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PLUMBING PERMIT
BUILDING ELECTRICAL PLUMBING Owner of Building Architect Contractor or Builder Legal Description Address of Building Lot CONTRACTOR OR BUILDER MIAMI SHORES VILLAGE, FLORIDA PERMIT N° 9498 Work to be performed under this Permit Bl. Subdi- vision Value of Project $ DATE 195 Contractor's License No Amt. 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 herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any ime 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 ranted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations •rtaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes responsibility for work le 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 ning thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. •epting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. BY AUTHORITY 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. Owner's Name and Address f' Registered Architect and /or Engineer tir Amount of Permit $ __2 Ss. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT Size Septic Tank Type of Tank Feet of Drain Tile Nature of Water Sup APPLICATION FOR PLUMBING PERMIT No 3 s ( Signed) Date__ ,' ••L Street Employing Plumber's Name fi 4 1-; , .. - --2... / ._ _____ No �� _ Location and Legal Description Lot 1. �;2.___C'_`. 7� "j� Block G Subdivision_ _C� _ �w Street and Number where work is to be performed—Ni Street State work to be performed and purpose of building (By Floors) New Building ' ' Remodeling Addition Repairs No. of Stories Capacity Gals Dist. Feet of Tank or Drain Field from Well ; Well Size of Soakage Pit bing Inspector. The undersigned applicant for this building permit does hereby certify that he derstands and accepts his obligatio s an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent pplement, 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 verformed under this permit, as are licensed by Miami Shores Village. Master Plumber. STATE OF FLORIDA, 1 COUNTY OF DADE. 1 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 FOU NT' NS TOTAL FIXTURES CONTR. LIST ,q O , (1 l/ /% N - . CHECK 4 'SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL. SPRKLR. SYSTEM SW IM'G POOL • NTR. CO LIST / op fD /I , 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. Owner's Name and Address f' Registered Architect and /or Engineer tir Amount of Permit $ __2 Ss. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT Size Septic Tank Type of Tank Feet of Drain Tile Nature of Water Sup APPLICATION FOR PLUMBING PERMIT No 3 s ( Signed) Date__ ,' ••L Street Employing Plumber's Name fi 4 1-; , .. - --2... / ._ _____ No �� _ Location and Legal Description Lot 1. �;2.___C'_`. 7� "j� Block G Subdivision_ _C� _ �w Street and Number where work is to be performed—Ni Street State work to be performed and purpose of building (By Floors) New Building ' ' Remodeling Addition Repairs No. of Stories Capacity Gals Dist. Feet of Tank or Drain Field from Well ; Well Size of Soakage Pit bing Inspector. The undersigned applicant for this building permit does hereby certify that he derstands and accepts his obligatio s an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent pplement, 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 verformed under this permit, as are licensed by Miami Shores Village. Master Plumber. STATE OF FLORIDA, 1 COUNTY OF DADE. 1 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. Date Type Insp'n Permit No. For Inspector: Approved Correction MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request f Name , h Address q dL Company 0 / C Phone # Re-Insp'n Fee ❑ ate *Type Insp - r �..J(ll L - Permit No. !/ • OC) " /7� Name ill Address / \- t _ /CS (' , Com..n Phone # For Inspector: Approved Correction Re- Insp'n Fee MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date Time y),3-36 Date Date Type Insp Permit No. Name Address < - ,fie' Company Phone # MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request For Inspector: 10 Approved I 1ldd Correction Re- Insp'n Fee (Li/1,4-35 Time , Pk') 7_3 BUILDING ELECTRICAL PLUMBING Owner of Building Architect Contractor or Builder Legal Lot Description Address of Building This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the application herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes responsibility for work done by his agents, servants or employees. Signed • BY INSPECTOR In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. CONTRACTOR OR BUILDER MIAMI SHORES VILLAGE, FLORIDA PERMIT N° 9484 Work to be performed under this Permit BI. Subdi- vision Value of Project $ DATF 195 Contractor's License No Amt. of Permit $ BY AUTHORITY BUILDING ELECTRICAL RLUMBING Owner of Building Architect Contractor or Builder Legal Description. Address of Building Lot CONTRACTOR OR BUILDER MIAMI SHORES VILLAGE, FLORIDA PERMIT N° 9628 Work to be performed under this Permit Bl. Subdi- vision Value of Project $ DATE 195 Contractor's License No Amt. 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 herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes responsibility for work done by his agents, servants or employees. Signed: BY INSPECTOR In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. BY AUTHORITY APPLICANT: AGENT: PROPERTY ADDRESS: LOT: STATE OF FLORIDA DEPARTMENT OF HEALTH ONSITE SEWAGE TREATMENT AND DIPOSAL SYSTEM CONSTRUCTION INSPECTION AND FINAL APPROVAL Il i j 7;'S � FILL / EXCAVATION MATERIAL [22] FILL AMOUNT (23] FILL TEXTURE [24] EXCAVATION DEPTH [25] AREA REPLACED [26] REPLACEMENT MATERIAL r ;i BLOCK: SUBDIVISION: CHECKED [X] ITEMS ARE NOT IN COMPLIANCE WITH = = == a==sx === ===aa ==a .. TANK INSTALLATION [ TANK SIZE [1] /' > [2] — (02] TANK MATERIAL (--- /- (03 ] OUTLET DEVI ) -k ( --tOy' (04] MULTI - CHAMBERED [ /(M)] [05] OUTLET FILTER .J U ?:Y (06] LEGEND [ WATERTIGHT [08] LEVEL - I '; i ( _ (09] DEPTH TO LID DRAINFIELD INSTALLATION (10] AREA [1] /c.' /7 [2] / i(. SQFT [11] DISTRIBUTION BOX _ HEADER / [12] NUMBER OF DRAINLINES (13] DRAINLINE SEPARATION [14] DRAINLINE SLOPE � (15] DEPTH OF COVER S [16] ELEVATION (ABOVE /BELOW] BM (17] SYSTEM LOCATION (18] DOSING PUMPS /U j • [19] AGGREGATE SIZE [20] AGGREGATE EXCESSIVE FINES [21] AGGREGATE DEPTH l l l l l l l l EXPLANATION OF VIOLATIONS /.REMARKS: [ l [ ] [ [ ] CONSTRUC TION ( '[APPROVED /D : ! OAN\ U4X S FINAL SYSTEM [APPROVED /DISAPPROVED]: JCl;:b'Y^ L y "S 1 DH 4016, 10/97 (Previous Editions May Be Used) Installer / Contractor = = =m= = = =s === STATUTE OR RULE AND MUST BE CORRECTED. SETBACKS [27] SURFACE. WATER [28] DITCHES [29] PRIVATE WELLS [30] PUBLIC WELLS r31] IRRIGATION WELLS [32] POTABLE WATER LINES [33] BUILDING FOUNDATION _J [34] PROgE$TY [35] FILLED / MOUND SYSTEM [36] DRAINFIELD COVER [37] SHOULDERS [38) SLOPES [39] STABILIZATION ADDITIONAL INFORMATION [40] UNOBSTRUCTED AREA [41] STORMWATER RUNOFF [42] ALARMS [43] MAINTENANCE AGREEMENT [44] BUILDING AREA [45] LOCATION CONFORMS WITH SITE PLAN [46] FINAL SITE GRADING - . [47] CONTRACTOR T/) 4 [48] OTHER ABANDONMENT ] [ TANK PUMPED / / ] [50] TANK CRUSHED & FILLED � / / rn ac_ PERMIT NO. !L . 4 ( .7 DATE PAID: /- FEE PAID: ,' - RECEIPT 0: f • 7 `l PROPERTY ID #: FT FT FT FT FT 3 0 FT FT FT FT CHD DATE: 7' - U -- PC CHD DATE: 2J Page 2 of 3 - TO THE f ' 1 7 ' ) J <' ? - $ :5S-6 () A ORDER OF PAY r c tibank FOR BOB'S SEPTIC & DRAIN, INC. 1020 NE 130TH ST. PH. 305 -55B -5818 NORTH MIAMI, FL 331 61 -421 1 CI} (BANK. F.S.B. BR M37 2750 AVENTURA BOULEVARD AVEN TURA. FL 33180 II'0052?30 I:2660E165:ito/ 21027060.911' --yy DATE 5 273 63- 865537 2660 DOLLARS 8 ,.. I /t (?() Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Printed: 7/10/2002 Applicant: PAULINE Owner: MINDES JOB ADDRESS: 354 NE 91 Contractor BOBS SEPTIC & DRAIN INC Local Phone: 305 - 558 -5818 Parcel # 1132060190220 Fees: Description Amount FEE2002 -3790 Building Fee $80.00 FEE2002 -3791 Buildier's Bond $300.00 FEE2002 -3792 CCF $1.80 FEE2002 -3793 Notary Fee $5.00 Total Fees: $386.80 Total Fees: $386.80 Total Receipts: $0.00 Permit Status: Approved Permit Expiration: 1/6/2003 Work: 200 SQ FT DRAINFIELD INSTALL (SOD INCL) If there is no permit package accessible on the job -site for inspectors to verify, there will be no inspections. Re- inspection fee is $50.00, which must be paid in advance before calling for another inspection. This Permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the application herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans, drawings, statements or specifications that may have been submitted to and approved by the p oper 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 furthe 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 regulati ns pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes responsibility for work done by his agents, servants r employees. Sign Plumbing Permit Permit Number: PL2002 -173 MINDES PAULINE ST Contractor's Address: 1020 NE 130 ST Construction Value: $2,500.00 Page 1 of 1 Legal Description: EL PORTAL PB 9 -101 LOT 6 & W1/2 LOT 5 BLK 2 LOT SIZE 75.000 X 135 (INSPECTOR) BY: In conside ation , uance 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, dr. ' g - 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: PERMIT APPLICATION FOR MIAMI SHORES VILLAGE 10050 N.E. 2nd Avenue • Miami Shores, Florida 33138.305- 795 -2204 16°1- 7� Job Address 4 / S / Tax Folio // 3 206 — 0 / 9 v Date Legal Description LJ T ! O 7 1 :) ) E x Historically Designated: Yes No !/ ssee/Tenet [' / ' ' / Master Permit # Owner's Address / ) ' ) Phone Contracting Co. Phone (i )$3'O State # Municipal # l/ Competency # J Ins. Co. l � Qualifier P-2j )),9- IF THERE IS NO PERMIT PACKAGE ACCESSIBLE ON THE JOB SITE FOR INSPECTORS TO VERIFY, THERE WILL BE NO INSPECTION. RE- INSPECTION FEE IS $50.00 AND MUST BE PAID IN ADVANCE BEFORE CALLING FOR ANOTHER INSPECTION. PLUMBING Permit Type (circle one): BUILDING ELECTRICAL WORK DESCRIPTION: Square Ft. 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 ANY 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 all disciplines. OWNERS AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Furthermore, I authorize the above named contractor to do the work stated. Zoning Building Mechanical Plumbing �ress 10)o Ne f 3V .Sl Estimated Cost (value) b as to 0 1`er and/or ♦ t i(7'_ ,. Date My Commiss n tp OFFICIAL NOTARY S:_AL 2 �6 e, ANGELA M BECKER - 1 ers (7 (1 CO10,03510N NUMBER 0 r), j�j' -4 Q CC786697 MY COMMISSION EXPIRES FEES: PERM r � F NOV. 15,2002 �ILA DON C.C.F 2I F NOTARY � (-7° BOND 3 2:)° APPROVED: �1 L 5 _ Signa re of Con actor or Owner er Date N otary as to Contractor or Owner Builder My Commission Expires MECHANICAL ROOFING dd Date TOTAL DUE Electrical Structural Engineer 07/05/2002 12:15 :;055133472 PROPERTY STREET ADDRESS: LOT: akig BLOCK: z __ [ 7S O] [GAS [ �.-. ] [GALLONS ( ] GALLONS [ — ] GALLONS A N D R A 1 N r r E L D o IJtrfe T H E R ( LOO ] SQUARE [ ] SQUARE TYPE SYSTEM: CONFIGURATION: f4 'o o'1 Zoo s, SPECIFICATIONS BY: APPROVED BY: DATE ISSUED: REPAIR STATE OF FLORIDA DEPARTMENT OF HEALTH ONSITE SEWAGE DISPOSAL SYSTEM CONSTRUCTION PERMMIT Authority: Chapter 381, FS & Chapter 10D - FAC CONSTRUCTION PERMIT FOR; [ p] New System [NJ Existing System On Repair (e0) Abandonment APPLICANT: I d a i I14 e I. a e . � SYSTEM DESIGN AND SPECIFICATIONS FEET FEET FILL REQUIRED: (Aj(aq ] INCHES 4' ZS S.F. eacitCCC:j 36 3Ssig,e, 91 st. P)r4•‘.,, si i-e.s F'1. 33 + 3t SUBDIVISION: PROPERTY ID # : _ 3 2 0 4 2 - 0 1 9 - 6 7 2 0 (f.)] Holding Tank [Pi Temporary /Experimental ( � ] Other(Specify) AGENT: 6(I) s-a10 T't q ICJ to Lit E / Pa a ct SYSTEM MUST BE CONSTRUCTED IN ACCORDANCE WITH SPECIFICATIONS AND STANDARDS OF CHAPTER 10D-6. FAC. REPAIR PERMITS AND HOLDING TANK PERMITS EXPIRE 90 DAYS FROM THE DATE OF ISSUE. ALL OTHER PERMITS EXPIRE ONE YEAR FROM THE DATE OF ISSUE. DEPARTMENT OF HEALTH APPROVAL OF SYSTEM DOES NOT GUARANTEE SATISFACTORY PERFORMANCE FOR ANY SPECIFIC PERIOD OP TIME. 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. ___ OM 4016, 10/96 (Replaces HR° -M Firm 4016 apps 11..M1cI may be vend) (Stack Number. 5744 -001.4016 -0( / GPD1 SEPTIC TANK /AEROBIC UNIT CAPACITY MULTI- CHAMBERED /IN SERIES:[ ] / GPI)] CAPACITY MULTI - CHAMBERED /IN SERIES:( ) GREASE INTERCEPTOR CAPACITY [MAXIMUM CAPACITY SINGLE TANK: 1250 GALLONS] PER DOSE DOSING TANK CAPACITY DOSE .RATE [ ] PER 24 HRS NO. OF PUMPS: PRIMARY DRAINFIELD SYSTEM --TT /I-STANDARD Y S'T'EM (✓] STANDARD [ ] / FILLED [ ] TRENCH [ ✓ ] BED Elegy LOCATION OF BENCHMARK: ELEVATION OF PROPOSED SYSTEM SITE E3 4i1 BOTTOM OF DRAINFIELD TO BE [ CAI. ZO ] =i re e� tueew ul r r. gremeu [ SECTION /TOWNSHIP /RANGE /PARCEL NUMBER] [OR TA% ID NUMBER] 1 TITLE: Health Departmcnnt [ ] [ ] MOUND PERMIT P DATE PAID FEE PAIO RECEIPT 0 PAGE 01 o,2 -zoo _Z 3 -0 7 [] [INCHES /FT] (ABOVE /BELOW] BENCHMARK /REFERENCE POINT [INCHES /FT] [ABOVE /BELOW, BENCHMARK /REFERENCE POINT EXCAVATION REQUIRED: (4 ] INCH 5 ,�IAt.t � �, G �ir�.'� �c4 f;01.1 Cv. d Ca 30 bar AT DART LE OUT VIDES AtIO U)1 GER THAN THt YL�� I TITLE: From G K FP;t Gii DMi TRENCH CHD EXPIRATION DATE: 1613/0 2. Page 1 of 2 Scale: Each block represents 10 feet and 1 inch 40 feet. Pk:rasa Notes: Lc 41 IF By 07/65/2002 12:15 2055133472 STATE OF FLORIDA DEPARTMENT OF HEALTH APPLICATION FOR ONSITE SEWAGE DISPOSAL SYSTEM CONSTRUCTION PERM{,; Permit Application Number al 4 • • • DFi 4015. 10/96 (RQplaces HRS -H Fam 4015 wh di may De u5etl) ;EMck Number: 5744 -002- 4015.6) PART II - SITEPLAN 7 CSTDS 111 C. 74-4644 11 6f 4 \40 ,J r 1 41i 4 1 ,6' mi l/ sr _Not Approved_ D =te ALL CHANGES MUST BE APPROVED BY THE COUNTY HEALTH DEPARTMENT PAGE ©:: *PI/ N c.� )41. ,0_S 4 frpwa2 C6 3 6. (Ng Site Plan subrnitte •��� Plan Approved County Health Department Page 2 of 4