SEAL: Personally FLORID J I UNTY OF MIAMI -DADE UV` Print Name Sw..s to and subscribed before me this rem J /] day of _ �_d __ ' _ , l�rTl. k • Ill ►_, r r ule of o .., P Ueei ANGELA oN� uMB N rr t> COMNISW r ** CC7 66697 N My °x . 9815 20t)2ES F FA NOV ,�..�.- l OR, Produced Identification SEAL: STATE QF LORIDA, CO_ Y OF MIAMI -DADE Type of Identification Produced: )—)- J m �S 3 29 �� 3 6 4 pe of Identification Prod PERMIT APPLICATION Signature of Contractor / Qualifier flio 7/IA S C /7/ Print Name nd subscribed before me this / day of Swc w /""" - °- . tore o . A ry • Personally known to of Flonda qY P U 6� ANGELA M7BECKER Ol r AN z N UMSl n r_ i 1P' Pr*pducedR &�i ic6e� c O 'I , ,• SStON A �r `' M i 2 'l' R. _, 0 1S. CONTRACTOR Name ....ICC r ,(v_ _ y / `� License No. ig66,7 Address '' q - S / z x'/ j:-....))9 - • .7 7 ( Fax Telephone30g JJ Qualifier Namg �/ /e 7sr 1:4 ENGINEER New Construction r Name A y� eU 1i f ' 1 /� Q� , L 1, J A: License No. Alteration Exterior Address q s 7 _,,,9 r , 7"-- Telephone(3o ) 2 7/ —O3 75 -7 / ? Fax Business Telephone �S y _ PROPERTY OWNER New Construction r Name Alteration Exterior Address /© 6 „ /4` � ck - 8 7"-- Home Telephone 3 ©s - __ 75 -7 / ? Business Telephone �S y _ Y` ire _ 7 sa 2. / Fax 95-Li — s) - - /.(144-- TYPE OF MANAGEMENT (✓ ) New Construction r Enclosure Alteration Exterior Repair Alteration Interior Demolish Relocation of Structure Shell Only Foundation Only Add'I Attachment Other Add'I Detachment Other INSTRUCTIONS - The following steps must be taken to obtain a permit from the Miami Shores Village: Step 1. Complete the attached permit application which must be signed by the property owner and qualifier. Both signatures must be notarized. Please print or type to allow for a more accurate processing of your application. If roofing work will be done, a roofing application must be submitted along with this permit application. Step 2. Submit the completed application with all necessary documents to the Building, Planning and Zoning Department for processing. During the processing of your application, you may be asked to submit additional information. APPLICATION Job Address: /O7 / q, . / //lJ/47/7 .. J % OR es , 2 4 Address Apt. City State Folio Number //3,20301803Y g Description of Work ,< Lot / 7 Block /9V Subdivision g PB PG_ Current Use of Property 1Z 3 j Bade/ Proposed Use of Property Tenant Information PERMIT TYPE (✓ ) Building Electrical Mechanical Plumbing LPGX Roofing Fence Other ARCHITECT Name License No. Address Telephone Fax PERMIT CHANGE (✓ ) Chg. Contractor Renewal Revision Extension Supplement Reinspection Master Permit No. Subsidiary Permit No. , PERMIT APPLICATION Zoning Linear Feet Square Feet / 5 - 7a 1 ” Units Floors Value of Work / 3/000 Bldg Value Tax Assessed/Appraised Value Flood Zone Base Floor Elev. ' kh /00' 75 r rr 0 '� a 75 N / .3 /4 /5 G lBD / /8 ti l 00 � 75 _ r � • i' "� i 75 ' 3601 S.W. 8TH. ST. SUITE 206 ( � � • • ••• • • • ••• MIAMI,FLORIDA 33136. 1111tt c 1 .:�IZtt� ••• �URVEY NO TELEPHONE NO.:(305) 220 -3171. B I O.BOX N8. ►11661 • • FAX NO. (306) 664 -7' '' LnND SURVEYORS CORFQ GA�E NO. SURVEY OF LOT 17 IN BLOCK 180 OF " REVISED PLAT OF riIAMI SHORES SECTION' 8" ACCORDING TO THE PLAT THEREOF IN PL T B 1 Q QiLK 43'pT'p.AGE. !�'r THE PUBLIC RECORDS OF MAIMI•-DADE COUNYTY, 'FLORIDA. :: • : ;' ' : : .' • • • • • • • • • • ••• • • • '••• '• PROPERTY ADDRESS:. 1076 NE 98 ST'MIAMI,FL 33138 - qOR: EDWARD MCINTYRE LOCATION SKETCH ,. 3 A /C- AIR CONDITIONER PAO. A /S. ALUMINUM SHED. ASPH.■ASPHALT. B- BEARING. BLDG. - BUILDING. B .M. BENCH MARK. C.B... CATCH BASIN. C.8.8.- CONCRETE BLOCK STRUCTURE. C.. CVRVE. CH.. CHORD DISTANCE. CL... CLEAR. C.L.F.■ CHAIN LINK FENCE. CH.B.. CHORD BEARING. CBW■CONCRETE BLOCK WALL. CONC.. CONCRETE. C.S.■ CONCRETE SLAB. DRIVE.. DRIVEWAY. DIST.. DISTANCE. o - DEGREES. 0.- DEGREES OF CURVE. E.T.P. ■ELECTRIC TRANS- FORMER PAD. ENCR.. ENCROACHMENT. E.. EAST. ELEV... ELEVATION. F.11.- FIRE HYDRANT. F.I.P.■ FOUND IRON PIPE. F.R. FOUND RE -BAR. F.F.E.- FINISHED FLOOR ELEVATION. FR.■ FRAME. F.B.. FIELD BOOK. FT.■ FEET. FNIP.■ FLORIOA NATIONAL INSURANCE PROGRAM. r) ,k E...c r/1 T, S@@6EYISIIQN9 SNQ tIESNIN9.• F.N. ■FOUND NAIL. F.D.H. -FOUND DRILL HOLE. 11 HIGH (HEIGHT). L.P. -LIGHT POLE. L.� ARC. L.C. LENGTH OF CURVE. L.F.E. LOWEST FLOOR ELEVATION. ' - MINUTES. M.■ MEASURED DISTANCE MON.. MONUMENT. M /L.- MONUMENT LINE. NOVD. NATIONAL GEODETIC VERTICAL DATUM. N. NORTH. N.T.S.■ NOT TO SCALE. • - NO. - NUMBER. WS.. OFFSET. OH.. OVERHEAD. OVH,QOVERHANG. O.R.B. OFFICIAL RECORD BOOK. PAV.- PAVEMENT. PL.. PLANTER. P /L.- PROPERTY LINE. P.C.C. -POINT OF COMPOUND CURVE. PC... POINT OF CURVE. CERTIFIED TO: EPWArtiu I RE _ ...... PT.. POINT OF TANGENCY. W.M.- WATER METER, POC.- POINT OF COMMEN- W.F.. W000 FENCE. CEMENT. - CENTRAL ANGLE. POB. -POINT OF BEGINNING. W.- WEST. P.R.C.• POINT OF REVERSE C - CENTER LINE. CURVE. 7 ANGLE. P.P... POWER POLE. P.B.■ PLAT BOOK. PG. ..PAGE. P- POINT. PWY-PARKWAY. PRM ■PERMANENT REFE- e. :State :1 • 1 . 1 .[ • • • • • •• • • •• • • • • • ••• •• LE986 NQIE9 IQ SEQQUEONY MEIQd PE WaY €Y S;iOYEY21 EXAMINATION OF THE ABSTRACT OF TITLE WILL HAVE TO BE MADE TO DETERMINE RECORDED INSTRUMENT9,IF ANY,AFFECTING THE PROPERTY.THIS SURVEY IS SUBJECT DEDICATIONS, LIMITATIONS ,RESTRICTIONS,RESERVATIONS OR EASEMENTS OF RECORD. LEGAL DESCRIPTIONS PROVIDED BY CLIENT OR ATTESTING TITLE COMPANY. SKETCH OF SURVEY MEANS A DRAWING AND /OR A GRAPHIC REPRESENTATION OF THE SURVEY WORK PERFORMED IN THE FIELD,COULD BE DRAWN AT A SHOWN SCALE AND /OR TO SCALE. THE LIABILITY OF THE SURVEY IS LIMITED TO THE COST OF THE SURVEY. THE TERM "ENCROACHMENT" MEANS VISIBLE AND ABOVE GROUND ENCROACHMENTS. ARCHITECTS SHALL VERIFY ZONING REGULATIONS,RESTRICTIONS AND SETBACKS AND THEY WILL BE RESPONSIBLE OF SUBMITTING PLOT PLANS WITH THE CORRECT INFORMATION FOR THEIR APPROVAL FOR AUTHORIZATION 70 AUTHORITIES IN A NEW CONSTRUCTION. UNLESS OTHERWISE NOTED,THl8 FIRM HAS NOT ATTEMPTED TO LOCATE FOOTINGS AND /OR FOUNDATIONS. THE FNIP FLOOD MAPS HAVE DESIGNATE() THE HEREIN DESCRIBED LAND TO BE SITUATED IN 'ONE SITUATED IN ZONE: AE COMMUNITY /PANEL /SUFFIX: 12509 0093 -J ' DATE..OF .FTR,' Y - 07/17719 1 95 SASE FLOOD 'ELVATY"O'i1 RENCE MONUMENT. 10.001 P.L.S. ■PROFESSIONAL LAND SURVEYOR. R.- RECORDED DISTANCE. RR.. RAILROAD. RES... RESIDENCE. R /W.e RIGHT -OF -WAY. RAD.- RADIUS OR RADIAL. R.P. RADIUS POINT. ROE.. RANGE. SEC... SECTION. STY. - STORY. SWK.- SIDEWALK. S.I.P. SET IRON PIPE NO. 2534. S. ■ SOUTH. SP.. SCREENED PORCH. " • SECONDS. T.- TANGENT TWP.■ TOWNSHIP. SURVEY" OF THE PROPERTY DESCRIBED U.E.- UTILITY EASEMENTHEREON,AS RECENTLY SURVEYED AND DRAWN UTIL.- UTILITY. UNDER MY SUPERVISION,COMPLIES WITH THE U.P. UTILITY POLE. MINIMUM TECHNICAL STANDARDS ADOPTED BY LE NQ IMAM. �' ,� WOOD FENCE. K f t CHAIN LINK FENCE. C.B.S. WALL(C.B.W.). 0.00 X EXISTING ELEVATIONS. $QBYEYQB'2 NQIE21 1.IF SHOWN,BEARINOS ARE REFERRED TO AN ASSUMED MERIDIAN,BY SAID PLAT IN THE DESCRIPTION OF THE PROPERTY.IF NOT, THEN BEARINGS ARE REFERRED TO DADE COUNTY TOWNSHIP MAPS. 2.IF SHOWN,ELEVATIONS ARE REFERRED TO NL.9s.Y.I.QAIE 12Z2� 3.THIS "SKETCH OF SURVEY" REPRESENTS A LAND SURVEY,ALSO REFERRED AS A BOUNDARY SURVEY. 4.THE CLOSURE IN THE BOUNDARY SURVEY IS ABOVE 1: 7500 FT. I HEREBY CERTIFY :THAT THIS "SKETCH OF THE FLORIDA STATE BOARD OF PROFESSIONAL LAND SURVEYORS PURSUANT TO SECTION 472.027 OF THE FLORIDA STATUTES AND ALSO CHAPTER 21 HH -6 OF THE FLORIDA ADMINISTRALIVE CODE. TO NOT ti PROPOSED ELEVATIONS. BY: GEORGE IBARRA (DATE OF FIELD WORK). PROFESSIONAL LAND SURVEYOR NO. 2634. STATE OF FLORIDA.(VALID COPIES OF THIS SURVEY WILL BEAR THE EMBOSSED SEAL OF THE ATTESTING LANG SURVEYOR). REVISED ON 1/31/02 FOR ELEVATION / OF a { S 2 HIAMI,FLO 3601 S.Y. 3T. RIDA 33136. 206 r Dint ItnICilt Z ����•• • ••• .• • . • RVEY N0 " eV 5 " 1 LO •• TELEPHONE NO. J (306) 220 -3171. r. 0'. Bl7X tt��OO . 141989 • • • FAX NO. (306) 664 -7822. LAND SURVEYORS COR6L OADLEE; ablitOFt.33134, gHEET NO. , OF 4 • ••• • • • • ••• Aree ,b ro • esioce coe. !o S$ETCH OF SURVEY• •'• •'s�'":E:':'• • o • ITN* eft4 ?S,DOH • X , /0,/0 3 b o b � o G O • i , IJ 1 /3.00 � � u V 1 J At 4 0 • „ c • 27'/ 'wy (9 0 ,. -1&' • • • • • • •• • • • • • • • • • • • ••• • • • ••• • • • • • • S ••• • • • • • • • • • •• • • • • • • •• • /5' ,47-4/._y (*To flfrT4/ ((/a ',�70,. P✓M'r) � 4 X Dates _ /07`(9 ob Address �. 7 . ILA /C , 2 (S%% Tax Folio Legal Description Historically Designated: Yes No x Owner /Lessee/Tenet /e �� ✓1/ 1 n ' / 11 DC' f Master Permit #0 P Q700 ,..-9/42 ,) j` Owner's Address /07-6 4' G, 7 i Contracting Co.%QACIM. Qualifier `,(7 4??//MQI2/ State # CA/r7 7/ Municipal # /0 c 7b J IF THERE IS NO PERMIT PACKAGE ACCESSIBLE ON THE JOB SITE FOR INSPECTORS TO VERIFY, THERE WILL BE NO INSPECTION. RE- INSPECTION FEE IS $50.00 AND MUST BE PAID IN ADVANCE BEFORE CALLING FOR ANOTHER INSPECTION. Permit Type (circle one): WORK DESCRIPTION: �/Y•yJ �wJS.ir/� /ote a orzer 7 71.0.v.- �- , -, ' .:1 4 is U .",./ r 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 ANY 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). 1 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 all disciplines. 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. K Signature of owner and/or Condo President Date FEES: PERMIT / o d RADON APPROVED: Zoning Mechanical PERMIT APPLICATION FOR MIAMI SHORES VILLAGE 10050 N.E. 2nd Avenue • Miami Shores, Florida 33138.305- 795 -2204 BUILDING ELECTRICAL C.C.F Phone 76 - 7- ° V' Adds 87.1 6 - V /u /6'7 Cr AW/ m SS# (? Phon / 3 o f � C4J o • a G- a 'R "" d Competency # Ins. Co. Signature of Contractor or Owner Builder . '♦ � 1 11 Notary as to Owner and/or Condo President Date ,tary as to Contractor or O* 'N'. 7g fi193 My Commission Expires My Commission Expires rQµMtS Y P Y P E:xr+Rt s AAA 12198884 7atzv1 PLUMBING NOTARY /— Building Electrical MECHANICAL TOTAL DUE Plumbing Structural Engineer BOND ROOFING Date EM ill ILE UNIT FEE ITEM SWITCH OUTLETS UNIT FEE ITEM SPACE HEATERS UNIT FEE GET LIGrfT OUTLETS CENTRAL HEATING SttWAS<iER RECEPTACLES A/C (Y(IND) SPOSAL SERVICE TESKRARY A/C (CENTRAL) MUG FOUNTAIN SERVICE SIZE IN ASPS DUCT WORK CCR [MAIN SERVICE REPAIR/NATER Ct1Al;GE REFRIGERATION EASE TRAP APPLIANCE OUTLETS • PROCESS »O PRESS PIPING ITERCEPTCR RANGE TOP UNDERGROUtO TANKS ,VATCRY OVEN ABOVE MOO TANKS ;UNGRY TRAY WATER HEATER U.F. PRESSLRE VESSELS OTHES WASHER SOTCRS 0- 1 FP STEAM BOILERS ;DYER SOUS OVER 1- 3 FP HOT WATER BOILERS HK, POT/3 cow. SOTORS OVER 3- -5 FP SEWN ICAL VENTILATION I NI( , RESIOENCE SOTCRS OVER 5- 8 if TRANSPORTING ASSESELIES INK, SLCP M3TCHS OVER 8- 10 HP ELEVATORS/ESCALATORS :WORMY WATER CLOSET SOTORS OVER 10- 25 if . FIRE SPRIPIXLER SYSTESS ANAL SOTCRS OVER 25-100 if COOLING TOWERS ;TER CLOSET SOTCRS OVER 100 if VIOLATION .DIRECT WASTES A/C WINDOW RE INSPECT ION ;TER SLFPLY TO: AIR CON) ITI0iERS - A/C UNIT STRIP HEATER FIRE SPRINXLER GENERATORS TRANIFCA RS • HEATER -NEW MST. GENERATORS TRANSFCRT RS HEATER - REPLACE GENERATORS TRANSFcflY RS • LAWN SPRIHXLER -WELL SPECIAL PLFPOSE SHISNIING POOL • CUTLETS COSMERCIAL WATER SERVICE • S I GM TUBES :HER CONNECTIONS SIGN TRINSFCx'i.4FRS "ILITY- SE'HER - SIGN THE MCC( 'ILITY -WATER FIXTLRES :PT IC TANK ANTENNA :LAY TELEVISION CURETS AAINFIELO, 4' TILE/RES. VIOLATION ;W & ABANDON SEPTIC TANK RE INSPECT ION )AXAGE P IT CU. FT. JON BASIN � =trek) AVM M FA ILSE rill - IA ISCMGE WELL ;NEST IC WELL IEA GRAIN :OF INLET ILAR WATER HEATER - IRE STANDPI XIL PIPING . 1Wti SPRIHXLER SYSTEM S R, GE :TER SET (GAS) S PIPING .N APPLICATION FOR 3IUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. IF A MASTER PERMIT HAS B. )STAINER, OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.) PLUMBING ELECTRICAL MECHANICAL Phone: 305 - 795 -2204 Printed: 3/15/2002 Applicant: W EDWARD Owner: MCINTYRE Miami Shores Village 10050 NE 2nd Avenue Contractor ALL DADE ELECTRIC CO INC Local Phone: (305)235 -8994 Electrical Permit Permit Number: EL2002 -82 MCINTYRE W EDWARD Address: 8965 SW 157 ST Cellular: Parcel # 1132050180340 Legal Description: REV PL MIAMI SHORES SEC 8 Job Address: 1076 NE 98 ST Permit Status: Approved This Permit is granted to the contra ordinances pertaining thereto and wit( and approved by the proper municipal authorization. A further condition upo ordinances and regulations pertaining by his agents. servants or employees Signed: In consideration of the issuance to with the plans, drawings, statements myself, my agent, servants or employ Signed: Permit Expiration: 9/11/2002 ?i2.(;.J -it)00,3 Construction Value: $2,500.00 V COMMERCIAL BANK OF FLORIDA Pinecresl /1'he Falls Office 13001 South Dixie highway, Miami, Florida 33156 ar f� /47 ALL -DADE ELECTRIC CO., INC. 8965 S.W. 157TH ST. 235 -8994 MIAMI, FL 33157 Page 1 of 1 PB 43 -69 LOT 17 \ 0 Total Fees: $O0 Total Receipts: $0.00 Work: NEW POOL 2 PUMPS 2 /LIGHTS 1 HEATER 10 AMP G.H NGE OVER SERVISEGROUND UPGRADE- -TB2OD -AMP If there is no permit package accessible on the job -site for inspectors to verify, there will be no inspections. Re- inspection fee is $50.00, which must be nail in_advanca_before- callina.for another_insoection. 8 -79 BLK 180 LOT 10735 63- 1037/660 $ /Oa wailer/ °- -- 1 PERMIT APPLICATION FOR MIAMI SHORES VILLAGE 10050 N.E. 2nd Avenue • Miami Shores, Florida 33138 • 305- 7 1 95 2 224 0 Date02 l 7 /Q' Address T lio //3 4 '' b 95 b 1 S 0 3 Y N Legal Description Historically Designated: Owner/Lessee/Te WORK DESCRIPTION: Owner's Address /© , �� f . ` Contracting Co. � " Qualifier �i.o'/ /pis ,i /�✓! State # �' nicipal # Competency # Ins. Co. IF THERE IS NO PERMIT PACKAGE ACCESSIBLE ON THE JOB SITE FOR INSPECTORS TO VERIFY, THERE WILL BE NO INSPECTION. RE- INSPECTION FEE IS $50.00 AND MUST BE PAID IN ADVANCE BEFORE CALLING FOR ANOTHER N CTION. Permit Type (circle one): BUILDING ELECTRICAL PLUMBING Ole Square Ft. Estimated Cost (value) 6 eo ' 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 ANY 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 all disciplines. 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 Notary as to Owner and/or Condo President My Commission Expires FEES: PERMIT 9 ° RADON APPROVED: Zoning Building Mechanical Plumbing s /illtet 1A/3 Master Permit # Phone Address 9b( 6 / 2 343 SS# Phone Yr 369`5 4 . Signat Date N 1 /04./... f 4 1141° 1 y Commi e of,n c�rOwr /` �I - .{J .��"f . •i` l.i Cr as to Yes 10 a . t t,rrctgi. raria &w �. t o ' in a CC7 86697 �r l 4 EEx 9T F O� MY N 5 20 0 2 OFD NOTARY -S., 0 (� No ' ,20 Oo1 . s CP MECHANICAL ROOFING BOND ate TOTAL DUE S V b Electrical ,°!j 4`2-- Structural Engineer ITEM BATH TL8 UNIT FEE ITEM SWITCH OUTLETS UNIT FEE ITEM SPACE HEATERS UNIT FEE BIDET LIGHT CURETS 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 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 ASSEM6LIES SINK, SLOP MOTORS OVER 8- 10 If ELEVATORS/ESCALATORS TEMPORARY WATER CLOSET MOTORS OVER 10- 25 FP 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 SLPPLY TO: AIR COH ITIONERS _ • A/C UNIT STRIP HEATER FIRE SPRINKLER GENERATORS TRANSFORMERS ' HEATER -NEW INST. GENERATORS TRANSFORMERS HEATER-REPLACE GENERATORS TRANSFORMERS LAWN SPRINKLER -WELL SPECIAL PURPOSE SWIMfi4ING POOL OUTLETS COMP RCIAL WATER SERVICE SIGN TUBES SEWER CONNECTIONS SIGN TRANSFORMERS UTILITY -SEWER SIGN TIME CLOCK UTILITY -WATER FIXTLRES SEPTIC TANK ANTENNA ' RELAY TELEVISION CUTLETS )RAINFIELD, 4' TILE/RES. VIOLATION PUMP & ABANDON SEPTIC TANK REINSPECTION SOAKAGE PIT CU. FT. :ATM BASIN DISCHARGE WELL )OMESTIC WELL AREA DRAIN ROOF INLET SOLAR WATER HEATER _ =IRE STANDPIPE '001 PIPING .AWN SPRINKLER SYSTEM ;AS RANGE KETER SET (GAS) SAS PIPING PLUMBING ADDENDUM TO BUILDING PERMIT APPLICATION (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.) ELECTRICAL MECHANICAL