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PLUMBING PERMITDat IV ' A A/P ?� Job Address Legal Description Historically Designated: Yes No Owner/Lessee / Tenant Master Permit # Phone Owner's Address 1.1/Zii 4 5 — 5 l",4 Contracting Co. 4M1f4 Address / 1-4) i Qualifier 94n -, Phone State # 2Y e a3 i ggy t i23 Municipal # Competency # Ins. Co. Architect/Engineer Address Bonding Company Address Mortgagor Address Permit Type (circle one): BUILDING ELECTRICAL LUMBING, MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION Square Ft. , 63t 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 YCUR 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 r: gulating 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 law regulating constructi and zoning. Furthermore, I authorize the above -named contractor to do the work stated. otary as to C My Commissiog CC NO. 00089 -0743 Office /Home: (305) 620 -8320 PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Real Estate Inspection f:/1 g -Nil Z 0 a, I1rYc re- 1 'p Date Signature of Contractor or Owner - Builder Date �dGG j 30 p 53c ° Sd 9 t 2- 33g -0 cp. oo ©o 1 L �" _ -g -20-°92 Free Estimates WALLACE J. PONDER SEPTIC TANK SERVICE Commercial • Residential Pump -Outs • Grease Trap • Parking Lots New Drain Fields Installed State Certified Septic Tank Contractor Beeper: (305) 824-7768 Estimated Cost (value) -3 , co 0 C y;1055KRi NO. a illiit' Ii C.C.F. ° e NOTARY BONfl 3 D TOTAL DUE S6 • G' Notary as to Contractor My C Electrical Date g -9,v –Pf Engineering CONSTRUCTION PERMIT FOR: [ ) New System [ ) Existing System [' ) Repair [ ) Abandonment APPLICANT: PROPERTY STREET ADDRESS: LOT: PROPERTY ID #: SYSTEM DESIGN AND SPECIFIQATIONS T [ A [ N [ K [ STATE OF FLORIDA PERMIT # DEPARTMENT OF HEALTH DATE PAID ONSITE SEWAGE DISPOSAL SYSTEM FEE PAID $ CONSTRUCTION PERMIT RECEIPT # Authority: Chapter 381, FS i BLOCK: SUBDIVISION: Chapter 10D -6, FAC [ ] Holding Tank [ ] Temporary /Experimental ( ] Othelr(Specify) (SECTION /TOWNSHIP /RANGE /PARCEL NUMBER] (OR TAX ID NUMBER) SYSTEM MUST BE CONSTRUCTED IN ACCORDANCE WITH S:ECIFICATIONS AND STANDARDS OF CHAPTER 1OD -6, FAC. REPAIR PERMITS AND HOLDING TANK PERMITS EXPIRE 90 DAYS FROM THE DATE OF ISSUE. ALL OTHER PERMITS EXPIRE ONE YEAR FROM THE DATE OF ISSUE. DEPARTMENT OF HEALTH APPROVAL OF SYSTEM DOES NOT GUARANTEE SATISFACTORY PERFORMANCE FOR ANY SPs'CIFIC 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 RESUL'.' IN THIS PERMIT BEING MADE NULL AND VOID. ] [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 MATE [ ] PER 24 HRS NO. OF PUMPS: [ ] D [ ] SQUARE FEET PRIMARY DRAINFIELD SYSTEM R [ ] SQUARE FEET SYSTEM A TYPE SYSTEM: [ ] STANDARD [ ] FILED ( ) MOUND [ ) I CONFIGURATION: [ ] TRENCH [ ] BED ( ) N F LOCATION OF BENCHMARK: I ELEVATION OF PROPOSED SYSTEM SITE [ ] [INCH);S /FT] [ABOVE /BELOW] BENCHMARK /REFERENCE POINT E BOTTOM OF DRAINFIELD TO BE [ ] (INCH2S /FT) [ABOVE /BELOW] BENCHMARK /REFERENCE POINT L D FILL REQUIRED: [ ] INCHES 0 T H E R SPECIFICATIONS BY: APPROVED BY: DATE ISSUED: DH 4016. 10/96 (Replaces HRS -M Form 4016 [page 1) which may be used) (Stock Number: 5744 -001 - 4016 -0) EXCAVATION REQUIRED: ( ) INCHES • T: TLE: TITLE: EXPIRATION DATE: .1 Page 1 of 2 INSTRUCTIONS: PERMIT NUMBER: Permit tracking number by County Health Department. APPLICATION FOR: Check type of permit:if "Other" specify type in blank. APPLICANT: Property owner's full name. TELEPHONE: Telephone number for applicant or agent. AGENT: Property owner's legally authorized representative. MAILING ADDRESS: P.O. box or street mailing address for applicant or agent. LOT, BLOCK, SUBDIVISION or PROPERTY ID #: 27 character ID number for property. (Health Department may require property appraiser ID# or section /township /range /parcel number.) SYSTEM DESIGN AND SPECIFICATIONS: TANK: Minimum specifications from Chapter 10D -6, FAC. DRAINFIELD: Minimum specifications from Chapter 10D -6, FAC. OTHER: Other specifications, such as operating permit requirements, low- volume flush toilets, variance provisos. SPECIFICATIONS BY: Name of individual providing specifications. If designed by a registered engineer must be sealed. APPROVED BY: County Health Department personnel reviewing and approving permit. DATE ISSUED: Date permit is issued by County Health Department. EXPIRATION DATE: One year from date issued if the system has not been installed. Permits for system repairs become void 90 days from the date issued. CLos Ts SEPTIC TANK BATH TUSs SEWER CONN. LAVA. SHOWERS TORIES DRAIN FIELD / SOAKAGE PIT SINK• SLOP SINKS G SOLAR TRAP HEATER APPLICATION FOR PLUMBING PERMIT InC0 tik k 1 Permit No ` 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 Miam; 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 4 C1-0-5—t-Ailki.— 10 1.5 — 1 1) _ t - 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) N Building Remodeling Addition. CONTR. LIST CHECK CONTR LIST CHECK Amount of Permit $ My Commission Expires MIAMI SHORES VILLAGE PLUMBING INSPECTICN DEPARTMENT Bleck LAUNDRY Yuma DEEP SPRKLR. WELL SYSTEM SW I M' POOL Registered Architect and /or Engineer �� cc 3a-91 /d std- Employing Plumber's Name . -. e• -"` i �__ L °r .t c< 0,. „, „„„,,teet. Repairs No. of Stories URINALS CATCH DAS I N FLOOR DRAIN DRINKING FOUNT' NS ize - Septic Tank...—. ''" ` ~ i ' 1 a_— __._Type of Tank —_ eot of Drain Tile3OD - - -6- . Feet of Tank or Drain L'ield from Well VVV Nature of Water Supply: City —Well of Soakage Pit Capacity Gals r TOTAL FIXTURES The undersigned applicant for this building permit does hereby certify that he understands and accepts his oblige +ns as an employer of labor under the Florida Workmen's Compensation Act, being Section 5980, Compiled General Laws of Florida Ferman Supplement, and has com- plied with the provisions thereof, and will require similar compliance from ell 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. / I (S.:gaed) `-_ '+. - --i- e.. L. umbing Inspector. Master Plumber. STATE OF FLORIDA, COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized :o administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposer; and says that he is the .--- ._..... - •-- •- ---- - ----- ---- -- -- _.. of the above described construction, that he has carefully read the foreg <ing application, and that he did sign the same, and that all facts therein by him stated are true. Notary Public, State of Florida NOTE: A re- inspection fee of $1.00 will be made when ooh ro-insportion is made necessary by improper notice for inspection, or faulty materials and /or workmanship. PERMIT APPLICATION FOR MUNS:CIPALITIES OF DADE COUNTY (OWNER TO RETAIN COPY) Date - �� /�� Job Addr ss p K (4 L=3 ST RE`TTx Folio / / -w O� ' ®v 7 ®07 Legal Description ;R�� "'. � 7 ► l�f �� Owner / Lessee / Tenant ��� (' ea. l` ac Master Permit 22 Owner's Address _� , v��`S re f Phone �f � - rl Contracting Co. ) Arf�L Mks Alernan oeP f I ,, 1,�f kdd ess !`YC J me M. is ! TEE Qualifier VA -849 A-) e m Q vl SS# R (D —5 7 / (O Phone (O i 59K 8 State # Mudipal # Competency # 4 0 ( ? i e7 Ins .Co . xiS !/K �/ 1 Architect /Engineer Address Bonding Company Address Mortgagor Address Permit Type(circle one): BUILDING ELECTRICAL WORK DESCRIPTION Sp f/' (i') j`s /'e rT L lvcs7`rry7 4f %ea d$) Square Pt. Estimated Cost(value) / 50i) WARNING TO OWNER: YOU MUST RECORD A NOTICE; OF COMMENCEMENT AND YOUR FAILURE TO DC SO MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTENI TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUF NOTICE OF COMMENCEMENT). Application is hereby made to obtain a permit to do work and installation as indicated above, an on the attached addendum (if applicable). I certify that all work will be performed to meet th standards of all laws regulating construction in this jurisdiction. I understand that separat( permits are required for ELECTRICAL, PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK. OWNER'S AFFIDAVIT: I certify that all the foregoin3 information is accurate and that all work wil_ be done in compliance with all applicable laws regulating construction and zoning. Furthermore, authorize the above-named contractor to do the work stated. Signature of owner and /or Condo President Date: Notary as to Owner and /or Condo President My Commission Expires: PLUMBING) MECHANICAL ROOFING PAVING FENCE SIGI Signature of Contractor or Owner- Builder Date? 5 Not` ary as to Contr$LIOR My Commission ExpirMMISSION EXP JUNE 27, 1993 BONDED THRU GENERAL INS. UND. ** * * * * * * * * * * * * * * * ** FEES: PERMIT 1 RADON C.C.F. 1' NOTARY TOTAL DUE 7 /%7C06 APPROVED: Fire Other Zoning Building Electrical Mechanical P umbing _s ' ' ! / engineering MIAMI SHORES VILLAGE PLUMBING CNSPECTICN DEPARTMENT APPLICATION FOR PLUMBING PERMIT Rani* 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 confamity 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 oar not. A copy of approved plans and specifications must be kept at building during progress of work. Owners Name and Address .E.Ddri {91P7 No 1245 1\1_ Registered Architect and/or Engineer K. PFEIFER Employing Plumbor's Name Location and Legal Description Lot 6 1245 N.E. 93r au Lure Street and Number where work is to be performed—No Street ..... _ ..... State work to be performed and purpose of building (By Floors)_____Sg...ponl New Building..—._ Remodeling__ Addition. Repairs No. of Stories Amount of Permit $ 16 3' STATE OF FLORIDA, } u. COUNTY OF DADE. Size Septic Tank_ _Type of Tank Feet of Drain Tile— _Dist Feet of Tank or Drain Eleld from Well . Nature of Water Supply: City—Well. sin c of Soakage Pit Plumbing Inspector. The undersigned applicant for this building permit does hereby certify fiat he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compi:ed General Laws of Florida Permanent Supplement, and hav com- plied with the provisions thereof, and will require similar compliance from ell contractors or sub-contractors employed by him in the woe,. 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 err required by the Act. The undersigned agrees to employ only ciach sub-ozntractors, on work to be under this permit, as are licensed by Miami Shores Village. Master Plumber. Before me, the undersigned authority, a notary public, duly authorized 5o administer oaths and take acknowledgments, personally appeared m. to me well known, and who, being by me first duly sworn, upon oath deposec and says that he is the of the above described construction, that he has carefully read the foregoing application, t he dm si me, and that t b him stated are true. Notary Public; State of Florida at i.erpo sa • Idly Commission Expires Seotorrbcr 27, 1991, My C43nuni&liZ T7:2 r...'zt) i ZzZ'al.:7;-- • Notary Public, nate NOTE: A re fee of $1.00 will he made whim mit awiss .rgerties is mede.neesesery by bnprepor intim m h as f au l ty materials and/or workmanship. CLOSETS BATH Tuns 6 ""g" LAVA. TORIES siNg• SLOP SINKS LAUNDRY Tun. URINALS CATCH BASIN FLOOR DRAIN DRINK I NO FOUNT' NO TOTAL FIXTURES CONTR. LIST CHECK SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT 0 TRAP SO LA IX HEATER DEEP WELL SPRKLR. 5 SWIMS POOL Comm LIST I CHECK - 1 MIAMI SHORES VILLAGE PLUMBING CNSPECTICN DEPARTMENT APPLICATION FOR PLUMBING PERMIT Rani* 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 confamity 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 oar not. A copy of approved plans and specifications must be kept at building during progress of work. Owners Name and Address .E.Ddri {91P7 No 1245 1\1_ Registered Architect and/or Engineer K. PFEIFER Employing Plumbor's Name Location and Legal Description Lot 6 1245 N.E. 93r au Lure Street and Number where work is to be performed—No Street ..... _ ..... State work to be performed and purpose of building (By Floors)_____Sg...ponl New Building..—._ Remodeling__ Addition. Repairs No. of Stories Amount of Permit $ 16 3' STATE OF FLORIDA, } u. COUNTY OF DADE. Size Septic Tank_ _Type of Tank Feet of Drain Tile— _Dist Feet of Tank or Drain Eleld from Well . Nature of Water Supply: City—Well. sin c of Soakage Pit Plumbing Inspector. The undersigned applicant for this building permit does hereby certify fiat he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compi:ed General Laws of Florida Permanent Supplement, and hav com- plied with the provisions thereof, and will require similar compliance from ell contractors or sub-contractors employed by him in the woe,. 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 err required by the Act. The undersigned agrees to employ only ciach sub-ozntractors, on work to be under this permit, as are licensed by Miami Shores Village. Master Plumber. Before me, the undersigned authority, a notary public, duly authorized 5o administer oaths and take acknowledgments, personally appeared m. to me well known, and who, being by me first duly sworn, upon oath deposec and says that he is the of the above described construction, that he has carefully read the foregoing application, t he dm si me, and that t b him stated are true. Notary Public; State of Florida at i.erpo sa • Idly Commission Expires Seotorrbcr 27, 1991, My C43nuni&liZ T7:2 r...'zt) i ZzZ'al.:7;-- • Notary Public, nate NOTE: A re fee of $1.00 will he made whim mit awiss .rgerties is mede.neesesery by bnprepor intim m h as f au l ty materials and/or workmanship. STATE OF FLORIDA, COUNTY OF DADE. ss. Disapproved (Signed) Chairman Member Member • ° — •' ft' MIAMI SHORES VILLAGE Le '215 BUILDING INSPECTICN DEPARTMENT ?,/3 APPLICATION FOR EUILDING PERMIT 7" j rye Y 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. i �f g. D ,///,4 Date..— ..._..... t _ .. _ ._ • " , 31 / 6 Y Owner's Name and Address ... •''! �...._._ _. No.. 7L....__. Street '6 q y / v eil ,47 �(!, . f��'s : ' �is�%/ /o �3 � � m /or Engineer P -k -- • /4!:7 l. Name and address of licensed contactor _ Location vld legal description of lot to be built on: i Lot.e /... •:1' ° 6 y "`r Block I Subdivision �j �' u� . _. ..._� .._.._ ¢ t� el / A.c' - 7 fib. S • f fi/ �/e� Street and Humber where work is to be done �) �� ��L ._ _.� ..� � State work to be done and purpose of building (by floors ‘ 2(4 .. C.G'� ,r /l!:e!•�,. C- -3 :.4 LLt- ' x -- and for no other purpose. New Building 1 Remodeling Addition Repairs No. of Stories To be constructed of C .5 -S Kind of foundation 'AM 6 kof .r • Roof Covering... f Estimated Total cost of improvements $....(4,./ 0 .4 G' Amount of Permit $ ..._...._.. Zone cubage required i 2lar. Cubage �a. Distance to next nearest building �@ =4� ?� Size of Building Lot live load to be borne by each floor ,4(;) A I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may be sent to... � • �$�i!� c 7a® Xv-atia The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under theFlorida 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 subcontractor w to be performed under this pennit, as are licensed by Miami Shores Village. Remarks (Signed) .. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap- peared _.. 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 foregcing application, and that he did sign the same, and that all facts therein by him stated are true. p _ Permit No._ _/�' Date Read, Sworn to and Subscribed before me. Notary Public, State of Florida Buil•rng Inspectyr My Commission Expires LANNING BOARD DATE 1.61 - 2. 2_ to me well known, Member Member Member Council Approved Date D.'.sapproved 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 51.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and /or workmanship. - i ° Permit No / 6 39 Date q-7- Application is hureb riiade 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. �Q p °� Owner's Name and Address°.0 ( °i � ' - = -s f� - ° - - __ - -- No. 2 _ StreetJJO_ - - -- __ S1 Registered Architect and /or En ineer__ !1 - p�, 4d CC; Employing Plumber's Name_ � i -1:l __ _-- --- - --_- No/ / Street_ ^ Location and Legal Description Lot___4 __ Subdivision__ Street and Number where work is to be performed— No.__J 2 515 Street. g /3S State work to be performed and purpose of building (By Floors) _L L° 4 ''.._A,.L` _ O° - N Building _—X Remodeling__ ________ Addition_________ Repairs No. of Stories. Size Septic Tank ______ Type of Tank Capacity Gals. Feet of Drain Tile _Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: City —Well _�� ........... __—_____Size of Soakage Pit Amount of Permit $ r My Commission Expires MIAMI SHOR[IS VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT — - -- (Signed)- ‘e---))1 (Signed)____ (Signed) - - -- 1_ Plumbing The undersigned applicant for this building permit does hereby certify that he understands and accepts his obl tons as an employer of labor under the Florida Workmen's Compensation Act, being Section 5988, Compiled General Laws of Florida Perna. -nt 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 ' be perfo d under this permit, as are licensed by Miami Shores Village. Master Plumber. STATE OF FLORIDA, I as. 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 NOTE: A re- inspection fee of $1.00 will be made when such re- inspecion is made necessary by improper notice for inspection, or faulty materials and /or workmanship. CLOSETS BATH TUBS SHOWERS LAVA- TORIES SINKS SLOP SINK6 LAUNDRY TUBS U CATCH BASIN FLOOR DRAIN DRINKING FOUNT'NS 8 f / © Gin wV 1 TOTAL FIXTURES CONTR. ti I ry I I / CHECK SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SWIM• P/ OOL A L G y'� p }!,// j� /�� - -. _ CONTR. LIST CHECK T Permit No / 6 39 Date q-7- Application is hureb riiade 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. �Q p °� Owner's Name and Address°.0 ( °i � ' - = -s f� - ° - - __ - -- No. 2 _ StreetJJO_ - - -- __ S1 Registered Architect and /or En ineer__ !1 - p�, 4d CC; Employing Plumber's Name_ � i -1:l __ _-- --- - --_- No/ / Street_ ^ Location and Legal Description Lot___4 __ Subdivision__ Street and Number where work is to be performed— No.__J 2 515 Street. g /3S State work to be performed and purpose of building (By Floors) _L L° 4 ''.._A,.L` _ O° - N Building _—X Remodeling__ ________ Addition_________ Repairs No. of Stories. Size Septic Tank ______ Type of Tank Capacity Gals. Feet of Drain Tile _Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: City —Well _�� ........... __—_____Size of Soakage Pit Amount of Permit $ r My Commission Expires MIAMI SHOR[IS VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT — - -- (Signed)- ‘e---))1 (Signed)____ (Signed) - - -- 1_ Plumbing The undersigned applicant for this building permit does hereby certify that he understands and accepts his obl tons as an employer of labor under the Florida Workmen's Compensation Act, being Section 5988, Compiled General Laws of Florida Perna. -nt 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 ' be perfo d under this permit, as are licensed by Miami Shores Village. Master Plumber. STATE OF FLORIDA, I as. 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 NOTE: A re- inspection fee of $1.00 will be made when such re- inspecion is made necessary by improper notice for inspection, or faulty materials and /or workmanship. fos 0 (""co Z r� r