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MECHANICAL PERMITPERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date C O/q( A d d r e s s N F /8( ST Tax Folio /1 - 37 ((p ` D 1 — )S') Legal Description Lo-r ? J CO 1/7 1 La 77 bU4 Historically Designated: Yes No Owner/Lessee / Tenant TD l J i J t4 L( MO G G Master Permit # Owner's Address ti € /6 ` T Contracting Co. 'f ,1(Z � a(_ RUC /� Qualifier J' ] -t 64 State# C ' AeoLI /ll�' Architect/Engineer Bonding Company Mortgagor Address Permit Type (circle one): BUILDING ELECTRICAL PLUMBING WORK DESCRWFION 4 .. , . . sit !L o President Si a : ture of owner and/or C:., Notary .s to My Commis PAULA J. RICHARDSON Ppl ^IA + Notary Public, State of Florida rants/ My Comm. expires May 29, 199i I. No. CC4433Ce B uaded Nu Ark r J. . •'her & Co. FEES: PERMIT APPROVED: Zoning Mechanical Phone ] �f8 g � 1l l S _J—Pl C Address 7 / rlt<Sl < 5 1d(R ) SS# / Municipal # Competency # Address Address 11MSP 993 930 Ins. C ROOFING PAVING FENCE SIGN Square Ft. Estimated Cost (value) c ()'r' 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 -n ed contractor to do the work stated. RADON D t0 9 /x'0 f6 • 44d er an d/ Condo President Date Expires: Signature pfj s actor or Owner- Builder Notary as to C .'r actor or Owner - Builder My Commis Expires: PAULA J. RICHAROSOM Notary Put!ic, St?fe of t ioridd nqy t am7. expires ? y ?q, ;Fr N4. CCV"''. la; A,thur J. iiit.ag "er & Co C.C.F. /. NOTARY BOND TOTAL DUE Building Electrical / Plumbing Engineering 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..._........_......_ ._ _ ��.. � — sas s... ,19 .7 _ 7 Owners Name and Address /'1.SITP CN`j ` Q b — No 76 sass Street Q_.1...... . Registered Architect and /or l,ngineer mkt) Name and address of licensed contractor, mkt) 4 ire...... MI), ..... 400 _ Is e004T, STATE OF FLORIDA, COUNTY OF DADE. j ss Location�4 legal d ipy n,gfiot to be bl,i on: Lot `( / Block 1 .1�1 Subdivision �••�r Street and Number where work is to be done 75 - ...1. - .1 1 �*7 -T -�`*� = . • .J-_ — — — •• - - --- State work to be slone and purpose of building (by floors).. ._i µ67e 1 "" 3 Td.1 _..=I : I T. uS .._ 9 ., Ku) .. - Fie L. P + "~ .. _ ,__ and for no other purpose. New Building Remodeling Addition Repairs No. of Stories To be constructed of Kind of foundation y Roof Covering .— Estimated Total cost of improvements $ 2 . 3 �� Amount of Permit S. 2 0 , 25 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 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 5966, Compiled General Laws of Florida, Permanent Sup element, and has complied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employ by hint in the work to be performed under this permit; and will post or cause to be posted spection on the site •. he work such >li • notice or notices as are required by the Act. The undersigned agrees to employ only s • ntracto s, on wor, be performe u er this pennit, as are licensed by Miami Shores Village. - Remarks Disapproved _ Dat (Signed) Buil• mg Inspcc , . - My Commission Expires S . ( 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. Permit No.._. _ 4 1 7 t ` i Date 6? "/ v r Read, Sworn to and Subscribed before me. Notary Public, State of Florida PL NNING BOARD DATE Chairman Member Mcrrber 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 ]bard. 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 ,/ �G+ Lim INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT Permit No 3 Date 2— 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, Flurida, 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 work. Owner's Name and Address .. .. ii No �� 9J- Registered Architect and /or Engineer P e Lk/ l..g .0 Ft K I t4 s 14..E `7 o o ,iS) ti.9 q k.1 to Employing Electrician's Name No Street Location and Legal Description Lot Block Subdivision Street and Number where work is to be performed —No ! ' Street State work to be performed and purpose of building (By Floors) New Building Remodeling Addition Repairs No. of Stories Service Overhead Underground Size Feeders STATE OF FLORIDA, COUNTY OF DADE. j ss ' Conduit Main Sw Amps Main Fuses Amps Type of Installation -- Conduit Tubin B.X. .Metal Moulding / o AL /4 /C.. G 0 0 ‘57 Amount of Permit $ O (Signed) Electrical Inspector. 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 Permanent Supplement, and has complied with the provisions thereof, and will require similar compliance from all contractors or subcontractors 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 subcontractors n work to be perforn ed under this permit, as are licensed by Miami Shores Village. (Signed) street 70 E7/ . - e Master 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 PLUO RECE'P'7'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 0.1 HP MOTORS 1.5 HP NEON TRANS. RADIO TOTAL CONTR. LIST CHECK // MIAMI SHORES VILLAGE ,/ �G+ Lim INSPECTION DEPARTMENT APPLICATION FOR ELECTRICAL PERMIT Permit No 3 Date 2— 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, Flurida, 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 work. Owner's Name and Address .. .. ii No �� 9J- Registered Architect and /or Engineer P e Lk/ l..g .0 Ft K I t4 s 14..E `7 o o ,iS) ti.9 q k.1 to Employing Electrician's Name No Street Location and Legal Description Lot Block Subdivision Street and Number where work is to be performed —No ! ' Street State work to be performed and purpose of building (By Floors) New Building Remodeling Addition Repairs No. of Stories Service Overhead Underground Size Feeders STATE OF FLORIDA, COUNTY OF DADE. j ss ' Conduit Main Sw Amps Main Fuses Amps Type of Installation -- Conduit Tubin B.X. .Metal Moulding / o AL /4 /C.. G 0 0 ‘57 Amount of Permit $ O (Signed) Electrical Inspector. 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 Permanent Supplement, and has complied with the provisions thereof, and will require similar compliance from all contractors or subcontractors 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 subcontractors n work to be perforn ed under this permit, as are licensed by Miami Shores Village. (Signed) street 70 E7/ . - e Master 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.