836 NE 100 St (8)Qualifier
(Continued on opposite side)
rE CED
AR 2 9 2004 Tel:
BUILDING
PERMIT APPLICATION
FBC 2001
Permit Type (circle): Building
C orner's Name (Fee Simple Titleholder)
Owner's Address b k3 6 4', /D0
City A /»fll c )-61-efta State
Architect/Engineer's Name (if applicable)
$ Value of Work For this Permit /g (/ —
Type of Work: ❑A 'lion DAlteration ['New
Describe Work:
Total Fee Now Due $ 7 7) )
Miami Shores Village
ding Department
2nd Avenue, Miami Shores, Florida 33138
(305) 795.2204 Fax: (305) 756.8972
Electrical
Plumbing echanical Roofing
/( 4, Phone # (^ '7.Y —/6
Zip 0
Tenant/Lessee Name Phone #
Job Address (where the work is being done) Alg"✓
City Miami Shores Village County Miami -Dade Zip
Is Building Historically Designated YES NO
Contractor's Company Name IPC� t1L SIAM > -U 4 69 nk404-ivy Phone # 30 -C lQS — 6 0 (1D
Con ctor's Address S r) /1 ti. . 1 MO P LC'
City ..A/V1,01-01 r e,IA. State T–LA– Zip 3 I / Q
le_t,t,t4-0-0.4 //V% . If /9-11,1 1
N Phone #
Square Footage Of Work:
* * * * * * * * * * * * * * * * * * * * * * * * * * ** F ees * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
,% Permit
Master =Perm-it _NO:r!i3ox.3. ,06,0 , /
Repair/Replace ❑ Demolition
Submittal Fee $ ,S( .00 Permit Fee $ � 00 ' CCF $ / ,
Notary $ Training/Education Fee $ , c-C/0 Technology Fee $ S 7)
Scanning $ Radon $ Bond $
Code Enforcement $ Structural Plan Review. $
•
e•'
Bonding Company's Name (if applicable)
Bonding Company's Address
City State
Mortgage Lender's Name (if applicable) 1/
Mortgage Lender's Address
City
Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has
commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating
construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS,
WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC
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.
"WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT 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."
Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also, a certified copy of the recorded notice of commen 'meet must be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued. I 1 ' absence of such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
Signature
Owner or Agent
The foregoing instrument was acknowledged before me this
day of 0111;1111 ,
who is pers, airy %so
•
• NOTAR `� *! ; L IC: • 40
Sign: • ' 326
Print:
My Co
Chc 10/14/03
APPLICATION APPROVED BY:
•
State
7
i
A or has produced
i1GS d$and who did take an oath.
tt
Zip
3.
Zip
Contractor
The foregoing instrument was acknowledged before me this
day of �� \\ \111111 lllltt
who is per sfall'�g or'jro has produced
„ •• 1on�1d who did take an oath.
NOTARY 8.43iIC: :
Sigi2
Prinir,"
• r s . /y
.., . �.- My Co t .. ., i � % Off'
1 Ili
************************************************************************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
(Certificate of Competency Holder)
State Certificate or Registration No. Ofte.49 6 R Certificate of Competency No.
***************************************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
i r Examiner
Engineer
Zoning
Sec. 5-1.1. Alr conditioning regulations.
(a) All individual air conditioning units installed in walls or
windows shall be securely anchored to the walls by approved
methods. Units installed over public property. paths of egress or
more than ten (10) feet above grade shall be secured to the struc-
ture by bolts or screws to resist horizontal wind loads. Such units
cantilevering more than flight (8) inches on the exterior of a
building shall be supported by steel angle brackets secured by
bolting. Bolts to masonry shall be set in lead shields or similarly
rot - resistant fastenings.
(b) The foll@ wing special requirements shall apply to the con-
trol and regulation of noise nuisance from air conditioning machinery:
(1) All equipment. existing or hereafter installed, regardless
of !oca:ion, shall be maintained in good working order.
Equipment so located that normal operating noises create
a nuisance to adjacent owners or occupants shall be pro-
vided with soundproofing, or sound - absorbing baffels, or
enclosures. as approved to insure maintenance of a rea-
sonable noise level.
(2) All equipment on outer walls, on roofs, or in other exposed
locations. which are unduly noisy, and which causes
complaints from adjoining property owners or occupants,
may be required to be relocated, redesigned and!or en-
. closed in noise - retarding materials when. in the opinion of
the building official, such enclosure is necessary or would
be effective.
,(3) Special consideration shall be given to the planning of all
future installations to minimize the noise nuisance to ad-
joining prdperty owners or occupants, and the 'building
official shall have authority to reject or require the rede-
sign of any system which, in his opinion, would cause such
*noise nuisance.
(c) Violation of this section shall be punished as is now or may
hereafter be provided by law. (Ord. No. 299, H 1 - 3, 2.21 - 61)
1 have read the above ordinance and will cagily, with the
-regulations thereof. .
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-ILLyi&jut, # NE2.003 - aa�
(A) a)16) 11Q t_ OLQ__. Fly (ma.
jaAkAkk_
Mechanical Permit
Miami Shores Village
10050 NE 2nd Avenue
Phone: 305- 795 -2204 Permit Number: MC2004 -44
Printed: 3/31/2004
Applicant: EVELYN MASSIE
Owner: MASSIE EVELYN
JOB ADDRESS: 836 NE 100 ST
Contractor
Local Phone: 305 - 652 -6040
Parcel # 1132060340040
RESIDENTIAL AIR CONDITIONING CORP Contractor's Address: 20250 NE 15 CT
Legal Description: MIAMI SHORES SEC 8 PB 14 -33 LOT 6 & E1/2 LOT 7 BLK 169 LOT SIZE 75.000
Fees: Description Amount
FEE2004 -3374 Building Fee $100.00
FEE2004 -3375 CCF $1.20
FEE2004 -3376 Training and Education Fee $0.40
FEE2004 -3377 Technology Fee $2.50
Total Fees: $104.10
Total Fees: $14.1
Total Receipts: 0.00
Permit Status: APPROVED Permit Expiration: 9/26/2004 Construction Value: $1,800.00
Work: REPLACE EXISITNG DUCTWORK
Page 1 of 1
A
Signed: (INSPECTOR)
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.
Signed: (Contractor or Builder) BY:
Name
Address
Company
Phone #
Inspection Date
Approved
Correction
Re- Insp'n Fee
MIAMI SHORES VILLAGE
BUILDING DEPARTMEN
305- 795 -2204
Building Inspection Request
Date
Type Insp'n
Permit No.
)1k/A..4)Qt.;
7 /ooh
3o1_ (S- . 6O Lto
`
% ye- 4.2.2
MIAMI SHORES VILLAGE
BUILDING DEPARTM
305- 795 -2204
Building Inspection Reques
Date� C)-1
Type Insp'n
Permit No..r C 0 L i'
Name_
Address
Company
Phone #
Inspection Date
Approved
Correction
Re- Insp'n Fee
{)-)D101
7{94g .4‘ wo 4
•
Date / lob Address R.4 & 1/4 72 t E • / 0 0 — �T Folio
Legal Description' Historically Designated: Yes
i(:L. //& Master Permit # t--t e 2 3-- va...)--).-
Oivner'sAddiess �a: /li..! V■ Add/ 1f Phone 1,517-- A l C f /
R
Contracting Co. IN__ � A "„ J1 G< Id � Address o7Do�S0 h -4 1-- � G (' — � 11
Qualifier- /14 /09 1/ 66 /Y) l i 1/4 / SS#
Ins. Co. i
eelTenet
State # CD 3St' / Municipal #
IF THERE IS NO PERMIT PACKAGE ACCESSIBLE ON THE JOB SITE FOR INSPECTORS TO VER1 '',
TliEitENVILL BE NO INSPECTION. RE- INSPECTION FEE IS 550.00 AND MUST BE PAID IN ADDAIVCE
BEFORE CALLING FOR ANOTHER INSPECTION.
Pemtlt` 'Type (circle one): BUILDING ELECTRICAL PLUMBING
WORK`DESCRIPTION: //91 15 )4/ SO N /d„. fit O
TO it) C Pi k
Square Ft. Estimated Cost (value)
WARNING;TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY RESUL1'IN
yOuttlAitiN6 TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH
YOUR LENDER OR ANY ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.)
Applicatibnislhereby made to obtain a permit to do work and installation as indicated above, and on the attached addendum (if applicable). 1 certify that
all work willibe performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits are tcgttlr+ed
for sill dliklplliies..
OWNERS AFFIDAVIT: I certify that all the foregoing information is accurate and that all wor
regulating constntction aliAlwiringtif I authorize the above named contractor to do
0 ■S `O
•••. 0 '
0 .n 0
sL-
Signature.oloStter ptt
tit
•
Z
I
..
0
PERMIT APPLICATION FOR MIAMI SHORES VIL
10050 N.E. 2nd Avenue • Miami
i•�
esidedt * f
. _
■
Notary "as.tto • tier AlQq 'dent Date Notary as to Contractor e64)
My Coitiiiiisfion' Expires My Commission Expires / / / / / 8 11 1111■,‘
m .f•
a
to, RADON
FEES: PERMIT
APPROVED:
Building Electrical
Zoning
Mechanical ; / 2 • //. u '3
Plumbing
Date
iores, Florida 33138.305 -795 -2
Competency #
C.C.F /. y NOTARY
TOTAL DUE
C ECEOVE®
204 uE C 0 9 2003
V-
No
ROOFING
I be done in compliance with all applicable laws
ork stated.
- coo Pol
Signature of Contractor pwnebAuilft
.
•
Date
i k H
,bate .
BOND
I I o-s
Structural Engineer
regulations thereof.
cliami Jbotenhinge
• L O w t O w
Sec. 5-1.1. Air conditioning regulations. -
(a) All individual air conditioning units installed in walls or
windows shall be securely anchored to the walls by approved
methods. Units installed over public property, paths of egress or
more than ten (10) feet above grade shall be secured to the struc-
ture by bolts or screws to resist horizontal wind loads. Such units
cantilevering more than eight (8) inches on the exterior of a
building shall be supported by steel angle brackets secured by
bolting. Bolts to masonry shall be set in lead shields or similarly
rot - resistant fastenings.
(b) The following special requirements shall apply to the con-
trol and regulation of noise nuisance from air conditioning machinery:
(1) All equipment. existing or hereafter installed, regardless
of location, shall be maintained in good working order.
Equipment so located that normal operating noises create
a nuisance to adjacent owners or occupants shall be pro-
vided % -ith soundproofing, or sound - absorbing bafels, or
enclosures, as approved to insure maintenance of a rea-
sonable noise level.
(2) All equipment on outer walls, on roofs, or in other exposed
locations. which are unduly noisy, and which causes valid
complaints from adjoining property owners or occupants,
may be required to be relocated. redesigned and'or en-
closed in noise. retarding materials when. in the opinion of
the building official, such enclosure is necessary or would
be effective.
,(3) Special consideration shall be given to the planning of all
future instkllations to minimize the noise nuisance to ad-
joining property owners or occupants, and the building
official shall have authority to reject or require the rede-
sign of any system which, in his opinion, would cause such
a noise nuisance.
(c) Violation of this section shall be punished as is now or may
hereafter be provided by law. (Ord. No. 299, II 1 -3, 2- 21 -61)
I have read the above a rdi \ na y will ccroply with the
��‘.3\N1S 008�d�i / /i
•• e� Nyl PePUo9 1 0.. �O i
Ne. 6ti9Z61d4 ' � �
a3
. b OZ'i.1S • .
Oiarbr /Signature ", .'••��Noiss\` t � .ontractor Signature
', ,,, ,r' a Uf e 11 I ...
.J
JOB NAME
ADDRESS
Different location than above?
EXISTING CONDITIONS
may, � -'�
1. HOUSE MAIN ELECTRIC SIZE AMPS 2 ea WIRE SIZE ) �C.''
2. COMPRESSOR BRANCH CIRCUIT: WIRE SIZE, & CIR. BKR. SIZE FUSE SIZE L )SW
AIR HANDLER BRANCH CIRCUIT:WIRE SIZE , & CIR. BKR. SIZE FUSE SIZE SW
3. SIZE OF EXISTING COMPRESSOR DfSCONNECT:
SIZE OF EXISTING AIR HANDLER DISCONNECT:
4. IS DISCONNECT WITHIN SIGNT AND REAADILY ACCESSIBLE? YES LI NO
5. EXISTING UNIT TO BE REPLACED (/ OR RELOCATED
NAME PLATE INFORMATION FROM EXISTING UNIT
MAKE Luq 4 C)(. PACKAGE MODEL #
CONDENSOR MODEL # H S » 1 1 A.H.U. MODEL #
HEAT PUMP TYPE YES NO x KW HEAT STRIP SIZE
CONDENSOR MINIMUM CIRCUITS AMPS A.H.U. .3'"f" :4INIMUM C :RCJIT A:1PS
MAXIMUM OVERCURRENT PROTECTION SIZE AND TYPE:
CONDENSOR AMP SIZE FUSE J n
AIR HANDLER AMP SIZE FUSE 0
EER I 0
NAME PLATE INFORMATION FROM NEW UNIT BEING INSTALLED
MAKE 1 A 0..j'& Q PACKAGE MODEL # 1 A
CONDENSOR MODEL 1 T1 Q.. a O LI-R A.H.U. MODEL # —TUO
HEAT PUMP TYPE YES NO V KW HEAT STRIP SIZE r7 taAj
CONDENSOR MINIMUM CIRCUITS AMPS 3 / A.H.U. MINIMUM CIRCUIT AMPS
MAXIMUM OVERCURRENT PROTECTION SIZE AND TYPE:
CONDENSOR
AIR HANDLER
EER
SIGNA 'RE OF QUALIFIER
'063 I L
In 1.1 L
AMP SIZE
AMP SIZE
FUSE
FUSE
AMPS. TYPE: FUSE j O CIR. BKR.
AMPS. TYPE: FUSE,[CIR. BKR.
•
era
HACR CIR. BKR.
HACR CIR. BKR.
#. O
HACR CIR. BKR.
HACR CIR. BKR.
`. �)M \SSI •. 1
2 , Ost 1 ? A� • •
% • ... . eC35 L i -
. •. T, o 'onde� hN,m • o3 FICATE NUMBER
�i ` Fain-1, oc �\, \ \\
� I 111 I. 0
t--- A__ _
virmi
Leg •
�,..
St
P
WOIF1CrD135C ON:
o ; :
N ' liis f iiei far& I Z
iVly 8;it#litlt`tli4pires
cr
FEES: BRMit
APPROVED:
Zoning
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
10050 N.E. 2nd Avenue • Miami gores, Florida 33138.305 -795 -2204 1/4 71 l Address C7 tU t f . / 0 0 - Tax Folio
eri&t /n4-s s'
f r:Air741 _ o e •
it's/to
3S7/ / Municipal #
(circle one):
square Fe Estimated Cost (value)
RADON
C.C.F
Historically Designated: Yes
Competency #
No
Master Permit #
Phone !l 1SY' A51-7/
Address 6 ``( a " •t'Z-+
ss#
Ins. Co. s'0/'d1
1100 PERMIT PACKAGE ACCESSIBLE ON THE JOB SITE FOR INSPECTORS TO "Enh1
. , �„ `BE NO INSPECTION. RE- INSPECTION FEE IS $50.00 AND MUST BE PAID IN ADVANL`E
BEFORE CALLING FOR ANOTHER INSPECTION.
BUILDING ELECTRICAL PLUMBING
ffy/SoN ' f97'& - fT n
�a
WARMING O OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY 11ESUL' ON
YOU1tl Af1C /TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTEND TO OBTAIN FINANCING, CONSULT
YOiJR°.L gk OR ANY ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.)
Applicatibtiiii:'heteby•made to obtain a permit to do work and installation as indicated above, and on the attached addendum (if applicable). 1 certify that
alt wont vHpllie performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permit: are to rated
OWNBItSAi''i?IDAVIT: 1 certify that all the foregoing information is accurate and that all wor 1 be done in compliance with all applicable iaws
regulitliiglt lthction t PNtpapip hermore, 1 authorize the above named contractor to do ork stated.
• ;.irr - '-•. \��� 1.9 '0118 / /
� O . i ���11111' 1 111 ,
Naa • -'0 d 4,
Date Signature of Contrac(jp ai Ownep l�b# �r
•
.
•
.
•
Notary as to Contractor etijp �
r'Berler
My Commission Expires ////00/111111110` � 1 11
NOTARY BOND
TOTAL DUE
•
Roo INC
4.
Building Electrical
Mechanical Plumbing Structural Engineer
cfizotes i Oage
• L o w 1 0
Sec. 5-1.1. Air conditioning regulations. •
(a) All individual air conditioning units installed in walls or
windows shall be securely anchored to the walls by approved
methods. Units installed over public property, paths of egress or
more than ten (10) feet above grade shall be secured to the struc-
ture by bolts or screws to resist horizontal wind loads. Such units
cantilevering more than flight (8) inches on the exterior of a
building shall be supported by steel angle brackets secured by
bolting. Bolts to masonry shall be Set in lead shields or similarly
rot - resistant fastenings.
(b) The following special requirements shall apply to the con-
trol and regulation of noise nuisance from air conditioning machinery:
(1) All equipment. existing or hereafter installed, regardless
of loca:ion, shall be maintained in good working order.
Equipment so located that normal operating noises create
a nuisance to adjacent owners or occupants shall be pro-
vided with soundproofing, or sound-absorbing bafTels, or
enclosures, as approved to insure maintenance of a rea-
sonable noise level.
(2) All equipment on outer walls, on roofs, or in other exposed
locations. which are unduly noisy, and which causes valid
complaints from adjoining property owners or occupants.
may be required to be relocated. redesigned and!or en-
closed in noise-retarding materials when. in the opinion of
the building official, such enclosure is necessary or would
be effective.
,(3) Special consideration shall be given to the planning of all
future installations to minimize the noise nuisance to ad-
joining property owners or occupants, and the building
official shall have authority to reject or require the rede-
sign of any system which, in his opinion, would cause such
a.noise nuisance.
(c) Violation of this section shall be punished as is now or may
hereafter be provided by law. (Ord. No. 299, §§ 1 -3, 2.21 -61)
I have read the above oxtiinac% p will ccnmly with the
regulations thereof. 0 \NiS 3�)g
m ° _ 00 Pa (IV 1 . � i
� •�' 80V:9:.: a4# : �
c r'b'r'Signatu a Mme •
., '
•bNoiss te \ ...011‘..... actor S7QJnature
° ✓ ' , /u Is +1 1 ```` .�� C"
4. IS DISCONNECT WITHIN SIGNT AND RE ADILY ACCESSIBLE? YES V NO
5. EXISTING UNIT TO BE REPLACED (J OR RELOCATED
JOB NAME
ADDRESS
0)3. IL
R U ML SCO3T
Different location than above?
EXISTING CONDITIONS
1. HOUSE MAIN ELECTRIC SIZE AMPS ? &C) WIRE SIZE
2. COMPRESSOR BRANCH CIRCUIT: WIRE SIZE O ,
AIR HANDLER BRANCH CIRCUIT:WIRE SIZE
(
-f
& CIR. BKR. SIZE
& CIR. BKR. SIZE
3. SIZE OF EXISTING COMPRESSOR DfSCONNECT: '- AMPS. TYPE: FUSE J O CIR. BKR.
SIZE OF EXISTING AIR HANDLER DISCONNECT: AMPS. TYPE: FUSE O CIR. BKR.
LEN. NAME PPLATE INFORMATION FROM EXISTING UNIT
MAKE
CONDENSOR MODEL # HS M :,)1 1
HEAT PUMP TYPE YES NO ____
CONDENSOR MINIMUM CIRCUITS AMPS Wk‘
MAXIMUM OVERCURRENT PROTECTION SIZE AND
MAKE
CONDENSOR
HEAT PUMP
CONDENSOR
SIGNA
PACKAGE MODEL #
A.H.U. MODEL #
KW HEAT STRIP SIZE
A.H.U. MINIMUM CIRCUIT
TYPE:
•
11MM
A:'PS
CONDENSOR AMP SIZE FUSE v HACR CIR. BKR.
AIR HANDLER AMP SIZE FUSE (✓, ( HACR CIR. BKR.
EER 0
NAME PLATE INFORMATION FROM NEW UNIT BEING INSTALLED
MODEL # - T Q p LA_
1) Q
TYPE YES NO U
MINIMUM CIRCUITS AMPS 3 I
MAXIMUM OVERCURRENT PROTECTION SIZE AND TYPE:
CONDENSOR AMP SIZE
AIR HANDLER AMP SIZE
EER 13
-LA /
RE OF QUALIFIER
PACKAGE MODEL #
A.H.U. MODEL #
KW HEAT STRIP SIZE
A.H.U. MINIMUM CIRCUIT AMPS
FUSE SIZE,`
FUSE SIZE SW
C_..l,t3
.o .
FUSE . HACR CIR. BKR.
FUSE ( t HACR CIR. BKR.
\\\\ \ \i111111111 N I //
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• 013 ?_648
i� �. T on de hN eC1' FICATE NUMBER
1 • ••.° Fa l �u«'; • • \`.?
\ -
...... Ztili upp,i,
Miami Shores Village
10050 NE 2nd Avenue
Phone: 305 - 795 -2204
Printed: 12 /12/2003
Applicant: EVELYN
Owner: MASSIE
JOB ADDRESS: 836 NE 100
Parcel # 1132060340040
Signed:
(INSPECTOR)
Mechanical Permit
Permit Number: ME2003 -222
MASSIE
EVELYN
ST
Contractor RESIDENTIAL AIR CONDITIONING CORP Contractor's Address: 20250 NE 15 CT
Local Phone: 305 - 652 - 6040
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.
Legal Description: MIAMI SHORES SEC 8 PB 14 -33 LOT 6 & E1/2 LOT 7 BLK 169 LOT SIZE 75.000
Fees:
FEE2003 -8185
FEE2003 -8186
FEE2003 -8187
FEE2003 -8188
Description
Building Fee
CCF
Technology Fee
Training and Education Fee
Total Fees:
Amount
$106.00
$1.80
$2.65
$0.60
$111.05
Total Fees: $111.05
Total Receipts: $0.00
Permit Status: APPROVED Permit Expiration: 6/6/2004 Construction Value: $2,400.00
Work: REPLACE EXISTING A/C 4 TON 7.5 KW
Signed: (Contractor or Builder)
BY:
Page 1 of 1
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT v
APPLICATION FOR BUILDING PERMIT
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein
described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the
State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with. whether
herein specified or not. A copy of approved plans and specifications must be kept at building during progress of the work.
, / Date - E 2 7
19_
Owner's Name and Address M f- S S'$f U6 /Y • " L 0 6 5' ` 31 37 No. Street
Registered Architect and /or Engineer .� n - , �- W 4 r �/
Name and address of licensed contractor l IFAf //[ii/ £IM�/ 0 C 7a p •W At " (p Z S . At/ 73/(,t(
Location and legal description of lot to be built on: s ,� n ` 2 �
Lot 7 E dti Block /!� / Subdivision / • Led 1 " ✓ a'" 6 J '"' ! dt
U
Street and Number where work is to be done r� t ' (. / 0 0 5 k t ew f 1 y 6126 7 ? , 3
State work to be done and purpose of building (by floors), state exterior colors (submit samples)
l � �� and for no other purpose.
New Building Remodeling Addition 4 6" (1�l '�+"" I Repairs No. of Stories
To be constructed of !Dpp / Kind of foundation Roof Covering
6 1
Estimated Total cost of improvements s / 30' Amount of Permit $ 1 ` f
Zone cubage required Plan Cubage
DI 1 /
D
Distance to next nearest building ' tf,,.t ale G Size of Building Lot
Maximum live load to be borne by each floor 1111[
I hereby submit all 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 does hereby certify that he understands and accepts his obligatons as
Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Supplem - . and has complied
compliance from all contractors or sub - contractors employed by him in the work to be perfor ltl-. under this permi
on the site of the work such public notice or notices as are required by the Act. The undersi agrees to emplo
under this permit, as are licensed by Miami Shores Village.
Remarks (Signed)
STATE OF FLORIDA
COUNTY OF DADE.
J SS.
Before me, the undersigned authority. a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
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 fo •going application, and that he did sign the same. and that all facts therein by him stated are true.
IC Permit No. r 1 1 N Date Read, Sworn to and Subscribed before me.
Disapproved
(Signed)
Building Inspector My Commission Expires
PLANNING BOARD DATE
Chairman Member
Member Member
Member Member
Council Approved Date Disapproved Date
NOTE: A charge of $25.00 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 $25.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and /or workmanship.
Date
ith t
and
onl
of
e ovisio
post or
ch subc
plo
Notary Public. State of Florida
abor under the Florida Workmen's
s thereof, and will require similar
cause to be po.ted for inspection
trac ,rs, on w to be performed
to me well known.
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THESE PLANS ARE APPROVED FOR ISSUANCE OF A BUILDING PERMIT
❑ WITH NO VARIANCES ❑ WITH VARIANCE(S) LISTED IN "REMARKS"
NO OTHER DEVIATIO "•!S FROM T'r:E'i1 ^ °':n' SH RES BUILDING AND ZONING
ORDINANCES WILL BE PERMITTED, UNLESS SPECIFICALLY LISTED BELOW.
.1 ALL OTHER APPLICABLE STATE AND COUNTY LAWS MUST BE COMPLIED
WITH BY ALL PARTIES.
FIRE DEPARTMENT
i PUBLIC WORKS
POLICE DEPARTMENT
BUILDING DIRECTOR
PLANNING & ZONING BOA.;:
VILLAGE COUNCIL
REMARKS:
S'ee'.ture Date
APPROVAL
PRELIMINARY: FINAL:
COMPLIANCE WITH THE SOUTH FLORIDA BUILDING CO ±tE AS ADOPTED
BY MIAMI SHORES VILLAGE IS REQUIRED. DE ARCHITECT. BUILDER &
SUB CONTRACTORS ARE r "'" Fj : ,' :: ;�srLF�F Al
ING REGULATIONS WHETHER OR NOT SPECIFICALLY INDICATED HEREIN.
City of Miami Shores
Building & Zoning Dept.
10050 N.E. 2nd Avenue
Miami Shores, F1. 33138
HMB /mc
CENTRAL COMFORT CORPS
7860 N.W. 62ND STREET / MIAMI, FLORIDA 33166
MIAMI PHONE: (305) 591 -8585 / BROWARD PHONE: (305) 523 -7401
- -Nbtary q?ublic - mate of Florida
Notary Publicc State of FloridR at Large
My Commissicm.Expires July 15, 1988
DoxiDGQ THRU HUCKLEBERRY, SIBLEY
& HARVEY INSURANCE & BONDS. INC.
May 22, 1987
This is to authorize Juan Campelo to pull permit for the
MASSIE Residence 836 N.E. 100th Street
Miami Shores.
If you have any questions, please do not hesitate
to call.
arold M. Baskin,
President