MECHANICAL PERMITPERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date g Job Address ?■ 0 �O l 5 Tax Folio
Legal Description
Owner/Lessee / Tenant
Owner's Address
Architect/Engineer
Bonding Company
Address
Phone
Historically Designated: Yes �— No
Q °
M ! <<L 1O/l /l l4 / 1 341.
Contracting Co. OW / 7e l7 M ,M'J it C Address 7 ) U (' 2 S c
Qualifier '�L/ Sj /C� �� (& (cC-, / SS# S"7 a y( �
State # ( 5 Municipal # Competenc # Ins. Co.
Address
Mortgagor Address
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ' OOFING PAVING FENCE SIGN
WORK DESCRIPTION e A. , 0 / Al c--, 4 6e- �C_ A. d I / 'R. ' -
• /
ki c% ? - 1 P (A-77 o' t.J. T° 6 ji, (- i s7"/"..7(.., / /I 1.-!// C s ��pG L .�c�;%
Square Ft Estimated Cost (value)
4 9
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 sta ed.
Signature of owner and/or Condo President Date '0 «'•
i
AAA il
Notary as to Owner and/or Condo President Date otary as to ontq pr • � : VSKr , Date
res' IfiLF
My Commission Expires:
FEES: PERMI
caner- Builder 5/6 9 Date
RADON C.C.F. -- ° NOTARY BOND
TOTAL DUE
APPROVED:
Zoning Building Electrical
Mechanical �`�` `{ Plumbing Engineering
i
Architect
Contractor
or Builder
Legal
Description
Address of
Building
MIAMI SHORES VILLAGE, FLORIDA
BUILDING El Date Date t� — f 1 _�Q
ELECTRICAL ❑ N_ 43416
PLUMBING ❑ PERMIT
ROOFING ❑
MLA
Work to be performed under this Permit
Owner of es--
Building r
Ukirre-c_H W �u- 4�s.n11
Lpt Io4
7or) rye. lol
CONTRACTOR or BUILDER
sibility for work done by his agents, servants o '' oyees. Q
License No: b .332 `�' y
P/F
k. G
II • c;16 O(7 222 C OT: `00
Subdi- A, 4 BOND:
vision t RADON
Sq Ft
Value of p •() 1 1 Amount of 3 /
Project $ S 1 1 Permit $
Signed• °�r - / ' (INSPECTOR) BY
In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulation.
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 responsibility for all work done by either, myself, my agent, servant or employee.
AUTHORITY
This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the applica-
tion berefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any
plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked
at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this
permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and
regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes respon-
BY
•
ITEM
BATH TL8
UNIT
I
ITEM
SWITCH OUTLETS
UNIT
FEE
ITEM
SPACE HEATERS
UNIT
FEE
B I OET
LIGHT CURETS
CENTRAL HEATING
DISHWASHER
RECVTACLES
A/C (WINO)
DISPOSAL
SERVICE TEWORARY
A/C (CENTRAL)
DRINKING FOUNTAIN
SERVICE SIZE IN AMPS
DUCT WORK
FLOOR ORAIN
SERVICE REPAIR/METER CHANT
REFRIGERATION
GREASE TRAP
APPLIAIDE CUTLETS
PROCESS AND PRESS PIPING
INTERCEPTOR
RANGE TOP
J ERGROUIO TAMS
LAVATORY
OVEN
ABOVE GROUND TANKS
LAUNDRY TRAY
WATER HEATER
U.F. PRESSURE VESSELS
CLOTHES HASHER
MOTORS 0- 1 NP
STEAM BOILERS
SHOWER
MOTORS OVER 1- 3 If
HOT WATER BOILERS
SINK, POT/3 COMP.
MOTCRS OVER 3- 5 NP
MECHANICAL VENTILATION C ),,,
SINK. RESIOENCE
_
MOTORS OVER 5- 8 1P
TRANSPORTING ASSEMBLIES
SINK. SLOP
MOTORS OVER 8- 10 If
ELEVATCRS/ESCALATDRS
TEMPORARY WATER CLOSET
MOTORS OVER 10- 25 NP
FIRE SPRINKLER SYSTEMS
URINAL
MOTORS OVER 25-100 NP
C00L I NG TONERS
WATER CLOSET
MOTORS OVER 100 NP
VIOLATION
INDIRECT WASTES
A/C WINDOW
REINSPECTION
WATER SUPPLY TO:
AIR CONDITIONERS
•
A/C UNIT
STRIP HEATER
FIRE SPRINKLER
GENERATORS TRANSFORMIERS
•
HEATER -NEW INST.
GENERATORS TRANSFORMERS
HEATER - REPLACE
GENERATORS TRANSFC RS
•
LAWN SPRINKLER -WELL
_
SPECIAL PURPOSE
SWIMMING POOL
-
CURETS CC RCIAL
_
WATER SERVICE •
SIGN TUBES
SEWER CONNECTIONS
SIGN TRANSFORMERS
UTILITY-SEER
SIGN TIME CLOCK
UTILITY -HATER
FIXTURES
SEPTIC TAN(
ANTENNA
RELAY
TELEVISION CURETS
GRAINFIELD, 4' TILE/RES.
VIOLATION
PUMP & ABANDON SEPTIC TAN(
REINSPECTION
SOAKAGE PIT CU. FT.
CATCH BASIN
.
0 I SC{ARGE WELL
DOMESTIC WELL
AREA GRAIN
ROOF INLET
SOLAR WATER HEATER
FIRE STANDPIPE
POOL PIPING
LAWN SPR I NQER 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 B.
OBTAL*TED, THE OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.)
PLUMBING
ELECTRICAL
MECHANICAL
Date 4 v.lob Address
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
ption Historically Designated: Yes No /�
/ Tenant / # MT`t' C=2 CI / Master Perrot # 6 4
/V / /0/ £>' Phone 4-224-1
Contracting Co. ( 4'/,/1//? W / 4 t( , Address s
Qualifier / SS# Phorgp C;K6.
Owner's Address
State # Municipal # Competency # Ins. Co.
Architect/Engineer -- Address
Bonding Company Address
Mortgagor Address
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING CHANICA ROOFING PAVING FENCE SIGN •
WORK DESCRIP'T'ION / 17 A &X (S/ / °✓ / /,c) f a :
1/cI ;C/ ®A.,k, c ,/�T7i� a A/ S �� t
/7
Square Ft. Estimated Cost (value PO() °
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 wi11 be done in compliance with all applicable
laws regulating construction and zoning. Furthermore, I authorize the above -named contractor s o the work stated. /�
Ii
Signature of owner and/or on . resident Date
Notary
My Commis
FEES: PERMIT
-(k Ale /0/
Tax Folio
d/or Condo President Date
n xpires:
RADON
Sign
wrier-
Date
.F/
/'her, 6:
Notary as to Contractor or Owner- Budlder / _ SEAL
Commission Expires: ` RY PVB BARB A FUGAIM
l E 0 =MISSION NUMBER
Q CC723468
o
q MY COMPASSION EXPIRES
MAR. 29 2002
C.C.F. , =RA NOTARY BOND
TOTAL DUE /
APPROVED:
Zoning Building Electrical
M echanical `jj i Ppinbing Engineering
BUILDING ❑ MIAMI SHORES VILLAGE FLORIDA
ELECTRICAL Date— + 19 -r
PLUMBING ❑ PERMIT N? 10425 Contractor's
ROOFING ❑ License No.
❑ Work to be performed under this Permit
Owner of
Building .r ' ' ca 1 �- � ; ek r
Architect
Contractor
or Builder `— i `• ..:-- L. / -. ) • 1 I -
Legal Lot 11
Description 11 Bl.
Address of
Building sr- f� c
CONTRACTOR or BUILDER
Subdi-
vision
Sq. Ft.
Value of 11 Amount of
Project $ 11 Permit $
This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the applica-
tion herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with am
plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked
at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this
permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and
regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes respon-
sibility for work done by his agents, servants or _employees.
Signed (-.0 17 `"' "'"' ' —^'tINSPECTOR) BY
In consideration of the issuance to me of this permit I agreeA6 perform the work covered hereunder in compliance with all ordinances and regulations
pertaining thereto and in strict conformity with the plans, drawing drawing,d, statements or specifications submitted to the proper authorities of Miami Shores Village.
In accepting thip'permit I assume ,responsibility for all work don* by either, myself, my agent, servant or employee.
BY
AUTHORITY
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMI
Permit No
Date.
Owner's Name and Address..
Amount of Permit $ t�
STATE OF FLORIDA,
COUNTY OF DADE. I &g'
(Signed).
kr, b No 6'6)
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 compi with, whether herein specified or not. A copy of approved plans and specifications must be kept at
building during progress of work.
Street
Registered Architect and /or En i er ,
Employing Electrician's Name:L.. ./ /G. .se` ../ No./ 7 , Street..L`" / �` /�%
Location and Legal Description Lot Block Subdivision
Street and Number where work is to be performed —No ,/CL..-'. .. .... Street ..�`� e
State work to be performed and purpose of building (By Floors) ;! _, r
New Building Remodeling Addition Repairs No. of Stories
Service Overhead Size Feeders Conduit Main Sw Amps Main Fuses Amps
Underground P
Type of Installation — Conduit Tubing B.X.L Metal Moulding
r.
Electrical Inspec
The undersigned applicant for this building permit does hereby certify that he understands and accepts hiligations 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 inspection on the site of the work such publw icitice or notices
as are required by the Act. The undersigned agrees to employ only such sub-contractors, on d+prk to be performed u' 'er hi permit, as are
licensed by Miami Shores Village
(Signed). ...t��.1
° Master Electrician.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally
appeared
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, and he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
My Commission Expires Notary Public, State of Florida
NOTE: A re-inspection fee of $1.00 will be made when such re-inspection is made necessary by improper notice for inspection, or faulty
materials and /or workmanship.
SWITCH
OUTLETS
LIGHT
OUTLETS
PLUG
RECE'P'T'S
FIXTURES
NO. LAMPS
REFRIO.
OUTLET
IRON
OUTLET
RANGE
OUTLET
RANGE
CONN.
WATER
HEATER
W. HEAT.
CONN.
SPACE
HEATER
STRIP
HEATER
TOTAL
CONTR.
LIST
CHECK
ENT.
SW.
DIST.
CAB.
SERVICE
TEMP.
SERVICE
PERM.
MOTORS
O.I HP
MOTORS
I•S HP
NEON
TRANS.
RADIO
TOTAL
CONTR.
LIST
CHECK
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMI
Permit No
Date.
Owner's Name and Address..
Amount of Permit $ t�
STATE OF FLORIDA,
COUNTY OF DADE. I &g'
(Signed).
kr, b No 6'6)
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 compi with, whether herein specified or not. A copy of approved plans and specifications must be kept at
building during progress of work.
Street
Registered Architect and /or En i er ,
Employing Electrician's Name:L.. ./ /G. .se` ../ No./ 7 , Street..L`" / �` /�%
Location and Legal Description Lot Block Subdivision
Street and Number where work is to be performed —No ,/CL..-'. .. .... Street ..�`� e
State work to be performed and purpose of building (By Floors) ;! _, r
New Building Remodeling Addition Repairs No. of Stories
Service Overhead Size Feeders Conduit Main Sw Amps Main Fuses Amps
Underground P
Type of Installation — Conduit Tubing B.X.L Metal Moulding
r.
Electrical Inspec
The undersigned applicant for this building permit does hereby certify that he understands and accepts hiligations 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 inspection on the site of the work such publw icitice or notices
as are required by the Act. The undersigned agrees to employ only such sub-contractors, on d+prk to be performed u' 'er hi permit, as are
licensed by Miami Shores Village
(Signed). ...t��.1
° Master Electrician.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally
appeared
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, and he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
My Commission Expires Notary Public, State of Florida
NOTE: A re-inspection fee of $1.00 will be made when such re-inspection is made necessary by improper notice for inspection, or faulty
materials and /or workmanship.