MECHANICALDate 6-7.01
Legal Description
Owner/Lessee / Tenant
Owners Address
Contractin Co. Cfi R W, . Co.
Qualifier QC) C i v. C
ss#
State # C /4 C 0 6C( 1 Municipal # Competency #
Address
Architect/Engineer
Bonding Company Address
Mortgagor
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING
WORK DESCRIPTION
Square Ft. Estimated Cost (value) 17
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
construc n and :.I
Signature of own r and/or Condo President
Notary as to er and/or Condo President Date
My Commission ).xvi -i,s:
fisP *; 'i1 ct;
FEES: PE
APPROVED:
Zoning
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Job Address 9° N E l o 0
eu Mcin �e s
H90 1i � =l oo T
rtify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
urthermore, I authorize the above -named contractor to • ' the work ted.
Si ul ature of Col; •
oigam
�
r otary as ' • Contra •r or •' = OFFICIAL NOTAR SEAL
My Commission Expires: P e e ANGELA M BECKER
l X2 ' * COIAMISSION NUMBER
N , 410 4J < CC786697
MY C OMMISSION EXPIRES
NOV . 15,2002
Robert 3. Chryst
MY COMMISSION # CC741112 EXPIRES
May 24, 2002
BONDED TNPU TROY FAIN NSURANCE INC
RADON
Mechanical l r , Plumbing
Tax Folio
Historically Designated: Yes No
Master Permit # 9' f f g
Phone JOS- 7S6 • 6E G L/
Address
Address P. 0 . 6 0, ( MI c1 ; Et. 3D (
C.C.F. ) .. D NOTARY5' 0 BOND
Phone 3 0S ?S 69
Ins. Co.
ROOFING PAVING FENCE SIGN
¢�o
B ilder
TOTAL DUE
Building Electrical
Structural Engineer
•n
MIAMI SHORES VILLAGE
n rr AIR C ONDITION REPLACEMENT
JOB NAME Qe(-) ' I Cnq YJ VeS_
ADDRESS / t 90 /) L (0 0
Different location than above? r
EXISTING CONDITIONS
1. HOUSE MAIN ELECTRIC SIZE AMPS WIRE SIZE
2. COMPRESSOR BRANCH CIRCUIT: WIRE SIZE , & CIR. BKR. SIZE FUSE SIZE SW
AIR HANDLER BRANCH CIRCUIT:WIRE SIZE , & CIR. BKR. SIZE FUSE SIZE SW
3. SIZE OF EXISTING COMPRESSOR DISCONNECT: AMPS. TYPE: FUSE CIR. BKR.
SIZE OF EXISTING AIR HANDLER DISCONNECT:_ AMPS. TYPE: FUSE CIR. BKR.
4. IS DISCONNECT WITHIN SIGNT AND READILY ACCESSIBLE? YES NO
5. EXISTING UNIT TO BE REPLACED OR RELOCATED
NAME PLATE INFORMATION FROM EXISTING UNIT
MARE L G oca i r PACKAGE MODEL #
CONDENSOR MODEL # t C H P F 036,44 A.H.U. MODEL #
HEAT PUMP TYPE YES X NO
KW HEAT STRIP SIZE
CONDENSOR MINIMUM CIRCUITS AMPS A.H.U. MINIMUM CIRCUIT AMPS
MAXIMUM OVERCURRENT PROTECTION SIZE AND TYPE:
CONDENSOR AMP SIZE FUSE HACR CIP.. BKR.
AIR HANDLER AMP SIZE FUSE HACR CIR. BKR.
EER
NAME PLATE INFORMATION FROM NEW UNIT BEING INSTALLED
MAKE O C PACKAGE MODEL #
CONDENSOR MODEL # � Y\ A 0 3 C A.H.U. MODEL #
HEAT PUMP TYPE YES 7C NO KW HEAT STRIP SIZE
CONDENSOR MINIMUM CIRCUITS AMPS A.E.U. MINIMUM CIRCUIT AMPS
MAXIMUM OVERCURRENT PROTECTION SIZE AND TYPE:
CONDENSOR AMP SIZE FUSE HACR CIR. SKR.
AIR HANDLER AMP SIZE FUSE HACR CIR. BKR.
EER
CERTIFICATE NUMBER
BUILDING INSPECTION DEPAf4TMENT
APPLICATION FOR BUILDING PERMIT
Application is hereby wade. for the approval of the detailed statement of the plans and specifications herewith submitted for the build-
ing or other structure herein described. This application is made in compliance and conformity with the Building Urdinanee 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 prggress of the work.
Disapproved
(Signed)
MIAMI SHORES V1L,LAGE
1190_N.E. lop St,, „ » _„
Building Inspector
904 -5
Date....» s�, Y......._ .. »......... »... ».�............ , 19 8 5
OwIncr Name and Address . Allen DombrOWSkZ_ ,,,, Np,,,,_ll Q _ ... Street. t J a ...1QQ St
Registered Architect and /or Engineer . . uu.e •• r..., •n,n uannvm +norm.. e:rt,nee
Fame and address of licensed contractor Hill York & Service Corp.. -5150 N.W. 37 Ave. — _ Miami
Location and legal description of lot to be built on: ••,._» Florida i 142 � »
Lot Block /.71r Subdivisio
Street and Number whero work is to be done
Stato work to be done and purpose of building (by floors) .. t o n�placement of 3 condensing
and for no other purpose.
New Building Remodeling Addition Repairs No. of Stories —
To be constructed of Kind of foundation . . Roof Covering
Estimated Total cost of improvements $ 2 � 0 0 0 . 0 0 Amount of Permit S. 19 • 50
Zone cubage required „sass_.. „...plan Cubage
Distance to next nearest building Size of Building Lot _
Maximum 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 undersigned applicant for this building permit dots hereby certify that he understands and accepts his obligations as an employer
of !,bur under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Supplement,
and has complied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him
in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice
or notices as are required by the Act. The undersigned agrees to employ only such subcontractor on work to be performed under this
. pennit, as are licensed by Miami Shores Village.
Remarks..._ (Signed)
STATE OF FLORIDA, ` v C ca -
ss
COUNTY OF DADE. j
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 duly sworn, upon oath deposes and says that he is the.
of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true. y�
Permit No..-26
o.._„ 'l Date... /.. 14 Read, Sworn to and Subscribed before me.
Notary Public, State of Florida
My Commission Expires ....... _.. „...„ ........ _sass. „... „.._..__ »_..�
PLANNING BOARD DATE
Chairman Mcmbcr
_ sass._. „ ...... _..._
Member Mcmbcr _
Member .. ... _.. „. — sass._ Member sass_
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 hero obtained from
tic Planning Board.
A re-inspection fee of 11.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty
materials anti /or workmanship.
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
2_ 974
PP LICATI0N FOR BUILDING PERMIT
Application is hereby inn for the approval of the detailed statement of the plans and specifications herewith submitted for the build- regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified Of not. A copy of approved
plans and specifications must be kept at building during progress of the work.
ing or other structure herein t escribe . This application 3 made in compliance and conformity with the Bu Iding dinance of Kam
Shores Village, Florida. and all provis ns of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and
March 25, 81
Date:.._..._... �_......._.. _._.__.....�_.._.._._.......... ,19.. — _
Owner's Name and Address Dr. J. F. K ee l ey___ No. . . ._ 1190 _ Street— N.E_100th St.
Registered Architect and /or Engineer HI - yoRK" - SXG'ES & SR 2VY "t'o'1T%
Name and address of licensed contractor _.
Location and legal description of lot to be built on:
Lot Block Subdivision
Street and Number where work is to be done 1190 N . E 100th St. —
State work to be done and purpose of building (by floors) ins York 2 — ton (S E.R. 9.3)
high efficiency air conditioner with 8 k.w. electric. heat.
This is an existing house with existing air conditiong
and for noother u
D use.
New Building Remodeling Addition Repairs No. of Stories
To be constructed of Kind of foundation Roof Covering
Estimated Total cost of improvements $... 3,400,04 Amount of Permit 3,. 21•44
Zone cubage required .Plan Cubage
Size of Building Lot
Distance to next nearest building.
Maximum 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 Hill York Sales & Service Corp., 5150 N.W. 37th Ave., Miami, Fl. 33142
The undersigned applicant for this building per:nit 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 Supplement,
and has complied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him
in the work to be performed under this permit; and will post or cause to be posted for inspecti• • . - -: o? of the work such public notice
or notices as arc required by the Act. The undersigned agrees to employ only such su • , o ., on work to be performed under this
pcnnit, as are licensed by Miami Shores Village. c___
Remarks (Signed)..
Disapproved
(Signed)
Building Inspector
STATE OF FLORIDA,
COUNTY OF DADE. ss
Before me, the under.signed 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 duly sworn, upon oath deposes and says that he is the.
of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true. �],, ff
Permit No. .__�_.��.�.. b..kh Date M2/'' 1 ...._.._._._ Read, Sworn to and Subscribed before me.
Notary Public, State of Florida
My Commission Expires
;
PLANNING BOARD _.._ DATE
Chairman Member
Member Member
Member sass.. _...--- ..._._ . -_ -_ 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 from
the Plannir;; Board.
A re inspection fee of $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty
materials and /or workmanship.
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
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 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.
Date June 24th, 1961 , 19
Owner's Name and Address.... Dr. Kee ly N 1190 St N. E.. ],00th St.
Registered Architect and /or Engineer
Name and address of licensed contractor LANG ROOFING & TIT,F CQM;X,___INC NW 79th..St.._,._.Niami..F1a.
Location and legal description of lot to be built on:
Lot Block Subdivision
Street and Number where work is to be done 1190 N. E. 100th St . 5 Miami Shores, Fla,
State work to be done and purpose of building (by floors)
Remove existing Celotex air - conditioning duct system and. __replace ._•with shee t meta / duct
insulated outside with 1 " Sisil -Kraft _paper back d ct___Inz_..__w , ,h,_ 1aps,2rand for no other purpose.
sel - joints.
New Building Remodeling Addition Repairs No. of Stories
To be constructed of Kind of foundation Roof Covering
Estimated Total cost of improvements $ &.3.3.0.00 Amount of Permit $ $._.240
Zone cubage required flan Cubage
Distance to next nearest building Size of Building Lot
Maximum 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 undersigned applicant for this building pennit does hereby certify that he understands and accepts his obligations as an employer
of labor under the Florida Workmen's Compensation Act, being Section 5968, Compiled General Laws of Florida, Permanent Supplement,
and has complied with the provisions thereof, and will require similar compliance from all contractors or sub- contractors employed by him
in the work to be performed under this permit; and will post or cause to be posted for inspection . the site of the work such oldie notice
or notices as are required by the Act. The undersigned agrees to employ only sue ubcontracto n work to be perfo... , der this
permit, as are licensed by Miami Shores Village.
Remarks (Signed).
Disapproved . ._ Dar
(Signed) (
Buil ding Ins ctor
STATE OF FLORIDA, L 00 NG & ILE CO., INC
COUNTY OF DADE. f ss
Before me, the undersigned authority, a notary public, duly authorized to a mi er o a t h s and take acknowledgments, personally ap-
peared
to me well known,
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 application, and that he did sign the same, and that all facts
therein by him stated are true.
Permit No._... 1.3 Date Read, Sworn to and Subscribed before me.
Notary Public, State of Florida
My Commission Expires
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 from
the Planning Board.
A re- inspection fee of 81.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty
materials and /or workmanship.
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
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 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.
Owner's Name and Address ''v •
Registered Architect and /or Engineer
Name and address of licensed contractor
Location and legal description of lot to be built on:
Block 1..7....E
Lot .y
Street and Number where work is to be done
Permit No
Disapproved
(Signed)
State work to be don and purpose of b ilding (by floors)
Ong
Date
/ / ,f O 1? e O v - Tr
C.0 .
Chairman
Member
Member
Council Approved Date Disapproved
Date 1 J
No //
Y
Subdivision. 1/ 0)/ I/ 5 r
and for no other purpose.
New Building .. Remodeling Addition Repairs No. of Stories
To be constructed of Kind of foundation Roof Covering
Estimated Total cost of improvements $ '2c3 B U Amount of Permit $ 0-0
Zone cubage required plan Cubage
Distance to next nearest building_... Size of Building Lot
Maximum live load to be borne by each floor
I hereby subm' all the pans and citations for said building. All notices with reference to the building and its construction may
be sent to
The undersigned 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, Pennanent SuPplement,
and has complied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him
in the work to be performed under this permit; and will post or cause to be posted for inspection o he site of the work such public notice
or notices as are required by the Act. The undersigned agrees to employ only such sub tr ors it work to be perfogned under this
permit, as are licensed by Miami Shores Village.
Remarks (Signed)._
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
and who, being by me first duly sworn, upon oath dep ses and says that he is the
of the above described construction, that he has caref y read t foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
Read, Sworn to and Subscribed before me.
PLANNING BOARD DATE
Street
to me well known,
Notary Public, State of Florida
My Commission Expires
Member
Member
Member
Date
NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has been obtained from
the Planning Board.
A re- inspection fee of $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty
materials and /or workmanship.