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PLUMBING PERMITPermit No Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. \,�' , - T Owner's Name and Address \‘.A..4% 4�-�' _._Yr r.CJtNA- No. ._ _ _--.. Street__- -_. -1 q .e• - _i - .. - ... Registered Architect and /or Eng' �; ----------- _-- - -_ - _. _ .__ V..4%__ f..__ No. BP • STATE OF FLORIDA, COUNTY OF DADE. J Size Septic Tank -Type of Tank Feet of Drain Tile__ - ' List. Fe of Tank Nature of Water Suppl MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMEM APPLICATION FOR PLUMBING Employing Plumber's Name Location and Legal Description Lot_ �l��L! SD I °Y ' lock__ —__ Subdivision.... .1_ Street a�.c_.L.._._q... S Street and Number where work is to be performed —No State work to be performed and purpose of building (By Floors)... New Building r� __._._ Remodeling_..__ __. —_ Addition_ (Signed) .._ e .. - - Date treat_ Repairs No. of Stories. . C /' Capadty Gals. . Drain F •. Well Amount of Permit $ /C - (Signed)_ d_ _.- The undersigned applicant for this building permit does hereby certify that he understands and accepts his ob gatfons as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Pennanent Supplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub- contractors employed by him in the work to be performed under this permit; and will post or cause to be posted' for inspection on the site of the work such public notice or notices as are required by tlie Act. The undersigned agrees to employ only such sub- contractors, on work to be p ed under this permit, as are licensed by Miami Shores Village. My Commission Expires Notary Public, State of Florida Master Plumber. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and.says that he is the__— of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. s , NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made•necessary by improper notice for inspection, or faulty materials and /or workmanship. CLOSETS BATH TUBE SHOWERS LAVA. TORIES SINKS SLOP SINKS LAUNDRY rues U RINAL/ CATCH BASIN FLOOR DRAIN DRINKING FOUNT'NB TOTAL FIXTURES CONTR. 6T / '/ RI --1_ / I y / , CHECK SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SWING POOL CONTR. LINT / / OM - -- _ CHECK Permit No Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. \,�' , - T Owner's Name and Address \‘.A..4% 4�-�' _._Yr r.CJtNA- No. ._ _ _--.. Street__- -_. -1 q .e• - _i - .. - ... Registered Architect and /or Eng' �; ----------- _-- - -_ - _. _ .__ V..4%__ f..__ No. BP • STATE OF FLORIDA, COUNTY OF DADE. J Size Septic Tank -Type of Tank Feet of Drain Tile__ - ' List. Fe of Tank Nature of Water Suppl MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMEM APPLICATION FOR PLUMBING Employing Plumber's Name Location and Legal Description Lot_ �l��L! SD I °Y ' lock__ —__ Subdivision.... .1_ Street a�.c_.L.._._q... S Street and Number where work is to be performed —No State work to be performed and purpose of building (By Floors)... New Building r� __._._ Remodeling_..__ __. —_ Addition_ (Signed) .._ e .. - - Date treat_ Repairs No. of Stories. . C /' Capadty Gals. . Drain F •. Well Amount of Permit $ /C - (Signed)_ d_ _.- The undersigned applicant for this building permit does hereby certify that he understands and accepts his ob gatfons as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Pennanent Supplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub- contractors employed by him in the work to be performed under this permit; and will post or cause to be posted' for inspection on the site of the work such public notice or notices as are required by tlie Act. The undersigned agrees to employ only such sub- contractors, on work to be p ed under this permit, as are licensed by Miami Shores Village. My Commission Expires Notary Public, State of Florida Master Plumber. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and.says that he is the__— of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. s , NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made•necessary by improper notice for inspection, or faulty materials and /or workmanship. - .Pent No. OWner's Name and Address Registered Architect and/or Engineer_ Dade) Gas Company Employing Plumber's Name __- Amount of Permit $ My Commission Expires MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT No. ( Signed )_ ( Signed )_ 67,3- /te/ 1 Date 10-26-67 Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or,other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. A. R. Roy Jr. 1207 No. Street N.E. 92 St. , . 955 East 25 St. Street Location and Legal Description Lot_._ Subdivision Street and Number where work is to be performed—No. —1207 11.AE..__92 _St. Street State work to be performed and purpose of building (By Floors) ROUGH & SET I3BQ GRILL — 2 100# Gas New Building Remodeling Addition Repairs No. of Stories ...... Size Septic Tank_ _Type of Tank_ Capacity Gals Feet of Drain Tile _Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: City—Well _Size of Soakage Pit Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts is obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub-contractors employed by him in the work to be performed under this permit; and will post or cause to be posted' for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such sub-contractors, on rk to be performed under this permit, as are licensed by Miami Shores Village. STATE OF FLORIDA, ss. COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. Notary Public, State of Florida NOTE: A re-inspection fee of $L00 will be made when such re-inspection is made necessary by improper notice for inspection, or faulty materials and/or workmanship. CLOSETS BATH TUBS SHOWERS LAVA- TORIES SINKS SLOP SINKS LAUNDRY TUBS URINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT• NS TOTAL FIXTURES CONTR. LIST -.- CHECK SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SW IM'G POOL --- CONTR. LIST CHECK - .Pent No. OWner's Name and Address Registered Architect and/or Engineer_ Dade) Gas Company Employing Plumber's Name __- Amount of Permit $ My Commission Expires MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT No. ( Signed )_ ( Signed )_ 67,3- /te/ 1 Date 10-26-67 Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or,other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. A. R. Roy Jr. 1207 No. Street N.E. 92 St. , . 955 East 25 St. Street Location and Legal Description Lot_._ Subdivision Street and Number where work is to be performed—No. —1207 11.AE..__92 _St. Street State work to be performed and purpose of building (By Floors) ROUGH & SET I3BQ GRILL — 2 100# Gas New Building Remodeling Addition Repairs No. of Stories ...... Size Septic Tank_ _Type of Tank_ Capacity Gals Feet of Drain Tile _Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: City—Well _Size of Soakage Pit Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts is obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub-contractors employed by him in the work to be performed under this permit; and will post or cause to be posted' for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such sub-contractors, on rk to be performed under this permit, as are licensed by Miami Shores Village. STATE OF FLORIDA, ss. COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. Notary Public, State of Florida NOTE: A re-inspection fee of $L00 will be made when such re-inspection is made necessary by improper notice for inspection, or faulty materials and/or workmanship. - -^ CLOSETS BATH TUB. SHOWERS LAVA. TORIES 61NKa SLOP SINKS LAUNDRY Tu.. URINAL[ CATCH BASIN FLOOR DRAIN DRINKING FOUNT'N. TOTAL FIXTURES CONTR. LIST CHECK . SEPTIC TANK SEWER CONK. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR M DEEP WttL SPRKLR. S SWIMG POOL CONTR. - LIST CHECK Permit No 1 MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Date... 1 6 - 75 ....-- - .... . _- - - Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the'Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division off Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at bZeting.tktn g progress of work. Owni 's.. aamefand Address Mr. & Mrs. R Oberman N N.B. S .9 ?ad Street Registered =mg and /or Engineer Janes Rodgers and Amociates Employing Plumber's Name EdwarL.W. Garcia $ treet....16 .;.1.6 - Avenue Location and Legal Description Lot. 19 148.1_„.E_• 50' and All Block 2 Subdivision. Bay Ltnte_ Seet3an Or LOt ZO 1 207 N.B. Street and Number where work is to be performed -No Street ..92nd..Strtaet - - - State work to be performed and purpose of building (By Floors)_p l Piping fot Sw ing_,Po01 Fap ,Uy..Re idence New Building _ Remodeling Addition..__..._ 8 Repairs No. of Stories ................ Size Septic Tank -------- - - -_ -- - - - -- Type of Tank_ Feet of Drain Tile.-.- — -_- _.Dist. Feet of Tank or Drain Field from Well ..._.._..___ _ _...--- • - -__ -- Nature of Water Supply: City-Well. __.___--...Size of Soakage Pit Amount of Permit $5-.0Q STATE OF FLORIDA, t se. COUNTY OF DADE. My Commission Expires (Signed)_ Capacity Gals Edward W. Garcia tor. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligation! as an employer of labor under the Florida Workmen's Compensation Act, being Section 5968, Compiled General Laws of Florida Permanent Supplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employ, "by him in the work to be performed under this permit; and will post or cause to be posted' for inspection on the site of the work such public otice or notices as are required by [hie Act. The undersigned agrees to employ only such sub - contractors, v k to be • orm . unk this permit, as are licensed by Miami Shores Village. III Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the. _.__......... _.. of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. Notary Public, State of Florida Master Plumber. NOTE: A re- inspection fee of $1.00 will be made when such re-inspection L made.neoessary by improper notice for inspection, or faulty materials and /or workmanship. CONTRACTOR New Construction Name N 1' ii P u11 /�y Qi INC Name License No. /809, Alteration Exterior Address 60113 t oj MST s° ire The A -Sress f�� 1061 Telephone 305 r1:3 _t3 J it Fax 3 s,)3 —0 , 52 s) Qualifier Name p g ° EN'fsTe,/' l� o fa ephone PROPERTY OWNER New Construction 1( Name Alteration Exterior A -Sress f�� 1061 .f 9N_ A l� o fa ephone �� Business Telephone Foundation Only Fax Other TYPE OF MANAGEMENT (✓ ) New Construction 1( Enclosure Alteration Exterior Repair Alteration Interior Demolish Relocation of Structure Shell Only Foundation Only Add'1 Attachment Other Add'l Detachment , Other !!:. INSTRUCTIONS - The following steps must be taken to obtain a permit from the Miami Shores Village: Step 1. 0 1 '101 Complete the attached permit application which must be signed by the property owner and qualifier. Both signatures must be notarized. Please print or type to allow for a more accurate processin of your application. If roofing work will be done, a roofing application must be submitted along with this permit application. Step 2. Submit the completed application with all necessary documents to the Building, Planning and Zoning Department for processing. During the processing of your application, y ou ma be asked to submit additional information. APPLICATION Job Address: n t c / )si Address Apt. Folio Number Lot Block Subdivision PB PG Current Use of Property Proposed Use of Property Tenant Information PERMIT TYPE (✓ ) Building Electrical Mechanical Plumbing LPGX Roofing Fence Other PERMIT CHANGE (✓ ) Chg. Contractor Renewal Revision Extension Supplement Reinspection ARCHITECT Name License No. Address Telephone Fax Master Permit No Subsidiary Permit City State Ni Description of Work Pf un2B/ 49 RPmoit'L ODD 1 Raih Rim PERMIT APPLICATION Zip Linear Feet Zoning Square Feet Units Floors Value of Work 36°O c5 Bldg Value Tax Assessed/Appraised Value Flood Zone Base Floor Elev. ENGINEER Name License No. Address Telephone Fax Page 2 SEAL: Personally known OUNTY OF MIAMI - DADE gnature of 0 per g/4 Print Name Sw� to and subscribed before me this I 1 day of 1 C S A w L& o rtt h - 6§tatgtp[r on da; Q CC765E97 iV PAY Ct7 Ni.1:.. CF � % t ,. ,? OR, Produced Identification Type of Identification Produced: Signature of Contractor / Qualifier x P8eRT EDe!s Tefg Print Name Signature o SEAL: o and subscribed before PERMIT APPLICATION IMPORTANT NOTICES 1. DO NOT BEGIN ANY WORK WITHOUT HAVING RECEIVED YOUR VALIDATED PERMIT AND PERMIT CARD. Applying for a permit does not grant the right to begin construction. HOURS OF CONSTRUCTION are limited to: Monday through Friday from 7:30 a.m. to 6:00 p.m., and Saturday from 8:00 a.m. to 5:00 p.m. No inspections will be conducted on weekends or holidays. 2. All construction of demolition areas MUST BE MAINTAINED IN A CLEAN, NEAT AND SANITARY CONDITION free from construction debris. 3. STREETS AND NEIGHBORING PROPERTIES SHALL BE KEPT FREE FROM DIRT AND DEBRIS. 4. SWALES MUST BE PROTECTED FROM BEING DAMAGED BY EQUIPMENT OR VEHICLES, AND MAY NOT BE USED FOR STORAGE. A bond is required for work in or near the street/sidewalk. 5. CONSTRUCTION TRAILERS ARE PROHIBITED ON SINGLE FAMILY RESIDENTIAL CONSTRUCTION SITES. Other construction may have a trailer which requires a separate permit. 6. PORTABLE TOILETS for a construction site require a separate permit. 7. DO NOT DISCHARGE WATER INTO THE RIGHT OF WAY OR STORM DRAINS without approval from the Building, Planning and Zoning Department. 8. EQUIPMENT AND MATERIALS SHALL BE STORED at least 10 feet from the edge of pavement. 9. Department of Health and Rehabilitative Services (HRS) approval is required for applications involving septic tanks. Department of Environmental Resources Management (DERM) and/or Miami -Dade Water and Sewer Department (MDWASD) approval is required for applications involving sewers. AFFIDAVIT - Please read carefully. Application is hereby made to obtain a permit to do work and installation as indicated. I, the OWNER of the property, 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, POOL, EXTERIOR DOOR, MECHANICAL, WINDOW, FENCE, DRIVEWAY, ROOFING and SIGNS and there may be additional permits required from other governmental agencies. I, the OWNER of the property, have disclosed all information related to any work at the property performed in the prior twelve months to the Building Official. Further, I am fully aware that if the cumulative cost of work to my home or business under this and any other permit equals or exceeds fifty percent (50 %) of the fair market value of the structure, the entire structure must meet the present federal flood criteria for finished floor elevation. I am also fully aware that if the total cost of work to my home or business under this and any other permit exceeds fifty percent (50 %) of the replacement cost of the structure, then the entire structure must conform to the current code requirements of the Building Code. WARNING TO OWNER: Your failure to record a NOTICE OF COMMENCEMENT may result in you paying twice for improvements to your property. If you are spending more than $2,500 or intend to obtain financing, you may wish to consult with your attorney or lender before recording your Notice of Commencement. The Notice of Commencement must be recorded at: 22 N.W. 1st Street, 1 °` Floor, (305) 679 -1078. Once recorded, the Notice of Commencement must be POSTED AT THE JOB SITE in accordance with Section 713 -35 of Florida Statutes. Review the brochure at Village Hall on Construction Lien Law and Choosing a Contractor. STATE OF FLORIDA, COUNTY OF MIAMI -DADE GALVA day 0V(21° C.J , ature of R\s � fI figq{trat. ,..C. l4r E l" A� t:.t� A 6EC�:EH n WhiNt:sSIUN NUMER + 4 < CC786697 ` F1. � ' . 1? � t Personally known OR, P roduced Identification 1 Type of Identification Produced'tg I ' ELECTRICAL TYPE Minimum Fee QTY. TYPE Dryer QTY. TYPE Outlet, Appliance QTY. TYPE. Service Repair QTY. A/C Central 1 -3 Ton Fan Dryer Vents, Number of Outlet, Wall Ventilation, Cost Service, Temporary Air Handler, Tons A/C Central 4 -7 Ton Piping, Flammable Liquid Fire Pump Outlet, Switch Fire Sprinkler System Signs A/C Central 8 -15 Ton Bath Fan - Vented, # Fixture - Fluorescent - Pressure Vessel Oven Space Heater (kw) A/C Central 16-20 Ton Fixture Light Parking Lot Lights Spas/Hot Tubs A/C Central 20+ Ton Flood Lights Plugmold/Strip Subfeeds, No. of Amps A/C Window FPL - Load Central Posts Swim Pool, Commercial Air Conditioners Garbage Disposal Range/Range Top Swim Pool, Residential Chiller Generators, etc. Receptacles Switchboards Clear Violations Heat Recovery Refrigerator, Comm. (p/PH) Temp Serv., Construction Compactor Low -volt, Burglar Refrigerator, Domestic Temp for Test - 30 days Deep Freezer Low -volt, Fire Renew - Temp Service Water Closet I Demolition Low -volt, Intercom/Teleph. Repair Circuits Water Heater j Dishwasher Low -volt, Television , Service, Number of Amps Water Heater New MECHANICAL TYPE Minimum Fee QTY. TYPE Condensate Drain QTY. TYPE Generator QTY. TYPE Refrigeration, Tons QTY. A/C Central, Tons Cooling Tower Heating Strips, each Vent Hood, Cost A/C Wall/Win. Tons Dryer Vents, Number of Paint Booth Ventilation, Cost Solar Water Heater Air Handler, Tons Ductwork, Cost of Piping, Flammable Liquid Periodic Inspections Barbecue Fire Sprinkler System - Process/Pressure Piping Cap - Fixture Bath Fan - Vented, # Fireplaces, Number of - Pressure Vessel Pump and Abandon PLUMBING T1'1'P. A/C Condensate QTY. TYPE Drains, Roof QTY. TYPE Miscellaneous Fixture QTY. TYPE Soakage Pit QTY. Bath Tub / Drinking Fountain Miscellaneous Repairs Solar Water Heater Bidet Filter Replace Pool Piping Sprinkler Repair Cap - Fixture 3 Fountain Pump and Abandon Sprinkler System Cap - Water Gas - Appliance Pump, Domestic Supply, AC Well Cap - Sewer Gas - Natural Pump, Fire Stand Temporary Toilet Catch Basin Gas - Propane Pump, Re- circulate Temporary Water Closet Clothes Washer Gas Piping Pump, Replace - Pool Urinal Dental Chair Grease Trap Pump, Sprinkler Utility - Sewer Discharge Well Ice 'Maker Pump, Sump Utility - Water Dishwasher Indirect Wastes Relay Repair Vacuum Pump Disposal Interceptor Roof Inlet Water Closet I Domestic Well Laundry Tray Septic Connection Water Heater j Drainfield, 4" Tile/Res. Lavatory , Septic Tank Water Heater New Drains, Area Meter Set (Gas) Sewer Connection Water Re -pipe Drains, Floor Minimum Fee Shower Water Service Drains, French Miscellaneous Equipment Sink Well, Supply Page 3 PERMIT APPLICATION INSTRUCTIONS: Please indicate the type of work being performed and quantity(ies) in the space provided below. RECEIVED AND REVIEWED BY: DATE: SECTION BY DATE Zoning Electrical Mechanical Plumbing /9 -4 Fire Public Works Structural Building Official Page 4 OFFICE USE ONLY CHECKLIST ❑ OWNER - BUILDER FORM (Attach) ❑ FIRE DEPARTMENT APPROVAL (Commercial / multi- family) ❑ CONCURRENCY (New Construction) ❑ OTHER (Specify & Attach) PERMIT FEES $3.00 per page (Scanning Fee) Miami Shores Village Bond Metropolitan Dade County (C.C.F.) Inspector State Educational Fund State DCA (Radon) Code Enforcement Fine Zoning Review ❑ PROOF OF OWNERSHIP (Attach) ❑ HRS / DERM APPROVAL (Septic / Sewer) ❑ IMPACT FEE (New Construction) ❑ OTHER (Specify & Attach) (sq.ft. = x/1000 x ¢.60) (¢.005 /sq.ft.) (¢.01 /sq.ft.) REVIEWED AND PREPARED BY: PERMIT APPLICATION ❑ CONDO ASSOCIATION APPROVAL (Attach) ❑ BPR APPROVAL (Restaurants) ❑ CONTRACTOR REGISTRATION (On File) TOTAL $ lJ v ISSUING OFFICIAL DATE: CONDITION OF APPROVAL Revised July 2001 10050 N.E. 2ND AVE., MIAMI SHORES, FL • (305) 795 -2207 • FAX (305) 756 -8972 • http : / /www.miamishoresvillage.com Permit No Size Septic Tank ---4� Feet of Drain Tile - -- " Nature of Water Supply: City — Well. STATE OF FLORIDA, 1 COUNTY OF DADE. me My Commission Expires G^vUTAMI SHORES VI", i1 PLUMBING INSPECTION DEPARTMEi - APPLICATION FOR PLUMBINS ' f,;`, No... ------ --- ---- -- -- -- ----- ---- - - - - - -- — Amount of Permit $ ------------ - - - - -- — - -- (Signed)_ -_- ` r Capacity Gals Notary Public, State of Florida Application is hereby made for the approval of the detailed statement of t'r,; Jiens and specifications herewith submitted for the building or other structure herein described. This application is made in compliance and coaf3). :. with the Sdiiding Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami .;,,Ores Viiiane a.ici all rules and regulations of the Building Division of MiaLli Shores Village shell be complied with, whether herein specified '+r''. A cop : of approved plans and specifications must be kept at building during progress of work. Owners Name and Address � ! j , _ Na..__ ___ -__ -_ Street Registered Archr; e t and /or Employing Plumber's Nam Street-- ______..._ Location and Legal Description Lot____ B1 _ _ Subdivision OQ:lC� Street and Number where work is to be performed —No.__ R 6 _... �� _- 9 k i+'tt treet. State work to be performed and purpose of building (By Floors) _ ____ N6w Building -___ -- _-------- --- ---- -- - - --_ -- Remodeling_. - -- __.____ -- Addition.---- _ -_ -._ Repairs No. of Stories - - .-- .....__----- e of Tank___ - 0- - F t of Tank or Drain Field from Well ----------- _- _ - - - -• - Size of Soakage Pit lumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such ublic notice or notices as are required by the Act. The undersigned agrees to employ only such sub - contractors, on,work to be perfoc red , idy+t this pc it as r- i . +ceased by Miami Shores Village. J (Signed)._ p Q - - c -" �; ( Master Plumber Befaae me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the _.. of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty mat/seals and /ar worlananship. CLOSETS BATH TUBS OW SHHRS LAVA- TORIES SIS SINKS SLOP SINKS LAUNDRY TUBS U RINALS CATCH BASIN FLOOR DRAIN DRINKING DRINK FOUNT' NS TOTAL FI %TORES CONTU. LIST CHECK SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR H EATER DEEP WELL SPRKLR. SYSTEM SW IM•O POOL CONTR. LIST ` — — CHECK Permit No Size Septic Tank ---4� Feet of Drain Tile - -- " Nature of Water Supply: City — Well. STATE OF FLORIDA, 1 COUNTY OF DADE. me My Commission Expires G^vUTAMI SHORES VI", i1 PLUMBING INSPECTION DEPARTMEi - APPLICATION FOR PLUMBINS ' f,;`, No... ------ --- ---- -- -- -- ----- ---- - - - - - -- — Amount of Permit $ ------------ - - - - -- — - -- (Signed)_ -_- ` r Capacity Gals Notary Public, State of Florida Application is hereby made for the approval of the detailed statement of t'r,; Jiens and specifications herewith submitted for the building or other structure herein described. This application is made in compliance and coaf3). :. with the Sdiiding Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami .;,,Ores Viiiane a.ici all rules and regulations of the Building Division of MiaLli Shores Village shell be complied with, whether herein specified '+r''. A cop : of approved plans and specifications must be kept at building during progress of work. Owners Name and Address � ! j , _ Na..__ ___ -__ -_ Street Registered Archr; e t and /or Employing Plumber's Nam Street-- ______..._ Location and Legal Description Lot____ B1 _ _ Subdivision OQ:lC� Street and Number where work is to be performed —No.__ R 6 _... �� _- 9 k i+'tt treet. State work to be performed and purpose of building (By Floors) _ ____ N6w Building -___ -- _-------- --- ---- -- - - --_ -- Remodeling_. - -- __.____ -- Addition.---- _ -_ -._ Repairs No. of Stories - - .-- .....__----- e of Tank___ - 0- - F t of Tank or Drain Field from Well ----------- _- _ - - - -• - Size of Soakage Pit lumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such ublic notice or notices as are required by the Act. The undersigned agrees to employ only such sub - contractors, on,work to be perfoc red , idy+t this pc it as r- i . +ceased by Miami Shores Village. J (Signed)._ p Q - - c -" �; ( Master Plumber Befaae me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the _.. of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty mat/seals and /ar worlananship. BUILDING ELECTRICAL PLUMBING ROOFING • Owner of Building Architect Contractor or Builder Legal Description Address of Building Lot a� f MIAMI SHORES VILLAGE. FLORIDA o PERMIT e " • Signed. N? - 3746 Work to be performed under this Permit Bl. CONTRACTOR OR BUMPER BY Subdi- vision Value of Project $ 4 DATF Contractor's / t ,y License No. Amount of . .r Permit $ This permit is granted to the contractor or builder named above to construc 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. INSPECTOR In consideration of the issuance to me of this permit I agree to perform the work covered hirr'sunder 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 ac- cepting this permit I ass responsibility r all work done by either, myself, my agent, se;vftrit ortbmployee. * L ` / " -' k ff - . tlt4i..fi..9i�'- ,V 4::_ AUTHORITY Bm Permit No. f 6.7 MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for tiie building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. 7 Owner's M a Name and Address - -- Rol J� • No. 1203 __ At 4 µ Street 7.2 Si Registered Architect and /or Engineer — _— _______________. __.__- -_ - _ --_ .__ ._ Employing-Plumber's Name i4 U STO L _ Sawn e C a __ ��_ - No. L I 1 -- - � / y Street--- - � --- -----•-- •-----•--------•----- Location and Legal Description Lot Bloele I g Subdivision _.___.______._________._______ Street and Number where work is to be performed -No / P-07 t' E • Street ---(__ A. sr ' State work to be performed and purpose of building (By Floors) New Building _---- .----------- __ -_ -- Remodeling ___.. Addition._ -_ Repairs No. of Stories .................. .... Size Septic Tank Type of Tank_ Capacity Gals.. Feet of Drain Tile_ Nature of Water Supply: City - Well.______ ________ ___________________________Size of Soakage Pit Amount of Permit $ STATE OF FLORIDA, } COUNTY OF DADE. —Dist. Feet of Tank or Drain Field from Well (Signed) _ (Signed) Date - - 1`P ti_ • / �� i • P um. : Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his o • ions as an employer of labor under the Florida Workmen's Compensation Act, being Section 5988, Compiled General Laws of Florida Perl ent Supplement, and bus coin - plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such sub- contractors, on work to be performed under this perinit, as are licensed by Miami Shores Village. My Commission Expires Notary Public, State of Florida M>Plmnber. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the _ .................. of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made•necesssry by improper notice for insp- • , 'n, or faulty materials and /or worlananship. CLOSETS BATH TUBS SHOWERS R LAVA- TORIES SINKS SLOP SINKS LAUNDRY TUBE INALS URINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT•NS TOTAL FIXTURES CONTR. LIST CHECK - SEPTIC TANK SEWER CONN. DRAIN SOAKAGE FIELD PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SWIM'G POOL CONTR. . 3 H yp 'LC p ct IQ - -- CHECK Permit No. f 6.7 MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for tiie building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. 7 Owner's M a Name and Address - -- Rol J� • No. 1203 __ At 4 µ Street 7.2 Si Registered Architect and /or Engineer — _— _______________. __.__- -_ - _ --_ .__ ._ Employing-Plumber's Name i4 U STO L _ Sawn e C a __ ��_ - No. L I 1 -- - � / y Street--- - � --- -----•-- •-----•--------•----- Location and Legal Description Lot Bloele I g Subdivision _.___.______._________._______ Street and Number where work is to be performed -No / P-07 t' E • Street ---(__ A. sr ' State work to be performed and purpose of building (By Floors) New Building _---- .----------- __ -_ -- Remodeling ___.. Addition._ -_ Repairs No. of Stories .................. .... Size Septic Tank Type of Tank_ Capacity Gals.. Feet of Drain Tile_ Nature of Water Supply: City - Well.______ ________ ___________________________Size of Soakage Pit Amount of Permit $ STATE OF FLORIDA, } COUNTY OF DADE. —Dist. Feet of Tank or Drain Field from Well (Signed) _ (Signed) Date - - 1`P ti_ • / �� i • P um. : Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his o • ions as an employer of labor under the Florida Workmen's Compensation Act, being Section 5988, Compiled General Laws of Florida Perl ent Supplement, and bus coin - plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such sub- contractors, on work to be performed under this perinit, as are licensed by Miami Shores Village. My Commission Expires Notary Public, State of Florida M>Plmnber. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the _ .................. of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made•necesssry by improper notice for insp- • , 'n, or faulty materials and /or worlananship.