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898 NE 91 Terr (4)Type Insp'n Phone # Inspection Date Approved Correction Re- Insp'n Fee MIAMI SHORES VILLA BUILDING DEPARTME 305- 795 -2204 Building Inspection Request Date ' I ? J /MANI Permit No. Name (eC Address 71q1C co +err • Company 17go - 046 -sl a0 Owcyl- Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Printed: 3/12/2004 Applicant: MICHAEL Owner: BECK JOB ADDRESS: 898 Contractor G & L PLUMBING SERVICE Local Phone: 305 - 551 -5090 Parcel # 1132060050310 NE 91 Signed: (INSPECTOR) Plumbing Permit Permit Number: PL2004 -86 BECK MICHAEL TERR Contractor's Address: 12335 SW 31 ST Page 1 of 1 Legal Description: GOLDEN GATE PARK ADDN PB 6 -130 LOT 1 E25FT OF LOT 2 BLK 3 LOT SIZE Fees: FEE2004 -2664 FEE2004 -2665 FEE2004 -2666 FEE2004 -2667 FEE2004 -2668 Description Building Fee CCF Notary Fee Training and Education Fee Technology Fee Total Fees: Amount $150.00 $1.20 $5.00 $0.40 $3.75 $160.35 Total Fees: $1AQ.3 5 Total Receipts: -$0.00 1, 0,35 0 t_c_( Permit Status: APPROVED Permit Expiration: 9/7/2004 Construction Value: $1,500.00 Work: PLUMBING FOR REMODELING REPIPE HOUSE PeA R 1 7 PAID 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: (Continued on opposite side) Miami Shores Village 1 2004 Building Department BUILDING PERMIT APPLICATION FBC 2001 Permit Type (circle): Building Electrical Plumbing Mechanical Roofing Owner's Name (Fee Simple Titleholder) B -Ge- Phone # 7 S - 7 t,a c Owner's Address V"? V w L = 1 7 e.r ,-� City Ni . 4-,- , S 11 v x . State F Zip Tenant/Lessee Name Phone # \_/ - Job Address (where the work is being done) - ci. rL)'. 5 1 l r a City Miami Shores Village County Miami -Dade Zip Is Building Historically Designated YES NO Contractor's Company Name Contractor's Address c� 33� St..J s/ City 1J4 , 8 ,vt State F (- Qualifier Z7 c AC( Architect/Engineer's Name (if applicable) Phone # $ Value of Work For this Permit Type of Work: ['Addition ['Alteration ❑New Repair/Replace ❑ Demolition Describe Work: R le k C 1734 ****************************F Submittal Fee $ 50 • c0 Permit Fee $ /Sb Notary 4-b Training/Education Fee D Scanning $ Radon $ Code Enforcement $ Total Fee Now Due $ I 1 0 [- 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Structural Plan Review. $ Permit No. PI ZO 4 5(, Master Permit No. ! ? c2 Zy 56C) Phone # ) cc 2D 9 - 364V Zip r �, 7 l / C/7i Square Footage Of Work: CCF $ 1 , O CO /CC Technology Fee $ 3, S Zoning Bond $ 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 conunencement 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 NOTARY PUBLIC: NOTARY PUBLI Sign: Sign: Print: Print: My Commission Expires: State Certificate or Registration No. Certificate of Competency No. * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** APPLICATION APPROVED BY: Chc 12/15/03 Signature Signature Owner or Agent / Contractor The foregoing instrument was acknowledged before me this The foregoing instrument was acknow edged before me this( day of , 20 _ , by , day of arm YU' ` , 206q, by n who is personally known to me or who has produced who pe sonally known to me or who has . roducedaW L Cl/. As identification and who did take an oath. 5 (1 as identification and who did take an oath. r r'e( My Commission Expire Expires: Jul 13, �• o - Bonded Thr? „ (Certificate of Competency Holder) ******************************** * * * * * * * * / * * * * * * * * * * * * * * * * * * ** 3 -/7- Q / Plans Examiner Engineer Zoning to - Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 BUILDING PERMIT APPLICATION FBC 2001 Miami Shores Village Permit No. V- &Veg v7 Master Permit No. L _. 1 , ',,��►�� Permit Type (circle): Building Electrical ( _ Plumbin _ Mechanical Roofing ) Owner's Name (Fee Simple Titleholder) \ \ (\ \t_ - -J 11 Phone # r Q Owner's dress 0 t� � P,\ E 1 s City .. d / State = (_ Zip 2—) ii Tenant/Lessee Name Phone # - 4i - Z O i •(r.) Job Address (where the work is being done) qc C�( t1 E °� � . ( City Miami Shores Village County Miami-Dade Zip Is Building Historically Designated YES , NO ✓ b R M1 U r I , l. Contractor's Company Name (..._0 N.-:- J tale CL Ar Phone # -� 2 Contractor's Address 9 t v I ? L- ' City 1 ■ 'Dn,CA ∎ State �t - Zip � Qualifier (1.C: v \2. i)‹ \C% ( \) L• Architect/Engineer's Name (if applicable) Phone # $ Value of Work For this Permit 11-:r' . Square Footage Of Work: Type of Work: ❑Addition Alteration ❑New ❑ Repair/Replace ' - ^❑ 1 Describe Work: ( ►�'1Q? L \ he.. �� ) l 4A * * * * * * * * * * * * * * * * * * * * * * * * * ** *F * * * * * * * * * * * * * * * * * * * * * * * * ** Submittal Fee $ �� 4 ' ermit Fee $ IP CCF $ CO /CC Notary $ ( Training/Education Fee $ a-c) Technology Fee $ j . OC,, Scanning $ S. ( Radon $ Zoning Bond $ Code Enforcement $ Structural Plan Review. $ Total Fee Now Due $ (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. i L The forgoing instrument as acknowledged before me this The foregoing instrument wa day of �" t by W \ cPekv 'C- , day of lf " , 20 who is sonally kn -to me or who has produced who is personally known to As id' ntyf t ion and v ihai �St� f ∎ MY COM MISSION 4 CC 432 Bonded EXPIRES N 2 TARP P aar% 7ubtic U ] My Commission Expires: ********* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** ***************** * * * * * * * * * * * * * * * *,t * * * * * * * * * * * ** * * * * * * * * * * * * * ** ** My Commission Expires: Chc 12/15/03 Owner or Agent r Registration No. APPLICATION APPROVED BY: 3 Signature Si Print: (Certificate of Competency Holder) aside ntractor acknorvled: d before me thi2? by GOica 1. :. r who has produced vn and whedjlk "--t'�REZ"....r C MISSION S kc 4S27 T II Certificate of Competency No. # # # # # # # # # #.# # # # # # # # # # # # # # # # # # ## iik , A Plans Examiner Engineer Zoning f •? 4 / / � APPLICANT: Pallo, Sandra LOT: 2 BLOCK: 3 OTHER REMARKS: DATE ISSUED: 10/30/01 STATE OF FLORIDA } . DEPARTMENT OF HEALTH ONSITE SEWAGE TREATMENT b DISPOAL EM CONSTRUCTION PERMIT CONSTRUCTION PERMIT FOR: [ ]New System [ ]Existing System ( ]Holding Tank [ X ]Repair [ ]Abandonment [ ]Temporary PROPERTY STREET ADDRESS: 898 NE 91 Ter FL 33138 PROPERTY ID #: 11- 3206 - 005 -0310 SYSTEM DESIGN AND SPECIFICATIONS L D FILL REQUIRED: [ 0.0 ]INCHES AGENT: SR0001343, Crockett Lester SUBDIVISION: Golden Gate [Section /Township /Range /Parcel No.] [OR TAX ID NUMBER] SYSTEM MUST BE CONSTRUCTED IN ACCORDANCE WITH SPECIFICATIONS AND STANDARDS OF CHAPTER 64E -6,FAC DEPARTMENT APPROVAL OF SYSTEM DOES NOT GUARANTEE SATISFACTORY PERFORMANCE FOR ANY SPECIFIC TIME PERIOD. ANY CHANGE IN MATERIAL FACTS WHICH SERVED AS A BASIS FOR ISSUANCE OF THIS PERMIT, REQUIRE THE APPLICANT TO MODIFY THE PERMIT APPLICATION. SUCH MODIFICATIONS MAY RESULT IN THIS PERMIT BEING MADE NULL AND VOID. ISSUANCE OF THIS PERMIT DOES NOT EXEMPT THE APPLICANT FROM COMPLIANCE WITH OTHER FEDERAL, STATE OR LOCAL PERMITTING REQUIRED FOR PROPERTY DEVELOPMENT. T [ 900 ]Gallons SEPTIC TANK A [ 0 ]Gallons N [ 0 ]GALLONS GREASE INTERCEPTOR CAPACITY K [ 0 ]GALLONS DOSING TANK CAPACITY [ 0 ]GALLONS @ [0 EXCAVATION REQUIRED: [ 30.0 ] INCHES Invert Elevation of the Drainfield to be no less than 11.5' NGVD Bottom Elevation of the Drainfield to be no less than 11.0' NGVD This permit is not for addition. SPECIFICATIONS BY: Paul Levelt Andre, P.E TITLE: -o F• a (2 CENTRAX #: 13 - - 10780 DATE PAID:le_? ®i FEE PAID : $ RECEIPT :�a /IpT el OSTDSNBR : 01 - ] Innovative Other MULTI - CHAMBERED /IN SERIES: [Y ] MULTI - CHAMBERED /IN SERIES: [Y ] ]DOSES PER 24 HRS # PUMPS[ 0 ] D [ 300 ]SQUARE FEET PRIMARY DRAINFIELD SYSTEM R [ 0 ]SQUARE FEET SYSTEM A TYPE SYSTEM: [ N ]STANDARD [ N ]FILLED [ N ]MOUND [ N ] I CONFIGURATION: [ N ]TRENCH [ N ]BED [ N ] N F LOCATION TO BENCHMARK: Finished Floor of Existing Res. Elev. 15.1' NGVD I ELEVATION OF PROPOSED SYSTEM SITE [ 1.6 ] [ FEET ] [ BELOW BENCHMARK /REFERENCE POINT E BOTTOM OF DRAINFIELD TO BE [ 4.1 ] [ FEET ] [ BELOW BENCHMARK /REFERENCE POINT APPROVED BY: Andre, Paul TITLE: EH Supervisor Dade DH 4016, 03/97 (Obsoletes previous editions which may not be used) (Stock Number: 5744- 001 - 4016 -0) [ostds cons 4016 -1[ • •.EXPSRA'lQ DATE: 1/28/02 CHD Page 1 of 2 • STATE OF FLORIDA DEPARTMENT OF HEALTH APPLICATION FOR ONSITE SEWAGE DISPOSAL SYSTEM CONSTRUCTION PERMIT Permit Application Number PART II - SITEPLAN Scale: Each block represents 10 feet and 1 inch = 40 feet. PJ?c S I �rAJ it F /C7-40 ! m , a / 13 tzz 1,C0 oiY Erk 7d at? REEdickb Notes: n4 P /L. UpC JL "moo HYDPI &G !C OVEkLriallb aximmmei.o•••••.•ww■m•IYININIIi 409/11. i Al L / 57 02 TlR4c (, i'j` / /7n') f i'go?l-E F , 35, 3e L P b e , - ; u ' ,>//' T L- RA 77 / l J G - ' 7 fo B$i AL fici Z Site Plan submitted y: ! (_ 7t �T Plan Approved . 2' F. ofAp� p ved Date / `» '75) e By -� '- 1,'1�; County He ALL CHANGES MUST BE APPROVED BY THE COUNTY HEALTH DEPARTMENT DH 4015, 10/96 (Replaces HRS-H Fort 4015 which may be used) (Stock Number. 5744 - 002 -4015 -6) Page 2 of 4 APPLICANT: LOT: PROPERTY ID I: 'y SITE EVALUATED BY: STATE OF FLORIDA - DEPARTMENT OF HEALTH ONSITE SEWAGE DISPOSAL SYSTEM SITE EVALUATION AND SYSTEM SPECIFICATIONS BLOCK: ' SOIL PROFILE INFORMATION SITE 1 OH 4015, 10196 (Replaces HRS -H Form 4015 [Paps 3] which may be used) (Stock Number: 5744 -003 - 4015 -1) SUBDIVISION: Munsell # /Color Texture USDA SOIL SERIES: Depth to to ; ..'' to to to to to to to AGENT: i „1 l' :. , PERMIT I • [Section /Township /Range /Parcel No. or Tax ID Number] TO BE COMPLETED BY ENGINEER, HEALTH UNIT EMPLOYEE, OR OTHER QUALIFIED PERSON. ENGINEER'S MUST PROVIDE REGISTRATION NUMBER AND SIGN AND SEAL EACH PAGE OF SUBMITTAL. COMPLETE ALL ITEMS. PROPERTY SIZE CONFORMS TO SITE PAN: [ of YES [ ] NO NET USABLE, ,A_AVAILABLE: -.1 ACRES TOTAL ESTIMATED SEWAGE FLOWi, GALLONS PER DAY '[.RESIDENCES- TABLE :,/ OTHER -TABLE 2] AUTHORIZED SEWAGE FLOW: 44(2) GALLONS PER DAY [1500 GPD /ACRE OR 2500 ,ppD /ACRE] UNOBSTRUCTED AREA AVAILABLE:, SQFT UNOBSTRUCTED AREA REQUIRED: ,,4 .. ,t.) SQFT BENCHMARK /REFERENCE POINT LOCATION: ELEVATION OF PROPOSED SYSTEM SITE IS s '= , rpidE W FT] [ABOV ELOi _BENCHMARK /REFERENCE POINT THE MINIMUM SETBACK WHICH CAN BE MAINTAINED FROM THE PROPOSED SYSTEM TO THE FOLLOWING FEATURES: SURFACE WATER. d '' ,'• _ i l FTe. DITCHES /SWALES: iii / % ' FT NORMALLY WET? [ ] YES y" ] NO WELLS: PUBLIC: i - FT LIMITED USE: c "e, r¢ ^' FT I bf, : /'; FT NON - POTABLE: 44 FT BUILDING FOUNDATIONS: FT PROPERTY LINES: 4 . \ FT POTABLE WATER LINES: + FT SITE SUBJECT TO FREQUENT FLOODING: [ 51- ti ] _YES (= O 10 YEAR FLOODING? [ ] YES_ NO y 10 YEAR FLOOD ELEVATION FOR SITE: •4 FT MSL NGVD SITE ELEVATION: ','',..1 IT MSUNGVD SOIL PROF/ME INFORMATION SITE 2 Munsell # Color xa :7 USDA SOIL SERIES: '.' . >/ Texture Depth f,) ': to '< : ) to ' E= ±?S ✓/� „�.., to to ?, to to to to - .4 14 • OBSERVED WATER TABLE: 4 "` INCHES [ABOVE / BELOW] EXISTING GRADE. TYPE,,:..- .[PERCHED / APPARENT] ESTIMATED WET SEASON WATER TABLE ELEVATION: /!-20 CINCHEf [ ABOVE/Lit EXISTING GRADE. HIGH WATER TABLE VEGETATION: -j DEPTH: 'a [ ] YES [ _,�] NO MOTTLING: [ ] YES (� NO INCHES DEPTH OF EXCAVATION: SOIL TEXTURE /LOADING RATE FOR SYSTEM SIZING: DRAINFIELD CONFIGURATION: [ ] TRENCH [ I REMARKS /ADDITIONAL CRITERIA: BED [ ] OTHER (SPECIFY) / DATE: ' INCHES Page 3 of 3 INSTRUCTIONS: {P PERMIT NUMBER: Permit tracking number by County Health Department. APPLICANT: Property owner's full name. AGENT: Property owner's legally authorized representative. LOT, BLOCK, SUBDIVISION: Lot, block, and subdivision for lot. PROPERTY ID NUMBER: 27 character number for property (property appraiser ID number or section /township /range /parcel number). PROPERTY SIZE: Check if property at site conforms to submitted site plan. Record net usable area available - lot area exclusive of all paved areas and prepared road beds within public rights -of -way or easements and exclusive of streams, lakes, normally wet drainage ditches, marshes, or other such bodies of water. SEWAGE FLOW: UNOBSTRUCTED AREA: MINIMUM SETBACKS: Record the estimated sewage flow for the establishment from Table 1 (residence) or Table 2 (non - residential), Chapter 10D-6, FAC. Record the authorized sewage flow for the lot based on net usable area and water supply (1500 gallons per day per acre for private water supplies and 2500 gpd per acre for public water supplies). If authorized sewage flow does not equal or exceed the estimated sewage flow, the application must be denied. Record the square feet of unobstructed area available and the amount required. Unobstructed area must be at least 2 times as large as the drainfield absorption area and at least 75 percent of the unobstructed area must meet minimum setbacks in Chapter 10D -6, FAC. The unobstructed area must be contiguous to the drainfield. BENCHMARK INFORMATION: Record the location of the benchmark. If using a surveyor's benchmark record the actual elevation. Record the elevation of the proposed system site in relation (above or below) to the benchmark. Record minimum setbacks which can be meet to all listed features. Actual measurements must be recorded or "NA" for nonapplicable features. Features on site plan or within 75 feet of the applicant lot must be measured. The location of any public drinking well within 200 feet of the applicant's lot must also be verified. FLOOD INFORMATION: Record information on lot's subject to flooding. For lots subject to flooding record 10 year flood elevation for site and actual site elevation. SOIL PROFILE INFORMATION: Two soil profiles within the proposed absorption area to a minimum depth of 6 feet or refusal are required. Soil identification will use USDA Soil Classification methodology (Munsell colors and USDA soil textures). Refusals must be clearly documented. Provide USDA soil series if available, record "UNK" if the series cannot be determined. WATER TABLE: Record the depth of the observed water table at the time of the evaluation. Mark "perched" or "apparent" as appropriate. Record the estimated wet season water table elevation based on site evaluation, USDA soil maps, and historical information. Indicate if there is high water table vegetation present. Indicate if mottling is present and depth. SOIL TEXTURE: Record soil texture or loading rate for system sizing. DEPTH OF EXCAVATION: If applicable record depth of excavation required. Record "NA" if not applicable. DRAINFIELD CONFIGURATION: Check drainfield configuration required. If other, specify type. ADDITIONAL CRITERIA: Record any additional remarks pertinent to site or installation. Ex. dosing required. SITE EVALUATED BY: Signature of evaluator, title, and date of evaluation. Professional engineers must seal all documents submitted. ELEVATION WORKSHEET ELEVATION OF BENCHMARK / REFERENCE POINT IS: BENCHMARK SITE l SITE 2 SITE 3 [ + ] SHOT H.I. H.I. H.I. H.I. [ - ]SHOT [ - ]SHOT [ - ]SHOT CONTRACTOR Name LLDyD /);77 D % / Cr 9(70 , / d License No. ,Z7 0 ?"/ d3' Address �7Y3 tu , ,, /D ? � / /q' l /,c-z., llt 53/ 6 P' Telephone Fax 2�. °�_� H 1p 3 7) , 1 _ 74.v... - 76 , 74 / E7 Qualifier Name ces- , - C o c k PROPERTY OWNER rn Name ov/A.)7)) 4 a...0 Address f3 NC 9 /sr 1 /14///-14/ �.3� -1e R Home Telephone _73 -7 , 9 7 / !7 � 7' ' � Business Telephone Fax TYPE OF MANAGEMENT (✓ ) New Construction Enclosure Alteration Exterior Repair Alteration Interior Demolish Relocation of Structure Shell Only Foundation Only Add'l Attachment Other Add'l Detachment Other Page 4 OFFICE USE ONLY CHECKLIST ❑ OWNER - BUILDER FORM (Attach) ❑ FIRE DEPARTMENT APPROVAL (Commercial / multi- family) ❑ CONCURRENCY (New Construction) ❑ 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 $ ❑ PROOF OF OWNERSHIP (Attach) • ❑ HRS / DERM APPROVAL (Septic / Sewer) ❑ IMPACT FEE (New Construction) ❑ OTHER (Specify & Attach) PERMIT FEES Ob $ 3oo,ec) D (sq.ft. = x/1000 x ¢.60) $ (¢.005 / sq.ft.) (¢.0I /sq.ft.) PERMIT APPLICATION ❑ CONDO ASSOCIATION APPROVAL (Attach) ❑ BPR APPROVAL (Restaurants) ❑ CONTRACTOR REGISTRATION (On File) TOTAL $ L (a) t ISSUING OFFICIAL REVIEWED AND PREPARED BY: SECTION Zoning Electrical Plumbing Mechanical Fire Public Works Structural Building Official BY DATE DATE: CONDITION OF APPROVAL Revised July 2001 10050 N.E. 2"D AVE., MIAMI SHORES, FL • (305) 795 -2207 • FAX (305) 756 -8972 • http : / /www.miamishoresvillage.com INSTRUCTIONS - The following steps must he taken to obtain a permit from the Miami Shores Village: Step 1. Tenant Information 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. APPLICATION Job Address: Complete the attached permit application which must be signed by the prope y 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 submitted along with this permit application. Folio Number // 3 - r d -10 Lot .. Block Subdivision (TDL,?t ?. t PB PG Zoning Linear Feet Current Use of Property RL / / /pit_ Square Feet Units Floors Proposed Use of Property 514704; Value of Work l (50 • CO Bldg Value Tax Assessed/Appraised Value Flood Zone PERMIT TYPE (✓ ) Building Electrical Mechanical Plumbing LPGX Roofing Fence Other ?En Air q/Er, ax ir: //411 4,14/ Oy E� Address Apt. City PERMIT CHANGE (✓ ) Chg. Contractor Renewal Revision Extension Supplement Reinspection ARCHITECT Name License No. Address Telephone Fax Description of Work PERMIT APPLICATION Master Permit No. Subsidiary Permit No. .5 o j 7 State Zip CP/Me ,P4/ J i /Ls,2E- z T/�vk t -a � EAJ 6 -G e l ) ARK / 402) /:2 . 49 ;/1 j .3 /5 Base Floor Elev. ENGINEER Name License No. Address Telephone Fax ELECTRICAL TYPE Minimum Fee QTY. TYPE Dryer QTY. TYPE Outlet, Appliance QTY. TYPE Service Repair QTY. A/C Central 1 -3 Ton Cooling Tower Fan Outlet, Wall Service, Temporary A/C Central 4 -7 Ton Paint Booth Fire Pump Ventilation, Cost Outlet, Switch Air Handler, Tons Signs Ductwork, Cost of A/C Central 8 -15 Ton Fixture - Fluorescent Oven Space Heater (kw) Process/Pressure Piping A/C Central 16-20 Ton Fixture Light Bath Fan - Vented, # Parking Lot Lights Fireplaces, Number of 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 Service, Number of Amps Water Heater New NIECHANICAL TypE Minimum Fee QTV Ti Condensate Drain cm'. TYPE Generator QTY TYPE Refrigeration, Tons QTY A/C Central, Tons Bath Tub Cooling Tower Heating Strips, each Vent Hood, Cost A/C Wall/Win. Tons Dryer Vents, Number of Paint Booth Filter Replace Ventilation, Cost Pool Piping Air Handler, Tons Sprinkler Repair Ductwork, Cost of Piping, Flammable Liquid Periodic Inspections Barbecue Fire Sprinkler System Process/Pressure Piping Cap - Water Gas - Appliance Bath Fan - Vented, # Pump, Domestic Fireplaces, Number of Pressure Vessel Cap - Sewer PLUMBING TYPE A/C Condensate QTY. TYPE Drains, Roof Q TYPE Miscellaneous Fixture QTY. TYPE Soakage Pit QTY. Bath Tub Drinking Fountain Miscellaneous Repairs Solar Water Heater Bidet Filter Replace Pool Piping Sprinkler Repair Cap - Fixture 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 Septic Tank Water Heater New Drains, Area Meter Set (Gas) Sewer Connection `Water Re -pipe Drains, Floor Minimum Fee Shower .Water Seryic Drains, French Miscellaneous Equipment Sink Well, Supply Page 2 IMPORTANT NOTICES 1. po NOT BEGIN ANY WORK WITHOUT HAVING RECEIVED YOUR VALIDATED PERMIT AND PERMIT CARD. Applying for a permit does not grant the right to begin construction. HOURS OF CONSTRUCTION are limited to: Monday through Friday from 7:30 a.m. to 6:00 p.m., and Saturday from 8:00 a.m. to 5:00 p.m. No inspections will be conducted on weekends or holidays. 2. All construction of demolition areas MUST BE MAINTAINED IN A CLEAN, NEAT AND SANITARY CONDITION free from construction debris. 3. STREETS AND NEIGHBORING PROPERTIES SHALL BE KEPT FREE FROM DIRT AND DEBRIS. 4. SWALES MUST BE PROTECTED FROM BEING DAMAGED BY EQUIPMENT OR VEHICLES, AND MAY NOT BE USED FOR STORAGE. A bond is required for work in or near the street/sidewalk. 5. CONSTRUCTION TRAILERS ARE PROHIBITED ON SINGLE FAMILY RESIDENTIAL CONSTRUCTION SITES. Other construction may have a trailer which requires a separate permit. 6. PORTABLE TOILETS for a construction site require a separate permit. 7. DO NOT DISCHARGE WATER INTO THE RIGHT OF WAY OR STORM DRAINS without approval from the Building, Planning and Zoning Department. 8. EQUIPMENT AND MATERIALS SHALL BE STORED at least 10 feet from the edge of pavement. 9. Department of Health and Rehabilitative Services (HRS) approval is required for applications involving septic tanks. Department of Environmental Resources Management (DERM) and/or Miami -Dade Water and Sewer Department (MDWASD) approval is required for applications involving sewers. AFFIDAVIT - Please read carefully. Application is hereby made to obtain a permit to do work and installation as indicated. I, the OWNER of the property, certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits are required for ELECTRICAL, PLUMBING, POOL, EXTERIOR DOOR, MECHANICAL, WINDOW, FENCE, DRIVEWAY, ROOFING and SIGNS and there may be additional permits required from other governmental agencies. I, the OWNER of the property, have disclosed all information related to any work at the property performed in the prior twelve months to the Building Official. Further, I am fully aware that if the cumulative cost of work to my home or business under this and any other permit equals or exceeds fifty percent (50 %) of the fair market value of the structure, the entire structure must meet the present federal flood criteria for finished floor elevation. I am also fully aware that if the total cost of work to my home or business under this and any other permit exceeds fifty percent (50 %) of the replacement cost of the structure, then the entire structure must conform to the current code requirements of the Building Code. WARNING TO OWNER: Your failure to record a NOTICE OF COMMENCEMENT may result in you paying twice for improvements to your property. If you are spending more than $2,500 or intend to obtain financing, you may wish to consult with your attorney or lender before recording your Notice of Commencement. The Notice of Commencement must be recorded at: 22 N.W. 1st Street, 1° Floor, (305) 679 -1078. Once recorded, the Notice of Commencement must be POSTED AT THE JOB SITE in accordance with Section 713 -35 of Florida Statutes. Review the brochure at Village Hall on Construction Lien Law and Choosing a Contractor. STATE OF FLORIDA, COUNTY OF MIAMI -DADE Signature of Owner )nivDM r pA-L Lc Print Name y ,�,�,j Print Name S . • and subscribed before me this L ZW day of AJOVa �G Swomno and subscribed before me this 5 day of _ f t- a LESTER E. CROCKS Tf c * MY COMMISSION # DO 014762 EXPIRES: May 20, 2005 ?pr Bonded Tin Budget —�— "ter sues . oll onda A Signature of SEAL: Personally known OR, Produced Identification Type of Identification Produced: • F . • RID f 1 : PP Y F MIAMI - DADE y � .4 ./ �Q Signature 0 s . . u . L L � � % C i f L- C c 7 T ature of otary Pu SEAL: Personally known PERMIT APPLICATION -Dada- RY P'- O . T . :c:. I t:. Z lam/ � l - YJC c ..z_�t 1. i ooz.: S .o;r wJr^str, F . OR, Produced Identification 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: ITEM BATH TUB UNIT FEE ITEM SWITCH OUTLETS UNIT FEE ITEM SPACE HEATERS UNIT FEE BIDET 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 (MOUND 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 FP ELEVATORS/ESCALATORS TEMPORARY WATER CLOSET MOTORS OVER 10- 25 If 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 1 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 DRAINFIELD, 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 GAS RANGE METER. SET (GAS) GAS PIPING 1Z/ ADDENDUM TO BUILDING PERMIT APPLICATION PL XP6Y .. • (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 L) A P. - I ELECTRICAL MECHANICAL SOUTH FLORIDA PERMITS, INC. 10-01 786 - 326 -0416 1100 MOFFETT ST. HALLANDALE, FL 33009 -2682 order of Pay to the \L iL�C� Bank ofAmrica ACH FUT 0063310op� 2.420 For 00 AALL S(JI'V1 2r TJI�g. 1:06 30000471: 00344 774869 20 Date ! 28 Q�4 L649 P"" 1649 63-4/630 FL 1222 8 6v Name:MICHAEL BECK ADDRE`3S :898 NE 91 TER MIAMI SHORES Phone 1:786 280 -5106 Phone 2: 305 757 -7420 CLIENT INFORMATION: Folio: Total Gas Load :40 000 BTUH Total Developed Length : 39' CONSUMER GAS PLUMBING CORP. o 4510 SW 154PL MIAMI FL 33185 305 608 -5400 COMPANY INFORMATION: EXISTING GAS METER SOV 3/4" / 3' `, / 1" UNDERGROUND . . \ / // PIPE 18" DEEP / / WATER HEATER 40 000 BTUH / / / / / 38' / / / EXTERIOR WATER HEATER 18" HIGH ON CONCRET BASE / SOV 3/4" / / / / / / 1" UNDERGROUND PIPE 18" DEEP _ S TS? 4 39 . ate / 1 9 1 ►` % sacs i0 Hcro Q OQQ Or 9 WS \ 'LeaLJC-r) 4 SKETCH OF SURVEY AC/. E. 0/6 7 — e P > ro (V 0 0 ( � 6 o ) \ / . 5 . �= 11 04'' / / a 0 • _,- SCALE : (h 5,.m - -(.>.), LOT OF ACCORDING TO THE PLAT OF THE PUBLIC RECORDS reservations, easements and L 0 A PORTION OF THE WEST 25.00 FEET OF BAY RIDGE AVENUE (NE 9 AVENUE), MORE PARTYCULARLY DESCRIBED AS FOLLOWS: THE WEST 25.00 FEET OF BAY RIDGE AVENUE (NE 9 AVENUE), LYING EAST OF LOT 1, BLOCK 3 OF GOLDEN GATE PARK ADDITION SUBDIVISION, AS RECORDED IN PLAT BOOK 6 AT PAGE 130 OF THE PUBLIC RECORDS OF MIAMI -DADE COUNTY FLORIDA: AND BOUND BY THE NORTH AND THE SOUTH PROPERTY LINES OF SAID LOT 1, EXTENDED EAST TO THE CENTER LINE OF SAID NE 9 AVENUE (50.00 R -O.W.) F.K.A. BAY RIDGE AVENUE, ALL THIS LANDS LYING AND BEING IN THE CITY OF MIAMI SHORES, MIAMI -DADE COUNTY, STATE OF FLORIDA. 'GK: •�� rr� r -%� %f� E !�/ci��; %- `CERTIFY T•; a� /cf.C_ 9/ 5 HEREBY CERTIFY: That the attached SKETCH OF SURVEY of the above described ,:ropt_ -rty is true and correct to the best of my knowledge and belief as - 'ecer:tly surveyed under my direction, also that there are not encroachments Bless shown, and that meets the minimun requirements adopted by the F.S.P.L. :$ the F. L.T.A. 0,ATE � oU z JOB H- " % g "es vE , e. 9/ REFS RE Ct. A ! ` `'$ / NOT VALID J4:-ESS DAB OSE SE sI LEGAL DESCRIPTION Ens/ 10,4 2 THEREOF AS RECORDED IN d COUNTY, FLORIDA. rig •f -way of record.) SKETCH tj I M a /0d 26 2s iTC LOCATION SCALE: DESCRIPTION OF PARCEL "A" ORLANDO GRANDAL P.S.M. 5839 SW 17` STREET MIAMI, FL 33155 PHONE: 305-262-2100 �•y. m� .�,, ,�. a..A... .. ��.. _..._.� FAN: 305-260-9880 BLOCK_ SUBDIVISION . PLAT BOOK AT PAGE A. d (Subject to all restrictions, 2g PROFESSIONAL LAND SURVEYOR CERTIFICATE KO. STATE OF FLORIDA 6 DIST 1.) 11 D/W L ENE FD F'71 ECM F:P FIP FN GAR GND 11.2: ARC LENGT AIP OCDTTIoNE ASPHnLT CT2A,TED CO) GT77) :META: P.:PE ADDITION ALUMINU ASPHALT AVEN-= BASE LINE BENr: BUILDING BLOCK 2.01iLEVARD Dfl!iNDARv 8C TTO CALCULATED CHORD BE N( CONCRETE ILOC CHORD rIIS7ANCE CENTER CLEAF CORRL3TETT CONCRETE CORNER CCUNTRY C=T '].U! VERT cc;NCRFTE DEED 1 r, DEPARTMEN OF TRArSFORTAT DISTANCE DRIVE DRIVE WAY EART EAS=NT ELE( ENC!CSLRE ENEPOEN FINISH EL: 't:LE'vr FLOW LINE FOU:ND FIRE HvD FOLJND CLINCRETE MONLMENT FCAY.,T PrFE FOUND IRON ROD ETELT) MEAEHRED F: NAIL GARARE GOVERNME GRoUND GUY WIRE PEAD WALL HIGH WATER LINE INVERT LEN7,-TH LEFT PC1.7 MAN:H:71F MAFKEP 1ASONR MEAN SEA EVEL OF" LD73 AN") NORTH NORTHEAR NORTHWEST NUEET' TIFFICIAL TZEPOFT CVERHEA)' ELECTPIC 7' '1.1 AFREvIATION3 T op! T 2171 rnu PC PrP PI r T ry FOE FRM F"P RAD PCP r FS PNG R/W SCM SCN SE SEC SEW r r CW, ST s _3TA STRUC STY TB TBM TEL TR - , TRANS TWP UTTL VAR w WD WNN WV ° 0" 7. No • 0 74- AT PARCEL PLAT Pr:117-K POINT OF CURVATURE PERMANENT CONTROL POINT POINT CF INTERSECTION PROPERTY LINE F 1 7: 1. - C . POVER METER PMNT OF PFRINNINf PERMANENT REFEREN7E MONUMENT POWER L-. -- .4 PEDEST‘=1L POINT 07 TANGENCY PoWER RECORD BY PLAT RADIAL/RADIUS REINEORCED CONCRETE PIPE RETENTION /RETAINING ;RESIDENCE RIGHT FIGHTFWA'f -- EET IRON' PIPE EET POD sp NAIL STATE ROAD STREET CREh; PCRHi STPLICTURE EYMBOLS FOR SURiE/ SANITARY SET CONcRETE MONliMENT SCREEN SOUTHEAST =IVISION SOUTHWEsT TANGENT TOP OF BANK TEMPcIPARY PENCP MARK TELEPHONE TRACT/TRAIL TELEVISION BOX TRANSErRKFP TOWNSHIP UNDERGROUND UTILITIES vERTICAL VARIES WERT WrInD WATER METER WATER MAIN WATER VALVE UELTA AN7 PEREES MINTF73. SECONDS EXISTING ElEvATION PROPOSED ELEVATION PROPOSED P.HPFACE FOUND TRCN OR :=' SET IRON PIN & CAP 774 C CSNC MAR'<EP Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Printed: 2/4/2004 Applicant: MICHAEL BECK Owner: BECK MICHAEL JOB ADDRESS: 898 NE 91 TERR Parcel # 1132060050310 Signed: (INSPECTOR) Plumbing Permit Permit Number: PL2004 -27 Contractor CONSUMER GAS PLUMBING CORP. Contractor's Address: 4510 SW 154 PLACE Local Phone: 305 - 608 -5400 Page 1 of 1 Legal Description: GOLDEN GATE PARK ADDN PB 6 -130 LOT 1 E25FT OF LOT 2 BLK 3 LOT SIZE Fees: Description Amount FEE2004 -1153 Building Fee $120.00 FEE2004 -1154 CCF $0.60 FEE2004 -1155 Training and Education Fee $0.20 FEE2004 -1156 Scanning Fee $3.00 FEE2004 -1157 Technology Fee $3.00 Total Fees: $126.80 Total Fees: $1268�0 C Total Receipts: $0.00 c Permit Status: APPROVED Permit Expiration: 7/26/2004 Construction Value: $475.00 Work: GAS METER LINE TO WATER HEATER 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: (Cp cQ Cp f ,r +",-fi /- Permit Amount of Permit $__ My Commission Expires MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT PLICATION 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, a 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 __: 1;_.j..1 4.__1±5 ' iiii 1__ __ No —_. Street Registered Architect and /or Engingyf 44.t o l -a+ street-n---till -4,„, u' Employing Plumber's Name _ _ Location and Legal Description Lot_ __1 £ !-____ Block a Subdivision__ '`.. `L_t4'` w '` Street and Number where work is to be performed— No. ___ ___i_�_____l�. State work to be performed and purpose of building (By Floors) New Building Remodeling Addition Repairs No. of Stories Size Septic Tank Type of Tank Feet of Drain _________________ Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: City —Well Size of Soakage Pit (Signed) Capacity Gals (Signed) Date -� / Notary Public, State of Florida i' 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 under signed agrees to employ only such sob - contractors , on wor ' b pe ed u • . er ,' is •ermit, as are licensed by Miami Shores Village. , Master Plumber. STATE OF FLORIDA, } ss. COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. 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 CONTR. LIST CHECK f ,r +",-fi /- Permit Amount of Permit $__ My Commission Expires MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT PLICATION 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, a 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 __: 1;_.j..1 4.__1±5 ' iiii 1__ __ No —_. Street Registered Architect and /or Engingyf 44.t o l -a+ street-n---till -4,„, u' Employing Plumber's Name _ _ Location and Legal Description Lot_ __1 £ !-____ Block a Subdivision__ '`.. `L_t4'` w '` Street and Number where work is to be performed— No. ___ ___i_�_____l�. State work to be performed and purpose of building (By Floors) New Building Remodeling Addition Repairs No. of Stories Size Septic Tank Type of Tank Feet of Drain _________________ Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: City —Well Size of Soakage Pit (Signed) Capacity Gals (Signed) Date -� / Notary Public, State of Florida i' 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 under signed agrees to employ only such sob - contractors , on wor ' b pe ed u • . er ,' is •ermit, as are licensed by Miami Shores Village. , Master Plumber. STATE OF FLORIDA, } ss. COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. 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. New Installed by: ( New ( Approved by: Remarks: Septic Tank Building has: Owner or Agent: LOT NO. f (' )eil DEPARTLENT OF PUBLIC SERVICE DIVISION OF PLUMBING INSPECTION CITY OF MIAMI, FLORIDA I herewith submit the following application for a permit covering the installation of a: Soakage Pit ( Garage wash floor Stores; Address of work: e No. of Plumbing Fixtures Additional information V a!t�.[�� Ready for Inspection - Date PERMIT NO. 1� ^f� Offices; Feet of drain tile Relaying Old Story / Addition Remodeled Waste water from a: Apts.; Date atr Yj / Address: // u' 7f- For a ( StoVe Garage Apt. Hotel Office Bldg. Res., Hotel Rooms; )' Bedrooms Address,: e pf, / ftc. f/ eL BLOCK NO. 3 SUBDIVISION "6:4 Ay a v Laundry Tubs Floor Drains Nature of water supply: Goy �'Vell Feet distant from all wells Type of tank installed: '44e4„ Tank capacity in gallons 1 7 4 0 b Size of Soakage Pit Purpose of same .j i Condemned by: Time , / /• /? • :') (y(? t d.4 f e t ; 4 r - do. ••• c4 h ; . I • r BUILDING ELECTRICAL PLUMBING A Owner of Building MIAMI SHORES VILLAGE, FLORIDA ?lel/4 DATE PERMIT N? 5837 Work to be performed under this Permi y: Architect Contractor f q or Builder r v Legal Lot BI. Description Address of 7 f f 4 rt 5',<J Building 44 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 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 cha.:ed w• out authorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above a ie resp ibilit for a thorough knowledge o he ordinances and regulations pertaining to the work covered hereby whether shown on the plan . L � or specificatiorpd the assumes respon- sibility for work done by his agents, servants or employees. r- / */ Signe. .—..../ / /L�w. /� By. INSP CTOR • Subdi- vision Value of Project Contractor's License No. Amt. of Permit R � AUTHORITY 1947_ /808 In consideration of the issuance to me of this permit I agree to perform the work ' .vered hereunder in compliance with,ai t l ordi j�(ices an r Qions pertain thereto and in strict conformity with the plans, drawings, statements or spec fications submitted to the proper authorities of iami Shores Vllge. In acce i g t s jermit I assume 7 + onsibili fora work done by either myself, my agent servant or employee. iii / `� �� I CONTRACTOR OR BUILD (v $Y E v Permit No bc 3 Application is hereby rhade for the approval of the detailed statement of the plans and specifications herewith sugmitt d 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. 1. Owner's Name and Address No. Size Septic Tank Feet of Drain Tile Amount of Permit $_. ss. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Registered Architect and /or Engineer Employing Plumber's Name v" ..t No Street .i KPV Location and Legal Description Lot Block -pa ,ye.- Subdivision j__ -' - Street and Number n where work is to be performed —No Pr ' '' State work to be performed and purpose of building (By Floors New Building Remodeling Addition Repairs Type of Tank Capacity Gals Dist. Feet of Tank or Drain Field from Well j Nature of Water Supply: City —Well / Size of Soakage Pit `' A r _ 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 performed under this permit, as are licensed by Miami Shores Village. (Signed) Date______ f_ / Jtreet ' '� ' ainar..x.a:rrx= My Commission Expires Notary Public, State of Florida Master Plumber. 4-41x c r Street No. of Stories 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 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 DRIVING FOUNT' NS TOTAL FIXTURES CONTR. LIST CHECK — SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SW POOL CONTR. LIST CHECK Permit No bc 3 Application is hereby rhade for the approval of the detailed statement of the plans and specifications herewith sugmitt d 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. 1. Owner's Name and Address No. Size Septic Tank Feet of Drain Tile Amount of Permit $_. ss. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Registered Architect and /or Engineer Employing Plumber's Name v" ..t No Street .i KPV Location and Legal Description Lot Block -pa ,ye.- Subdivision j__ -' - Street and Number n where work is to be performed —No Pr ' '' State work to be performed and purpose of building (By Floors New Building Remodeling Addition Repairs Type of Tank Capacity Gals Dist. Feet of Tank or Drain Field from Well j Nature of Water Supply: City —Well / Size of Soakage Pit `' A r _ 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 performed under this permit, as are licensed by Miami Shores Village. (Signed) Date______ f_ / Jtreet ' '� ' ainar..x.a:rrx= My Commission Expires Notary Public, State of Florida Master Plumber. 4-41x c r Street No. of Stories 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 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.___ New Building Size Septic Tank__ Feet of Drain Tile_ Owner's Name and Address _ AWPLICATION FOR PLUMBING PERMIT Registered Architect and /or Employing Plumber's Name Location and Legal Description Lot__t Street and Number where work is to be performed —No Amount of Permit S_ Remodeling_ MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT Application is hereby made for the approval of the detailed statement of the plans and specifications herewith lbmitted for 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 D �� ----- - - - - -- Block Subdivision_ Ella X P4' 1 j State work to be performed an purpose of building (By Floors) Addition Repairs No. of Stories Type of Tank Capacity Gals.____ Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: City Well. Size of Soakage Pit _ (Signed) um ing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his o .' ations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Pe vent 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 under signed agrees to employ only such sub - contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. (Signed Date My Commission Expires Notary Public. State of Florida ?if — — — Street-f-< g L– / ---- - -- Master Plumber. STATE OF FLORIDA, k COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me 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 FIXTURE CONTR. LIST e � /{ �(r w 1 / 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.___ New Building Size Septic Tank__ Feet of Drain Tile_ Owner's Name and Address _ AWPLICATION FOR PLUMBING PERMIT Registered Architect and /or Employing Plumber's Name Location and Legal Description Lot__t Street and Number where work is to be performed —No Amount of Permit S_ Remodeling_ MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT Application is hereby made for the approval of the detailed statement of the plans and specifications herewith lbmitted for 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 D �� ----- - - - - -- Block Subdivision_ Ella X P4' 1 j State work to be performed an purpose of building (By Floors) Addition Repairs No. of Stories Type of Tank Capacity Gals.____ Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: City Well. Size of Soakage Pit _ (Signed) um ing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his o .' ations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Pe vent 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 under signed agrees to employ only such sub - contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. (Signed Date My Commission Expires Notary Public. State of Florida ?if — — — Street-f-< g L– / ---- - -- Master Plumber. STATE OF FLORIDA, k COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me 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.__ Amount of Permit $ appeared - _----- ____ —� /i y ... Street and Number where work is to be performed —Ne State work to be performed and purpose of building New Building Remodeling The undersigned applicant for this building permit under the Florida Workmen's Compensation Act, being plied with the provisions thereof, and will require simi performed under this permit; and will post or cause to required by the Act. The under signed agrees to empl licensed by Miami Shores Village. My Commission Expires MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT AI7PLICATION FOR PLUMBING PERMIT Date } Application is hereby made for the approval of the detailed statement of the plans and specifications herewithbmitted for/Ehe 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. - .-----2 /� ',....t?.. r t + �'} Owner's Name and Address ____ _ _________ ' No. / Street__ / T Registered Architect and /or gineer .:7,..- _ ____________________ Employing Plumber's Name -,4--/ -4.4 o Street ., E Location and Legal Description Lot_J— __ 2_� j_' '________._Block '•'' r Subdivision_ s Mork done b e .address of work Owne r Size Septic Tank_____ ______ —___ Ty Brainf eld Feet of Drain Tile___ _— _____________________________ Dist. Feet Nature of Water Supply: CityV -wen. Plumbing - Final Rough ,<} P out Whe n read. / i Received by Date : h i ... Time r � (Signed) _° J if 11 PLUMBING Permit No. i.v Gay STATE OF FLORIDA, ) COUNTY OF DADE. ss. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the . of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. - Notary Public. State of Florida Al' 1 Master Plumber. 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. -\ 2 PM CLOSETS T BATH UBS SHOWERS LAVA- TORIES SINK CONTR. LIST CHECK SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREAA TRAI CONTR. LIST CHECK Permit No.__ Amount of Permit $ appeared - _----- ____ —� /i y ... Street and Number where work is to be performed —Ne State work to be performed and purpose of building New Building Remodeling The undersigned applicant for this building permit under the Florida Workmen's Compensation Act, being plied with the provisions thereof, and will require simi performed under this permit; and will post or cause to required by the Act. The under signed agrees to empl licensed by Miami Shores Village. My Commission Expires MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT AI7PLICATION FOR PLUMBING PERMIT Date } Application is hereby made for the approval of the detailed statement of the plans and specifications herewithbmitted for/Ehe 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. - .-----2 /� ',....t?.. r t + �'} Owner's Name and Address ____ _ _________ ' No. / Street__ / T Registered Architect and /or gineer .:7,..- _ ____________________ Employing Plumber's Name -,4--/ -4.4 o Street ., E Location and Legal Description Lot_J— __ 2_� j_' '________._Block '•'' r Subdivision_ s Mork done b e .address of work Owne r Size Septic Tank_____ ______ —___ Ty Brainf eld Feet of Drain Tile___ _— _____________________________ Dist. Feet Nature of Water Supply: CityV -wen. Plumbing - Final Rough ,<} P out Whe n read. / i Received by Date : h i ... Time r � (Signed) _° J if 11 PLUMBING Permit No. i.v Gay STATE OF FLORIDA, ) COUNTY OF DADE. ss. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the . of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. - Notary Public. State of Florida Al' 1 Master Plumber. 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. -\ 2 PM yfr �7a Permit No. Y ' Owner's Name and Address STATE OF FLORIDA, COUNTY OF DADE. My Commission Expires MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT PLICATION FOR PLUMBING PERMIT Amount of Permit $ - - -�– -eV __(Signed) (Signed) Date Notary Public, State of Florida 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 wor No (Street_ 4 ± Registered Architect and /or Engin r 1 Employing Plumber's Name ____�.LIt, ,.t lo. )y2 Street_n__14l4004 Location and Legal Description Lot_ £ _ 1 ;e* . Block 6,1 Subdivision .. Street and Number where work is to be performed— No.11,___.h_ olitwni State work to be performed and purpose of building (By Floors) New Building____ ____ — Remodeling Addition Repairs No. of Stories.. Size Septic Tank__— ______ _ Type of Tank Capacity Gals.______ Feet of Drain Tile____ —_ —___ Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: City —Well. ...Size of Soakage Pit. Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accef 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 under signed agrees to employ only such sub - contractors . on worder ,is permit, as are 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 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 Tuns 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 CONTR. LIST %. CHECK �7a Permit No. Y ' Owner's Name and Address STATE OF FLORIDA, COUNTY OF DADE. My Commission Expires MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT PLICATION FOR PLUMBING PERMIT Amount of Permit $ - - -�– -eV __(Signed) (Signed) Date Notary Public, State of Florida 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 wor No (Street_ 4 ± Registered Architect and /or Engin r 1 Employing Plumber's Name ____�.LIt, ,.t lo. )y2 Street_n__14l4004 Location and Legal Description Lot_ £ _ 1 ;e* . Block 6,1 Subdivision .. Street and Number where work is to be performed— No.11,___.h_ olitwni State work to be performed and purpose of building (By Floors) New Building____ ____ — Remodeling Addition Repairs No. of Stories.. Size Septic Tank__— ______ _ Type of Tank Capacity Gals.______ Feet of Drain Tile____ —_ —___ Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: City —Well. ...Size of Soakage Pit. Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accef 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 under signed agrees to employ only such sub - contractors . on worder ,is permit, as are 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 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. • PLUMBING - IIISPECTION :fork done by i_ddress of work '' ( .1 Owner Se' tic Tank 1rainf_ad f PlumbLig - Final dot It ^ugh `:Then r ate Receivuci by Date Time Permit No`. d Ton out AM PM BNIEaNlG ELECTRICAL P PLUMBING Owner of Building . ' Architect and /or Enginee / Contractor or Builder Proposed Location Dated AMOUNT 1, IT A N? 704 AMR NOTE: A charge of $1.00 will be made for making corrections or changes to this application after app 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 an MIAMI SHORES VILLAGE BUILDING JNSPECTION DEPARTMENT LICENSE NO. LOT tL - iUR• • VISION ` NO. � � } � � r T To This permit is issued to "�" ••{ _ _i the building above described. as per application. Plans and Specifications heretofore filed in this office. This permit is granted upon the express condition that all facts stated in the application are true and that the construction complies strictly with the plans and specifications submitted, and in accordance and compliance with the building laws of the State of Florida and with the buil. • _ ordinances and zoning laws of Miami Shores Village, and rules and regulations of the building departmen of ' mi horn Village. This permit may • revoked at any t' upon the violation • any proviei of said laws, ordinances or rules and regula ' any • e plans and i , n ' uthori • th • , ilding ' . • • r. I ,' 6-a• ..0 ✓ . ' / . .✓ yrf J ..ltrE: INSPECTOR • In consideration of the issuance to me this permit I hereby agree to the proposed construction strict confo 'ty with the application and plans and specifications thereof heretofore by i re submitted, and n compliance with all provisions of all building laws of the State of Florida, all the building ordiq ee and zoning laws of Miami Shores Villa and all rules and regulations of the build' • g pa eta of Miami Shores Village. &J1LIMPAIP ELECTMCAL PERMIT A N? PLUMBING Owner of Building °'' Architect and /or Engiree f Contractor or Build Proposed Location This permit is issued to • •+ r• - .i To the building above described. as per application. Plans and Specifications heretofore filed this office. This permit is granted ups the express condition that all facts stated in the application are true and that the construction complies stric with the plans and specifications submitted. and in accordance and compliance with the building ws of the State of Florida and with the building ordinances and zoning laws of Mia i Shores Village, and: rules and regulations of the building depart nt f Miami Shores Village. This permit may revoked at any time upon the v' tion of any provisions, -ol said laws, ordinances or rules and , - a pon aid change in the plans and spec' cad() • nauthorized by theebnildi s Da 19' 0 688 MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMEN NO. In consideration of the issuance to me of this permit I hereby agree to the proposed construction in strict 2. nformity with the application and plans and specifications thereof heretofore by me submitted, and in compliance with all provisions of all building laws of the State of Florida, all the building ordinances and zoning laws of Miami Shores Village apd all rules and regulations of the buil • department of Miami Shores Vilyge. 1 . 19 0 LICENSE NO. (SEAL) NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has been obtained from e P lanning Board. 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. • APPLICANT: AGENT: PROPERTY ADDRESS: BLOCK: s ss=sMMMi_i:uM CHECKED [X] ITEMS ARE NOT IN COMPLIANCE WITH STATUTE OR RULE AND MUST BE CORRECTED. Si -:z= -- =ssssss=isssss TANK INSTALLATION [01] TANK SIZE [1] /P.7 [2] [02] TANK MATERIAL [03] OUTLET DEVICE [04] MIULTI- CHAMBERREED [ Y / N [05] OUTLET FILTER (06] LEGEND 4 [07] WATERTIGHT' (08) LEVEL [09] DEPTH TO LID FILL [ [23] [ [25] [26] STATE OF FLORIDA DEPARTMENT OF HEALTH ONSITE SEWAGE TREATMENT AND DIPOSAL SYSTEM CONSTRUCTION INSPECTION AND FINAL APPROVAL SUBDIVISION: / EXCAVATION MATERIAL FILL AMOUNT FILL TEXTURE EXCAVATION DEPTH AREA REPLACED REPLACEMENT MATERIAL EXPLANATION OF VIOLATIONS / REMARKS: 1 DRAINFIELD INSTALLATION [10] AREA [1] • `7`• [2] !MIT [11] DISTRIBUTION BOX HEADER [12] NUMBER OF DRAINLINES '\ [13] DRAINLINE SEPARATION [14] DRAINLINE SLOPE [15] DEPTH OF COVER [16] ELEVATION [ABOVE /BELOW] BM _ [17] SYSTEM LOCATION [18] DOSING PUMPS /J [19] AGGREGATE SIZE ' [20] AGGREGATE EXCESSIVE FINES [21] AGGREGATE DEPTH .[ PERMIT NO. DATE PAID: FEE PAID: RECEIPT #: PROPERTY ID #: SETBACKS [27] SURFACE WATER FT [28] DITCHES FT [29] PRIVATE WELLS FT [30]. PUBLIC WELLS FT [ 31 ] IRRIGATION WELLS FT [32] POTABLE WATER LINES FT [33] BUILDING FOUNDATION FT [34] PROPERTY LINES FT [35] OTHER FT FILLED / MOUND SYSTEM [36] •DRAINFIELD COVER [37] SHOULDERS [38] SLOPES [39] STABILIZATION ADDITIONA1L INFORMATION [40] UNOBSTRUCTED AREA [41] STORMWATER RUNOFF '�- [42] ALARMS (43] MAINTENANCE AGREEMENT [44] BUILDING AREA [45] LOCATION CONFORMS WITH SITE PLAN [46] FINAL SITE GRADING [47] CONTRACTOR [48] OTHER :Miss===: =a= = ===_____ ABANDONMENT [49] TANK PUMPED _ / / [50] TANK CRUSHED & FILLED _ / 1, 1 l l CONSTRUCTION [APPROVED /DISAPPROVED]: CHD DATE: FINAL SYSTEM [APPROVED /DISAPPROVED]: CHD DATE: DE 4016, 10/97 (Pr.vious Editions May Be Used) Installer / Contractor Page 2 of 3 PERMIT NUMBER: Permit t ►ir -`'• 10 noer assigned by CHD. APPLICANT: Properi v LW name. AGENT: Property owners legally authorized representative. MAILING ADDRESS: P.O. box or street mailing address for applicant or agent. LOT, BLOCK, SUBDIVISION Lot, Block and Subdivision for lot or PROPERTY ID#: 27 character number for property. (property appraiser ID # or GIS location) COUNTY HEALTH DEPARTMENT CHECKS [X] ITEMS NOT IN COMPLIANCE WITH CONSTRUCTION PERMIT AND STATUTE OR RULE. INFORMATION IS COMPLETED BY CHD ON FOLLOWING ITEMS: TANK SIZE (gallons) TANK MATERIAL (concrete, fiberglass, etc) OUTLET FILTER (manufacturer, make, model) LEGEND (manufacturer code) DRAINFIELD AREA (square feet) DISTRIBUTION BOX / HEADER (check box) NUMBER OF DRAINLINES (number installed) SYSTEM ELEVATION (in relation to BM) DOSING PUMPS (number installed) SETBACKS (record actual setbacks in ft) SETBACKS OTHER (as required) STABILIZATION (date stabilized) CONTRACTOR (contractor installing system) ADDITIONAL INFORMATION (as required) ABANDONMENT TANK PUMPED (date) ANK CRUSHED AND FILLED (date) EXPLANATION OF VIOLATIONS: •. CNSTRUCTION APPROVAL: AS BUILT INSTALLATION SKETCH Record item number, explanation of violation, and required Circle approved or disapproved, CHD signature and date. EXISTING GROUND TOP OF AGGREGATE j +] SHOT H.I. H.I. H.I. H.I. [ -] SHOT [ -] SHOT [ -] SHOT ELEVATION 0 =INAL APPROVAL: Circle approved or disapproved. CHD signature and date of approval. =inai approval shall not be granted unit the CHD has confirmed that building construction and lot grading are in substantial ornpliance with plans and specifications submitted with the permit application. ELEVATION WORKSHEET ELEVATION OF BENCHMARK OR REFERENCE POINT: BUILDING ELECTRICAL PLUMBING Owner of Building f`� • Architect Contractor or Builder Legal Description Address of Building Lot MIAMI SHORES VILLAGE, FLORIDA DA'L'E � 194 /Rog dkv-4 CONTRACTOR OR BUILDE ERMIT N? 5837 Work to be performed under this Permi Bl. Subdi- vision Contractor's License No. � J Value of Amt. of / �'� d �/ , Project Permit ""."'.' This permit is granted to the contractor or builder nam 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 cha. • -d wi • out authorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above as esa ` resp I, r I flit for a thorough knowledge of a ordinances and regulations pertaining to the work covered hereby whether shown on the plans, or specification that assumes respon- sibility for work done by his agents, servants or employees. Signed 'ems" AL '/' By BY INSP OR In consideration of the issuance to me of this permit I agree to perform the work ered hereunder in compliance with all ordi es and regulations pertaini iereto and in strict conformity with the plans, drawings, statements or speci ications submitted to the proper authorities of i Shores Village. In acce ermit I assume rrysoonsibili for all work done by either myself, my agent, servant or employee. AUTHORITY PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date q914 - Job Address C('{F Folio Legal Description C Owned / Lessee / Tenant y 11n Master Permit # Owner's Address 3 k) G=- g/ Phone 1S 7 - q Z �% Contracting Co. Ivl,ll fl 5I Ve PiLJVriloinD Address _ \AL ( p @ Ct.LY�' Qualifier 3'� M' LCZ4_ SS# ? Phon(' ) ' �I 2'11 State # +'- Municipal # Competency # C'F 4 5Ins.Co. NAC i ,---- fr y ✓ . Architect /Engineer Address Bonding Company Address Mortgagor Address Permit Type(circle one): BUILDING ELECTRICAL PLUMBI MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION < - �°_∎ 1� (i.•. --) t -�2 `` . Z. L — s 1 -s: . ��.. C:S* — d t i -- .,.Yr (.,\ 1 _. n jc. l Square Estimated Cost(value) 50 0 Dr te: A of owner and /or Condo President APPROVED: Zoning Mechanical Plumbi 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 autlQorizethe_ above-named contractor to do the work s otaryka t610wn�r aI /q Condo President otary - Builder My Commi s s ibn tgR>i s :GLORIA E SUVILLAGO My Commi s s 1 •: �: • ' a : ; Commission CC308750 My Commission CC308759 * � 1 1 1 * Expires Aug. 16.1997 * Expires Aug. 16,1997 ; .� Bonded by HAI •s nded by H 1 ** * * *4.4 � 800.422.1555 * * * ** ? w e bm.azisst FEES: PERMIT # J3 15 RADON C.C.F. Fire Other ignature Date: of Contraor or wrier- Builder NOTARY TOTAL DUE `e Electrical e ngineering i-b • 0 AO C.■