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PLUMBING PERMIT
APPLICANT AGENT:__ PROPERTY ADDRESS: LOT: CH =CKED [X] ITEMS ARE NOT IN STATE OF FLORIDA DITPARTMEN T OF HEALTH ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM CONSTRUCTION INSPECTION AND FINAL APPROVAL BLOCK: SUBDIVISION: TANK INSTALLATION [01] TANK SIZE [1]_ [2]. [02] TANK MATERIAL_ [03] OUTLET DEVICE [04] MULTI-CHAMBERED [Y / N ] [05] OUTLET FILTER [06] LEGEND_ [07] WATERTIGHT [08] LEVEL [09] DEPTH TO LID DRAINFIELD INSTALLATION [10] AREA [1]_ __ [2] SOFT [11] DISTRIBUTION BOX HEADER._ [12] NUMBER OF DRAINLINES [13] DRAINLINE SEPARATION [14] DRAINLINE SLOPE [15] DEPTH OF COVER [16] ELEVATION [ABOVE /BELOW] BM [17] SYSTEM LOCATION [18] DOSING PUMPS [19] AGGREGATE SIZE [20] AGGREGATE EXCESSIVE FINES [21] AGGREGATE DEPTH FILL / EXCAVATION MATERIAL [22] FILL AMOUNT [23] FILL TEXTURE [24] EXCAVATION DEPTH [25] AREA REPLACED [26] REPLACEMENT MATERIAL EXPLANATION OF VIOLATIONS / REMARKS: CONSTRUCTION [APPROVED /DISAPPROVED]: COMPLIANCE WITH FINAL SYSTEM [APPROVED /DISAPPROVED]: DH 4016 (Page 2), 10/97 (Previous Editions May Be Used) Stock Number: 5744- 002- 4016 -4 PER1.M11 T NO._ . DATE PAID: FEE PAID: __ _ RECEIPT 4: _ _ PROPERTY ID #: RULE AND MUST BE CORRECTED. SETBACKS [27] SURFACE WATER [28] DITCHES._ [29] PRIVATE WELLS __ _ [30] PUBLIC WELLS_ [31] IRRIGATION WELLS._ [32] POTABLE WATER LINES__ [33] BUILDING FOUNDATION _ [34] PROPERTY LINES _ [35] OTHER 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 S!TE: P A,N [46] FINAL SITE GRADING [47] CONTRACTOR. __ _ [48] OTHER ABANDONMENT [49] TANK PUMPED _ _ L. _ [50] TANK CRUSHED & FILLED.. L PT 1: App!:cant PT 2: Inskilicr Ccn',ridcr PT 3: Bu:-J.ng Depa H -ent PT 4: Health Department CHD DATE:_ CHD DATE: Page 2 of :i -1C 11):IJ INF:0V1AfI(1,\1 (),\I TANK SI/Z. (ga.ilcns) mAi (concrato, atc) (manufacturec, (rnaliLitacturer codc) DATED ARI]:A (square . i'cat) [):3'...,,UTI,C,N SOX / 1-11:iA,31T; b'JN) DI (in relation ,703INO (nuiTibar (..ceord actLial sotbact;u 1. •:11 3 IT:1, (as rcpuircr;I) ii:.:7ATI,C)N (date stabilixac,), CON AC 0,1 (coltractor • AIT3A1\DONM I.:NT TANK PUMII:,; I,ANK AN.) Ca\,5 .0 1(); Pci•Ait tracitiiin assignci b myncrs 0:' ac'drzn)s •:•,),' t: or :ic 3 Udiviiiic,), •,:or tor :app2," ( • ;'a. : . : o;' CIS loc).tir,,i) I AS approvcui ciii",i7.2prOVCC, ..', cIisap,)rovcc,. CI I,) CI CI: 0' approval. approval shall not Po grtn;. ..LII ;Hi) has coriticrricLi. •Lna.t c • g,;7,LIing co, JI:anco with plaris and spec,tI2i..ii porn ajilicatInii, \. Is1 c. i I (' O.' t; ••■ • ;••;:0:\l, AN: APPLICANT: AGENT : t• q r t1 - r' .l. { (•: . PROPERTY ADDRESS: TANK INSTALLATION [01] TANK SIZE [ 1 1 ° ` l=' �._. (2] [02] TANK MATERIAL '_ '': - [03] OUTLET DEVICE .'err; r -,, [04] MULTI-CHAMBERED CY; / WW1 [05] OUTLET FILTER Y•'> ` ^;' °t ! [06] LEGEND / .. "( - !i`J L2 [07] WATERTIGHT [08) LEVEL A J 1 [09] DEPTH TO LID FILL [22] [23] [24] [25] [26] STATE OF FLORIDA DEPARTMENT OF HEALTH ONSITE SEWAGE TREATMENT AND DIPOSAL SYSTEM CONSTRUCTION INSPECTION AND FINAL APPROVAL 1.1 1 lI ., r / /7) t;1 L . - ' / EXCAVATION MATERIAL FILL AMOUNT o FILL . TEXTURE EXCAVATION DEPTH AREA REPLACED REPLACEMENT MATERIAL '' i c CONSTRUCTION [(APPROVED /DISAPPROVED]: FINAL SYSTEM [(APPROVED /DISAPPROVED]: LOT: , BLOCK: � : SUBDIVISIONS '1 C %rt yr CHECKED [X) ITEMS ARE NOT IN COMPLIANCE WITH DRAINFIELD INSTALLATION [ 10) AREA [ 1 0.0 i» [ 2 ] ,.� .l � j SQFT [11] DISTRIBUTION BOX HEADER [12] NUMBER OF DRAINLINES , [13] DRAINLINE SEPARATION ,; [14] DRAINLINE SLOPE ,6 [15] DEPTH OF COVER [16] ELEVATION [ABOVE /BELOW] BM [17] SYSTEM LOCATION � [18] DOSING PUMPS '• G (19] AGGREGATE SIZE. ,ij ; [20] AGGREGATE EXCESSIVE FINES [21] AGGREGATE DEPTH 171 EXPLANATION OF VIOLATIONS / REMARKS: [ ] [ ] [ ] 1 1 DH 4016, 10/97 (Previous Editions May Be Used) STATUTE OR RULE AND MUST BE CORRECTED. [ ] [ [ ' ] [ [(' ] [ [ ] [ [%; ] (31] 2 [ ] [ [ ] [33] [ ] [ [ ] [35] SETBACKS FILLED / MOUND SYSTEM [36] DRAINFIELD COVER [37] SHOULDERS [38] SLOPES [39] STABILIZATION SURFACE WATER OTHER (11- 1 1 y PERMIT NO® - DATE PAID: FEE PAID: RECEIPT #: PROPERTY ID 1: / wasrmazassa=arass=acms=s2========n DITCHES _ PRIVATE WELLS PUBLIC WELLS IRRIGATION WELLS POTABLE WATER LINES BUILDING FOUNDATION PROPERTY LINES 3./.; 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 GEADING, [47] CONTRACTOR ,' _.1; 1, • [ OTHER ABANDONMENT ] [49] TANK PUMPED 1 ] [50] TANK CRUSHED£ , CED DATE: CHD DATE FT FT FT FT FT FT FT FT FT 1-5`1D5 Page 2 of 3 11 n§taflkkr / Contractor ' 7 .- 41 ? 35)-)- ` ^ __-_- __1 Date Issued to OWNER For a _ story Fixtures Fixtures Sewer Septic Tank iami c-rhoreslillage F 1. 0 F. 1 13 A PLUMBING PERMIT IP.' 825 to install the following described plumbing, in accordance with the laws, statutes and regu- lations of Miami Shores Village, Florida and the State of Florida, governing plumbing and drainage work done in Miami Shores Village, Florida. building at Total $ Village Plumbing Inspector Received Payment by LOT BLOCK SUBDIVISION ate 1 � s _ ued to For a story Fixtures Fixtures _ _ - Se wer optic Tank OWNER aiami cShores9illage F L O A S D A PLUMBING PERMIT N9 825 LOT to install the following described plumbing, in accordance with the laws, statutes and regu- lation, of Miami Shores Village, Florida and the State of Florida, governing plumbing and drainage work done in Miami Shores Village, Florida. building at Total $ Village Plumbing Inspector _ _ Received Payment by BLOCK SUBDIVISION BUILDING ELECTRICAL PLUMBING Owner of Building Architect Contractor or Builder Legal Description_ Lot MIAMI SHORES VILLAGE, FLORIDA DATE PERMIT N9 3649 Work to be performed under this Permit Bl. L Contractor's License No._ By CONTRACTOR OR BUILDER BY AUTHORITY 194 Subdi- vision Address of Value of I' Amt. of Building it Pro 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: 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 regula- tions 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. MIAMI SHORES VILLAGE, FLORIDA BUILDING ELECTRICAL PLUMBING Owiter.• of Building Architect Contractor or Builder Legal Description Lo_ PERMIT N9 3649 L - Work to be performed under this Perixut CONTRACTOR OR BUILDER BI. Subdi- vision DATE 194 Contractor's License No. _ - Address of Value of I Amt. of BuilLing Project Permit TL-is permit is granted to the contractor or builder named above to construct the building or to install the equipment or dcvirc do cribed in thi application herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any pI1ns, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit nia; be revoked at any ti - n_ 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 knrncledge c f the ordinances and :egulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications anei that h assumes responsibility for work done by his agents, sorvants or employees. Signed: By INSPECTOR :.n consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regula- tions pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper auillibflties of :bii.u„iS1%ures Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servant or employee. BY AUTHORITY BUILDING Lil ELECTRICAL Li PLUMBING ROOFING Li Owner of Building Architect —4 — ,-. ontractor ' ' . it., . t , or Builder , I t; V ' 1 .. ,, • IN -- Legal . Lot ' i! Bl. i SUbdi- Description vision „k Address of Fro] ect 1 .10 .11 Thi3 permit is frranted to de contiacibr or builderinarkd above to coOstruct the building or to install the equipment or device descrfbed in the 4 alltaiication herefor in strict compliance wit 'all ordinances pertainirig thereto and with /the understanding that the work will be performed in compliance with any plans, drawings, statements or specificagons that may have been submitted to and pproved 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 arc 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 knowle -throordiaasect.„aughavaig pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications ancletha) he assumes responsibility or done by his agents, servants or employee CONTRACTOR R OR BUILDER MIAMI SHORES VILLAGE, FLORIDA PERMIT N? 15868 Work to be performed under this Permit_ Signed• Value of DATE ° 71 195_1_ Contractor's License No. Bt I NSPECTOR il Amt. of I • In consideration of the issuance to rne of this permit I agree to perform the work covered hereunder in compliance with all ordinartcef'and regulatighs 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 clone by either. myself, my agent, servant or employee. BY AUTHORITY • Address 1105 MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date /Z-a/ Type Insp'n PCB Permit No. 4=1 1 q Name I\4.0 r'fi r Po 1 h'Ye.r Inspection Date Approved Correction Re- Insp'n Fee 4C,cR N. qi 3T. Phone # 305& 2E=. r 39 a Z Company I \'e E me r 1 fu 1:► fl . Inc 00 0 Address MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date 1 f I 0 Ica • Type Insp'n R V9 ¢-d _C 014 =- L—COR Permit No. L 05 — a 0 13 1872.. j�l 'LlV Name M 0 lNe 4409 NE 1 ." Company N: erg. iS�t� UL�ID1� Phone # `305 I — 3 cRi 4 Z Inspection Date Approved Correction Re- Insp'n Fee e_,,, _a 6 /it d'a ,,, _ ,, lir Passed s e �lor C • mments Failed Correction Needed Re- Inspection Fee ($75) No Additional Inspections can be scheduled re- inspection fee is paid. until Inspection Number: INSP -24492 Permit Number: PL2005 -193 Inspection Date: 08/11/2006 Inspector: Levrack, James Owner: DEVELOPMENT, TALISMAN Job Address: 469 91 Street NE Miami Shores Village, FL 33138 Project: <NONE> Contractor: NELMAR PLUMBING INC Building Department Comments Thursday, August 10, 2006 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Block: Permit Type: Imported Permit Inspection Type: Top Out Work Classification: Plumbing Phone Number (305)310 -4673 Parcel Number PARC2004 -16 Lot: Phone: (305) 261 -3942 Page 2 of 2 V i nspection Number: INSP -11408 Inspection Date: 03/08/2006 Inspector: Levrack, James Owner: DEVELOPMENT, TALISMAN Job Address: 469 91 ST. N E Project: <NONE> Tuesday, March 7, 2006 Miami Shores Village, FL 33138 Contractor: NELMAR PLUMBING INC Building Department Comments Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phoo (305)795 -2204 Fax: (305)756 -8972 Block: tSP X64-11A Permit Number: PL2005 -193 Permit Type: Imported Permit Inspection Type: Top Out Work Classification: Plumbing Phone Number ([305)310 -4673 Parcel Number PARC2004 -16 Lot: Phone: (305) 261 -3942 Page 1 of 2 I n pe to v i = •uI.H t Passed Failed Correction Needed Re- Inspection Fee ($75) No Additional Inspections can be scheduled until re- inspection fee is paid. V i nspection Number: INSP -11408 Inspection Date: 03/08/2006 Inspector: Levrack, James Owner: DEVELOPMENT, TALISMAN Job Address: 469 91 ST. N E Project: <NONE> Tuesday, March 7, 2006 Miami Shores Village, FL 33138 Contractor: NELMAR PLUMBING INC Building Department Comments Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phoo (305)795 -2204 Fax: (305)756 -8972 Block: tSP X64-11A Permit Number: PL2005 -193 Permit Type: Imported Permit Inspection Type: Top Out Work Classification: Plumbing Phone Number ([305)310 -4673 Parcel Number PARC2004 -16 Lot: Phone: (305) 261 -3942 Page 1 of 2 Inspection Date: 02/21/2006 Inspector: Levrack, James Owner: DEVELOPMENT, TALISMAN Job Address: 469 91 ST. Miami Shores Village, FL 33138 Project: <NONE> Contractor: NELMAR PLUMBING INC Building Department Comments Friday, February 17, 2006 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: {305)795 -2204 Fax: (305)756 -8972 Block: ' % ilk ! y' i nspection Number INSP -10107 Permit Number: PL2005 -193 Phone Number Q305)310 -4673 Parcel Number PARC2004 -16 Permit Type: Imported Permit Inspection Type: Rough Work Classification: Plumbing Lot: Phone: (305) 261-3942 Page 1 of 2 I Passed I spct � mments D p G 13 � / f o G ��-1 (-7'E '1( 1 1 i ) �� Z_sl: i, �'�� L Failed Correction Needed Re- Inspection Fee ($75) No Additional Inspections can be scheduled re- inspection fee is paid. until Inspection Date: 02/21/2006 Inspector: Levrack, James Owner: DEVELOPMENT, TALISMAN Job Address: 469 91 ST. Miami Shores Village, FL 33138 Project: <NONE> Contractor: NELMAR PLUMBING INC Building Department Comments Friday, February 17, 2006 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: {305)795 -2204 Fax: (305)756 -8972 Block: ' % ilk ! y' i nspection Number INSP -10107 Permit Number: PL2005 -193 Phone Number Q305)310 -4673 Parcel Number PARC2004 -16 Permit Type: Imported Permit Inspection Type: Rough Work Classification: Plumbing Lot: Phone: (305) 261-3942 Page 1 of 2 . Miami Shores Village BUILDING PERMIT APPLICATION FBC 2001 Permit Type (circle): Building Owner's Name (Fee Simple Titleholder) Owner's Address 1 C I, 0 D G si City NA ®A State Tenant/Lessee Name Job Address (where the work is being done) City Miami Shores Vi11aRe County Miami -Dade Zip Is Building Historically Designated YES NO )0 Contractor's Company Name Contractor's Address City Qualifier Building Department Electrical ( Plumbing 1 $ Value of Work For this Permit ( r Mechanical Roofing C).‘ (073 l S G IVY A� � ' � � ' Phone # � V 5 J \AO IG 1)e. �c ' Zip Phone # State Permit No. v Master Permit No. 5 " O T - t3- 0 Phone # Zip ; . - Architect/Engineer's Name (if applicable) . Phone # Architect/Engineer's Address City State Zip Number of: Bays Stories Families Type of Work: DAddition QAlteration Describe Work: New Square Footage Of Work: Bedrooms Baths 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 ❑ Repair/Replace ❑ Demolition * * * * * * * * * * * * * * * * * * * * * * ** * * ** Fees ** * * * * * * * * * * * * * * * * * * * * * * * * * * ** County Escrow Fee $ Permit Fee $ Notary $ Education/Training Fee $ Tech $ Scanning $ Radon $ Code Enforcement $ Bond $ Struct. $ Minus Plans Check Fee $ Total Fee Now Due $ (Continued on opposite side) Bonding Company's Name (if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State Zip Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issjed. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature L �2 . tA Signature �` ' 1-' y '' is Owner or Agent `Con c r The foregoing instrument was acknowledged before me this The foregoing instrument was aCknowledged before me this / Y day of ,20,by day of T. '- , 20 _ _,by / . /- ,4 /A'i j L , who is personally known to me or who has produced who is personally known to me or who has produced NOTARY PUBLIC: NOTARY PUB Sign: Sig Print: P My Commission Expires: State Certificate or Registration No. APPLICATION APPROVED BY: chc7/7 /03 As identification and who did take an oath. (Certificate of Competency Holder) as identification and who did take an oath. Yiary Public s State of Florida Certificate of Competency No. ! `� ' L Plans Examiner Engineer Zoning BUILDING PERMIT APPLICATION FBC 2001 Permit Type (circle): Building Electrical LPlumbing Mechanicall Roofing Owner's Name (Fee Simple Titleholder) Owner's Address Tenant/Lessee Name Architect/Engineer's Name (if applicable) $ Value off Work For this Permit g72& ®O Type of Work: Addition DAlteration Describe Work: c Code Enforcement $ Total Fee Now Due $ (/ 5 , (Continued on opposite side) Miami Shores Village Building Department >0050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 P Permit No. 10.5 Master Permit No. A V >:7 Bo, /� Phone # ,305° City State Zip Phone # Job Address (where the work is being done) '/' Ve 9A-4 ,5��rwl City Miami Shores Village County Miami -Dade Zip Is Building Historically Designated YES NO . Contractor's Company Name /& .4 /' . Phone # P..i (L; � �<'� !1 Contractor's Address ('�`- .z ' 05 ,E City /2c" ( � ' State ,Y Zip 330/V //i /� Qualifier N/ ()/ ( /.(:� O <.',`J g ">�c5 11 ; ' g , Phone # ( JI ll eNew r � ❑ Repair /Replace ❑ Demol'r_.m Structural Plan Review. $ Square Footage r ' Work: * * * * * * * * * * * * * * * * * * * * * * * * * * ** F ees * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Submittal Fee $ 4 , �� • 0 Permit Fee $ 3q. CCF $ o Technology Fee $ Scanning $ Radon $ ,)/) .i Bonding Company's Name (if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State Zip Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such Hosted notice, the inspection will not be approved and a reinspection fee will be charged. Signature Signature NOTARY P1'5LIC: NOTARY PUBLIC: Sts.;. Sign: Print: Print: My Commission Expires: * * * * * * * * * * * * * * * * * * * * * * * * * ** APPLICATION APPROVED B Chc 10/14/03 Owner or Agent Contra. or The foregoing instrument was acknowledged before me this fhe foregoing instrument was acknowledged before me this a ' day of r, 20 , by - day of 4 1121/ , 200r by GGh.LS Pli I'D A) , who is personally known to me or who -t produced who is ersonally know to me or who has produced 144 As id.itification and who did take an oath. as identification and who did take an oath. My Commission Expires: .TULy / (Certificate of Competency Holder) State Certificate or Registration No. 8, Certificate of Competency No. i * ** *aa**.***************** a************** * *** * * * * * ** * **** * * * * * * * * * * * * * ** try I/ 1 111 1Pre. Plans Examiner Engineer Zoning Miami Shores Village 10050 NE 2nd Avenue Phone: 305795 -2204 Permit Number: PL2005193 Printed: 6/27/2005 Applicant: MARTIN Owner: PALMER JOB ADDRESS: 469 N.E. 91 Contractor NELMAR PLUMBING INC Local Phone: (305) 261 -3942 Parcel # PARC2004 -16 Legal Description: Fees: Description Amount FEE2005 -8849 Building Fee $227.50 FEE2005 -8850 CCF $4.20 FEE2005 -8851 Training and Education Fee $1.40 FEE2005 -8852 Technology Fee $5.68 FEE2005 -8853 Scanning Fee $3.00 Total Fees: $241.78 Total Fees: $241.78 Total Receipts: $0.00 Permit Status: APPLIED Permit Expiration: 12/12/2005 Construction Value: $6,500.00 Work: PLUMBING MASTER PERMIT IS BPO4 -920 IS IS FOR A NEW CONSTRUCTION Signed: (INSPECTOR) Plumbing Permit PALMER MARTIN ST. Contractor's Address: 4954 SW 75 AVE Page 1 of 1 .JUN 2 8 PM GdA S 6-0 In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responisibility for all work done by either myself, my agent, servants or employes. Signed: (Contractor or Builder) BY: i( ..... nspe t" :. I C. me i ts Passed Failed Correction Needed Re- Inspection Fee ($75) No Additional Inspections can be scheduled until re- inspection fee is paid. Inspection Date: 11/01/2006 Inspector: Levrack, James Owner: DEVELOPMENT, TALISMAN Job Address: 469 91 Street NE Miami Shores Village, FL 33138 Project: <NONE> Contractor: NELMAR PLUMBING INC Building Department Comments Tuesday, October 31, 2006 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Block: Inspection Number: INSP -31228 Permit Number: PL2005 -193 Permit Type: Imported Permit Inspection Type: Final Work Classification: Plumbing Phone Number (305)310 -4673 Parcel Number PARC2004 -16 Lot: Phone: (305) 261 -3942 Page 2 of 2 Inspection Date: 10/18/2006 Inspector: Levrack, James Owner: PALMER, MARTIN Job Address: 469 91 Street NE Project: <NONE> Miami Shores Village, FL 33138 Contractor: MIAMI DADE WATER & SEWER DEPT Building Department Comments Wednesday, October 18, 2006 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 9 E 0J Block: Phone Number Parcel Number Permit Type: Plumbing - Residential Inspection Type: Water Service Work Classification: New Lot: 305-310-4673 PARC2004 -16 Phone: (305)669 -7623 Page 1 of 2 Passed c f, ` Comments sp � / / ( t Failed Correction Needed Re- Inspection Fee ($75) No Additional Inspections can be scheduled re- inspection fee is paid . until Inspection Date: 10/18/2006 Inspector: Levrack, James Owner: PALMER, MARTIN Job Address: 469 91 Street NE Project: <NONE> Miami Shores Village, FL 33138 Contractor: MIAMI DADE WATER & SEWER DEPT Building Department Comments Wednesday, October 18, 2006 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 9 E 0J Block: Phone Number Parcel Number Permit Type: Plumbing - Residential Inspection Type: Water Service Work Classification: New Lot: 305-310-4673 PARC2004 -16 Phone: (305)669 -7623 Page 1 of 2 Project: <NONE> ............... ............... lsct Inspection Date: 10/18/2006 Inspector: Levrack, James Owner: PALMER, MARTIN Job Address: 469 91 Street NE Miami Shores Village, FL 33138 Contractor: MIAMI DADE WATER & SEWER DEPT Building Department Com Wednesday, October 18, 2006 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Block: Permit Type: Plumbing - Residential Inspection Type: Water Service Work Classification: New Phone Number Parcel Number Lot: 305 - 310 -4673 PARC2004 -16 Phone: (305)669 -7623 Page 2 of 2 Passed e to Comments Failed Correction Needed Re- Inspection Fee ($75) No Additional Inspections can be scheduled re- inspection fee is paid . until Project: <NONE> ............... ............... lsct Inspection Date: 10/18/2006 Inspector: Levrack, James Owner: PALMER, MARTIN Job Address: 469 91 Street NE Miami Shores Village, FL 33138 Contractor: MIAMI DADE WATER & SEWER DEPT Building Department Com Wednesday, October 18, 2006 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Block: Permit Type: Plumbing - Residential Inspection Type: Water Service Work Classification: New Phone Number Parcel Number Lot: 305 - 310 -4673 PARC2004 -16 Phone: (305)669 -7623 Page 2 of 2 B Y: • 1 R MCTE:rii WTI Public Works Permit Application FBC 2004 Permit 'lynx ubitc Wattle WATER Chanori, Mum) (1 co &Inn% TitIntiolthu) . Ownere, Addrean City 1 enent/1 men Nunn! Jab Addrons (le/humbly work 13 being done) City It, binding Historically Otgitgiutifirl City Iwo 4.4 Work: De= itre Wink Submilnul Von CsIt.loty $ Stonning $ ° Coate Eitten Teta Fee Nov/ Due $ ((;pritinuNI on optioNte (nag) 1 Minini Shoten rn Gontructoft. Company Nemo , /. 1 /17341.70 Continetner, Mei= 1 5,p_trliz.„.... blic Works Departent 10050 N.E. 2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 M I (PI L iv61 24/9 F-- V#.412/0- Phana V:...:3 9_774 $ Vattua won( Vol thin Nunn 2-00 00 / insiKt1 Foot ivo 01 Wink: -.a i Shores Va YES County Milan Data NC) c,14,6-(4._ P ph. - -76,- 1.7-guluE stow rj madam LIAtiemlion G NC* r 1 Rapetriliep±acp U (1;71110iten rO re<fw.Lit. - • ... * 01.9...9.14.914 999.999.••••■•999.,...9 M oue State 2 C).C5 -2,3S3 porMi tta. Zip -7 7 PonPit Foe t CV= $ t ZO CO/CC Trainiagraexation Fc'e Ticeranotogy Fen $ Z. 50 RadqA $ Zairtino Cand Structural Pkuo Revlon? • Bonding Company's; Name (If applicable) Bonding Company's Address City Mongngu I tinders Name (if applicable) Mortgage Leaders Address Gdy Signature 1y 1 ft Sign: Pont. My Commission Ixplres: 11/17/2005 Owner or Agent Slat Stale i(ZC &AlA)r ( ��2V 1 A-1 yl'S NE q( ',r Signature N/A N/A Zip Zip Application is hereby made to obtain a pemvt In do the work and installations as indicated. I certify that no wont or installation has commenced print lo the issuanai of a permit and that all work will be performed to meet the standards of all lows regulating ennrtrui;9inn in this jurisdiction) I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS. POOL S, FURNACES, BOILERS. HEATERS, TANKS and AIR C,ONDI1'IONERS, fc . . r . • •• Notice to Applrcunt: Asa condition to ti prom) o in good faith flint o - - •' property is subject inspac " t OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will txa done in laws regulating construction and zoning 'WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COM FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO ATTORNEY GEFORE RECORDING YOUR NOTICE OF C inco with all nooksabt<e. ENT MAY RESULT IN YOUR PAYING TtiCE FINANCING, CONSULT WITH YOUR LENDER OR AM CEMENT." ..uanco of a Public Works permit with en estimated value exceeding $2500, the cpplicn1 must tho notice of commerree mint 0W Construction lien law brochure wit! bo delivomd to the per:n*xi whose ichmvnt Also, a certibed copy 01 the mcordod notice of commencement must be posted tit the Job site fir the first occurs, seven (7) day after the bulttfirly llomnit is issuad. In tlih absenao of such posted notice, 1 t poc1ion will not be roved and a roin&pOctlon NO will be charged 9sv reit /eafl Vt64=A Jul / Fen_ T > fl b1 0 A6LT, - Thu forgoing instrument was acknowledged betaro the this The foregoing instrument was acknowledged before me this____,_ day of 20 by dny et 20 , by who b personally known to mo or who has produced Who Is personally know to me or has produced a ..� as identification and who did take on oath. as bland ki tlon and who did tctie an oath, NOTARY PUBLIC: NOTARY PUBLIC: Sign- Print: My Commission Expires: .« 4.4 4444 44 ..4.4R..t• ♦Nw4.4444.1144..... 6r•ta* .. 4•fZ •+•H•i•4 „l•YY4• ♦. ......sv•• 144.44N*•. sow4✓ 4... e ..... ..............*.....•...a.11.r6 I APPLICATION APPROVED tab: . �; � ' / Politic Works Dire or or his designee. Issue Date: 9/15/2006 Owner's Name: MARTIN PALMER Permit Type: Plumbing - Residential Work Classification: New Job Address: 469 91 Street NE Additional Information Miami Shores Village, FL 33138 Contractor(s) Phone Primary Contractor MIAMI DADE WATER & SEWER DEl (305)669 - 7623 Yes Comments: INSTALLATION OF 1" SERVICE IN THE REAR ALLEY TAP WATER MAIN RUN SERVICE LINE AND SER METER BOX ADA 400 ER 16011 Type of Work: WATER LINE Additional Info: Classification: Residential Type of Piping: Bond Return : 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 assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL, PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work. 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. Futhermore, I authorize the above -named contractor to do the work stated. Fees Due CCF Education Surcharge Permit Fee - New Construction Scanning Fee Technology Surcharge Total: Amount $1.20 $0.40 $100.00 $3.00 $2.50 $107.10 Invoice Number PL -9 -06 -26144 Total: Amt Due $107.10 Amt Paid $107.10 $107.10 Building Department File Copy Applicant Signature Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Fax: (305)756 -8972 Permit Expires: 03/14/2007 Parcel #: Block: Section: Permit Status: APPROVED Permit Number: PL -9 -06 -2333 on e: 305 -310 -4673 PARC2004 -16 Lot: PB: Total Square Feet: Total Valuation: Re • uired Ins • ections Underground Rough Water Main Top Out Main Drain Lavatory Water Service Re Pipe Heater Final 0 $ 1,000.00 NOTICE: In addition to the requirements of this permit, there may be additional restrictions applicable to this property that may be found in the public records of this county. AND THERE MAY BE ADDITIONAL PERMITS REQUIRED FROM OTHER GOVERNMENTAL ENTITIES SUCH AS WATER MANAGEMENT DISTRICTS, STATE AGENCIES, OR FEDERAL AGENCIES. Check Date: 08/31/2006 Vendor Name: MIAMI SHORES VILLAGE Check Number: 00321607 Payment Deductions Invoice Number Invoice Date Voucher ID Gross Amount Insp Gen Fee User Access Fee Discount Paid Amount PERMIT 16011B 08/23/2006 DP24297 107.10 0.00 0.00 LfriG MG 6 'r. PEA Lice 16,71( The attached check represents the amount due you as shown on our records. For additional information, contact (305) 665 -7471 0.00 107.10 Check Number Date Total Total Total Gross Amount Insp Gen Fee User Access Fee Total Discount Total Paid Amount 00321607 08/31/2006 $107.10 $0.00 $0.00 $0.00 $107.10 MIAMI -DADE WATER AND SEWER DEPARTMENT POOLED CASH ACCOUNT P.O. BOX 330316 MIAMI, FL 33233 -0316 Bill To MARTIN PALMER TALISMAN DEVELOPMENT CORP 1900 S. BAYSHORE DRIVE MIAMI, FL 33133 Return to: Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Date 09/13/2006 09/13/2006 09/13/2006 09/13/2006 09/13/2006 CCF Fee Name Scanning Fee Permit Fee - New Construction Education Surcharge Technology Surcharge Wednesday, September 13, 2006 Invoice Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Fax: (305)756 -8972 Invoice Number: PL -9 -06 -26144 Invoice Date: September 13, 2006 Permit Number: PL -9 -06 -2333 Fee Type Calculated Percentage Calculated Calculated Calculated Total Fees Due: Fee Amount $3.00 $100.00 $0.40 $2.50 $1.20 $107.10 Payments Date Pay Type Check Number Amount Paid Change 09/13/2006 Check 00321607 $107.10 $0.00 Total Paid: $107.10 Total Due: $0.00 I MIAMI SHORES VILLAGE MIAMI -DADE COUNTY SEC. 6 -53 -42 NEW 1" SINGLE SERVICE SET BOX AND SPACER, DO NOT SET METER 1 LOCATE 5 FEET FROM WEST PROPERTY LINE 9' PAVEMENT RNV RNV RNV 20 • • ••• • • • ••• • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • ••• • • • • • 'C __ v x • • • • • • • • • ` 11 • • ••• • • • • ••• s .��u !!�:,< . .. ▪ • N.E. 22 • • • • • • • •• • • • ••• • •• 410. • • • • • • • • • • • • • ••• • • • • • • • • • • ••• • • • •• • • • •• ••• •• • • • • • • • • • • • • • • 4100 • • EXISTING 3" WATER MAIN MATERIAL AND LOCATION TO BE FIELD VERIFIED J - 15' ALLEY \ _` ) • 23 24 91 STREET W z W W. z SCALE: N.T.S. GENERAL NOTES 1.48 HOURS BEFORE DIGGING CALL SUNSHINE STATE ONE CALL AT 1- 800 - 432 -4770 2. LANE CLOSURES PER F.D.O.T. DESIGN STANDARD INDEX # 621. 3. PAVEMENT RESTORATION PER M.D.C.P.W.M. R -21.1. 4. SIDEWALK RESTORATION PER M.D.C.P.W.M. R -13.1. 5. MAINTAIN MIN. 30" COVER ON ALL SERVICE LINES. 6. DO NOT SET METER(S) AT THIS TIME. DRAWN: H.B. 1 DATE: 7 /26/06 1 CKD: NEW WATER SERVICE FOR 465 N.E. 91 STREET AFA -400 ER -16011 MIAMI - DAD r ATER AND SEWER DEPARTMENT P SYMBOLS Work Area a C:= 0, Sign With 18 x 18 ( Min. 1 Orange Flop And Type 8 Ught H Type 1 Or Type Q Barricade Or Vertical Panel Or Drum ( With Steady Burning Light At Night Only ). (T stntior Markers May Be Used During Daylight Only. Cones May Be Used -See Index No. 600.) 8 Type I Or Type II Barricade Or Vertical Panel Or Drum (with Flashing Light At Night Only 1 U Work Zone Sign 1:r Flogger JI. J 2 0 0 ' p gIF 8 II .Wank Area PI I Le l Than l IIII`"` 200' "''''111111 GENERAL NOTES 1. Work operations shall be confined to one travel lane. leaving the opposing travel lane open to traffic. 2. All vehicles, equipment, workers ( except (loggers) and their activities are restricted of all times to one side of the roadway. .5. For work operations of 60 minutes or less see Index No. 607. 4. When vehicles In a parking zone block the line of sight to TCZ signs or when TCZ signs encroach on a normal pedestrian walkway, the signs shall be post mounted and located 1n accordance with Index No. 11302. 5. If work area Is confined to an outside auxiliary lane the work area shall be barricaded and the FLAGG£R signs replaced by ROAD WORK AHEAD signs. Fleggers are not required. 6. Flaggers shall be In sight of each other or In direct communication at all times. ,J r a 7. The ROAD CONSTRUCTION AHEAD and FLAGG£R signs shall have an l8 x l8 (min.l orange flag and a Type B light attached and operating of all times. • Mesh signs may be used for (Daylight Only) operations • • Type B Lights and Orange Flags are not required. 8. The FLAGG£R legend sign may be substituted for the symbol sigry • 9. All signs shall be post mounted If the closure time exceeds 12 hours. 10. The moxinsum spacing between devices shall be not greater than 25'. • • I!. Arrows denote direction of truffle only and do not reflect pavement markings. 12. Longitudinal dimensions aro to bo adjusted to fit field conditions Soo Index No. 600. 1.3. For general TCZ requirements and additional Information refer 10 Index No. 600. CONDITIONS WHERE ANY VEHICLE. EQUIPMENT, WORKERS OR THEIR ACTMTIES ENCROACH ON THE PAVEMENT REQUIRING THE CLOSURE OF ONE TRAFFIC LANE. FOR WORK AREAS LESS THAN 200'DOWNSTREAM FROM AN INTERSECTION FOR A PERIOD OF MORE THAN 60 MINUTES. WHERE ANY VEHICLE, EQUIPMENT, WORKERS OR THEIR ACTIVITIES ENCROACH ON THE PAVEMENT REQUIRING THE CLOSURE OF ONE TRAFFIC LANE. FOR WORK AREAS 201Y OR MORE DOWNSTREAM FROM AN INTERSECTION FOR A PERIOD OF MORE THAN 60 MINUTES. • • • • • •• • • • • • . = YPICAI: jatICATION3 • UNNty'York Pavement Repots • ▪ •• Strucerg.1 .W. ments • • • • • • • • • • • • OTATL OF FLORWP011:1 OF TR%nePORTATID) TnarrekcArtet Mown °aA mots TWO -LANE, TWO -WAY• URBAN DAY OR NIGHT OPERATIONS Mr AD7 / nj�II�✓If� .•1.a. � g(/ O man It, Wm N. °a.al tln. I.O,a tla. °°.aa.° °, WV a 1 i of i I 62/ J CONDITIONS • • •• • • •••• • •• • • • • ••• •••• • • Oates •••• • • • o • • • • • • M I A M I•DADE ADA Coordination Agenda Coordination Animal Services Art in Public Places Audit and Management Services Aviation Building Building Code Compliance Business Development Capital Improvements Construction Coordination Citizens' Independent Transportation Trust Commission on Ethics and Public Trust Communications Community Action Agency Community & Economic Development Community Relations Consumer Services Corrections & Rehabilitation Cultural Affairs Elections Emergency Management Employee Relations Empowerment Trust Enterprise Technology Services Environmental Resources Management Fair Employment Practices Finance Fire Rescue General Services Administration Historic Preservation Homeless Trust Housing Agency Housing Finance Authority Human Services Independent Review Panel International Trade Consortium Juvenile Assessment Center Medical Examiner Metro-Miami Action Plan Metropolitan Planning Organization Park and Recreation Planning and Zoning Police Procurement Management Property Appraiser Public Library System Public Works Safe Neighborhood Parks Seaport Solid Waste Management Strategic Business Management Team Metro Transit Task Force on Urban Economic Revitalization Vizcaya Museum And Gardens Water & Sewer 06 -233 13- Sep -06 Miami Shores Village Building Department c/o Mr. Claudio Grande, CBO Building Official /Director 10050 NE 2 Avenue Miami Shores, FL 33138 -2382 Re: Water Service Installation for: 465 NE 91 ST AFA # 400 ER # 16011 Dear Mr. Grande: Sincerely, O Victor Rodriguez Conveyance and Permits Unit vmrod01@miamidade.gov 305 - 669 -7623 :• •: •:• • irtDAk and Sewer Department • • : :•: : v. 1. Box 330316 o 3071 SW 38th Avenue ••• • • • • ••• Miami, Florida 33233 - 0316 • • • ••• • •• • • • • •• • • • • • • • • • • • • • •• • • • • • • • • • • • • • • • • • •• ••• • • • •• • • • •• ••• •• • • • • • • • • • •• • • • • • ••• •• SE �. BY:��e°a.vee : ( ■ T 305 - 665 -7471 miamidade.gov Transmitted herewith for your approval and ' p - one (1) s of the permit application and two (2) sets of the water service installation referenced above. Upon approval and issuance of the permit, it is requested that you return to us one copy of the approved sketch and the original permit. IJ If your approval and issuance of the permit has special restoration requirements, we will need to notify the customer of the additional charges involved with the installation. Please inform us if there will be special restoration requirements for this permit request. Should you have any questions regarding this matter, please advise. F ,0c 4 Passed Inspector Comments 4u . f , .',- , i 1(.-' -- `t 5 )'2 Failed Correction Needed Re- Inspection Fee ($75) pa No Additional Inspections can be scheduled re- inspection fee is paid. i 0 until ( Inspection Number: INSP -24139 Permit Number: PL2005 -193 Inspection Date: 08/08/2006 Inspector: Levrack, James Project: <NONE> Contractor: NELMAR PLUMBING INC Building Department Comments Tuesday, August 8, 2006 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Owner: DEVELOPMENT, TALISMAN Job Address: 469 91 Street NE Miami Shores Village, FL 33138 Block: Permit Type: Imported Permit Inspection Type: Top Out Work Classification: Plumbing Phone Number (305)310 -4673 Parcel Number PARC2004 -16 Lot: Phone: (305) 261 -3942 Page 2 of 2 Permit No. APPLICATION FOR PLUMBING PERMIT Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. Owner's Name and Address �(�r - ' _f� No Street .________!_C - Registered Architect and /or Engineer Employing Plumber's Name ______f„21_ /.2:-'2 No i lt€PAI _4 Street_ /7_ Je - Location and Legal Description Lot Block Subdivision____ Street and Number where work is to be performed— No.___ _ 7.11c - . _____ _____ Street _2. State work to be performed and purpose of building (By Floors) New Building Remodeling__ __ Addition Size Septic Tank_ 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 $ 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 corn - plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The under signed agrees to employ only such sub - contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. ' �o (Signed) STATE OF FLORIDA, COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally apf eared -- -- — — — -- — — — — 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. ss. My Commission Expires MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT Type of Tank _ (Signed) Repairs Date_ _= _Capacity Gals. Notary Public, State of Florida 1 L t . / No. of Stories 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 TUBS URINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT' NS TOTAL FIXTURES CONTR. LIST / CHECK SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SWIM'S POOL CONTR. LIST CHECK Permit No. APPLICATION FOR PLUMBING PERMIT Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. Owner's Name and Address �(�r - ' _f� No Street .________!_C - Registered Architect and /or Engineer Employing Plumber's Name ______f„21_ /.2:-'2 No i lt€PAI _4 Street_ /7_ Je - Location and Legal Description Lot Block Subdivision____ Street and Number where work is to be performed— No.___ _ 7.11c - . _____ _____ Street _2. State work to be performed and purpose of building (By Floors) New Building Remodeling__ __ Addition Size Septic Tank_ 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 $ 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 corn - plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The under signed agrees to employ only such sub - contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. ' �o (Signed) STATE OF FLORIDA, COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally apf eared -- -- — — — -- — — — — 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. ss. My Commission Expires MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT Type of Tank _ (Signed) Repairs Date_ _= _Capacity Gals. Notary Public, State of Florida 1 L t . / No. of Stories 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. S im Se ptic Tank Amount of Permit S Permit No NEW Building __ Remodeling Nature of Water Supply: City —Well. M0AM0 S : • d ' . E S V L A GE PLUMBING INSPECTION DEPARTMENT 1; PPLOC ATI $N FAR PLUAAR 8I 1© pC C°QI, N N 67 -94 7874 (Signed)- Date Feet of Drain Tile _Dist. Feet of Tank or Drain Field from Well My Commission Esrpires Notary Public, State of Florida Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. n O ea'a Name and Address Andrew J I ea No._ 469_ Street. 1E 91st Sea oO" Registered Architect and /or Engineer __ _ __.— _.__ Employing Plumber's Name Peo$? e _ i � C ? ._ Sy; .teiP! _ - — _ No. _5_6-4_ Street_ NE 125th Sena: t 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)_ Street Addition_- ____ -- Repairs No. of Stories- _ -_ ......... ... ..... Type of Tank Capacity Gals. 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 5968, 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 se$l by One Act. The undersigned agrees to employ only such sub - contractors, on work to be performed under this permit, as are Hicarxed Miami Shares Village. (Signed) Master Plumber. STATE OF FLORIDA, COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly an I.orized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. NOTE: A re-inspection fee of $1.00 will be made when such re-inspection Is maade•neaassary by improper notice for inspection, or faulty =Walls ales and /ar C,ycr"cn nship. CLO6E3YQ BATH TU DS $HOWERU LAVA TORIES SIN" SIMKO LAUNDRY TUDS URINAL° CATCH OASIPo FLOOR DRAIN DRINKING FOUNT •NS L ex° � ao TOTAL FUiYUREo CoNTR. LIOT • SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SW IPI•G POOL Ce=i. LI07 CMCCts S im Se ptic Tank Amount of Permit S Permit No NEW Building __ Remodeling Nature of Water Supply: City —Well. M0AM0 S : • d ' . E S V L A GE PLUMBING INSPECTION DEPARTMENT 1; PPLOC ATI $N FAR PLUAAR 8I 1© pC C°QI, N N 67 -94 7874 (Signed)- Date Feet of Drain Tile _Dist. Feet of Tank or Drain Field from Well My Commission Esrpires Notary Public, State of Florida Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. n O ea'a Name and Address Andrew J I ea No._ 469_ Street. 1E 91st Sea oO" Registered Architect and /or Engineer __ _ __.— _.__ Employing Plumber's Name Peo$? e _ i � C ? ._ Sy; .teiP! _ - — _ No. _5_6-4_ Street_ NE 125th Sena: t 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)_ Street Addition_- ____ -- Repairs No. of Stories- _ -_ ......... ... ..... Type of Tank Capacity Gals. 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 5968, 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 se$l by One Act. The undersigned agrees to employ only such sub - contractors, on work to be performed under this permit, as are Hicarxed Miami Shares Village. (Signed) Master Plumber. STATE OF FLORIDA, COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly an I.orized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. NOTE: A re-inspection fee of $1.00 will be made when such re-inspection Is maade•neaassary by improper notice for inspection, or faulty =Walls ales and /ar C,ycr"cn nship. �- #- C.en.Z.. CLOc3VO BATH lls •'Tiros S HOYdER© LAVA- TORIES SINKS SLOP SINKS LAUNDRY TUaB I NA URINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT NE TOTAL FIKT' URRI Cif ztx SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SWING POOL CcNMI. - - Perm; N. CS'- _ /:'r; Date. Application is hereby remade for the approval of the detailed statement of the plans and specifications herewith submitted for the building or ntlon struct re herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida and s:1 provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Divisior of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. Ow .e n Name and Address .: - ` - -- _ - - No. , ✓ Street - -- ¢ Beg`_stered Architect and /or Engineer 4i; Empinying Plumber's Name ____ -- No.._�l_fL/ 24 M g r /- Street - ---•. t ' Lo ' or and Lzga1 Description Lot ----- _ - -.._ Bloch - - -�. _ . ..________ _ __ Subdivision_. K -__ -- -- _ -__.. _ ...... Strecs and Number where work is to be performed —No. J L C _// Z• . " /I � fi State work to be pal-ionized and purpose of building (By Floors) ' L>' G � % '� : �- , °` -.. .�' - New Building Remodeling Additiomm__.____. ...... ___ I Repairs_ Siva Septic Tare. Fest of Drain . "Ile y f Nr't:::re of Wate, Supply: City —Well Amount of Permit $_ MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT My Con - mission Expires Type of Tank_ n r ` Dist. Feet of Tank or Drain Field from Well _-- _------ __ -_ -- .- _ -_ -.- _ -: __ -- Size of Soakage Pit =r "t (Sided ) - �� v ' Plumbing • r . The undersigned applicant for this building permit does hereby certify that he understazrde 5nii accepts his obliga' ions as ae emplioyce u" ', carder the Florida Workmen's Compensation Act, being Section 5888, Compiled General Laws of Florida Pennanent Supplement, and h' • ;plied with the provisions thereof, wad will require similar compliance from all contractors or sub. contractors employed by him in the vfu-1; :o he peefnee ed under this permit; snd will post or cause to be posted for inspection on the site of the work such public notice oa rIoticc:: are rewired by tree Act. The underesned agrees to employ only such sub- contractors, on work to be performed under than r f17,11, RI; art lie ^sed by Miami Shores Village. i - (Signed)- Capacity Gals. . _.- No. of Stories_.- .............. F2 ATE OF FIOR1DA, . COUNTY OF DADE. efore mo, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally .,pine se to a*•e well known, and who, being by me first duly sworn, upon oath deposes and says that he is the a 4 °he above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that ell Ezeezin by lz`.an u'_ated are true. Notary Public, State of Florida Fh tuber. NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, o:: ff, u't :3terials and /or workmanship. Owner's Name and Address Registered. Architect and /or Engineer _ Employing Plumber's Nantc - . - Location and Legal Description Lot 1 CLOSETS - - - CONTR. - L ST CHECK CONTR. LIST CHECK Size Septic Tank _ _ Feet of Drain Tile -- Nature of Water Supply: City —Well. STATE OF FLORIDA, I COUNTY OF I)ADE. BATH TUNS SEPTIC SEWER TANM. CONN. SHOWERS DRAIN FIELn s s. LAVA- TORIES MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Permit No. Datc ppiic atiou i _ I creby made for the approval of the detailed statement of the plans and specifications herewith submitted for till building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shams Village. Florida, and :ell pruvis.ous of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and reg alatious of the Building Dig ision _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. SINKS SOAKAGE GREASE PIT TRAP Block __ Subdivision Street and Nirnbcr where work is to be performed —No. Street State work to he performed and purpose of building (By Floors)________ New Building Remodeling _.. Addition __ _ _.___ ______ Repairs SLOP SINKS SOLAR HEATER LAUNDRY TUBS URINALS DEEP SPRKLR. WELL SYSTEM Type of Tank Dist. Feet of Tank or Drain Field from Well Size of Soakage Pit ,mount of Perc 5 (Signed) (Signed) No. _ _ Street No. _ -- --- _-_ ____ __ _ __ ___ Street CATCH BASIN SWIM'G POOL FLOOR DRAIN DRINKING FOLNT NS • Capacity Cals. My Commission Expires Notary Public, State of Florida No. of Stories Master Plumber. TOTAL FIXTURE Plumbing Inspector. Tie undersigned applicant for this building permit does hereby certify that he understands and accepts his I,hli aHnns as an emlplo■ er of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida 1'erin:,ra id Supplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors eluployc ci by him in the work 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 HT notices as arc required by the Act, The undersigned agrees to employ only such sub - contractors, on work to be performed under this permit, .is are licensed by Miami Shores Village. Beture ate, the undersigned authority, a notary public, duly authorized to administer oaths and take ackno ledaments. personally appeared to ale 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 male, auc1 that all facts therein by hint stated are true. NOTE: A re- inspection fee of $1.00 will be made when such re - inspection is made necessary by improper notice for inspection, or faulty materials and /or workmanship. Litt!AM6 SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT AFFIXATION FOR PLUMBING PERMIT 0 --7( N 68 -25A 30 Permit No - I $ App1 cation i 1 ereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build rig or other s'ruct herein describ 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 th Building 1)i ' Sion a§ ICarni Shores Village shall be complied with, whether herein specified or not A copy of approved plans and specifications must be kept at b-- i11dix.3 during prom. ess of work. tvner o Name and Address. .......... . _4 °__p:c ___ No.__d: ; 7. °,i,. °C 't; ____. _ 4 _ - --- .-- ___ - - - _.___ -. Street . i_.... 9 _ Registered Architect and: or Engineer .. _- - - Employing Plumber °s Name - -- = - - -- -- 'eo ' lcszs System ------ - --- -- --- Y - - - - - — — - No.. 564 -- -- — - - Street . i� - - - :. 2 , .17 Ski Location arzd Legal Description Lot___,_.._ _ ___ _____ — - - - Block_ _ Subdivision.._ Staest rvrTli Naanaber There work is to be perforated -No ___ Street State worts to be performed and purpose of building (icy Floors) . _ Nov.r Building--__ ____ _ - ".- .__ -- Remodeling —__ ___ __ _ _ _ Addition____ Sim Selene Tank_._ _ Feet of Drain Tile. Nature cf Water Supply. City-Well. Amount of Permit 6 _ STATE Off' FLORMA, COUNTY CIF DAIDE. hdliy Commission E$pires NOM: A re-f .7es✓tarn fee $LOO wi11 materials cr.d1/ ogdzirairship. __ __Dist. Feet of Tank or Drain Field from Well._ __ _ Si - of Soakage Pit (Signed)- (Signer ) Repairs. _- -. - . _ _.. No. of Stories _ Capacity Gais. L__ r 1, mb ng IIn .pecto. The undersigned applicant for this building permit does hereby certify that he understands and :-cc its his obliga°io>'as an e nployer of labor under the Florida Worinnen's CompensatioA Act, being Section 5988, Compiled General Laws of Florida Pei manent. Supp1. meet, 'n 1 1 a om plied wil a the provisions thereof, and will require similar compliance from all contractors or sub - contractors employ d by hin in the wo k to pea-form F =? under this permit; and will post or cause to be posted ° for inspection on the sine of ilia work such public notice or no ices as are required] ley t1ie Act. The undersigned agrees to employ only such sub contractors, on work to be perfo. ed under this per nit, as are 11 1 by Micral Sl=e3 Village. ]garter Plumber. IBefcae me, the undersigns authority, a notary public, duly authorized to administer oaths and take acknowledgn ents, personal] 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 •acts therck by him stated are true. Notary Public, State of Florida - - made when ✓&tech re- inspection in made•nenessazy by improper notice for inspection, or faulty CLOSETS BATH 'Nos SHOWERS LAVA- TORIES S INLi6 SLOP SINKS LAUNDRY Tues URINALS CA'dc : SABIN FLOOR DRAI DRINKING FOU"T'NS ABC i�.0 }. TOTAL F MTURES CONT4i. LI ST .. •• Ca:sea SEPTIC TAW`N SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR THEATER DEEP WELL SPRKLR. SYSTEM SW IM'G POOL Cam. L _— CKRC:t Litt!AM6 SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT AFFIXATION FOR PLUMBING PERMIT 0 --7( N 68 -25A 30 Permit No - I $ App1 cation i 1 ereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build rig or other s'ruct herein describ 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 th Building 1)i ' Sion a§ ICarni Shores Village shall be complied with, whether herein specified or not A copy of approved plans and specifications must be kept at b-- i11dix.3 during prom. ess of work. tvner o Name and Address. .......... . _4 °__p:c ___ No.__d: ; 7. °,i,. °C 't; ____. _ 4 _ - --- .-- ___ - - - _.___ -. Street . i_.... 9 _ Registered Architect and: or Engineer .. _- - - Employing Plumber °s Name - -- = - - -- -- 'eo ' lcszs System ------ - --- -- --- Y - - - - - — — - No.. 564 -- -- — - - Street . i� - - - :. 2 , .17 Ski Location arzd Legal Description Lot___,_.._ _ ___ _____ — - - - Block_ _ Subdivision.._ Staest rvrTli Naanaber There work is to be perforated -No ___ Street State worts to be performed and purpose of building (icy Floors) . _ Nov.r Building--__ ____ _ - ".- .__ -- Remodeling —__ ___ __ _ _ _ Addition____ Sim Selene Tank_._ _ Feet of Drain Tile. Nature cf Water Supply. City-Well. Amount of Permit 6 _ STATE Off' FLORMA, COUNTY CIF DAIDE. hdliy Commission E$pires NOM: A re-f .7es✓tarn fee $LOO wi11 materials cr.d1/ ogdzirairship. __ __Dist. Feet of Tank or Drain Field from Well._ __ _ Si - of Soakage Pit (Signed)- (Signer ) Repairs. _- -. - . _ _.. No. of Stories _ Capacity Gais. L__ r 1, mb ng IIn .pecto. The undersigned applicant for this building permit does hereby certify that he understands and :-cc its his obliga°io>'as an e nployer of labor under the Florida Worinnen's CompensatioA Act, being Section 5988, Compiled General Laws of Florida Pei manent. Supp1. meet, 'n 1 1 a om plied wil a the provisions thereof, and will require similar compliance from all contractors or sub - contractors employ d by hin in the wo k to pea-form F =? under this permit; and will post or cause to be posted ° for inspection on the sine of ilia work such public notice or no ices as are required] ley t1ie Act. The undersigned agrees to employ only such sub contractors, on work to be perfo. ed under this per nit, as are 11 1 by Micral Sl=e3 Village. ]garter Plumber. IBefcae me, the undersigns authority, a notary public, duly authorized to administer oaths and take acknowledgn ents, personal] 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 •acts therck by him stated are true. Notary Public, State of Florida - - made when ✓&tech re- inspection in made•nenessazy by improper notice for inspection, or faulty