MECHANICALMIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
Building Inspection Reques
Date
Type Insp'n r inn\
Permit No. ►`QE. o �^ Z�
Name ul beirS
Address 1 g S1
Company i`{ k lb s i) C Se w •
Phone # / S 1 — JU I I `i
Inspection Date IMOU VI3
Approved 9 Z A. o 4
Correction ❑
Re- Insp'n Fee ❑
J
imam" 311Ure5 v iilagc
;;��it ilding Department
!.!�1 ECEIN id venue, Miami Shores, Florida 33138
Tel: 20 (305 795.2204 Fax: (305) 756.8972
DEC 2 03
BUILDING
PERMIT APPLICATION
FBC 2001
Permit Type (circle): Building Electrical Plumbing ( Mechanical Roofing
Owner's Name (Fee Simple Titleholder) 1 \ A CV J V6U `r kezo Phone #
Owner's Address 3 U? A-/ E., 4 q s I"
nn
,City 0 ► i Gam- gks■— State
Tenant/Lessee Name ,3'S - ?S - ?- 329 Q .
Contractor's Company Name
Job Address (where the work is being done) -Cam 3 a 7 /V 99 S/
City Mianu Shores Village County Miami -Dade Zip 3 3 J / 3 0
Is Building Historically Designated YES NO
f»21 lee '3 4 . ./Z._v/e Phone #
Contractor's Address '7
City l rti'y1�
State A
Qualifier /2 s Z — /y7
Architect/Engineer's Name (if applicable) Phone #
$ Value of Work For this Permit 2/ r
Type of Work: ❑Addition ❑Alteration
Describe Work: /4
X
� ° 6 CCF $
cll . c �Cj - * * * * * * * * * * * * * * * * * * * * * * * * ** F ees * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
G/ - 1
1
Submittal Fee $ • 00 Permit Fee $
Notary $ , 0 f) Training/Education Fee "•., 6 9 Technology Fee $ k. 4--
Scanning $ Radon $ Bond $
Code Enforcement $ Structural Plan Review. $
Total Fee Now Due $ () i h
(Continued on opposite side)
['New
Permit No. N E- P.On - �3J
Master Permit No.
Zip 73/ 3 g
Phone #
zip P3 / 3 '
Square Footage Of Work:
Repair/Replace
❑ Demolition
Bonding Company's Name (if applicable)
Bonding Company's Address
City
)(Signature
Sign:
Pri
***
Chc 10/14/03
K\PQ vo-L
NOTARY PUBLIC:
State Certificate or Registration No.
APPLICATION APPROVED BY:
State
tzet
tion and who did take an oath.
* .*
I O t e:aedTnr
p ry Pub;,c Undznvritora
Zip c
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
City State Zip
Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has
commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating
construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS,
WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDMONERS, ETC
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.
"WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT 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."
Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued In the absence of such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
Signature
Contractor r
The foregoing instrum acknowledged f thi a F Th f instrument acknowledged bf thi 21(. a
Owner or Agent
e oreegoing ent was b before me s e ore oing m en was before
me s
day of D-- cefrao , by f 1#9J).6.4 J2J TE E. 1I 0 0 tW€ day of , 20C , by � uszit I Ul
who is personally known to me or who has produced cVNI0 v9 Y. who is personally known to me or who has produced
NOTARY PUBL
Sign:
Print:
identification and who did take an oath.
• (� M Commissio Expires: ` ,;fir
* ** * ******** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** * +ems *`
U• ::
(Certificate of Competency Holder)
Certificate of Competency No.
Vargas
..I�u'1'73,.DU7
Bonded Thru
A tlantic Bonding Co., Inc.
***************************************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
Plans Examiner
Engineer
Zoning
W
H TUB
UNIT
FEE
ITEM
SWITCH OUTLETS
UNIT
FEE
ITEM
SPACE HEATERS
UNIT
FEE •
ET
LIGHT OUTLETS
CENTRAL HEATING i4) 41_0
;
RECEPTACLES
A/C (WIND)
POSAL
SERVICE TEMPORARY
A/C (CENTRAL) 3 Tv , LJ
NKING FOUNTAIN
SERVICE SIZE IN ARS
DUCT WORK
CR (MAIN
SERVICE REPAIR/}kTER CHANGE
REFRIGERATION
:ASE TRAP
APPLIANCE OUTLETS
PROCESS AND PRESS PIPING
'ERCEPTOR
RANGE TOP
UNDERGROUND TANKS
'ATCRY
OVEN
ABOVE GROUND TANKS
1
INDRY TRAY
WATER HEATER
U.F. PRESSURE VESSELS
ITHES WASHER
MOTORS 0- 1 HP
STEAM BOILERS
T1_R
MOTORS OVER 1- 3 HP
HOT WATER BOILERS
+K, POT /3 COMP.
MOTORS OVER 3- 5 HP
MECHANICAL VENTILATION
.K, RESIDENCE
MOTORS OVER 5- 8 HP
TRANSPORTING ASSEMBLIES
X, SLOP
MOTORS OVER 8- 10 If
ELEVATORS/ESCALATORS
*TIRARY WATER CLOSET
MOTORS OVER 10- 25 HP
FIRE SPRINKLER SYSTEMS.
INAL
MOTORS OVER 25-100 HP
COOLING TOWERS
TER CLOSET
MOTORS OVER 100 HP
VIOLATION
DIRECT WASTES
A/C WINDOW
REINSPECTION
TER SUPPLY TO:
AIR CONDITIONERS
AJC UNIT
STRIP HEATER
FIRE SPRINKLER
GENERATORS TRANSFORMERS
•
HEATER -NEW INST.
GENERATORS TRANSFCRMERS
HEATER- REPLACE
GENERATORS TRANSFORMERS
LAWN SPRINKLER -WELL
SPECIAL PURPOSE
SWIMfiIIYU POOL
OUTLETS COMMERCIAL
MATER SERVICE
SIGN TUBES
WER CONNECTIONS
SIGN TRANSFORMERS
I L I TY -SEWER
SIGN TIME CLOCK
ILITY -WATER
FIXTURES
?TIC TANK
ANTENNA
LAY
TELEVISION OUTLETS
AINFIELD, 4' TILE/RES.
VIOLATION
M' & ABANDON SEPTIC TANK
REINSPECTION
AKAGE PIT CU. FT.
TCH BASIN
,
SCHARGE WELL
MESTIC WELL
EA DRAIN
OF INLET l
LAR WATER HEATER `.
RE STANDPIPE
DL PIPING
AN SPRINKLER SYSTEM
S RANGE
TER SET (GAS)
S PIPING
PLUMBING
ADDENDUM TO BUILDING PERMIT APPLICATION
4 APPLICATION FOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. IF A MASTER PERMIT HAS B.
-
STAINED, G'FTNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.)
ELECTRICAL
MECHANICAL
Applicant: MARGUERITE VOORHEES
Owner: VOORHEES MARGUERITE
JOB ADDRESS: 307 NE 99 ST
Signed: (INSPECTOR)
Contractor MIKES A/C SERVICE, INC
Local Phone: 305 - 714 -4400
Parcel # 1132060135480
Mechanical Permit
Miami Shores Village
10050 NE 2nd Avenue
Phone: 305 - 795 -2204 Permit Number: ME2003 -230
Printed: 12 /29/2003
Contractor's Address: P.O BOX 4384
Permit Status: APPROVED Permit Expiration: 6/23/2004 Construction Value: $2,475.00
Work: REPLACE 3 TON NC AND HEATING SYSTEM
Page 1 of 1
Legal Description: MIAMI SHORES SEC 1 AMD PB 10 -70 LOT 13 & 14 BLK 40 LOT SIZE 100.000
Fees: Description Amount
FEE2003 -8601 Building Fee $106.00
FEE2003 -8602 CCF $1.80
FEE2003 -8603 Notary Fee $5.00
FEE2003 -8604 Training and Education Fee $0.60
FEE2003 -8605 Technology Fee $2.65
Total Fees: $116.05
Total Fees: $iy9p5
Total Receipts: � $0.03
tr
get.2-
JAN 0 2 PAID
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 responisibility for all work
done by either myself, my agent, servants or employes.
Signed: (Contractor or Builder) BY:
r