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PLUMBINGPERMIT APPLICATION FOR MUNICIPALITIES OF DADE COUNTY (OWNER TO RETAIN COPY) Date 08/22/91 Job Address 1260 NE 93 St. Tax Folio- /igaQc-ea7 (WO ' Legal Description 9 /97ay Master Permit # Owner / Lessee / Tenant MR. KIM STEARNS Owner's Address 1260 NE 93 ST. Contracting Co. BROOKS AMERICAN SPRINKLER CO. Qualifier State# Square Ft. VANN ELLIOTT 1418 La JI.A Signature of Owner and ondo Date: Notary ' as to`' 4 �ner and /or Condo President My Commission Expires: * * :.; *_ * * * * PERMIT FEE: APPROVED: Fire Zoning Building Mechanical Competency # Wok., My Commissit- ` 71i 22, lc ' Address 2430 N.W. 79 St. SS# Phone 691 -1182 0193 We/ Architect /Engineer Address Bonding Company Address Mortgagor Address Phone Ins. Co. Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL PAVING FENCE SIGN WORK DESCRIPTION LAWN IRRIGATION SYSTEM Estimated Cost $2,300.00 LIBERT!'Y MUTUAL 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 the above -named contractor to do tb work stated. President Signature of Contractor or Owner - Builder Date: Az/ Notary as t Contractp,r or Owner - Builder My Commiss on Expires • la4r17 Qommis *1n *. 113, Bonded Thru Tro fain . Inwranca Ind Other Electrical Engineering Permit No / Application is hereby made for the approval of the detailed statement of the plans and specifications here ith submitted for the building or other structure herein described. This application is made in compliance and conformity with the Building 0 , nance 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__, /A.CA ______ -_ /O%iNo Registered Architect and /or EnFineer Employing Plumber's Name_ _. e 0 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._._____.________ ______ Repairs No. of Stories _.....__.... : ... .__.... Size Septic Tank ....... of Tank__ Capacity Gals. Feet of Drain Tile_ Nature of Water Supply: City —Well Amount of Permit $ STATE OF FLORIDA, } COUNTY OF DADE. - - - - -_ _ —__._ _ My Commission Expires MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT 1 66'. No. Block_ � 01 6 o Dist. Feet of Tank or Drain Field from Well Date_. /,r,r Street (4/ „rig; .... .. 4 771_ Street. Subdivision - --_--:--------_ - •---- Street /V 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 perfo • under this permit, as are licensed by Miami Shores Village. ( Signed Notary Public, State of Florida r 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 SINKS LAUNDRY TUBS URINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT' NS ,... ✓ W�%I TOTAL FIXTURES CONTR. LIST / / / Id / - I � �- o CHECK / - - O- , S � �" C /�J \ SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE P IT GREASE TRAP i'iOSTL' HEATER DEEP WELL SPRKLR. SYSTEM SWIM'G POOL Corms. L. L IST q I ft) O ------__ CHECK ___56 Permit No / Application is hereby made for the approval of the detailed statement of the plans and specifications here ith submitted for the building or other structure herein described. This application is made in compliance and conformity with the Building 0 , nance 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__, /A.CA ______ -_ /O%iNo Registered Architect and /or EnFineer Employing Plumber's Name_ _. e 0 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._._____.________ ______ Repairs No. of Stories _.....__.... : ... .__.... Size Septic Tank ....... of Tank__ Capacity Gals. Feet of Drain Tile_ Nature of Water Supply: City —Well Amount of Permit $ STATE OF FLORIDA, } COUNTY OF DADE. - - - - -_ _ —__._ _ My Commission Expires MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT 1 66'. No. Block_ � 01 6 o Dist. Feet of Tank or Drain Field from Well Date_. /,r,r Street (4/ „rig; .... .. 4 771_ Street. Subdivision - --_--:--------_ - •---- Street /V 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 perfo • under this permit, as are licensed by Miami Shores Village. ( Signed Notary Public, State of Florida r 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. t I k► J Permit No /- STATE OF FLORIDA, COUNTY OF DADE. ss. 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 here vyziffh 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. /; ' Street Registered Architect and /or Engineer �:. r�,7 • �_ 1 r Employing Plumber's Name / 3 r �` t / �,c.�..:= .,. ri ______________ + Location and Legal Description Lot Street and Number where work is to be performed —No _ Street State work to be performed and purpose of building (By Floors) ¢' New Building Remodeling Addition Repairs No. of Stories Block Size Septic Tank Type of Tank Capacity Gals 1 Feet of Drain Tile /7) -- Dist. Feet of Tank or Drain Field from Well Nature of Water Suppl Well Size of Soakage Pit Amount of Permit $ ( 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 otice or notices as are required by the Act. The undersigned agrees to employ only such sub - contractors, . work to be ; rfor ped i nder this permit, as are licensed by Miami Shores Village. (Signed) Date Street Subdivision 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 aster 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 terials 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 CHECK Permit No /- STATE OF FLORIDA, COUNTY OF DADE. ss. 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 here vyziffh 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. /; ' Street Registered Architect and /or Engineer �:. r�,7 • �_ 1 r Employing Plumber's Name / 3 r �` t / �,c.�..:= .,. ri ______________ + Location and Legal Description Lot Street and Number where work is to be performed —No _ Street State work to be performed and purpose of building (By Floors) ¢' New Building Remodeling Addition Repairs No. of Stories Block Size Septic Tank Type of Tank Capacity Gals 1 Feet of Drain Tile /7) -- Dist. Feet of Tank or Drain Field from Well Nature of Water Suppl Well Size of Soakage Pit Amount of Permit $ ( 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 otice or notices as are required by the Act. The undersigned agrees to employ only such sub - contractors, . work to be ; rfor ped i nder this permit, as are licensed by Miami Shores Village. (Signed) Date Street Subdivision 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 aster 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 terials and /or workmanship. �-- CLOSETS TATS TUBE SHOWERS LAVA- TORIES SINKS SLOP SINKS LAUNDRY TUBS I NALS URINALS BASIN IN B FLOOR DRAIN NKI NO FOUNT' NS FO TOTAL F %TURE6 CONTR. LIST CHECK SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SW IM'G POOL CONYR. LIST CHECK 1:` No._ 21 ? Ce 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 Employing Plumber's Name ?L__ Location and Legal Description Lot--- __________._- __— __..._ ' __Block Street and Number where work is to be performed —No ,e►� State work to be performed and purpose of building (By Floo�rs)_1�- Y� LI__ff . New Building — ___ Remodeling__ -__ -- Addition Repairs No. of Stories. _ Size Septic Tank.--- w ___ - - - -- - - -- -- Tank__ .. I � ! • e of Feet of Drain Tile__? _- - eet of Tank or Drain Field from Well ---- -------- - - - - -- Nature of Water Supply: City— Well._______ _______________ _____Size of Soakage Pit Amount of Permit $ MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT No._— _ -_ --- - --- ____,_ -- Street_ (Signed)_ Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and acceptehis obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florid '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. Capacity Gals Date / � 1/ / Street. Subdivision Street STATE OF FLORIDA, COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared Master Ple'i 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. .. Dat ' '9 .:Job Address /2 1 e Tax Folio // D,5 7/Gy Legal Description '4 ,9 j Ar7 aiee Owner / Lessee / Tenant L i �19i -> i Zn S Master Permit 43...0Ki` Owner's Address C, /1. . 4 95 Phone /Z 75%-)./ii Contracting / Co. /'9,�1-f44W : / 0i 7JQP Address /. :? ? 4( �GCJ. W, i Qualifier �, �� ,4 4� /, - Phone -- c�3� Mortgagor Permit Type(circle one): WORK DESCRIPTION ** * * PERMIT APPLICATION FOR MIAMI SHORES VILLAGE State # � / Municipal # X9 7 Competency # Architect /EngineerU\b i . I 1?-9 Bonding Company Address Square Ft. Estimated Cost(value) P * 6 Notary as to Owner and /or Condo President My Commission Expires: l ns.Co . Address /ZVZZ Sic) - 25 Address PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN PAJC WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE 10 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 the above -named contractor to do the work stated. a ( 4,O ) Signature of owner and /or Condo President Sig azure of Cont # aEtor or Owner- Builder Date: Date: Notary as to Contractor or Owner- Builder My Commission Expires: * * * * * * * * * * * * ** FEES: PERMIT '' e)a RADON C.C. F . "4 NOTARY TOTAL DUE , I a>56 APPROVED: ' gt4 Fire Other Zoning Buildin Electrical Mechanical Plumbin:Z ' ' Engineering iviiAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Application is,hcrchy mndc for the approval of the detailed statement us Inc plans and specifications herewith submitted for the build inc or other 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. Block Su Street and Number where work is to be done.... 1 State work to be done and purpose of building (by floors). To be constructed of Kind of foundation �rL/ �l..l.!. .:T �rfTG.� D, ate..._... »...�..�.�......_ _.... _ _ .... »...19..�_ Owner's Name and Address .... „_ ,,, -_ Registered Architect and /or &.grocer ... � Q C.* ... �. r .1 v1{f(2/ Name and address of licensed contractor Location and legal description of lot to be built on: Lot / y r Permit No..__ -_ Date - .... ». -_ -_ -_ Di sapproved _...._....,....... Date. ._ ..... ......... fl,.........„,.,„, e....., . iii on. and who, being by me first duly sworn, upon oath deposes and says that he is t of the above described construction, that he has carefully read the foregoing ap on, and that he therein by him stated are rue.. .». -» and for no other purpose. New Building Remodeling Addition Repairs No. of Stories _ Roof Covering Estimated Total cost of improvements $ ,lG/i Amount of Permit Zone cubage required plan Cubage Distance .to next nearest building Size of Building Lot Miaxunum live load to be borne by each floor 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. ... 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 59G6, Compiled General Laws of Florida, Permanent Sup element, anti 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 w rk such public nonce or notices as are required by the Act. The undersigned agrees to employ only such subcoi ppctors, on work o rformed under this pcnnit, as are licensed by Miami Shores Village. Rem arks...„ _. -.» - .- .------- _-. »-- _-- .__ -_— (Signed). STATE OF FLORIDA, COUNTY OF DADE. ss. Before me, the'/` u ndersigned authority. a�nol public, duly authorized to administer o the d take acknowledgments. personally ap- peared .....L.J / th `�...T �A /7it�l"� / V---- _ --- / to me weU known. s and the,►, alit facts Notary Pu ic St (Signed) 1461 P LI STATE . il, Building Inspector My Commission Expires MY COMMISSION EXP SCPT. ?7 MEET Tfaira.1PI'R1{t"'I'FT S . UND. PLANNING BOARD DATE Chair ...... _ ... _- .._.._- ..._ ..... .- Member MIcrr,ber _ Member Sfcmbcr .. ••••••••• ...... ........_......_ .... » Member — _....._....»..... ......._ ... _ Council Approved Date Disapproved Date NOTE: A charge of $l.00 will be mode for making corrections or changes to this application after approval has been obtained from the I'Lutnir,g Board. A re.in.pec•tion fee of 31.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials anti /or workmanship. 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 ia 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 or ces of Miami Shores Village and all rules and regulations of the Building Division of. Miami Shores Village shall be complied with, whether specified or not. A Dopy of approved plans and specifications must be kept at building during progress of work. i Owners Name and Address/el t r Registered Architect and /or En ' Employing Plumbers Name L i♦ No..�� ss� __..._ p �....�....... Yttwt_I Location and Legal Description Lot B10 # Subdlvlalon. Street and Number where work is to be performed -No -22(40...-22(40..._ �� Street. State work to be performed and purpose of building (By Floors)__._ Amount of Permit $ STATE OF FLORIDA. w. COUNTY OF DADE. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT New Building. ._..._._._.._...... ...._.. Remodeling..__ __._.__ Addition. 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. Size of Soakage Pit. (Signed)_ Plumbing ingpector. 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 5989, Compiled General Laws of Florida Permanent Supplement, and h„Y com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the weer 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 such sub- contractors, on work to be performed under this perinit,1 as are Loensed by Miami Shores Village. (Slimed) Before me, the undersigned authority, a notary public, duly authorised to administer oaths an take lodgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and says of the above described construction, that he bas carefully. read the foregoing therein by him stated are true. NOTARY PUBLIC STATE OF FLORIDA t EXP ieltis 7,1994 jtis. UNO• No , Vel - , ✓ & Street 29c3' ' is the ._ that the ...____ Capacity Cols of Florida Master Plumber. that Rll facts NOTE: A materiels and/or wroc re-inspection fee of 41.00 will be made whoa snob in ispsottaa Is mede by ., . - wit, ( ' t or fealty CLOtrre BATH Tint ""1" LAVA. TORItt S SLOP fINKs LAUNDRY Tuts URINAL/ CATCH BASIN FLOOR DRAIN DRINKING FOUNY'NI TOYAL /IltuRee CO NTR. LIST - _-.___ CHICK I BIPTIC TANK BIWtR CONN. DRAIN PIILD SOAKAOI PIT G TRAP SOLAR H DIV WILL (PRRLR. SYSTEM •WIN', POOL I Co,TK. LIST - _ --- CHICK I 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 ia 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 or ces of Miami Shores Village and all rules and regulations of the Building Division of. Miami Shores Village shall be complied with, whether specified or not. A Dopy of approved plans and specifications must be kept at building during progress of work. i Owners Name and Address/el t r Registered Architect and /or En ' Employing Plumbers Name L i♦ No..�� ss� __..._ p �....�....... Yttwt_I Location and Legal Description Lot B10 # Subdlvlalon. Street and Number where work is to be performed -No -22(40...-22(40..._ �� Street. State work to be performed and purpose of building (By Floors)__._ Amount of Permit $ STATE OF FLORIDA. w. COUNTY OF DADE. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT New Building. ._..._._._.._...... ...._.. Remodeling..__ __._.__ Addition. 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. Size of Soakage Pit. (Signed)_ Plumbing ingpector. 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 5989, Compiled General Laws of Florida Permanent Supplement, and h„Y com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the weer 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 such sub- contractors, on work to be performed under this perinit,1 as are Loensed by Miami Shores Village. (Slimed) Before me, the undersigned authority, a notary public, duly authorised to administer oaths an take lodgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and says of the above described construction, that he bas carefully. read the foregoing therein by him stated are true. NOTARY PUBLIC STATE OF FLORIDA t EXP ieltis 7,1994 jtis. UNO• No , Vel - , ✓ & Street 29c3' ' is the ._ that the ...____ Capacity Cols of Florida Master Plumber. that Rll facts NOTE: A materiels and/or wroc re-inspection fee of 41.00 will be made whoa snob in ispsottaa Is mede by ., . - wit, ( ' t or fealty ;er%7 -:: . ;f +y'� :Z S x �t +�; � :r 3 _ t .:.:.. • 'i� .' :' . .1 ^.'.'n _ .. /•`;_. ^.. �� r'y�F. ...i•� ,'r.1... -r f '- tl•..i � ` - P j• . �'Y! - • ! T y' rt j . .'4r ,;y f ? 4 ✓ R •, .. ::i . • i , IyF 'F.A--. c a ,. - ^y ti y > :-a: •1 •i l Vi P •.� "::,/ � n?! *. S ' y�"p� .fs ?rte. 3 s7:s••..y. 11 w: V . iii mss } ' "5• *o.: .. t 11. 3r. i • • �''"` 4.•T''= •�, 4S ' 1 KJ^• Pi /E .1:1 Ld o. 73 vas. /S oS ; 1 4. 49-(/' ro cef ,do x /260 .f/E 92 `-•a <' oa• /3 G S SKETCH OF SURVEY c.•Vc fb 0 5 5 .20. 75 / /o 7. .7- 0 t.KO..v L /.vim ••c:E - 7- 7 o 9a• /low AWE 2.0 • •A/ c..✓E SCALE: 1' - 20 Date J/ffr Miami Shores Village Building and Zoning Department Attention: Building Official SWIMMING POOL ,OWNER' S_ CERTI Fl CATION I certify that I am the legal owner of the property described as 49 cO(/ z. B,� , located at I2 /the 9 3 In accordance with Section 33- 12(f), Code of Metropolitan Dade County, I certify that I understand and agree that the swimming pool to be constructed at the above address cannot be used or filled with water until a separate permit has been obtained for an approved safety barrier, and such barrier erected, inspected and approved. I further understand that this certification, however, does not eliminate the need for obtaining a permit and erecting an approved barrier prior to final inspection and use of the pool. legal Owne Note: This certification is to be submitted with a swimming pool permit application in duplicate. ELECTRICAL TYPE - Minimum Fee - . QTY. TYPE - Dryer - - -- QTY. 'TYPE Outlet, Appliance._ _ QTY. - _ TYPE Service Repair QTY. A/C Central 1 -3 Ton Fan Outlet, Wall Service, Temporary A/C Central 4 -7 Ton Fire Pump Outlet, Switch Signs A/C Central 8 -15 Ton Fixture - Fluorescent Oven Space Heater (kw) A/C Central 16-20 Ton Fixture Light Parking Lot Lights Spas/Hot Tubs A/C Central 20+ Ton Flood Lights Plugmold/Strip - Subfeeds, No. of Amps A/C Window FPL - Load Central Posts Swim Pool, Commercial Air Conditioners Garbage Disposal Range/Range Top Swim Pool, Residential Chiller Generators, etc. Receptacles Switchboards Clear Violations Heat Recovery Refrigerator, Comm. (p/PH) Temp Serv., Construction Compactor Low -volt, Burglar Refrigerator, Domestic Temp for Test - 30 days Deep Freezer Low -volt, Fire Renew - Temp Service Water Closet Demolition Low -volt, Intercom/Teleph. Repair Circuits X Water Heater Dishwasher Low -volt, Television Service, Number of Amps Water Heater New MECHANICAL TYPE Minimum Fee Q1'1'. TYPE Condensate Drain QTY. 'TYPE Generator QTY. TYPE Refrigeration, Tons QT Y. A/C Central, Tons Cooling Tower Heating Strips, each Vent Hood, Cost A/C Wall/Win. Tons Dryer Vents, Number of Paint Booth Ventilation, Cost Air Handler, Tons Ductwork, Cost of Piping, Flammable Liquid Periodic Inspections Barbecue Fire Sprinkler System Process/Pressure Piping Supply, AC Well Bath Fan - Vented, # Fireplaces, Number of Pressure Vessel - Temporary Toilet PLUMBING TYPE A/C Condensate QTY. TYPE Drains, Roof QTY. TYPE Miscellaneous Fixture QTY. TYPE. Soakage Pit QTY. Bath Tub Drinking Fountain Miscellaneous Repairs Solar Water Heater Bidet Filter Replace Pool Piping Sprinkler Repair Cap - Fixture Fountain Pump and Abandon Sprinkler System Cap - Water Gas - Appliance Pump, Domestic Supply, AC Well Cap - Sewer Gas - Natural Pump, Fire Stand Temporary Toilet Catch Basin Gas - Propane Pump, Re- circulate Temporary Water Closet Clothes Washer Gas Piping Pump, Replace - Pool Urinal Dental Chair Grease Trap Pump, Sprinkler Utility - Sewer Discharge Well Ice Maker Pump, Sump Utility - Water Dishwasher Indirect Wastes Relay Repair Vacuum Pump Disposal Interceptor Roof Inlet Water Closet Domestic Well Laundry Tray Septic Connection X Water Heater Drainfield, 4" Tile/Res. Lavatory Septic Tank Water Heater New Drains, Area Meter Set (Gas) Sewer Connection Water Re -pipe Drains, Floor Minimum Fee Shower Water Service Drains, French Miscellaneous Equipment Sink Well, Supply Page 2 IMPORTANT NOTICES 1. DO NOT BEGIN ANY WORK WITHOUT HAVING RECEIVED YOUR VALIDATED PERMIT AND PERMIT CARD. Applying for a permit does not grant the right to begin construction. HOURS OF CONSTRUCTION are limited to: Monday through Friday from 7:30 a.m. to 6:00 p.m., and Saturday from 8:00 a.m. to 5:00 p.m. No inspections will be conducted on weekends or holidays. 2. All construction of demolition areas MUST BE MAINTAINED IN A CLEAN, NEAT AND SANITARY CONDITION free from construction debris. 3. STREETS AND NEIGHBORING PROPERTIES SHALL BE KEPT FREE FROM DIRT AND DEBRIS. 4. SWALES MUST BE PROTECTED FROM -BEING DAMAGED BY EQUIPMENT OR VEHICLES, AND_MAY_NOT BE USED_FOR- STORAGE._A.bond is required for work in or near the street/sidewalk. 5. CONSTRUCTION TRAILERS ARE PROHIBITED ON SINGLE FAMILY RESIDENTIAL CONSTRUCTION SITES. Other construction may have a trailer which requires a separate permit. 6. PORTABLE TOILETS for a construction site require a separate permit. 7. DO NOT DISCHARGE WATER INTO THE RIGHT OF WAY OR STORM DRAINS without approval from the Building, Planning and Zoning Department. 8. EQUIPMENT AND MATERIALS SHALL BE STORED at least 10 feet from the edge of pavement. 9. Department of Health and Rehabilitative Services (HRS) approval is required for applications involving septic tanks. Department of Environmental Resources Management (DERM) and/or Miami -Dade Water and Sewer Department (MDWASD) approval is required for applications involving sewers. AFFIDAVIT - Please read carefully. Application is hereby made to obtain a permit to do work and installation as indicated. I, the OWNER of the property, 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, POOL, EXTERIOR DOOR, MECHANICAL, WINDOW, FENCE, DRIVEWAY, ROOFING and SIGNS and there may be additional permits required from other governmental agencies. I, the OWNER of the property, have disclosed all information related to any work at the property performed in the prior twelve months to the Building Official. Further, I am fully aware that if the cumulative cost of work to my home or business under this and any other permit equals or exceeds fifty percent (50 %) of the fair market value of the structure, the entire structure must meet the present federal flood criteria for finished floor elevation. I am also fully aware that if the total cost of work to my home or business under this and any other permit exceeds fifty percent (50 %) of the replacement cost of the structure, then the entire structure must conform to the current code requirements of the Building Code. WARNING TO OWNER: Your failure to record a NOTICE OF COMMENCEMENT may result in you paying twice for improvements to your property. If you are spending more than $2,500 or intend to obtain financing, you may wish to consult with your attorney or lender before recording your Notice of Commencement. The Notice of Commencement must be recorded at: 22 N.W. 1st Street, lt' Floor, (305) 679 -1078. Once recorded, the Notice of Commencement must be POSTED AT THE JOB SITE in accordance with Section 713 -35 of Florida Statutes. Review the brochure at Village Hall on Construction Lien Law and Choosing a Contractor. E OF - 0 . COUNTY OF MIAMI -DADE I ?r 3 L icipcL ?£- Gr))7-OAJ I JL AJ C & JE Signature of Owner Print Name So ubscribed before me this Signature of Notary SEAL: ff f da o OEP #3`4 c - State -of Florida p : Be c LESTER E CROCKETT * MY COMMISSION # DD 014762 EXPIRES: May 20, 2005 uu Budget Notary Services Personally known Type of Identification Produced: PERMIT APPLICATION STATE ,F FLORIDA, OUNTY OF IAMI Si • ature of Contractor / • ualifier r re-A leb Li JJ t) c� Print Name Sw.r t.. • • subscribed before me this o 97fday of Signature of No SEAL: LESTER E. CROCKETT MY COMMISSION # DD 014762 EXPIRES: May 20, 2005 ,o¢� Bonded Thru Budget Notary Services Personally known Type of Identification Produced: Page 3 PERMIT APPLICATION INSTRUCTIONS: Please indicate the type of work being performed and quantity(ies) in the space provided below. RECEIVED AND REVIEWED BY: DATE: CONTRACTOR P R.0 N 7 p New Construction G � . Name t g�' / ,. u& u r - Address .jE9 -A9 4J i_260 ,vz 9 r m )ov 0/-40 ` 5--- F.L. 3-3)3 License o. c - c 6 67 7 5 , Repair Address 1 .- L. / Z 5 --- , ii p N , iv n fi 4 / rt.. I9- - ' } 3 /b/ Telephone _ U r?5Z - 2 z _nrx- Relocation of Structure Shell Only Qualifier Name t Q 6 R D w 1) 6 c: t, ! -i- PROPERTY OWNER New Construction // Name mCNA 7'QSt/2ZCAJ1 Enclosure Address .jE9 -A9 4J i_260 ,vz 9 r m )ov 0/-40 ` 5--- F.L. 3-3)3 i94h/ Home Telephone 3,,, t- �/s, / q, / t , L `f Repair Business Telephone ^ GL - 4L4 i (5,„, // ` Alteration Interior Fax cSMLC Demolish TYPE OF MANAGEMENT (1 ) New Construction Enclosure Alteration Exterior Repair 2\ Alteration Interior Demolish Relocation of Structure Shell Only Foundation Only Add'l Attachment Other Add'l 'I etachment Other Page 4 OFFICE USE ONLY • OWNER - BUILDER FORM (Attach) U FIRE DEPARTMENT APPROVAL (Commercial / multi - family) • CONCURRENCY (New Construction) U OTHER (Specify & Attach) • PROOF OF OWNERSHIP (Attach) • HRS / DERM APPROVAL (Septic / Sewer) U IMPACT FEE (New Construction) U OTHER (Specify & Attach) P FIR IViIT'PEES $3.00 per page (Scanning Fee) $ Miami Shores Village Bond Metropolitan Dade County (C.C.F.) $ Inspector State Educational Fund $ State DCA (Radon) $ Code Enforcement Fine $ Zoning Review $ ZLLop SECTION Zoning Electrical Mechanical Plumbing Fire Public Works Structural Building Official BY DATE ( sq.ft. = x/1000 x ¢.60) (¢.005 /sq.ft.) (¢.01 / sq.ft.) REVIEWED AND PREPARED BY: PERMIT APPLICATION U CONDO ASSOCIATION APPROVAL (Attach) • BPR APPROVAL (Restaurants) U CONTRACTOR REGISTRATION (On File) TOTAL $ OFFICIAL DATE: COND_I_T_I_O.N =OF A Revised July 2001 10050 N.E. 2"`D AVE., MIAMI SHORES, FL m (305) 795 -2207 FAX (305) 756 -8972 0 http:/ /www.miamishoresvillage.com • 1NS-TRU T-10NS ,lie4olloit ng stepsxriust• Perin f fron__:>I ,e.'i .114-011.-S hores Vlll' g Step I. Step 2. Submit the completed application with all necessary documents to the Building, Planning and Zoning Department for processing. During the processing of your application, you may be asked to submit additional information. Folio Numbes Q/�. T om�(( 0� Lot Block c G Subdivision ' ,r! LJZC PB PG : &- /rAJTiCJL Current Use of Property Address Proposed Use of Property 457; Tenant Information PERMIT TYPE (J ) ]Building Electrical oofing Fence Other Address Fax Apt. PERMIT CHANGE (1 ) Chg. Contractor Renewal Revision Extension Supplement Reinspection ARCHITECT Name License No. Telephone Description •f Work Zoning Square Feet Value of Work Master Permit No. Subsidiary Permit No. t 1 �� Complete the attached permit application which must be signed by the property owner and qualifier. Both signatures must be notarized. Please print or type to allow for a more accurate processing of your application. If roofing work will be done, a roofing application must be submitted along with this permit application. City Fax State / / PERMIT APPLICATION 5 313 Zip ) IN - C.v - Linear Feet Units Floors Tax Assessed/Appraised Value Flood Zone Base Floor Elev. Bldg Value ENGINEER Name License No. Address Telephone