MECHANICAL PERMITPERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date 6, '34 - q Job Address (Z 2 5 ,J 1 z / ( J' %. Tax Folio / 1 - 3 2 - ° 5 — ' d c ' 0
Legal Description Historically Designated: Yes No i
Owner/Lessee / Tenant 14 ,J (14,-) .4" c tic (A.m.. v it Master Permit # 93/e0
Owner's Address (L L J /JI L ( Phone
Contracting Co. G 4,6 L. i 5 , i C- .� f \ . J 1E/ Address 6 S W - r c/
Qualifier ( l e - .J 7 7 4 - , 4 " ‘ . 1 ' SS# 2 lO `i ' Z ° L
State # C d 3 Municipal #
Architect/Engineer
Bonding Company
Mortgagor Address
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING
Competency #
Address
Address
ECHANICAL)
WORK DESCRIPTION 5 � . 1 T 1-/4 ,j d( e✓
Square Ft. Estimated Cost (value) 2. I L ,
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.
Si e of owner and/or Condo President Date
(C
Notary as to Owner and/or Condo President Date
My Commission Expires:
: WILLARD KEITH PHILLIPS, III
MY COMMISSION # CC 472510
• EXPIRES: June 14, 1999
T ••• Bonded Thm Notary Pubic Undeiwdtefe
FEES: PERMIT � RADON
Signature of Contractor or S er- Builder
Notary as • Contracto or Owner : udder Date
My Commission Expires:
v
C.C.F. NOTARY
Ins. Co.
ROOFING PAVING FENCE SIGN
WILLARD KEITH MY COMMISSION C 4726 0 ll
s; EXPIRES: Ji ?rrb 1 4.1999
R„, 8orwed?In Noirg Puck Undenvilteis
BOND //
TOTAL DUE �b
i�
APPROVED:
Zoning �]
Mechanical ( $ / �"✓ 9 Plumbing Engineering
Building Electrical
ITEM
BATH TUB
UNIT
FEE
ITEM
SWITCH OUTLETS
UNIT
FEE
ITEM
SPACE HEATERS
UNIT
FEE
BIDET
LIGHT OUTLETS
CENTRAL HEATING
SK�r
DISHWASHER
RECEPTACLES
A/C (WIN))
DISPOSAL
SERVICE TEMPORARY
A/C (CENTRAL) /}(H r.,..,,,,
it
DRINKING FOUNTAIN
SERVICE SIZE IN MPS
DUCT WORK
FLOOR DRAIN
SERVICE REPAIR/IETER CHANGE
REFRIGERATION
GREASE TRAP
APPLIANCE OUTLETS
PROCESS AND PRESS PIPING
INTERCEPTOR
RANGE TOP
UNDERGROUND TANKS
LAVATORY
OVEN
ABOVE GROU?O TANKS
LAUNDRY TRAY
WATER HEATER
U.F. PRESSURE VESSELS
CLOTHES WASHER
MOTORS 0— 1 HP
STEAM BOILERS
SHOWER
_
MOTORS OVER 1— 3 HP
HOT WATER BOILERS
SINK, POT /3 COMP.
MOTORS OVER 3— 5 HP
MECHANICAL VENTILATION
SINK, RESIDENCE
MOTORS OVER 5— 8 HP
TRANSPORTING ASSEM3LIES
SINK, SLOP
MOTORS OVER 8— 10 HP
ELEVATORS/ESCALATORS
TEMPORARY WATER CLOSET
MOTORS OVER 10— 25 HP
FIRE SPRINKLER SYSTEMS
URINAL
MOTORS 'OVER 25-100 HP
COOLING TOWERS
WATER CLOSET
MOTORS OVER 100 HP
VIOLATION
INDIRECT WASTES
A/C WINDOW
REINSPECTION
WATER SUPPLY TO:
AIR CONDITIONERS
1
A/C UNIT
STRIP HEATER
FIRE SPRINKLER
GENERATORS TRANSFORMERS
•
HEATER —NEW INST.
GENERATORS TRANSFORMERS
HEATER — REPLACE
GENERATORS TRANSFORMERS
LAWN SPRINKLER —WELL
SPECIAL PURPOSE
SWIMMING POOL
OUTLETS COMdERCIAL
WATER SERVICE
SIGN TUBES
SEWER CONNECTIONS
SIGN TRANSFORMERS
UTILITY —SEWER
SIGN TIME CLOCK
UTILITY —WATER
FIXTURES '
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
ROOF INLET
SOLAR WATER HEATER
FIRE STANDPIPE
POOL PIPING
LAWN SPRINKLER SYSTEM
GAS RANGE .
METER SET (GAS)
GAS PIPING
ADDENDUM TO BUILDING PERMIT APPLICATION
(AN APPLICATION FOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. IF A MASTER PERMIT HAS BEEN
OBTAINED, THE OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.)
PLUMBING
ELECTRICAL
MECHANICAL
NOTICE OF COMMENCEMENT'
A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF FIRST INSPECTION
PERMIT NO. TAX FOLIO NO. I L " 32_. `V �" — 'O co 0
STATE OF FLORIDA:
COUNTY OF DADE:
THE UNDERSIGNED hereby gives notice that improvements will be made to certain real property, and in accordance with
Chapter 713, Florida Statutes, the following information is provided in this Notice of Commencement.
1. Legal description of property and street address: c r Z Z J / ( j T
2. Description of improvement: G / (1.4-•v ( t ✓
3. Owner(s) name and address:
p
Interest in property: (rDc..) ,. I 711.
Name and address of fee simple titleholder:
4. Contractor's name and address:
Lr
r.
-e—
G, c-,C.1 64�
�f ■.J 7 r — ✓a -ems
7. Persons within the State of Florida designated by Owner upon /
by Section 713.13(1)(a)7., Florida Statutes,
Name and address:
C.
C ,J i , 9..s i
5. Surety:(Payment bond required by owner from contractor, if any)
Name and address:
Amount of bond $ STATE OF FLORIDA,
1 HEREBY CERTIFY ih0, I O NTY OF DADE
6. Lender's name and address: original , !. 0
3 c ::c i n e - . •
8. In addition to himself, Owner designates the following person(s) to receive a copy of the Lienor's Notice as provided in
Section 713.13(1)(b), Florida Statutes.
Name and address:
9. Expiration date of this Notice of Commencement: (the expiration date is 1 year from the date of recording unless a
different dale is specified)
Srgrta ure 01 Owner h // .- (L , �
Print Owners Name V m 0.1 (.�- C .( cc-
c`
Sworn to and subscribed before me this Z P day of �T _.' , 19��
Alo T' 4C., P• c +3 -
Prepared by: (-). (c "4. r r ye
To
cC 6 .D , fcJ 7..r
• ( / / 1 � .fit % tCc J" • :U v • ►..1,4= -RfiM -Nabs e .. L < <(' r , 1 " e.- • R 0 • ' 1O • r'; r
My Commission Expires: __ MY COMMISSIONEXP.SE!L1 °''
12301-52 2/93
WORK DESCRIPTION
Si i ture of owner and /or
Date:
Notary as to Owner and
My Commission
** *
FEES: PERMIT ftOr RADON
APPROVED:
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
VG
s • WILLARD KEITH PHILLIPS, Iii
' MY COMMISSION 0 CC 472610
EXPIRES: June 14, 1999
h • ended 1tww No Pubic UNietwrIters
Zoning
Mechanical
!�? i =1 mot"
Date 7 - 7 Job Address 4 4 % fi b Tax Folio / / - 3 1 . . . 0 5 - 0 1 S - O O ( O
Legal Description L c T 7 tea .! T L( r" r o 4 L. r P d/) d e z e, fc cAii
Lessee / Tenant ToH big e (c LA. .•.1 Master Permit # v177
Owner' s Address 710 S J - t - 1 S b .rT
Contracting Co. C1"'46 4 T 1.7
Qualifier 16.i T A^ SS#
State #C4t 'W Municipal #
Architect /Engineer
Bonding Company
Mortgagor Address
Permit Type(circle one): BUILDING ELECTRICAL PLUMBING
r ta//, 1
..► S I.S /
e_ 1.1 T ..1 p / . ,- l rn. n C. O nJ C ° 7f-G c- ' ti E 9 ..a 1 c .✓J�e
)407
Square Ft. Estimated Cost(value) e
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.
Condo President
or Condo President
Building
Plumbing_
Phone _3? 37J
Address `/ 6 0 A S W v e.
Competency (fr Ins.Co.
Address
Address
-.actor
Signature of Contract
Date:
Notary as to Co
My Commis
2- c. Z o •.-
ROOFING PAVING FENCE SIGN
or Owner- Builder
Owner- Builder
inn RirpirPs:
, ;� ak,,, WILLARD KEITH PHILLIPS, III
:. �•� ,,;_ MY COMMISSION 0 CC 472510
EXPIPCS: June 14„999 !
?p1;, ' ' Bonded 7Mu Public 1 nde lmlare
* * *
C.C.F.
Fire Other
**
NOTARY TOTAL DUE
Electrical
Engineering
09/01/93 15:55 '8'3053752811
NOTICE OF COMMENCEMENT
A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF FIRST INSPECTION.
97R346063 1997 AUG 41 11:41
PERMIT NO. TAX FOLIO NO. � OO(3
STATE OF FLORIDA:
COUNTY OF DADE:
THE UNDERSIGNED hereby gives notice that Improvements will be made to certain real property, and In accordance with
Chapter 713, Florida Statutes, the following information is provided in this Notice of Commencement.
1. Legal description of property and street address: s! o T 7 '-( 1'1— OTF for .7
A ay 8 te-ez S c_rc,.z F /.4-r L k to._ ea, L er -
2. Description of Improvement:
3. Owner(s) name and address:
Inter= t In property: Oc.).1 e ✓1'
Name and address of fee simple titleholder:
4. Contractor's name and
t( �
5. Suroy:(Payment bond
Name and address:
T (4
address: G4. (fzj' 4.1% C•-.0 cT •� ;�,
J .,J
— 7 r au At- . 3 3 3'
51A1 h. OF FLOI TDA, COUNTY Qr OAU
required by owner from contractor, If flii91 E3Y CERTIPY that this is o true co�y the
e 13■na :f.I in this office on day of
A 0 io
h - �r oP %fetal
Amount of bond $ W INE , 5 Soal.
HA .Vt RUIN
6. Lender's name and address: ay
7. Persons within the State of Florida designated by Owner utr notices or other documents may be served as provided
by Section 713.13(1)(a)7., Florida Statutes,
Name and address:
8. In addition to himself, Owner designates the following person(s) to receive a copy of the Lienor's Notice as provided in
Section 713.13(1)(b), Florida Statutes.
Name and address:
9. Expiration date of this Notice of Commencement: (the expiration date is 1 year from the dale of recording unless a
different date Is specified)
R
• of Owner
Sip
Pf
S ! 0_ lfi `aid Vailf NtS b 1b 1e t
EXPIRES: September 18, 1997
•,... Th Pub � , .tw,mrs
(J4 .%I c (c tit. n., S a l�,� v I s
s 1 day of `.7—r:- 17 , 19 77 .
Notary Public /i�.�"-
111E1149-DADE 11 & Z l �i. i uu:t
:
u.. -. Prepared by: Li . / 1 6L 4
Address: 4 Jw
ITEM
BATH TUB
UNIT
FEE
ITEM
SWITCH OUTLETS
UNIT
FEE
ITEM
SPACE HEATERS
UNIT
FEE
BIDET
LIGHT OUTLETS
CENTRAL HEATING
DISHWASHER
RECEPTACLES
A/C (WIN))
DISPOSAL
SERVICE TEMPORARY
A/C (CENTRAL) 76...) 5
3.',
DRINKING FOUNTAIN
SERVICE SIZE IN AMPS
DUCT WORK
0
FLOOR DRAIN
SERVICE REPAIR/METER CHANGE
REFRIGERATION
GREASE TRAP
APPLIANCE OUTLETS
PROCESS AND PRESS PIPING
INTERCEPTOR
RANGE TOP
UNDERGROUND TANKS
LAVATORY
OVEN
ABOVE GROUND TANKS
LAUNDRY TRAY
WATER HEATER
U.F. PRESSURE VESSELS
CLOTHES WASHER
MOTORS 0- 1 HP
STEAM BOILERS
SHOWER
MOTORS OVER 1- 3 HP
HOT WATER BOILERS
SINK, POT /3 COMP.
MOTORS OVER 3- 5 FP
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
MOTORS OVER 25-100 HP
COOLING 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 TRANSFORMERS
HEATER - REPLACE
GENERATORS TRANSFORMERS
I
LAWN SPRINKLER -WELL
SPECIAL PURPOSE
SWIMMING POOL
OUTLETS COMMERCIAL
WATER SERVICE
SIGN TUBES
SEWER CONNECTIONS
SIGN TRANSFORMERS
UTILITY -SEWER
SIGN TIME CLOCK
UTILITY -WATER
FIXTURES
SEPTIC TANK
ANTENNA
RELAY
TELEVISION OUTLETS
DRAINFIELD, Al" TILE/RES.
VIOLATION
PUMP & ABANDON SEPTIC TANK
REINSPECTION
SOAKAGE PIT CU. FT.'
CATCH BASIN
DISCHARGE WELL •
DOMESTIC WELL
AREA DRAIN
ROOF INLET e.
SOLAR WATER HEATER
FIRE STANDPIPE
POOL PIPING
LAWN SPRINKLER SYSTEM
GAS RANGE .
METER SET (GAS)
GAS PIPING
PLUMBING
ADDENDUM TO BUILDING PERMIT APPLICATION
(AN APPLICATION FOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. IF A MASTER PERMIT HAS BEEN
OBTAINED, THE OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.)
ELECTRICAL
MECHANICAL