14-523-0021C�D[Lco
I.
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 • (786) 315 -2100
APPLICATION F-0.4 `0UNICIPAL PERMIT APPLICANTS
THAT REQUIRE PLAN REVIEW FROM MIAMI -DADE FIRE RESCUE
AND /OR DEPARMENT OF ENVIRONMENTAL RESOURCES MANAGEMENT
PROVIDE MUNICIPAL PROCESS NUMNER HERE
Job Address 7400 SW 62nd Avenue SouthMiami
Contractor No.
LL0
° w
Folio Q9- 4036 - 000 -0290
WZ
00
Last four (4) digits of Qualifier No.
Contractor Name
Lot Block
Oa
Subdivision PBpg
o
Qualifier Name
U?
Address
Metes and bounds
City State Fl Zip
[ ] New Construction on
[ ] Demolish
Current use of property Health Cale
cn
Vacant Land
( ] Shell Only
Lu
( ] Alteration Interior
( ] Addition Attached
South Miami Hospital
Description of Work
Lu
w2
[ ] Alteration Exterior
[ ] Addition Detached
a.
[ ] Relocation of Structure
[ ] Re -Roof
Data Center Interior Renovations.
Sq. Ft. 1200 Units N/A Floors N/A
i
9
[ ] Enclosure
[ ]Foundation Only
[ ] Repair
[ ] Repair Due to Fire
Value of Work $300,000.00
LU
MBLD*
N
[ ] Chg. Contractor
W
Owner Qaptist Health South Florida
a.
Category _.
[ ) Re -Issue
i
Address $900 N. Kendall Drive,
[ ] MELE
N
[ ] Re -Stamp
City Miami State FL Zip 33176
c
[ ] MLPG
[ ]Revision
(n
k
W
786 596 -5940
Phone ( )
�
[ ] MMEC,
[ ] Not Applicable for
Last four (4) digits of
[ ] FIRE
e:
Fire
o
Owner's Social Security No.
Z
Name Carlos Sanchez - Need Permits
Owner Naya Architects.
Address PO Box 142013
4
z5
Uw
Address 2100 Ponce De Leon BLVD. Suite 1170
W
X
City Coral Gables State FL Zip 33114
Z
v Z
City Coral Gables State FL Zip 33134
E
Phone (305) 439 -7717
Ir w
Phone (305) 265 -7177
Z
I am requesting a Special Request Plan Review (SRI) to be scheduled as soon as passible at the rate of $ 110 for the first hour
:5 r-
Ir
and $65 per each additional hour In addition to the review fees. Minimum charge one -hour.
vILe
N w �
12d Request: Date:
W w �
2"' Request: Date:
3" Request: Date:
Z
1 am requesting Optional Plan Review (OPR) to be scheduled as soon as possible at the rate of $75 for each discipline,
a.
Additional review fees may apply.
zn
0
1 rt Request: Date:
a
O w
2"' Request: Date:
2K
Ir
31' Request: Date:
A
123_01 -132 12/09