864 NE 91 Terr (8)Date - / I - 0 1
WORK DESCRIPTION
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Job Address 86., LP nl e q / Tax Folio
Historically Designated: Yes No
Master Permit #
Legal Description
Owner/Lessee / Tenant K o m ot---a
Owner's Address Phone 305 b 0 0 l/ 3 )
Contracting Co. NO V ✓ Ci(V P ( 1 Cf Address c, 6 I Al . �l. 118 Sf . Nl l /C ✓YYt//
Qualifier - 76k pkt, k. A 1l l SS# Phone 30 S 6 / 00 0 q
State # Municipal # Competency # C F CO 3 Ins. Co.e.2i3-7
Architect/Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type (circle one): BUILDING ELECTRICA PLUMB1NN MECHANICAL ROOFING PAVING FENCE SIGN
Square Ft. Estimated Cost (value) 7 0 0
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 a' . ' • amed contractor to do the work stated.
dka C ( i�
Signature of ov�ner and/or Condo President gnature of Con Owner Builder Date
Notary as to 0 d/or ondo President Date
My Commission Expires:
FEES: PERMIT
IMO
t.c-f-!-,,f , - l / - a l
P.3X;a Luocke
Comonneion * CC i1540212
Emilia hum 25, 200
"
Atlantiri Akeebarg 013., twc.
APPROVED:
Zoning
Mechanical Plumbing
Z!� 67 l / yo
4-1 1-0 (
Date
Building
ctor or
Notary as to ct br or Owner- Builder
My Commission Expires:
Electrical
�- /1 - ol
Date
Roller Luecke
Commission 6+ CC /64282
kzpirea lane 23, 2'08
P Thn44Tru
°ira a 06., lea
C.C.F. 6 0 NOTARY BOND
TOTAL DUE
Engineering
ITEM
3ATH TUB
UNIT
FEE
ITEM
SWITCH OUTLETS
UNIT
FEE
ITEM
SPACE HEATERS
UNIT
FEE
3IOET
LIGHT OUTLETS
CENTRAL HEATING
DISHWASHER
RECEPTACLES
A/C (WIND)
DISPOSAL
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 If
MECHANICAL VENTILATION
SINK, RESIDENCE
MOTORS OVER 5- 8 HP
TRANSPORTING ASSEMBLIES
SINK, SLOP
MOTORS OVER 8- 10 HP
ELEVATORS /ESCALATORS
TEMPORARY WATER CLOSET
MOTORS OVER 10- 25 HP
FIRE SPRINKLER SYSTEMS
URINAL
MOTORS OVER 25-100 HP
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
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
FIXTURES
SEPTIC TANK
ANTENNA
RELAY
TELEVISION OUTLETS
GRAINFIELD, 4' TILE/RES.
VIOLATION
PUMP R. 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
3AS RANGE
METER SET (GAS)
3AS PIPING
_
ADDENDUM TO BUILDING PERMIT APPLICATION
AN APPLICATION FOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. IF A MASTER PERMIT HAS B.
OBTAINED, THE OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.)
PLUMBING
ELECTRICAL
MECHANICAL
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
z /Z 1 V p� ! ^ 3 r
Date /[ Job Ad b64 P' `� ^ t QPP Tax Folio
Legal Description Historically Designated: Yes No
v r/Lessee / Tenant
Owner's Address
P134, vvoirt
Master Permit # 45 7
Phone ( 3o5) .5 et- 5 ?-
Contracting Co. 5 o^' a Address
Qualifier SS# Phone
State # Municipal # Competency # Ins. Co.
Architect/Engineer Address
Bonding Company Address
Mortgagor g f e4) 1 4i L N 42)+ JO UV Address
Permit Type (circle one): BUILDING ELECTRICAL
Square Ft.
14o (c7
LUMBING
7'rcc
MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION 5 t" K N . N 6 SYS t,t 2j - �G�S
Estimated Cost (value)
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 above -named contractor to do the work stated.
Signature of odn and/or Condo President
My Conunission Expires:
APPROVED:
Zoning Building
Mechanical Plumbing
3/Wei
3g °
i ature of Contractor or Owner - Builder � �
gr► Date
00
Notary as to Owner and/or Condo President Date Notary as to Con
My Co c ,.;, ,., F v p rep•
(2Y P OFRCIAL NOTARY SEAL
' � �1s1(tR UA T s
r , n F�� wa NUmaza
rv.i a CC797277
n _
OF R.d MY DEC. 17
FEES: PERMIT .
RADON
BOND
Electrical
r - 3/9-WY?'
or or Owner - Builder Date
TOTAL DUE
Structural Engineer
Permit No /
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 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. } L /= /��
/ ' / & ` (.� / /A2__ No 1 � (/ Street /- "
Owner's Name and Address —
Registered Architect and /or A• ! me /er/�
Employing Plumber's Name !I -�1L —N (2176
Location and Legal Description Lot Block
Street and Number where work is to be performed —No 'Y
State work to be performed and purpose of building (By Floors) .___. —
New Building_.. - -- .--------- - - - - -- -- - - -- Remodeling — _ --- __ -_ -- Addition
Amount of Permit $
STATE OF FLORIDA,
COUNTY OF DADE.
f
(Signed)
(Signed)
Size Septic Tank- - .` - - - -` --
Feet of Drain' e — "" `."F r i of T nk or Drain Field from Well ..
Nature of Water Supply: City — Well..— ...---- ----- ---- --- - - ---- •.Size of Soakage Pit
Date - - P -
a
Capacity Gals
��.� ,... /677- .
Street.- lJ ' — Q / .7
Repairs No. of Stories.. .......
P Iri.ap�c orr'
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 Sup6lement, and Ilan com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed / him in the work be
performed under this permit; and will post or cause to be posted' for inspection on the s e o e work such publ - notic _ or notices as ,, -
required by the Act The undersigned agrees to employ only such sub - contractors, wor to be erfbrmed under i s permit. as ar
licensed by Miami Shores Village.
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 be has carefully rend the foregoing application, and that he did sign the same, and that all facts
therein by hire stated are true.
My Commission Expires Notary Public, State of Florida
NOTE: A re- inspection fee of $1.00 will be made wheat =oh in-kaapecalasa is t aede•neeessary by improper notice foe inspection, or faulty
materials and /or workmanship.
CLOSETS
BATH
TUBS
SNOW ERO
LAVA-
TORIES
SINKS
SLOP
SINKS
LAUNDRY
Twos
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT' NO
TOTAL
FIXTURES
CONTR.
LIST
CHECK
■
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SWIM•S
POOL
CONTR
LIST
CHECK
Permit No /
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 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. } L /= /��
/ ' / & ` (.� / /A2__ No 1 � (/ Street /- "
Owner's Name and Address —
Registered Architect and /or A• ! me /er/�
Employing Plumber's Name !I -�1L —N (2176
Location and Legal Description Lot Block
Street and Number where work is to be performed —No 'Y
State work to be performed and purpose of building (By Floors) .___. —
New Building_.. - -- .--------- - - - - -- -- - - -- Remodeling — _ --- __ -_ -- Addition
Amount of Permit $
STATE OF FLORIDA,
COUNTY OF DADE.
f
(Signed)
(Signed)
Size Septic Tank- - .` - - - -` --
Feet of Drain' e — "" `."F r i of T nk or Drain Field from Well ..
Nature of Water Supply: City — Well..— ...---- ----- ---- --- - - ---- •.Size of Soakage Pit
Date - - P -
a
Capacity Gals
��.� ,... /677- .
Street.- lJ ' — Q / .7
Repairs No. of Stories.. .......
P Iri.ap�c orr'
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 Sup6lement, and Ilan com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed / him in the work be
performed under this permit; and will post or cause to be posted' for inspection on the s e o e work such publ - notic _ or notices as ,, -
required by the Act The undersigned agrees to employ only such sub - contractors, wor to be erfbrmed under i s permit. as ar
licensed by Miami Shores Village.
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 be has carefully rend the foregoing application, and that he did sign the same, and that all facts
therein by hire stated are true.
My Commission Expires Notary Public, State of Florida
NOTE: A re- inspection fee of $1.00 will be made wheat =oh in-kaapecalasa is t aede•neeessary by improper notice foe inspection, or faulty
materials and /or workmanship.
BUILDING
ELECTRICAL
PLUMBING
MIAMI SHORES VILLAGE, FLORIDA
PERMIT N2 4029
Work to be performed under this Permit
Owner of
Building
Architect
Contractor
or Builder
Legal Lot Bl. Subdi-
Description vision
Address of Value of Amt. of
Building 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 w th the understanding that the work wil 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.
Signed. 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 for all work done by either myself, my agent, servant or employee.
DATE
194 _. a .
Contractor's
License No.
CONTRACTOR OR BUILDER BY AUTHORITY
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Permit No old _ - Date Jan. 10 1967
Application is hereby merle 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 Mr . Egiamond No. _ 8_6) S -__.Ten
Registered Architect and /or Engineer_ __________
Employing Plumber's Name 0 ±_Ne aL_ S c p.bi.a- _Lank 0 n . 22nd Sitei __J ie_. -
Location and Legal Description Lot_-._---_......... —_— Block__
Street and Number where work is to be performed— No.__a 4__o- E eY9.1r3 _Th S_X'_AA St $k
State work to be performed and purpose of building (By Floors)--_---- _...... _ ..... ___.__.... ___ ....
_
drainfield ela
New Building ....._ . Remodeling____ _.._ Addition__ Repairs o. of tone . - -
Size Septic Tank
Feet of Drain Tile
Nature of Water Supply: City —Well.
Plumbing Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obi' ,: + ons as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Perna .e t Supplement, and has com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors emp oyed 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.
Amount of Permit 41_3_0_0D
STATE OF FLORIDA, I as,
COUNTY OF DADE.
My Commission Expires
Type of Tank._ Capacity Gals.__.
Dist. Feet of Tank or Drain Field from Well
---------- •----- ____ -- -Size of Soakage Pit
32 block drainfleld relay
(Signed) _
(Signed)
Master Plumber.
Subdivision
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.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
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.
CL.�BPTB
BATH
TUBS
SHOWERS
LAVA-
TORIES
SINKS
SLOP
SINK
LAUNDRY
TUBS
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT'NS
TOTAL
FIXTURES
4
CONTF.
LIST
CHECK
.........
SEPTIC
TANK
SEWER
CONN.
DRAIN SOAKAGE
FIELD PIT
GREASE SOLAR
TRAP HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SWIM'G
POOL
co .
—
32 block
re1 ay
3raain_�ield
CHECK
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Permit No old _ - Date Jan. 10 1967
Application is hereby merle 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 Mr . Egiamond No. _ 8_6) S -__.Ten
Registered Architect and /or Engineer_ __________
Employing Plumber's Name 0 ±_Ne aL_ S c p.bi.a- _Lank 0 n . 22nd Sitei __J ie_. -
Location and Legal Description Lot_-._---_......... —_— Block__
Street and Number where work is to be performed— No.__a 4__o- E eY9.1r3 _Th S_X'_AA St $k
State work to be performed and purpose of building (By Floors)--_---- _...... _ ..... ___.__.... ___ ....
_
drainfield ela
New Building ....._ . Remodeling____ _.._ Addition__ Repairs o. of tone . - -
Size Septic Tank
Feet of Drain Tile
Nature of Water Supply: City —Well.
Plumbing Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obi' ,: + ons as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Perna .e t Supplement, and has com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors emp oyed 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.
Amount of Permit 41_3_0_0D
STATE OF FLORIDA, I as,
COUNTY OF DADE.
My Commission Expires
Type of Tank._ Capacity Gals.__.
Dist. Feet of Tank or Drain Field from Well
---------- •----- ____ -- -Size of Soakage Pit
32 block drainfleld relay
(Signed) _
(Signed)
Master Plumber.
Subdivision
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.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
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.
Owner of
Building
Architect
Contractor
or Builder
Legal
Description
Address of
Building
Lot
CONTRACTOR OR BULL R
■
MIAMI SHORES VILLAGE, FLORIDA
BUILDING ❑ DATE 195
ELECTRICAL ❑ PERMIT IC? 13806
PLUMBING
ROOFING ❑ Work to be performed under this Permit
BI.
Subdi-
vision
Value of
Project $
Contractor's
License No
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 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.
Signed. ' 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 for all work done by either, myself, my agent, servant or employee.
Amt. of
Permit
BY AUTHORITY
Permit No.. __- l --D 6
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 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 Divisior
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept al
building during progress of work.
Owner's Name and Address OD . _ 61!"..,,®v---° No Street
Registered Architect and /or Engineer �
Employing Plumber's Name___ ________ ___ _ , pp ° ' ___ No. Street._
Location and Legal Description Lot____..______ _Block___.___ __ Subdivision
Street and Number where work is to be performed —No. ° $.�AL_.____._ � .- 9.. LF ~
State work to be performed and purpose of building (By Floors)_
New Building .- Remodeling Addition Repairs.
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.- ' 0 _ - - - - -- - Size of Soakage Pit
Amount of Permit $
My Commission Expires
(Signed)
Date
Capacity Gals.
No. of Stories
Notary Public, State of Florida
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
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 perform - . - under this permit, as an
licensed by Miami Shores Village.
(Sign ell) -. : — -C'- _& C-i..0 1
Master Plumber.
STATE OF FLORIDA, sc.
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally .lppeare
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 i.Ic
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 f,nll
material lad/or workmanship.
CLOSETS
BATH
TUBS
SHOWERS
LAVA -
TORIES
SINKS
SLOP
SINKS
LAUN DRY
TUBE
URINALS
INALS
CATCH
BABIN
FLOOR
DRAIN
DRINKIMO
FOUNT'NS
/
iiCO �,
TOTAL
FIXTURE!
CONTR.
LIST
3
J
� - ..
I
/
.41
CHECK
1)
5 U
R ��
l°
nlJ
G
�
�
zs
EP
WELL
--
- - —
SEPTIC
TANK
SEWER
CONN.
AIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
,---,- ,
SPRKLR.
SYSTEM
SWIM '0
POOL
I e �
HEATER
COHTR.
LIST
X' W
4
CHECK
C2 .
/ O 0
j�
/ Q e)
Permit No.. __- l --D 6
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 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 Divisior
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept al
building during progress of work.
Owner's Name and Address OD . _ 61!"..,,®v---° No Street
Registered Architect and /or Engineer �
Employing Plumber's Name___ ________ ___ _ , pp ° ' ___ No. Street._
Location and Legal Description Lot____..______ _Block___.___ __ Subdivision
Street and Number where work is to be performed —No. ° $.�AL_.____._ � .- 9.. LF ~
State work to be performed and purpose of building (By Floors)_
New Building .- Remodeling Addition Repairs.
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.- ' 0 _ - - - - -- - Size of Soakage Pit
Amount of Permit $
My Commission Expires
(Signed)
Date
Capacity Gals.
No. of Stories
Notary Public, State of Florida
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
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 perform - . - under this permit, as an
licensed by Miami Shores Village.
(Sign ell) -. : — -C'- _& C-i..0 1
Master Plumber.
STATE OF FLORIDA, sc.
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally .lppeare
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 i.Ic
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 f,nll
material lad/or workmanship.
st
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 Miaini 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 Divisior
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
Size Septic Tank -- ..... O D
Nature of Water Supply: City —Well
0 v
Amount of Permit $_ 1, -
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
No Street
Registered Architect and /or Engineer
Employing Plumber's Name
Location and Legal Description Lot._ Block__ Subdivision •
Street and Number where work is to be performed —No. 4:-C.D. ___ X11_._ E ._ Street- 2 _.L L
t� — -- - No
State work to be performed and purpose of building (By Floors)
New Building Remodeling Addition Repairs
Type of Tank___
Feet of Drain Tile � U Dist. Feet of Tank or Drain Field from Well
—. Size of Soakage Pit
(Signed)
Date
Street
Capacity Gals.
My Coinmission Expires Notary Public, State of Florida
No. of Stories
PlunThing Inspector.
The undersigned applicant for this building permit does hereby certify that he understand and accepts his obligations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5988, Compiled General Laws o lorida 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 the Act. The undersigned agrees to employ only such sub- contractors, on work to be performed under this permit, as art
licensed by Miami Shores Village.
(Signed) -- / C-‘7
/
M aster Plumber.
STATE OF FLORIDA, }
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally .Ippeare
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 tae
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 Lail
m terials and /or workmanship.
CLOSETS
BATN
TUBS
SHOWERS
LAVA-
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TUBE
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT'NS
-
--
TOTAL
FIKTUREI
— —_
CONTR.
LIST
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SWIM'G
POOL
CONTR.
LIST
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 Miaini 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 Divisior
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
Size Septic Tank -- ..... O D
Nature of Water Supply: City —Well
0 v
Amount of Permit $_ 1, -
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
No Street
Registered Architect and /or Engineer
Employing Plumber's Name
Location and Legal Description Lot._ Block__ Subdivision •
Street and Number where work is to be performed —No. 4:-C.D. ___ X11_._ E ._ Street- 2 _.L L
t� — -- - No
State work to be performed and purpose of building (By Floors)
New Building Remodeling Addition Repairs
Type of Tank___
Feet of Drain Tile � U Dist. Feet of Tank or Drain Field from Well
—. Size of Soakage Pit
(Signed)
Date
Street
Capacity Gals.
My Coinmission Expires Notary Public, State of Florida
No. of Stories
PlunThing Inspector.
The undersigned applicant for this building permit does hereby certify that he understand and accepts his obligations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5988, Compiled General Laws o lorida 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 the Act. The undersigned agrees to employ only such sub- contractors, on work to be performed under this permit, as art
licensed by Miami Shores Village.
(Signed) -- / C-‘7
/
M aster Plumber.
STATE OF FLORIDA, }
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally .Ippeare
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 tae
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 Lail
m terials and /or workmanship.