361 NE 102 St (2)PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Dateq'a q4 Job Address �" ( NE (OZ ✓ Tax Folio
Legal Description
Owner/Lessee / Tenant
WORK DESCRIPTION
,S
Phone` ` rl J\.J
Contracting Co. '(A PI 1 Address CO a /44, t j.
Qualifier N,VUS ntial9h.ek)
SS# Phone 71 a446
O? n Cy Com eten 4 A O( Ins. Co. z3' u L i 2
State # Municipal t /�"l� P cy
Owner's Address l (.0 Vre-Pj
Architect/Engineer
Bonding Company
Mortgagor
Permit Type (circle one): BUILDING ELECTRICAL
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 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 AFF DAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable
law: e� 1: ' g co .truction nin Furthermore, I authorize the above -named contractor to do the work stated.
gnature of o der an Condo President Date
Stow
LA.
Not
My C
ssi�$ WILBANILS
NOTARY PUBLIC STATE OF FLORID
COMMISSION NO. CC409293
MY COMMISSION EXP. SEPT 221998_]
FEES: PERMIT � , RADON
APPROVED:
Zoning
Mechanical
Building
r �� )
Plumbing
Date
Historically Designated: Yes No
Master Permit # - l / 8 g 1
Address
Address
Address
LUMBING MECHANICAL ROOFING PAVING FENCE SIGN
f" Signature of Contractor or Owner- Builder Date
g
C.C.F. / ' NOTARY
Electrical
BOND
TOTAL DUE - go
Engineering
ITEM
3A i r{ E
UNIT
FEE
ITEM
SNITCH OUTLETS
UNIT
FEE
Ira-
SPACE HEATERS
(BT
FEE
310E7
LIGiT a1TLETS
(3:?ITR,& HEATING
L_-:
C
OISHNASf'ER
t RECEPTACLES
A/C (RIND)
OISFOSAL
I
SERVICE TEMPORARY
A/C (CENTRAL)
CRINKING FCNTAIN
I
J SERVICE SIZE IN AMPS
OLCT VOW
FUCR CRAIN
J
SERVICE REPAIR/METER C
J REFRIGERATION
GREASE TRAP
APPLIANCE CUTLETS
1 PROCESS APU PRESS PIPING
I
INTERCEPTCR
RANGE TOP
` UNOERGRQA2D TANS
UVA T CRY
2.
/2
OVEN
ABOVE f ICUNO TAM
LAM '( TRAY
WATER WATER
U.F. PRESSIRE VESS`S
CLOTHES use
t
`
1CTCRS 0- 1 HP
STEAM 30IL RS
SKIER
( (
b
4DTCRS OVER 1- 3 H
HUT NATO !OILERS
SINK. POT /3 CAP .
MOTCRS OVER 3- 5 HP
-
W.CMI IC: L VENTILATION
SINK. RESIDENCE
t (
4;-
MOTORS OVER S- 3 P
IRANSPORTIM ASSEMBLIES
SINK. SLOP
T aFCRARY ura C:St i
URINAL
?(A i ER CLOSE i
`
2
/2
MOTORS OVER 3- 10 FP
SOTS OVER 10- 2.5 HP
%OTGRS OVER 25-1C0 HP
x2TCRS OVER ICO HP
[
ELEVATORS/ESCALATORS
FIRE SPRINKLER STST"IS
COOLING rives
VIOLATION
INDIRECT NASiES
j
A/C MOON
RE :NSFECTION
NA T ER SL.FP'_Y TO:
i
AIR C:.'!O IT IONERS
•
A/C UNIT
t
STRIP HEATER
1
I
1 I
(AN ?22LICy_ ON FOR BUILDING P _T SST ACCCM2 NT T IS .L.7DE_NDCtf. IT A VASTER MI HAS 3E=
OBTAINED, 77 Ow'N-,..R' S NOTAPIZED SIGN.LTURE N= NOT HE 2R= Sr..1T ON SUBS'ZQUzTT AZELIC TIONS. )
PLUMBING
r inG Jr711rIRL.'�`l
WARM-NEI IGT.
HEATER.-RGLACE
LAM SPR I NKL_ R-7E1
SW 1!,M i NG POOL •
YATaa Sava
�r IONS
UT(LiTt S' s
UTILITY -WATER
SEPTIC TANK
RELAY
DRAINFIELO. R' TILE/RES.
Pt &P S ABAM:ON SEPTIC TAM(
a =KAG& PIT CU. FT.
CATCH 3ASIN
OISCHARGE NELL
COUESTIC NIL
AREA CRAIN
RCCF INLET
SZLAR NATER HEATER
FIRE STANCPME
pal ?'P!%
LAWN 71INKLL S
METE::. :E f
GAS ?TING
ADDENDUM TO BUILDING PERMIT APPLICATION
GENERATCLS TRANS -S
GEN A TORS TRArtSF0ReS
SNEAATCRS TRAM 7a Aes
SPECIAL ?ARM
GURUS Cv ,RC:A.
SIGH DES
I' ( SIGN TRAi GI RS
I I SIGNN TILE CLCCX
)
f
FIXTLRES
,ANTENNA
TELEVISION CUTLETS
VIOUTION
REINSPECTION
ELECTRICAL
MECHANICAL
BUILDING
ELECTRICAL
PLUMBING
Owner of
Building
Architect
PERMIT N9 3944
Work to be performed under this Permit
Contractor
or Builder
Legal Lot Bl.
Description
Address of
Building
MIAMI SHORES VILLAGE, FLORIDA
Subdi-
vision
Value of
Project
DATE
194
Contractor's
License No.
Amt. of 0.1,
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
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 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 responsibility for work done by his agents, servants or employees.
Signed• By
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 regula-
tions 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.
CONTRACTOR OR BUILDER BY AUTHORITY