PLUMBING PERMITMIAMI SHORES. VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
Building Inspection Requ
Date
Type Insp'n
Permit No.
Name
Address I R - cy c. , ,,, Company 0 i
Phone # OS
For Inspector: Ct IS 1
Approved
Correction
Re- Insp'n Fee
Qualifier
Buildin. Department
BUILDING
PERMIT APPLICATION
FBC 2001
Permit Type (circle): Building Electrical ( Plumbi g
Mechanical Roofing
Owner's Name (Fee Simple Titleholder) M el, 5S Q
Owner's Address 120 tel q ( �T -
Cit I',( fAtu ,5"hbir - state
Tenant/Lessee Name
Job Address (where the work is being done) 2 () ] L / f e
City Miami Shores Village County Miami -Dade Zip
Is Building Historically Designated( YES) NO
Si 6 1 4 e Contractor's Company Name ` l ( �C l t � 'j { wles # 3 J 5j.. Z T 3�
Contractor's Address 9 6
I t lJ c yam'
City M' l P1 1(/ State L Zip _ .3-16,
Vie 0 4 S / 1 L */G /U I A(
Architect/Engineer's Name (if applicable) . Phone #
Architect/Engineer's Address
City State Zip
$ Value of Work For this Permit 4(J�
Number of: Bays Stories
Type of Work: ['Addition ['Alteration
Describe Work: Q ._
Miami Shores Village
Families
[New
t ic?
(4)
* * * * * * * * * * * * * * * * * * * * * * * * * * ** F ees * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
County Escrow Fee $ "l . C.� Permit Fee $ / we
Education/Training Fee $ Tech $ Scanning $
Code Enforcement $ Bond $ Struct. $
10050 N.1
Miami Shores, l
Tel: (3
Fax: (3
Permit No. ?( 2oB
Master Permit No.
a
Zip
3 2 I
Phone #
Square Footage Of Work:
Bedrooms Baths
❑ Repair/Replace ❑ Demolit
Notary $
Radon $
Minus Plans Check Fee $ Total Fee Now Due $ (Continued on opl
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nding Company's Name (if applicable)
nding Company's Address
Y State Zip
'rtgage Lender's Name (if applicable)
'rtgage Lender's Address
Y
plication is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has
nmenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating
,struction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS,
-LLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC
YNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all
ilicable laws regulating construction and zoning.
'ARMING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR
YING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING,
JNSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
)MMENCEMENT."
tice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must
'raise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
?se property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site
the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the
section will not be approved and a reinspection fee will be charged.
nature P,l/rl GC.. Xli...
Owner or Agent
- foregoing insgniment was acknowledged before me this /. 0
o tersonally known to me or who has produced
EU d who did take an oath. as ides id take an bath.
NOTARY P c� :•• ,;0� '•
Sign: _� 1 - 4 w a': 1
Print: IT',It ii t
My Commission E'&;
(Certificate of Competency Holder)
to Certificate or Registration No. Certificate of Competency No.
�rrtrtdt.
PLICATION APPROVED $Y:
* **
State Zip
************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
Signature
The fore
day of
who is personal
Contractor
oing• ins tryment was acknowledged before me thisL
200, by
known to moiwhq has produced
Plans Examiner
Engineer
Zoning
TEM
ATH TUB
UNIT
FEE
ITEM
SWITCH OUTLETS
UNIT
FEE
ITEM
SPACE HEATERS
UNIT
FEE
IDET
LIGHT OUTLETS
CENTRAL HEATING
ISHWASHER
RECEPTACLES
A/C (WIND)
ISPOSAL
SERVICE TEMPORARY
A/C (CENTRAL)
RINKING FOUNTAIN
SERVICE SIZE IN AMPS
DUCT WORK
1 LOOR DRAIN
SERVICE REPAIR/METER CHANGE
REFRIGERATION
:REASE TRAP
APPLIANCE OUTLETS
PROCESS AND PRESS PIPING
NTERCEPTOR
RANGE TOP
UNDERGROUND TANKS
.AVATCRY
OVEN
ABOVE GROUND TANKS
.AUNDRY TRAY
WATER HEATER
U.F. PRESSURE VESSELS
:LOTHES WASHER
MOTORS 0- 1 HP
STEAM BOILERS
WER
MOTORS OVER 1- 3 HP
HOT WATER BOILERS
;INK, POT /3 COMP.
MOTORS OVER 3- 5 11'
MECHANICAL VENTILATION
;INK, RESIDENCE
MOTORS OVER 5- 8 HP
TRANSPORTING ASSEMBLIES
i NK, SLOP
MOTORS OVER 8- 10 HP
ELEVATORS/ESCALATORS
tEWORARY WATER CLOSET
MOTORS OVER 10- 25 HP
FIRE SPRINKLER SYSTEMS
JRINAL
MOTORS OVER 25-100 HP
COOLING TOWERS
tiATER CLOSET
MOTORS OVER 100 HP
VIOLATION
INDIRECT•WASTES
A/C WINDOW
REINSPECTION
PATER SLPPLY T0:
AIR CONDITIONERS
A/C UNIT
STRIP HEATER
FIRE SPRINKLER
GENERATORS TRANSFORMERS
_
HEATER -NEW INST.
GENERATORS TRANSFORMERS
I
HEATER- REPLACE
GENERATORS TRANSFORMERS
LAWN SPRINKLER -WELL
SPECIAL PURPOSE
SWIMAING POOL
OUTLETS COMdERCIAL
WATER SERVICE
1
SIGN TUBES
;EWER CONNECTIONS
SIGN TRANSFORMERS
ITILITY -SEWER
SIGN TIME CLOCK
ITILITY -WATER
FIXTURES
3EPTIC TANK
ANTENNA
;ELAY
TELEVISION OUTLETS
)RAINFIELD, 4' TILE/RES.
VIOLATION
'UMP & ABANDON SEPTIC TANK
EINSPECTION
SOAKAGE PIT CU. FT.
;ATCH BASIN
7 A LTX;
)1i
(
1
DISCHARGE WELL
DOMESTIC WELL
AREA GRAIN
ROOF INLET 1
•
SOLAR WATER HEATER ..
=IRE STANDPIPE
POOL PIPING
•
LAWN SPRINKLER SYSTEM
3AS RANGE
4 ETER 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 No °G
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 et
building during progress of work.
Owner s Name and Address �1 � 1 �� � _� � No 1 a $ hLE • Street.. ct \ 1 I F: . .
Registered Architect and /or Engineer
' i plc / yang // pi s ,Na \ � \ /
i1 Doca �ni Le eu�fption Lot9 n`�,� 1 / 9�'/ Mork 7 Subdivision r'T
V Street and Number where work is to be performed —No 1 '\ • 9 Street ..1._.
-State work to be performed and purpose of building (By Floor)__._._ _••----- _--- .- -� - -- — ...
New Building.. - - -._ _ __._.........._.. Remodeling—_. -- Addition.. ___... -.. -_ Repair No. of Stories
Size Septic Tank— '�( _Type of Tank--_
9
Feet of Drain Tile `� oe 2•'� -- __Dist Feet of Tank or Drain Field from WeU..._.__. - - - - -.
Nature of Water Supply: City—WeIL Size of Soakage Pit
Amount of Permit $ . ® v ( Signed) _
My Commission Expires
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
(Signed(
/VIP
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 5988, Compiled General Laws of Florida Permanent Supplement, and hie com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the worn to he
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 an-
required by the Act. The undersigned agrees to employ only such sub- oontractorsy. on work to be performed � nder t pert as are
Loensed by Miami Shores Village.
aster Plumber.
STATE OF FLORIDA, ( u.
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 be did sign the same, and that all facts
therein by him stated are true.
Notary Public, State of Florida
NOTE: A re- inspection fee of $1.00 will be mods whoa wain sr•speollau Y rnadelseceasary by improper notice for inspection, er faulty
materials and /or workmanship.
CLOSETS
OATH
TUI.
aNOW[Ra
LAVA-
TOR'[/
/INK[
SLOP
SINKS
LAUNDR
Tuns
URINALS
CATCH
SAWN
FLOOR
DRAIN
DRINK' NO
FOUNT 'NS
TOTAL
Flttunts
CONTR.
LIST
CHICK
e
SEPTIC
TANK
SIWIR
CONN.
DRAIN
FIELD
SOAKAGE
PIT
G
TRAP
SOLAR
HEATER
DEEP
WELL
SYSTEM
IIWIM'O
POOL
comm.
LIS
1
,
r—�-
CHECK
Permit No °G
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 et
building during progress of work.
Owner s Name and Address �1 � 1 �� � _� � No 1 a $ hLE • Street.. ct \ 1 I F: . .
Registered Architect and /or Engineer
' i plc / yang // pi s ,Na \ � \ /
i1 Doca �ni Le eu�fption Lot9 n`�,� 1 / 9�'/ Mork 7 Subdivision r'T
V Street and Number where work is to be performed —No 1 '\ • 9 Street ..1._.
-State work to be performed and purpose of building (By Floor)__._._ _••----- _--- .- -� - -- — ...
New Building.. - - -._ _ __._.........._.. Remodeling—_. -- Addition.. ___... -.. -_ Repair No. of Stories
Size Septic Tank— '�( _Type of Tank--_
9
Feet of Drain Tile `� oe 2•'� -- __Dist Feet of Tank or Drain Field from WeU..._.__. - - - - -.
Nature of Water Supply: City—WeIL Size of Soakage Pit
Amount of Permit $ . ® v ( Signed) _
My Commission Expires
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
(Signed(
/VIP
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 5988, Compiled General Laws of Florida Permanent Supplement, and hie com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the worn to he
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 an-
required by the Act. The undersigned agrees to employ only such sub- oontractorsy. on work to be performed � nder t pert as are
Loensed by Miami Shores Village.
aster Plumber.
STATE OF FLORIDA, ( u.
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 be did sign the same, and that all facts
therein by him stated are true.
Notary Public, State of Florida
NOTE: A re- inspection fee of $1.00 will be mods whoa wain sr•speollau Y rnadelseceasary by improper notice for inspection, er faulty
materials and /or workmanship.
I '"..')
•
Date of Application D Q 6 C1
STATE OF FLORIDA
DEPARTMENT OF HEALTH AND REHABILITATIVE SERVICES
APPLICATION FOR ONSITE SEWAGE DISPOSAL SYSTEM CONSTRUCTION PERMIT
Type of
Establishment
HRS-H Form 4015, Feb 85 (Obsoletes previous editions which may not be used)
(Stock Number: 5744 -001 - 4015 -1)
Authority: Chapter 381, FS
Chapter 100 -6, FAC
Permit Application Number
PART 1 - APPLICATION
6 _5?S
Name of Owner 1i1 C . �j to E SC` G \ Telephone Number �
Mailing Address of Owner 1 Po r t F ST
Owner's Agent ! lam\ vR ! � :r.� ` � 1 i i C'` Builder
Agent's Mailing Address i 4'(1 .0 V.3 . A J. Telephone No 1 - c' �r 5 �f
Property Street Address 1 3 C. C\ • Z. .
Lot No Block No Subdivision Date Subdivided
NOTE: IF NOT IN A SUBDIVISION ATTACH A METES AND BOUNDS DESCRIPTION
This Application is for: New System Repair v Existing System
TOTAL FLOW =
Type of No. Bedrooms Heated or Cooled Area No. Dwelling
Residential (each dwelling unit) (each dwelling unit) Units
SQ t ft2.
Exact Directions to Property
AUDIT CONTROL NO 136226 Applicant's Signature
Sewage Flow Sewage Flow
(Gallons per day) Based On
ft
QI
Sewage Flow
(Gallons per day)
Page 1 of 3
Permit Neg 1F
New Building. Remodeling__
0
Amount of Permit $
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
(Signed
(Signed) iE
Street.
3 -
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida,
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division
of. Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at
building during progress of work.
Owner's Name and Address
, , "...., _ , I NO/ a20 .6 Sired-. 7 / r / .
Registered Architect and/or Engin , /
-,k ,_., a.,ei--2- litreet..a2.." )4 0'
---- Employing rlm es Nme
74 t ai A Z
Subctivisioni-LLYZ-eY___4._
Street and Number where work is to be performed-No M 0 77
State work to be performed and purpose ql-building--(-Brirli)__
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 accepts his obligations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5988, Compiled General Laws of Florida Permanent Supplement, and Iii com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub-contractors employed by him in the work to he
performed under this permit; and will post or MUM to be posted' for inspection on the site of the work such public notice or notices as 0./1`
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.
Mesta PZumbei......
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 depose. and says that he is the
of the above described construction, that he has carefully reed the foregoing application, and that be did sign the cause, mud that all facts
therein by him stated are true.
My Commission Expires Notary Public, State of Florida
NOTE: A re-inspection fee of $1.00 will be made when mesh reinspeedon soade.neosewry by mper aotle® few iin;pattal„ cat faulty
materials and/or workmanship.
CLOSETS
BAIN
TUBS
*1
LAVA-
Tomas
SIN"
SLOP
SINKS
LA UNDR
Tuns
URINALS
CATCH
I NH
FLOO
R DRAIN
DRINK! NO
FOUNTWS
TOTAL
•IATURES
Corfni.
LIST
CHICK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOA KAGIL
PIT
G
TRAP
SOLAR
HEATER
DaiP
WELL
Irsocut.
SYSTEM
fhb IWO
POOL
Comm.
LIST
,------
CHECK
Permit Neg 1F
New Building. Remodeling__
0
Amount of Permit $
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
(Signed
(Signed) iE
Street.
3 -
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida,
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division
of. Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at
building during progress of work.
Owner's Name and Address
, , "...., _ , I NO/ a20 .6 Sired-. 7 / r / .
Registered Architect and/or Engin , /
-,k ,_., a.,ei--2- litreet..a2.." )4 0'
---- Employing rlm es Nme
74 t ai A Z
Subctivisioni-LLYZ-eY___4._
Street and Number where work is to be performed-No M 0 77
State work to be performed and purpose ql-building--(-Brirli)__
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 accepts his obligations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5988, Compiled General Laws of Florida Permanent Supplement, and Iii com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub-contractors employed by him in the work to he
performed under this permit; and will post or MUM to be posted' for inspection on the site of the work such public notice or notices as 0./1`
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.
Mesta PZumbei......
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 depose. and says that he is the
of the above described construction, that he has carefully reed the foregoing application, and that be did sign the cause, mud that all facts
therein by him stated are true.
My Commission Expires Notary Public, State of Florida
NOTE: A re-inspection fee of $1.00 will be made when mesh reinspeedon soade.neosewry by mper aotle® few iin;pattal„ cat faulty
materials and/or workmanship.
BUILDING
ELECTRICAL
PLUMBING
ROOFING
Owner of
Building
Architect
Contractor
or Builder
Legal
Description
Lot
MIAMI SHORES VILLAGE, FLORIDA
❑ DATE 19_
PERMIT N? 3727 Contractor s
License No.
❑ Work to be performed under this Permit
;.v
B1
Subdi-
vision
Address of / / - Value of I Amount of
Building ? Project $ I 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 apt
tion herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with
plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be re%
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
permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances
regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes rei
sibility for work done by his agents, servants or employees. / /
.'
Signed �� ! INSPEC
In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regult
Pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. 1
- opting this permit I assume responsibility for aIr tvork done by either, myself, my agent, servant or employee.
CONTRACTOR OR BUILDER BY AUTHORITY ABBOT
BUILDING
ELECTRICAL
PLUMBING
ROOFING
Owner of
Building
Architect
Contractor
or Builder
Legal
Description
Address of
Building
t.
MIAMI SHORES VILLAGE. FLORIDA
❑ DATE 195__4_
PERMIT N? 5795 Contractor's
License No.
Lot
CONTRACTOR OR BUILDER
Bl.
Work to be performed under this Permit
!'
Subdi-
vision
Value of
Project $
Amount of
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 application
hers 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 cr 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 ac-
cepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee.
BY AUTHORITY
0
UILDING
LECTRICAL
LUMBING
)caner of
uilding
: ontractor
r Builder
x
egal Lot
lescription
1 '
CONTRACTOR OR BUILDER
MIAMI SHORES VILLAGE, FLORIDA
PERMIT N? 8591
Work to be performed under this Permit
rchitect
Bl.
Sii-
vision
ddress of
uilding r
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-
-tion herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any
fans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked
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
ermit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and
gulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes respon-
bility for work done by his agents, servants or employees.
Signed. , f By
INSPECTOR
In consideration of the issuance to me of this permit I agree to perform the vyork covered hereunder in compliance with all ordinances and regulations
r rtaining thereto and • strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of lefiami Shores Village.
• accepting this pen I assume responsibility for all work done by tither myself, my agent, servant or employee.
Value of
Project
DATE 194
Contractor's
License No.
Amt. of
Permit
BY AUTHORITY
REQUEST FOR INSPECTION
Company
PHONE
Job
Address
Inspection
Time Ready A.M. P.M.
Date Ready
At No.
Size Septic Tank
Amount of Permit $ __, %._____:
STATE OF FLORIDA,
COUNTY OF DADE.
ss.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
plication is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other
tucture 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.
i {
Owner's Name and Address .___. `.' - -`__ _ ' �_✓ ��- No. / t Street
Registered Architect and /or Engineer
Employing Plumber's Name .. - f - t; / .1 S , � No. ' Street c
Location and Legal Description Lot Block Subdivision
Street and Number where work is to be performed— No. ______: .�___!' r ' ✓�' �-
State work to be performed and purpose of building (By Floors)
Street
New Building - _ - -- __ __ -- -- - Remodeling Addition.- - -- _ - --- -_ - _ - -- _- Repairs -_ t .
/2-
Date
Type of Tank____ Capacity Gals.
Feet of Drain Tile. Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City —Weft — Size of Soakage Pit
( Signed)
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 by Serforme0 tvr}der this permit, as arc
licensed by Miami Shores Village.
(Signed)'
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the
of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
My Commission Expires Notary Public, State of Florida
NOTE: A re- inspection fee of $1.00 will be made when 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
_I
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER -
DEEP
WELL
SPRKLR.
SYSTEM
SWIM'G
POOL
CONTR.
LIST
CHECK
At No.
Size Septic Tank
Amount of Permit $ __, %._____:
STATE OF FLORIDA,
COUNTY OF DADE.
ss.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
plication is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other
tucture 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.
i {
Owner's Name and Address .___. `.' - -`__ _ ' �_✓ ��- No. / t Street
Registered Architect and /or Engineer
Employing Plumber's Name .. - f - t; / .1 S , � No. ' Street c
Location and Legal Description Lot Block Subdivision
Street and Number where work is to be performed— No. ______: .�___!' r ' ✓�' �-
State work to be performed and purpose of building (By Floors)
Street
New Building - _ - -- __ __ -- -- - Remodeling Addition.- - -- _ - --- -_ - _ - -- _- Repairs -_ t .
/2-
Date
Type of Tank____ Capacity Gals.
Feet of Drain Tile. Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City —Weft — Size of Soakage Pit
( Signed)
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 by Serforme0 tvr}der this permit, as arc
licensed by Miami Shores Village.
(Signed)'
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the
of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
My Commission Expires Notary Public, State of Florida
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty
materials and /or workmanship.
Permit No 7
z
Registered Architect and /or Engineer______
Location and Legal Description
Street and Number where work is to be performed —No
Amount of Permit $
STATE OF FLORIDA,
COUNTY OF DADE.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
(Signed)-
(Si
Date
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida,
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at
building during progress of work.
Owner's Name and Address 02,4ed w No.__ . _--- _-- _ - -_ - Street./Vk
Employing Plumber's Name- .1✓ G O 61 '- ( 6 ) No. -- 4i '
- ---- - Street__.- . — •_ ---
Subdivision
eet �J
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 Tile _Dist. Feet of Tank or Drain Field from Well .
Nature of Water Supply: City — Well.___ _ _____.Size of Soakage Pit
Capacity Gals
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 em 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 pub ' notice or notices as are
required by the Act. The undersigned agrees to employ only such sub - contractors, ork to b perforndunder this 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.
My Commission Expires 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.
CLOSET S
BATH ',SHOWERS
TUBS
LAVA-
TORIES
SINK6
SLOP
SINKS
LAUNDRY
TUeS
U RINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT' NS
TOTAL
FIXTURE6
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 7
z
Registered Architect and /or Engineer______
Location and Legal Description
Street and Number where work is to be performed —No
Amount of Permit $
STATE OF FLORIDA,
COUNTY OF DADE.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
(Signed)-
(Si
Date
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida,
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at
building during progress of work.
Owner's Name and Address 02,4ed w No.__ . _--- _-- _ - -_ - Street./Vk
Employing Plumber's Name- .1✓ G O 61 '- ( 6 ) No. -- 4i '
- ---- - Street__.- . — •_ ---
Subdivision
eet �J
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 Tile _Dist. Feet of Tank or Drain Field from Well .
Nature of Water Supply: City — Well.___ _ _____.Size of Soakage Pit
Capacity Gals
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 em 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 pub ' notice or notices as are
required by the Act. The undersigned agrees to employ only such sub - contractors, ork to b perforndunder this 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.
My Commission Expires 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.
MIAMI SHORES VILLAGE, FLA.
JOB
ADDRESS /
f
INSPECTION
TIME READY � / / ,� . / / ' c
REMARKS •
I
N9 6350
INSPECTOR DATE
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 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. ,p D
Ul (n i��t )
Owner's Name and Address
Registered Architect and /or Engineer__L____L-L....,,.._,�,
Employing Plumber's Name.
State work to be performed and purpose of building (By Floors)_._
New Building Remodeling ______ Addition
STATE OF FLORIDA,
COTJNTY OF DADE.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING °` ,MIT
Amount of Permit $___- __..._. ..... - ------ ____ -- — — (Signed)
Date
� - /t J7
No- Street
Street.
Location and Legal Description Lot_____ _____________________ _ _ Bloe.k y� Subdivision
Street and Number where work is to be performed —No ) c2 `� L L'�J Street
(Signed).
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— ....... _______ ...... _______-.Size of Soakage Pit
Capacity Gals
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 5968, Compiled General Laws of Florida Permanent Supplement, and Ilas 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
retired 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.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the__
of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
My Ccnlmission Expires Notary Public, State of Florida
No. of Stories.
Maste er.
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
TUBE
SHOWER/
LAVA-
TORIEe
SINKS
SLOP
SINKS
LAUNDRY
Tues
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINK NG
FOUNT' NS
TOTAL
FIXTURES
CONTR.
LIST
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SW IM'G
POOL
CONTR.
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 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. ,p D
Ul (n i��t )
Owner's Name and Address
Registered Architect and /or Engineer__L____L-L....,,.._,�,
Employing Plumber's Name.
State work to be performed and purpose of building (By Floors)_._
New Building Remodeling ______ Addition
STATE OF FLORIDA,
COTJNTY OF DADE.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING °` ,MIT
Amount of Permit $___- __..._. ..... - ------ ____ -- — — (Signed)
Date
� - /t J7
No- Street
Street.
Location and Legal Description Lot_____ _____________________ _ _ Bloe.k y� Subdivision
Street and Number where work is to be performed —No ) c2 `� L L'�J Street
(Signed).
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— ....... _______ ...... _______-.Size of Soakage Pit
Capacity Gals
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 5968, Compiled General Laws of Florida Permanent Supplement, and Ilas 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
retired 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.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the__
of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
My Ccnlmission Expires Notary Public, State of Florida
No. of Stories.
Maste er.
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.