461 NE 93 St (7)Employing Plumber's Name ____
Size Septic Tank__
Feet of Drain Tile___
Nature of Water Supply: City - -Well
Amount of Permit $___/ V 0
STATE OF FLORIDA,
COUNTY OF DADE.
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Permit No.. _._
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted 'for the building or other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village. Florida,
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at
building during progress of work.
Owner's Name and Address
t - hyrks a PA
Registered Architect and /or Engin r
_
C Street -- ...... ______________
Location and Legal Descri Lot 2
ption - ______� B
Street and Number where work is to be performed —l\l',o 4e' L (
State work to be performed and purpose of building ,(By Floors)
New Building_________ _____ Remodeling Addition Repairs —___ No. of Stories____— _______
Type of Tank
A
The undersigned applicant for this building permit does hereby ce
under the Florida Workmen's Compensation Act, being Section 5966,
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.
Before me, the undersigned authority, a notary public, duly
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
MIAMI SHORES VILLAGE
Date_
Di, ,. .Feet of Tank or Drain Field from Well
Size of Soakage Pit
9"/
111;
Street____ n_
Capacity Gals.__— ______ ____
� - -__
– - -- — (Signed) – —
Plumbing Inspector.
rtify that he understands and accepts his obligations as an employer of labor
Compiled General Laws of Florida Permanent Supplement, and has com-
from all contractors or sub - contractors employed by him in the work to be
inspection on the site of the work such public notice or notices as are
sub - contractors, on work to be performed under this permit, as are
1
(Signed) 1 ' �-
Notary Public. State of Florida
Master Plumber.
authorized to administer oaths and take acknowledgments, personally
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'N5
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
Employing Plumber's Name ____
Size Septic Tank__
Feet of Drain Tile___
Nature of Water Supply: City - -Well
Amount of Permit $___/ V 0
STATE OF FLORIDA,
COUNTY OF DADE.
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Permit No.. _._
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted 'for the building or other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village. Florida,
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at
building during progress of work.
Owner's Name and Address
t - hyrks a PA
Registered Architect and /or Engin r
_
C Street -- ...... ______________
Location and Legal Descri Lot 2
ption - ______� B
Street and Number where work is to be performed —l\l',o 4e' L (
State work to be performed and purpose of building ,(By Floors)
New Building_________ _____ Remodeling Addition Repairs —___ No. of Stories____— _______
Type of Tank
A
The undersigned applicant for this building permit does hereby ce
under the Florida Workmen's Compensation Act, being Section 5966,
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.
Before me, the undersigned authority, a notary public, duly
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
MIAMI SHORES VILLAGE
Date_
Di, ,. .Feet of Tank or Drain Field from Well
Size of Soakage Pit
9"/
111;
Street____ n_
Capacity Gals.__— ______ ____
� - -__
– - -- — (Signed) – —
Plumbing Inspector.
rtify that he understands and accepts his obligations as an employer of labor
Compiled General Laws of Florida Permanent Supplement, and has com-
from all contractors or sub - contractors employed by him in the work to be
inspection on the site of the work such public notice or notices as are
sub - contractors, on work to be performed under this permit, as are
1
(Signed) 1 ' �-
Notary Public. State of Florida
Master Plumber.
authorized to administer oaths and take acknowledgments, personally
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. 7 77 7
State work to be performed and purpose of building', (By Floors)
New Building. Remodeling ! Addition J�
Size Septic Tank. L. r �peank
STATE OF FLORIDA, 1
COUNTY OF DADE.
Amount of Permit $________
ss.
elm
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
(Signed) _
Date
apa
a
- P -1
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted /r the uilding or er
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, F rida,
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 ivision
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 1 "£s 'r LF`>L.[z a7 No ‘- / 7 Street 7
Registered Architect and /o ineer
Employing Plumber's Name No Street
Location and Legal Description Lot Block Subdivis' n
Street and Number where work is to be performed —No m`' Street a.» -*-.e.—
Repairs No. of Stories___________..____
s
Feet of Drain Tile Dist. Feet of Tank or Drain Field from Well /
Nature of Water Supply: City —Well Size of Soakage Pit
My Commission Expires Notary Public, State of Florida
lambing ctor.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of'labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be
performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are
required by the Act. The undersigned agrees to employ only such sub - contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village.
(Signed) - 7Z- '4'e'
U Maiter 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
TOTAL
FIXTURES
CONTR.
LI1ST ST
/
/
/
J —_
CHECK
/ 50
- 7S
"15
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
H EATER
DEEP
WELL
SPRKLR.
SYSTEM
SW IM'G
POOL
CONTR.
LIST
CHECK
_
..- �t C_
1`
!► —
/��
C
1
Permit No. 7 77 7
State work to be performed and purpose of building', (By Floors)
New Building. Remodeling ! Addition J�
Size Septic Tank. L. r �peank
STATE OF FLORIDA, 1
COUNTY OF DADE.
Amount of Permit $________
ss.
elm
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
(Signed) _
Date
apa
a
- P -1
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted /r the uilding or er
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, F rida,
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 ivision
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 1 "£s 'r LF`>L.[z a7 No ‘- / 7 Street 7
Registered Architect and /o ineer
Employing Plumber's Name No Street
Location and Legal Description Lot Block Subdivis' n
Street and Number where work is to be performed —No m`' Street a.» -*-.e.—
Repairs No. of Stories___________..____
s
Feet of Drain Tile Dist. Feet of Tank or Drain Field from Well /
Nature of Water Supply: City —Well Size of Soakage Pit
My Commission Expires Notary Public, State of Florida
lambing ctor.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of'labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be
performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are
required by the Act. The undersigned agrees to employ only such sub - contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village.
(Signed) - 7Z- '4'e'
U Maiter 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.
3"
BUILDING
ELECTRICAL
PLUMBING.
Owner of
Building
MIAMI SHORES VILLAGE, FLORIDA
Architect
Contractor j �j l e; . :4,
or Builder l
Legal Lot
Description
PERMIT N° 7877
Work to be performed
, �,Jt: l t
under this Permit
d
Bl.
Subdi-
vision
Value of
Project
DATE )11 / / 194i_
Contractor'
License No
Address of
Building
This p rmit is granted to the contra or or builder named above to construct the building or to install the equipment or device described in the appli-
cation 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-
- a ) £i
sibility for work done by his agents, servants or employees.
INSPECTOR By
In consideration of the issuance to me of this permit I agree to perform jhjwork covered hereunder in compliance with all or . na es and regulations
pertaining thereto and in strict conformity with the plans, drawings, statement or specifications submitted to the proper authorities o iami Sholillage.
In accepting this permit I assume responsibility for all work done by either mys�e my anent, servant or employee.
CONTRAerOR'OR BUILDER Yom ,. • BY 1
Amt. o
Permit
AUTHORITY
0d
Permit No
Application is hereby made for the approval of the detailed statement of th,, plans and specifications herewith submitted for the building or other
structure herein described. This application is made in compliance and coufax rw.y 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 A copy of approved plans and specifications must be kept at
building during progress of work.
Owner's Name and Address t 'z. .------ _- _----------------- - - -_ -. • - - -- No...__ _1.------ - - - - -- Street_ 7 12_ •_ • c"
Registered Archliect and /or
Employing Plumber's Name
•..
••° ........... -
_ - - -__ Subdivision.-- _ -__ --
Location and Legal Description Lot
Street and Number where work is to be performed —No cg
State work to be performed and purpose of building (By Floors)
New Building Remodeling___ —_____ Addition.
Size Septic Tank.
Feet of Drain Tile
Dist. Feet of T
Nature of Water Supply: City —Well.. , - --
/
Amount of Permit $ ` A:7
MIAMI SHORES VI'. _ADZ-
PLUMBING INSPECTION DEPARTMEk
APPLICATION FOR PLUMBING
( Signed)._
Street
Repairs No. of Stories.
Type of Tank Capacity Gals.
in Field from Well
_._Size of Soakage Pit
Date
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 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. o
B
( Signed) ,
r4 I
Master Plumber.
STATE OF FLORIDA,
COUNTY OF DADE.
3efore 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
TUBS
LAVA-
TORIES
SINKS
S
SLOP
SINKS
LAUNDRY
TUBS
UR
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'O
POOL
CONTR.
LIST
CHECK
Permit No
Application is hereby made for the approval of the detailed statement of th,, plans and specifications herewith submitted for the building or other
structure herein described. This application is made in compliance and coufax rw.y 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 A copy of approved plans and specifications must be kept at
building during progress of work.
Owner's Name and Address t 'z. .------ _- _----------------- - - -_ -. • - - -- No...__ _1.------ - - - - -- Street_ 7 12_ •_ • c"
Registered Archliect and /or
Employing Plumber's Name
•..
••° ........... -
_ - - -__ Subdivision.-- _ -__ --
Location and Legal Description Lot
Street and Number where work is to be performed —No cg
State work to be performed and purpose of building (By Floors)
New Building Remodeling___ —_____ Addition.
Size Septic Tank.
Feet of Drain Tile
Dist. Feet of T
Nature of Water Supply: City —Well.. , - --
/
Amount of Permit $ ` A:7
MIAMI SHORES VI'. _ADZ-
PLUMBING INSPECTION DEPARTMEk
APPLICATION FOR PLUMBING
( Signed)._
Street
Repairs No. of Stories.
Type of Tank Capacity Gals.
in Field from Well
_._Size of Soakage Pit
Date
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 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. o
B
( Signed) ,
r4 I
Master Plumber.
STATE OF FLORIDA,
COUNTY OF DADE.
3efore 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.
Permit No
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
/9 (FC(3 -
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 tarot. A copy of approved plans and specifications must be kept at
building during progress of work. �/�
Owner's Name and Address 5 / 2 -S // �' ,Q c A T No g / Street/ ' �• Y_ -S
Registered Architect and /or Engineer
Employing Plumber's Neune / J t " AS .S ).C ..... ®.�m. itrt � ., T •
Location and Legal Description Lot_ Bleck Subdivision
Street and Number where work is to be performed —No y‘ / Street. 3 .. -5 T .
State work to be performer and purpose of building (By Floors)_______
New Building.__..__ _.._..........._.. Remodeling —_._ _ __ Addition
Repairs No. of Stories...............
Size Septic Tan
Feet of Drain Tile
Nature of Water Supply: City—Well.
Amount of Permit $
crio
Type of Tank__ — — -- —
t)lst. Feet of Tank or Drain Field from Well
Size of Soakage Pit
( Signed ) - - - -- ---.�
( Signed) --` LPL_
-Capacity Gals-
I
Plumbing Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts *Obligations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 59138, Complied General Laws of Florida Pennanent 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.
Muter Plumber.
STATE OF FLORIDA,
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
to me well known, and who, being by me first duly sworn, upon oath deposes and says that be b the Y_._ --- .._..-- • -_ - -. _ _... __ _..
of the above described construction, that he bas 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 sea srlagpaetlen is madarososwry by improper notice for hapsdion, or faulty
materials and /or workmanship.
BATH
CL0S S TUS•
KNOW [RS
LAVA•
TORI[s
61NKa
860/
a1NKe
LAUNDRY
TUBS
U RINAL/
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT'NS,L
AOO g
P 7�
... �C 1
TOTAL
FIXTURES
GL I•T
LIST
1s cp.
CHICK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKADI
PIT
ORIGAMI
TRAP
SOLAR
NEATER
DEEP
WELL
SPKKL .
SYSTEM
SWIM'S
POOL
CONTR.
IFT
LIST
CHECK
Permit No
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
/9 (FC(3 -
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 tarot. A copy of approved plans and specifications must be kept at
building during progress of work. �/�
Owner's Name and Address 5 / 2 -S // �' ,Q c A T No g / Street/ ' �• Y_ -S
Registered Architect and /or Engineer
Employing Plumber's Neune / J t " AS .S ).C ..... ®.�m. itrt � ., T •
Location and Legal Description Lot_ Bleck Subdivision
Street and Number where work is to be performed —No y‘ / Street. 3 .. -5 T .
State work to be performer and purpose of building (By Floors)_______
New Building.__..__ _.._..........._.. Remodeling —_._ _ __ Addition
Repairs No. of Stories...............
Size Septic Tan
Feet of Drain Tile
Nature of Water Supply: City—Well.
Amount of Permit $
crio
Type of Tank__ — — -- —
t)lst. Feet of Tank or Drain Field from Well
Size of Soakage Pit
( Signed ) - - - -- ---.�
( Signed) --` LPL_
-Capacity Gals-
I
Plumbing Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts *Obligations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 59138, Complied General Laws of Florida Pennanent 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.
Muter Plumber.
STATE OF FLORIDA,
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
to me well known, and who, being by me first duly sworn, upon oath deposes and says that be b the Y_._ --- .._..-- • -_ - -. _ _... __ _..
of the above described construction, that he bas 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 sea srlagpaetlen is madarososwry by improper notice for hapsdion, or faulty
materials and /or workmanship.
n
PEOPLES GAS COANY
Date Permit Taken:
Permit No.
Account Name
Installation Address P
' CmusxnttY Joh Order ..
Type of Account: 1✓JResidential '. r Commercial Industrial
• Appliances to be used:`
•Total Connected Load: e 7 Therms
SZETCH 07 INSTALLATION SITE:
• 1. Indicate North.
2. AI,1 property linos.
3. 79=tion of structure
4. Distance of structure
all property lines.
L.P. GAS It S ALt .TTC "d tlOatt ORDER.
Show the following:
A
Dual Exchange Cylinders
Saies 1 presentative:
+istrict 1!c ger:
%letercd Non Metered
Remote TsrAk Installation
aPECZAL Fr3STRUCTIONS :
THE 'AI -IP i ' ED GAS COO ANY
CapLta . ,No. ._
Customers Acct. ado.' 7
Phone No.: - ' :,7
Job Order
Date Service Required - /P - 7 -1 , -- 7 7— ' 7 771
5. location of LP storage &c ft.of fill hove reluire*:.
.6. Location and size of houso line' stub aut. , '
on property._ 7. instance from L.P.. atoragcttoo the heuac 1 r,e.
from ' 8... Location of all electric bores or 'equipz
such ae pumps and air conditioning units. '
Does thin account ha a present suppUicr : 7.T.Yos No M'Above Ground 7 perMb.ca
Gas Cc t : - r 1y ut1f i 5,/,i`5' Namc :� ,. �; rr�� r :�- Time / /�/ By t
•
TYPE INSTALLATION
Horizontal Tank(e) Storage Cap.
Vertical Tan1z(o).4 _p }_-�: Storage Cap.,' ti
' Two Stage 1:cguQ ion '
rate: ' P - � s
Lpprcved L.P. Installation. Supervisor:
Not A Droved By: Returned To:
Znstsnation to be made by:. ® Distribution ri Installation
5Twr)V01 t on 6cheauled Ear: CoMplot A ®n: ,
Date
Date Returned :�_
Service " L.�'. D1p1.;e
-. . b ...a..a.t a..� :.,s,ta..:..e;.... a ..... a - ��.•M..l a:l"es... -.,r .ra4e.-- - -'-'-
q
-_^
GLOaxTa
BATH
Tua•
SHOWERS
LAVA.
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TUSS
URINALS
CATCH
SAWN
FLOOR
DRAIN
DRINKING
FOUNT' NO
TOTAL
FIXTURES
CONTR.
LIST
CHECK
SWIM'O
POOL
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
AREAS[
TRAP
SOLAR
HATER
DEEP
WELL
SPRKLR.
SYSTEM
CLI ST
LIST
■
CHECK
Permit No
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida,
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division
of Miami Shores Village shall be complied with, whether herein specified or not. A Dopy of approved plans and specifications must be kept at
building during progress of work.
Owner's Name and Address
Registered Architect and /or Engineer
£atploYinB Plumber's Nano ® c' - .ain'� N a,,....,..L.7.zza_.,.,... /tr.st_4(.....w..../2.2.d -t,..
Location and Legal Description Lot Block SubdivWon._.--_....- —
Street and Number where work L to be performed —No �t / Street.._._ f..e ._ �/._
State work to be performed and purpose of building (By Floors)._ - -- ------ _— .----- •• -.. -_
New Building.. _ _------- .....__.___ Remodeling_— _____ -____— -- Addition.. - - - -- _—_... Repairs
Size Septic Tank_.
Feet of Drain Tile
/2
Nature of Water Supply: City-
Amount of Permit $
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligati s as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5968, Compiled General Laws of Florida Pennanent u pplement, and has can -
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employ b y 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.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Type of Tank---._ —
Feet of Tank or Drain Field from Well
Size of Soakage Pit_
(Signed )-
(stoma)
D a t e _
No 4 /‘ ( Street. - -.M
No. of Stories.
STATE OF FLORIDA, 1
COUNTY OF DADE. r
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 oses and says that he is the Y.._ .._.._...- - -_ - -• - -... _._.._ .
of the above described construction, that he has carefully read the foregoing application, and that be did sign the same, and that all fads
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 wham seek srrispeetioe is merie.aaoemery by improper nodes for impaction, er freaky
materials and /or walaaanahip.
BUILDING
ELECTRICAL
PLUMBING
Owner of
Building
Architect
Contractor
or Builder 114 i•/�
7
Legal Lot i.:
Description
CONTRACTOR OR BUILDER
MIAMI SHORES VILLAGE, FLORIDA
DATE / 'I ''1 / 194_
PE R lei IT N? 1765 Contractor's 6 3 .
License No.
Work to be performed under this Permit
Bl.j /
Address of , dr ► Value of I Amt. of
Building "'1 k f . ,1. * ,,,,,7 Project Permit
■
This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the
application herefor in strict compliance with al ordinances pertaining thereto and with the understanding that the work will be performed in compliance
with any plans, drawings, statements or specific Lions 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 b his agents, servants or employees. if /
Signed: 1 ` 4 By
INSPECTOR
In consideration of the issuance to me of this permit I agree to perform re work covered hereunder in compliance with all ordinances And regula-
tions pertaining thereto and in strict conformity with the plans, drawings, star eats or specifications submitted to the proper authorities of Miami Shores
Village. In accepting this permit I assume responsibility for all work done by etcher myself, my agent, servant or employee.
', �,/ . toti
Subdi-
vision
L .
844A
OW.
Date `i/Ov /.T 93 Job dys y / Al , f' , 9,3 Tax Folio 3cz& 'm'
Legal Description _ V /
Owner / Lessee / Tenant 3 / f,4e /e Master Permit g
7 6y 9 `�
Owner's Address '/ Q A" f% / ,1 J / , Phone e7S ///3
Contracting Co .to // A( Co,•?* e ✓ a y Address 770 A•✓- C /62 joi .
Qualifier (42 c2 I (de ✓14 SS# / Phone tf 9-5 // /J.
State itP Municipal # /' Competency # i ' Ins.Co. 0»-' 62, .
Architect /Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type(circle one): BUILDING ELECTRICAL LUMB 'CHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION 1 0 r,q..,, �� „d ee-
/
Square Ft. Estimated Cost(value)
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.
r ( Art-Q
Sign Lure of owner
Pate:.
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
/4, f r, #" /3 P s
or Cordo PrPc 4 r1Pnt
.... ANNA QUINONES
Itre MY COMMISSION 1 CC 147711
$ EXPIRES: September 29, 1995
.,; ha• � �,�.: NIISRderwriters
Notary as to Owner ... -__ -_
my Commission Expires: � CP44-4
** * * * * * * *
FEES: PERMIT J ' ' RADON
APPROVED:
Zoning Buildin
Mechanical
Signature of Contractor or Owner-.Builder `
DO: '''•o, ANNA QUINONES
*' MY COMMISSION 1 CC 147711
� �• OF ` FXPrPES• sep tembcr 28, 1885
NBts F� ,' B3d vmu Nbbpe ubdioriter
• 1
r
Owner - Builder
•.f
y mmission 1vxpires:
'Uov. /S 93
* * * * * * * * **
C.C.F. • S NOTARY TOTAL DUE r
Fire Other
Electrical
Engineering
CONSTRUCTION PERMIT FOR:
] New System [ ] Existing System [ ] Holding Tank [ ] Temporary /Experimental
] Repair [ ) Abandonment [ ] Other(Specify)
APPLICANT:
PROPERTY STREET ADDRESS:
LOT:
PROPERTY ID #:
APPROVED BY:
DATE ISSUED: //.....y_ °'/ t'
‘....2_
STATE OF FLORIDA ' y ` , PERMIT # +'
DEPARTMENT OF HEALTH AND REHABILITATIVE SERVICES DATE PAID If . - t ® • �
ONSITE SEWAGE DISPOSAL SYSTEM FEE PAID $ 'O .
CONSTRUCTION PERMIT RECEIPT # 33.;.s
Authority: Chapter 381, FS & Chapter 1OD -6, FAC
( JLJ E 3
BLOCK: SUBDIVISION:
AGENT:
I Th
[SECTION /TOWNSHIP /RANGE /PARCEL NUMBER]
[OR TAX ID NUMBER]
SYSTEM MUST BE CONSTRUCTED IN ACCORDANCE WITH SPECIFICATIONS AND STANDARDS OF CHAPTER 1OD -6, FAC
REPAIR PERMITS AND HOLDING TANK PERMITS EXPIRE 90 DAYS FROM THE DATE OF ISSUE. ALL OTHER PERMITS
EXPIRE ONE YEAR FROM THE DATE OF ISSUE. 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 SPECIFICATIONS
) [GALLONS / GPD] SEPTIC TANK /AEROBIC UNIT CAPACITY MULTI- CHAMBERED /IN SERIES:[
A [ ) [GALLONS / GPD] CAPACITY MULTI-CHAMBERED/IN IES:[ ]
N ( ] GALLONS GREASE INTERCEPTOR CAPACITY [MAXIMUM CAPACITY SINGLE TANK: 1250 ALLONS]
K [ ] GALLONS PER DOSE DOSING TANK CAPACITY DOSE RATE [ ] PER 24 HRS NO. OF PS: [ ]
BENCHMARK/REFERENCE D SQUARE FEET PRIMARY DRAINFIELD SYSTEM
A TYPE SYSTEM: [ ] STANDARD [, ] FILLED [ ] MOUND [ ]
F LOCATION OF BENCHMARK:
I ELEVATION OF PROPOSED SYSTEM SITE [ ] [INCHES/FT] [ABOVE/BELOW] POINT
BENCHMARK/REFERENCE E BOTTOM OF DRAINFIELD TO BE [ ] [INCHES/FT] [ABOVE/BELOW] POINT
T r... --#n' / , 54-11 I { / 4 ) . 0 , - '+ - - '�' " V \ . / V L Q t/ 1 t ) -3".. s a . . H 1 ✓ U . - / fN 4m
H i
E
R
SPECIFICATIONS BY: TITLE:
HRS -H Form 4016, Mar 92 (Obsoletes previous editions which may not be used)
(Stock Number: 5744 -001- 4016
EXCAVATION REQUIRED: [ ] INCHES
TITLE:
APPLICANT
CPHU
EXPIRATION DATE:,
/7l N
Page 1 of 2
INSTRUCTIONS:
PERMIT NUMBER: • Permit tracking number assigned byt CPHU.
APPLICATION FOR: Cneck type of permit, if "Other` specify type in blank.
APPLICANT: Property owner's full name.
TELEPHONE: Telephone rwmber for applicant or agent.
AGENT. pc -y awrcr'r lagcil, authorized repre5ent.tivw
MAILING ADDRESS: P.O. sox or street 'nailing address for applicant or agent.
LOT, BLOCK, SUBDIVISION or
PROPERTY ID#: 27 character id number for property. (CPHU may require property appraiser ID N or section/township /range /parcel number)
SYSTEM DESIGN AND
SPECIFICATIONS:
TANK: Minimum specifications from Chapter 10D-6, FAC.
DRAINFIELD: Minimum specifications from Chapter 10D-6, FAC.
OTHER: Other specifications, such as operating permit requirements, low- volume flush toilets, variance provisos.
SPECIFICATIONS BY: Name of individual providing specifications. If designed by a registered engineer must be sealed.
APPROVED BY: County 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.
.;! ■■! 1, f I . ' I
I I I 11 I I
,1 11
I 11 I I tFI
/ 1 , • /
. • ,
Site Plan Submitted by
STATE OF FLORIDA
DEPARTMENT OF HEALTH AND REHABILITATIVE SERVICES
APPLICATION FOR ONSITE SEWAGE DISPOSAL SYSTEM CONSTRUCTION Pc179/1IT
Permit Application Number ff - - -
I
I
I ' I
11 I , . _
II !
iRS-H Form 4015, Feb 85 (Obsoletes orevious editions which may riot be used)
Stock Number. 5744-002-4015-6)
PART II SITE PLAN
' I i
Not Approved
Plan Approved
./". ' ■
By
ALL CHANGES MUST BE APPROVE IA TH COUNT
Notes
SIGNATURE 1T1LE
7)1j 2
gBLIC HEALTH UNIT
Date '
County Public Unit
Page 2 of 3
APPLICANT:
PROPERTY STREET ADDRESS:
LOT:
PROPERTY ID #:
T __.L i
H
E
R
SPECIFICATIONS BY:
* i, •
STATE OF FLORIDA
DEPARTMENT OF HEALTH AND REHABILITATIVE SERVICES
ONSITE SEWAGE DISPOSAL SYSTEM
CONSTRUCTION PERMIT
Authority: Chapter 381, FS & Chapter 10D -6, FAC
DATE ISSUED:
BLOCK: SUBDIVISION:
APPROVED BY:
HRS-H Form 4016, Mar 92 (Obsoletes previous editions which may not%
(Stock Number: 5744 - 001 - 4016 - 0) �j
AGENT: f ,,(4
SYSTEM DESIGN AND SPECIFICATIONS
T [r.�� ] [GALLONS / GPD] SEPTIC TANK /AEROBIC UNIT
A [ ] [GALLONS /*GPD]
N [ ] , GAI, ,,ONS- e t INTERCEPTOR CAPACITY
K [ ] \ *05 A * DOSE DOSING TANK CAPACITY
D [-t SQUARE FEET PRIMARY DRAINFIELD SYSTEM
R [ ] SQUARE FEET SYSTEM
A TYPE SYSTEM: [ ] STANDARD [ ] FILLED
I CONFIGURATION: [ ] TRENCH [k] BED
N !1
F LOCATION OF BENCHMARK:
L'
TITLE:
TITLE: 4 — ri
l)kci
BUILDING DEPARTM
411
PERMIT #
DATE PAID / 1
FEE PAID $ Li
RECEIPT # --; 7
CONSTRUCTION PERMIT FOR:
[ ] New System [ ] Existing System [ ] Holding Tank [ ] Temporary /Experimental
(„ ] Repair [ ] Abandonment [ ] Other(Specify)
[SECTION /TOWNSHIP /RANGE /PARCEL NUMBER]
[OR TAX ID NUMBER]
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.
CAPACITY MULTI- CHAMBERED /IN SERIES:[ ]
CAPACITY MULTI- CHAMBERED /IN SERIES:[ ]
[MAXIMUM CAPACITY SINGLE TANK: 1250 GALLONS]
DOSE RATE [ ] PER 24 HRS NO. OF PUMPS: [
[ ] MOUND [ ]
[
I ELEVATION OF PROPOSED SYSTEM SITE [ ] [INCHES /FT] [ABOVE /BELOW] BENCHMARK /REFERENCE POINT
E BOTTOM OF DRAINFIELD TO BE [ ] [INCHES /FT] [ABOVE /BELOW] BENCHMARK /REFERENCE POINT
L
D FILL REQUIRED: [ ] INCHES EXCAVATION REQUIRED: [ ] INCHES
/ 1 CPHU
EXPIRATION DATE: B
,z /
Page 1 of 2
INSTRUCTIONS:
SYSTEM DESIGN AND
SPECIFICATIONS:
PERMIT NUMBER: Permit tracking number assigned by CPHU.
APPLICATION FOR: Check type of permit, if "Other" specify type in blank.
APPLICANT: Property owner's full name.
TELEPHONE: Telephone number for applicant or agent.
AGENT: Property owner's legally authorized representative.
MAILING ADDRESS: P.O. box or street mailing address for applicant or agent.
LOT, BLOCK, SUBDIVISION or
PROPERTY ID#: 27 character id number for property. (CPHU may require property appraiser ID # or section/township /range /parcel number)
TANK: Minimum specifications from Chapter 10D-6, FAC.
DRAINFIELD: Minimum specifications from Chapter 1OD-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 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.