PLUMBING PERMIT1'
Amount of Permit $
(-4
Size Septic Tank__
Feet of Drain Tile
Nature of Water Supply: City—Well.
4.00
My Commisdon Expires
MOAM1 ENktiMEO VIILAGE
numem ENSPECTION DEPARTMENT
APPLICATIVeM Fi a PLUM [ICA PERM'
--
Permit No 32278
Application is hereby made for the approval of the detailed itategnes12 of the plans and specifications herewith submitted for the building or other
structure herein described. This application is made in compliance end conformity with the Building Ordinance of Miami Shores Village, Florida,
and all provisions of the Laws of the State of Florida, all ordinances al 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.
C 1 ets li 517 N0 F. 91 g
Owner's N e and Address
Registered Architect and/or Engineer
Employing Plumber's Name Rase it8±
4 eeh3011
Location and Legal Description Lot_ Mork Subdivision
517 N0 E0 91 street
Street and Number where work is to be performed— o Steve._
State work to be performeil and purpose of building (Elly Fleeaa)
New Building._ Remodeling Addition.
Type of Ter4r
Dist. Feet of Temtk nee
stab e
Plumbing Inspector.
The undersigned applicant for this building permit does heesby certify that he =denten& and accepts s obligations as an employer of labor
under the Florida Worlcmen's Compensation Act, being Section 5! 4, Compil General Lows of Flan / Permanent Supplement, and has com-
plied with the provisions thereof, and will require similar comnplieneo from all =tractors 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 die Act The undersigned agreed to employ only rech GAI-COATCCTOST, CM work to be performed under this permit, as are
liceased by Miami Shores Village.
1 40
i.
STATE OF FLORIDA, I u.
COUNTY OF DADE.
Before me, the undersigned authority, a notary pubic aelbwisesil
FieM
Si
No
e
NOTE: A re-inspection fee of $LOO will be made when en* ceeitegsectiers seeskeneoessary
materials and/or workmanship.
Repairs No. of Stories. ......
Capacity Cals.
Ll)'
Notary Public, State of Florida
at0/31184.17101 SS 1ST, sIT • •
Master Plumber.
edminiater oaths and take acknowledgments, personally appeared
to me well known, and who, being by me first duly sworn, upon oath elms and says that he is the
of the above described construction, that be has cleefugy rcd the 'foregoing application, and that be did sign the sense, and that all facts
therein by him stated are true.
Improper notice for Inspection, or findty
•
CLOSETS
BATH
'Yugo
SHOWERS
LAVA.
Tennis
GINKC9
SLOP
co
LAUNDRY
Tu Do
UMW
CATCH
ah**IN
FLOOR
DRAIN
DRINKING
FOUNT' NS
TOTAL
FIXTURES
CONTR.
LIST
---
CHECK
SEPTIC
TANK
SEWER
Comm.
DRAIN
FIELD
SOAKAGS
PIT
GREASE
TRAP
SOLAR
HEATRR
Map
%Riau.
S9C:IKLIN.
Onavam
SWIWG
P006
Gwent.
LIST
25'
CNSCK
I
1'
Amount of Permit $
(-4
Size Septic Tank__
Feet of Drain Tile
Nature of Water Supply: City—Well.
4.00
My Commisdon Expires
MOAM1 ENktiMEO VIILAGE
numem ENSPECTION DEPARTMENT
APPLICATIVeM Fi a PLUM [ICA PERM'
--
Permit No 32278
Application is hereby made for the approval of the detailed itategnes12 of the plans and specifications herewith submitted for the building or other
structure herein described. This application is made in compliance end conformity with the Building Ordinance of Miami Shores Village, Florida,
and all provisions of the Laws of the State of Florida, all ordinances al 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.
C 1 ets li 517 N0 F. 91 g
Owner's N e and Address
Registered Architect and/or Engineer
Employing Plumber's Name Rase it8±
4 eeh3011
Location and Legal Description Lot_ Mork Subdivision
517 N0 E0 91 street
Street and Number where work is to be performed— o Steve._
State work to be performeil and purpose of building (Elly Fleeaa)
New Building._ Remodeling Addition.
Type of Ter4r
Dist. Feet of Temtk nee
stab e
Plumbing Inspector.
The undersigned applicant for this building permit does heesby certify that he =denten& and accepts s obligations as an employer of labor
under the Florida Worlcmen's Compensation Act, being Section 5! 4, Compil General Lows of Flan / Permanent Supplement, and has com-
plied with the provisions thereof, and will require similar comnplieneo from all =tractors 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 die Act The undersigned agreed to employ only rech GAI-COATCCTOST, CM work to be performed under this permit, as are
liceased by Miami Shores Village.
1 40
i.
STATE OF FLORIDA, I u.
COUNTY OF DADE.
Before me, the undersigned authority, a notary pubic aelbwisesil
FieM
Si
No
e
NOTE: A re-inspection fee of $LOO will be made when en* ceeitegsectiers seeskeneoessary
materials and/or workmanship.
Repairs No. of Stories. ......
Capacity Cals.
Ll)'
Notary Public, State of Florida
at0/31184.17101 SS 1ST, sIT • •
Master Plumber.
edminiater oaths and take acknowledgments, personally appeared
to me well known, and who, being by me first duly sworn, upon oath elms and says that he is the
of the above described construction, that be has cleefugy rcd the 'foregoing application, and that be did sign the sense, and that all facts
therein by him stated are true.
Improper notice for Inspection, or findty
MIAMI SHORES VILLAGE, FLORIDA 7
BUILDING ❑ DATE 19
ELECTRICAL �y r� r�
PLUMBING PERMIT N 7277 `� 1 1 Contractor `
License No.
ROOFING ❑
❑ Work to be performed under this Permit
Owner of
Building _ r� " t --- ! 1
Architect
Contractor
or Builder f t t
Legal Lot
Description 11 B1
Address of j t
Building
1
4. . r l:✓'
Subdi-
vision
Value of
Project $
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. / ! . ,
Signed: L .. S ' < INSPECTOR
In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance witV 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 as
cepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee.
BY AUTHORITY
Amount of =-
Permit $
ABBOT
Permit No
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida,
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and 'all rules and regulations of the Building Division
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at
building during progress of work. ^�
Owner's Name and Address .............. - -• - -._ No.
_'__!! _ -__ d' ��� `6 1
----------- •---- -- - - -- - Street.
Registered Architect and /or Engineer_____
Employing Plumber's Name-_1 _'___
Location and Legal Description Lot
Amount of Permit $
STATE OF FLORIDA,
COUNTY OF DADE.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Date AI C 3 r � %
a
New Building ------- _--- '• - - -_ -- Remodeling___ -- ____ Addition
Street and Number where work is to be performed —No
State work to be performed and purpose of building (By Floors)__. _
Block Subdivision
S
(Signed) _
'o44 9/ 7 7
� p .o
street_ _ J_� '_✓
_t
7 , Street
_- -W , -
Repairs No. of Stories _
Size Septic Tank _Type of Tank_______,
Feet of Drain Tile--------_--....... -..... ----____--
—Dist. Feet of Tank or brain Field from Well
Nature of Water Supply: City— Well.____ _____________________ _ ___Size of Soakage Pit
Capacity Gals.
My Commission Expires Notary Public, State of Florida
Master Plumber.
rel
mbing Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent pplement, and has coin -
plied with the provisions thereof, and will require similar compliance from all contractors or sub- contrac -. 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 .rk s h public notice or notices as are
required by the Act. The undersigned agrees to employ only such sub-contractors work o be r 'rformed under this permit, as are
licensed by Miami Shores Village.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the
of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
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.
CLO'SETCi
BATH
TUBE
SHOWERS
LAVA-
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TUBE
U
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT' NS
TOTAL
FIXTURES
CONTR.
LIST
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SWIM'G
POOL
CONTR.
LIST
`
CHECK
Permit No
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida,
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and 'all rules and regulations of the Building Division
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at
building during progress of work. ^�
Owner's Name and Address .............. - -• - -._ No.
_'__!! _ -__ d' ��� `6 1
----------- •---- -- - - -- - Street.
Registered Architect and /or Engineer_____
Employing Plumber's Name-_1 _'___
Location and Legal Description Lot
Amount of Permit $
STATE OF FLORIDA,
COUNTY OF DADE.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Date AI C 3 r � %
a
New Building ------- _--- '• - - -_ -- Remodeling___ -- ____ Addition
Street and Number where work is to be performed —No
State work to be performed and purpose of building (By Floors)__. _
Block Subdivision
S
(Signed) _
'o44 9/ 7 7
� p .o
street_ _ J_� '_✓
_t
7 , Street
_- -W , -
Repairs No. of Stories _
Size Septic Tank _Type of Tank_______,
Feet of Drain Tile--------_--....... -..... ----____--
—Dist. Feet of Tank or brain Field from Well
Nature of Water Supply: City— Well.____ _____________________ _ ___Size of Soakage Pit
Capacity Gals.
My Commission Expires Notary Public, State of Florida
Master Plumber.
rel
mbing Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent pplement, and has coin -
plied with the provisions thereof, and will require similar compliance from all contractors or sub- contrac -. 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 .rk s h public notice or notices as are
required by the Act. The undersigned agrees to employ only such sub-contractors work o be r 'rformed under this permit, as are
licensed by Miami Shores Village.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the
of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty
materials and/or workmanship.
Date
Issued to
OWNER
ddtiami A o�l
F L O
PLUMBING PERMIT N9 1272
LOT
BLOCK
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.
For a story building at
Fixtures
Fixtures $
Sewer $
Septic Tank $
Total $
Village Plumbing Inspector
Received Payment by
SUBDIVISION
Relaying:
Inst 1 ed by:
(NEW:
For a (Store:
Building has:
Owner or Agent:
LOT NO.
Address of work:
No. of Plumbing Fixtures:
Type of tank installed:
Size of Soakage Pit:.i
Additional information:
Ready for Inspection: Date:
APPROVED BY: '
Remarks:
PERMIT NO.
DADE COUNTY ZONING APICE
Form #11
DIVISION OF PLUMBING INSPECTION
I herewith submit the following application for a permit covering the installation
of a Septic Tank
Soakage Pit:
New: Feet of drain tile:
Old: Story: Addition: Remodeled:
Garage: Apt.: Hotel: Office Bldg: Res:
(Garage wash floor: Waste water from a:
Stores; Offices; Apts.; Hotel Rms; Bedrms
Address: !
BLOCK NO. SUBDIVISION
Nature of water supply: City: / - We11: Feet distant from all wells:
't=
Laundry Tubs: Floor Drains:
Tank capacity in Lallons:
Purpose of same:
CONDEI\[ ED BY:
Date:
Address:
Time:
0
I 7 \( °
6
G•A"
/
•
2-3 y/C
/376 'x
JL
5 z
•
•
Date
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
/// O `"/ Job Address J / Az- Tax Folio
Legal Description Historically Designated: Yes No
Owner/Lessee / Tenant CHIN--57 C ° 7 //�9 �--,rG Master Permit #
Owner's Address 37 4)E 9/ / -
Contractin Co. b--0) /D --/up,e77-iverkporpfic Address k ) ///77/ O r
Qualifier TEeEA 1 e -DE7L' ss# 4,r 3-3/41r
state# c O c f d 262 2 Municipal # Competency # 24 Ins. Co. 1/4S,,FiNtrfr401
Architect/Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type (circle one): BUILDING ELECTRICAL U M i MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION /AJ 71 �M`�Vrl
Square Ft. Q0
WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY
RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTEND TO OBTAIN FINANCING,
CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.)
Application is hereby made to obtain a permit to do work and installation as indicated above, and on the attached addendum (if applicable). I
certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate
permits are required for ELECTRICAL, PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK.
OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable
laws regulating constry>ption and zoning. Furthermore, I authorize the above -named contractor to do the work stated.
of owner and/
Condo President
Notary as to Owncreondo President
My Commission Expires
LESTER E. CROCKETT
My Comm Exp. 5/20/2001
Bonded By Service In
No. CC649326
f :Personalty Known 11 Other 1.D
FEES: PERMIT 3 . P RADON
Date
Date
Estimated Cost
(value) 4 ]Soo
value
Notary as to Co ractorur Builder
My Commission Expires:
Phone
LESTER E. CROCKETT
My Comm Exp. 5/20/2001
Bonded By Service Ins
No. CC649326
I I Personally Known I 1 Other 1.0
C.C.F. P NOTARY — BOND 3
Date
TOTAL DUE
APPROVED:
Zoning Building Electrical
Mechanical Plumbing Engineering
STATE OF FLORIDA
DEPARTMENT OF HEALTH AND REHABILITATIVE SERVICES
ONSITE SEWAGE DISPOSAL SYSTEM
CONSTRUCTION PERMIT
Authority: Chapter 381, FS & Chapter 10D -6, FAC
PERMIT #
DATE PAID
FEE PAID $
RECEIPT #
CONSTRUCTION PERMIT FOR:
[ ] New System [' ] Existing System [' ] Holding Tank [ 1 Temporary /Experimental
[ ] Repair [. 1 Abandonment [; ] Other(Specify)
APPLICANT:
PROPERTY STREET ADDRESS:
LOT:
PROPERTY ID #:
SYSTEM MUST BE CONSTRUCTED IN ACCORDANCE WITH SPECIFICATIONS AND STANDARDS OF CHAPTER 10D -6, FAC
REPAIR PERMITS AND HOLDING TANK PERMITS EXPIRE 90 DAYS FROM THE DATE OF ISSUE. ALL OTHER PERMITS
EXPIRE ONE YEAR FROM THE DATE OF ISSUE. HRS APPROVAL OF SYSTEM DOES NOT GUARANTEE SATISFACTORY
PERFORMANCE FOR ANY SPECIFIC PERIOD OF TIME. ANY CHANGE IN MATERIAL FACTS WHICH SERVED AS A
BASIS FOR ISSUANCE OF THIS PERMIT, REQUIRE THE APPLICANT TO MODIFY THE PERMIT APPLICATION. SUCH
MODIFICATIONS MAY RESULT IN THIS PERMIT BEING MADE NULL AND VOID.
SYSTEM DESIGN AND SPECIFICATIONS
T [
A [
N
K [
0
T
H
E
R
SPEC::FICATIONS BY:
APPROVED BY:
DATE ISSUED:
BLOCK: SUBDIVISION:
AGENT:
[ SECTION /TOWNSHIP /RANGE /PARCEL NUMBER]
[OR TAX ID NUMBER]
] [GALLONS / GPD] SEPTIC TANK /AEROBIC UNIT CAPACITY MULTI - CHAMBERED /IN SERIES:[
[GALLONS / GPD] CAPACITY MULTI- CHAMBERED /IN SERIES:[ ]
] GALLONS GREASE INTERCEPTOR CAPACITY [MAXIMUM CAPACITY SINGLE TANK: 1250 GALLONS]
] GALLONS PER DOSE DOSING TANK CAPACITY DOSE RATE [ ] PER 24 HRS NO. OF PUMPS: [ ]
D [ J SQUARE FEET PRIMARY DRAINFIELD SYSTEM
R [ ] SQUARE FEET SYSTEM
A TYPE SYSTEM: [ J STANDARD [ J FILLED [ ] MOUND
I CONFIGURATION: [ ] TRENCH [ ] BED [
N
F LOCATION OF BENCHMARK:
I ELEVATION OF PROPOSED SYSTEM SITE [
E BOTTOM OF DRAINFIELD TO BE [
L
D F :(LL REQUIRED: [ ] INCHES
.2
TITLE:
HRS -H Form 4016, Mar 92 (Obsoletes previous editions which may not be used)
(Stock Number: 5744 - 001 - 4016 -0)
J [INCHES /FT] [ABOVE /BELOW]; BENCHMARK /REFERENCE POINT
]; " [INCHES /FT] [ABOVE /BELOW] BENCHMARK /REFERENCE POINT
EXCAVATION REQUIRED: [ ] INCHES
TITLE: CPHU
EXPIRATION DATE:
Page 1 of 2
.y ?o o Sf "alto:"
?roi?erly fuil rattle.
Tel.tpholo number for applicant or agent.
Proper:y ova: :r's legally au_borizeci
NL AZ:DRESS: P.C. bon bo' c sir....ct rcl:ln.:is for appl:cnnt (31 Egent.
AND
SI:aDiV:SIONT 07
C:1111"..,1::" ( C'J rur.y it:cuirn e_ .y• cL 0 07 r:ctiont.
from ...."1 AC.
is from Chapte:
3; ift:uitunj, zilch as
- mus:
Cot..nty 7.1ealth Unit perLonncl a approving
issneri by
1:-'ermit3 90 euys
1 I 1
)
-1
Scale: Each block represents 5 feet and 1 inch = 50 feet.
Notes:
Site Plan submitted by
STATE OF FLORIDA
DEPARTMENT OF HEALTH AND REHABILITATIVE SERVICES
APpUCATION FOR ONSITE SEWAGE DISPOSAL SYSTEM CONSTRUCTION PERMIT
Permit Application Number
HRS -H Form 4015, Feb 85 (Obsoletes previous editions which may not be used) '
(Stock Number. 5744-002-4015-6)
PART II - SITE PLAN
SIGNATURE TITLE
Plan Approved ` Not Approved Date
By County Public Unit
ALL CHANGES MUST BE APPROVED BY THE COUNTY PUBLIC HEALTH UNIT
Page 2 of 3
BUILDING
ELECTRICAL
PLUMBING
Owner o
Building
Architect
Contract
or Builde
Legal
Descripti
Address
Building
CORACTOR OR BUILDER
MIAMI SHORES VILLAGE, FLORIDA
PERMIT N9 2750
Work to be performed under this Permit t ;
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 specifipttons and
that he assumes responsibility for work done by his agents, servants or employees.
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' assupt esponsibility for all work done by either myself, my agent, servant or employee.
DATE
Contractor's
License No
Signed • .. , t:. By
INSPECTOR
BY
r r �
AUTHORITY
or
r
r- . .i
Ori
Lot
Bl.
Subdi-
vision
of:`
w,.,-
y
Value of
Project
Amt. of , -
Permit
BUILDING
ELECTRICAL
PLUMBING
Owner o
Building
Architect
Contract
or Builde
Legal
Descripti
Address
Building
CORACTOR OR BUILDER
MIAMI SHORES VILLAGE, FLORIDA
PERMIT N9 2750
Work to be performed under this Permit t ;
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 specifipttons and
that he assumes responsibility for work done by his agents, servants or employees.
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' assupt esponsibility for all work done by either myself, my agent, servant or employee.
DATE
Contractor's
License No
Signed • .. , t:. By
INSPECTOR
BY
r r �
AUTHORITY
Permit No -
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Date
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida,
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at
building during progrrss of work.
/
Owner's Name and Address _ _ �lJ -, No. __ _. ______ Street___ S =
Registered Architect and /or Engineer
Employing Plumber's Name __ ,.ter
Block Subdivision___ _______________________________
Street and Number where work is to be performed— No.____. Street g.1—
State work to be performed and purpose of building (By Floors) 7__i I_ __
New Building Remodeling Addition Repairs No. of Stories _________._.
Location and Legal Description Lot_
Size Septic Tank__
Feet of Drain Tile______ -5r _J
Amount of Permit
The undersigned applicant for this building permit does hereby ce
under the Florida Workmen's Compensation Act, being Section 5966,
plied with the provisions thereof, and will require similar compliance
performed under this permit: and will post or cause to be posted for
required by the Act. The under signed agrees to employ only such
licensed by Miami Shores Village.
STATE OF FLORIDA,
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly
ss.
My Commission Expires
No. __
- 1./ 4 . 1 - A' Street___ 2 <= —� �- --- - - - - - --
Type of Tank . Capacity Gals.
Feet of Tank or Drain Field from Well
Nature of Water Supply: City —Well Size of Soakage Pit
(Signed
Plumbing Inspector.
rtify , that he understands and accepts his obligations as an employer of labor
Compiled General Laws of Florida Permanent Supplement, and has com-
from all contractors or sub - contractors employed by him in the work to be
inspection on the site of the work such public notice or notices as are
sub - contractors, on work to be perf rued under this permit, as are
authorized to administer oaths and take acknowledgments, personally
appeared
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the
of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
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
-riats 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
CONTR.
LIST
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SWIM'G
POOL
CHECK
Permit No -
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Date
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida,
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at
building during progrrss of work.
/
Owner's Name and Address _ _ �lJ -, No. __ _. ______ Street___ S =
Registered Architect and /or Engineer
Employing Plumber's Name __ ,.ter
Block Subdivision___ _______________________________
Street and Number where work is to be performed— No.____. Street g.1—
State work to be performed and purpose of building (By Floors) 7__i I_ __
New Building Remodeling Addition Repairs No. of Stories _________._.
Location and Legal Description Lot_
Size Septic Tank__
Feet of Drain Tile______ -5r _J
Amount of Permit
The undersigned applicant for this building permit does hereby ce
under the Florida Workmen's Compensation Act, being Section 5966,
plied with the provisions thereof, and will require similar compliance
performed under this permit: and will post or cause to be posted for
required by the Act. The under signed agrees to employ only such
licensed by Miami Shores Village.
STATE OF FLORIDA,
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly
ss.
My Commission Expires
No. __
- 1./ 4 . 1 - A' Street___ 2 <= —� �- --- - - - - - --
Type of Tank . Capacity Gals.
Feet of Tank or Drain Field from Well
Nature of Water Supply: City —Well Size of Soakage Pit
(Signed
Plumbing Inspector.
rtify , that he understands and accepts his obligations as an employer of labor
Compiled General Laws of Florida Permanent Supplement, and has com-
from all contractors or sub - contractors employed by him in the work to be
inspection on the site of the work such public notice or notices as are
sub - contractors, on work to be perf rued under this permit, as are
authorized to administer oaths and take acknowledgments, personally
appeared
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the
of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
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
-riats and /or workmanship.
Size Septic Tank_.._
� =LDS
Feet of Drain Tile ' -
Nature of Water Supply: City-Well.
STATE OF FLORIDA,
.A.,IWTY OF DADE.
j
MIAMI SHORES VIL AG
PLUMBING INSPECTION DEPARTMEI
APPLICATION FOR PLUMBING .v
Permit No -' Date. .._.__-
Application is hereby made for the approval of the detailed statement of t:: plans and specifications herewith submitted for the building or other
structure herein described. This application is made in compliance and confer ...y with the Funding 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 sr ?. A copy of approved plans and specifications must be kept at
building during progress of work.
Owners Name and Address _
State work to be performed and purpose of building (By Floors)_.
New Building Remodeling - __ __ _ - Addition
Type of Tank
Amount of Permit $ 1-- ° - - - - -- - --- - - - - -- — — (Signed) (J
No • / 7 /I Street. 0
R egistered Architect and /or Engineer _ - .- --- , - --- __---•------------._---------------------
Employing Plumber's Name ./ C .1( � � _����0 (' = " ' No..__ ���o_� ° ��� Street__ - - )
Location and Legal Description Lot__ Bloclr _ _.______.__.. Subdivision
Street and Number where work is to be performed- No._ Aa _ Street.
Repairs No. of Stories.
Capacity Gals
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 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 uncle:: 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) ` 1r; r � -v 3 r.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
to s .a 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
tahlscAT by him stated are true.
My C' 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
KS
SINKS
SLOP
SINKS
LAUNDRY
TUBE
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKI NO
FOUNT' NS
TOTAL
FIXTURES
CONTR.
LIST
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SW IM'G
POOL.
CONTR.
LIST
~--
CHECK
Size Septic Tank_.._
� =LDS
Feet of Drain Tile ' -
Nature of Water Supply: City-Well.
STATE OF FLORIDA,
.A.,IWTY OF DADE.
j
MIAMI SHORES VIL AG
PLUMBING INSPECTION DEPARTMEI
APPLICATION FOR PLUMBING .v
Permit No -' Date. .._.__-
Application is hereby made for the approval of the detailed statement of t:: plans and specifications herewith submitted for the building or other
structure herein described. This application is made in compliance and confer ...y with the Funding 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 sr ?. A copy of approved plans and specifications must be kept at
building during progress of work.
Owners Name and Address _
State work to be performed and purpose of building (By Floors)_.
New Building Remodeling - __ __ _ - Addition
Type of Tank
Amount of Permit $ 1-- ° - - - - -- - --- - - - - -- — — (Signed) (J
No • / 7 /I Street. 0
R egistered Architect and /or Engineer _ - .- --- , - --- __---•------------._---------------------
Employing Plumber's Name ./ C .1( � � _����0 (' = " ' No..__ ���o_� ° ��� Street__ - - )
Location and Legal Description Lot__ Bloclr _ _.______.__.. Subdivision
Street and Number where work is to be performed- No._ Aa _ Street.
Repairs No. of Stories.
Capacity Gals
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 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 uncle:: 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) ` 1r; r � -v 3 r.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
to s .a 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
tahlscAT by him stated are true.
My C' 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 •e ,;;r
Street and Number where work is to be performed—No.__Y__�-
Size Septic Tank
APPLICATION FOR PLUMBING PERMIT
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 $_ ___1
STATE OF FLORIDA,
ss.
COUNTY OF DADE.
My Commission Expires
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
( Signed
Street Q1____
• t
Date
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida,
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at
building during progress of work.
s
Owner's Name and Address __r _ —.c_:_ ' .„„C No. 5 • : 1/_10t_. Street / • _5
Registered Architect and /or Engineer
lo
Employing Plumber's Name ___
__/ / !L !alb y 1` No._ 1. __,fit lfi'' 14 Street__ `" „r
___r
Location and Legal Description Lot _ Block Subdivision___ _______
________— _________
State work to be performed and purpose of building (By Floors) 7"/ 4 G''
New Building Remodeling Addition Repairs
No. of Stories ___/
Type of Tank . Capacity
I �.
l v--i
(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 under signed agrees to employ only such sub - contractors, on work to be per,`pri d under this permit, as are
licensed by Miami Shores Village.
Notary Public, State of Florida
Master Plumber.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally
appeared
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the
of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty
materials and /or workmanship.
CLOSETS
BATH
TUBS
SHOWERS
LAVA-
TORIES
SINKS
SLOP
r 'NKS
LAUNDRY
TUBS
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT' N5
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
�.r'
CHECK
✓
Permit No •e ,;;r
Street and Number where work is to be performed—No.__Y__�-
Size Septic Tank
APPLICATION FOR PLUMBING PERMIT
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 $_ ___1
STATE OF FLORIDA,
ss.
COUNTY OF DADE.
My Commission Expires
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
( Signed
Street Q1____
• t
Date
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida,
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at
building during progress of work.
s
Owner's Name and Address __r _ —.c_:_ ' .„„C No. 5 • : 1/_10t_. Street / • _5
Registered Architect and /or Engineer
lo
Employing Plumber's Name ___
__/ / !L !alb y 1` No._ 1. __,fit lfi'' 14 Street__ `" „r
___r
Location and Legal Description Lot _ Block Subdivision___ _______
________— _________
State work to be performed and purpose of building (By Floors) 7"/ 4 G''
New Building Remodeling Addition Repairs
No. of Stories ___/
Type of Tank . Capacity
I �.
l v--i
(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 under signed agrees to employ only such sub - contractors, on work to be per,`pri d under this permit, as are
licensed by Miami Shores Village.
Notary Public, State of Florida
Master Plumber.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally
appeared
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the
of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty
materials and /or workmanship.
OWNER
LOT
BLOCK
SUBDIVISION
s >
•
Issued to / �C 4.
For a ___I_—story
Fixtures
Jhores
F L O R D ill A
PLUMBING PERMIT N9 1272
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 e,
Fixtures $
Sewer $
•ic Tank J $ r
Total
Village Plumbing Inspector
Received Payment by
OWNER .'
LOT
BLOCK
SUB9VISION
1
/
, 'd !
4 , ; ( ;‘)
Issued 'to
4liami cShores9' llage
F L 0 R 1 D A
PLUMBING PERMIT
2' 4'1 f'
to install the following described plumbing, in accordance with the laws, statutes and regu-
lations of Miami Shores Ville, Florida and the State of Florida, governing plumbing and
drainage work done )iiapfii Shores Village, F19rida. "
For a 1 story buildin at 4 1 r' _
t T `` A '" 4.tl
Fixtures t ,..• .. ,. .. ,� �� %. +; �',� � ; � � � R , ;. / � 410 f
f � �
Fixtures 1 $ i "'s ' r"-
Sewer ' $ / ' r ' "
•tic Tank $/
Total $ (,,;.' (
Village Plumbing Inspector y
.i
Received Payment by "':::-.",
N9 1233
(o2a:
1 :;CC W.2 E 1
1 :P; - cr ViS IITE6 iag
1 4166 23
,
6213
124I:4'eaea
launi) g
turc.;
PLUMBING REPAIRS A SPECIALTY SANITARY ENGINEERS
•
B. K. GUNN & SONS
PLUMBING & HEATING CONTRACTORS
1601 N. W. 18TH STREET
MIAMI, FLORIDA
PHONE 2 -5657
CLOSETS
BATH
TUBS
SHOWERS
LAVA.
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TUBS
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT' NS
TOTAL
FIXTURES
Sketch position of building and lot lines in square (which represents an entire city block showing on which
street the building and lot faces; also show exact locations Rof "Y" in street and position of lateral or septic
tank. Show sewer and any change in direction same may mak . The purpose of this plan is l o have an accurate
layout of all underground pipes for future references. l✓
WEST
NORTH
A
SOUTH
EAST
Remarks:
NORTH
SOUTH
A -244 5M 5 -39
DIVISION OF UBLIC INSPECTION
DEPARTMENtT OF PUBLIC SERVICE
,MIAMI, FLORIDA
I herewith submit the following plan of plumbing for approval:
Employing Plumber
For a
New p
Builder or Contractor is
Lot No.
Address
Sewer Connections
Block No.
m
N
Date -
ROUGH -IN INSPECTION
Ground Rough -In Rain Leader
Condemned by
REMARKS
Plan No.
Old ❑ Story
Dwelling ti Store ❑ Garage ❑ Apartment ❑
Owner or Agent Address
Address
Subdivision //
At center of St. ❑ At curb ❑ At property line ❑ Existing in alley ❑ Existing bldg. sewer ❑
A charge of $'1.00 will be made for correcting any inaccuracies in the foregoing information.
DO NOT WRITE IN SPACE BELOW. THIS IS FOR THE USE OF THE DIVISION OF PLUMBING INSPECTION ONLY.
1- A M P M ` A M
Approved by - = ' - Approved by
Date { ✓ _ ' a
SEWER INSPECTION
Condemned by
REMARKS
Work executed by
Sewer Permit No
PM
, 19
Addition ❑ Remodeled Cu
Hotel ❑ Office Bldg. ❑
To septic tank ti Existing bldg. drain ❑ To dry well ❑
Date
FINAL INSPECTION
A M PM
Approved by
Condemned by
REMARKS
THIS SPACE FOR ELEVATION SKETCH
In alterations to existing work show the old work in red ink and the new in black ink. Letter eachl staclk
to correspond with the opening shown in floor plan or ground plan on opposite page.
A PERSPECTIVE SKETCH WILL BE SUFFICIENT
I'ROVIDED THE WORK CAN BE CLEARLY SHOWN
THIS SPACE FOR PLAN SKETCH
Show location of stacks and horizontal drains inside building, lettering each opening to correspond with the
stack connections as shown on the elevation sketch on opposite page. Where ground work is concealed, draw
floor plan of building showing location of walls, partitions, columns, etc., and the location of all horizontal
soil and waste pipes, in reference to same.