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357 NE 92 St (6)3a S PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date 71 01 01 Job Address aS1 NE 92 Si- Tax Folio 1% –32 (1.- ( . )13-- 6 3 '7 o _____ Legal Description L4 19 4- 20 BI k v/0,1 t Iistorically Designated: Yes No Owner/Lessee / Tenant f20 410i ( r i u Master Permit # '/ 9r 9 357 N C 0 1 2 e-f- / MS 33) 38 Owner's Address Contracting Co. 5ep"r C C Qualifier e/tEgyA. SO L° M '9913 State # 096v ? - 7 8 Municipal # Competency # Ins. Co. NO L+ ") 41 --P Architect/Engineer X' Address Bonding Company x Address Mortgagor k Address Permit Type (circle one): BUILDING ELECTRICAL RJMB MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION Square Ft. 4 4.) o 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. F , I authorize the above -named contractor to do the work stated. re of owner and/or Condo ' ent 3oQvn. _ ►, �► Notary My Co + -#t 3NOTARY Fla tER a J, SOLOMON tdYdt&WINMIONie ®gD&e xpire X ' = '61' i 6-, $i)O3 FEES: PERMIT COO RADON INSSA -LL.. D )ii ■ Iel ZW ipolo r O C.C.F. SS# Phone (3oS) 759— 1 Address P 1301 ?jg LS t (4vIQ (f C 3o k3 `/° hone C30S) G6/ -6 633 Estimated Cost (value) Q')0 on NOTARY r BOND ? eo APPROVED: TOTAL DUE Zoning Building Electrical Mechanical Plumbing I 1�>k �� Structural Engineer D R A I N I E L D 0 T H E R CO STRUCTION PERMIT FOR: [ New System Repair APPLICANT: PROPERTY ADDRESS: [ ® ] SQUARE FEET [ ] SQUARE FEET TYPE SYSTEM: CONFIGURATION: LOT: 17 41 BLOCK: 4 L 7 SUBDIVISIO ( L / /2 ' . G� , / [SECTION, TOWNSHIP, RANGE, PARCEL NUMBER] ' PROPERTY ID #: Ol - 3 Z °G — ( .3 /e) [OR TAX ID NUMBER] SYSTEM MUST BE CONSTRUCTED IN ACCORDANCE WITH SPECIFICATIONS AND STANDARDS OF SECTION 381.0065, F.S., AND CHAPTER 64E-6, F.A.C. DEPARTMENT APPROVAL OF SYSTEM DOES NOT GUARANTEE SAFTISFACTORY PERFORMANCE FOR ANY SPECIFIC PERIOD OF TIME. ANY CHANGE IN MATERIAL FACTS, WHICH SERVED AS A • FOR ISSUANCE OF THIS PERMIT, REQUIRE THE APPLICANT TO MODIFY THE PERMIT APPLICATION. SUCH MODIFICATIONS MAY RESULT IN THIS PERMIT BEING MADE NULL AND VOID. ISSUANCE OF THIS PERMIT DOES NOT EXEMPT THE APPLICANT FROM COMPLIANCE WITH OTHER FEDERAL, STATE, OR LOCAL PERMITTING REQUIRED FOR DEVELOPMENT OF THIS PROPERTY. SYSTEM DESIGN AND SPECIIFIC —. T [/I�ir] GALLONS / GPDEMPAEROBIC UNIT A [ ] GALLONS / GPD N [ ] GALLONS GREASE INTERCEPTOR CAPACITY K [ ] GALLONS DOSING TANK CAPACITY [ FILL REQUIRED:. [ 0 le SPECIFICATIONS BY: APPROVED BY: DATE ISSUED: DH 4016, STATE OF FLORIDA DEPARTMENT OF HEALTH ONSITE SEWAGE TREATMENT AND .DIS CONSTRUCTION PERMIT Existing System [IJ Holding Tank Abandonment [/(,) Temporary 0,ei (Ja ?olor-16 N.3S N e 7407" PRIMARY DRAINFI LD SYSTEM SYSTEM [ FILLED [7.4 BED STANARD TRENCH LOCATION OF BENCHMARK: ELEVATION OF PROPOSED SYSTEM SITE [o`. BOTTOM OF DRAINFIELD TO BE (.3 /] INCHES EXCAVATION ®O la...„ [INCHES/ [INCHES/ TITLE: ci“) 'i16 94150 CAPACITY MULTI- CHAMBERED /IN- SERIES [ ] CAPACITY MULTI- CHAMBERED /IN- SERIES [ ] [MAXIMUM CAPACITY SINGLE TANK: 1250 GALLONS] GALLONS @ [ ] DOSES PER 24 HRS # PUMPS [ ] , r1fIR c■r?r c anq c-n n��rp Cnnnn p 7,7 , — ...,. 12/99 (Page 1) (Prev i i*s l$ditions „May He, Used)J SYSTEM MOUND VI; 1 [ABOVE/ [ABOVE/ ] REQUIRED: [ / % ] INCHES INSI ALL t O'''..i::,' . r "APSE SAND • I: AINFIELD UNDER 6OTi C)iv. + ,, SUMMIT BEN ' -IMARK BEt C: ° L irvE TN) THIS pt= RwT IS NOT Fcli ° ERT ELEVATION �- BOTTOM OF DRAINI-II.D ELEVATION- AeSpalp TITLEIN!/: !! i rte'. &J4. 1. EXPIRATION DATE: pt. 1: Health Department pt. 2: Applicant pt. 3: Installer /Contractor pt. 4: Building Department PERMIT NO. Q joiC _ de 30- DATE PAID: 7 3O _ D# FEE PAID: 75- o4 RECEIPT #: 39 / D# 3 . 017 ¢ 8 77 vep BENCHMARK /REFERENCE POINT ENCHMARK /REFERENCE POINT Page 1 of 3 INSTRUCTIONS: PERMIT NUMBER: CONSTRUCTION PERMIT FOR: SYSTEM DESIGN AND SPECIIFIICATIONS: Permit tracking number assigned by CPHU. 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, SUBDIVIISION or PROPERTY ID #: 27 character id number for property. (CHD may require property appraiser ID # or section /to wnship /range /parcel number) TANK: Minimum specifications from Chapter 64E-6, FAC. DRAIINFIELD: Minimum specifications from Chapter 64E-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 (CHD) personnel reviewing and approving permit. DATE ISSUED: Date permit is issued by CHD 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. Notes: Scale: Each block represents 10 feet and 1 inch = 40 feet. Site Plan submitted by Plan Approved By C r " STATE OF FLORIDA DEPARTMENT OF HEALTH APPLICATION FOR ONSITE SEWAGE DISPOSAL SYSTEM CONSTRUCTION PERMIT ' _r g . Permit Application Nu n opt e % t�? d k S-em . 1 • PART II - SITEPLAN q2 ;V . 27)•••, ISTOVrOR N tpproved Date — 11 0 101 j.'466ty Health Department ALL CHAN a ES MUST BE APPROVED BY THE COUNTY HEALTH DEPARTMENT DH 4015, 10/96 (Replaces HRS -H Form 015 which may be used) (Stock Number: 5744 - 002 - 4015 -6) Page 2 of 4 STATE OF FLORIDA DEPARTMENT OF HEALTH ONSITE SEWAGE DISPOSAL SYSTEM SITE EVALUATION AND SYSTEM SPECIFICATIONS .APPLICANT: . ` Rods I3 tl no d AGENT: LOT: Vg 4 20 BLOCK: 41 s( 1 SUBDIVISION: MNOrP �, At , -‘d 3� 1 Ad / PROP ID #: "� ( Section /Township /Range /Parce1No.fo>r: TazID Number) 3si s.E cia 3$ 3S1 TO BE COMPLETED BY ENGINEER, HEALTH UNIT EMPLOYEE, OR OTHER QUALIFIED PERSON. ENGINEER'S MUST PROVIDE REGISTRATION NUMBER AND SIGN AND SEAL EACH PAGE OF SUBMITTAL. COMPLETE ALL ITEMS. PROPERTY SIZE CONFORMS TO SITE PLAN: (X] YES [ ] NO NET USABLE AREA AVAILABLE: - ACRES TOTAL ESTIMATED SEWAGE FLOW: 400 GALLONS PER DAY [RESIDENCES -TABLE 1 / OTHER -TABLE 2) AUTHORIZED SEWAGE FLOW: ` r2 0 GALLONS PER DAY (1500 GPD /ACRE OR 2500 GPD /ACRE) UNOBSTRUCTED AREA AVAILABLE: <RCM SQFT UNOBSTRUCTED AREA REQUIRED: 4O0 SQFT CITE EVALUATED BY �•�.3 ' SOIL PROFILE INFORMATION SITE 1 Munsell /Color Texture Depth Pl (i S 1 GQ. 1 LAA f ,(`AN0 co to -72) /! to to t0 USDA SOIL SERIES: L4RbA to to to t0 to, +olaces HRS -H Form 4015 [Pape 3J which may be used) n03- 4015 -1) , R aJor(\-0--- 1 BENCHMARK /REFERENCE POINT LOCATION: Ffe Y ELEVATION OF PROPOSED SYSTEM SITE IS ( 2-4.- [INCHES/ ) [ABOVE/ E O ] BENCHMARK /REFERENCE POINT THE MINIMUM SETBACK WHICH CAN BE MAINTAINED FROM THE PROPOSED SYSTEM TO THE FOLLOWING FEATURES: SURFACE WATER: NA FT DITCHES /SWALES: NA FT NORMALLY WET? [ ] YES kr , NO WELLS: PUBLIC: N.Pe FT LIMITED USE: NA FT PRIVATE: N f FT NON- POTABLE: pjA FT BUILDING FOUNDATIONS: FT PROPERTY LINES: 5 FT POTABLE WATER LINES: 7; FT SITE SUBJECT TO FREQUENT FLOODING: [ ] YES [ ) NO 10 YEAR FLOODING? [ ] YES 0 NO n 10 YEAR FLOOD ELEVATION FOR SITE: FT MSL /NGVD SITE ELEVATION: "I FT MSL /NGVD SOIL PROF %LE INFORMATION SITE 2 Munsell # /Color Texture Depth 101(2. -SIb P40 to 1a to t0 t0 to t0 to t0 to USDA SOIL SERIES (, �{�t►a�l,6►.i3 PERMIT ,# LJ l! )-y? 7 3) Cot'1neckomc h-t i f OBSERVED WATER TABLE: P1t^ INCHES [ABOVE / ] EXISTING GRADE. TYPE: PERCHED / AREALENT] ESTIMATED WET SEASON WATER TABLE ELEVATION: tnq INCHES [ ABOVE / LO ] EXISTING GRADE. HIGH WATER TABLE VEGETATION: [ ] YES N] NO MOTTLING: [ J YES (- NO DEPTH: )J 6 INCHES SOIL TEXTURE /LOADING RATE FOR SYSTEM SIZING: t DEPTH OF EXCAVATION: 24 INCHES DRAINFIELD CONFIGURATION: [ J TRENCH [ 1(J BED ( ] OTHER (SPECIFY) REMARKS /ADDITIONAL CRITERIA: DATE: Page 3 of 3 INSTRUCTIONS: PERMIT NUMBER: Permit tracking number by County Health Department. APPLICANT: Property owner's full name. AGENT: Property owner's legally authorized representative. LOT, BLOCK, SUBDIVISION: Lot, block, and subdivision for lot. PROPERTY ID NUMBER: 27 character number for property (property appraiser ID number or section /township /range /parcel number). PROPERTY SIZE: Check if property at site conforms to submitted site plan. Record net usable area available - lot area exclusive of all paved areas and prepared road beds within public rights -of -way or easements and exclusive of streams, lakes, normally wet drainage ditches, marshes, or other such bodies of water. SEWAGE FLOW: UNOBSTRUCTED AREA: Record the estimated sewage flow for the establishment from Table 1 (residence) or Table 2 (non - residential), Chapter 10D -6, FAC. Record the authorized sewage flow for the lot based on net usable area and water supply (1500 gallons per day per acre for private water supplies and 2500 gpd per acre for public water supplies). If authorized sewage flow does not equal or exceed the estimated sewage flow, the application must be denied. Record the square feet of unobstructed area available and the amount required. Unobstructed area must be at least 2 times as large as the drainfield absorption area and at least 75 percent of the unobstructed area must meet minimum setbacks in Chapter I0D -6, FAC. The unobstructed area must be contiguous to the drainfield. BENCHMARK INFORMATION: Record the location of the benchmark. If using a surveyor's benchmark record the actual elevation. Record the elevation of the proposed system site in relation (above or below) to the benchmark. MINIMUM SETBACKS: Record minimum setbacks which can be meet to all listed features. Actual measurements must be recorded or "NA" for nonapplicable features. Features on site plan or within 75 feet of the applicant lot must be measured. The location of any public drinking well within 200 feet of the applicant's lot must also be verified. FLOOD INFORMATION: Record information on lot's subject to flooding. For Tots subject to flooding record 10 year flood elevation for site and actual site elevation. SOIL PROFILE INFORMATION: Two soil profiles within the proposed absorption area to a minimum depth of 6 feet or refusal are required. Soil identification will use USDA Soil Classification methodology (Munsell colors and USDA soil textures). Refusals must be clearly documented. Provide USDA soil series if available, record "UNK" if the series cannot be determined. WATER TABLE: Record the depth of the observed water table at the time of the evaluation. Mark "perched" or "apparent" as appropriate. Record the estimated wet season water table elevation based on site evaluation, USDA soil maps, and historical information. Indicate if there is high water table vegetation present. Indicate if mottling is present and depth. SOIL TEXTURE: Record soil texture or loading rate for system sizing. DEPTH OF EXCAVATION: If applicable record depth of excavation required. Record "NA" if not applicable. DRAINFIELD CONFIGURATION: Check drainfield configuration required. If other, specify type. ADDITIONAL CRITERIA: Record any additional remarks pertinent to site or installation. Ex. dosing required. SITE EVALUATED BY: Signature of evaluator, title, and date of evaluation. Professional engineers must seal all documents submitted. ELEVATION WORKSHEET ELEVATION OF BENCHMARK / REFERENCE POINT IS: BENCHMARK SITE 1 SITE 2 SITE 3 [ + ] SHOT H.I. H.I. H.I. H.I. [ - ] SHOT [ - ]SHOT [ - ]SHOT ,pc? i + y �o d Date Legal Description Historically Designated: Yes /�� J� Master Permit # Owner's Address 3S . L • - J Phone Owner/Lessee / Tenant ©( W N Il) 0 p-- Contracting Co. 60A A f ( A cF- Pan e Qualifier aT' ed< Phone Competency # Ins. Co. Architect/Engineer Address Bonding Company Address Mortgagor Address State # WORK DESCRIP'T'ION PERMIT APPLICATION FOR MIAMI SHORES VILLAGE CS Job Address ' 1 Pi , C • q ' �— M r Tax Folio Municipal # Permit Type (circle one): BUILDING ELECTRICAL ' LUMBING MECHANICAL ROOFING PAVING FENCE SIGN Square Ft lad 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 the work stated. *." -,j4u,, 6( &frvirok- L ao-i , 9c - i gnature of owner and/or Condo President Date o gsb SAL NOTARY SEAL O 1 SANDRA PA MONTIEL 2 c * COMMISSION NUMBE6: N '•+ 'r CC401261 9 � � o`' �� M G. O ° FEES: PERMIT RADON Date APPROVED: Zoning Building Mechanical Plumbing Address Estimated Cost (value) AaCrer sic M } I l$S1e li. NOTAR SEAL O <i SANDRA M MONTIEL 2 Ir * COMMISSION NUMBER %i� ., Q CC401261 MY COMMISSION EXP. OF F■ A 4 . 9 . 6 s Electrical No 7798 Signature of Contractor or Owner- Builder Date otary as to Contractor or Owner- Builder Date C.C.F. � - NOTARY5 ®' TOTAL DUE q l Engineering APPLICATION FOR: [) New System 1.2 „h Existing System [, Holding Tank 0] Temporary /Experimental [] Repair ( Abandonment [ ,)] Other(Specify) PLICANT: "' AGENT: z //f7p._, /hrej.iiipie9 MAILING ADDRESS: TO BE COMPLETED BY APPLICANT OR APPLICANT'S AUTHORIZED AGENT. ATTACH BUILDING PLAN AND TO -SCALE SITE PLAN SHOWING PERTINENT FEATURES REQUIRED BY CHAPTER 10D -6, FLORIDA ADMINISTRATIVE CODE. PROPERTY INFORMATION [IF LOT IS NOT IN A RECORDED SUBDIVISION, ATTACH LEGAL DESCRIPTION OR DEED] LOT: / �J BLOCK: PROPERTY GP I D #: STATE OF FLORIDA DEPARTMENT OF HEALTH AND REHABILITATIVE SERVICES ONSITE SEWAGE DISPOSAL SYSTEM APPLICATION FOR CONSTRUCTION PERMIT Authority: Chapter 381, FS & Chapter 10D -6, FAC 9 5 K PERMIT # DATE PAID FEE PAID $ 4) RECEIPT # * TELEPHONE: 1 ? 3777 , SUBDIVISION: DATE OF A ti4e g jdr [Section /Township /Range /Parcel No.] ZONING: SUBDIVISION:{ / - :2 PROPERTY SIZE: p ACRES [Sqft /43560] PROPERTY WATER SUPPLY: [ ] PRIVATE [ PUBLIC PROPERTY STREET ADDRESS: DIRECTIONS TO PROPERTY: j l / . S� Q�e5 BUILDING INFORMATION Unit Type of No Establishment 1 2 3 4 1(069,- [1f] RESIDENTIAL No. of Bedrooms 3 Building # Persons Area Sgft Served [ ] Garbage Grinders /Disposals [ ] Spas /Hot Tubs [ ] COMMERCIAL Business Activity For Commercial Only [ ] Floor /Equipment Drains [ ] Ultra -low Volume Flush Toilets [ ] Other (Specify) APPL I CANT ' S SIGNATURE: ��) , � e ., DATE: -- -' p -i 5 HRS -H Form 4015, Mar 92 (Obsoletes previous editions which may not be used) (Stock Number: 5744 - 001 - 4015 -1) Page 1 of 3 INSTRUCTIONS: APPLICATION FOR: APPLICANT: TELEPHONE: AGENT: MAILING ADDRESS: LOT, BLOCK, SUBDIVISION:, , ;DATE 07 SUBDIVISION: 57:Z.c: C F� A:):713.,SS: Check type of permit, if Other specify type in blank. Property owner's full name. Telephone number for applicant or agent. Property owner's legally authorized representative. P.O. box or street, city, state and zip code mailing address for applicant or agent. Lot, block, and subdivision for lot (recorded or unrecorded subdivision). If lot is not in a recorded subdivision, a copy of the lot legal description or deed must be attached. Official date of subdivision recorded in county plat books (month /day /year) date lot originally recorded. Dividing an approved lot into two or more parcels for the purpose of conveying ownership shall be considered c subdivision of the lot. 27 character number for property. (CI?L'11 may require property appraiser ID 1) or c ctionJtownship /range /parcel number. Net usable area of property in acres (eqt ":a footage divided by 43,560 atzuam feet) c:tsei_trive of all paved areas and prepared road beds within public rights -of way or eases eats and exclusive of streams, lakes, no ~.a.'.!y wet drainage ditches, marshes, or other suck:. bodies of water. Contipv.ovn unpaved and noncompacted road rights-of-way -x; ^:;c' aente with no subsurface obstructions may be included in calculating lot area. Chec ?t private or public. Street address for property. For lots without an assigned street address, indicate a ::,: ;: or _Deck aid lace1e in county. provide detailed instructions to lot or attach an area map showing lot location. :N':= 02iV_lA3 ":ON: Check residential or commercial. ' ?:a " ^.:3 :S i, !:3NT: List type of establishment from Table 5, Chapmx 10Y -6, =AC. Examples: sing) : f':: .i ;5, =r g!c wif.:o mobile home, restaurant, doctor's office. Count all rooms designed primarily for sleeping and those areas expected to routinely provide sleeping accommodations for occupants. :. ".....3la: Total square footage of ene'osed habitable area of dwell■ng unit, excluding garage 'r.:';c,_, e:resior storage shed, or open or fully screened patios or decks. I3csed on outside measurements for each story of strze._ i_ r5: -. J`ir__r€rt, 2 persons per bedroom cm ^Or commercial applications oily. List naie%Jer of employees, allins, anti .Aura c° , or other :n''o rc?,'0n iequired by Tabl€ Y., Chapter 10D-6, FAC. • !: Mark each listed fixture with number installed or "NA" if not applicable. Number of persons residing, vsi ^g, a° wcrai tS in establishment. '.For residential e. assumed. Signature of applicant or agent. )ate cpplicatio,0 one day subm_ %tied to the C?Y':1 eppeop.-iete fees end attachments. I s'te tic: (. aW0 to scale., , :'Cwing IILt_.... wi o i7s —a_ioo , locations of 'e skits sewn °,e risJO:''1 Sys :•.x ro-r7,c- t;:_.., r.::.. ?^. shop, rlope of pro?: .�J..�. : " = 0 , C' c.: ∎ .. 2..C3 ..:e: .'O.: . i`. flan: Q!f: ::. (. 7100 ..:gS' ,.r:T.J._a.= ___ „__ , .__ • RCf.J.. 7 - ^.: :'?'._., eo::7CO01..c....: . C 70010 , •€ €o. :dec1 :t. t or proposed 070110, APPLICANT: y ,, ) 0 /6®,c JAJ�4 AGENT: 2) i1 /4��'J LOT: BLOCK: q, SUBDIVISION: //.)744 PROPERTY ID #: sj [Section/Township/Range/Parcel No. or Tax ID Number) OTHER TO BE COMPLETED BY ENGINEER, HEALTH UNIT EMPLOYEE, OR :OTHER QUALIFIED PERSON. ENGINEER'S MUST PROVIDE REGISTRATION NUMBER AND SIGN AND SEAL EACH PAGE OF SUBMITTAL. COMPLETE ALL ITEMS. PROPERTY SIZE CONFORMS TO SITE PLAN: TOTAL ESTIMATED SEWAGE FLOW: AUTHORIZED SEWAGE FLOW: UNOBSTRUCTED AREA AVAILABLE: BENCHMARK /REFERENCE POINT LOCATION: ELEVATION OF PROPOSED SYSTEM SITE IS SOIL PROFILE INFORMATION SITE 1 Munsell # /Color USDA SOIL SERIES: Texture ' Depth . to to to to to to to to to STATE OF FLORIDA DEPARTMENT OF HEALTH AND REHABILITATIVE SERVICES ONSITE SEWAGE DISPOSAL SYSTEM SITE EVALUATION AND SYSTEM SPECIFICATIONS (YES [(] NO NET USABLE AREA AVAILABLE: 7 HRS-H Form 4015,, Mar 92 (Obsoletes previous editions which may not be used) (Stock Number: '5744- 003 - 4015 -1) PERMIT # ACRES GALLONS PER DAY [RESIDENCES -TABLE 1 / OTHER -TABLE 2) GALLONS PER DAY [1500 GPD /ACRE OR 2500 GPD /ACRE] SQFT UNOBSTRUCTED AREA REQUIRED: 544 SQFT [INCHES /FT] [ABOVE /BELOW] BENCHMARK /REFERENCE POINT THE MINIMUM SETBACK WHICH CAN BE MAINTAINED FROM THE PROPOSED SYSTEM TO THE FOLLOWING FEATURE : SURFACE WATER: l/ FT DITCHES /SWALES: i1J - FT NORMALLY WET? [ ] YES [ NO WELLS: PUBLIC: _451 FT LIMITED USE: Aki FT PRIVATE: A) FT NON - POTABLE: ...-1 FT BUILDING FOUNDATIONS: /f FT PROPERTY LINES: 5f FT POTABLE WATER LINES: /I FT SITE SUBJECT TO FREQUENT FLOODING: [ ] Y S [/] NO 10 YEAR FLOODING [ ] YES [1(NO 10 YEAR FLOOD ELEVATION FOR SITE: � Y FT MSL /NGVD SITE ELEVATION: FT MSL /NGVD SOIL PROFILE INFORMATION SITE 2 Munsell # /Color 5 2/64u.r USDA SOIL SERIES: to to to to to to to -to Texture Depth /to f,q OBSERVED WATER TABLE: INCHES [ABOVE / BELOW] XISTING GRADE. TYPE: [PERCHED / APPARENT] ESTIMATED WET SEASON WAT R TABLE ELEVATIO(1-: l� INCHES [ ABOVE / BELOW ] EXISTING GRADE. HIGH WATER TABLE VEGETATION: [ ] YES [ � NO OTTLING: [ ] YES [ 4' NO DEPTH: 3 INCHES DEPTH OF EXCAVATION: X; SOIL TEXTURE /LOADING RATE FOR SYSTEM SIZING• DRAINFIELD CONFIGURATION: /[ ] TRENCH [ ]BED [ ] OTHER (SPECIFY) REMARKS /ADDITIONAL CRITERIA: SITE EVALUATED BY: GC).4 /41-2411) DATE: Page 3 of 3 INSTRUCTIONS: PERMIT d: Permit tracking number assigned by CPHU. APPLICANT: Property owner's full name. AGENT: Property owner's legally authorized representative. LOT, BLOCK, SUBDIVISION: Lot, block, and subdivision for lot. PROPERTY ID //: 27 character number for property. (property appraiser ID 0 or section. /township /range /parcel number) PROPERTY SIZE: Check if property size at site conforms to submitted site plan. Record net usable area available - lot area exclusive of all paved areas and prepared road beds within public rights -of -way or easements end exclusive of streams, lakes, normally wet drainage ditches, marshes, or other such bodies of water. SEWAGE 'FLOW: Record the estimated sewage flow for the establishment from Table 1 (residences) or Table 2 (non - residential), Chapter 10D -6, FAC. Record the authorized sewage flow for the An based on 2•2 usable area end water supply (1500 gallons per day per acre for private water supplies and 2500 gpd per acre for pubic water supplies). If cuthorized sewage flow does not equal or exceed the estimated sewage flow, the application n*_:zet be denied. UNOBSTRUCTED AREA: SOIL PROFILE INFORMATION: FLOOD INFORMATION: MINIMUM SETBACKS: Record the square feet of unobstructed area available and the amount mcuired. Unobstructed area must be at least 2 times as large as the drainfield absorption area and at least 75 percent of the unobstructed area must meet minimum setbacks in Chapter I0D -6, FAC: The unobstructed area must be contiguous to the drainfield. BENCHMARK INFORMATION: Record the location of the benchmark. , .If using a surveyor's benchmark record the ectuafelevation. Record the elevation of the proposed system site in relation (above or below) to the benchmark. Record minimum setbacks which can,be meet to all listed features. Actual measurements must be recorded or "NA" for non applicable features. Features on site plan or Within 75 feet of the applicant lot must be measured. The location of any public drinking well within 200 feet of the applicant's lot must also be verified. Record information on lot's subject to flooding. For lots subject to flooding record 10 year flood elevation for site and actual site elevation. Two soil profiles within the proposed absorption area to a minimum depth of 6 feet or refusal are required. Soil identification will use USDA Soil Classification methodology (Munsell colors and USDA soil textures). Refusals must be clearly documented. Provide USDA soil series if available, record "UNK " the series cannot be determined. WATER TABLE: Record the depth of the observed water table at the time of the evaluation. Mark "perched" or "apparent" as appropriate. Record the estimated wet season water table elevation based on site evaluation, USDA soil maps, and historical information. Indicate if there is high water table vegetation present. Indicate if mottling is present and depth. SOIL TEXTURE: Record soil texture or loading rate for system sizing. If applicable record depth of excavation required. Record "NA" if not applicable. DEPTH OF EXCAVATION: DRAINFIELD CONFIGURATION: Check drainfield configuration required. If other, specify type. ADDITIONAL CRITERIA: SITE EVALUATED BY: Record any additional remarks pertinent to site or installation. Ex. dosing required. Signature of evaluator, title, and date of evaluation. Professional engineers must seal all documentation submitted. ELEVATION WORKSHEET ELEVATION OF BENCHMARK / REFERENCE POINT IS: BENCHMARK SITE 1 SITE 2 SITE 3 [¢1 SHOT: H.I. H.I. • WI. HI. [ -] SHOT [ -1 SHOT [ -1 SHOT LOT: PROPERTY ID #: D L5 1O 1c55 R [ ] SQUARE FEET A TYPE SYSTEM: I CONFIGURATION: N F LOCATION OF BENCHMARK: I ELEVATION OF PROPOSED SYSTEM SITE [ E BOTTOM OF DRAINFIELD TO BE [ L T TH T.4 T` )30T OF SPECIFICATIONS BY: APPROVED BY: DATE ISSUED: g,_ STATE OF FLORIDA DEPARTMENT OF HEALTH AND REHABILITATIVE SERVICES ONSITE SEWAGE DISPOSAL SYSTEM CONSTRUCTION PERMIT Authority: Chapter 381, FS & Chapter 10D -6, FAC CONSTRUCTION PERMIT FOR: [A') New System [/V] Existing System [06 olding Tank [Temporary /Experimental [ y] Repair N] Abandonment [4-1—Other(Specify) APPLICANT: �� / 6/ G Q /z/N-. /-, AGENT: /(6k PROPERTY STREET ADDRESS: „:96-7) /7/4. `� /� G � s BLOCK: SUBDIVISION: SYSTEM MUST BE CONSTRUCTED IN ACCORDANCE WITH SPECIFICATIONS AND STANDARDS OF CHAPTER 10D -6, FAC REPAIR PERMITS AND HOLDING TANK PERMITS EXPIRE 90 DAYS FROM THE DATE OF ISSUE. ALL OTHER PERMITS EXPIRE ONE YEAR FROM THE DATE OF ISSUE. HRS APPROVAL OF SYSTEM DOES NOT GUARANTEE SATISFACTORY PERFORMANCE FOR ANY SPECIFIC PERIOD OF TIME. ANY CHANGE IN MATERIAL FACTS WHICH SERVED AS A BASIS FOR ISSUANCE OF THIS PERMIT, REQUIRE THE APPLICANT TO MODIFY THE PERMIT APPLICATION. SUCH MODIFICATIONS MAY RESULT IN THIS PERMIT BEING MADE NULL AND VOID. SYSTEM DESIGN AND SP CUICATIONS T [ C'e ] LO / GPD] EPTIC TANK /AEROBIC UNIT CAPACITY MULTI- CHAMBERED /IN SERIES:[ ] A [ ] [GALLONS / GPD] CAPACITY MULTI- CHAMBERED /IN SERIES:( ] N [ ] GALLONS GREASE INTERCEPTOR CAPACITY [MAXIMUM CAPACITY SINGLE TANK: 1250 GALLONS] K [ ] GALLONS PER DOSE DOSING TANK CAPACITY DOSE RATE [ ] PER 24 HRS NO. OF PUMPS: [ ] PRIMARY DRAINFIELD SYSTEM SYSTEM [ ] STANDARD [ ] FILLED [ ] MOUND [ ] [ ] TRENCH [ ] BED [ ] D FILL IiittOWAEL ;'2[ a TJr, mi l r E XcAVATION REQUIRED: [ ] INCHES UNDER B07; _., _ r �','� .�. A li: ui O SUZIYFT HRS -H Form 4016, Mar 92 (Obsoletes previous editions which may not be used) (Stock Number: 5744 - 001 - 4016-0) APPLICANT TITLE: TITLE: PERMIT # DATE PAID ^ -'t - V FEE PAID $ // U RECEIPT # `q 0-97 [SECTION /TOWNSHIP /RANGE /PARCEL NUMBER] [OR TAX ID NUMBER] C 1? ] [INCHES /FT] . [ABOVE /BELOW] BENCHMARK /REFERENCE POINT ] [INCHES /FT] [ABOVE /BELOW] BENCHMARK /REFERENCE POINT CPHU EXPIRATION DATE: `1 Page 1 of 2 ENS', 2UCT ONS: P6RM17 NUMBER: Permit tracking number assigned by CPHU. APPL;CA TON 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. MAILINC ADDRESS: P.O. box or street mailing address for applicant or agent. LOT, 3LCCX, SU3DIVISION or ,'t2OP .??TY ZD1 /: 27 character id number for property. (CPHU may require property appraiser ID tf or section /township /range /parcel number) SYSTEY. D"SICN AND SPECI CATION S: TAN.(: Minimum specifications from Chapter 10D -6, LAC. .DRAYN IELD: Minimum specifications from Chapter 10D -6, FAC. OT} ER Other specifications, such as operating permit requirements, low - volume flush toiler, variance provisos. SPECIFICATIONS 3Y: Name of individual providing specifications. If designed by a registered engineer must be sealed. A'?PROVED 3Y: County Public Health Unit (CPHU) personnel reviewing and approving permit. [DATE ISSUED: Date permit is issued by CPHU. 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. c,. - Fri 1 , _I ; r r I ■ i Ill.t , ■■ 11 I_I_`� _I. ■� 1. [E I r j ; - j!� LL. ■■■■ EE 1 1 i � ■M t J I „ fi Q D 71 I i t ; 7 i - t (1 I I t I 1 1 ( •. 1 1 _, ---- - Cr - C- 1 ,_t I 1 1 1 I'I_ Fr_ J i l-- 1 1 FIJI i _) 1 _i ___I J l 1 I 1 I f (( I I I I_I_1_,;,_ _l _I.._ 11 I t I I I 1. 1, _' • I 1 1 L rJ J J. I_, _Li -- -I J t_.I 1 1 _f ± _ _i i _ l _ i f 1 L _t 1_. }_I - 1 I i _ ( 1- T 1 -t 1 1 _�. �_! I _ - i -- 1 1 I 11, L : I I J_ ( - 1 - "n -,- __. ,- 1 - 1 - Li � I [ _ 1 I 1 - JJ J _ . Ti • - 1 0 ! ■ 1 1 1 1 iI _ f1 - 1 J l 1 I , I , I i 1 l 1 I J- ' _LL Li 1 I - - - L ' -L IJ I -i • ' J 1_ J 0_1 1 I _I _I 1 _I_ ; i [ C ' 1=I I- - -1-1--!-- I 1 I I t i II Li_ rl 1 f_1 i 1 I - I 1 1 1 ! ; I � I 1 ' 1 I ''..I I J -- 1 -, I I I 1 1 I II I `1 I i - 1 J r I 1 ! 1 1_ irn 1 ccI I� I ! I . _1 1 I ' i 1. _i_4_i 07_ `1 IL} ' 1 IJ II I I I I I I_I t ) 1 I J1 1 1 -L1 [ IJ 1 -L, I I I -, ,+ ( i l 1 1 1 1 i 11- t -1 t 1 T__-1--till u , 1 i_[ [ 1_Ll I I I _ I 1 1 1 I -_ I I .ii i C._1�T� L! f } I I ., 1 1 1 '_i- _ L _1±_I 1 i_ 1 1 1 1 I I�-1 .__i _i__, j V1 I _ I E r? IJ_`'1'I f _ i_f1_I �"i1 fit 1_!nI_I J E I IJ _i_1 - 1... i= 1i 1 1'! I ! fI 11_1_,_. 0 - LIi� I r i I 1 1�; w � _1_IJ I I : 1 __ I _ 1 l 1:1 (_'1 ;' l I i I I 11 ! _)_I_ -1 t_l 1 "1__ II 1 J .JJ u J il�_I ,I sI� _ X 1 . ,1 I � I � ;.� I �I !yt.� s�.,�.L Notes Plan Approved ; 1 l r1 �I L. I II I 1 _i 1H- ID ■ J i_ U I ID r I f _ r - I -I L - -' I I STATE OF FLORIDA DEPARTMENT OF HEALTH AND REHABILITATIVE SERVICES APPLICATION FOR ONSITE SEWAGE DISPOSAL SYSTEM CONSTRUCTION P E J// 6 Permit Application Number • - SIGNATURE ,IRS -H Form 4015, Feb 85 (Obsoletes previous editions which may not be used)' 4Stock Number: 5744-002-4015-6) PART II - SITE PLAN _ _ 1. 1 I_ _1_1 1 t i I • LL �'t I 1 LJ 1 �1;J - l Site Plan Submitted by ((( ;, 4 TITLE Not Approved i 1} - - � r J - 1 I L i 1 1 • I 1 I JJ_f 1 I) �■ L I t. I • 1 I 1 I IJ I 0 ( 1 _ I _ _ t_ 1 i _ ' I 1-11 1 1_I_i L1 I 1 ;J_ 1 i 1_f-1- V I - 11 r I} -I l I JJ - __u [ 1_f -I.. . _I I c[ E ✓_ I ' 1_1 I i ' ALL CHANGES MUST BE APPROVED `I' THE G`OUNP PUBLIC HEALTH UNIT N t County Public Unit Page 2 of 3 Date 1)/-56-- _.._— CLOSETS BATH TUS[ SHOWERS LAVA- TORIES SINKS SLOP SINK[ LAUNDRY TU•• URINAL[ CATCH BASIN FLOOR DRAIN DRINKING FOUNT'NS TOTAL PICTURE[ CONTR. LIST CHECK SEPTIC TANK SEWER Comm. DRAIN FI ELD SOAKAGE PIT G TRAP SOLAR HEATER DEEP WELL SPRKLR. 5 SW IM'O POOL CONTK. LIFT �-- CH[CN Amount of Permit $ W My Commission Expires MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Permit No 7 715 71° Date... g . 2 (Signed) j'i X2 Application is bereby made for the approval of the detailed statement of the plans and specifications herewith submitted fbr the building or other structure herein dei ribed. 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 Dopy of approved plans and specifications must be kept at building during pr8gress of work. I Owner's Name and Address 6 do il �V �� , C c e9, - - ' No. ' �-;` 7 s treet . /...1 S Registered Architect and /or Engineer `�/[ / � - - �N ,�p „ g pi 's N e f .1 J. JJ L- 1 4 _ Na,._.... ; J.4 ....... idn /1 c...64_&... ADD¢ ' /A g i/ Location an Legal : - ption L.ot... / ° ' 4 -.s 2 L Block —Y-2— SubdivWon A /YIP Street and Number where work is to be performed —No .3`S' 7 ? L Street... :._. � •C ._ , Ul State work to be performed and purpose of building (By Floors)__ se�= ��,�.�/� � l t .-- � - t 67-3 C„. t� ..-..`. New Building .._ -.._ --- •-- .........._.. Remodeling —_ _ .__ Addition-- - - - -__ - - -_ Repairs No. of Stories.... Size Septic Tank— _Type of Tank- - Feet of Drain Tile rust. Feet of Tank or Drain Field from Well ..._._- .---- •_ - - - -_ Nature of Water Supply: City —Well. Size of Soakage Pit Notary Public, State of Florida 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 5968, Compiled General Laws of Florida Permanent Supplement, and ha•I com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the wort- re be performed under this permit; and will post or cause to be posted for inspection on the site of the wor such public notice or notices as arP required by the Act. The undersigned agrees to employ only such sub-contractors, on to • . pert. under this permit, as are licensed by Miami Shores Village. STATE OF FLORIDA, 1 0. 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. NOTE: A re- inspection fee of $1.00 will be made wham mob saispeotiom is made nee awry by improper notice for inspection, or faulty materials and /a worlmsansi ip. Master Plumber. Permit No l 11 Vk Application is hereby made for the approval of the detailed statement of the plans and specifications her 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 �! 71 /` / ' s �— No ■ 35— 7 street/ 9 ? Registered Architect and/or Engineer '- �/r'?v !'t" die'S Employing Plumber's Namur b e ° Gs Na !'J 5 .�...�._.d..�....... itrA ": ST Location and Legal Description Lot /9 `a 0 Mork 11 7 Street and Number where work is to be performed —No 5 7 Street . _ -.• - -. ` .._. aceti,,n /+-7 i .rJ State work to be performed and purpose of building (By Floors) Remodeling _ Addition.. -�� Repairs. No. of Stories New Building-------- •----- .... - - - - -- 8�_..._.._. -- Size Septic Tank Type of Tank__ Feet of Drain Tile Dist- Feet of Tank or Drain Field from Well Nature of Water Supply; City —We1L Size of Soakage Pit. Amount of Permit CS! -* MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT (Signed) l �TId SN4 .ley AgNit 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 Pennanent 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, work to be performed under permit, its are licensed by Miami Shores Village. Date..` ._ L2 2 s . & - Cee_T.v� /o /4 Capacity Plumbing Inspector. STATE OF FLORIDA, I u. 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 dep oses and says that he is the - - - -. -- of the above described construction, that be 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 11.00 will be made whoa snob mimeo** aotk* fs Bsada•Baoassary by Improper notion for luspection. or faulty materials and /or workmanship. CLOSETS BATH TUBS BHOW[RS LAVA- TORIES SINKS SLOP SINKS LAUNDRY TUBS URINAL/ CATCH BASIN FLOOR DRAIN DRINKING FOUNT' NIB TOTAL FIXTURES CONTR. LIST CHECK GREASE TRAP SOLAR NEATER Drat WELL SPRKLN. SYSTEM SWIM'O POOL SEPTIC TANK SEWER comm. DRAIN FIELD SOAKAGE PIT CONTR. LIST .. CHICK Permit No l 11 Vk Application is hereby made for the approval of the detailed statement of the plans and specifications her 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 �! 71 /` / ' s �— No ■ 35— 7 street/ 9 ? Registered Architect and/or Engineer '- �/r'?v !'t" die'S Employing Plumber's Namur b e ° Gs Na !'J 5 .�...�._.d..�....... itrA ": ST Location and Legal Description Lot /9 `a 0 Mork 11 7 Street and Number where work is to be performed —No 5 7 Street . _ -.• - -. ` .._. aceti,,n /+-7 i .rJ State work to be performed and purpose of building (By Floors) Remodeling _ Addition.. -�� Repairs. No. of Stories New Building-------- •----- .... - - - - -- 8�_..._.._. -- Size Septic Tank Type of Tank__ Feet of Drain Tile Dist- Feet of Tank or Drain Field from Well Nature of Water Supply; City —We1L Size of Soakage Pit. Amount of Permit CS! -* MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT (Signed) l �TId SN4 .ley AgNit 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 Pennanent 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, work to be performed under permit, its are licensed by Miami Shores Village. Date..` ._ L2 2 s . & - Cee_T.v� /o /4 Capacity Plumbing Inspector. STATE OF FLORIDA, I u. 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 dep oses and says that he is the - - - -. -- of the above described construction, that be 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 11.00 will be made whoa snob mimeo** aotk* fs Bsada•Baoassary by Improper notion for luspection. or faulty materials and /or workmanship. Permit No. ' ¢_! MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work I Owner's Name and Address �Y _ T 1 14v Date__. No._ 3 S 71 _.`Z- - -- Street? Re Ar and /or Engineer_— __—_— ___—_____ � / • ! -- No._ Street Location and Legal Description Lot____ _ R +__2- O _ _ _ Block___ 7 Street and Number where work is to be performed —No 3 S-7 N 12 S , ___ Street State work to be performed and purpose of building (By Floors) __. L v n.L j N G New. Building____________ ___ Remodeling/ Addition____ Repairs Subdivision./141 L __—¢1Pq ____..1._.l 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 $_ STATE OF FLORIDA, } COUNTY OF DADE. (Signed)_ (Signed)_ A Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his o. 'gations 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 yv k to be performed under this 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 necessary by improper notice for inspection, or faulty materials and /or workmanship. CLOSETS BATH TUBS SHOWERS LAVA- TORIES SINKS SLOP SINKB LAUNDRY TUBS U URINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT' NS TOTAL FIXTURES CONTR. LIST / f 2 i / / O N t Elf / o ./—* _ i<2-■ e•Ci '2%` L�CiQ� - CHICK (2 SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SWIM -G POOL CONTR. LIST _ CHICK Permit No. ' ¢_! MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work I Owner's Name and Address �Y _ T 1 14v Date__. No._ 3 S 71 _.`Z- - -- Street? Re Ar and /or Engineer_— __—_— ___—_____ � / • ! -- No._ Street Location and Legal Description Lot____ _ R +__2- O _ _ _ Block___ 7 Street and Number where work is to be performed —No 3 S-7 N 12 S , ___ Street State work to be performed and purpose of building (By Floors) __. L v n.L j N G New. Building____________ ___ Remodeling/ Addition____ Repairs Subdivision./141 L __—¢1Pq ____..1._.l 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 $_ STATE OF FLORIDA, } COUNTY OF DADE. (Signed)_ (Signed)_ A Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his o. 'gations 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 yv k to be performed under this 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 necessary by improper notice for inspection, or faulty materials and /or workmanship. \' (,) L SO N A nxt 51(.JG- c,A4 -4Rm Permit No. Location and Legal Description Lot. Amount of Permit $___ ....... STATE OF FLORIDA, } COUNTY OF DADE. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work.A- r7/274/1 / Owner's Name and Address_ ` »__ `• __ No.�_ -: c.___ -__ -- Street Registered Architect and /or Engineer_ _�______ Employing Plumber's Name/ / :. r4 /L Block Street and Number where work is to be performed —No 9 / State work to be performed and purpose of building (By Floors) _ New. Building Remodeling ________________________ Addition Repairs '. No. of Stories (Signed) (signeoc9/11. - -9?.7 Date -- 7 Street__________ ..... - - .......... subdivision __ --------------_---_---------- Street F 9 ' Size Septic Tank ________ __________Type of Tank__ Capacity Gals. Feet of Drain Tile_ d _zf.i_'___ &AL!L_Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: (Jtty-. Well._ _ ________ ..... of Soakage Pit Gfeiovi Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligalfons as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted' for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such sub- contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. 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•necesssry by improper notice for inspection, or faulty materials and /or workmanship. CLOSETS BATH TUBS SHOWERS LAVA- TORIES SINKS SLOP SINKS LAUNDRY TUBS U CATCH BASIN FLOOR DRAIN DRINKING FOUNT•NS TOTAL FIXTURE6 CONTR. LI6T - CHECK SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SW IM•G POOL CONTR. LIST CHECK Permit No. Location and Legal Description Lot. Amount of Permit $___ ....... STATE OF FLORIDA, } COUNTY OF DADE. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work.A- r7/274/1 / Owner's Name and Address_ ` »__ `• __ No.�_ -: c.___ -__ -- Street Registered Architect and /or Engineer_ _�______ Employing Plumber's Name/ / :. r4 /L Block Street and Number where work is to be performed —No 9 / State work to be performed and purpose of building (By Floors) _ New. Building Remodeling ________________________ Addition Repairs '. No. of Stories (Signed) (signeoc9/11. - -9?.7 Date -- 7 Street__________ ..... - - .......... subdivision __ --------------_---_---------- Street F 9 ' Size Septic Tank ________ __________Type of Tank__ Capacity Gals. Feet of Drain Tile_ d _zf.i_'___ &AL!L_Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: (Jtty-. Well._ _ ________ ..... of Soakage Pit Gfeiovi Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligalfons as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted' for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such sub- contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. 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•necesssry by improper notice for inspection, or faulty materials and /or workmanship. BUILDING ❑ PLUMBING PERMIT ROOFING ❑ 0 Owner of Building : 1 /:' / ,4 !' Architect Contractor /7 or Builder 6 - f i/ % v Legal Lot Description Address of Building CONTRACTOR OR BUILDER MIAMI SHORES VILLAGE, FLORIDA g N9 5289 DATE j - Li 19 Contractor's License No. Work to be performed under this Permi Z/ PD #h-1,4) ., 7`r4 -- 7 � M//f(-, 0 Air B1 Subdi- vision Value of Project $ This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the applica- tion herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes respon- sibility for work done by his agents, servants or employees. BY Amount of Permit $ lx z) Signed 7 c rx . � 3 - .'i' - ' INSPECTOR In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in com_dii nce with all c <lfi&tic a-'aad regulations pertaining thereto and in strict conformity with the plane, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In as cepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. . ,j ?/./6 1 tI (, 1 AUTHORITY � O80T °' BUILDING 'ELECTRICAL PLUMBING Owner pf I. Building 7 j ..e ' Architect Contractor 1 or Builder Legal Lot Description. Address of Building 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 to 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. MIAMI SHORES VILLAGE, FLORIDA P1 I PERMIT Work to be performed under this Permit Bl. INSPECTOR In consideration of the issuance to me of this permit I agree to perform the work cover hereunder in compliance with alt ordinances and regulations ertaining thereto and in strict conformity with the plans, drawings, statements ) or specifications omitted to the proper authorities of Miami Shores Village. cce ing this permit I assu responsibili all w one by either, ysel£, my agent, e . or = •..loyee. ......4 CONTRACTO$ OR BUILDER N° 9187 Signed: Subdi- vision Value of Project $ 1 DATE / 195 Contractor's License No Amt. of , Permit $ , BY AUTHORITY remit No State work to be performed and purpose of building (By Floors) Size Septic Tank Feet of Drain Tile___ Nature of Water Supply: City —Well Lt Amount of Permit $ My Commission Expires MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT ( Signed)... ( Signed )__ Date Lo Appiication 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 r, No. Street Registered Architect and /or Engineer — _ __ _ _ _ Employing Plumber's Name 4-4 _ t!44 /`> ' '! " G N o. -__ - - - _ S eet___ Lo- a- and Legal Description ‹....&,..9.2.. __ Subdivision Street and Number where work is to be performed —No -2 S 7 _l New Building-_ - -_- _-_-_ _ -- Remodeling Addition --•__ -_. p s No. of Stories. _Type of Tank Capacity Gals. __Dist. Feet of Tank or Drain Field from Well __Size of Soakage Pit Notary Public, State of Florida 1 Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his • •ligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Pe anent Supplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractor 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. Master Plumber. STATE OF FLORIDA, ( es. COUNTY OF DADE. I 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 Tints URINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT'NS �, , TOTAL FIXTURES CiONTR. LIGT ........ / CHUCK SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SWIM'G POOL CoNra. LIST / CHECK remit No State work to be performed and purpose of building (By Floors) Size Septic Tank Feet of Drain Tile___ Nature of Water Supply: City —Well Lt Amount of Permit $ My Commission Expires MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT ( Signed)... ( Signed )__ Date Lo Appiication 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 r, No. Street Registered Architect and /or Engineer — _ __ _ _ _ Employing Plumber's Name 4-4 _ t!44 /`> ' '! " G N o. -__ - - - _ S eet___ Lo- a- and Legal Description ‹....&,..9.2.. __ Subdivision Street and Number where work is to be performed —No -2 S 7 _l New Building-_ - -_- _-_-_ _ -- Remodeling Addition --•__ -_. p s No. of Stories. _Type of Tank Capacity Gals. __Dist. Feet of Tank or Drain Field from Well __Size of Soakage Pit Notary Public, State of Florida 1 Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his • •ligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Pe anent Supplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractor 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. Master Plumber. STATE OF FLORIDA, ( es. COUNTY OF DADE. I Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the _. of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made•necessary by improper notice for inspection, or faulty materials and /or workmanship. BUILDING ELECTRICAL PLUMBING ROOFING Owner of Building CONTRACTOR OR BUILDER MIAMI SHORES VILLAGE, FLORIDA 0 PERMIT N9 4282 0 0 Architect Contractor or Builder Legal Description Lot B1 Work to be performed under this Permit t t`. BY e; DATE Contractor's License No. AUTHORITY r t f. Subdi- vision Address of .,. ; i Value of 11 Amount of y Building ,. t t `� - L. Project $ 11 Permit $ This permit is grant .d to the contractor or builder named above to construct the building or to install the equipment or device described in the applica- tion herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications arid• that he assumes respon- sibility for work done by his agents, servants or employees. Signed "" - 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 ac cepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. AY BOT Architect Contractor or Builder MIAMI SHORES VILLAGE, FLORIDA BUILDING ❑ DATE '° ti 19 ELECTRICAL P E R M I T PLUMBING ROOFING ❑ ❑ Work to be performed under this Permit Owner of Building , 4 a N° 4269 Legal Lot Subdi- Description Bl vision Address of Value of I Amount of t J Building # . i Project $ I Permit $ This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the applica- tion herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes respon- sibility for work done by his agents, servants or employees. Contractor's < . �- License No. / �~ BY AUTHORITY Signed 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 ' - '-'a thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In as --mit I assume responsibility for all work done by either, myself, my agent, servant or employee. ABBOT tP7 Permit No. 0 MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Date___ / .L_F/ 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, wheth 4E L herein sp ecifie C Jf d or not. A copy of approved plans and specifications must be kept at building during progress of work. 1. e°1---0 0 Owner's Name and Address � . - _X -12.2 -f/ _ 40 t " is:T 34 Street_ d 41- e �1 � Registered Architect and /or Engineer.- _------ - - - - -- _ --- - - - - -- __ - _--------- _._.._ Employing Plumber's Name. f/__— - _ _� / - -- No.,L 41/-!! L �T _ - - - -- Location and Legal Description Lot.- -___. — __.____ _ Block __ Subdivision _ Street and Number where work is to be performed —No b 7 1Lt 92 Street. State work to be performed and purpose of building (By Floors)._ __ New Building Remodeling _______ Addition Repairs No. of Stories -- - - -- - -- Amount of Permit $ OF FLORIDA, COUNTY OF DADE. Type of Tank__ Capacity Gals. Size Septic 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)_4- /[- P umbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and a ,.sus his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Fl. da 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 be performed under this permit, as are licensed by Miami Shores Village. ( Signed) -- -- C7*" 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 hire 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 U URINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT' NS TOTAL FIXTURES Comm LIST CHICK SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SW IM'G POOL CONTR. LIST 1 Q �— - -- CHECK tP7 Permit No. 0 MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Date___ / .L_F/ 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, wheth 4E L herein sp ecifie C Jf d or not. A copy of approved plans and specifications must be kept at building during progress of work. 1. e°1---0 0 Owner's Name and Address � . - _X -12.2 -f/ _ 40 t " is:T 34 Street_ d 41- e �1 � Registered Architect and /or Engineer.- _------ - - - - -- _ --- - - - - -- __ - _--------- _._.._ Employing Plumber's Name. f/__— - _ _� / - -- No.,L 41/-!! L �T _ - - - -- Location and Legal Description Lot.- -___. — __.____ _ Block __ Subdivision _ Street and Number where work is to be performed —No b 7 1Lt 92 Street. State work to be performed and purpose of building (By Floors)._ __ New Building Remodeling _______ Addition Repairs No. of Stories -- - - -- - -- Amount of Permit $ OF FLORIDA, COUNTY OF DADE. Type of Tank__ Capacity Gals. Size Septic 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)_4- /[- P umbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and a ,.sus his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Fl. da 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 be performed under this permit, as are licensed by Miami Shores Village. ( Signed) -- -- C7*" 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 hire 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. REQUEST FOR INSPECTION Company Job Address Inspection Time Ready T - 7? PHONE Permit No Y 7 Date Application is hereby made for the approval of the detailed statement of the plans and specifications herewith s mitted 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 dot. 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 1 _ 7..... Location and Legal Description L6't Block Subdivision 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 Y 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 $ ! ` / l umbing Inspector. The undersigned applicant for this building permit does hereby certify that he . -rstands and accepts his obligati. l's an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled Ge >sral 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 - contractor work to be rmed undej, this permit, as are licensed by Miami Shores Village. STATE OF FLORIDA, 1 COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to as sinister 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 NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or f materials and /or workmanship. ss. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT eie;; No 3 1 Stree 1 Street___ /_!__- (Signe (Si gned_ Notary Public, State of Florida Master Plumber. CLOSETS BATH TUBS SHOWERS LAVA- TORIES SINKS SLOP SINKS LAUNDRY TUBS URINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT •NS TOTAL FIXTURES CONTR. LIST T —�— CHECK SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SW IM'G POOL CONTR. LIST CHECK Permit No Y 7 Date Application is hereby made for the approval of the detailed statement of the plans and specifications herewith s mitted 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 dot. 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 1 _ 7..... Location and Legal Description L6't Block Subdivision 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 Y 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 $ ! ` / l umbing Inspector. The undersigned applicant for this building permit does hereby certify that he . -rstands and accepts his obligati. l's an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled Ge >sral 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 - contractor work to be rmed undej, this permit, as are licensed by Miami Shores Village. STATE OF FLORIDA, 1 COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to as sinister 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 NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or f materials and /or workmanship. ss. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT eie;; No 3 1 Stree 1 Street___ /_!__- (Signe (Si gned_ Notary Public, State of Florida Master Plumber. BUILDING ELECTRICAL PLUMBING Owner of Building CONTRACTOR OR BUILDER MIAMI SHORES VILLAGE, FLORIDA ERMIT N9 3227 Work to be performed under this Permit ' Architect BI. Subdi- vision BY DATE 194 Contractor's License No. Contractor or Builder Legal Lot Description Address of / g `� ` "I 'r .(/ ,/' �'i Value of Amt. of e '%.,.-id,/ Building I . , Project Permit This permit is grap+ed to the contractor -or builder named above to construct the building or to install the equipmen 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 She„s.tat s emits -or �pecifica 'Ons and that he assumes responsibility for work done by his agents, servants or employee. - Signed- By INSPECTOR In consideration of the issuance to me of this permit I agree t e'r#orm the work/overed hereunder in compliance with all ordinances and regula- tions pertaining thereto and in strict conformity with the plans, d s, statements /or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all don y eitl myself, my agent, servant or employee,. JJ /C. *, f AUTHORITY Permit No 40%' �.► Date Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall Je complied with, whether rein specified or not. A copy of approved plans and specifications must be kept at building_during progress of w Size Septic Tank___ —_ Feet of Drain Tile____ — __________�:: -� Nature of Water Supply: City —Well Amount of Permit $_ • APPLICATION FOR PLUMBING PERMIT 2 The undersigned applicant for this building permit does hereby certify under the Florida Workmen's Compensation Act, being Section 5966, Co plied with the provisions thereof, and will require similar compliance performed under this permit; and will post or cause to be posted for required by the Act. The under signed agrees to employ only such licensed by Miami Shores Village. STATE OF FLORIDA, COUNTY OF DADE. Before me, the undersigned appeared – – — – — – ss. MIAMI SHORES VILLAGE My Commission Expires PLUMBING INSPECTION DEPARTMENT No 7 Street _ Owner's Name and Addre //` Registered Architect att'd /or�jxngineer Employing Plumber's ` N No._ Street Location and Legal Description Lot__ �_r ___ _ _ _ f�–_ _ Block____ _ Subdivision ___ _______ ________— �_______ Street and Number where work is to be performed —No d _ – `� `! –_ : reef----- - - -- -- -- — State work work to be performed and purpose of building (By Floor New Building __ Remodeling Addition Repairs No. of Stories Type of Tank D isc. Feet of Tank or Drain Field from Well ________ ____________ Size of S _______ _(Signed) inspection on the site of the sub tractors, on work to L'f,f authority, a notary public, duly authorized to administer _Capacity Plumbing Inspect he understands and accepts his obligations as an employer'bf labor piled General Laws of Florida Permanent Supplement, and has com- from all contractors or sub - contractors employed by him in the work to be work such public notice or notices as be ., ormed under this permit, a Notary Public. State of Florida Master Plumber. are are oaths and take acknowledgments, personally to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty materials and /or workmanship. CLOSETS BATH TUBS SHOWERS LAVA- TORIES SINKS SLOP SINKS LAUNDRY TUBS URINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT' NS TOTAL FIXTURES CONTR. LIST CHECK SEPTIC TANK SEWER CONN. DRAIN FI ELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SWI M ' G POOL CONTR. LIST CHECK Permit No 40%' �.► Date Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall Je complied with, whether rein specified or not. A copy of approved plans and specifications must be kept at building_during progress of w Size Septic Tank___ —_ Feet of Drain Tile____ — __________�:: -� Nature of Water Supply: City —Well Amount of Permit $_ • APPLICATION FOR PLUMBING PERMIT 2 The undersigned applicant for this building permit does hereby certify under the Florida Workmen's Compensation Act, being Section 5966, Co plied with the provisions thereof, and will require similar compliance performed under this permit; and will post or cause to be posted for required by the Act. The under signed agrees to employ only such licensed by Miami Shores Village. STATE OF FLORIDA, COUNTY OF DADE. Before me, the undersigned appeared – – — – — – ss. MIAMI SHORES VILLAGE My Commission Expires PLUMBING INSPECTION DEPARTMENT No 7 Street _ Owner's Name and Addre //` Registered Architect att'd /or�jxngineer Employing Plumber's ` N No._ Street Location and Legal Description Lot__ �_r ___ _ _ _ f�–_ _ Block____ _ Subdivision ___ _______ ________— �_______ Street and Number where work is to be performed —No d _ – `� `! –_ : reef----- - - -- -- -- — State work work to be performed and purpose of building (By Floor New Building __ Remodeling Addition Repairs No. of Stories Type of Tank D isc. Feet of Tank or Drain Field from Well ________ ____________ Size of S _______ _(Signed) inspection on the site of the sub tractors, on work to L'f,f authority, a notary public, duly authorized to administer _Capacity Plumbing Inspect he understands and accepts his obligations as an employer'bf labor piled General Laws of Florida Permanent Supplement, and has com- from all contractors or sub - contractors employed by him in the work to be work such public notice or notices as be ., ormed under this permit, a Notary Public. State of Florida Master Plumber. are are oaths and take acknowledgments, personally 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. Permit No t.% # Size Septic Tank_ Nature of Water Supply: City —Well Amount of Permit $_. PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT 2 7 2- ,�. — 44 .E Date _ Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall a complied with. whether ,lffirein specified or not. A copy of approved plans and specifications must be kept at building during progress of w rk, Owner's Name and Addr { C` Registered Architect an'dior ngineer Employing Plumber's Name 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 STATE OF FLORIDA, COUNTY OF DADE. Before me, the undersigned authority, a My Commission Expires MIAMI SHORES VILLAGE notary public, duly Block authorized No. Street Type of Tank . Capacity Gals.________ ______ Feet of Drain Tile _____________________._ Dist. Feet of Tank or Drain Field from Well Size of S aka Pit Plumbing Inspect The undersigned applicant for this building permit does hereby certify jdt" he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Co piled General Laws of Florida Permanent Supplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The under signed agrees to employ only such sub- retractors, on work to be performed under this permit, are licensed by Miami Shores Village. to administer oaths Subdivision___ Notary Public, State of Florida Master Plumber. and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the. of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty materials and /or workmanship. CLOSETS BATH TUBS SHOWERS LAVA- TORIES SINKS SLOP SINKS LAUNDRY TUBS URINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT' NS TOTAL 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 t.% # Size Septic Tank_ Nature of Water Supply: City —Well Amount of Permit $_. PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT 2 7 2- ,�. — 44 .E Date _ Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall a complied with. whether ,lffirein specified or not. A copy of approved plans and specifications must be kept at building during progress of w rk, Owner's Name and Addr { C` Registered Architect an'dior ngineer Employing Plumber's Name 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 STATE OF FLORIDA, COUNTY OF DADE. Before me, the undersigned authority, a My Commission Expires MIAMI SHORES VILLAGE notary public, duly Block authorized No. Street Type of Tank . Capacity Gals.________ ______ Feet of Drain Tile _____________________._ Dist. Feet of Tank or Drain Field from Well Size of S aka Pit Plumbing Inspect The undersigned applicant for this building permit does hereby certify jdt" he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Co piled General Laws of Florida Permanent Supplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The under signed agrees to employ only such sub- retractors, on work to be performed under this permit, are licensed by Miami Shores Village. to administer oaths Subdivision___ Notary Public, State of Florida Master Plumber. 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. JOB: BUILDING ELECTRICAL PLUMB The following 43 ready for inspection:- Inspector's Rep6rt:- .41111.- • • ADD: WORK DONE Lff: • • 4t _ 4 4_ REQUESTED ensureamPAIseg 1 WILL BE READY WINOMMOWS-.9•••••?; -• / • 7 4, \,3% /I\