1180 NE 102 St (3)10050 N.E. Avenue • Miami Shores, Florida 33138.305- 795 -2204
Date -'9 -43/1— Job Address 1�'i Pi 02 9- Tax Folio
Legal Description Historically Designated: Yes
wn ' /Lessee/Tenet GC' DR- G( 0-04): r' Master Permit #
Owner's Address
Contracting Co.
4 PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
\\fAk A-C 02- ' M a,4,
Qualifier SS# Phone
State # Municipal #
IF THERE IS NO PERMIT PACKAGE ACCESSIBLE ON THE JOB SITE FOR INSPECTORS TO VERIFY,
THERE WILL BE NO INSPECTION. RE- INSPECTION FEE IS $50.00 AND MUST BE PAID IN ADVANCE
BEFORE CALLING FOR AN I • PECTION.
Permit Type (circle one): BUILDING ELECTRICAL
WORK DESCRIPTION:
Square Ft. Estimated Cost (value)
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 ANY 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 all disciplines.
OWNERS 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 wor stated
Signature of owner and/or Condo President
Notary as o Owners nd/or Condo President
APPROVED:
Zoning Building
Mechanical Plumbing
`1.30.02
Phone GS " - 759 - t l 2_1
Address
No
Competency # Ins. Co.
MECHANICAL ROOFING
ate Signature of Con ctor or Owner B *der � u b q� � o 1 Date
.- 3� -- 4 �3
Date Notary as ti' Contracto or Owner Builder . _.., ►ate
My Commission Expires 9 -q My Commission Expires, : ; ; a ��` a M t
r Marla Jahn • _ • o
er ' • My Commission D0039
N a Expires Sepiernber 09 2005
FEES: PERMIT /o< G RADON C.C.F NOTARY S' O C) BOND
TOTAL DUE
Electrical
Structural Engineer
ITEM
BATHTUB
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 AMPS
DUCT WORK
FLOOR DRAIN
SERVICE REPAIR/METER CHANGE
REFRIGERATION
GREASE TRAP
APPLIANCE OUTLETS
PROCESS AND PRESS PIPING
INTERCEPTOR
RANGE TOP
UNDERGROUND TANKS
LAVATORY
OVEN
ABOVE GROUND TANKS
LAUNDRY TRAY
WATER HEATER
U.F. PRESSURE VESSELS' .
CLOTHES WASHER
MOTORS 0- 1 HP
•
STEAM BOILERS
EWER
MOTCRS OVER 1 - 3 HP
HOT WATER BOILERS
SINK, POT /3 COMP.
MOTCRS OVER 3- 5 HP
MECHANICAL VENTILATION
SINK, RESIDENCE
MOTORS OVER 5- 8 IP
TRANSPORTING ASSEMBLIES
SINK, SLCP
MOTORS OVER 8- 10 HP
ELEVATORS/ESCALATORS
TEMPORARY WATER CLOSET
.
OVER 10- 25 HP
FIRE SPRINKLER SYSTEMS
URINAL
_
MOTORS OVER 25-100 HP
, COOLING TOWERS
WATER CLOSET
MOTORS OVER 100 IHP
VIOLATION
INDIRECT WASTES
A/C WINDOW
REINSPECTION
HATER SUPPLY TO:
AIR CONDITIONERS
'
A/C UNIT
STRIP HEATER
FIRE SPRINKLER
GENERATORS TRANSFORMERS
HEATER -NEW INST.
GENERATORS TRANSFORMERS
HEATER - REPLACE
GENERATORS TRANSFORMERS
LAWN SPRINKLER -WELL
SPECIAL PURPOSE
SWIMMING POOL
OUTLETS COM,ERCIAL
WATER SERVICE
SIGN TUBES
;EWER CONNECTIONS
SIGN TRANSFORMERS
fTILITY -SEWER
SIGN TIME CLOCK
ITILITY -WATER
FIXTLRES
SEPTIC TANK
ANTENNA '
,FLAY
_
TELEVISION OUTLETS
RAINFIELD, 4" TILE/RES.
VIOLATION
UMP & ABAICON SEPTIC TANK
REINSPECTION
OAKAGE PIT CU. FT.
-
ATCH BASIN
ISCHARGE WELL
OMESTIC WELL
REA DRAIN
70F INLET
•
7LAR WATER HEATER
_
IRE STANDPIPE
JOL PIPING
1
WN SPRINKLER SYSTEM
LS RANGE
:TER SET (GAS)
.S PIPING
PLUMBING
ADDENDUM TO BUILDING PERMIT APPLICATION
(AN APPLICATION tOR 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.)
ELECTRICAL
MECHANICAL
Miami Shores Village Plumbing Permit
10050 NE 2nd Avenue
Phone: 305- 795 -2204 Permit Number: PL2002 -278
Printed: 10/18 /2002
Applicant: ALICE GLADDING
Owner: GLADDING ALICE
JOB ADDRESS: 1189 NE 102 ST
Contractor T C R POOLS INC
ocal Phone:
Parcel # 1132050190100
Signed:
Contractor's Address: 9615 SW 187 ST
Page 1 of 1
Legal Description: MIAMI SHORES SEC 8 REV PB 43 -67 LOT 10 BLK 175 LOT SIZE
p.Q O 7
S- Da
,
Total Fees:
Total Receipts: $0.00
Permit Status: Approved
Work: POOL PIPING
Permit Expiration:
4/16/2003
Construction Value:
$1,000.00
If there is no permit package accessible on the job -site for inspectors to verify, there will be no inspections. Re- inspection
fee is $50.00, which must be paid in advance before calling for another inspection.
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 application herefor 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 • dition 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 regulation • pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes responsibility for work done
by his agents, , or - ' ployees.
se
Signed: 114-1.A. (INSPECTOR) BY:
v %
In consideration • 'rise ance 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.
�{ (Contractor or Builder) \\ \ , BY: