777 NE 98 St (3)Date
Legal Description
Owner/Lessee / Tenant
Owner's Address
Contracting Co.
Qualifier / /
State # / Municipal # Competency ei ovg /// Ins. Co.
Architect/Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL,RVIOFING PAV t G FENCE SIGN
WO RI DESCRIP'T'ION
1
Square Ft. 11 i o
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Job Address / 77 /(— 32 /7°
Tax Folio
`ez .3 (73—;
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.
Signatur _ o ,• ii , �r • o President
Notary as to O ` er and/
My Commission Expire
FEES: PERMIT
APPROVED:
Zoning
Mechanical
/ RADON
6
=MARA, Mari CY RCM
(41Y
JAN ; , 1 <'37
Historical) Designated: Yes No
Master Permit #
`(‘/.?
s/b -72. /90 L_Ft
Address
Phone
ss# 9z6
Estimated Cost (value % 3
C.C.F. /. ,50 NOTARY
Building
Sign e of o tr :'ctor or Owner- Builder
Notary a to Contractor or Owner - Builder
My Commission Expires:
Electrical
,.�' 2 gr2C0 I
Dae
OWN tArgO,
TOTAL DUE '7 '-{ fe
Plumbing Engineering
ITEM
BATH 1113
UNIT
FEE
ITEM
SWITCH OUTLETS
LIGHT OUTLETS
t.1IT
FEE
ITEM
SPACE HEATERS
CENTRAL HEATING
MIT
FEE
BWOET _
5 ASN
ISI ER
—
RECEPTACLES
A/C (WINO)
ram
•
DISPOSAL
DRINKING FOUNTAIN
SERVICE TUMMY
SERVICE SIZE IN AMPS
A/C (CENTRAL
MCI �,
REFRIGERATION
FLOOR MAIN
SERVICE REPAIR/1ETER CHANGE
GREASE TRAP
APPLIANCE OUTLETS
PROCESS ARO PRESS PIPING
—�
INTERCEPTOR
RAN3E TOP
—'
UNJERGROUND TANKS
LAVATORY
OVEN
ABOVE (ROUND TANKS
IALKRY TRAY
HATER NEATER
U.F. PRESSURE VESSELS
CLOTHES WAS{R
ACTORS 0- 1 HP
STEAM BOILERS
SHE
MOTORS OVER 1- 3 HP
HOT WATER BOILERS
SINK POT/3 COMP.
MOTORS OVER 3-- 5 HP
_
MECHANICAL VENTILATION
5IM(, RESIDENCE
MOTORS OVER 5- 8 HP
TRANSPORTING ASSEMX IES
SINK, SLOP
MOTORS OVER 8- 10 HP
ELEVATCRS/ESCALATCRS
FIRE SPRINKLER SYSTEMS
TEMPORARY WATER CLOSET
,AINAL
MOTORS OVER 10- 25 HP
MOTORS OVER 25-100 If
COOLING TOWERS
WATER CLOSET
aill
MOTORS OVER 100 Pp
VIOLATION
R INSPECTION
■�
WOLF CT WASTES
MATER SUPPLY TO:
A/C UNIT
FIRE SPRINKLER
NEATER -#(I INST.
—�
_ �
—
A/C WINDOW
AIR CCMOITIONIERS
STRIP HEATER
GENERATORS TRANSFORMERS
I _
- �
GENERATORS TAA SFIJ'RS
HEATERIACE
�
GENERATORS TRANSFQ�RS
SPECIAL PLRPOSE
�=
LAM RIP iELl
SWIMMI
51fIWINO PO010.
WATER SERVICE
CUTLETS CObbfACIAL
C01J(C
SIGN TUBES
EWER OXIN CT IONS
SIGN TRANSFORMERS
TILlTY- SEVER
SIGN TIME CtO
FIXTURES
-
_
TILITY -HATER
EPTIC TAPE(
ANTENNA
�■
__
MUM
__
(LAY
TELEVISION OUTLETS
RAINFIELD, 4 TILE/RES.
VIOLATION
W & ABAPOON SEPTIC TANK
REINSPECTIoN
)AKAGE PIT CU. FT.
ITCH BASIN
ISCMARGE WELL
1ESTIC NELL
EA DRAIN
--
-
CE INLET
LAR RATER HE ATFR
E STAMP IPE
X PIPING
IN SPRINKLER SYSTEM
1RAP&
IIIIII
DER SET (GAS)
I PIPING •
—
�
�
F 1
PLUMBING
03/07/95 15:24 MSV
ADDENDUM TO BUILDING PERMIT APPLICATION
004
(AN APPLICATION FOR BUILDING PERMIT MUST ACC0MpANT THIS ADDENDUM. IF A MASTER PERMIT HAS BEEN
OBTAINED, THE OWNER'S NOTARIZED SIGNATDRE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.)
ELECTRICAL - MECHANICAL