MECHANICALApplicant: VANESSA SIREN
Owner: SIREN VANESSA
JOB ADDRESS: 945 NE 98 ST
Contractor J M ARCE SERVICE
Local Phone: 305 - 262 -3589
Parcel # 1132060143450
Permit Status: Approved Permit Expiration:
Work: A C INSTALLATION
Signed:
1-6a‘ 3.,i -03
Mechanical Permit
Miami Shores Village
10050 NE 2nd Avenue
Phone: 305 - 795 -2204 Permit Number: ME2003 -47
Printed: 3/31/2003
Legal Description: MIAMI SHORES SEC 3 PB 10 -37 LOTS 19 & 20 BLK 80 LOT SIZE 100.000 X
�gs,00 S. ot)
Cc � a 0
9.
Total Fees:PO'0
Total Receipts: $0.00
9/27/2003
Contractor's Address: 6030 SW 22 ND ST
Construction Value:
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 paid in advance before calling for another inspection.
This Permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the application herefor in strict compliance with all
ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans, drawings, statements or specifications that may have been submitted to
and approved by the proper municipal authorities. This Permit may be revoked at any time if the work is not done in compliance with such ordinances or if the plans are changed without
authorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the
ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes responsibility for work done
by his agents, servants or employees.
(INSPECTOR) BY:
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.
Sinned , (Contractor or Builder) BY:
Page 1 of 1
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CONTRACTOR
Name J ' : n 5 , ` zu
f
License No. d4 r. 9 -,
Address c, , r , 30 5(.4) D-- -a,- .5 ,
///-44 u. .3 )4 . c'611
Telephone *930s74).-7. /V fox OS / _ \ 5 t `UC
I
6..
Qualifier Name $ C ^ 1 a
PR PEER OWNFLR)
New Construction
/
Name
Name
License No.
Repair
Address , :iii./, 7 #
9 (t S
Mt 1 "b ' H�V<-CS
l 0
)- (--
Sf
5
Home Telephone
... t s - 7 5 13
b
C ----7
7
Business Telephone
yt,
/
Add'I Attachment
Fax
-
Add'I Detachment
ENGINEER
New Construction
/
Name
/
///
License No.
Repair
Address
/r
Demolish
Telephone
Relocation of Structure
Fax
Foundation Only
TYPE OF MANAGEMENT (✓ )
New Construction
Enclosure
Alteration Exterior
Repair
Alteration Interior
Demolish
Relocation of Structure
Shell Only
Foundation Only
Add'I Attachment
Other
Add'I Detachment
Other L)61) 1.0 Sri¢ /47/0/7
INSTRUCTIONS - The following steps must be taken to obtain a permit from the :Miami Shores Village:
Step 1.
Complete the attached permit application which trust 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 submit-
ted 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.
APPI !CATION
ob Address:-
9S AJF
Address
Folio Number e�scription of Work
Lot Block
Subdivision PB
Current Use of Property
Proposed Use of Property
Tenant Information
PERMIT TYPE (✓ )
Building
Electrical
Mechanical
Plumbing
LPGX
Roofing
Fence
Other
Apt.
PG Zoning Linear Feet
Square Feet Units Floors
pf of Work �` t, ..04; 2 Da 0 Bldg Value
T Tax Assessed/Appraised Value
Flood Zone Base Floor Elev.
PERMIT CHANGE (✓ )
Chg. Contractor
Renewal
Revision
Extension
Supplement
Reinspection
ARCHITECT
Name
License No.
Address
Telephone
Fax
3
Master Permit No.
City
r,#1
A C
PERMIT APPLICATION
Subsidiary Permit No.
Y1-- 3 3 /3 ,V
State Zip
je + SrittL- It7i`f7
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, 1°' 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
Signature of 0
IAMI -DADE
Print Name
Sworn to and subscribed before me this
i gnature of o' otary Public t to ofktibliklm Becker
• • ' My Commission DD150048
�R Expires November 15, 2006
SEAL:
OR, Produced Identification �^
Personally known (J
Type of Identification Produced: P"2' n1. S ‘So -5 OO °rO6.
STATE OF ' / ORIDA, CO OF MIAMI -DADE
%!
atur of Contz ctor / ualifier
cc
Print Name G2-0 a-/
Sworn to and subscribed .. ore me this . T day of MO r'
,20 03.
Signature
SEAL:
PERMIT APPLICATION
o 01 11 41110/0 %
pe of Identification Produced:
° � ' ° Noe
e *'o o0C e
li
o 400 114026 OS o °° °i Onde 4:0;9 0 �ii�h� f: vYP61kU� ' / � * S \1 ' °
Personally known V OR, Produced Identification /f /tlif 111111 ��
oie
ELECTRICAL
11 P1{
Minimum Fee
(11' 1'.
T1 Pr
Dryer
Q'I'1.
'I 11'I:
Outlet, Appliance
(x
I 1 I'1•:
Service Repair
(,YIN.
AJC Central 1 -3 Ton
Heating Strips, each / 2
Fan
Z. Vent Hood, Cost
Outlet, Wall
Service, Temporary
Paint Booth
A/C Central 4 -7 Ton
Ventilation, Cost
Fire Pump
5"
Outlet, Switch
- Piping, Flammable Liquid
Signs
Periodic Inspections
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
TvI'1':
Minimum Fee
Q'I'1'.
Q'1'1'. TYPE
Condensate Drain
Q' I'1'. '11 1'F:
Generator
'I'1 I'I::
Miscellaneous Fixture
(x'11. I11'I: QY11.
Refrigeration, Tons
A/C Central, Tons
Q 1 1.
P M Cooling Tower
Heating Strips, each / 2
//
Z. Vent Hood, Cost
A/C Wall/Win. Tons
Dryer Vents, Number of
Paint Booth
Bidet
Ventilation, Cost
Air Handler, Tons
5"
= Ductwork, Cost of
- Piping, Flammable Liquid
Sprinkler Repair
Periodic Inspections
Barbecue
Fire Sprinkler System
Process/Pressure Piping
Pump and Abandon
Bath Fan - Vented, #
Fireplaces, Number of
Pressure Vessel
Gas - Appliance
PLUMBING
Tl'I'1{
AJC Condensate
Q'I'1'.
T1'1'1:
Drains, Roof
QTY.
'I'1 I'I::
Miscellaneous Fixture
Q11.
'I 1 I'I•:
Soakage Pit
Q 1 1.
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
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
INSTRUCTIONS: Please indicate the type of work being performed and quantity(ies) in the space provided below.
RECEIVED AND REVIEWED BY: DATE:
PERMIT APPLICATION
SECTION
BY
DATE
Zoning
Electrical
Mechanical
g‘o G•
3.3 (. b 3
Plumbing
Fire
Public Works
Structural
Building Official
Page 4
OFFICE USE ONLY
CHECKLIST
❑ 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)
❑ IMPACT FEE
(New Construction)
❑ OTHER
(Specify & Attach)
PERMIT FEES
$3.00 per page (Scanning Fee) $
�Do
Miami Shores Village
Bond $
Metropolitan Dade County (C.C.F.) $
Inspector State Educational Fund $
State DCA (Radon) $
Code Enforcement Fine $
Zoning Review
Notary
$ S O v
x ¢ 60) x/1000
(¢.005 /sq.ft.)
($.01 /sq.ft.)
PERMIT APPLICATION
❑ CONDO ASSOCIATION APPROVAL
(Attach)
❑ BPR APPROVAL (Restaurants)
❑ CONTRACTOR REGISTRATION
(On File)
TOTAL $ a
ISSUING OFFICIAL
REVIEWED AND PREPARED BY: DATE:
CONDITION OF APPROVAL
Revised July 2001
10050 N.E. 2ND AVE., MIAMI SHORES, FL • (305) 795 -2207 • FAX (305) 756 -8972 • http : / /www.miamishoresvillage.com