PLUMBING PERMITDate
Legal Description L U �� 3, / Historically Designated: Yes No
CS v,Q LL P°71 -7,d
/ Tenant / � Master Permit #
c Ale / ✓ T Phone
Owner's Address
Contracting Co. a o b S� 7c `��� / /0 Address / 43 /L) , A S7
Qualifier 'V �j J�}/1 f M SS# 6Phon(5iJ S/
State # d "M6 Municipal # I-- / Z- g Competency # J / J Ins. Co.
Architect/Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type (circle one): BUILDING ELECTRICA PLUMBING M HANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
I � l
0 O 3 0 /Job Address V6-) �� //c �� S /Tax Folio 1/ - 5 6 - 0
Square Ft. Estimated Cost (value) .� OO -
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 al • • 11 be done in compliance with all applicable laws regulating
construction and zoning. Furthermore,) authorize the above -named contractor to a work ted.
Notary
My Co
FEES: PERMIT
APPROVED:
Zoning
Mechanical
o • er and/or
ssion Expires:
ondo President
RADON
Building
Plumbing
Date
7 -L -
GLADIS J VILLAR
NOTARY PUBLIC STATE OF FLORIDA
COMMISSION NO. CC71,1103
MY COMMISSION] EXP. MAR. 1 ^002
a� of Contr• �� Owner -� uilder
•
...I as to I %.ntractor o • er -Bum der
y Commission Expires:
Si
N
C.C.F. j (7 NOTAR
Electrical
OFFICIAL NOTARY SEAL
\PaY P '(9 ANGELA Mi BECKER
�' � ��� COMMUSSION NUMBER
�p. Q C C7 d669 7
� CM G MY COMMISS E XPIRES
F OF FAO NOV. 15,2002
�Tb BOND p O b a
Structural Engineer
7 )
TOTAL DUE 3 b ..1
Da e
O
T
H
E
R
APPLICANT:
PROPERTY ADI,RESS:
SPECIFICATIONS BY:
APPROVED BY:
STATE OF FLORIDA
DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM
CONSTRUCTION PERMIT
( Pig ] INCHES
C�STRUCTION PERMIT
UV] New System [ Existing System
Repair [ Abandonment
ha-Y aafc R
qe. Afe. 1,
PROPERTY ID #: lid - a02 06, . 1' 00 6
D (J3 0] SQUARE FEET PRIMARY DRAINFIELD SYSTEM
R [ ] SQUARE FEET SYSTEM
A TYPE SYSTEM: [ STANARD [ AY FILLED [44 MOUND [�JI
I CONFIGURATION: , t ; TRENCH [ + BED [J/
N _ _
F LOCATION OF BENCHMARK:
I ELEVATION OF PROPOSED SYSTEM SITE
E BOTTOM OF DRAINFIELD TO BE
L
D FILL REQUIRED:
[ Q ] [INCHES /
o� ] (INCHES
EXCAVATION REQUIRED:
Holding Tank
Temporary
[ABOVE
[ABOVE
SOYTOM OF DRA NFIE
TITLE:
DATE ISSUED: a+ 1^a c h-,.,� �)�
DH 4016, 12/99 (Page 1) (Pie
1) ions-Editions May ,Be' Used)
] INCHES
FCVD
p E e . ILK. ntpartment
dA
pt. 3: Installer/Contractor
pt. 4: Building Department
PERMIT No f 1.J / 4, A
DATE PAID: 7_ 006 .-00
FEE PAID: '7'S. as
RECEIPT #:�OS07 /(aoC.
6 3. _ ��p e-
Innovative
� i (
LOT: 4 V � tk BLOCK: SUBDIVISION:
[SECTION, TOWNSHIP, RANGE, PARCEL NUMBER]
[OR TAX ID NUMBER]
SYSTEM MUST BE CONSTRUCTED IN ACCORDANCE' WITH. SPECIFICATIONS AND STANDARDS OF SECTION 381.0065,
F.S., AND;CHAPTER 64E-6, F.A.C. DEPARTMENT APPROVAL OF SYSTEM DOES NOT GUARANTEE SAFTISFACTORY
PERFORMANCE FOR ANY SPECIFIC PERIOD OF TIME. ANY CHANGE IN MATERIAL FACTS, WHICH SERVED AS A
BASIS FOR ISSUANCE OF 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 DEVELOPMENT OF THIS PROPERTY.
SYSTEM DESIGN AND SP IF OTI r >NS
T [ OD] GALLONS / GPD i„ EROBIC UNIT CAPACITY MULTI- CHAMBERED /IN- SERIES [ ]
A [ ] GALLONS / GPD CAPACITY MULTI- CHAMBERED /IN- SERIES [ ]
N [ ] GALLONS GREASE INTERCEPTOR CAPACITY [MAXIMUM CAPACITY SINGLE TANK: 1250 GALLONS]
X [ ] GALLONS DOSING TANK CAPACITY [ ]GALLONS @ [ ] DOSES PER 24 HRS # PUMPS [ ]
BENCHMARK /REFERENCE POINT
BENCHMARK /REFERENCE POINT
t„iuALL OF LOAMY COARSP SANn
uhocn I OTTOM DRAINFIELD
A ItT BENCHMA9K BEFORE INSPECTION
EXPIRATION DATE:
p
•
Page 1 of 3
INSTRUCTIONS:
PERMIIT NUMBER: Permit tracking number assigned by CPHU.
CONSTRUCTION
PERMIT FOR: Check type of permit, if "Other" specify type in blank.
APPLICANT: Property owner's full name.
TELEPHONE: Telephone number for applicant or agent
AGENT: Property owner's legally authorized representative.
MAILING ADDRESS: P.O. Box or street mailing address for applicant or agent.
LOT, BLOCK, SUBDIVISION or
PROPERTY IID #: 27 character id number for property. (CHD may require property appraiser ID # or section/township /range/parcel number)
SYSTEM DESIGN AND
SPECIFICATIONS:
TANK: Minimum specifications from Chapter 641E-6, FAC.
DRAIINPIELD: Minimum specifications from Chapter 64E -6, FAC.
OTHER: Other specifications, such as operating permit requirements, low- volume flush toilets, variance provisos.
SPECIFICATIONS BY: Name of individual providing specifications. If designed by a registered engineer must be sealed.
APPROVED BY: County Health Department (CHD) personnel reviewing and approving permit.
DATE ISSUED: Date permit is issued by CHD
EXPIRATION DATE: One year from date issued if the system has not been installed. Permits for system repairs become void 90 days from the date
issued.
Scale:
Each block represents 10 feet and 1 inch = 40 feet.
Site Plan submitted by:
Plan Approved J
By
Not Approved
1i
•
STATE OF FLORIDA
DEPARTMENT OF HEALTH
APPLICATION FOR ONSITE SEWAGE DISPOSAL SYSTEM CONSTRUCTION PERMIT
Permit Application Number
ALL CHANGES UST BE APPROVED BY THE COUNTY HEALTH DEPARTMENT
DH 4015, 10/96 (Replaces HRS-H Form 4015which may be used) ( .
(Stock Number. 5744-002 -4015 -6) t ti
'\
\ `• Y
PART II - SITEPLAN ----------- - - - -- -- -
4
Notes:
o
/ .0
a OOL N t '
fir - ‘1. 30 .
forty
8/
3a/us
MC-
fi
/ . X ;S7`1AiP
s, l .# � ! ro/ ,I G , '. /
111 - 1111711111111111111111111111 - II
Itir
fir t 7'Z4v1L-
5
Page 2 of 4
Da e
County Health Department
• = --
CLOSETS
BATH
TUBS
SHOWERS
LAVA-
TORIES
SINKS
INKS
SLOP
SINKS
LAUNDRY
TUBE
URINALS
B
BASIN
DRAIN DRAIN
DRINKING
FOUNT'Nfi
TOTAL
FIXTURES
CONTR.
LIST
CHECK
g•
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
N EATER
DEEP
WELL
SPRKLR.
SYSTEM
SW IM•G
POOL
[•�/
CIENTR.
LIST
-
CHECK
?er; eit No ,J.11 __. /__ ......
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._
Registered Architect and /or Engineer .?"..
Employing Plumber's Name__
Size Septic Tank
Feet of Drain Tile
Nature of Water Supply: City —Well.
Amount of Permit $
88.
MIAMI SKORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
•
Date
No.L 7 Street__ _/v ?/2L
No.________.___._____ Street
Location and Legal Description Lot._ ______......... ________..... _._ _ _ _ ___Block_____ _ _ Subdivision
Street and Number where work is to be performed— No. ___ — __
State work to be performed and purpose of building (By Floors)
N Building Remodeling Addition Repairs No. of Stories..
Street
Type of Tank_ Capacity Gals .___.....
_Dist. Feet of Tank or Drain Field from Well
__Size of Soakage Pit
(Signed)_
( Signed)___
Plumbing Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his o•ligations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5988, Compiled General Laws of Florida Permanent Supplement, and lies 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 s public notice or notices as are
required by the Act. The undersigned agrees to employ only such sub - contractors, on work to be •erform under this permit, as are
licensed by Miami Shores Village.
STATE OF FLORIDA, t
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgements, 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
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.
Permit No D a t e e
Application is 1 erebf y m ade 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 Naive and Address___
Registered Architect and /or Engineer _____
___ �l_!!_
Employing Plumber's Name
Location and Legal Description Lot.
Size Septic Tank
STATE OF FLORIDA, }
COUNTY OF DADE.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
1/1 4 /f No._ 1 - - —_ Street-//ja 57
421.1_\ .` _ , C�t_ iN
No.
Block_ _. `j - - ; f - -- -
Street and Number where work is to be performed -No / ‘ T - Street 9 / -
State work t b performed and purpose of building (By Floors) _ ," ' ,l _ � l� 9 ) //vi? e, vie.. - - - -. ,/1 _r-i
New Building Remodeling______ Addition Repairs No. of Stories
Street__
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
Amount of Permit $ ( 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 be performed under this permit, as are
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 hire stated are true.
My Commission Expires Notary Public, State of Florida
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.
CLOSETS
BATH
TUBS
SHOWERS
LAVA-
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TUBE
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT•N8
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
Permit No D a t e e
Application is 1 erebf y m ade 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 Naive and Address___
Registered Architect and /or Engineer _____
___ �l_!!_
Employing Plumber's Name
Location and Legal Description Lot.
Size Septic Tank
STATE OF FLORIDA, }
COUNTY OF DADE.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
1/1 4 /f No._ 1 - - —_ Street-//ja 57
421.1_\ .` _ , C�t_ iN
No.
Block_ _. `j - - ; f - -- -
Street and Number where work is to be performed -No / ‘ T - Street 9 / -
State work t b performed and purpose of building (By Floors) _ ," ' ,l _ � l� 9 ) //vi? e, vie.. - - - -. ,/1 _r-i
New Building Remodeling______ Addition Repairs No. of Stories
Street__
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
Amount of Permit $ ( 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 be performed under this permit, as are
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 hire stated are true.
My Commission Expires Notary Public, State of Florida
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.
Architect
Contractor
or Builder
Legal Lot II BL
Description
Address of
Building ��
BUILDING ❑ DATE
ELECTRICAL ❑ PERMIT N° 15588
PLUMBING
❑ Work to be performed under this Permit
Owner of
Building r
MIAMI SHORES VILLAGE, FLORIDA
Subdi-
vision
Value of
Project $
Contractor's
License No
Amt. of
Permit $
195
•
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.
'�
g
Si ned 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
BY AUTHORITY
Permit No. .. -
Registered Architect and /or Elgineer
Employing Plumber's Name
g)
Nature of Water Supply: City—Well .
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Amount of Permit $_
No.
(Signed)
(Signed) ) a
Date ,[ 5
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Divisior
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept al
building during progress of work.
Owner's Name and Address. \ k h _. ___ ; - No Street
Street -
Location and Legal Description Lot______.. ......... .. ____ __ - - -_ -_ _ Block- - -____ .. _ Subdivision __ -_ -_
Street and Number where work is to be perforated —No treat-
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
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'etnployer of labor
under.the Florida Workmen's Compensation Act, being Section 5988, 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 an
licensed by Miami Shores Village.
My Commission Expires Notary Public, State of Florida
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 appeare
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the
the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all lac
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 foul
materials and /or workmanship.
CLOSETS
BATH
TUBS
SHOWERS
LAVA.
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TUBS
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT'NS
TOTAL
FIXTUREI
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. .. -
Registered Architect and /or Elgineer
Employing Plumber's Name
g)
Nature of Water Supply: City—Well .
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Amount of Permit $_
No.
(Signed)
(Signed) ) a
Date ,[ 5
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Divisior
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept al
building during progress of work.
Owner's Name and Address. \ k h _. ___ ; - No Street
Street -
Location and Legal Description Lot______.. ......... .. ____ __ - - -_ -_ _ Block- - -____ .. _ Subdivision __ -_ -_
Street and Number where work is to be perforated —No treat-
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
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'etnployer of labor
under.the Florida Workmen's Compensation Act, being Section 5988, 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 an
licensed by Miami Shores Village.
My Commission Expires Notary Public, State of Florida
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 appeare
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the
the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all lac
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 foul
materials and /or workmanship.
BUILDING ❑ MIAMI SHORES VILLAGE, FLORIDA
ELECTRICAL ❑
PLUMBING X PERMIT NA 8849
ROOFING ❑
Owner of
Building
Architect �`
Contractor -i i ./
or Builder L� i�; - ? i :% ,' )/.. -;•
., ,=
Legal Lox 1 1
Description 11 Bl
a
Address of
Building
zp, el
CONTRACTOR or BUILDER
Signed • Yr j! F _
In consideration of the issuance to me o this permit I a
pertaining thereto and in strict conformity with the plans, draw]
In accepting this permit I assume responsibility for all work d
Work to be performed under this Permit
BY
Lie
Date
ev
1947
Contractor's
License No.
Subdi-
vision
Sq Ft
Value of 11 Amount of s°' „;::
Project $ 11 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 applica-
tion 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 respon-
sibility for work done by his agents, servants or employees.
(INSPECTOR) BY
e to perform the work covered hereunder in compliance with all ordinances and regulations
, statements or specifications submitted to the proper authorities of Miami Shores Village.
e by either, myself, my servant or employee.
AUTHORITY
UILDING
LECTRICAL
LUMBING
)wner of
uilding
- ontractor
r Builder
•egal Lot 10- - 1
)escription *�
MIAMI SHORES VILLAGE, FLORIDA
DATE 2 -4 194_7 -
PERMIT N? 5428 Contractor's /1e,
License No.
Work to be performed under this Permit
.
rchitect
Bl.
Subdi-
vision
ddress of .ift, F`
uilding
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-
ition herefor in strict compliance with all ordinances pertaining thereto and w th the understanding that the work will be performed in compliance with any
ans, 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
_rmit 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 asses respon-
bility for work done by his agents, servants or employees. '' to° A ,,
Signed +' By b '
INS'ECTOR
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
rtaining thereto and in strict conforniity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village.
accep'g this permiLI apume responsibility for all work done by either myself, my agent, servant or employee.
CONT
1
Value of
Project
BY
Amt. - of
Permit
AUTHORITY
•
BUILDING
-
'ELECTRICAL
PLUMBING
Owner of
Buirding
ArQhitect
Contractor
or Builder
Legal
Description
Address of
Building
CO
PERMIT N° 5428
MIAMI SHORES VILLAGEk.:,FLORIDA.
D A 10 :117 2-a
Work to be performed under this Permi
Lot ri W ithe 4l . Bl
4 /6
,Z (2/
RACTO
Subdi-
vision 5.1
Value of
Project
BY
Contractor'g iff
License No.
Signed:1 By
AUTHORITY .
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 appli-
cation 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 rqunicipal 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 - authorizaticin. A fuither condition- upon Aich this
permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough khowledge of the ordinances :and -
regulations pertaining to the work covered, hereby whether shown on the plans drawi 0 in the statements or specificatio • that he asrnes respon-
sibility for work done by his agents, servants or employees.
. ..• IN ECTOR . .
In consideration of the issuance to me of this permit I agree to perform the work covered ereunder in compliance With-all ordinancei and re4uka
• .4 •
pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authWiles of Miami SION age
In acc s ing this pe suit I .ssume responsibility for all work done by either myself, my agent, servant or employee. . .