ALARMPERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date Job Address 9‘0 A/05 597 Tax Folio //. ?O - 0 / g' 07'
Legal Description14 PO �/ // • -b'storicall Designated: Yes No
e ta # /� . H z , /.Dp!/e/1' Master Permit #
Owner's Address 7 N 97
Owner/Lessee / Tenant
Contracting Co.
state # A0073
Municipal #
Permit Type (circle one): BUILDING E C
WORK DESCRIPTION /� l / �`fy •
Square Ft.
iotary as to er`and7or
Commission Expires:
resident Date
Address $7.1rNW /$ 4'77
e
ss# / Phone �4-,
Competency #
Address
Address
Architect/Engineer
Bonding Company
Mortgagor Address
Phone
FEES: PERMIT 3 RADON C.C.F. • ° NOTARY
Ins. Co.
MBING MECHANICAL ROOFING PAVING FENCE SIGN
j erp-r - G G.- w b
Estimated Cost (value) /7/
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: E
Date
Notary as m ntractor or • er- Builder Date
My Commission Expires:
BOND
TOTAL DUE X15 D
APPROVED:
Zoning Building Electrical � / / ✓ l./l. -y/g
Mechanical Plumbing Engineering
ITEM
BATH TUB
UNIT
FEE
ITEM
SNITCH OUTLETS
UNIT
FEE
ITEM
SPACE HEATERS
UNIT
FEE
BIDET
LIGHT OUTLETS
CENTRAL HEATING
DISHWASHER
RECEPTACLES
A/C (WIND)
DISPOSAL
SERVICE TEMPORARY
A/C (CENTRAL)
DRINKING FOUNTAIN
SERVICE SIZE IN AMPS
DUCT WORK
FLOOR DRAIN
SERVICE REPAIR/NETER Q{ANGE
REFRIGERATION
GREASE TRAP
APPLIANCE OUTLETS
PROCESS AND PRESS PIPING
INTERCEPTOR
RANGE TOP
UNDERGROUND TANKS
LAVATORY
OVEN
ABOVE GROUDO TANKS
LAUNDRY TRAY
WATER HEATER
U.F. PRESSURE VESSELS
CLOTHES WASHER
MOTCRS 0- 1 HP
STEAM BOILERS
SHOWER
MOTORS OVER 1- 3 HP
HOT WATER BOILERS
SINK, POT /3 COMP.
MOTCRS OVER 3- 5 HP
MECHANICAL VENTILATION
SINK, RESIDENCE
MOTORS OVER 5- 8 HP
TRANSPORTING ASSEMBLIES
SINK, SLOP
MOTCRS OVER 8- 10 HP
ELEVATORS/ESCALATORS
TEMPORARY WATER CLOSET
MOTORS OVER 10- 25 HP
FIRE SPRINKLER SYSTEMS
URINAL
MOTORS OVER 25-100 HP
CODLING 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 TRANSFORMMS
HEATER - REPLACE
GENERATORS TRANSFORMERS
.
LAWN SPRINKLER -WELL
SPECIAL PURPOSE
SWIMMING POOL
CUTLETS COMAERCIAL
WATER SERVICE
•
SIGN TUBES
.
SEWER CONNECTIONS
SIGN TRANSFOMERS
UTILITY-SEWER
SIGN TIME CLOCK
• .
UTILITY -WATER
FIXTLRES
SEPTIC TANK
ANTENNA
RELAY
TELEVISION OUTLETS
DRAINFIELD, 4' TILE/RES.
VIOLATION
PUMP & ABANDON SEPTIC TANK
REINSPECTION
SOAKAGE PIT CU. FT.
CATCH BASIN
��,�,, �
DISCHARGE WELL
DOMESTIC WELL
--
//'
AREA DRAIN
,�
"0014::
ROOF INLET
alicj /G p,,, -
,;
SOLAR WATER HEATER
_
FIRE STANDPIPE
POOL PIPING
•
LAWN SPRINKLER SYSTEM
3AS RANGE
ETER 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
MECHANICAL