CC-12-1928 (2) M'�_o I foo 15"2
NOTE: ALL SHEET MUST BE REVIEWED
MIAMI-DADE COUNTY BUILDING AND NEIGHBORHOOD COMPLIANCE DEPARTMENT
Herbert S.SafFir Permitting and Inspection Center
11805 SW 26th Street(Coral Way) * Miami, Florida 33175-2474 a(786)315-2100
APPLICATION FOR MUNICIPAL PERMIT APPLICANTS
THAT REQUIRE PLAN REVIEW FROM MIAMI-DADE FIRE RESCUE
AND/OR DEPARMENT OF ENVIRONMENTAL RESOURCES MANAGEMENT
PROVIDE MUNICIPAL PROCESS NUMBER HERE
LL� Job Address 70Sv B;atal,7,e 11)14. ¢Z Contractor No. C66 0.!'6.00o1Z 00 Last four(4) 9 digits of Qualifier No.
Z W Folio F
0 Lot Block 0 Contractor Name Of N
a 0 to
QualifierName thar®rs eirdemse
Subdivision PBpg O
03 Address 41000 S4/ 30 Avryu r
Metes and bounds City Ff. laudtr4wlt state.E1_-_Zip M312
[ ] New Construction on [ ] Demolish
Vacant Land [ ] Shell Only Current use of property �7terasrll17t
Alteration Interior
o� [rl [ ] Addition Attached
[ ] Alteration Exterior [ ] Addition Detached Description of work Alert—i- A-"+ee 4l IG04041
W
lu C [ ] Relocation of Structure [ ] Re-Roof
IL [ ] Enclosure [ ] Foundation Only
[ ] Repair Sq.R. Units Floors
[ ] Re air Due to Fire Value of Work $�S5 aha
[ ] MBLD" N [ ] Chg.Contractor W Owner Puhh"v .Suver AretrY5 A
Category [ ] Re-Issue Address l'0 kik 41PI
[ ] MELE [ ] Re-Stamp w City talks l4-nState zip
—
2 [ ] MLPG [ ] Revision W Phone IV- `ff` Flit[ ] MMEC [ ] Not Applicable for LU Last four(4)digits of
[ ] FIRE ¢ Fire O
Owner's Social Security No.
i'
o
Name/''ty 74f Owner A&6(oa Address Z Address %&&I Mkt 1U7� Arewsse
ff
20 City State Zip vz
ToCity I '?��r�a State F` Zip 33172
W
Phone_4S�N- e4f7-#%SG Phone W-Sell-7175'
1 am requesting a Special Request Plan Review(SRI)to be scheduled as soon as possible at the rate of$190 for the first hour
f and$65 per each additional hour in addition to the review fees.Minimum charge one-hour.
IL C-0
NW� 1m Request: Date:
LLW 2nd Request: Date:
ani Request: Date:
I am requesting Optional Plan Review(OPR)to be scheduled as soon as possible at the rate of$75 for each discipline.
Additional review fees may apply.
o03go-
0
181 Request: Date:
o2nd Request: Date:
MM
31d Request: Date:
0
123_01-192 12/09
Department of Regulatory and Economic Resources
Plan Review&Development Approval Division
MIAMI-MAD 11805 SW 26th Street Suite 124
Miami,Florida 33175-2464
T 786-315-2800 F 786-315-2919
miamidade.gov
GENERATOR FUEL CONSUMPTION WORKSHEET
Facility: Process/Permit#:
Address: Folio Number#:
Date: Reviewed by:
GENERATOR
1. Type of Fuel: ❑ Diesel ❑ Gasoline ❑ Propane ❑ Natural Gas
2. Number of Generators:
(include new and existing for entire site) New: Existing:
3. Fuel Consumption of all Emergency
Generators at full (100%)load(Table 1):
(gallon/hour)
4. Exercise time: 5. Annual Fuel Usage(gal/yr):
(hour/week) _(3)x(4)x(52 weeks/yr)
6. Is(5) greater than any of the following amounts?
[5,400 gallons o asoline;64,000 gallons of diesel fuel;288,000 gallons of propane;8.8 million standard cubic feet of natural gas]
F1 Yes. RM. State and County Air Permit Applications need to be completed.Contact Air Facilities Section
at 305.372.6925 for instructions.
❑ No. Go to line 7.
7. Potential Annual Fuel Consumption(gal/yr):
_(3)x 500(hr/year)
8. Is(7)greater than any of the following amounts?
[5,400 gallons o asoline;64,000 gallons of diesel fuel;288,000 gallons of propane;8.8 million standard cubic feet of natural gas]
❑ Yes. MM. County Air Permit Application needs to be completed.
❑ No. Go to line 9.
9. Is there an other source of air emissions?
❑ Yes. MM. County Air Permit Application needs to be completed.
❑ No. Resubmit your plans w/com leted worksheet or make an appt.786.315.2800 to see an AIR Reviewer.
Table 1: List of Generators*
Fuel Consumption New/
No. Manufacturer Model kW Fuel @ full(100%)load Existing
1
2
3
4
5
Attach generator's specifications.
Total gal/hr
The information provided above is true to the best of my knowledge and corresponds to the referenced project site.
Name in Print Responsible Party/Title Signature
awh 06/12