MC-15-62Miami Shores Village;
Building Department JAN 13 2015
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795-2204 Fax: (305) 756-8972ez I 1 1-1
` --
INSPECTION LINE PHONE NUMBER: (305) 762-4949
BUILDING
PERMIT APPLICATION
❑BUILDING ❑ ELECTRIC ❑ ROOFING
FBC 20 / -,-D
Master Permit No. r�') Q !; 2 --
Sub Permit No.
❑ REVISION ❑ EXTENSION ❑RENEWAL
❑PLUMBING IVMECHANICAL ❑PUBLIC WORKS [:]CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: 1141 b ��
City: Miami Shores County: Miami Dade Zip: :
Folio/Parcel#: Is the Building Historically Designated: Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): a'� Cu Phone#: fO �`� 00
; C"
Address: 1(4 - �_[ 9-) Sr
City: Yl ( C,i rt' 3ww-D State: - Zip: ) 3� _
Tenant/Lessee Name: Phone#: _18( 4�3 0 U
Email
CONTRACTOR: Company Name:
Address:
City: State:
Qualifier Name:
w t v -d ce) C,,o (-Cow)
Phone#:
ne#:
State Certification or Registration #: Certificate of Competency #: _
DESIGNER: Architect/Engineer: Phone#:
P:
Address: City: State: Zip:
Value of Work for this Permit: $� • cS� Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition
Description of Work: (a -e- jCkJ m
Specify color of color thru tile:
Submittal Fee $
Scanning Fee $
Permit Fee $
Radon Fee $
Technology Fee $ Training/Education Fee $
Structural Reviews $ _
(Revised02/24/2014)
CCF $ CO/CC $ _
DBPR $ Notary $
Double Fee $ _
Bond $
TOTAL FEE NOW DUE $ 12-2- - F'O
Bonding Company's Name (if applicable)
Bonding Company's Address
City
State
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
City
State
Zip
Zip
Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has
commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating
construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRIC, PLUMBING, SIGNS, POOLS,
FURNACES, BOILERS, HEATERS, TANKS, AIR CONDITIONERS, ETC.....
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.
"WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT 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."
Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
Signature ` "'"� Signature
OWNER or AGENT CONTRACTOR
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
day of
me or who has produced
20 by
who is personally known to
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
as
day of
me or who has produced
20 by
who is personally known to
identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
Seal: Seal:
as
APPROVED BY Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)
Miami Shores Village
Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
OWNER BUILDER DISCLOSURE STATEMENT
NAME: &z DATE: t t �, `=�
ADDRESS: 14" ll`4 — X1'1 51 �-1�� �� SVL-) VC) � G L
Do hereby petition the Village of Miami Shores to act as my own contractor pursuant to the laws of the State of Florida, F.S 489.103(7). And I have
read and understood the following disclosure statement, which entitles me to work as my own contractor; I further understand that I as the owner
must appear in person to complete all applications.
State Law requires construction to be done by a licensed contractor. You have applied for a permit under an exception to the law. The exemption
allows you, as the owner of your property, to act as your own contractor even though you do not have a license. You must supervise the
construction yourself. You may build or improve a one -family or two-family residence. You may also build or improve a commercial building at a
cost of $25,000.00 or less (The new form states 75,000). The building must be for your own use and occupancy. It may not be built for sale or
lease. If you sell or lease a building you have built yourself within one year after the construction is complete, the law will presume that you built
for sale or lease, which is a violation of this exemption. You may not hire an unlicensed' person as a contractor. It is your responsibility to make
sure the people employed by you have licenses required by state law and by county or municipal licensing ordinances. Any person working on
your building who is not licensed must work under your supervision and must be employed by you, which means that you must deduct F.I.C.A and
with -holdings tax and provide workers' compensation for that employee, all as prescribed by law. Your construction must comply with all
applicable laws, ordinances, buildings codes and zoning regulations.
Please read and initial each paragraph.
I. I understand that state law requires construction to be done by a licensed contractor and have applied for an owner -builder permit under an
exemption from the law. The exemption specifies that I, as the owner of the property listed, may act as my own contractor with certain
restrictions even though I do not have a license.
Initial
2. 1 understand that building permits are not required to be signed by a property owner unless he or she is responsible for the construction and
is not hiring a licensed contractor to assume responsibility.
Initial
3. 1 understand that, as an owner builder, I am the responsible party of record on a permit. I understand that I may protect myself from potential
financial risk by hiring a licensed contractor and having the permit filed in his or her name instead of my own name. I also understand that the
contractor is required by law to be licensed in Florida and to list his or license numbers on permits and contracts.
Initial V
4. 1 understand that I may build or improve a one family or two-family residence or a farm outbuilding. I may also build or improve a commercial
building if the costs do not exceed $75,000. The building or residence must be for my use or occupancy. It may not be built or substantially
improved for sale or lease. If a building or residence that I have built or substantially improved myself is sold or leased within 1 year after the
construction is complete, the law will presume that I built or substantially improved it for sale or leg5e, which violates the exemption.
Initial (�`
5. 1 understand that, as the owner -builder, I must provide direct, onsite supervision of the construction.
Initial_
6. 1 understand that I may not hire an unlicensed person to act as my contractor or to supervise persons working on my building or residence. It
is my responsibility to ensure that the persons whom I employ have the license required by and by county or municipal ordinance.
Initial
7. 1 understand that it is frequent practices of unlicensed persons to have the property owner obtain an owner -builder permit that erroneously
implies that the property owner is providing his or her own labor and materials. I, as an owner -builder, may be held liable and subjected to
serious financial risk for any injuries sustained by an unlicensed person or his or employees while working on my property. My homeowner's
insurance may not provide coverage for those injuries. I am willfully acting as an owner -builder and am aware of the limits of my insurance
coverage for injuries to workers on my property.
Initial
8. 1 understand that I may not delegate the responsibility for supervising work to be a licensed contractor who is not licenses to perform the
work being done. Any person working on my building who is not licensed must work under my direct supervision and must be employed by
me, which means that I must comply with laws requiring the withholding of federal income tax and social security contributions under the
Federal Insurance Contributions Act (FICA) and must provide workers compensation for the employee. I understand that my failure to follow
these may subject to serious financial risk.
Initial
9. 1 agree that, as the party legally and financially responsible for this proposed Construction activity, I will abide by all applicable laws and
requirement that govern owner -builders as well as employers. I also understand that the
Construction must comply with all applicable laws, ordinances, building codes, and zoning regulations.
Initial
10. 1 understand that I may obtain more information regarding my obligations as an employer from the Internal Revenue Service, the United States
Small Business Administration, and the Florida Department of Revenues. I also understand that I may contact the Florida Construction Industry
Licensing Board at 850.487.1395 or httpJ/www.myfloridalicense.com/dbpr/pro/cilb/"index.htmi
Initial_
11. 1 am aware of, and consent to; an owner -builder building permit applied for in my name and understands that I am the party
legally and financially responsible for the proposed construction activity at the following address:
Initial
12. 1 agree to notify Miami Shores Village immediately of any additions, deletions, or changes to any of the information that i have provided on
this disclosure.
Initial_
Licensed contractors are regulated by laws designed to protect the public. If you contract with a person who does not have a license, the
Constr4uction Industry Licensing Board and Department of Business and Professional Regulation may be unable to assist you with any financial
loss that you sustain as a result of contractor may be in civil court. It is also important for you to understand that, if an unlicensed contractor or
employee of an individual or firm is injured while working on your property, you may be held liable for damages. If you obtain an owner -builder
permit and wish to hire a licensed contractor, you will be responsible for verifying whether the contractor is properly licensed and the status of
the contractor's workers compensation coverage.
Before a building permit can be issued, this disclosure statement must be completed and signed by the property owner and returned to the local
permitting agency responsible for issuing the permit. A copy of the property owner's driver license, the notarized signature of the property
owner, or other type of verification acceptable to the local permitting agency is required when the permit is issued.
Was acknowledged before me this 12:' day of 3F'"^' , 20 1 S
Produced there License or (=-(—
OWNER
who was personally known to me or who has
NOTARY'•. �°�E113p59' 4,
s� rCc....�
'111111111110\\\>
111111111 11 \\\\>
S
PERMIT APPLICATIONFOR MIAMI SHORES VILLAGE
Address .11467,uts 9hi/Tax Folio
r
LCO Desmipt ion Historically Designated: Yes No.
Owns Amsw / T �/e l% Master Permit #
Owns Address
Contracting Co.
d
Qualifier G
State # C X e0 57/b / Munidpal #
::,
CompazW
Mortgagor
Permit Type (circle ase): BUILDING ELECTRICAL
WORK DESCRIPTION
Square FL
Address s.2 Y AW C> �t
SS# hone 30-'S Y% f 6,9e' 7
Comps #
Ins. Co.
PAVING FENCE
?00 Estimated Cost (value) d`/ C
WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COM ENCEMENT AND YOUR FAILURE TO DO SO MAY RESULT IN YOUII
PAYING TWICE FOR 1WROVEMENTS TO YOUR PROPERTY (IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER
OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.)
Applicahor_ is hereby made to obtain a permit to do vmk 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.
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 work stated.
Signature
' 6 ' 1
Notary as to . 'ar m0ar Con& President
my ` LUIS C. U.ORET
CQMW WN CONVI9
' 4nao w
16
FEES: PERMIT �L- RADON C.C.F
APPROVED:
Zoning Building
Notdry as to Com
My Commission
0
WIS C:' UORET
�000!2719
1F1126 0 20W
ADX*4mqPoun
F "` �'Ln]
TOTAL DUE
Mechanical 2L 4 * 2f•t) I Plumbing Struchud Engineer
w�
Miami Shores Village Mechanical Permit
10050 NE 2nd Avenue
Phone: 305-795-2204 Permit Number: ME2002-159
Printed: 11 12 112002 Page 1 at 1
�rw�rr�.�r�rirrrrrw r r.rr+r�rri
Applicant: GAYLE PUMO
Owner: PUMO GAYLE
JOB ADDRESS: 1147 NE 97
Contractor THERMAL MANAGEMENT
Local Phone:
Parcel # 1132050170040
Permit Status: Approved
Work: REPLACE SYSTEM
ST
Contractor's Address: 7379 NW 54 ST
Legal Description: REV PL MIAMI SHORES SEC 8
6O_DD
k?�
it Expiration: 5/19/2003 Construction Value:
PB 43-51 LOT 4
Total Fees: $O.ft
Total Receipts: $0.00
If there Is no permit package accessible on the job -site for inspar_tnrs to verity. there will_be-no_ n— spections. Re -inspection
fee is $50.00, which must be paid in advance before calling for am
This Permit Is granted to the contractor or builder termed above to construct the bulk
ordinances pertaining thereto and with the understanding that the work will be performe
and approved by the proper municipal authorities. This Permit may be revoked at any t
authorization. A further condition upon which this permit is granted is the understanding
ordinances and regulations pertaining to the work covered hereby whether shown on th
by his agents, servants or employees.
gid; �P-�. �•� �� �� (INSPECTOR)
In cwrfsideration of the issuance to me of this permit, i agree to perform the work oow
with the pians, drawings, statements or specifications submitted to the proper authodtk
myself, my agent, se is or
(1
(Contractor or Bul
BLK 180 LOT
THERMAL. MANAGEMENT UMK OR AMtsJt1CA, KA
7779 54TH 87gEET 7s
MIAFAI, Fl 77198
PAYro
VI 114
oa
xx
1531
Date�-
�� ! �J
DOLLARS
o,w� en wa.
Memo /�!`�Np �U/yl /
i/ av
1:0 6 700 3 98 5t: 003062625925iis i53
4
S
�
-
i
Ir
Garage
Sheet 1
®AM22 x 24
2000 dm
44x10
tatthen Dinning Family
8`
282 dm
258 dm _ S P
18
10"
102 dm
6`
Bath Closet
113 dm8"
Living Room
9"
B om 1 - ----.
318 dm
Job #:
Performed by CARL.OS H for;
Mark Pumo
1147 NE 87 St
Miami Shores, Fl 33138
Phone: 305-7588783
282 dm
P
Room 2
�4248 On
12` 9P
8•" 113 dm
Heh Bath 2
P 100 Cfm
Bedroo 3 10,
322 dm
Thermal Management Inc. Scale: 1: 102
Page 1
7379 NW 54 St Right -Suite Residential A
Miami, Fl 33166 5.8.21 RSR31277
Phone: 305.471-0999 Fax:305-883-4383 2002 -Nov -1517:05:58
D.14 Downents%Wdghtsoft HVA...
Duct System Summary
Entire House
Thermal Management Inc.
Job:
Date: 11115102
By: CARLOS H
7578 NW 54 St. Muni, R 38188 Phone: 305471-0599 Fax: 3ON031883 EMGH: THERMAL MANAGEMENT@YAHOO.COM Web: W W W.THERMALMNGT.COM
Project• i
For. Mark Pumo
1147 NE 87 St, Miami Shores, FI 33138
Phone: 305-756-6783
External Static Pressure:
Pressure tosses:
Available Static Pressure:
Friction Rate:
Actual AVF:
Total Effective Length (TEL):
HEATING
COOLING
0.50 in H2O
0.50 in H2O
0.00 in H2O
0.00 in H2O
0.50 in H2O
0.50 in H2O
0.133 in/100ft
0.133 in/100ft
2000 cfm
2000 cfm
377 ft
Supply Branch Detail Table
Name
Dsn
(Stuh)
Dsn
(ch)
Dsn
(in H20)
Dsn
FR
Dia
(in)
Rect
Sz (in)
Duct
Matt
Actual
Ln (ft)
Equiv
Ln (ft)
Tmk
Mhe"
c 6378
256
0.42
0.209
8
Ox 0
VIFx
19.0
180.0
st1
LMV Rte+
h 1488
113
0.42
0.170
6
Ox 0
ViFx
29.9
215.0
st2
sedroW 1-A
h 4199
318
0.42
0.167
9
Oxo
VIFx
34.7
215.0
st3
Dedrow M
h 4256
322
0.42
0.133
10
Ox 0
VIFx
54.1
260.0
WA
saM 2
c 2493
100
0.42
0.136
6
Ox 0
VIFx
47.3
260.0
WA
Rot 2-A
h 3252
246
0.42
0.134
9
Ox 0
VIFx
50.4
260.0
WA
Living RSA
h 1488
113
0.42
0.169
6
Ox 0
VIFx
31.4
215.0
st2
DWdMg a Faroiy
h 3725
282
0.42
0.171
9
Ox 0
VIFx
28.8
215.0
st2
Dbft a Family -A
h 3725
282
0.42
0.170
9
Ox 0
V1Fx
29.6
215.0
st2
Bath 1
c 2547
102
0.42
1 0.171
6
Ox 0
VIFx
29.1
215.0
st3
Supply Trunk Detail Table
wnghtsoft RlgM-Suite ResWWW A 5.8.21 RSR31277 2002 -Nov -15 17:050D
D.Wy Doan ftWdghtft HVAC1Mark ..np CW. = Mie Mentation = N Page 1
Trunk
Htg
Clg
Vel
Diam
Rect Duct
Duct
Name
Type
(cfm)
(cfm)
(fpm)
(in)
Size (in)
Material
Trunk
st2A
Peak AVF
662
617
843
12
0 x 0
VinlFlx
st2
W
Peak AVF
1451
1347
821
18
0 x 0
VInIFIX
st1
st3
Peak AVF
420
396
770
10
0 x 0
VinlFlx
st1
st1
Peak AVF
2000
2000
655
22
10 x 44
ShtMetl
wnghtsoft RlgM-Suite ResWWW A 5.8.21 RSR31277 2002 -Nov -15 17:050D
D.Wy Doan ftWdghtft HVAC1Mark ..np CW. = Mie Mentation = N Page 1
Name
:Difi`us
- Sz (in)
Design
AVF (dm)
Design
(in H2O)
Design
FR
Vel
(fpm)
Dia
(in)
Rect Sz
(in)
Stud/Joist
Opening (in)
Duct
Mat!
Trunk
Return
Branch
Detail
Table
Name
:Difi`us
- Sz (in)
Design
AVF (dm)
Design
(in H2O)
Design
FR
Vel
(fpm)
Dia
(in)
Rect Sz
(in)
Stud/Joist
Opening (in)
Duct
Mat!
Trunk
rb0
0 x 0
2000
0.08
0.133
545
24
24 x 22
ShMt
4= wng htsoft Rj9M-Sujoe Rakfodlel JS 5.8.21 RSR31277 2UO2-Nov-1517:05:00
JM WMY a►Wd9hteott NVACWIWkPu..np Ce1c - MJ8 O *Meti. - N Pape 2
Building Analysis Job:
Date: 11/15/02
Q Entire House By. CARLOS H
Thermal Management Inc.
7378 NW 54 St, Mlw 1, FI 33168 Phone: 305.471-0999 Fax 3054834M Email: THERMAL MANAGEMENTOYAHOO.COM Web: W W W.THERMALMNGT.COM
Project• •
For. Mark Pumo
1147 NE 87 St, Miami Shores, F133138
Phone: 305-756-6783
Jesian Conditic
Location:
Indoor:
Heating
Cooling
Miami, Int'I AP, FL, US
Indoor temperature ("F)
70
70
Elevation: 13 ft
Design TO (°F)
20
20
Latitude: 26°N
Relative humidity (%)
30
50
Outdoor: Heating Cooling
Moisture difference (grub)
-10.2
65.9
Dry bulb (°F) 50 9D
Infiltration:
4437
19.0
Daily( F) 11 (L)
Method
Simplified
13.6
_
Construction quality
Average
7.8
Wind speed (mph) 15.0 7.5
Fireplaces
0
0.0
i
Heating
Component
Btuhlfe
Btuh
% of load
Walls
2.8
3739
16.0
Windows
21.7
6934
29.7
Doors
5.2
109
0.5
Ceilings
1.4
2490
10.7
Floors
2.5
4437
19.0
Infiltration
2.1
3175
13.6
Ducts
1821
7.8
Piping
0
0.0
Humidification
0
0.0
Ventilation
611
2.6
Total
23317
100.0
Component
Btuh/fF
Btuh
% of load
Walls
3.3
4342
10.0
Windows
61.3
19597
45.1
Doors
9.3
195
0.4
Ceilings
4.1
7371
16.9
Floors
0.0
0
0.0
Infiltration
1.1
1580
3.6
Ducts
6255
14.4
Ventilation
608
1.4
Internal gains
3550
8.2
Blower
0
0.0
Total
43498
100.0
Overall U -value = 0.179 Stuh/fe--°F
nghtsoft Right-SUKeR eiderdiel,M5.8.21RSR31277 2D02-NOV-15 17'05-'00
-r--
wD:1My D0MMWft1WrlgMsoft WACWe;kPwno.rrp Calc = MJS Orientation = N Page 1
Project Summary Job:
"o Entire House Date: 1111902 H
o Thermal Management Inc.
7379 NW 54 St. Miwni. F1 33166 Phare: 305471-0888 Fax: 305883.4383 Email: THERMAL MANAGEMENTCYAHOO.COM Web: W W W.THERMALMNGT.COM
Project Information
For. Mark Pumo
1147 NE 87 St Miami Shores, F133138
Phone: 305-7 783
Notes:
Design Information
Weather. Miami, Int'I AP, FL, US
Winter Design Conditions Summer Design Conditions
Outside db
50 OF
Outside db
90
OF
Inside db
70 OF
Inside db
70
OF
Design TD
20 OF
Design TD
20
OF
Daily range
L
Relative humidity
50
%
Moisture difference
66
grub
Heating Summary
Sensible Cooling Equipment Load Sizing
Building heat loss
22706 Btuh
Structure
42890
Stuh
Ventilation air
28 cfm
Ventilation
608
Btuh
Ventilation air loss
611 Btuh
Design temperature swing
3.0
OF
Design heat load
23317 Btuh
Use mfgg. datan
Rate/swIng multiplier
0.95
Infiltration
Total sens. equip. load
41280
Btuh
Method
Simplified
Latent Cooling Equipment Load Sizing
Construction quality
Average
Fireplaces
0
Internal gains
1000
Stuh
Ventilation
1245
Btuh
Heating Cooling
Infiltration
3233
Btuh
Area (ftp
1805 1805
Total latent equip. load
6239
Stuh
Volume (fe)
14440 14440
Air changes/hour
0.60 0.30
Total equipment load
47518
Stuh
Equiv. AVF (cfm)
144 72
Req. total capacity at 0.70 SHR
4.9
ton
Heating Equipment Summary
Cooling Equipment
Summary
Make n/a
Make Rheern
Trade
Trade Rheem RKKA Series
n/a
RKKA-AD60Y
Efficiency
100 EFF
Efficiency
10.1 SEER
Heating input
0 Btuh
Sensible cooling
42000
Btuh
Heating output
23317 Btuh
Latent cooling
18000
Stuh
Heating temp rise 11
OF
Total cooling
60000
Btuh
Actual heating fan
2000 cfrn
Actual cooling fan
2000
cfm
Heating air flow factor
0.088 cf nBtuh
Cooling air flow factor
0.047
cfm/Btuh
Space thermostat
Load sensible heat ratio
87
%
Printout certified by ACCA to meet all requirements of Manual J 8th Ed.
wng hrtsoft RW Sale Raaldendal J8 5.8.21 RSR31277 2002-Now1517,05:00
0461y DocirenUMMhooft HVACW ftPwr o.np Cale = MJ8 Orlenwim = N Page 1
Right -l8 Worksheet Job:
Entire House Date: 11H6102
Thermal Management Inc. By: CARLOS H
7379 NW 54 SL Miami. Fl 33166 Phone: 305.471.OM Fete 306.8834383 Emae: THERMAL MANAGENIEMOYAHoo_CeM Wab- W Ww T6rERum Y1NPT rnu
1
Roan name
Entire House
IOtchen
2h
188.0 ft
15.0 ft
8.0 ft d
8.0 ft heaNcool
4
Room dimensions
12.0 x 15.0 ft
5
Room ew
1805.0 if
180.0 its
Ty
Construction
U -value
or
HTM
Area((ft}�p
Load
Area
Load
number
I
(Bddtlft;'F)
(Btuhlft'1
or pedmeter (ft)
(Blah)
or perimeter (ft)
( h)
Heat
Cool
Gross
NIPS
Heat
Cad
Gross
tWIS
Heat
Cod
6
V6
13BB4)=ns
0.109
n
2.18
2.39
264
196
427
468
0
0
0
0
1A-clob
1.080
n
21.60
37.22
24
0
518
893
0
0
0
0
1A-clomd
1.270
n
25.40
41.00
44
0
1116
1804
0
0
o
C
1388 Oocros
0.109
a
2.18
2.39
352
284
619
678
0
0
0
C
11
1A-clob
1.080
a
21.80
95.66
88
0
1469
6498
0
0
0
0
Y)I
13AA-0oc
0.584
a
11.88
15.53
58
44
514
684
0
0
0
0
t -.G
1A -slob
1.080
a
21.60
95.56
12
0
259
1147
0
0
0
0
13BB-Ooans
0.109
s
2.18
2.39
424
283
617
676
0
0
0
0
1A.clob
1.080
s
21.80
42.32
72
72
1656
2824
0
0
0
0
to -slob
1.080
s
21.60
40.32
46
48
1037
1786
0
0
0
0
11 EO
0.280
s
5.20
9.28
21
21
109
196
0
0
0
0
4)I
13664)ocsns
0.109
w
2.18
2.39
344
304
86.9
726
120
104
227
248
t�---GG
1A-clob
1.080
w
21.60
95.56
24
0
511
2282
0
0
0
0
I D-c2ob
0.650
w
13.00
77.32
16
0
208
1237
18
0
208
1237
13AA4)oc
0.684
w
11.68
15.63
64
52
807
808
0
0
0
0
1A-clob
1.080
w
21.60
95.58
12
0
259
1147
0
0
0
0
P
12C4Osw
0.091
-
1.82
1.89
160
180
291
303
96
96
176
182
C
168-13ad
0.070
1.40
4.14
1653
1663
2314
6850
180
180
252
746
C
168-15ad
0.061
-
1.22
3.81
112
112
137
404
0
0
0
0
C
16B-19ad
0.049
-
0.98
2.90
40
40
39
118
0
0
0
0
F
22A-tpm
1.180
23.80
0.00
1749
186
4437
0
180
15
354
0
F
22A4ph
1.358
27.15
0.00
55
0
0
0
0
0
0
0
Envelope I
17710
315051
1 1215
2413
12
a) hilwation
3176
1580
253
126
b) Ventilation
0
0
0
0
13
Internal gains: 230
6
1400
�5 1200
2
2
2
24300
Less external load
0
0
0
0
ss
R
iisbib
tln
o
o
s
a
14
Subtotal
20885
3834
1i
486
6218
15
Dud loads
0%
17%
1821
. 6265
1596
2296
228
1162
Totalroom bad
I
22706
42890
1 1711
6378
Air required (din)
2000
2000
151
297
Printout certified by ACCA to meet all requirements of Manual J 8th Ed.
L wngtit5 >ft RIW-Suite ResMentlel JB 6.8.21 1161131277 7A02 -Nov -1517:05:
L� D,Wy Doma ents%Vfttteat WACWIarkPumo.rrp Calc = MJS Ori M!Dn = N Page 1
Right -J8 Worksheet .lob.
° Entire House Date: 111151t}2
By: CARIAS H
• Thermal Management Inc.
7379 NW 54 St, MIEN, F133186 Phone: 305471 -OM Fax 3064r,4383 Emdl: THERMAL_ MANAGEMENTOYAHOO.COM Web: WWW_THERMALNNnT MAI
1
Roam name
Dhxdng & Family
am 1
2
ExpOsed wall
24.0 ft
8.0 ft
Roan
8.0 ft hmVcool
8.0 ft healAmol
4
dimensions
25.0 x 15.0 ft
5.0 x 8.0 ft
5
Roan gree
375.0 fP
40.0 W
TY
Construcdon
U -Value
Or
MTM
Area (ftp
Load
Area (112)
Load
number
(Btuhlft''F)
(Btuhlft')
or perimeter (ft)
MM)
or perimeter (t)
(Stuh)
Heat
Coni
Gross
NO$
Heat
Cod
Gross
NIPS
Heat
Cool
6
13BB4Oocros
0.109
n
2.18
2.39
136
92
201
220
0
0
0
0
1A-clob
1.080
a
21.60
37.22
0
0
0
0
0
0
0
0
1A-cland
1.270
n
25.40
41.00
44
0
1118
1604
0
0
0
0
Ih1
13BBAomw
0.109
a
2.18
2.39
56
36
78
88
0
0
0
3
11
L --G
1A -slob
1.080
a
21.60
95.56
20
0
432
1911
0
0
0
0
Vii
13AA4Ooc
0.584
a
11.68
15.53
0
0
0
0
0
0
0
0
--G
1A-clob
1.080
a
21.60
95.56
0
0
0
0
0
0
0
0
Vh1386.00cma
0.109
s
2.18
2.39
0
0
0
0
0
0
0
0
to-C1ob
1.080
S
21.60
42.32
0
0
0
0
0
0
0
0
1A-C1ob
1.080
s
21.60
40.32
0
0
0
0
0
0
0
0
11 EO
0.280
s
5.20
9.28
00
0
0
0
0
0
0
yt
13BB-Oocros
0.109
w
2.18
2.39
0
0
0
0
0
0
0
0
1A-clob
1.080
w
21.60
95.56
0
0
0
0
0
0
0
0
tF--GG
1D-c2ob
0.850
w
13.00
77.32
0
0
0
0
0
0
0
0
Y)I
13AA-Ooc
0.564
w
11.68
15.53
0
0
0
0
64
52
607
808
�-G
1A-clob
1.060
w
21.60
95.56
0
0
0
0
12
0
259
1147
P
12C-0sw
0.091
-
1.82
1.89
64
64
11e
121
0
.0
0
0
C
188-13ad
0.070
-
1.40
4.14
375
375
$25
1554
0
0
0
0
C
168-15ad
0.081
-
1.22
3.81
0
0
0
0
0
0
0
0
C
168-198d
0.049
-
0.98
2.90
0
0
0
0
40
40
39
116
F
22A4pm
1.180
-
23.60
0.00
375
24
586
0
40
8
189
0
F
22A-Iph
1.358
-
27.16
0.00
0
0
0
0
0
0
0
0
Envelope to"aln
3037
5698
1095
2071
12
81.0% on
405
202
135
67
b Ventilatlon
0
0
0
0
13
InterrralOains: 230
��a 12DD
0
0
0
0
Less external load
0
0
0
0
Less tram
0
0
0
0
Redistribution
0
018
54
14
Subtotal
3442
5897
1248
21 92
15
Dud bads
8%
16%
283
956
8%
16%
103
355
Total man load
3725
8864
1350
2647
Air required (c*n)
328
32DI
119
119
Printout certified by ACCA to meet all requirements of Manual J 8th Ed.
wrsgFltSOR RIpM-Suite R9sidentlal JB 5.8.21 RSR31277-iow1517:05:00
D.ft DocmneNstWrightsoa HVACOAarL*t mo.rrp Calc - MJB OdenWMon = N Pap 2
Right48 Worksheet
° Entine House
'0
Thermal Management Inc.
7379 Nw 54 St, Miami, n 33168 Phone: w5.471-0999 F. w&w3-4w Etnwl: THERMAL
Job:
Date: 11/15/02
By: CARLOS H
wan www Tar UAI unrrzr rnu
1
Roan name
Closet
Bedroom 1
2
Exposed wail
0.0 ft
40.0 ft
3
Ceiling height
8.0 It heev000l
8.0 R heaticool
4
Roan dimensions
7.0 x 8.0 It
1.0 x 254.0 R
5
Roan area
56.0 fr
264.0 W
Ty
Conauction
u-vww
Or
HTM
Area (ft')
Load
Area(R'�
oad
number
I
(BtulINVOF)
(B1uhIR')
or perimeter (ft)
(Btuh)
or peri (fti
i
Heat
Cool
Gras
NIPIS
Heat
Cool
Groes
NIPS
Heat
Cool
6
1366400ans
0.109
n
2.18
2.39
0
0
0
0
a
0
0
0
to-Ctob
1.080
n
21.60
37.22
0
0
0
0
0
0
0
0
1A-clomd
1.270
n
25.40
41.00
0
0
0
0
0
0
0
0
13BB-0oo ms
0.109
a
2.18
2.39
0
0
0
0
72
72
157
172
11
IA-clob
1.080
a
21.60
95.56
0
0
0
0
0
0
0
0
V�7
13AA-0oc
0.584
a
11.68
15.53
0
0
0
0
0
0
0
0
t -G
Webb
1.080
a
21.60
95.58
0
0
0
0
0
0
0
0
13884bcrns
0.109
s
2.18
2.39
0
0
0
0
120
84
183
201
1A-C1ob
1.080
a
21.60
42.32
0
0
0
0
36
38
778
1412
1A-clob
1.080
s
21.60
40.32
0
0
0
00
0
0
0
11E0
0.260
s
5.20
9.28
0
0
0
0
0
D
0
0
Y,V
13BB4Ooams
0.109
w
2.18
2.39
0
0
0
0
128
104
227
249
1A-c1ob
1.080
w
21.60
95.56
0
0
0
0
24
0
511
2282
t�---GC
1111c2ob
0.650
w
13.00
77.32
0
00
0
0
0
0
0
W/
13AA OCC
0.584
w
11.88
15.53
0
0
0
0
0
0
0
0
�--G
1Aclob
1.080
w
21.60
95.56
0
0
0
0
0
0
0
0
P
12C.Osw
0.091
-
1.82
1.89
0
0
D
0
0
0
0
0
C
188-13ad
0.070
-
1.40
4.14
0
0
0
0
254
254
370
1094
C
1613-15ad
0.061
-
1.22
3.61
56
56
88
202
0
0
0
0
C
166.19ad
0.049
-
0.98
2.90
0
0
0
0
0
0
0
0
F
22A-tpm
1.180
23.60
O.OD
0
0
0
0
254
40
944
0
2244ph
1.358
-
27.18
0.00
56
0
0
0
0
0
0
0
i
Envelope bss/gain
68
202
3170
5389
12
a) Infiltration
0
0
676
338
b) Ventilation
0
0
0
0
13
Internal gains: Occupants a 230
0
0
2
480
Appliances Q 1200
0
0
0
0
Less external load
00
0
0
Less transfer
0
0
0
0
Redistrlbulion
68
-202
34
101
14
Subtotal
0
0
3880
6286
15
Duct bads
8%
10%
0
0
8%
16%
319
1019
Total morn bad0
0
4199
7305
Air required (Ctm)
0 1
0
370
3411
Printout certified by ACCA to meet all requirements of Manual J Sth Ed.
Wr-1Q"1tSo19t Right-SuPoe ResidenW J8 5.821 RSR31277 2002 -Nov -1517:05:00
D:Wiy Docunw twrightsott HVAC%MerkPumo.mp Cale - MJ8 Orientation - N Page 3
Right -J8 Worksheet Job:
Entire House Off: 1111SM2
By: CARLOS H
Thermal Management Inc.
7379 NW 54 SL Miami, F133186 Phare: 305.471.0999 Fax: 305.9834983 Emelt: THERMAL_MANAGEMENTQYAHOO.COM Web: WWW.THERMALMNGTCM
1
Room nameliving
Room
Room 2
dwallheight
22.0 ft
30.0 ft
3
Ce
8.0 R heatftd
8.0 ft treaV000l
4
Room dimensions
22.0 x 15.0 R
16.0 x 14.0 ft
5
Roan area
330.0 ft'
224.0 IF
TY
Consbuctim
U-vakra
Or
HTM
Area (fP)
Load
Area (fF)
Load
number
I
(BtuW*F)
or perimeter (it)
(BWh)
or perimeter (ft)
(6tuh)
Heat
Cool
Grow
NVIS
Heat
Coot
Gnus
NMIS
Hast
Cool
81388.Oocros
0.109
n
2.18
2.39
0
0
0
0
128
104
227
248
1A-clob
1.080
n
21.60
37.22
0
0
0
0
24
0
518
893
���-----GGG
to-ctomd
1.270
n
25.40
41.00
0
0
0
0
0
0
0
0
L138B•Ooans
G
0.108
a
2.18
2.39
0
0
0
0
112
88
192
210
11
1A-clob
1.080
a
21.60
95.58
0
0
0
0
24
0
518
2293
13AA-Doe
0.684
a
11.88
16.53
0
0
0
0
0
0
0
0
to -club
1.080
a
21.50
95.56
0
0
0
0
0
0
0
0
1388.0ooms
0.109
8
2.18
2.39
176
107
233
255
0
0
0
0
WOW
1.080
s
21.60
42.32
0
0
0
0
0
0
0
0
1A-ctob
1.080
s
21.60
40.32
48
4e
1037
1788
0
00
0
11EO
0.200
s
5.20
9.28
21
21
109
195
0
0
0
0
bf
138840x=
0.109
w
2.18
2.39
0
0
0
0
0
00
0
1A•clob
1.080
w
21.60
95.56
0
0
0
0
0
0
0
0
1D<2ob
0.850
w
19.00
77.32
0
0
0
0
0
0
0
0
VN
13AA-Ow
0.684
w
11.88
15.53
0
0
0
0
0
0
0
0
- .a
1A•clob
1.080
w
21.60
95.56
0
0
0
0
0
0
0
0
P
12C.Osw
0.091
1.82
1.89
0
0
0
0
0
0
0
0
C
168-13ad
0.070
1.40
4.14
330
330
462
1368
224
224
314
928
C
168.15ad
0.081
-
1.22
3.61
0
0
0
0
0
0
0
0
C
168-1984
0.049
-
0.98
2.90
0
0
0
0
0
0
0
0
F
22A4pm
1.180
23.80
0.00
330
22
$19
0
224
30
708
0
F
22A-tph
1.358
27.18
0.00
0
0
0
0
0
0
0
O
Envelope bsslgain
2360
3604
I 2477
4573
12
8
372
185
507
252
b�Inhltratbrr
Venft*m
0
0
0
0
13
Internal gains
Appliances 1200
0
0
0
0
Less external load
0
0
Less transfer
0
0
0
0
Redisfibuution
18
54
21
62
14
Subtotal
2750
3843
3005
5117
1S
Dud bads
8%
18%
226
623
8%
16%
247
830
Total room toad
2978
4488
3252
5947
Air required (drn)
262
208
288
277
Printout certified by ACCA to meet all requirements of Manual J 8th Ed.
wng 1�tsafit Right-SuRe Residential J8 5.8.21 RSR31277 2OM-Nov-1517:05:00
D1MY Dooznw blWdgMsofl WACW wkPunw.rrp Cale - Mie Orientetion = N Page 4
Right -A Worksheet
° Entire House
• Thermal Management Inc.
Job:
Date: 11/15!02
By: CARLOS H
7378 NW 54 St, Miami, FI 33166 Phone: 30$471-0999 Fax: 3058834383 Emali: THERMAL MANAGEMENTOYAHOO.COM Web: W W W.THERMALMNGT.COM
1
Roan name
Bath 2
Bedroom 3
7.0 ft
42.0 ft
3
Ceding height
8.0 It heaUC001
8.0 It heath
4
Roan dimensions
8.0 x 7.0 ft
16.0 x 14.0 It
5
Roan area
56.0 ft'
224.0 ft'
Ty
Construction
U -value
Or
HTM
Area
Load
Area (if)
Load
number
I
(BWWft ='F)
(BtuhW)
or perimeter (ft)
(Btuh)
or perimeter (M
(
Heat
Cool
Gross
NIPIS
Heat
Cool
Gross
NIPIS
Heat
Cod
6
V)I
1388.Ooems
0.109
n
2.16
2.39
0
0
0
0
0
0
0
0
to-clob
1.080
n
21.80
37.22
0
0
0
0
0
0
0
0
1A-clomd
1.270
n
25.40
41.00
0
0
0
0
0
0
0
0
1388-Ooclns
0.109
a
2.18
2.39
0
0
0
0
112
Be
192
210
11
1A-Clob
1.080
9
21.60
95.56
0
0
0
0
24
D
518
2293
V)I
13AA-Ooc
0.584
a
11.68
15.53
55
44
514
684
0
0
0
0
i G
1A-C1ob
1.080
a
21.60
95.56
12
0
259
1147
0
0
0
0
Yjl
1368-0ocros
0.109
s
2.18
2.39
0
0
0
0
128
92
201
220
Webb
1.080
s
21.60
42.32
0
0
0
0
36
36
778
1412
to -clot
1.080
s
21.60
40.32
0
0
0
0
0
0
0
0
I{�-------;DG'
11 EO
0.260
s
5.20
9.28
0
0
0
0
0
0
0
0
0.109
w
2.18
2.39
0
0
0
0
96
96
2D9
229
Tj13BB-0ocros
1A-clob
1.080
w
21.60
95.56
0
0
0
0
0
0
0
0
1D-c2ob
0.650
w
13.00
77.32
0
0
0
0
0
0
0
0
yJ
13AA-Doc
0.584
w
11.68
15.53
0
0
0
0
0
0
0
0
Y -G
to -slob
1.080
w
21.60
95.58
0
0
0
0
0
0
0
0
P
12C-Osw
0.091
1.82
1.89
0
0
0
0
0
0
0
0
C
168-13ad
0.070
1.40
4.14
0
0
0
0
224
224
314
928
C
16B-15ad
0.061
-
1.22
3.61
56
56
68
202
0
0
0
0
16B-19ad
0.049
0.98
2.90
0
0
0
0
0
- 0
0
0
F
27A-4pm
1.180
-
23.60
0.00
56
7
165
D
224
42
991
0
F
22A-tph
1.358
-
27.16
0.00
0
0
0
0
0
0
0
0
Envelope losalgain
1007
2032
3202
5282
12
a) Infilbabon
118
59
709
353
b) Ventilation
0
0
0
D
13
Internal gains: Occupams a 230
0
0
1
230
Appliances 1200
0
0
0
0
Less external load
0
0
0
0
Less transfer
0
0
0
0
Redistribution
18
54
21
82
14
Subtotal
1143
2145
3933
5937
15
Duct bads
8%
16%
94
348
B -A
16%
323
963
Total roan load
1237
2493
4256
6900
Air required (afro)
109
116
375
322
Printout certified by ACCA to meet all requirements of Manual J 8th Ed.
rT_ w1`NQ"t50'tt RW*,%ite ResidmtiW JB 5.8.21 RSR31277 2002 -Nov -1617:05:00
!aa DiMy Doasnent %Wdghtsofi HVACWIarkPunw.np Calc = MJ8 Orierdatlon = N Page 5
AhQ
Right -A Worksheet Boa:
Entire House Date: 11115f02
tb By: CARLOS H
Thermal Management Inc.
7379 NW 54 St, Miami. FI 33186 Phone: 305.471-0989 Fax: 305-0834383 Erta t THERMAL_MANAGEMENT®YAHOOZOM Web: WWW.THERMALMNOT.COM
1
Roan name
Ha8
E) pose' waft
0.0 ft
3
m9 t
8.0 ft hew ooi
4
Roan dimensiats
8.0 x 7.0 fl
5
Room area
55.0 IF
Ty
Construction
U -value
Or
HW
Area2)
{meter
Load
Area
Load
number
I
(BWhd OF)
i8tu
or Ped (ft)
(Me )
or i�
Heat
Cod
Gross
NIPIS
Heat
Cool
Gross
NIPS
Heat
Cod
6
1388-OOcros
0.109
n
2.18
2.39
0
0
0
0
1-G
1Aclob
1.080
n
21.60
37.22
0
0
0
0
��----GG
1Acland
1.270
n
25.40
41.00
0
0
0
0
1388-oocros
0.109
a
2.18
2.39
0
0
0
0
i t
1A-c/ob
1.080
a
21.80
95.56
0
0
0
0
Vjl
13AA-Ooc
0.584
a
11.68
15.53
0
0
0
0
1 G
1A-clob
1.080
a
21.60
95.56
0
0
0
0
ns
0.109
s
2.18
2.39
0
0
0
0
TE�1
1A-clobA�C1pb
1.080
s
21.60
42.32
0
0
0
0
tAclob
1.080
s
21.60
40.32
0
0
0
0
11E0
0.280
s
5.20
9.28
0
0
0
0
16
13BB-Oocros
0.109
w
2.18
2.39
0
0
0
0
1A-ctob
1.080
w
21.60
95.50
0
0
0
0
0.650
w
13.00
77.32
0
0
0
O
L1D-c2ob
13AA-Ooe
0.684
w
11.68
15.53
0
0
0
0
-0
1A -c10
1.080
w
21.00
95.55
0
0
0
0
P
12C-0sw
0.091
-
1.82
1.89
0
0
0
0
C
168.13ad
0.070
. -
1.40
4.14
56
56
78
232
C
168.15ad
0.081
-
1.22
3.61
0
0
0
0
C
188-19ad
0.049
-
0.98
2.90
0
0
0
0
F
22A-tpm
1.180
-
23.80
0.00
56
0
0
0
F
22A-Vh
1.358
-
27.18
0.00
0
0
0
0
Envelope loss/gain
1
78
232 1
1
12
a Infiltration
0
0
b) Vandietion
0
0
13
Internal gains: Occupants a 230
0
0
AppBances Q 1200
0
0
Less external bad
0
0
Less transfer
0
0
Redis tMon
78
-232
14
Subtotal
0
0
15
Dud loads
85L
16%
0
0
Tote] mom load
0
0
Air required {dm}
0
0
Printout certified by ACCA to meet all requirements of Manual J 8th Ed.
%AW"QkVI.SoR RW-Sufte Residential A 5.8.21 RSR31277 2OD2-Nar1517:05:00
D:WIy Doaxra<rda1VlrVtwft WACWIarkR=.rrp Cale = MJ8 Orientation = N Page 6
Miami Shores Village
10050 NE 2nd Avenue
Phone: 305-795-2204
Printed: 4/18/2005
Applicant: GAYLE
Owner: PUMO
JOB ADDRESS:
1147 NE 97
Contractor MARS POOLS
Local Phone: 954-214-2844
Mechanical Permit
Permit Number: MC2005-41
Page 1 of 1
PUMO
GAYLE
ST
Contractor's Address: 1000 E. ATLANTIC #11
Parcel # 1132050170040 Legal Description: REV PL MIAMI SHORES SEC 8 PB 43-51 LOT 4
Fees:
Description
Amount
FEE2005-5001
Building Fee
$100.00
FEE2005-5002
CCF
$0.60
FEE2005-5003
Training and Education Fee
$0.20
FEE2005-5004
Technology Fee
$2.50
FEE2005-5005
Submittal Fee
($50.00)
Total Fees:
$53.30
Permit Status: APPROVED Permit Expiration: 9/26/2005 Construction Value: $800.00
Work: POOL HEATER
Total Fees: $53.30
Total Receipts: $0.00
PR 19 PAM
41
BLK 180 LOT
Signed: (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 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.
Signed: (Contractor or Builder) BY:
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
BUILDING
PERMIT APPLICATION
FBC 2001
Permit No. i" I C
Master Permit No.
7
Permit Ty=pe (circle): Building Electrical Plumbing Mechanical Roofing
Owner's Name (Fee Simple Titleholder) % 4 Jai q Phone # : O 7 �r "_� 171F17
Owner's Address __ 147 A11lC g7
-
City_State , - Zip
Tenant/l,essee Name Phone #
Job Address (where the work is being done) —J%t-Z W/i 51--010Z_-
City __ Miami Shores Village _ County Miami -Dade Zip
Is Building Historically Designated YES NO
Contractor's Company Name_ /�! �lv,�/,gyp`` !3 _ Phone #
Contractor's Address A904) _
City_ 1 �"+i►?v �1't? C.- ----- State Gt- _ —zip -3 67 - — -
Quali f er
State Certificate or Registration No.402 3'25S' `�2 5 O _ Certificate of Competency No._ O
Architect'Engineer's Name (if applicable)
4�
$ Value of Work For this Permit F00
Phone #--- - -- - -
Square Footage Of Work:
Type of Work: []Addition ❑Alteration []New ❑ Repair/Replace ❑ Demolition
Describe Work: — ?dy /
1L� LA-' ** * �****�****««* *******Fees** **,a*** *** **** * ***•* *
Submittal Fee S Permit Fee $ 4V 4lG; �'�L.� CCF $ CO/CC
r
Notary $` #-- Training/Education Fee $- i' - `�' Technology Fee $
Scanning S Radon $ Zoning Bond $
Code Enforcement $ Structural Plan Review, $
Total Fee Now Due $ y <
(Continued on opposite side) ���
Bonding Company's Name (if applicable)
Bonding Company's Address
City
State
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
City
State
Zip
Zip
Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has
commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating
construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS,
WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC.....
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.
"WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT 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."
Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
Signature _
Owner or Agent
The foregoing instrument was acknowledged before me this
day of ^ , 20 ___, by
who is personally known to me or who has produced
As identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
My Commission Expires:
Signature �a`�"� / "2�
---
Contractor
The foregoing instrument was acknowledged before me this 2,,Y
day of 20 e f, by Afe'�61 k ✓r
who is personally known to me or who has produced
as identification and who did take an oath.
NOTARY PUBLIC: M �,� �«„��+•����K`ILGORE ”""�
Sign: tlfeabtt # D00103451
—120p6-- S—
Print: sondedonugh
My Commission Ex
-a
APPLICATION APPROVED BY: _ %� '� Plans Examiner
Engineer
Zoning
chc 05/13/03