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47 NE 93 StSTATE OF FLORIDA DEPARTMENT OF HEALTH AND REHABILITATIVE SERVICES ONSITE SEWAGE DISPOSAL SYSTEM CONSTRUCTION AND INSTALLATION PERMIT Appilcant�' ^e rmi Nu ber 417_ � PAR II - SYSTEM INSTALLATION INSPECTION AND INAL I STA� APPROVAL- --------- • - -• lr.stalier Proper tank legend: Yes Ir k No if-Inks watertight: Yes ` • No ',oiler tank exit/et device: Yes No o'P'.Y -'rth Width 4 cet feet feet feet feet feet `?otaG = ft Systems located as permitted: Yes No Systems including plumbing stub -outs installed at proper elevation: Yes / No evi Average depth to drainpipe invert from finished grade' inches Maximum depth: fi' A\..rage depth of drainfield gravel I Z. inches Minimum depth of gravel: re:— inches gravel size: Yes No Gravel is suitable quality: Yes No ;- acizfill or fill material as required: (Quality) Yes No (Quantity) Yes No �d :I T ei wected by: iZ ,J,. I Dra)nfield Trench I.7 C.10 ."ov.n.o®m.mo- a-- =3- a ®......a..- so-- ®- . -o ®®a ®. PART Tank Manufa?turer y�^� Tank material Tank level: Yes No Tank size: —'1 gallons gallons gallons i o Lengths Width Man role or marker to grace: Yes LLATION APPROVAL- Absorption AN APPROVED INSTALLAT!ON DOES NOT GUARANTEE PERFORMANCE Approved by: Length 34. Beet x )� reat = ` t 2 feet fl eet Length _ feet x ' "eet == ft d� feet feet Proper No. drainlines: Yes __ No —' feet feet Proper pipe separation: Yes__ _ No Total = ft Distribution box level: Yes __ No inches Date 4 3 " v COUNTY PUBLIC HEALTH UNIT No:e: Completed copies of this form will be provided to the applicant, installer and the building department. For 4096, Jan 86 (Replaces Feb 85 edition which may be used) (Stock Number: 5744-002-4016-4) ?age 2 of 2 BUILDING ELECTRICAL Pi PLUMBING LI ROOFING III Lit Owner of Building MIAMI SHORES VILLAGE:, FLORIDA PERMIT N. 4128 Worir to he performed under this Permit Architect Gcnfractor or Builder Legal Lot Subct, Description Bl. vision DATE Contractor's Lican_se No. Address of Value of Building i Project $ Arrifet_sat :', Permit F.I_ This permit is granted to the contractor or b11 named above to construct the building or to install he Equipment or dcya.c ile ril,c(1 in di t' al,p'ii(•;1- tion herefor in strict compliance with all ordinances pertaining the tato and with the understanding tht the NA irh will he perft)rint d it ewnpliallec with plans, drawings, statements or specifications that may have been submitted to and approved ly the proper m inicipal : 11; V i ' 1 . 3.S . Iray 1,c re \ Okt'd at any time if the work is net done in compliance with such ordinances or if the plans tire changed without authorization. A further rendition upon which thi. permit is granted is the understanding that the contractor or 3uileler named above assumes the responsibility 'or a t toreugh knowledge of the ordinance. and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the itaterneuts (17 tpecifications and that he a91.11/12s n' sibility for work done by his agents, servants or employees. Signed: In consicioradon of the isec.anci to ra P. of this pmmit I agree to perform the covered heroundcr t with :111 cri.rlonces and regalatior, pertaining thoroto and in atriet conformity with the plans, drawings, statements or specifecations sulomittoc, to the :repot- cuhoriooe of 111 ,::11,--,res Village. To ac- cepting this permit I assume responsibility for all work dono by either, myself, my ago at, : or employee CONTRACTOR OR BUILDER BY ATITT,-;: 11,1 BUILDING ELECTRICAL PLUMBING ROOFING Owner of , Building Architect Contractor or Builder Legal Description Lo: .: Q PERMIT N? 9551 Address of .) Building MIAMI SHORES VILLAGE, FLORIDA This permit is g;-anted to the contractor or builder na nod above to constr tion herefor in strict compliance with all ordinances pertaining thereto and with plans, drawings, statements or specifications that may have been r ibmitted to and at any time if the work is not done in compliance with such ordinances or if the permit is granted is the understanding that the contractor or builder named above regulations pertaining to the work covered hereby whether showr. on the plans or sibility for work done by his agents, servants or employees. CONTRACTOR or BUILDER BY Work to be performed under this Permit r` Suhd'- r itiion Sq. Ft. Valle of Project $ Date_ Contractor's License No. Permit AU'I'ili'RI'I'Y 19 uct tae building or to install the equipment or der`co in th; the understanding that tile work ss be perfor IICC in runt1 ::m I \each a il approved b) the proper rot nicipa' authorities. 'Phi- Permit ma re n' cr plans are changed without ;authorization. A furti or cnnelition upon ■shic`1 :hi- assumes the responsibility for a thorough knowletlp the ur,iinanrc drawing.; of in the statement, or specifications :n:1 t'':: her rt-nt Signed • (INSPEC'FOR) BY - In consideration of tic issuance to me of this permit J. agree to perform the work covered hereunciec in compliance with :"I u - lit inru and r: git it pertaining thereto and in strict conformity with the plans, drawings, statements or specifications subm.tted to the proper authnritie' of Miami Fhuee Vi l:__.: In accepting this permit I assume responsibility for all work done by either, myself, my agent-, servant or employee. OWNER•S NAME . 4 . 0/42,1 (.c c e....,. 6® iit,,wtriei PRESENT ADDRESS 47 Al. 4y 3 " fr. LICENSE NO. PHONE NO. JOB LOCATION / (ST. OR AVE.) �� 4-, Gi. t�G• 7.7 � 4 LOT /7 4 4 a c. BLOCK 1 ``5 ( � SUBDIVISION ®hi e►.no i dm4ecsi ..rec, is I nh,p,r1 GENERAL CONTRACTOR C, ij 66 ie. ADDRESS 6 5c S.� . i3 4 . PHONE NO. LICENSE NO. /k.R9 i �} BUILDING PERMIT NO. S DATE o /° 4 7 PERMIT FEE S ICI. BUILDER'S BOND NO. DATE Add IS'o ®rJ ZONE REQUIREMENTS CU. FT. ®� PLAN CUBE'�T®IM CU. FT. a EST. COST S 41.11-c::, p Q ) DRAWINGS. SPECIFICATIONS, RESTRICTIONS AND CUBE CHECKED BY: 61 �°' �/ mi•-� BUILDING PERMIT AND INSPECTION RECORD — MIAMI SHORES VILLAGE DAT� NEW CONSTRUCTION TYPE it 5, STORIES pie ROOF CONSTRUCTION c e.. ®li C� ®. INTERIOR CONSTRUCTION 0 A. e5 REPAIRS DESCRIPTION p aa DE ° �l T LION ..[ p i GfP I $v".- v VI . ' w 4P / BA R 7 4 '°-P� p�.ut.4da•c. Id 0. C rw. N DESCRIPTION ALTERATION (� A ADDITION ce, 7 oaf �SOt �3+�s =b G'+ Ts+e• -®,,, 0 8 ie +Sfl 5 — SUBMITTED TO PLANNING BOARD APPROVED REJECTED REFERRED TO COUNCIL REASONS RE- SUBMITTED TO PLANNING BOARD SUBMITTED TO VILLAGE COUNCIL REMARKS CERTIFICATE OF OCCUPANCY NO. I ISSUED BY TO p Q ) DRAWINGS. SPECIFICATIONS, RESTRICTIONS AND CUBE CHECKED BY: 61 �°' �/ mi•-� BUILDING PERMIT AND INSPECTION RECORD — MIAMI SHORES VILLAGE DAT� INSPECTIONS DATE BY INSPECTIONS DATE BY FOUNDATION PERMIT NO. DATE ROOF TEMPORARY SERVICE BEAMS & LINTELS $ SEPTIC TANK POOL $ FRAMING H. W. HEATER CONN AIR COND. SOLAR HEATER FINAL $ GAS CLEAN UP $ SLAB $ INSPECTIONS DATE SLAB RE- INSPECT BY RE- INSPECT BY ROUGHING CONTRACTOR PHONE PERMIT NO. I DATE FEE $ NEW BLDG. • I ALTERATION I ADDITION REPAIRS SPECIALS PERMITS PERMIT NO. DATE FEE TEMPORARY SERVICE $ SEPTIC TANK $ SEWER H. W. HEATER CONN $ SOLAR HEATER $ GAS $ $ INSPECTIONS DATE BY RE- INSPECT BY RE- INSPECT BY ROUGHING TUB & TOP OUT SEWER SEPTIC TANK SOLAR HEATER FIXTURES GAS CONTRACTOR �FC..7iL, 0._ J i . vice. PHONE PERMIT NO. 7 ,rJY- I DATE I - ®"' P FEE $ Fr. Q'tz NEW BLDG. I ALTERATION X. I ADDITION REPAIRS SPECIAL PERMITS PERMIT NO. DATE FEE TEMPORARY SERVICE $ H. W. HEATER CONN. $ RANGE CONN. H. W. HEATER CONN $ MOTORS $ FIXTURES $ $ INSPECTIONS DATE BY RE - INSPECT BY RE- INSPECT BY TEMP. SERVICE ROUGHING H. W. HEATER CONN RANGE CONN. FIXTURES & FINAL BUILDING INSPECTIONS PLUMBING PERMITS & INSPECTIONS ELECTRICAL PERMITS & INSPECTIONS APPROVAL TO POWER CO. FOR SERVICE DATE BY - 10 * CON OR S NU.. FRL F N I ADORES:2 i •.• " * H.C7D r/..-![ CU. ET. LID 0 F ZIC :LSE PLAN CUBE 11 : T 0000 =L CV NO. I SSLIEZ)5 EY -a 0 --0 LG P17.6:V.IT AND INSPECTION PECORI3--MIAA,I: SHOR S 4.1.,,,s; NO. L - '.0. CU. FT. I-! COST C CJEIE cH;:r..zro ETOR:ES 000F CONSTRUCTION 7= (. 51 DESCRIPTION DESOR AFPROVEC REJECTL!1) REFERRED TO COUNCIL REASONS REVARKS I ILE:IC/SE F .11: CONS INSP CTIONS DATE BY RE- INSPECT BY RE- INSPECT BY FOUNDATION PERMIT NO. - FEE TEMPORARY SERVICE / —3 / —s7 ✓ $ /O u BEAMS& LINTELS 6 7-1.3- b / 3--3—.-11 / / / /' / 7 L 5 .......2.4 4I $ I WP,...........' $ SEWER SOLAR HEATER FRAM I; MOTORS $ GAS S FIXTURES S FINAL J_./.-4.r/ 11 INSPECTIONS DATE CLEAN -UP RE- INSPECT BY RE- INSPECT BY ROUGHING CONTRACTOR;�„�� PHONE • PERMIT NO. ,'d DATE o ° Q ^ 0 FEE $ NEW BLDG. I ALTERATION ADDITION REPAIRS SPECIAL PERMITS PERMIT NO. DATE FEE TEMPORARY SERVICE / —3 / —s7 ✓ $ /O u S SEPTIC TANK 'p..,4`Q� / / / /' / 7 L 5 .......2.4 4I $ I WP,...........' $ SEWER SOLAR HEATER S MOTORS $ GAS S FIXTURES S S INSPECTIONS DATE BY RE- INSPECT BY RE- INSPECT BY ROUGHING 4v 6R- fi o GAS ROUGHING -- ,. 3_. s-i eh, SEWER TANK ~ °,p? SEPTIC (J tea _ SOLAR HEATER FIXTURES , I-' 51 FIXTURES & FINAL ,c—/- 3 I p c 7-5) ( pq CONTRACTOR #, {44it� PHONE 4 PERMIT NO. // O / 7 DATE 2 ° C - / FEES , ::*? • NEW BLDG. I ALTERATION I ADDITION REPAIRS SPECIAL PERMITS PERMIT NO. DATE FEE TEMPORARY SERVICE / D 7 7 Y / —3 / —s7 ✓ $ /O u H. W. HEATER CONN. / $ RANGE CONN. S MOTORS S FIXTURES S $ INSPECTIONS DATE BY RE- INSPECT BY RE- INSPECT BY TEMP. SERVICE ROUGHING -- ,. 3_. s-i eh, H. W. HEATER CONN RANGE CONN. FIXTURES & FINAL ,c—/- 3 I p c 7-5) ( pq BUILDING INSPECTIONS LS MBING PERMITS tit INSPECTIONS ELECTRICAL PERMITS et INSPECTIONS APPROVAL TO POWER CO. FOR SERVICE DATE 6 • BY 271,3 1169 Approved use bv occupancy_ Remarks: CERTIFICATE OF OCCUPANCY MIAMI SHORES VILLAGE, FLORIDA BUILDING DIVISION Miami Shores Village, Fla.,_ Owner, Agent or Tenant of Building _ L.ot Block Street Address_ Subdivision This Certificate of Occupancy is issued to the above named. for building at above named location only upon the czpress provision that the applicant will abide by and comply with all conditions of Ordinances Nos. 92, 93, 94 and 97, known : s the Zoning, Electrical, Plumbing and Building Ordinances of Miami Shores Village pertaining to the erection, construction, alteration or remodeling of buildings or structures. BUILDING DIVISION OWNER'S NAME ' NEW CONSTRUCTION PRESENT ADDRESS • ' •' y 'S LICENSE NO. PHONE NO. JOB LOCATION (ST. OR AVE.) REPAIRS LOT BLOCK ALTERATION I SUBDIVISION GENERAL CONTRACTOR ADDITION ADDRESS bb d APPROVED'' PHONE NO. LICENSE NO. . �= BUILDING PERMIT NO. �' r % - DATE •••-.). _ PERMIT FEE S 1 ° 0 ' BUILDER'S BOND NO. DATE ZONE REQUIREMENTS CU. FT. � PLAN CUBE 2 Pi CU. FT. EST. COST S c %( ) DRAWINGS. SPECIFICATIONS, RESTRICTIONS AND CUBE CHECKED BY: :r•• • C� BUILDING PERMIT AND INSPECTION RECORD — MIAMI SHORES VILLAGE • DAT: NEW CONSTRUCTION TYPE STORIES ROOF CONSTRUCTION INTERIOR CONSTRUCTION <,— REPAIRS DESCRIPTION <3r',a°'2r, �- �'>( •�- /'.,L.c�, • - i(� Pa" r� ? „'? ;, '�r�l (3.,•, ,,,,'(% ALTERATION u DESCRIPTION J / i • e = -,F', --,-- C , !in Il n. % � - • -�, n 'l o� l� - Y� 6• o c. ADDITION SUBMITTED TO PLANNING BOARD APPROVED'' REJECTED REFERRED TO COUNCIL REASONS RE- SUBMITTED TO PLANNING BOARD S URMITTFI) TO VILLAGF COUNCIL REMARKS CERTIFICATE OF OCCUPANCY NO. f 1 l • / � l ISSUED / - - 4 BY /// ' �. / TO t/,'' /,i , , DRAWINGS. SPECIFICATIONS, RESTRICTIONS AND CUBE CHECKED BY: :r•• • C� BUILDING PERMIT AND INSPECTION RECORD — MIAMI SHORES VILLAGE • DAT: INSPECTIONS DATE BY INSPECTIONS / DOE BY FOUNDATION $ SEPTIC TANK ROOF TEMPORARY SERVICE $ BEAMS & LINTELS $ TUB & TOP OUT POOL SOLAR HEATER S FRAMING $ GAS AIR COND. MOTORS S FINAL S FIXTURES CLEAN UP SEPTIC TANK S SLAB S SOLAR HEATER SLAB SPECIALS PERMITS PERMIT NO. DATE FEE TEMPORARY SERVICE RE- INSPECT BY $ SEPTIC TANK FEE TEMPORARY SERVICE $ SEWER $ TUB & TOP OUT $ SOLAR HEATER S RANGE CONN. $ GAS SEWER MOTORS S RANGE CONN. S FIXTURES S INSPECTIONS DATE BY RE- INSPECT BY RE- INSPECT BY ROUGHING DATE FEE TEMPORARY SERVICE ROUGHING $ TUB & TOP OUT S RANGE CONN. SEWER MOTORS RANGE CONN. S FIXTURES SEPTIC TANK S S SOLAR HEATER FIXTURES & FINAL FIXTURES GAS CONTRACTOR e - C- Aa_C) GE •6L. -\ NA. p.", 'i:.`L - PHONE PERMIT NO. 4a,-fel I DATE C.-1.1-C. FEE c $�- 3 NEW BLDG. I ALTERATION ty / I ADDITION REPAIRS SPECIAL PERMITS PERMIT NO. DATE FEE TEMPORARY SERVICE ROUGHING $ H. W. HEATER CONN. S RANGE CONN. $ MOTORS RANGE CONN. S FIXTURES S S INSPECTIONS DATE BY RE- INSPECT BY RE- INSPECT BY TFMP. SERVICE ROUGHING H. W. HEATER CONN RANGE CONN. FIXTURES & FINAL CONTRACTOR PERMIT NO. NEW BLDG. PLUMBING PERMITS & INSPECTIONS DATE I ALTERATION APPROVAL TO POWER CO. FOR SERVICE DATE Cc, BUILDING INSPECTIONS OZara/ I_ a. I ADDITION ELECTRICAL PERMITS & INSPECTIONS PHONE FEE $ REPAIRS BY CERTIFICATE OF OCCUPANCY MIAMI SHORES VILLAGE, FLORIDA BLThDL r G DIVISION Lot ' -) Block___ Street Address ° "-'" )‚ Remarks Owner, Agent or Tenant of Building_ Miami Shores Village, Florida, Approved use by occupancy Subdivision ';%?' This Certificate of •ccupancy is issued to the above named for building at above named location only upon the express provision that the applicant will abide by and comply with all conditions of Ordinances Nos. 92, 93. 94 and 97, known as the Zoning, Electrical, Plumbing and Building Ordinances of Miami Shores Village pertaining to the erection, construction, alteration or remodeling of builclin9s or structur M 1,6rt e () BUILDING DIVISION AL M J:ss 47 :7. 93rd St:raat 7Lo `d & 1 251 Lot 6, 13:.ock 3 LEGAL, i ,r,; 8horss Sec .1 A.,rdo RECORD (3A,RBA,E E TAX ?AID BY YEAR ANNUAL TAX PERIOD USED AMOUNT PAID DATE PAID RECEIPT ;VUFA6ER 1 1 /1 ,,, ,tip- ;• "\s';'ti / ' ; r ; . ! %4°.`,,,, , L.,2 AL M J:ss 47 :7. 93rd St:raat 7Lo `d & 1 251 Lot 6, 13:.ock 3 LEGAL, i ,r,; 8horss Sec .1 A.,rdo RECORD (3A,RBA,E E TAX Legal Description: Inspected by: Comments: APPLICATION FOR CERTIFICATE OF RE- OCCUPANCY I, rv1 GIa-Q_ I to re- occupy the single family residence known as : (address) 1 , Miami Shores, Florida. Lot: Block PB & PG: I hereby certify that I understand that the zoning. of the property is for single -fam ly residential use and that it is unlawful for more than one family to reside therein. I also understand that any Certificate of Re- Occupancy that may be issued by Miami Shores Village, certifies only that the referenced property is being used for single -family purposes and that such Certificate does not constitute any representation, warranty or certification as to the condition of the dwelling or other structures on such property. Applicant "'" \, c ,,,\ Date J 1— l5 - o < � Print Name k }v\ i C H �L , (\o y q&f * * * * * * * * ** * * * * * * * * * * * * * * * * * * * * * * * * * * ** ******* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** For purposes of conducting the inspection required by Section 902 of the Miami Shores Land Development and Zoning Code, please contact: I � �.� �, ® 99 l oas,� 3 Contact Name: 1 Telephoner 305 - Buyer Seller Realtor x Company Name Application Fee ($50) paid: Cash Check No. 75/ 7 PAGE 1 OF 2 X Denied , hereby apply for a certificate Date 11/16/00 CER'i 1■ICATE OF RE- OCCUPANCY On behalf of Miami Shores Village, Florida, the undersigned certifies that the property described in the above application has been inspected for purposes of re- occupancy pursuant to Sections 901 and 902 of the Miami Shores Land Development and Zoning Code and that such property may be re- occupied by the above applicant for single- family residential purposes. PAGE 2 OF 2 MIAMI SH RES VILLAGE, FLORIDA By: a4g, Date of Certification: 11/16/00 THIS CER 1 . 1FICATE VERIFIES THAT THE REFERENCED PROPERTY HAS BEEN INSPECTED BY MIAMI SHORES VILLAGE AND HAS BEEN DETERMINED TO PRESENTLY COMPLY WITH THE SCHEDULE OF REGULATIONS OF THE MIAMI SHORES LAND AND DEVELOPMENT CODE PERTAINING SOLELY TO THE REQUIREMENT THAT EACH ONE-FAMILY DWELLING IS USED AND INTENDED TO BE USED FOR A ONE- FAMILY DWELLING PURPOSE ONLY; HOWEVER, THIS CERTIFICATE DOES NOT CONSTITUTE ANY REPRESENTATION OR WARRANTY AS TO THE CONDITION OF THE DWELLING OR OTHER STRUCTURES ON THE PREMISES DESCRIBED HEREIN, OR ANY ASPECT OF SUCH CONDITION, AND INTERES 1ED PERSONS ARE ADVISED AND ENCOURAGED TO MAKE THEIR OWN INSPECTION OF THE PREMISES IN ORDER TO DETERMENE THE CONDITION, THEREOF.