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PLUMBINGPermit No is hereby made for the approval of the detailed statement of the plans and specifications he a sub for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of i Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regul. 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 ............ ___ . ___ --D., Registered Architect and /or Eng' eer_.i //-Q s-- _—J-��k_ L — / i G Employing Plumber's Name-__ ..._4"^L -1 _ - -- -- _- No. .L ?3 - 1 .� StreeL-- ..J� _ * 2 - d (°[ Location and Legal Description Lot_-- Z.... .... _____—_ Block--_ L Subdivisio0r. f �'� Q_? !I� ae� Street and Number where work is to be performed —No._— _. ___—_____ __ —__ Street-A f 5 t " l State work to be perfo ed and purpose of building (By Floors)_-___ —.. _ -__ -- - -- .___.- New Building ___ Remodeling —__ Addition Repairs 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 Supp , ell.-_---_........ _ ....... ____________________Size of Soakage Pit Amount of Permit $ r7 umbing Ins . or. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligatio as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent � pplement, and Ilas 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 pu ; lic notice or notices as are required by the Act. The undersigned agrees to employ only such sub - contractors, n wor under this permit, as are licensed by Miami Shores Village. My Commission Expires MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT (Signed ) Street_ f_t :-• - --� ,� _S�i Dat Notary Public, State of Florida / 7 73 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 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. TUBE I URINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT'NS TOTAL FIXTURES LIST CHECK SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SWIM•G POOL £ . s g - CONTR. LIST / ���� `G // A� CHECK Permit No is hereby made for the approval of the detailed statement of the plans and specifications he a sub for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of i Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regul. 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 ............ ___ . ___ --D., Registered Architect and /or Eng' eer_.i //-Q s-- _—J-��k_ L — / i G Employing Plumber's Name-__ ..._4"^L -1 _ - -- -- _- No. .L ?3 - 1 .� StreeL-- ..J� _ * 2 - d (°[ Location and Legal Description Lot_-- Z.... .... _____—_ Block--_ L Subdivisio0r. f �'� Q_? !I� ae� Street and Number where work is to be performed —No._— _. ___—_____ __ —__ Street-A f 5 t " l State work to be perfo ed and purpose of building (By Floors)_-___ —.. _ -__ -- - -- .___.- New Building ___ Remodeling —__ Addition Repairs 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 Supp , ell.-_---_........ _ ....... ____________________Size of Soakage Pit Amount of Permit $ r7 umbing Ins . or. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligatio as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent � pplement, and Ilas 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 pu ; lic notice or notices as are required by the Act. The undersigned agrees to employ only such sub - contractors, n wor under this permit, as are licensed by Miami Shores Village. My Commission Expires MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT (Signed ) Street_ f_t :-• - --� ,� _S�i Dat Notary Public, State of Florida / 7 73 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 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. L.sm W /NL G N P D e 0 1 i/ PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date Job Address I P ' /V 1 ! 3 Sr Tax Folio f I — 3.2 U 6 — Of K— 0 SO/ 1 A-AA 1 Site) le Es Se- C 2 Legal Description el 7 .2 2 - BL 1 < 5/ pa 16/3 7 Historically Designated: Yes No Owner/Lessee / Tenant i A) I fa. C, ALP /A) A) Master Permit # 7 /� d- C9?- Owner's Address V 7 C1 /U 9 .) St I/O t f}�n t I S tit/2 ES Phone 7 is — ( Z 4. y _ Contracting Co. j/ < ,,,e ,� 2/�C- Address 3l �v / sT.,,„ S S # , „ Phone 7M6 372- Qualifi State # CiL D4e5 2 Municipal # Competency # Ins. Co. Architect/Engineer Address Bonding Company Address Mortgagor Address Permit Type (circle one): BUILDING ELECTRICAL PLUMBING ECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION v1/ er _ f P����'c P �� �e� �► ©� f Square Ft. Estimated Cost (value) 1 70 0 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. U /7 ture of owner and/or Cond President Date Notary as to Owner and/or Condo President Date Notary as to Contractor or Owner - Builder Date My Commission Expires: My Commission Exr,kes. O ,p P Y F/4 OFFICIAL NOTARY SEAL / 0 , 6 _ i SANDRA M MONTIEL 2 w ,, COMMISSION NUMBER l :;«!'„� ( CC401261 1 � o G 0 MY COMMISSION UP, OFF\ AUG, 11,1ft$ C.C.F. r NOTARY BOND TOTAL DUE .-0- & O FEES: PERMIT RADON APPROVED: Zoning Building Mechanical Plumbing Siknatuxe o'f Contractor or 0 - ,cei-t— 1 Electrical /o —1-97 Date Engineering Miami Shores Village Contractor's Company Narne State Certificate or Registration No. ;ElV ilding Department 2 3 2 64050 .E.2nd Avenue, Miami Shores, Florida 33138 I I: (305) 795.2204 Fax: (305) 756.8972 BUILDIN PERMIT APPLICATION FBC 2001 Permit Type (circle): Building Electrical Plumbing Mechanical Roofing Owner's Name (Fee Simple Titleholder) 4 il fli2iL% Phone # Owner's Address L( ) • l 3 7-1.-/ City Lt-`t. t l State Tenant/Lessee Name Architect/Engineer's Name (if applicable) Total Fee Now Due $ 1 `1 a (Continued on opposite side) City Miami Shores Village County Miami -Dade Zip Is Building Historically Designated YES NO p6, (i ' c= Phone # 36 Job Address (where the work is being done) Contractor's Address a / L Al L ' / > , `1 t ° City Li4. State t'� --- Qualifier C-; (t— l�%� 7 / %r t �-5 (i-z) $ Value of Work For this Permit / C' C ;0' 00 Type of Work: ■ Addi '.n ❑Alteration Describe Work: C Z--• Certificate of Competency No. ❑New Permit NoT & O 9`), 9 Master Permit No P a y )1S 1' Zip � ) 3 Phone # Zip Phone # f.3cny_ Square Footage Of Work: II/Repair/Replace ❑ Demolition .`) 1,i\ ****************************Fees****************************** Submitt Fee $S 0 Permit Fee $ / CCF $ v ) CO /CC Notary $ Training/Education Fee $ Technology Fee $ Scanning $ Radon $ Zoning Bond $ Code Enforcement $ Structural Plan Review. $ Bonding Company's Name (if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State Zip Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Chc 05/13/03 Signature Signature My Commission Expires: Owner or Agent Contractor The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged / before me this c) 3 day of , 20 _ , by day of d/ ✓4)� b (7 / /�7e'y ' eiG S who is personally known to me or who has produced who is . • rsonally known to ihe or who has produced NOTARY PUBLIC: Sign: Print: * * * * * * * * * * * * * * * * * * * * * * * * * * * ** * *�KA� i APPLICATION APPROVED BY: As identification and who did take an oath. 1 lc„ 1 * COMMISSION NUMBER MjN Q D0118514 9 4** * m * � 14.1188106heitl RESt OF F\ JUNE 15,2006 NOTARY PUBLIC• Sign: Print: My Commission Expir (1 A ?1 G'r) • f vl, as identification and who s 1 i h e an oath. * * * ** ********************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Plans Examiner Engineer Zoning ITEM BATH TUB UNIT FEE ITEM SWITCH OUTLETS UNIT FEE ITEM SPACE HEATERS UNIT FEE BIDET LIGHT OUTLETS CENTRAL HEATING DISHWASHER RECEPTACLES A/C (WIND) DISPOSAL SERVICE TEMPORARY A/C (CENTRAL) DRINKING FOUNTAIN SERVICE SIZE IN AMPS DUCT WORK. FLOOR DRAIN SERVICE REPAIRA ETER CHANGE REFRIGERATION GREASE TRAP APPLIANCE OUTLETS PROCESS AND PRESS PIPING INTERCEPTOR RANGE TOP UNDERGROUND TANKS LAVATORY -2, OVEN ABOVE MOUND TANKS LAUNDRY TRAY WATER HEATER U.F. PRESSURE VESSELS CLOTHES WASHER MOTORS 0- 1 IP STEAM BOILERS SHOWER i MJTCRS OVER 1- 3 HP HOT WATER BOILERS SINK, POT /3 COMP. MOTORS OVER 3- 5 HP MECHANICAL VENTILATION SINK, RESIDENCE 1 MOTORS OVER 5- 8 HP TRANSPORTING ASSEMBLIES SINK, SLOP MOTORS OVER 8- 10 HP ELEVATORS/ESCALATORS TEMPORARY WATER CLOSET MOTORS OVER 10- 25 HP FIRE SPRINKLER SYSTEMS URINAL MOTORS OVER 25-100 HP COOLING TOWERS WATER CLOSET MOTORS OVER 100 If VIOLATION INDIRECT WASTES- A/C WINDOW REINSPECTION WATER SUPPLY TO: AIR CONDITIONERS • A/C UNIT STRIP HEATER FIRE SPRINKLER GENERATORS TRANSFORMERS HEATER -NEW INST. GENERATORS TRANSFORMERS HEATER - REPLACE GENERATORS TRANSFORMERS LAWN SPRINKLER -WELL SPECIAL PURPOSE SWIMMING POOL OUTLETS COMMERCIAL WATER SERVICE SIGN TUBES SEWER CONNECTIONS SIGN TRANSFORMERS UTILITY -SEWER SIGN TIME CLOCK UTILITY -WATER FIXTL>FRES SEPTIC TANK ANTENNA _ RELAY TELEVISION OUTLETS DRAINFIELD, 4' TILE/RES. VIOLATION PUMP & ABANDON SEPTIC TANK REINSPECTION SOAKAGE PIT CU. FT. CATCH BASIN DISCHARGE WELL DOMESTIC WELL AREA DRAIN ROOF INLET SOLAR WATER HEATER FIRE STANDPIPE POOL PIPING LAWN SPRINKLER SYSTEM GAS RANGE METER SET (GAS) GAS PIPING .ADDENDUM TO BUILDING PERMIT APPLICATION (AN APPLICATION FOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. IF A MASTER PERMIT HAS B. OBTAINED, THE OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.) PLUMBING ELECTRICAL MECHANICAL Plumbing Permit Miami Shores Village 10050 NE 2nd Avenue Phone: 305- 795 -2204 Permit Number: PL2004 -244 Printed: 9/13/2004 Applicant: HUBERT FATAL Owner: FATAL HUBERT JOB ADDRESS: 479 NE 93 ST Contractor ATLAS PLUMBING INC Local Phone: (305) 597 -9800 Parcel # 1132060140411 Signed: (INSPECTOR) Page 1 of 1 Contractor's Address: 9314 NW 13 ST 8 Legal Description: MIAMI SHORES SEC 2 PB 10 - 37 LOT 22 BLK 51 LOT SIZE 50.000 X 128 OR Fees: Description Amount FEE2004 -9206 Building Fee $185.00 FEE2004 -9207 CCF $0.60 FEE2004 -9208 Training and Education Fee $0.20 FEE2004 -9209 Technology Fee $4.62 Total Fees: $190.42 Total Fees $190.2 Total Receipts: 0:00 1 Permit Status: APPLIED Permit Expiration: 2/19/2005 Construction Value: $1,000.00 Work: PLUMBING FOR REMODELING SEP 1 a PAID In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responisibility for all work done by either myself, my agent, servants or employes. Signed: (Contractor or Builder) BY: