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MECHANICALPERMIT APPLICATION FOR MIAMI SHORES VILLAGE 9Q ci .lJ. e', 55 S�'faxFolio It - '2 0 ( -03q, 023 Legal Description Historically Designated: Yes No N y Date 9 I 00 Si - , / /1 Da FEES: PERMIT 60 Job Address / Tenant C) )7 ,v Dc, 1 Owner's Address 0 '7 A. ( _ S 5 577 Contracting Co. A - / A/ 4 46, Address Qualifier Do W/5 c e. 5Va.ie✓% State #436 e 013 Municipal # Architect/Engineer Bonding Company Mortgagor Permit Type (circle one): BUILDING ELECTRICAL PLUMBIN WORK DESCRIPTION /0 Square Ft. Estimated Cost (value i3 ® -4 ' 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 z• ing. Furthermore, I authorize the above -named co actor to do the work stated. I u -_ ,, ture of d/or C • do " '�ident otary .: • Owner and/or Condo President My omm' Sion Expires: 0 ate DORRANCE L. YOUNT My Comm Exp. 8125100 WNW ey Service In No. C4579393 '19 Mow 1) 0r 1 0 RADON 6 --/-0 0 Date Address Address Address Master Permit # I/69 a z Phone 30 S — ) S 1 -. 7.5 P.61- #ox 7o c' 7 SS #, 7,khone'- of,O �.S Competency # Ins. Co. 6/2/0-✓4e,40 OFING PAVING FENCE SIGN 5 /34 u re of C . or or Owner- Builder / 4 ate Notary as to Contrac My 7 mm i ssion Expir r or Owner- Builder Of f My Comm n- 6/2EJ2001 Bonder a! Sento kis Nis CC650501 Penangi MON 1100ar I.D. C.C.F. ) i O NOTARY �` d'� TOTAL DUE C7 / -l/i ©v Date APPROVED: Zoning Building Electrical a Mechanical . ev 6..2.I6 Q Plumbing Engineering ITEM BATH TU8 UNIT FEE ITEM SWITCH OUTLETS UNIT FEE ITEM SPACE HEATERS UNIT FEE BIDET LIGHT OUTLETS CENTRAL HEATING DISHWASHER RECEPTACLES A/C (WIN)) - ro ° DISPOSAL SERVICE TEMPORARY A/C (CENTRAL) DRINKING FOUNTAIN SERVICE SIZE IN A6PS DUCT WORK FLOOR DRAIN SERVICE REPAIR/METER CHANGE REFRIGERATION GREASE TRAP APPLIANCE OUTLETS PROCESS AND PRESS PIPING INTERCEPTOR RANGE TOP UNDERGROUPO TANKS LAVATORY OVEN ABOVE GROUND TANKS LAUNDRY TRAY WATER HEATER U.F. PRESSURE VESSELS CLOTHES WASHER MOTORS 0- 1 HP STEAM BOILERS SHOWER ROTORS OVER 1- 3 HP 1 HOT WATER 80ILERS 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 1 MOTCRS OVER 25-100 HP COOLING TONERS WATER CLOSET MOTORS OVER 100 If 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 SWIM&AING P001. ' CUTLETS COMMERCIAL _ WATER SERVICE • SIGN TUBES SEWER CONNECTIONS _ SIGN TRANSFORMERS UTILITY -SEWER SIGN TIME CLOCK UTILITY -WATER FIXTLAES SEPTIC TANK ANTENNA • RELAY TELEVISION OUTLETS ORAINFIELO, 4' TILE/RES. VIOLATION PUMP & ABANDON SEPTIC TANK RE INSPECT ION SOAKAGE PIT CU. FT. CATCH BASIN DISCHARGE WELL DOMESTIC WELL AREA DRAIN ROOF INLET SOLAR WATER HEATER FIRE STANDPIPE P001. PIPING • LAWN SPRINKLER SYSTEM ` GAS RANGE METER SET (GAS) GAS PIPING ADDENDUM TO BUILDING PERMIT APPLICATION (AN A'LPPLICATION 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 MECHANICAL MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Application is hereby wade for the approval of the detailed statement of rile plans and specifications herewith submitted for the build • inc 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 the work. D ate..._... »..�� .. 3 ...Q _... ».__... ».... ,19.._._ Owner's Name and Address 77#? .....Tos✓E 5 ,,, .. Street._.. _ Registered Architect and /or Engineer _ •:•• ..••••••• •••••••••t••• Name and address of licensed contractor....' e. S,ZOIzr- //X,74 5_ Location and legal description of lot to be built on: Lot /3 e4/ `i Block / 7' Subdivision � //�/-?' 5 � 6 s rti Street and Number where work is to be done 7‘, 2 ti ..... 9' • _. _,s T _., ,�• State work to be done and purpose of building (by floors) A S..? &' S/'i /e -5.7-57.E" /. kcv ,1.srr1-7—R. pe -.eel / 23w e.7" .zoe.s ' . / 9-5 •p�rz J'A /7 15 /3 X ..,,. '/ e 57 - 0/0 6 ,,...ixTU2 - __ and for no other purpose. New Building Remodeling 7 Addition Repairs No. of Stories _ To be constructed of Kind of foundation R f Covering oa Amount of Permit R........._..4. Estimated Total cost of improvements $ •3,�•�� A Zone cubage required .Plan Cubage Distance .to next nearest building. Size of Building Lot \faxitnum live load to be borne by each floor • I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may be sent to.. The unrtersigncd 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 Strp pleutent, and h.ts complied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors em loved by him in the work to be performed under this permit; and will post or cause to be posted for inspe on on the site of the k su tlic notice or notices as are required by the Act. The undersigned agrees to employ only such subco a o on work o rf under this pcnnit, as are licensed by Miami Shores Village. Retn.uks __._.__ (Signed)X (NOTARY PU l C STAIR OF RORIDA MAIM • MY COMMISSION DVt19S ME. Q 1911 BONDED INN COWL MI. AINDOI11fUS11>:1S Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap- peared to Pie well known. STATE OF FLORIDA, COUNTY OF DADE. ss. and who, being by me first duly sworn, upon oath deposes and says that he is the. of the above described construction, that he has carefully read the foregoing a therein by him stated are true. Q e o 8r ion, and that he did sign the same, and that all facts e : , Sworn o and ' ub • �' A . . O My Commission Esprt »:, ...._ .� > _ ttOr,n� 1 t•r><u ivrxAl _ i r4s -. UNDt&W J RI TEAS PLANNING BOARD DATE Chairman Member Member Member Member .. .. _....._......_..._._ ...._..... Member Council Approved Date Disapproved Date NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has been obtained fmtn tirc P1.urnir.g Hoard. . A re inspection fee of 51.00 will be charged when such re- inspection is made necessary by Improper notice for inspection or faulty materials and /or workmanship. Permit No.._. N.Zll. . Disapproved .. (Signed) Building Inspector Date .. t Date .._........_........._ otary Pub Total Ceiling Bracket Receptacle Switch Bell Floods Sign SERVICE Outlets Outlet AMP. Form 63 (Rev.) I hereby make application for below, and I agree to comply LEGAL DESCRIPTION: Lot Address Block d1 Building Occupied as: New Construction ROUGH WIRING Main Switch Size Service Wires EQUIPMENT Stove Receptacle FIXTURES Master Electrician Application Received Final OK No. OK for Water Heater Special Power or Heat W ROUGH WIRING BUILDING DEPARTMENT ELECTRICAL INSPECTION DIVISION FLORIDA DATE an electrical permit to install or change electrical wiring in or on the premises described with all the rules and regulations governing electrical installations in the City of Miami. Size Service Conduit Subdivision Existing Structure Owner NO. B Occupant Addition to Existing Building Spaceheater (ring tor: No. Circuit -Orif MOTORS (List and Give H. P. f Each Motor) 3 Phone_ iU/ Address / /Ji 7 Ready ✓ Will Call INSPECTION REPORT Fee Paid EQUIPMENT Inspector FIXTURES APPLICATION FOR BUILDING PERMIT Application is hereby made for the approval of the detailed statement- of the plans and specifications herewith submitted for the build- ing or ocher structure her -r described. This ::p is made in compliance and comormty with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws et the Stato of Florida. all o finances of Mi :nu Shores Village and all rules and regula? ions of the Building Div; i, in of ?.iianu Shor,• iilage .h ,e rompLed with, whether herein specified or not. A copy of approved plans and specifications must be kepi at building durinc progress of the work. Date J. Owner's Name and Address _. S No Street --. Registered Architect and /or Engineer_. ' n ` Name and address of licen ed contractor New Building_ Location and legal description of lot to be built on: Lot_ Block.._ ___ . Subdi isio Street and Number where work is to be done_.. cloci o .. State work to be done and purpose of building (by floors) Remodeling__ ___ _ __. Addition To be constructed of ___ _ -_. Kind of foundation MIAMI SHORES VILLAGE BUILDIN'.= INSPECTION DEPARTMEN" Date _ Council Approved .___ Date 1 3isapuroved . PLANNING BOARD DATE Chairman Member Member ____ _ Member Member _ Member ._. .. Read, Sworn to and Subscribed before me. Date_ . Notary Public State of Florida uT2' ,ing Inspector My Com:nission Expires. 19 -.and for no other purpose. Repairs_ . - _ No. of Stories Roof Coworing._ Estimated " ,ta1 cost of improvements $__ �_ 0- Amount c` Permit $_ Zone "ubage required __. _Plan Cubage .. ....... ..... Distance to next nearest building__ . _ _Size of Building Lot Maximum live Load to be borne by each floor hereby submit all the plans and speciiications for said building. All notices with reference to the building and its construction may be sent to The unde signed applicant for th;s budding permit does hereby certify ihat he understands and accepts his obligations as an employer of 1 bor under he Florida Workmen's Compensation Act. being S• (•tion 5966 Col-pled Gen' 'al Laws of Florida. P -r anen, S rent, and h s compl ed w;th he rrov ons thereof, and will require similar coon lance from all contractors or sub - contractors emplo ed by hint in the wok to he p rf med under th ;s pern it • and vill post or cause to he posted for inspection on the site of the work su..h public non, e or •otices as are requtr d by the Act. The u. ch r•ignr•d agrees to employ only such . ubc• •tr, ctors, on worn -to) be perform .: der this permit as are licensed by M arn: Shores Remarks_- STATE OF FLORIDA, COUNTY OF DADE. ss. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally Ap- peared to me well known, and who, being by me first d, ly sworn, upon oath deposes and says that he is the e Of th abov. de t ibed , tstr that therein by him stated are trae. Permit No._. 1 -72'- Disapproved (Signed) Date NOTE: A charge of $1.00 will be made for making corrections or _ :hanges to this application !ftrr approval h bet n obtained from the Planr'ng Board. A re-inspection fee of $1.00 will be charged when such re- inspection is m.: its necessary by improper notice t� for inspt-t'o or It ity materials and/or workmanship.