131 NE 101 St (2)Date /0
2t
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Job Address /3/ /VE /O/ Ste Tax Folio
Legal Description Historically Designated: Yes No
Owner/Lessee / Tenant /V y' � cc- e ,2;9 V/e
Owner's Address / /V E• /0/
Contracting Co. /19,z /42 44 acoo7 Address 97‘e /41///G
Qualifier / 6 /?./4/)d // /1..� Z.--
State # o f 2 //P Municipal # Competency # Ins. Co.
Architect/Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
/ /
WORK DESCRIPTION /9(-1/17/1A-- 23i ,..ieck.s
Square Ft. Estimated Cost (value) ca
Z
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 . •r. .. done in compliance with all applicable laws regulating
construction and zoning. Furthermore, I authorize the above -named contractor to
Signature of owner and/or Condo President Date
Notary as to Owner and/or Condo President Date No
My Conunission Expires:
FEES: PERMIT 9 , e 4 e) RADON C.C.F.))1 NOTARY ''a ✓ BOND
APPROVED:
Zoning
Mechanical
SS#
My Co
Master Permit #(
Phone 3o.� 939- /2 Z. id
Phone :3,1 X7
Owner- Builder
OENZA
E$CtildOr
NDED.THRU
NDING CO., INC.
TOTAL DUE .3 0 J
le 33
Date
Date
Plumbing Structural Engineer
ITEM
BATH TL8
UNIT
FEE
ITEM
SWITCH 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 ASPS
DUCT WORK
FLOOR DRAIN
SERVICE REPAIRAETER CHAte
REFRIGERATION
GREASE TRAP
APPLIANCE OUTLETS
PROCESS AND PRESS PIPING
INTERCEPTOR
1 RANGE TOP
UNDERGROUtm TANKS
LAVATORY
OVEN
ABOVE GROUND TANKS
LAUNDRY TRAY
WATER HEATER
U.F. PRESSURE VESSELS
CLOTHES WASHER
W3TCRS 0- 1 If
STEAM BOILERS
SHOWER
M]TCRS OVER 1- 3 HP
HOT WATER BOILERS
SINK, POT /3 C014P.
W3TCRS OVER 3- 5 HP
MECHANICAL VENTILATION
SINK. RESIDENCE
1 MOTORS OVER 5- 8 If
TRANSPORTING ASSEMBLIES
SINK. SLOP
MJTCRS OVER 8- 10 HP
ELEVATORS/ESCALATORS
TEMPORARY WATER CLOSET
, KITCRS 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 TRANSMMERS
HEATER - REPLACE
GENERATORS TRANSFCRIERS
'
LAWN SPRINKLER -WELL
SPECIAL PURPOSE
SWIMMING POOL
'
OUTLETS COMhERCIAL
WATER SERVICE
•
SIGN TUBES
SEWER CONNECTIONS
SIGN TRANSFORI€RS
UTILITY -SEWER
SIGN TIME CLOCX
UTILITY -WATER
FIXTURES
SEPTIC TANK
ANTENNA
RE
TELEVISION OUTLETS
,
GRAINFIELD, 4' TILE/RES.
VIOLATION
PUMP & ABANDON SEPTIC TANK
REINSPECTION .
SOAKAGE PIT CU. FT.
/
7 i,p, e' A/ /J ✓rte .S
CATCH BASIN
DISCHARGE WELL
DOMESTIC WELL
AREA DRAIN
ROOF INLET
SOLAR WATER HEATER
FIRE STANDPIPE
POOL PIPING
LAWN SPRINKLER SYSTEM
GAS RAKE
METER SET (GAS)
GAS PIPING
NG
•
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