MECHANICALPERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date / \C _ boo \ Job Address 560®'E � � C � Tax Folio
Legal Description Historically Designated: Yes No
Owner/Lessee / Tenant • jJ 8/L) ( L G UZ P Master Permit # 9 gg,c3
Owner's Address ''nn n Phone -- 6° S ° '� " b / S� 3
Contracting Co. g ? r Cr C, Grp Address 4 kJ. W - 5- kV- 4- (
Qualifier . 5 - b Se- (7 ctbri Scuti Z SS# Phone
State # CA C. d 53 gJ ? Municipal # Competency # Ins .C Co. �� tf P ko h e
Architect/Engineer
Bonding Company Address
Mortgagor �gd
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING ECHANICA
WORK. K DESCRIPTION
iVI Irv'Aotk' dtn was 1nu>f (4..
Square Ft.
Zoning
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 th all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
constructio .:, r d zoning.
My Commission Expires:
FEES: PERMIT 2
APPROVED:
Condo • esident
60-
Mechanical /"' � � r</.. `a Plumbing
_j . ROOFING PAVING FENCE SIGN
1 / I C } Q - OC e _ y - 1 ` , v\ 9 r1 t t W 6 , S , l d c c R riek v
Estimated Cost (value) 4 `....peot:s
e, I authorize the above -named contractor to do the work stated.
° °1 Date
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eSidetr,c ,::' ate •
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MY COMMISSION 1S)
RADON C.C.F.
Address
°" 'or or Owner -B ilder _
0 S r_•
► ZS " S
as t ni / ontract. or Owner-
y Conusion Expires.
uilder
OFFICIAL NOTAPY AL
♦PRY P- e! A V.-AL
M BECKER
r � 0 CO &WISE ON IIUre SER
01) ? r
< CC78G6 7
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' OF f� ._—
NOTARY �. 0 a BOND
TOTAL DUEa l O
Date
Building Electrical
Structural Engineer
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) fau5 Se&ik
1
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 HD
HOT WATER BOILERS
SINK, POT /3 COMP.
MOTORS OVER 3- 5 IP
_
MECHANICAL VENTILATION
SINK, RESIDENCE
MOTORS OVER 5- 8 HP
TRANSPORTING ASSEMBLIES
SINK, SLOP
MOTORS OVER 8- 10 I•P
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
DRAINFIELD, 4' TILE/RES.
VIOLATION
.
PUMP S. ABANDON SEPTIC TANK
REINSPECTION
SOAKAGE PIT CU. FT.
:ATCH BASIN
DISCHARGE WELL
]OMESTIC WELL
AREA DRAIN
100F INLET
SOLAR WATER HEATER
'IRE STANDPIPE
'COL PIPING
_AWN SPRINKLER SYSTEM
;AS RANGE
IETER SET (GAS)
AS PIPING
• 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.)
PLUMBING
ELECTRICAL
-7 MECHANICAL
•
JOB NAME
ADDRESS ce,O RE C‘\ S\v4
Different ;location than .above?
,.
EXISTING CONDITIONS
1. HOUSE MAIN ELECTRIC SIZE AMPS Z WIRE SIZE
2. COMPRESSOR BRANCH CIRCUIT: WIRE SIZE 4 , & CIR. BKR.
AIR HANDLER BRANCH CIRCUIT:WIRE SIZE, & CIR. BKR.
3. SIZE OF EXISTING COMPRESSOR DISCONNECT: AMPS. TYPE:
SIZE OF EXISTING AIR HANDLER DISCONNECT:_ AMPS. TYPE:
4. IS DISCONNECT WITHIN SIGNT AND READILY ACCESSIBLE? YES
5. EXISTING UNIT TO BE REPLACED OR RELOCATED
MAKE
CONDENSOR MODEL #
HEAT PUMP TYPE YES
CONDENSOR MINIHUM CIRCUITS AMPS A.H.U. MINIMUM CIRCUIT AMPS
MAXIMUM OVERCURRENT PROTECTION SIZE AND TYPE:
CONDENSOR AMP SIZE FUSE HACR CIR. BKR.
AIR HANDLER AMP SIZE FUSE HACR CTR. BKR.
EER
MIAMI SHORES VILLAGE
AIR CONDITION REPLACEMENT
Q1n� mot.. 7,
NAME PLATE INFORMATION FROM EXISTING UNIT
PACKAGE MODEL #
A.H.U. MODEL ,,
NO KW HEAT STRIP SIZE
NAME PLATE INFORMATION FROM NEW UNIT BEING INSTALLED
MAKE�\t\ACI-Co L
CONDENSOR MODEL # � 1. A.H.U. MODEL # W "T_\ `'
HEAT PUMP TYPE YES NO 7.•- KW HEAT STRIP SIZE \a ■■N+' •
CONDENSOR MINIMUM CIRCUITS AMPS 1. 2-• t t > A.H.U. MINIMUM CIRCUIT AMPS
MAXIMUM OVERCURRENT PROTECTION SIZE AND TYPE:
CONDENSOR AMP SIZE
AIR HANDLER AMP SIZE
EER ` L.-f
r
SIGNATURE OF QUALIFIER
FUSE
FUSE
SIZE v" FUSE
SIZE FUSE
PACKAGE MODEL * 44231
SIZE
SIZE
FUSE CIR. BKR.
FUSE CIR. BKR.
NO
HACR CIR. SKR. ' 37)
HACR CIR. BKR. " L I D
C 4 CO SR 7
CERTIFICATE NUMBER
SW
SW