PLUMBINGDate
Type Insp'n
Permit No.
Name
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
Building Inspection Re
Address pJ t C • l a_
Company _.S l lI
Phone # ; 6 ^ SS3 -S
Inspection Date
Approved
Correction
Re- Insp'n Fee
AP R 7pr,
BUILDING
PERMIT APPLICATION
FBC 2001
Permit Type (circle): Building Electrical
Owner's Name (Fee Simple Titleholder) / /l_. itleholder) w l Phone #
p �
Owner's Address 95 0 g IV
City q -C State
Tenant/Lessee Name
Job Address (where the work is being done)
City Miami Shores Village
Is Building Historically Designated YES
Contractor's Company Name jr
rC..
Contractor'', Address . q 4/6
City A/f
4/77/
- State
Qualifier : i / :h/tit)
Architect/Engineer's Name (if applicable)
Architect/Engineer's Address
City
$ Value of Work For this Permit
Type of Work:
Describe Work:
Miami Shores Village
Building Department
Q
State
f �l OOH
County Miami -Dade
NO
.1 ?kaki/.
* * * * * * * *t * *,yk * * * * * ** ** ** *F * * * * * * * **
• r
County Escrow Fee $ 50 V Permit Fee $
Education/Training Fee $ -0 Tech $ 3 . S Scanning $
Code Enforcement $ Bond $ ll Str ru uct. $
y
Minus Plans Check Fee $ Total Fee Now Due $ V
Permit No.L 09 1 $
Master Permit No.
Mechanical Roofmg
Zip
Phone #
Zip
hone #
Zip . /6Cc
- Phone #
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
Zip
Square Footage Of Work:
Number of: Bays Stories Families Bedrooms Baths
Addition ['Alteration [New ❑ Repair/Replace ❑ Demolition
* * * * * * * * * * * * * * * **
Notary $
iSr; .Radon $
(Continued on opposite side)
Bonding Company's Name (if applicable)
Bonding Company's Address
City State Zip
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
City State 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.
411
Signature
The foregoing
day of
who •
chc7/7 /o3
wner or Agent
trument was acknowledged before me this
20 , by
onally knpatitbt
State Certificate or Registration No.
APPLICATION APPROVED B7f:
duced {7- Z-
o did take an oath.
NOTARY P
IIIG'G Sign:
Contractor
The foregoing i strument was acknowledged before me this
day of A i� , 20 lt `
t
•n.
JAL 42k.
•
wh. •
e an oath.
4 A /3 — 07 Plans Examiner
Engineer
Zoning
Print: r •
Print: i /' • 'Arti c•
My Commission My Commissi l� :-
� ��
0
(Certificate of Competency Holder)
Certificate of Competency No.
ADDENDUM TO BUILDING PERMIT APPLICATION
;AN APPLICATION FOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. IF A MASTER PERMIT HAS BEEN
OBTAINED, THE OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.)
PLUMBING
ELECTRICAL
MECHANICAL
ITEM
SPACE HEATERS
MIT
FEE
TEM
;ATH TUB
UNIT
•
FEE
ITEM
SWITCH OUTLETS
UNIT
FEE
:IDET
1
1 LIGHT OUTLETS
CENTRAL HEATING
;1St-RASHER
RECEPTACLES
A/C (WIND)
iISAOSAL
1
SERVICE TE1 RARY
. A/C (CENTRAL)
DRINKING FOUNTAIN
SERVICE SIZE IN AMPS
DUCT WORK
LOOR GRAIN
SERVICE REPAIR/IETER CHANGE
REFRIGERATION
sIEASE TRAP
APPLIANCE OUTLETS
PROCESS AND PRESS PIPING
-.
• NTERCEPTOR
RANGE TOP
UNDERQ CU110 TANKS
AVATORY
OVEN
ABOVE GROUND TANKS
AUIORY TRAY
1
WATER HEATER - --
U.F. PRESSURE VESSELS
LATHES WASHER
j IATCRS 0- 1 HP -
STEAM BOILERS
}LOWER
-
hOTC1 S OVER 1- 3 HP
HOT WATER BOILERS
INK , POT /3 COMP. -
MOTCRS OVER 3- 5 HP
MECHANICAL VENTILATION
;INK, RESIOENCE -
M3TCRS OVER - 8 HP
TRANSPORTING ASSEMBLIES
=INK. SLOP
MOTORS OVER 8- 10 FP -
ELEVATORS/ESCALATORS
EWORARY WATER CLOSET — 1
MOTORS OVER 10- 25 HP
FIRE SPRINKLER SYSTEMS
.
>QINAL
MOTORS OVER 25-100 HP
-
COOLING TOWERS
:ATER CLOSET
MOTORS OVER 100 IP
VIOLATION
.ND IRECT WASTES
A/C WIIOW
RE I NSPECTION
_
:ATER SUPPLY TO 1
1
AIR CONDITIONERS
-
A/C UNIT
STRIP HEATER
FIRE SPRINKLER I
GENERATORS TRANSFORMERS
•
HEATER -NEW INST. 1_
GENERATORS TRANSFORMERS
HEATER- REPLACE 1
GENERATORS_ TRANSFORMERS - -
LAWN SPRINKLER -WELL L 1 SPECIAL PI,RPOSE
-
SWIMMING POOL
OUTLETS CQJ ERCIAL
-
I
WATER SERVICE 1 1
SIGN TIES -
EWER CONRECT I ONS _ 1
SIGN TRANSFORMERS
TILITY -SEWER 1
SIGN TIME CLOCK
-
-
HL ITY -WATER 1
FIXTLRES
EPT I C TANG( 1
I ANTENNA '
FLAY L
TELEVISION OUTLETS 1
E I
.AINFIELD. 4' TILE/RES. _
VIOLATION
1PJ ABAICON SEPTIC TANK 1
l RE INSPECTION
1
OAKAGE PIT CU. FT. I
_
1 1
1 1
ATCH BASIN 1 L
ISCHARGE WELL 1
:WES T IC WELL
1
REA CRAIN
OOF INLET 1 1
OLAR WATER HEATER 1
1
IRE STANPP IPE 1 1
1 -
COL PIPING
-
AWN SPRINKLER SYSTEM 1
-
ETER SET (GASH
_ - .
PIPING
AS NG 1
� � r
ADDENDUM TO BUILDING PERMIT APPLICATION
;AN APPLICATION FOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. IF A MASTER PERMIT HAS BEEN
OBTAINED, THE OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.)
PLUMBING
ELECTRICAL
MECHANICAL
Miami Shores Village
10050 NE 2nd Avenue
Phone: 305- 795 -2204 Permit Number: PL2004 -115
Printed: 4/13/2004
Applicant: KAREN
Owner: MILLER
JOB ADDRESS: 258 NE 92
Parcel # 1132060133390
Signed: (INSPECTOR)
Plumbing Permit
MILLER
KAREN
ST
Contractor THE NEW MIAMI SHORES PLUMBING Contractor's Address: 900 NW 144 ST
Local Phone: 786 553 - 5424
Page 1 of 1
Legal Description: MIAMI SHORES SEC 1 AMD PB 10 -70 LOT 5 & W1/2 OF LOT 4 & E1OFT OF LOT 6
Fees: Description Amount
FEE2004 -3912 Building Fee $130.00
FEE2004 -3913 CCF $1.20
FEE2004 -3914 Technology Fee $3.25
FEE2004 -3915 Training and Education Fee $0.40
Total Fees: $134.85
Total Fees: $131
Total Receipts: $0.00
8`I
Permit Status: APPROVED Permit Expiration: 10/9/2004 Construction Value: $1,700.00
Work: REPLACE WATER SERVICE
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:
REQUEST FOR INSPECTION
Company
PHONE
Job die/A/A
Address
Inspection
Time Ready
Date Ready
P.M.
Permit No 7
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.
Owner's Name and Address. Add No j
Registered Architect and /or Engineer___
Employing Plumber's Name _ No Street
Location and Legal Description Lot Block Subdivision
Street and Number where work is to be performed —No Street
State work to be performed and purpose of building (By Floors)
New Building Remodeling Addition Repairs No. of Stories
Nature of Water Supply: City —We
Amount of Permit $ L
STATE OF FLORIDA, 1
COUNTY OF DADE. I
d
ss.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
( Signed)
Date
(Signed) <",;-
Street
Street � ( i
d
Size Septic Tank Type of Tank Capacity Gals
. Feet of Drain Tile_00 - 7 Dist. Feet of Tank or Drain Field from Well
Size of Soakage Pit
Plumbing 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
perfonned 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 permit, as are
licensed by Miami Shores Village.
My Commission Expires Notary Public, State of Florida
Master lumber.
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.
I
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.
PI
// Y
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.
LI ST
CHECK
Permit No 7
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.
Owner's Name and Address. Add No j
Registered Architect and /or Engineer___
Employing Plumber's Name _ No Street
Location and Legal Description Lot Block Subdivision
Street and Number where work is to be performed —No Street
State work to be performed and purpose of building (By Floors)
New Building Remodeling Addition Repairs No. of Stories
Nature of Water Supply: City —We
Amount of Permit $ L
STATE OF FLORIDA, 1
COUNTY OF DADE. I
d
ss.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
( Signed)
Date
(Signed) <",;-
Street
Street � ( i
d
Size Septic Tank Type of Tank Capacity Gals
. Feet of Drain Tile_00 - 7 Dist. Feet of Tank or Drain Field from Well
Size of Soakage Pit
Plumbing 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
perfonned 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 permit, as are
licensed by Miami Shores Village.
My Commission Expires Notary Public, State of Florida
Master lumber.
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.
I
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.
PI
// Y
BUILDING
ELECTRICAL
PLUME!NG
PERMIT N? 7588
Work to be performed under this Permit
Owner of at "
Building
CONTRA �R • �B _�' "`
Or
MIAMI SHORES VILLAGE, FLORIDA -
DATE .5/4
Contractor's
Signed.
1947
License No.
1!
a ,,„,
Architect
Contractor
or Builder
Legal Lot
Description
Address of
Building
This permit is granted to t e contractor o builder named above to construct the building or to install the equipment or device described in the appli-
cation herefor in strict compliance with all ordinances pertaining thereto and w th 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 respon-
sibility for work done by his agents, servants or employees.
Subdi-
vision
Value of
Project
Amt. of _ ✓ /�}
Permit ?
4.="104. Z-.-o By
INSPECTOR
In consideration of the issuance to me of this permit I agree to perform work covered hereunder in compliance Ivith all ordi at4"ces and regulations
pertaining thereto and in strict conformity with the plans, drawings, stateme ts or specifications submitted to the proper authorities of Miami Shores Village.
In accepting thi permit I assume sp ' sibility for a work done by either myself, my agent, servant or employee.
BUILDING
ELECTRICAL
PLUMBING
Architect
Contractor
or Builder ._
Legal Lot
Description
sibility for work done by his agents, servants or employees.
In consideration of the issuance to me of this permit I agree to perfo
MIAMI SHORES VILLAGE, FLORIDA oo
DAT 9
PERMIT N° 7603
Work to be performed under this Permit
Building
f //
194
Contractor's
License No.
Subdi-
vision
Address of ^ .�^ Value of Amt. of
Building[ :J �� _ Project Permit .2 / J
This permit is granted tb the contractor or builder named above to construct the building or to install the equipment or device described in the appli-
cation 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 respon-
Signed• 4 , -1q te-By
INSPECTOR
work covered hereunder in compliance wi ordinan regutioiis
pertaining thereto and in stri t conformity with the plans, drawings, statemennts 6r`specifications submitted to the prop aut�ies of M Shtfe§ \nage.
In accep..g this permit I . f ' e responsibility for all work done by either myself, my agent, servant or employee.
BY
AUTHORITY
REQUEST FOR INSPECTION
Company,
Job
7_,///4/
Address h f U )//) /
Inspection J )(,)i12
Time Ready
Date Ready
P.M.
Permit No 7 O3
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.
Owner's Name and Address // !'`� No �� Street_
Registered Architect and /or Engin
Employing Plumber's Name
Location and Legal Description Lot Block ubdivi ' n
Street and Number where work is to be performed —No C __[1 S ub
State work to be performed and purpose of building (By Floors
New Building Remodeling Addition Repairs No. of Stories
Amount of Permit $
STATE OF FLORIDA,
COUNTY OF DADE.
ss.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Nature f Water Supply: C' y— We11.
The undersigned applicant for this building permit does hereby certify
under the Florida Workmen's Compensation Act, being Section 5966, Corn
plied with the provisions thereof, and will require similar compliance from
performed under this permit; and will post or cause to be posted for i
required by the Act. The undersigned agrees to employ. only such sub - contra
licensed by Miami Shores Village.
Date
No
Street
Size Septic Tank Type of Tank Capacity Gals
Feet of Drain Tile Dist. Feet of Tank or Drain Field from Well
of S age Pit
at he underst
'led General
11 contractors
inspecti � on the
(Sign
( Signed)
Plumbing nspector.
ds and accepts his obliga '.ns as an emp .yer of labor
ws of Florida Permanent Supplement, d has com-
or sub - contractors employed by him in t e work to be
ite of the work such public notice or otices as are
s, on work' to be performed un a this 'ermit, as are
My Commission Expires Notary Public, State of Florida
Master
Street
12 . ( ,.,
lumber.
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 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
V
4
. CHECK
/ p
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SWIM'G
POOL
CONTR.
LIST
CHECK
Permit No 7 O3
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.
Owner's Name and Address // !'`� No �� Street_
Registered Architect and /or Engin
Employing Plumber's Name
Location and Legal Description Lot Block ubdivi ' n
Street and Number where work is to be performed —No C __[1 S ub
State work to be performed and purpose of building (By Floors
New Building Remodeling Addition Repairs No. of Stories
Amount of Permit $
STATE OF FLORIDA,
COUNTY OF DADE.
ss.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Nature f Water Supply: C' y— We11.
The undersigned applicant for this building permit does hereby certify
under the Florida Workmen's Compensation Act, being Section 5966, Corn
plied with the provisions thereof, and will require similar compliance from
performed under this permit; and will post or cause to be posted for i
required by the Act. The undersigned agrees to employ. only such sub - contra
licensed by Miami Shores Village.
Date
No
Street
Size Septic Tank Type of Tank Capacity Gals
Feet of Drain Tile Dist. Feet of Tank or Drain Field from Well
of S age Pit
at he underst
'led General
11 contractors
inspecti � on the
(Sign
( Signed)
Plumbing nspector.
ds and accepts his obliga '.ns as an emp .yer of labor
ws of Florida Permanent Supplement, d has com-
or sub - contractors employed by him in t e work to be
ite of the work such public notice or otices as are
s, on work' to be performed un a this 'ermit, as are
My Commission Expires Notary Public, State of Florida
Master
Street
12 . ( ,.,
lumber.
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 necessary by improper notice for inspection, or faulty
materials and /or workmanship.
Permit No. __ _43
Nature of Water Supply: ity —Well
Amount of Permit $
ss.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
(Signed)
(Signed)
Street__
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.
Owner's Name and Address No.
Registered Architect and /or Engineer
Employing Plumber's Name
a"-' /5'44.
at —A
No / ''' U' Street (6 / ct°
Location and Legal Description Lot Block Subdivision_
Street and Number where work is to be performed —No A -sd VI E. Street Q
State work to be performed and purpose of building (By Floors)
New Building V 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
Size of Soakage Pit
umbii g 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 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 permit, as are
licensed by Miami Shores Village. ,� +
My Commission Expires Notary Public, State of Florida
Master Plumber.
STATE OF FLORIDA,
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 cpnstruction, 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
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
SWIM'G
POOL
o
CONTR.
LIST
CHECK
Permit No. __ _43
Nature of Water Supply: ity —Well
Amount of Permit $
ss.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
(Signed)
(Signed)
Street__
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.
Owner's Name and Address No.
Registered Architect and /or Engineer
Employing Plumber's Name
a"-' /5'44.
at —A
No / ''' U' Street (6 / ct°
Location and Legal Description Lot Block Subdivision_
Street and Number where work is to be performed —No A -sd VI E. Street Q
State work to be performed and purpose of building (By Floors)
New Building V 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
Size of Soakage Pit
umbii g 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 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 permit, as are
licensed by Miami Shores Village. ,� +
My Commission Expires Notary Public, State of Florida
Master Plumber.
STATE OF FLORIDA,
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 cpnstruction, 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
materials and /or workmanship.
e
s1/4
JUILDING
ELECTRICAL
PLUMBING
Owner of
Building
Architect
Contractor
or Builder
Legal • Lot
Description •
d!
MIAMI SHORES VILLAGE, FLORIDA
/PERMIT N? 4589
Work to be performed under this Permit
f
e,
Bl.
CONTRACTOR OR BUILDER BY
DATE
Contractor's
License No.
Subdi-
vision
4 i 3
'1 .
194
1
Address of
Building
This permit is granted to the contractor or builder named above to construct the buileting or to install the equipment or device desc 'be n the appli-
cation herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in cony nce 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 respon-
sibility for work done by his agents, servants or employees.
Signed • `� ' By r �r I►
INSI'ECTOR
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 responsibiity f r all work done by either myself, my agent, servant or employee.
Value of
Project
Amt. of
Permit
AUTHORITY
BUILDING
ELECTRICAL
PLUMBING
Owner of
Building
CONTRACTOR OR BUILDER
MIAMI SHORES VILLAGE, FLORIDA
DATE
,PERMIT N° 4432
Work to be performed under this Permit
Architect
err - „ow
Contractor's
License No.
194
Contractor !:
or Builder
Legal Lot Bl. Subdi-
Description vision
Address of f + 7,
�` 4► P roject
Value of Amt. of
Permit '
Building ,
This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in e . pli-
cation herefor in strict compliance with all ordinances pertaining thereto and w th the understanding that the work will be performed in compliance 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 respon-
sibility for work done by his agents, servants or employees. ,, . :r>
Signed. ' ' ``ya 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 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 responsibility fox all work done by either myself, my agent, servant or employee.
BY AUTHORITY
BUILDING
ELECTRICAL
PLUMBING
Owner of
Building
'MIAMI SHORES VILLAGE, FLORIDA
DATE
ERMIT N? 4432
, Work to be' performed under this Permit '"11 +te
Architect
Contractor
or Builder
Legal Lot
Description
Address of ff ,R ' _ ,� Value of �." "Amt..of
Building J ' `• ' !' ' Project ;'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 appli - ,
cation herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work willbe '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 maybe 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 lie assumes respon-
sibility for work done by his agents, servants or employees. Q. Signed• Q. By
INS CTOR
In consideration' of the issuance,to mei'of this, permit I agree to perform the work covered hereunder in compliance with • all ordinances and reggul .
pertaining thereto and • in strict confor ity .with the. plans, drawings,'statements or specifications submitted to the proper`a o f Miami Sh'�Ies�Ulllage:
In accepting this permit\I as ume for all work done by either myself, my agent, servant or employee. '' -
AUTHORITY ..
T
Bi.
Subdi-
vision
Contractor's
License No.
//b
-
BUILDING
ELECTRICAL
PLUMBING
In consider
pertaining thereto
In accepting this p
ation of the issuance to me of
and in . rict conformity with
er ume responsibiity
L . , �_.rrl.•l i • t'"�.r
CONTRACTOR OR BUILDER
MIAMI SHORES VILLAGE, FLORIDA
DATE 194 4
ERMIT N? 4589
Fork to be performed under this Permi
i
Owner of
Building
Architect
Contractor 1
or Builder
Legal Lot Bl. Subdi
Description '' vision
•
Address of j j Value of Amt. of f`°
Building `�' " ° Ir 1I P roject 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 appli-
cation 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 th estatement's or specifications and that he assumes respon-
sibility for work done by his agents, servants or employees.
Signed•
By
INSPECTOR
this permit I agree to perform the work covered hereunder in compliance with alcdinances and irgulgt ns`�f
the plans; drawings, statements or specifications submitted to the proper authori i of Miami Short's Tillage."''
r work done by either myself, my agent, servant or employee.
Contractor's
License No. '/
• + i
BY AU HORITY