1225 NE 91 Terr (12)MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
Building Inspection Request
Date t0 — I - 03 Time
Type Insp'n /
Permit No. /� .2603-
�O
Name 7
Address /oZ o? � �
Company /37,9.47 /
Phone # 0
For Inspector: 7 -a3
Approved LW
Correction ❑
Re-Insp'n Fee ❑
Date
Type Insp
Permit No.
Name
Company
Phone #
For Inspector:
Approved
Correction
Re- Insp'n Fee
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
Building Inspection Request
ZLIArV.A.
Address I ac
.D
Time
ate
Approved
Correction
Re- Insp'n Fee
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
Building Inspection Request
V Time
Date
j ri fj 1 / 4 J 3 Vt"^N —Qt)'
Type Insp'n
Permit No. pz a 00.3 - S
Name P
Address R-5 c. 9 '1 1 e-IA
Company
Phone # i
For Inspector:
Type Insp'n
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
Building Inspection Request
Date k -Sze) A. Time
Permit No. ,2.p,2--/99
Name 7" I l S k,e4 L
Address g C- 1) f/ 7
Company h41 ;;44f G~
Phone # 78‘ ` 3a3 " e S k‘ (fa)
For Inspector:
Approved
Correction
Re- Insp'n Fee
Name & Date
7 1,44 734-1 A-
7e6 - 31
/Le &, ceeys a,e 4,ateh"
ced,
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
Building Inspection Request
Date
Type Insp'
Permit No.
Name
Address
Company • /l/ A_
Phone # = �
For Inspector:
c
Approved 1
Correction
Re- Insp'n Fee ❑
Time
c9 16 7
CONTRACTOR
Name ' ..
•-1
License No. c /� 5.-6 S/
Address / / 2c L
N. 024-474-v4„, / f g 3 / ‘ /
Telephone- ,U &,2„,-;„:24ax
Qualifier Name e _ , ,qt
PROPERTY OWNER
Name r /J /Ut i sXet -
`"
Address id .2 S N E q/ 7-ea L4,,
l 04 / . s� g6, es, :/ '3/ 31
Home Telephone 30J- J . 7 tr y • ' ///
Business Telephone
Fax (?05-') 7 C 2 / 3
TYPE OF MANAGEMENT (✓ )
New Construction
Enclosure
Alteration Exterior
Repair
Alteration Interior
Demolish
Relocation of Structure
Shell Only
Foundation Only
Add'l Attachment
Other
Add'I Detachment
Other
Page 4
OFFICE USE ONLY
CHECKLIST
CI OWNER - BUILDER FORM
(Attach)
❑ FIRE DEPARTMENT
APPROVAL (Commercial /
multi - family)
❑ CONCURRENCY
(New Construction)
LI OTHER
(Specify & Attach)
$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
Notary
CI PROOF OF OWNERSHIP
(Attach)
❑ HRS / DERM APPROVAL
(Septic / Sewer)
CI IMPACT FEE
(New Construction)
CI OTHER
(Specify & Attach)
PERMIT FEES
$ (¢.01 /sq.ft.)
SECTION
Zoning
Electrical
Mechanical
Plumbing
Fire
Public Works
Structural
Building Official
BY
DATE
-36--oz,
..f
(s .ft.. ) x/1000
x 0.60
(¢.005 /sq.ft.)
PERMIT APPLICATION
❑ CONDO ASSOCIATION APPROVAL
(Attach)
❑ BPR APPROVAL (Restaurants)
❑ CONTRACTOR REGISTRATION
(On File)
TOTAL $
ISSUING OFFICIAL
REVIEWED AND PREPARED BY: 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
INSTRUCTIONS - The following steps must be taken to obtain a permit from the Miami Shores Village:
Step 1.
Master Permit No.
Subsidiary Permit No.
PERMIT APPLICATION
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 processing of your application. If roofing work will be done, a roofing application must be submit-
ted 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, you may be asked to submit additional information.
A PPLICATION
ob Address:
Address y Folio Number //- � 2 0�. ad/ - 0
Lot 21d e -15 64- Block
Subdivision - Se PB PG ' "
Current Use of Property /S" 7 e w f /mil
Proposed Use of Property
Tenant Information
PERMIT TYPE (✓ )
Building
Electrical
Mechanical
Plumbing
LPGX
Roofing
Fence
Other
Ie
/ R S ,q) g y' /,y` 7;„ „La c
Apt.
PERMIT CHANGE (✓ )
Chg. Contractor
Renewal
Revision
Extension
Supplement
Reinspection
ARCHITECT
Name
License No.
Address
Telephone
Fax
City
escription of Work
State
?J/3d
Zip
Zoning Linear Feet
Square Feet Units Floors
of Work CJ_ Bldg Value
Tax Assessed/Appraised Value
Flood Zone Base Floor Elev.
ENGINEER
Name
License No.
Address
Telephone
Fax
ELECTRICAL
TYI'I'
Minimum Fee
Q"1'1'.
TYPE
Dryer
QTY.
TYPE
Outlet, Appliance
Q"1'1'.
TN pi.:
Service Repair
QTY.
A/C Central 1 -3 Ton
Heating Strips, each
Fan
Outlet, Wall
Service, Temporary
Paint Booth
A/C Central 4 -7 Ton
Fire Pump
Outlet, Switch
Piping, Flammable Liquid
Signs
A/C Central 8 -15 Ton
Fixture - Fluorescent
Process/Pressure Piping
Oven
Space Heater (kw)
A/C Central 16-20 Ton
Pressure Vessel
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
Demolition
Low -volt, Intercom/Teleph.
Repair Circuits
Water Heater
Dishwasher
Low -volt, Television
f
Service, Number of Amps
Water Heater New
MECHANICAL
TYPE
Minimum Fee
QTY.
TYPE
Condensate Drain
QTY. TYI'E
Generator
QTY. TYPE
Refrigeration, Tons
QTY.
A/C Central, Tons
QTY.
Cooling Tower
Heating Strips, each
Vent Hood, Cost
A/C Wall/Win. Tons
Dryer Vents, Number of
Paint Booth
Ventilation, Cost
Air Handler, Tons
Ductwork, Cost of
Piping, Flammable Liquid
Periodic Inspections
Barbecue
Fire Sprinkler System
Process/Pressure Piping
Pump and Abandon
Bath Fan - Vented, #
Fireplaces, Number of
Pressure Vessel
Gas - Appliance
PLUN1131NG
TYPE
A/C Condensate
QTY.
'I'Yl'E
Drains, Roof
QTY.
TYPE
Miscellaneous Fixture
QTY.
TYPI'.
Soakage Pit
QTY.
Bath Tub
1
Drinking Fountain
Miscellaneous Repairs
Solar Water Heater
Bidet
Filter Replace
Pool Piping
Sprinkler Repair
Cap - Fixture
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
Domestic Well
Laundry Tray
Septic Connection
Water Heater
Drainfield, 4" Tile/Res.
Lavatory
f
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 2
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 govemmental 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.
STAB OF FLORIDA, COUNTY OF MIAMI -DADE
Signature of Owner
Print Name
Sworn to and subscribed before me this day of
Signature of Notary Public - State of Florida
SEAL:
PERMIT APPLICATION
STATE OF FLORIDA, C OF AMI -D
gnature of Contractor / Qualifier
Print Name
Sworn to and subscribed before me this ■ S day of
„lad
gnature of Notary Publ - State of FJHidE A DA
NOTARY PUBLIC STATE OF FLORIDA
SEAL: COMMISSION NO. CC836040
MY COMMISSION EXP. MAY 112003
Personally known OR, Produced Identification Personally known OR, Produced Identification
Type of Identification Produced: Type of Identification Produced:
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:
Miami Shores Village
10050 NE 2nd Avenue
Phone: 305 - 795 -2204
Printed: 7/29/2002
Applicant: ELLIOT PILSHAW
Owner: DEFENDI CHRISTINA
JOB ADDRESS: 1225 NE 91 TERR
Contractor PRONTO PLUMBING INC Contractor's Address: 12135 NE 11 PL
Local Phone:
Parcel # 1132050010240 Legal Description: WATERSEDGE
Permit Status: Approved Permit Expiration: 1/25/2003 Construction Value: $1,200.00
Work: RESET FIXTURES
If there is no permit package accessible on the job -site for inspectors to verify, there will be no inspections. Re- inspection
fee is $50.00, which must be paid in advance before calling for another inspection.
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 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 pro er 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 i ondition 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 regulatio s 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 . employees.
Signed:
In considerati o
with the plans, draw
myself, my agent, se
•
t fee, 00
issuah e to me of
s, statements or s
ants or employe
Plumbing Permit
Permit Number: PL2002 -194
Page 1 of 1
PB 9 -141 LOT 28 & LOT 29 LESS E15FT BLK 1
Total Fees: $0.00
Total Receipts: $0.00
(INSPECTOR) BY:
his permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity
ecifications submitt =.js th- proper authorities of Miami Shores Village. In accepting this permit I assume responisibility for all work done by either
Signed: (Contractor or Builder) BY:
PAY
TO THE
« ORDER OE
��
PRONTO PLUMBING INC.
PH. (305) 892 -2255
12135 NE 11TH PLACE
NORTH MIAMI, FL 33161
TRANSATLANTIC
12700 Biscayne Blvd.
North Miami, FL 33181
0'00 26 4 Lo'
1
1:0670 L LB 2 5I: 5050645 L06»
2641
63- 1182/670
Permit No
E!a.nza
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
1225
No._.______ -_
2
Appl!cation i 1 ereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build ng 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 th Building Di ' sion
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.
__ Street N, 91
Owner's Name and Address_
Registered Architect and /or Engineer _ .
Employing Plumber's Name Q.u•a-r4ge,&_P bLrig_ Co., Inc- _ No._ 1083 _ _ _ Street _E. 2 3 St. HLaIeah
Location and Legal Description _ _ _ Block_ _ Subdivision_ _
Street and Number where work is to be performed —No 1225 N • E • 91 tQ' c k.N.r Miami ShOh2J6
State work to be performed and purpose of building (By Floors) _
New Building_-_ -- Remodeling__-__ ___ __ _ _ _ Addition_--_ _ ....... _ .. Repairs. - - - - - - - - - -N o . of Stories . ..
Size Septic Tank_ --
Feet of Drain Tile. _. _ __ __ _ __ _ _ _ .__ _Dist. Feet of Tank or Drain Field from Well._
Nature of Water Supply. City —Well.
Amount of Permit $ _ _ 3 .0 0 _
STATE OF FLORIDA,
COUNTY OF DADE.
My Commission Expires
_ Si s of Soakage Pit
- (Signed) - - --
The undersigned applicant for this building permit does hereby certify that he understands and ecezpts his obhgations as an e nployer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, rn 1 1 as om •
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by hin in the wo-k 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 no ices as are
required by the Act. The undersigned agrees to employ only such sub contractors, on work to be perfo. ed under this per nit, as are
licensed by Miami Shores Village.
__ Capacity Gals.
PLmb'g In:pecto.
( Signed) _.
Master Plumber.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledge ents, personal) 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 .acts
therein by hun stated are true.
— Notary Public, State of Florida
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
O
LAVA
TORIES
SI NKS
SLOP
SINKS
LAUNDRY
Tuss
URINALS
CATC:i
BASIN
FLOOR
DRAIN
ORINKI NG
FOU "T'N6
TOTAL
F %TURES
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
CHICK
1
Permit No
E!a.nza
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
1225
No._.______ -_
2
Appl!cation i 1 ereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build ng 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 th Building Di ' sion
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.
__ Street N, 91
Owner's Name and Address_
Registered Architect and /or Engineer _ .
Employing Plumber's Name Q.u•a-r4ge,&_P bLrig_ Co., Inc- _ No._ 1083 _ _ _ Street _E. 2 3 St. HLaIeah
Location and Legal Description _ _ _ Block_ _ Subdivision_ _
Street and Number where work is to be performed —No 1225 N • E • 91 tQ' c k.N.r Miami ShOh2J6
State work to be performed and purpose of building (By Floors) _
New Building_-_ -- Remodeling__-__ ___ __ _ _ _ Addition_--_ _ ....... _ .. Repairs. - - - - - - - - - -N o . of Stories . ..
Size Septic Tank_ --
Feet of Drain Tile. _. _ __ __ _ __ _ _ _ .__ _Dist. Feet of Tank or Drain Field from Well._
Nature of Water Supply. City —Well.
Amount of Permit $ _ _ 3 .0 0 _
STATE OF FLORIDA,
COUNTY OF DADE.
My Commission Expires
_ Si s of Soakage Pit
- (Signed) - - --
The undersigned applicant for this building permit does hereby certify that he understands and ecezpts his obhgations as an e nployer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, rn 1 1 as om •
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by hin in the wo-k 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 no ices as are
required by the Act. The undersigned agrees to employ only such sub contractors, on work to be perfo. ed under this per nit, as are
licensed by Miami Shores Village.
__ Capacity Gals.
PLmb'g In:pecto.
( Signed) _.
Master Plumber.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledge ents, personal) 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 .acts
therein by hun stated are true.
— Notary Public, State of Florida
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
Tulsa S
LAVA.
TONICS
SINKS
SLOP
SINKS
LAUNDRY
Tuns
URINAL[
CATCH
Swaim
FLOOR
DRAIN
DRINKING
FOUNT•NS
TI OTAL
rumTURES
CONTK.
LIST
CHECK
•—
SEPTIC
TANK
6[W[R
Comm.
DRAIN
FIELD
SOAKAGE
PIT
G
TRAP
SOLAR
HEATER
DEEP
WELL
B
SYSTEM
sWIM'O
POOL
CONTR.
LIST
.--
CN[CK
Permit No.
d 40
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith lbbmitted or 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 f
Owners Name and Addr G -XVC / r N.rif No Street.. .._
Registered Architect and /or Engin
EmploYief Plumber's / Name
0 E, No.,---21X-2 ..V . " .3--...... .
�i ., ...-. - -
Lbcatio maul Legal best ptption D Lot_ 1 0 l a'/ L E / s ' Mort Su yWon
Street and Number where work is to be performed —No 4992 r G Street..._..._ . _...._
. yam �
State work to be performed and purpose of building (By Floors)__ . L . � = . _ . 2v 9 a / . s
New Building.- __._— _..-- ..... .. -._.. Remodeling r.__ Addition..--_..._...__ Repairs No. of Stories
Size Septic Tank__
Feet of Drain Tile
Nature of Water Supply: City—WelL
Amount of Permit $__1.3 vV
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Type of Tank__
__Dist. Feet of Tank or Drain Field from Well...-.__. —_.
Size of Soakage Pit
Date. 37/
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 5986, Compiled General Laws of Florida Permanent Supplement, and Ilan com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the worb 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 err
required by die 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.
Master Plumber.
STATE OF FLORIDA, µ
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.
My Commission Expires Notary Public, State of Florida
NOTE: A re- inspection fee of $1.00 will be made when seek sriirpeotI.— fs mede'naoessmy by improper notice for depecdo , er family
materials and/or workmanship.
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333 N. E. 121t1, STREET NORTH MIAMI. R 101110A
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of
FIRE DEPARTMENT
PUBLIC WORKS
POLICE DEPARTMENT
BUILDING DIRECTOR
PLANNING & ZONING BO.ARU
VILLAGE COUNCIL
PRELIMINARY:
REMARKS:
THESE PLANS ARE APPROVED FOR ISSUANCE OF A OU;;MG PERMIT
0 WITH MO VARIANCES 0 WITH VARIANCE(S) 1 JST i1! "REMARKS"
NO OTHER DEVIATIONS FROM THE UAMl SLIORES BUN.91NG AND ZONING
ORDINANCES WILL BE pERmirrEo, UNLESS SPECIFICMY L!SIED BELOW.
ALL OTHER APPLICABLE STATE AND COUNTY LAWS MUST BE COMPLIED
WITH BY AU. PARTIES.
APPEVAL
FINA!..1
Authorized Signoture Date
V/.41
L
COMPLIANCE WITH THE SOUTH FLORIDA BUILDING CODE AS ADOPTED
BY MIAW SHORES VILLAGE IS REQUIRED. THF. ARCHITECT, BUILDER &
SUB CONTRACTORS ARE WITLI K 'O'N1 EnnE OF At 91111 D-
ING REGLILATIONS WEETHER.OR NOT SPECIFICALLY INDICATED HEREIN.