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PLUMBING PERMITName Date Type Insp'n Permit No. Pu' Address Company Phone # Inspection Date MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Build g Inspection Request g..\ 2 �> so- Abu . Approved Correction Re- Insp'n Fee P(3 3S5 BUILDING PERMIT APPLICATION FBC 2001 Permit Type (circle): Building Electrical Owner's Name (Fee Simple Titleholder) Owner's Address /?L3 � E City M- p Shore S State Tenant/Lessee Name Type of Work: ❑Additio ❑Alteration Describe Work: Del- f1) k j 1 S. Total Fee Now Due $ (Continued on opposite side) Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 7' S. Q4 Fax: (305) 756.8972 .. TArif.fr 9A ,Sl Architect/Engineer's Name (if applicable) /W M- $ Value of Work For this Permit /j SOD. O ❑New Permit Non Oi S ter Permit No. Phone # Zip 3 3/38 • Phone # State Certificate or Registration No. Certificate of Competency No. Mechanical Roofing x'07 ?1'3 Job Address (where the work is being done) Xis e ee.Q_ lC'S L e7/ (0k3 QV' d City Miami Shores Village County Miami -Dade Zip is Building Historically Designated YES NO x 305)d'3 S'er Contractor's Company Name C - r? r f eS ` ?(4 -e ?pee Phone # �j a) — *1 7 - ;; / 1 Contractor's Address go' e) C7'C ce r 1 G A C fr. Q t - � - e ([-c) 66- City (` rfr do State (C Zip 3?) 1 � ) Qualifier CJ /e r (e s C'e )L�iP. snh' -7 &6- Aoe 6 � Phone # - 75(;- .3/6— 00 B0 Square Footage Of Work: , Repair/Replace ❑ Demolition r'0_03h ****************************F *t*************************** Submittal Fee $) en Permit Fee $ O 60 CCF $ CO /CC Notary $ Training/Education Fee $ Technology Fee $ A... 00 - Scanning $ Radon $ Zoning Bond $ Code Enforcement $ Structural Plan Review. $ Bonding Company's Name (if applicable) Bonding Company's Address • City State Zip Mort Mortgage Lender's Address City State Zip Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is sub ct to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspect', which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not se ..proved a• � a reinspection fee will be charged. • X \ Signature �s�c , 20 Owner or • gent g instrument was acknitwted"_ed bet'. •Y t emethis * ** Signature The forego' day of who is personally kno n to me or y'ho has produced NOTARY PUBL Sign: Print: My Commissio Expires: ** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** APPLICATION APPROVED BY: Chc 05/13/03 I 4.04 applicable) As identif • ' d who did take an oath. as identification and who did take an oath. 1 S � 1 • I Contractor The foregoing instram'ent was acknowledged before me this lei day of Q /'t her 200' y , by O jie des E. C e,L`,,iy, ,•. who is personally knowro me or who has produced NOTARY PUBLIC: /': Sign: Print: a My Commission Expires: +� ! t'. NANCY GONZALQ ,r_ MY COMMISSION # Dp 271683 EX_ PIRES: February 15, 2008 Thru Nan Ptak Underwdkrs * * * * * * * * * * * ** * * * * * * * * * * * * ** * * * * * * * * * * * * ** ******************************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** ****************************** * * * ** * * * * * * * * ** * * * * * * * * * * * * * * ** yLZ / Plans Examiner Engineer Zoning ITEM BATH TUB UNIT FEE ITEM SWITCH OUTLETS UNIT FEE ITEM SPACE HEATERS UNIT FEE BIDET / LIGHT OUTLETS CENTRAL HEATING DISHWASHER RECEPTACLES A/C (WIND) DISPOSAL SERVICE TEMPORARY A/C (CENTRAL) DRINKING' FOUNTAIN SERVICE SIZE IN AMPS DUCT WORK FLOOR DRAIN SERVICE REPAIR/METER CHANGE REFRIGERATION GREASE TRAP APPLIANCE OUTLETS PROCESS AND PRESS PIPING INTERCEPTOR RANGE TOP UNDERGROUND TANKS LAVATORY OVEN ABOVE GROUND TANKS LAUNDRY TRAY __ WATER HEATER U.F. PRESSURE VESSELS CLOTHES WASHER MOTORS 0- 1 If STEAM BOILERS SHOWER MOTORS OVER 1- 3 If HOT WATER BOILERS SINK, POT /3 COM). MOTORS OVER 3- 5 If MECHANICAL VENTILATION SINK, RESIDENCE / MOTORS OVER 5- 8 HP TRANSPORTING ASSEM3LIES SINK, SLOP MOTORS OVER 8- 10 If ELEVATORS/ESCALATORS TEMPORARY WATER CLOSET MOTORS OVER 10- 25 HP FIRE SPRINKLER SYSTEMS URINAL MOTORS OVER 25-100 HP COOLING TOWERS WATER CLOSET 2� MOTCRS OVER 100 If VIOLATION INDIRECT WASTES - A/C WINDOW REINSPECTION WATER SUPPLY TO: AIR CONDITIONERS A/C UNIT STRIP HEATER FIRE SPRINKLER GENERATORS TRANSFORMERS HEATER -NEW INST. GENERATORS TRANSFORMERS i HEATER - REPLACE GENERATORS TRANSFORMERS LAWN SPRINKLER -WELL SPECIAL PURPOSE SWIMdING POOL OUTLETS COIJIERCIAL WATER SERVICE SIGN TUBES SEWER CONNECTIONS SIGN TRANSFORMERS UTILITY -SEWER SIGN TIME CLOCK UTILITY -WATER FIXTLRES SEPTIC TANK ANTENNA RELAY TELEVISION OUTLETS GRAINFIELD, 4' TILE/RES. VIOLATION PUMP 8 ABANDON SEPTIC TANK REINSPECTION SOAKAGE PIT CU. FT. CATCH BASIN DISCHARGE WELL DOMESTIC WELL 1 AREA DRAIN ROOF INLET SOLAR WATER HEATER FIRE STANDPIPE POOL PIPING LAWN SPRINKLER SYSTEM GAS RANGE METER SET (GAS) 1 GAS PIPING f PLUMBING ADDENDUM TO BUILDING PERMIT APPLICATION (AN APPLICATION FOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. IF A MASTER PERMIT HAS B. OBTAINED, THE OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.) ELECTRICAL MECHANICAL Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Printed: 12/27/2004 Applicant: TOMAS SUAREZ Owner: SUAREZ TOMAS JOB ADDRESS: 1263 NE 92 ST Contractor CHARLES CULPEPPER Local Phone: 305 - 759 -8255 Parcel # 1132050270270 Signed: (INSPECTOR) Plumbing Permit Permit Number: PL2004 -358 Contractor's Address: 801 brickell bay dr Legal Description: BAY LURE PB 44 -63 LOT 16 Permit Status: APPROVED Permit Expiration: 6/15/2005 Construction Value: $1,500.00 Work: SET FIXTURES Page 1 of 1 DEC 2 7 PAID BLK 2 LOT SIZE 75.000 X 125 OR Fees: Description Amount FEE2004 -13110 Building Fee $160.00 FEE2004 -13111 CCF $1.20 FEE2004 -13112 Notary Fee $5.00 FEE2004 -13113 Technology Fee $4.00 FEE2004 -13114 Training and Education Fee $0.40 FEE2004 -13115 Submittal Fee ($50.00) Total Fees: $120.60 Total Fees: $120.60 Total Receipts: $0.00 `2 ; In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responisibility for all work done by either myself, my agent, servants or employes. Signed: (Contractor or Builder) BY: Permit No/ 7 �� GM&GKO SHOG2ES VOILE GIE PLUMBING INSPECTION DEPARTMENT APPLeC VTOON FOR PLUMBOI1 © PI RMOT Date - 2_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. Owner's Name and Address No._ — �ZZv 3__---- -__ --_ Street Registered Architect and /or En ineer__ .13.. u I13 — .1 Lam.__ Employing Plumber's Name Ate —FLOW No.__-- /Os_ Street__ )4eJ ✓9 -1 Location and Legal Description -- Block- Z. Subdivision Street and Number where work is to be performed —No 1 (.3 Street Abr- ? — s 7 - State work to be performed and purpose of building (By Floors) '0__4.6.— _ -'-� 1 J I /0 L New Building ------------- -- - - - - -- Remodeling______ Addition __ -_X- Repairs No. of Stories .......... ... Amount of Permit $_ STATE OF FLORIDA, I COUNTY OF DADE. e (Signed)- (Signed)._ 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._ C __C9 . _!-L atamg_.._____Size of Soakage Pit Capacity Gals. 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 w k to be performed . nder is permit, as are licensed by Miami Shores Village. 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. My Commission Expires Notary Public, State of Florida NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made by improper notice for insp m, or faulty materials and /oz workmanship. CLOBUTB B ATH TUBS E SHOWERO LAVA TORIES INKS SINKS SLOP SINKS LAUNDRY TUBE URINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT'NS TOTAL FIXTURES CONTR. LI CHUCK SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR H EATER DEEP WELL SPRKLR. SYSTEM SWIM'G POOL CONTR. LIST 6. ^ -.- _ CHUCK Permit No/ 7 �� GM&GKO SHOG2ES VOILE GIE PLUMBING INSPECTION DEPARTMENT APPLeC VTOON FOR PLUMBOI1 © PI RMOT Date - 2_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. Owner's Name and Address No._ — �ZZv 3__---- -__ --_ Street Registered Architect and /or En ineer__ .13.. u I13 — .1 Lam.__ Employing Plumber's Name Ate —FLOW No.__-- /Os_ Street__ )4eJ ✓9 -1 Location and Legal Description -- Block- Z. Subdivision Street and Number where work is to be performed —No 1 (.3 Street Abr- ? — s 7 - State work to be performed and purpose of building (By Floors) '0__4.6.— _ -'-� 1 J I /0 L New Building ------------- -- - - - - -- Remodeling______ Addition __ -_X- Repairs No. of Stories .......... ... Amount of Permit $_ STATE OF FLORIDA, I COUNTY OF DADE. e (Signed)- (Signed)._ 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._ C __C9 . _!-L atamg_.._____Size of Soakage Pit Capacity Gals. 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 w k to be performed . nder is permit, as are licensed by Miami Shores Village. 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. My Commission Expires Notary Public, State of Florida NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made by improper notice for insp m, or faulty materials and /oz workmanship. BUILDING ELECTRICAL PLUMBING Architect Contractor or Builder Legal Description Address of Building Lot PERMIT N? 9911 CONTRACTOR OR BUILDER MIAMI SHORES VILLAGE, FLORIDA Work to be performed under this Permit Owner of Building Bl. Subdi- vision Value of Project $ DATE 195 Contractor's License No Amt. of Permit $ This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the 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 • BY INSPECTOR In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. 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 MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT No Street I Location and Legal Description Lot - .- �> (� Block Subdivision___ Street and Number where work is to be performed —No _._ — Street '' Employing Plumber's Name State work to be performed and purpose of building (By Floors) ____f ) r New Building `'' Remodeling Addition Repairs No. of Stories Size Septic Tank Type of Tank 7 ,' 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 $___ ' • STATE OF FLORIDA, 1 ss. COUNTY OF DADE. (Signed) ' Date_.__ . ' No Street BES Capac-rryr-alc x = -' ------------ Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligat jpns 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 he performed under this permit, as are licensed by Miami Shores Village. ( Signed) 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. My Commission Expires Notary Public, State of Florida 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 � - F CONTR. LIST ,, °yam / / , 1 CHECK SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR H EATER DEEP WELL SPRKLR. SYSTEM SW IM'G POOL .— CONTR. LI ST / b 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 MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT No Street I Location and Legal Description Lot - .- �> (� Block Subdivision___ Street and Number where work is to be performed —No _._ — Street '' Employing Plumber's Name State work to be performed and purpose of building (By Floors) ____f ) r New Building `'' Remodeling Addition Repairs No. of Stories Size Septic Tank Type of Tank 7 ,' 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 $___ ' • STATE OF FLORIDA, 1 ss. COUNTY OF DADE. (Signed) ' Date_.__ . ' No Street BES Capac-rryr-alc x = -' ------------ Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligat jpns 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 he performed under this permit, as are licensed by Miami Shores Village. ( Signed) 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. My Commission Expires Notary Public, State of Florida 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. ■ LX '‘) 4/1 Permit No /9 s Application is hereby made for the approval of the detailed otatement of the plans and specifications herewith Dubin ted 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 aperslfied or teat. A copy of approved plans and specifications must be kept at building during progress of work. � /, 0 ,, .� Pi/LiLa,K.0 / Owners Name and Address t SI t i4 R10 / 3 �E Stn i-. -_ Registered Architect and /or Engineer Employing 1'hutal 's No AU T` G /0' N©,,.a- - Zce.,� EadS ® S .� - ..._ Location and Legal Description Lot. Blarh / 4 Subdivision..___ Street Stre and Number where work is to be perform —No � ii 6 3 9 2 ° §tre . _.._. — ..._.._._ State work to be performed and purpose of building (By Flares) New Building_ -__ _-------- ....- - - - -.. Remodeling__ ._ -_ —_ Addition Amount of Permit $ s STATE OF FLORIDA, I COUNTY OF DADE. Before me, the undersigned authority, a notary pules, to me well known, and who, being by me first duly sworn, urn cads of the above described construction, that he lem =day rwaa the therein by him stated are true. G IDANJD ONORES MDddt? © PLUMBING INSPEalOI1 DEPARTMENT APP 8 t4 OM GAO l PLUGaI116:1© P[ LQMO'' (sisima)J�L. Repairs Capacity Gab- ___ Size Septic Tank_- Type of Tank Feet of Drain Tile 5c2 Di Feat of Tank or Drain Field from @ / ell - - - -- — - - - - -- - -- - -..._ _ Nature of Water Supply: City —Well Size of Soakage Pit. Plum . : 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 3'4;, Compiled General Laws of Florida i'erinanent Suppl t com- plier with the provisions thereof, and will require similar compliance from all contractors or su actors e • ployed b - performed under this permit; and will post or cause to be posted( for inspection on the site ��e work such publi required by the Act. The undersigned agrees to employ only such sub-contractors, oso� . to be per licensed by Miami Shores Village. to administer oaths and take acknowledgments, personally appeared cc= and soya that he is the regrdasc applicatme, and that he al the same, and that all facts No. of Stories. ... Master Plumber. My Commission Enstbco h`soaasq %Mk, ate of Florida NOTE: A re-inspection foe of MO ho b lDy doe for Inspection, or faulty materials Ind /or CLOOQTa a ATH Tuoo OHOWQRO LAVA. TORIao OIPoaO CLOP OINao LAUNDRY Tuoo URINAL() DAO1Po FLOOR DRAIN DRINK IH% FOUNT' NS TOTAL RI ;TU11[% COPoTP. LIOT CHRCR O BPTIC TANK G5W KR Ceram. DRAIN PIaLD GOA KACQ PIT GM :MOD TRAP COLAR HaAT¢R Dam" MILL OPrnma. OVOTaq OWIM •O POOL CONTR. LIOT „- CNRCa Permit No /9 s Application is hereby made for the approval of the detailed otatement of the plans and specifications herewith Dubin ted 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 aperslfied or teat. A copy of approved plans and specifications must be kept at building during progress of work. � /, 0 ,, .� Pi/LiLa,K.0 / Owners Name and Address t SI t i4 R10 / 3 �E Stn i-. -_ Registered Architect and /or Engineer Employing 1'hutal 's No AU T` G /0' N©,,.a- - Zce.,� EadS ® S .� - ..._ Location and Legal Description Lot. Blarh / 4 Subdivision..___ Street Stre and Number where work is to be perform —No � ii 6 3 9 2 ° §tre . _.._. — ..._.._._ State work to be performed and purpose of building (By Flares) New Building_ -__ _-------- ....- - - - -.. Remodeling__ ._ -_ —_ Addition Amount of Permit $ s STATE OF FLORIDA, I COUNTY OF DADE. Before me, the undersigned authority, a notary pules, to me well known, and who, being by me first duly sworn, urn cads of the above described construction, that he lem =day rwaa the therein by him stated are true. G IDANJD ONORES MDddt? © PLUMBING INSPEalOI1 DEPARTMENT APP 8 t4 OM GAO l PLUGaI116:1© P[ LQMO'' (sisima)J�L. Repairs Capacity Gab- ___ Size Septic Tank_- Type of Tank Feet of Drain Tile 5c2 Di Feat of Tank or Drain Field from @ / ell - - - -- — - - - - -- - -- - -..._ _ Nature of Water Supply: City —Well Size of Soakage Pit. Plum . : 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 3'4;, Compiled General Laws of Florida i'erinanent Suppl t com- plier with the provisions thereof, and will require similar compliance from all contractors or su actors e • ployed b - performed under this permit; and will post or cause to be posted( for inspection on the site ��e work such publi required by the Act. The undersigned agrees to employ only such sub-contractors, oso� . to be per licensed by Miami Shores Village. to administer oaths and take acknowledgments, personally appeared cc= and soya that he is the regrdasc applicatme, and that he al the same, and that all facts No. of Stories. ... Master Plumber. My Commission Enstbco h`soaasq %Mk, ate of Florida NOTE: A re-inspection foe of MO ho b lDy doe for Inspection, or faulty materials Ind /or