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1160 NE 91 Terr (10)Address For Inspector: Approved Correction Re- Insp'n Fee MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date Type Insp'n No. G 03 � Name✓�- • Company Time A./ Phone # O 5 6131- 000 ) 0 0 Name & Date OOcD3 tL MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date '_4_,L122:/,2 Time Type Insp'n Permit No. i, 14 Name ,-.4)14d1 Address //60 /d l/ TEM Company Phone # For Inspector: e-Dz N Approved Correction Re- Insp'n Fee ❑ Date Type Insp' Permit No. Nam Company Phone # For Inspector: Approved " 7 Correction Re- Insp'n Fee MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request ' 0O 2Q J l� Address // `y 0 /11 L Time 0-70 •, 3(.S' 4)3 PERMIT APPLICATIQN ROAD lA VII:SI'IORES VILLAGE • Date 1 ' 1 L1 -)3 Job Address 1 / ( 0 WE- q 1 Tax Folio 1 2 .3 2 C)5 - OC / - 0 4- 5U Legal Description tdaki/S(G(� P8 q— IL/ I Histptica1t Designated! :�'es No Owner/Lessee / Tenant !Qv) a M' G 1,a e ( 11 k • • • • • 'Master Permit # pi,,03 Owner's Address I /(o 0 ['/C. q / .. ! v P /_, 0 v -�- -.�h 305 - 7 -(— qo (k Contracting Co. ► " (a V I u & CI • • T 4C_ . i �o f !� �.c.) // 0 0 . /q/ et -„ u .,,- .33(6/ -- ... Qualifier /a Y) eS . /4" h SS# 5 7e -Te 9q74 PhoneJo J - (, f /— aD L State # Municipal # Competency # C-F 1.035 Ins. Co. A if Architect/Engineer Address Bonding Company Address Address Mortgagor Permit Type (circle one): BUILDING ELECTRICA PLUMBING CHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION Ire / CGGk ii sfa I l ti ea f i. ieep b -i-7 1 i ‘5 sink Square Ft. U 2- ( Estimated Cost (value) 1200.00 WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO 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.) Application is hereby made to obtain a permit to do work 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. 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. Furthermore, I authorize the abb amed contractor to do the work stated. Notary as to My Conunission Expires: FEES: PERMIT / -/4- 63 r L t Caaitrr4 oa is CC 834982 E p r2a ».) I4 d Ttiry i asjc RADON APPROVED: Zoning Building Mechanical Plumbing ature of Contractor or Owne Notary as to C My Commission C.C.F. ! ,) 0 NOTARY Electrical er . lder Date Roles Luecke _ Esp "7 j cc 33 BOND j- /L/ - a/ Date TOTAL DUES 1*, Engineering ITEM 3ATH TUB UNIT FEE - • • ITEM •• SWITCH OUTLETS • r 1 ..s •PE i • • ITEM SPACE HEATERS UNIT FEE 3IDET LIGHT OUTLETS CENTRAL HEATING )ISHWASHER RECEPTACLES A/C (WIND) )ISPOSAL SERVICE TEMPORARY A/C (CENTRAL) DRINKING FOUNTAIN SERVICE SIZE IN AMPS DUCT WORK FLOOR DRAIN SERVICE REPAIR/METER CHANGE REFRIGERATION GREASE TRAP APPLIANCE OUTLETS PROCESS AND PRESS PIPING INTERCEPTOR RANGE TOP UNDERGROUND TANKS LAVATORY OVEN ABOVE GROUND TANKS LAUNDRY TRAY WATER HEATER U.F. PRESSURE VESSELS CLOTHES WASHER MOTORS 0- 1 HP STEAM BOILERS SHOWER MOTORS OVER 1- 3 HP HOT WATER BOILERS SINK, POT /3 COMP. MOTORS OVER 3- 5 HP MECHANICAL VENTILATION SINK, RESIDENCE 1 MOTORS OVER 5- 8 HP TRANSPORTING ASSEMBLIES SINK, SLOP MOTCRS OVER 8- 10 HP ELEVATORS/ESCALATORS TEMPORARY WATER CLOSET MOTORS OVER 10- 25 HP FIRE SPRINKLER SYSTEMS URINAL MOTORS OVER 25-100 FP COOLING TOWERS WATER CLOSET MOTORS OVER 100 HP VIOLATION INDIRECT WASTES A/C WINDOW REINSPECTION WATER SUPPLY TO: AIR CONDITIONERS • A/C UNIT STRIP HEATER FIRE SPRINKLER GENERATORS TRANSFORMERS HEATER -NEW INST. GENERATORS TRANSFORMERS I HEATER - REPLACE GENERATORS TRANSFORMERS LAWN SPRINKLER -WELL SPECIAL PURPOSE SWIMMING POOL OUTLETS COMMERCIAL WATER SERVICE SIGN TUBES SEWER CONNECTIONS SIGN TRANSFORMERS UTILITY -SEWER _ SIGN TIME CLOCK UTILITY -WATER FIXTLRES •' SEPTIC TANK ANTENNA RELAY TELEVISION OUTLETS ORAINFIELD, 4' TILE/RES. VIOLATION PUMP & ABANDON SEPTIC TANK REINSPECTION SOAKAGE PIT CU. FT. _ CATCH BASIN DISCHARGE WELL DOMESTIC WELL AREA DRAIN ROOF INLET SOLAR WATER HEATER FIRE STANDPIPE POOL PIPING LAWN SPRINKLER SYSTEM SAS RANGE - VETER SET (GAS) GAS PIPING . . .•. • .•. •• 'ADDENDUM TO BUILt I G R.E.VIT • APPLICATION CAN APPLICATION FOR BUILDING PERMIT MUST ACCOMPANY ADDPN1TJ$i. IF A MASTER PERMIT HAS B. OBTAINED, THE OWNER'S NOTARIZED SIGNATURE 1lED NIT Ap ;RL°SENT•ON SUBSEQUENT APPLICATIONS.) • • • • • • • • • • ••• ••• • • PLUMBING ELECTRICAL •• • • • •• ••• •• • MECHANICAL Memo: Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Printed: 1/22/2003 Applicant: DANA MICHAEL INMAN Owner: INMAN DANA MICHAEL JOB ADDRESS: 1160 NE 91 TERR Contractor MARBAR PLUMBING CO INC Contractor's Address: 661 NW 118 ST Local Phone: 305 - 681 -0009 Parcel # 1132050010450 Fees: FEE2003 -395 FEE2003 -396 Description Building Fee CCF Total Fees: Approved Permit Expiration: Work: RELOCATE & INSTALL WATI=Q I-J r: AT.-•• Permit Status: MARBAR PLUMBING CO., INC. • (305) 681 -0009 661 N.W. 118TH ST MIAMI, FLORIDA 33168 1160 N.E. 91st Terrace Eighty —One and 20/100 Dollars I7 Miami Shores Village TO THE ORDER OF Permit Number: PL2003 -11 Legal Description: WATERSEDGE PB 9 -141 ELY3OFT OF LOT 20 & ALL LOT 21 & WLY5FT LOT 7/15/2003 Plumbing Permit Constructinn %� ••• FIRST UNION FNOTIONAL BANK OF 6318 63. 643/67 DATE Amount $80.00 $1.20 $81.20 Jan 22, 2003 uv00631811' 1:06 70064 3 2i:200200 Q� A CHECK NO. 6318 AMOUNT * * * * * * * * ** *$81.20 Page 1 of 1 Total Fees: $81.20 Total Receipts: $0.00 e- inspection m ° ition herefor in strict compliance with all a jations that may have been submitted to g it if the plans are changed without isibility for a thorough knowledge of the it he assumes responsibility for work done 8 )ertaining thereto and in strict conformity onisibility for all work done by either r LOT: APPLICANT: AGENT: PROPERTY ADDRESS: STATE OF FLORIDA DEPARTMENT OF HEALTH ONSITE SEWAGE TREATMENT AND DIPOSAL SYSTEM CONSTRUCTION INSPECTION AND FINAL APPROVAL I - i 1 ke i {` /A c , > I /7(') 7,,}, SUBDIVISION: Way Si =Si2 tia1WW21 :W CHECKED [X] ITEMS ARE NOT IN COMPLIANCE WITH STATUTE ----_============ TANK INSTALLATION a [01] TANK SIZE [1] /0 U [2] , [02] TANK MATERIAL (''p [03] OUTLET DEVICE 4)6K..(, [04] MULTI - CHAMBERED [ Y / [05] OUTLET FILTER [06] LEGEND [07] WATERTIGHT [08] LEVEL [09] DEPTH TO LID DRAINFIELD INSTALLATION (10] AREA (11/ r} X `lj [ 2 ] •-) ' s U SQFT [11) DISTRIBUTION BOX HEADER ✓ [12] NUMBER OF DRAINLINES ( 13 ] DRAINLINE SEPARATION 0/y (14] DRAINLINE SLOPE t").. [15] DEPTH OF COVER [16] ELEVATION [ABOVE /BELOW] [17) SYSTEM LOCATION [18) DOSING PUMPS N / [19] AGGREGATE SIZE xj' [20) AGGREGATE EXCESSIVE F INES [21] AGGREGATE DEPTH FILL [22] [23] [24] [25] [26) / EXCAVATION MATERIAL FILL AMOUNT FILL TEXTURE EXCAVATION DEPTH AREA REPLACED REPLACEMENT MATERIAL BM X00 [ [ [29] [30] [31] [32] [33] [34] [35] PROPERTY ID 1: // 390`; 0 - o9SC OR RULE AND MUST BE CORRECTED, SETBACKS SURFACE WATER DITCHES PRIVATE WELLS PUBLIC WELLS IRRIGATION WELLS POTABLE WATER LINES BUILDING FOUNDATION PROPERTY LINES c / OTHER FILLED / MOUND SYSTEM [36] DRAINFIELD COVER [37] SHOULDERS [38] SLOPES [39] STABILIZATION ADDITIONAL INFORMATION [40] UNOBSTRUCTED AREA [41] STORMWATER RUNOFF [42] ALARMS [43] MAINTENANCE AGREEMENT [44] BUILDING AREA [45] LOCATION CONFORMS WITH SITE PLAN [46] FINAL SITE [47] CONTRACTOR [48] OTHER ] [49] TANK PUMPED _ / / ] [50] TANK CRUSHED & FILLED ` // EXPLANATION OF VIOLATIONS / REMARKS: [ ] [ l [ ] [ l CONSTRUCTION [APPROVED /DI APPROVED) i d ( I I'll I) C- CND DATE: G r 7 FINAL SYSTEM [AP DISAPPROVED]_ '1144N. '` CHD DH 4016, 10/97 (Previous Editions May Be Used) Page 2 of 3 PT 1: Applicant • PT 2: Installer /Contractor PT 3: Building Department PT 4: Health Departmer.t PERMIT NO. DATE PAID: FEE PAID: RECEIPT 1: D' /S ? 1- FT FT FT FT FT FT FT FT FT -4