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.