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PLUMBING PERMIT
PERMIT APPLICATION FOR MUNICIPALITIES OF DADE COUNTY (OWNER TO RETAIN COPY) Date /"J 93 Job Address 11 yr' N- C. • 9 a S r Legal Description 06 a Owne Lessee / Tenant will° c fjflij Owner's Address Mit /V 6 9fS 41 S / Contracting Co. 1 roiU9 &c / Qualifier lows o Presid Signs Date* No MY ** * APPROVED: o tlliidoS aids ion Expiry& Comm. Exp. Au'4, 1995 Commission # C 133062 * * * * Zo er and /or Mechanical ss# State 4/00/;]?/? Municipal # Competency # Ins.Co. Architect /Engineer Address Bonding Company Address Mortgagor Address Permit Type(circle one): BUILDING ELECTRICAL MECHANICAL ROOFING PAVING PENCE SIGN WORK DESCRIPTION Zrtlg o e6 Square Ft. L /00 Estimated Cost(value) // $6 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 construction and zoning. Furthermore, I authorize t - a••ve -named contractor to do the work stated. * * FEES: PERMIT i)• �� RADON C.C.F. /'O * * Tax Folio // � �i S ciS / . /f Master Permit # ,s3-1 Phone Address - Phone 576 - /FO 144 ( EP P 1_ . + 'Radar dar omn. Exp. Aug. 4, 1995 Commission # CC133062 * * * * * * ** NOTARY TOTAL DUE d .30 6 Electrical gineering, STATE OF FLORIDA DEPARTMENT OF HEALTH AND REHABILITATIVE SERVICES APPLICATION FOR ONSITE SEWAGE DISPOSAL SYSTEM CONSTRUCTION PERMIT Building Permit #: Authority: Chapter 301, F.S. & Chapter 10D -G, F.A.C. Application / Permit Number q..9 — 3 L/ 3 L i Date Application Received /2- / /6 / Applicatjon is For; s;'' / Fee Amount Pald z/ . c' C New System: ..:;: V Existing System: Experimental System (Temporary): Receipt #Z. ?'2 Tank Abandonment; Hblding Tank: Other (Specify): Date Pald ___-_ /47 / e i l e. NOTE:`:'f?ERMITS EXPIRE. ONE YEAR FROM THE DATE OF ISSUANCE AND ARE NOT RENEWABLE. REPAIR PERMITS AND HOLDING TANK PERMITS EXPIRE 90 DAYS FROM DATE OF 'ISSUANCE APPROVAL OF A SYSTEM DOES NOT GUARANTEE SATISFACTORY PERFORMANCE FOR ANY SPECIFIC PERIOD OF l`IME. To BE COMPLETED RYAPPLICANT: GENERAL INFORMATION Owner: MU /UC . /f1 ti L Telephonq: (Work) 75 7d Yb(Home) / 1/9 Owner's Mailing Addres: // Li r N t� T.G ___ 3 City:0/091n / 1104'6 • 'State: -rt, Zip: Owner's Agent: (J/VO "06 r2•2 • Telephono:(W)3'7 Ared (H) Agent's Mailing Address: a ' ? /V W /2 J T City: M /i / State: � Zip: Property Street Address: f / Vi 7V6 200 S Exact Directions to Property: Lot # Block # Sutxdlvislon: Section: To nship: Range: Parcel Number: Zoning Designation: Property size: p y / Square Fee cres water Supply: Private: Public: i-Llmlted Use: / u,r Unit: Date Subdivided: Is Sanitary Sewer Available: Yes ,No ✓ II No, approximate the distance to tho sower lino closest to your property: Is Public Water Available: Yes " No If No, approximate the distance to the water lino closest to your property: BUILDING INFORMATION Typo of Estab xint 1 01 Units Building Aroa (Square Fool) 1 01 Persons 1 01 Seats Commercial •'sidenlial irclo ono) & Number ' 1 Bedrooms 6 2-00D Hours of Operation Plumbing Fixtures: Garbage Grinders /Disposals: Spas /Hot Tubs: Floor /Equipment Drains: Ultra -low volume Flush Toilets: Other: BUILDING PLANS MUST DE ATTACHED SHOWIN OFFICES, BEDROOMS, TOTAL BUILDING AREA, AND ANY PERTINENT FEATURES REQUIRED BY CHAPTER 10D -6, F.A.C. IN ADDITION, A D LED SITE PLAN AND /OR SURVEY, DRAWN TO SCALE,MUST BE ATTACHED SHOWING PROPERTY DIMENSIONS, BUILDING LOCATIONS, AN 'f TINENT FEATURES REQUIRED TO BE SUBMITTED PER CHAPTER 10D- 8.048, F.A.C. Applicant's Signature: Date: / //1" / 7 l/ HRS -H Form 1015 Jan 1992 (Obs• otos All Previous Edilions) _ Page 1_ of 2 P STATE OF FLORIDA N ' ,, DEPARTMENT OF HEALTH AND REHABILITATIVE SERVICES _1;3 ,CNSITE SEWAGE DISPOSAL SYSTEM CONSTRUCTION AND INSTALLATION PERMIT 3 q Permit Application Number c ol . t ti,r Sg0Ic:.. ' b 5 feet an 1 Inch ti • ;- Guar *5C S-ob 8 Site Plan submitted by: L 7 / \ 0 P)41- -- T II • SITE PLAN feel. Notes: 40.,0 f y00 Q R R, Oct du6r y 4 (� L (Gi.0 1 CC >10 14w v IL c;o6r ,- ��/ r 111 L E SIOHAIUIIE Plan Approved Nol Approved Date p County Public U ALL CHANGES MUST DE APPf1OVED DY THE COUNTY PUOLIC HEALTH UNIT BUILDING 0 MIAMI SHORES VILLAGE, FLORIDA 1 19 (r, Date ELECTRICAL ❑ PLUMBING ❑ PERMIT N° 8293 Contractor's hC. t 4 , ROOFING ❑ License No. ❑ Work to be performed under this Permit Owner of B T c- uilding ! F; :t."'lf",. _ to •v c )' . sr Architect Contractor or Builder Legal Description Address of Building I. 1 V Signed CONTRACTOR or BUILDER tL 3 it B1 Lot re Subdi- vision Sq. Ft. Value of 11 Amount of Project $ H Permit $ This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the applica- tion herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above-assumes the responsibility for a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the - plans qt drawings or in the statements or specifications and that he assumes respon- sibility for work done by his agents, sernts or employees. 1 . "' - '('INSPECTOR) BY In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done b/ either, myself, my agents servant or employee. BY AUTHORITY Permit No Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. Owner's Name and Address_ - Registered Architect and /or Engineer________________________ _ _ --- -- _ - ___ --- �IC�IP Ql� �b� fir. mptoyin g Plumber's � IArame /e" s 14 - - -- — _------ -_ - - -- No.------- - - - - - ?L Street._ ‘&-r, 5- Location and Legal Description Lot_- ____ _____ ____________________ Block Subdivision Street and Number where work is to be performed— No._ _ 11a.f Street_ 9�f7 State work to be performed and purpose of building (By Floors) -t AX . e! 0 79 e, /fIiiJ foul iv New Building Remodeling___ ____._ Addition Repairs No. of Stories. Size Septic Tank Feet of Drain Tile _Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: ,y—Well Amount of Permit $- __ -_L, ----------------------- - - - - -- — — (Signed) My Commission Expires MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT No. — — I / 4/5-- Street-. -_ /ot. . Date Va n' /4, - -10 Type of Tank____ Capacity Gals _Size of Soakage Pit Plumbing Inspec The undersigned applicant for this building permit does hereby certify that he understands and accepts his obli:: do s as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Perin. nt upplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors em .. ed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such sub- contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. ( Signed ._. STATE OF FLORIDA, } COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath 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 ro- 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. CLOr3erra BATH TUBS SHOWERS LAVA- TORIES SINKS SLOP SINKS LAUNDRY TUBS URINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT'N6 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_ - Registered Architect and /or Engineer________________________ _ _ --- -- _ - ___ --- �IC�IP Ql� �b� fir. mptoyin g Plumber's � IArame /e" s 14 - - -- — _------ -_ - - -- No.------- - - - - - ?L Street._ ‘&-r, 5- Location and Legal Description Lot_- ____ _____ ____________________ Block Subdivision Street and Number where work is to be performed— No._ _ 11a.f Street_ 9�f7 State work to be performed and purpose of building (By Floors) -t AX . e! 0 79 e, /fIiiJ foul iv New Building Remodeling___ ____._ Addition Repairs No. of Stories. Size Septic Tank Feet of Drain Tile _Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: ,y—Well Amount of Permit $- __ -_L, ----------------------- - - - - -- — — (Signed) My Commission Expires MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT No. — — I / 4/5-- Street-. -_ /ot. . Date Va n' /4, - -10 Type of Tank____ Capacity Gals _Size of Soakage Pit Plumbing Inspec The undersigned applicant for this building permit does hereby certify that he understands and accepts his obli:: do s as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Perin. nt upplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors em .. ed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such sub- contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. ( Signed ._. STATE OF FLORIDA, } COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath 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 ro- 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. APPLICATION FOR BUILDING PERMIT Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build- ing 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 the work. Owner's Name and Address Registered Architect and /or Engineer___ _ Name and address of licensed contractor__,!__ J__!___=_ _J1_--.44LYr // )/ - Cr IArn axe _1J_714)_ Location and legal description of lot to be built on: o� c� /�Q Block_-_ - Subdivision G z , �r__� __ - /�` o 2 ,4 '�F- - -� 3 Street and Number where work is to be done ,lf 9J 22 S5_ State 4.143 work to be done and purpose of building (by floors) g: due t C�o' /// ding Remodeling Addition Q6+ To be constructed of Kind of ffoundatign Estimated Total cost of improvements $ _1z*- �2__Jj Zone cubage required_ Distance to next nearest building Maximum live load to be borne by each floor I hereby submii all the plans and specifications or said bu' ding. All notices with reference to the building and its construction may be sent to----- ��_� >r-�� ' 1 /_s� 9A --`-- 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 complied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such subcontractors, on work to be performed under this permit as are licensed by Miami Shores Village Remarks (Signed) d/z ,� STATE OF FLORIDA, COUNTY OF DADE. ss Before me e undersigned uth rity a notary public, duly authorized to administer oaths and take acknowledgments, personally ap- peared __. MIAMI SHORES VILLAGE 2 BUILDING INSPECTION DEPARTMENT - - - - - -- to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the- ____Od- of the above described construction, that he has carefully read the for oing application, and that he did sign the same, and that all facts Permit No Date o and Subscribed therein by him stated are trxe, / - � , /' // /7 p 96--1 Disapproved ______ ( Signed) ate Building Inspector PLANN BOARD DATE Chairman - Member Member Member Member Member Council Approved Date Disapproved Date NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has been obtained from the Planning Board. A re- inspection fee of $L00 will be charged when such re- inspection is made necessary by improper 1. ,ti, a for inspection or faulty materials and /or workmanship. Date 7- / ,19 C5 No. _.// 171 S" Street 17 6 . , ` f�a -- j E GA. r.. • - and for no other purpose. Repairs No. o St ries. ° • Roof Covering ( +$, !amount of Permit $ _ __..Plan Cubage Size of Building Lot tary Public, Stat fore me. ..'tPn,Stor -Et r - - - My Commission Expires / \ ` _ / / � � � �` ` �.' |�\ .`, | ' n/ ) `v' ( BUILDING ELECTRICAL PLUMBING ROOFING Owner of Building r 11 Architect Contractor or Builder •.(` 1 r `s ., f.` Legal Lot Description. Address of ' Building / s - j •.: . CONTRACTOR OR BUILDER MIAMI SHORES VILLAGE, FLORIDA r DATE r PERMIT ,N? 11719 ❑ Work to be performed under this Permit r Subdi- vision Value of Project $ BY Contractor's License No Amt. of j r �, Permit $ l . 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 • d "* c ~ e / IV ` " BY l P r1 � ` . INSPECTOR / AUTHORITY 195 In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. MIAMI SHORES VILLAGE. FLORIDA BUILDING ri DATF -/ -- .4-- -- 195 , ELECTRICAL 1 PERMIT IN? 11216 Contractor's PLUMBING 11=-1 License No ROOFING ❑ Work to be performed under this Permit Owner of Building Architect Contractor or Builder Legal Lot II BI. Description. Address of Building Subdi- vision This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device descalbed 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- 7 /_ r P N E:rO ' s ,i . ' i C BY i ', In consideration of the issuance to me of this permit I agoe )d perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawilgs/statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work d6:) by either, myself, my agent, servant or employee. CONTRACTOR OR BUILDER BY Value of Project $ Amt. of Permit $ C:t r--- Permit No. // Application is hereby made for the approval oailed statement of the plans and specifications herewith submitted for the building or other structure herein described. This applicaijpsr 1s 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 with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. Owner's Name and Address Registered Architect and /or Engineer____- Employing Plumber's Name __.. ' _ [' .. A t " "! 1 J No. Location and Legal Description Lot Street and Number where work is to be performed —No. State work to be performed and purpose of building (By Floors) New Building _ _- Remodeling______ Addition LAVA- TORIES SINKS SLOP SINKS LAUNDRY TUBS J ` � CONTR. LIST CHECK CONTR. LIST CHECK CLOSETS SEPTIC TANK Amount of Permit $ BATH TUBS SEWER CONN. STATE OF FLORIDA, t COUNTY OF DADE. SHOWERS DRAIN FIELD Nature of Water Supply: City—Well ss. SOAKAGE PIT MIAMI SHORE VILLAGE PLUMBING INSPEC N DEPARTMENT APPLICATION F R PLUMBING PERMIT GREASE TRAP Type of Tank / 7 No. Street Block Subdivision r S Street__ _ 7 _ )' URINALS SOLAR H EATER DEEP WELL SPRKLR. SYSTEM Repairs CATCH BASIN SWIM G POOL Date FLOOR DRINKING DRAIN FOUNT'NS Capacity Gals. Size Septic Tank_ Feet of Drain Tile ____ ______ _ Dist. Feet of Tank or Drain Field from Well Size of Soakage Pit ) (Signed) My Commission Expires Notary Public, State of Florida - No. of Stories str -- _ -? l Plumbing Inspector. The undersigned applicant fdr this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees tgmiploy only such sub - contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. / 7 (> Master Plumber. Before me, the undersigned authority, a no ly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me firstffluly sworn, upon oath deposes and says that he is the of the above described construction, that h has carefully read the foregoing application, and that he did sign the salve, 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. TOTAL FIXTURES Permit No // 7 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. 1 Owner's Name and Address Registered Architect and /or Engineer , -. 0 ----- • , Employing Plumbers Name _ ' t __,__ _ No. _f___•:__—_ _ Street _i__, _.. .-- s. Location and Legal Description Lot____ Block . __ Subdivision vs- a _ "_ _11.2--_ __ Street and Number where work is to be performed —No State work to be performed and purpose of building (By Floors) New Building Remodeling Addition Amount of Permit $ • '" STATE OF FLORIDA, COUNTY OF DADE. ss. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT 1 (Signed) No. __f -.� '.' Repairs Size Septic Tank Type of Tank Feet of Drain Tile Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: City —Well . Capacity Gals. Size of Soakage Pit (Signed) Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such sub - contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. D ate_ -___ r • Street /_t! t rt 1 No. of Stories My Commission Expires Notary Public, State of Florida 7.( Master P1unher. 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 SINKS LAUNDRY TUBS URINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT'NS TOTAL FIXTURE CONTR. LIST — CHECK SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SWIM'G POOL CONTR. LIST CHECK Permit No // 7 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. 1 Owner's Name and Address Registered Architect and /or Engineer , -. 0 ----- • , Employing Plumbers Name _ ' t __,__ _ No. _f___•:__—_ _ Street _i__, _.. .-- s. Location and Legal Description Lot____ Block . __ Subdivision vs- a _ "_ _11.2--_ __ Street and Number where work is to be performed —No State work to be performed and purpose of building (By Floors) New Building Remodeling Addition Amount of Permit $ • '" STATE OF FLORIDA, COUNTY OF DADE. ss. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT 1 (Signed) No. __f -.� '.' Repairs Size Septic Tank Type of Tank Feet of Drain Tile Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: City —Well . Capacity Gals. Size of Soakage Pit (Signed) Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such sub - contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. D ate_ -___ r • Street /_t! t rt 1 No. of Stories My Commission Expires Notary Public, State of Florida 7.( Master P1unher. 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. BUILDING ❑ ELECTRICAL ❑ PLUMBING ® PERMIT N° ROOFING ❑ Owner of Building 1 ! f it r �' i e Architect Contractor or Builder Legal Description Address of Building Lat {r \y} Sq Ft y ` Value of 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 an} 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 wheth shown on the plans or drawings or in the statements or specifications and that ha assumes respon- sibility for work done by his agents, servants or employ Signed In consideration of the issuance to me of this permit I agr pertaining thereto and in strict conformity with the plans, drawin In accepting this permit I assume responsibility for all work do MIAMI SHORES VILLAGE, FLORIDA Date 3 Work to be performed under this Permit /r "1 h-.. I 131. CONTRACTOR or BUILDER 8901 Subdi- vision ,my age s BY i Contractor's License No. a S' Ss- H I Amount of 3 Project $ II Permit $ AUTHORITY 1941 / jINSPECTOR) BY o perform the work covered hereunder in compliance with all ordinances and regulations s( statements or specifications submitted to the proper authorities of Miami Shores Village. ' e by either, myself ervant or employee. Permit No 0 U © D MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT 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. a Owner's Name and Address_ -_ �'0 F'aY'�fAe%' -- _ -- 114 5 NE 92 street - _ — No. 145 - Registered Architect and /or Engineer _________ — ___ Employing Plumber's Name- Rps®._..S t g__1'{ _ C Street-- Location and Legal Description Lot__ Block____ _ _ _ - - Subdivision Street and Number where work is to be performed —No 1 145 NE 92 s t ® Street. State work to be performed and purpose of building (By Floors) _ New Building Remodeling —__ -- _ --- Addition__ Size Septic Tank — Type of Tank__ Capacity Gals Feet of Drain Tile __Dist. Feet of Tank or Drain Field from Well __Size of Soakage Pit Nature of Water Supply: City —Well Amount of Permit ( ( Signed)_ - "` umbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligat s as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanen Supplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted' for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such sub - contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. My Commission Expires Date. ------ ____ - 6-30-67 Notary Public, State of Florida Repairs No. of Stories. STATE OF FLORIDA, } COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly swom, 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 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'G POOL CONTR. LIST c.� p t fJ CHECK _ - Permit No 0 U © D MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT 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. a Owner's Name and Address_ -_ �'0 F'aY'�fAe%' -- _ -- 114 5 NE 92 street - _ — No. 145 - Registered Architect and /or Engineer _________ — ___ Employing Plumber's Name- Rps®._..S t g__1'{ _ C Street-- Location and Legal Description Lot__ Block____ _ _ _ - - Subdivision Street and Number where work is to be performed —No 1 145 NE 92 s t ® Street. State work to be performed and purpose of building (By Floors) _ New Building Remodeling —__ -- _ --- Addition__ Size Septic Tank — Type of Tank__ Capacity Gals Feet of Drain Tile __Dist. Feet of Tank or Drain Field from Well __Size of Soakage Pit Nature of Water Supply: City —Well Amount of Permit ( ( Signed)_ - "` umbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligat s as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanen Supplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted' for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such sub - contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. My Commission Expires Date. ------ ____ - 6-30-67 Notary Public, State of Florida Repairs No. of Stories. STATE OF FLORIDA, } COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly swom, 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. MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date V I i Time Type Insp'n ritti C rG u yam /' Permit No. PI D003- Name 2 eet Address l 3 U 1-- J- Company ' 6 1 J nool . Phone # For Inspector: 101 ) Approved L� Correction ❑ Re- Insp'n Fee ❑