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544 NE 93 St (7)PERMIT u A ( PPLICATION FOR MIAMI SHORES VILLAGE Date S /2') 1 1i Job Address . l �l n ~ sf Tax Folio Legs: Description // �� Historically Designated: Yes No Owner/Lessee / Tenant `'S' R L & P v a t∎ t C ) C. Master Permit # 99V/ Owner's Address Phone 705 95 1 )0 1 Contracting Co. Ida- a I QC L "0 /l Q K Address ` V 5 4!4 / c-47 Qualifier SS# .r/r.-_,t:Vaa Phone C4 3 State t' Municipal # Competency # Ins. Co. Archit xt/Engineer Address Bonding Company Address Mortg gor Address Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN r WORD, DESCRIPTION LPL ` -\ ` € Square :rt. Estimated Cost (value) WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY RESULT IN YOU`? PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENQER 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 perfonned 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, thorize the above -named contractor to do the work stated. Signatyf gP6 an • / or C . . . President Date Signature of Contractor or Owner- Builder Date Notary as lo My Commissi FC C. FEES: PERMIT P C Nutj � S * ca7G n MS81ON YB COWS �7 // '``'OF F`O DEC 17,200 • ;: RADON y APPROVE): Zoning Building Mechanical Plumbing Date Notary as to Contractor or Owner- Builder Date My Commission Expires: J c C.C.F. (SD NOTARY 5 BOND 30 O TOTAL DUE , #t Electrical Structural Engineer CONSTRUCTION PERMIT FOR: [`] New System [ ] Existing System [ 1] Repair [r] Abandonment APPL I CANT : t l SYSTEM T [ / A [ N [ K [ D R A I N F I E L D 0 T H E R STATE OF FLORIDA DEPARTMENT OF HEALTH AND REHABILITATIVE SERVICES ONSITE SEWAGE DISPOSAL SYSTEM CONSTRUCTION PERMIT Authority: Chapter 381, FS & Chapter 10D -6, FAC DESIGN AIJD ,S PFtIFICATI0NS ] f ] [GALLONS ] GALLONS ] GALLONS FILL REQUIRED: [ ] INCHES SPECIFICATIONS BY: APPROVED BY: DATE ISSUED: f' PROPER. STREET ADDRESS:; LOT: -F j ` �.,, BLOCK: SUBDIVISION: PROPERTY ID #: 4 `t _a' £ :} ,* .:7 ] SQUARE__FEFT -RRIMARL DRAINF-IELD- SYSTEM [ ] SQUARE FEET SYSTEM TYPE SYSTEM: CONFIGURATION: [ ] STANDARD [ ] FILLED [ ] TRENCH [‘`] BED 7 LCCATION OF BENCHMARK: �- c ELEVATION OF PROPOSED SYSTEM BOTTOM OF DRAINFIELD TO BE [ SITE [ r- ] .[INCHES /FT] 1 [INCHE_S/FT] EXCAVATION REQUIRED: ` ] INCHES TITLE: TITLE:_ HRS-H Form 4016, Mar 92 (Obsoletes previous editions which may not be used) (Stock Number: 5744 - 001 - 4016 - 0) AGENT: i! , [ ] MOUND i PE # 'i DATE PAID ?-- 277 FEE PAID $ 7 /` -} RECEIPT # r (7E:`:30 `e) L ], Holding Tank [ / Temporary /Experimental ] Other(Specify) r rc 1'e s� [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. / GPD]�-SEPTIC. - TANK /AEROBIC UNIT CAPACITY MULTI- CHAMBERED /IN SERIES:[ ] / GPD] CAPACITY MULTI- CHAMBERED /IN SERIES:[ ] GREASE INTERCEPTOR CAPACITY [MAXIMUM CAPACITY SINGLE TANK: 1250 GALLONS] PER DOSE DOSING TANK CAPACITY DOSE RATE [ ] PER 24 HRS NO. OF PUMPS: [ ] [ [ABOVE /BELOW] BENCHMARK /REFERENCE POINT ABOV BELQNr. )3ENCHMA REFERENCE POINT EXPIRATION DATE: CPHU Page 1 of 2 ...:?:STRTJC7101" I : AND Pc. umber assignf..d y CP.HT.;. :y of rr, ownt::'s .JE T1 i3), :FAC. Couniy ptriom viir End appl:m. ISSUED: Date permit is issued by CPRIJ. On year from dat,: 15...ueu - ' : issued. APPLICANT: LOT : PROPERTY ID #• USDA SOIL SERIES: STATE OF FLORIDA DEPARTMENT OF HEALTH ONSITE SEWAGE DISPOSAL SYSTEM SITE EVALUATION AND SYSTEM SPECIFICATIONS / ); *f BLOCK: 1476 V.— 4/ TO BE COMPLETED BY ENGINEER, HEALTH UNIT PROVIDE REGISTRATION NUMBER AND SIGN AND PROFERTY SIZE CONFORMS TO SITE PLAN; TOTAL ESTIMATED SEWAGE FLOW: �.���✓ AUTHORIZED SEWAGE FLOW: "//5 UNOBSTRUCTED AREA AVAILABLE: ` / C' BENCHMARK /REFERENCE POINT LOCATION: ELEVATION OF PROPOSED SYSTEM SITE IS SOIL PROFILE INFORMATION SITE 1 SITE EVALUATED BY: Aisi() ':). c'dt- , to to to to to to to DH 4015, 1(196 (Replaces HRS -H Form 4015 (Page 3] which may be used) (Stock Number: 5744 - 003 - 4015 -1) SUBDIVISION: SITE SUBJECT TO FREQUENT FLOODING: [ ] YES 10 YEAR FLOOD ELEVATION FOR SITE: J40 �* Munsell # /Color Texture Depth f ' 4 to a„ J f to EMPLOYEE, SEAL EACH SOIL TEXTURE /LOADING RATE FOR SYSTEM SIZING: CONFIGURATION: [ ] TRENCH [ BED [ REMARKS /ADDITIONAL CRITERIA: AGENT: PERMIT # 9 r� P6 ' [Section /Township /Range /Parcel No. or Tax ID Number] OR OTHER QUALIFIED PERSON. ENGINEER'S MUST PAGE OF SUBMITTAL. COMPLETE ALL ITEMS. YES [ ] NO NET USABLE AREA AVAILABLE: ACRES GALLONS PER DAY [RESIDENCES -TABLE 1 / OTHER -TABLE 2] GALLONS PER DAY [1500 GPD /ACRE OR 2500 GPD /ACRE] SQFT UNOBSTRUCTED AREA REQUIRED: ' SQFT r ��� _ .® Y.7 ✓ .�% , c b=:, EY> ( [INCHES /FT] [ABOVE /BELOW] BENCHMARK /REFERENCE POINT THE :4INIMUM SETBACK WHICH CAN BE SURFACE WATER: ,f FT WELL1;: PUBLIC: j9e FT LIMITED USE: .�,-/ ` FT PRIVATE: FT NON - POTABLE: if FT BUILDING FOUNDATIONS: r FT PROPERTY LINES: " FT POTABLE WATER LINES FT h MAINTAINED FROM THE PROPOSED SYSTEM TO THE FOLLOWING FEATURES: DITCHES /SWALES: /a9 FT NORMALLY WET? [ ] YES [ /J NO ['A NO 10 YEAR FLOODING? [ ] YES [ ] NO FT MSL /NGVD SITE ELEVATION: FT MSL /NGVD - 44'7 ,, SOIL PROFILE INFORMATION SITE Munsell # /Color Texture Depth �f�Fx l to to { to (,\ to to to to ;to to USDA SOIL SERIES: OBSERVED WATER TABLE: f-fkl INCHES (ABOVE / BELO1) EXISTING GRADE. TYPE: [PERCHED / APPARENT] ESTIMATED WET SEASON WATER TABLE ELEVATION: J y Ay INCHES [ ABOVE / BELOW,] EXISTING GRADE. HIGH HATER TABLE VEGETATION: [ ] YES [i,} NO MOTTLING: [ ] YES [ ] NO DEPTH: " INCHES DEPTH OF EXCAVATION: INCHES ] OTHER (SPECIFY) /r ' DATE: i j ( 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. .07, . Lot, block, and subdivision for lot. NUMBER: 27 character nimb.c fo pi ( oierty appraiser 7.0 /tovr Check f propc'sty at. siti. conforms to S:1:;117!:t.'2.S1 site 2lan. rL net Lii;E all paved Z,V,F.S and prepar..ici road beds v. OL13HC i'ir:hts-o or :s normally viet drainage di,ches, ma.ishes, jr °the': such 'Joe:Ls 0 f!cw f01 1h:: TTE.i3H. C. ;-n, Itfic s.:v. 1.30E 590 3ailo.,s pof day .vater supplies :59! SCV.T.SC does not Or ••_:LCCS.',Cit_11C CS177::. acco,ftl nce. 1:,:EISt , :!.71(,5 r.s lc Lbsc:ption area and at least 75 ',7;f1 minimum setbacks in C" The Linobstructeci ai 1;r: no o tl.z: e;:o the locatio:, of the bench7ark. 7:71!Silig 0 surveyor's beri.CHTIE.'c. 7.01:1;, C of the proposed SyStr site (abovc or bLlow) Aeco:d. In.focrnation on lot's subject to flooding. For lots to ilot . 7ocd site C.i7C: FC. 3 .1E-1 site elevation. iNl7CaMA Tvic sci the pcoposer, r cat to t. . n • 7' icicliti will use UStOL Soil Classification mc7:706.0'3:!,:l (:1-• musl 13C clearly documented. 1rovidc USJOA soil su:'les if a determined. lkocord the depth of the observed wr.toO t at tilt 0.• appropriCc. l.ccord the estimated wt sac. \later tzbli: o and historical in Indicate if there IS high water table veL,:tctic and depth. Record soil texture or loading rate for system sizir.g. "fapT. reco depth of excavattio.1 . :70NFIC:11F,TICN: Cknck clrainfieldt confi required. If other, speci•fy type. 1:107„ONA: . .2.1i:l" . 17 ills A: 7(1 o.y additional liemarls pertinent to site or inst1.112'tio d• • it 7772, 0 SigniWrt' of evaIuato. titic, and &lir, of tvalaltion. sual al' Hc:• WORKSEET ELEV/'.TION 0 3ENC7MARK / RiF.FTERENC.E PCtNT lS: 3ENC ViARK [ 1 Record minimum setbacks CEil be .7. to all listed . - .1 - ...st "Nt." To nortapplicahlc feat:': Featturus on site plrn Or v. lthin if, Cu.: .;: i1., 'fin:: location of view v.'ithin 200 feet SITN 1 H.I. [ -1 SHOT SIT:: 2 H.I. [ SHOT 3 STATE OF FLORIDA DEPARTMENT OF HEALTH AND REHABILITATIVE SERVICES APPLICATION FOR ONSITE SEWAGE DISPOSAL SYSTEM CONSTRUCTION P t Permit Application Number PART II - SITE PLAN , Notes: _d!, fit Site Plar Submitted by By HRS-H Form 4 (15, Feb 85 (Obsoletes previous editions which may not be used) 'Stock Number 5744-002-4015-6) Plan Approved Not Approved 1 2 "7 - 4, .4- 4 tc.1 j! 4 / /".1 t e l t 1' r , 1 ,) ( - ‘e, - ,, 6,.. 61.-ey., ■ SIGNATURE TITLE ALL CHANGES MUST BE APPROVED BY THE COUNTY PUBLIC HEALTH UNIT Date County Public Unit Page 2 of 3 Site Plar Submitted by Plan Approved t By - STATE OF FLORIDA DEPARTMENT OF HEALTH AND REHABILITATIVE SERVICES APPLICATION FOR ONSITE SEWAGE DISPOSAL SYSTEM CONSTRUCTION PERMIT Permit Application Number PART II - SITE PLAN HRS-H Form 4( 15, Feb 85 (Obsoletes previous editions which may not be used) '`qock Number: 5744-002-4015-6) f .) Not Approved 0 -1 '`e+‘ SIGNATURE * 1, , --- ---- 1 Pt -- ,/./. , i 4 I - , ALL CHANGES MUST BE APPROVED BY THE COUNTY PUBLIC HEALTH UNIT TITLE Date ' County Public Unit Page 2 of 3 Data: -'/ 7 Job Address S L i g M 3 Std Q+ Tax Folio Legal Description 1,Abs 4- 20 L4 3 4 i41 At Of- y � Historically Designated: Yes M.."( 41 A Q Iv P 3 Owner/Lessee /Tenant G ro L S1,. 1 Ru� c fr Master Permit # Owner's Address S Y /VG I-3 ST PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Phone Arch Bonding Company - — Address i 3 206- o- / -I --- Q7 -O No Contracting Co. 7 P Phi (� , � „ + C Address Qualifier SS# Phone State # (�� O S.2-1 e Municipal # Competency # Ins. Co. W'14 7 Address Mortgagor Address Permit Type (circle one): BUILDING ELECTRICA I PLUMBIN MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION We t•✓ k ; 4 h 2 95 r ",, Square Ft Estimated Cost (value) S--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. Signature of owner and/or Condo President Date Notary as to Owner and/or Condo President Date My Corrimission Expires: FEES: PERMIT RADON C.C.F. 1 44 Signature 7:41 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. Notary as to Contractor or Owner - Builder My Commission Expires: NOTARY APPROVED: Zoning Building Mechanical LS A Electrical c to orM fi fIN. C a1 CC 419381 EXPIRES: November 7, 1998 Bonded Tin Notary PidJMc Underwriters 7 /dayiIP Date TOTAL DUE Date cqf Plumbing Engineering Permit No..___ _...! 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 be complied with, whether herein secified or not. A copy 'of approved plans and specifications must be kept at building during progress of work. Owner's Name and Address Registered Architect and /or Engineer Employing Plumber's Name - -__- allE / Location and Legal Description Lot_ _Block Street and Number where work is to be performed —No State work to be performed and purpose of building (By Floors) New Building____— _ ___ ___________T_ Remodeling Addition Repairs Size Septic Tank_ Type of Tank Feet of Drain Tile____� ,___ Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: City Size of Soakage Pit _____ ______________ ____w_____ Amount of Permit S_ .(Signed) _ ______—___-___—_—_---___----_-_------------__-__-_-_- Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts bis 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 *ill 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 - contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. ? STATE OF FLORIDA, COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared APPLICATION FOR PLUMBING PERMIT MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT (Signed) 0 Street ? da /fiCf 4 1 i Street —ZW Subdivision_____ rl Street__ . ."_1.1-"/ No. of Stories Capacity Gals._____.____________ — 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 Master Plumber. NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty 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. DRAIIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SWIM'G POOL CONTR. LIST 2 P ( . "' CHECK Permit No..___ _...! 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 be complied with, whether herein secified or not. A copy 'of approved plans and specifications must be kept at building during progress of work. Owner's Name and Address Registered Architect and /or Engineer Employing Plumber's Name - -__- allE / Location and Legal Description Lot_ _Block Street and Number where work is to be performed —No State work to be performed and purpose of building (By Floors) New Building____— _ ___ ___________T_ Remodeling Addition Repairs Size Septic Tank_ Type of Tank Feet of Drain Tile____� ,___ Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: City Size of Soakage Pit _____ ______________ ____w_____ Amount of Permit S_ .(Signed) _ ______—___-___—_—_---___----_-_------------__-__-_-_- Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts bis 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 *ill 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 - contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. ? STATE OF FLORIDA, COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared APPLICATION FOR PLUMBING PERMIT MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT (Signed) 0 Street ? da /fiCf 4 1 i Street —ZW Subdivision_____ rl Street__ . ."_1.1-"/ No. of Stories Capacity Gals._____.____________ — 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 Master Plumber. NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty materials and /or workmanship. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Permit No..___,�c_ ____ Date____- 0 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 hfrein s ecified or not. A copy of approved plans and specifications must be kept at building during progress of work. / - Owner's Name and Address —aL -- -- o Street- - Registered Architect and /or Engineer Employing Plumber's Name Location and Legal Description Lot_____ —_______ _________ _ ___: ___ ___ —�___ Bloch No Street Street and Number where work is to be performed —No.._ State work to be performed and purpose of building (By Floors) New Building___._-- ___— __— __:___ Remodeling Addition Repairs No. of Stories Size Septic Tank - -__ -___ __ Type of Tank Capacity Gals _________ ______ —___ Feet of Drain Tile____ ___ �C {_— __—_ —___ Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: City —Weft Size of Soakage Pit Amount of Permit $ licensed by Miami Shores Village. STATE OF FLORIDA, COUNTY OF DADE. _ (Signed) (Signed) lit Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966. Compiled General Laws of Florida Permanent Supplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The under signed agrees to employ only such sub - contractors, on work to be performed nder this permit, as are Notary Public, State of Florida 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 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 MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Permit No..___,�c_ ____ Date____- 0 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 hfrein s ecified or not. A copy of approved plans and specifications must be kept at building during progress of work. / - Owner's Name and Address —aL -- -- o Street- - Registered Architect and /or Engineer Employing Plumber's Name Location and Legal Description Lot_____ —_______ _________ _ ___: ___ ___ —�___ Bloch No Street Street and Number where work is to be performed —No.._ State work to be performed and purpose of building (By Floors) New Building___._-- ___— __— __:___ Remodeling Addition Repairs No. of Stories Size Septic Tank - -__ -___ __ Type of Tank Capacity Gals _________ ______ —___ Feet of Drain Tile____ ___ �C {_— __—_ —___ Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: City —Weft Size of Soakage Pit Amount of Permit $ licensed by Miami Shores Village. STATE OF FLORIDA, COUNTY OF DADE. _ (Signed) (Signed) lit Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966. Compiled General Laws of Florida Permanent Supplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The under signed agrees to employ only such sub - contractors, on work to be performed nder this permit, as are Notary Public, State of Florida 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 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. Owner of Building Architect Contracl or or Builder Legal Lot Descriptton Address of Building ' 4 %i CONTRACTOR OR BUILDER MIAMI SHORES VILLAGE. FLORIDA BUILDING ELECTRICAL ❑ DATE f - ' '� 195 PLUMBING ® P E 11 M I T N? 8229 Contractor's License No 5 ) l 1 ROOFING ❑ ❑ Work to be performed under this Permit 1-1 i4p L Bl. Subdi- vision Sq. Ft Value of Project $ Amt. of Permit $ Th 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 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. Signed: BY a 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 acceptir g this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. BY AUTHORITY BUILDING ELECTRICAL PLUMBING Owner of Building Legal Lot Description t./' Architect Contractor 6- t or Builder . i d 6 /••,. Address of C Building i / CONTRACTOR OR 18UI MIAMI SHORES VILLAGE, FLORIDA--. , DATE ` ' ° ' ' ` '' '194 t/ > 1 I PERMIT N9 3145 5 Contractor's Nos 5 ' _ 9 7 brk to et It s s erormed under this Permt 1 Subdi- vision Value of Project BY ' ' ) Amt. of 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 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 iis not done in compliance with such ordinancaa-.?r if the p s are changed without authorization. A further condition upon which this permit is granted is the understanding that the contractor or bufldet.named ve assuu}}n�gs the responsibility for a tho ugh knowledge of the ordinances and regulations pertaining to the work covered hereby whether s own ans or drawinga or in the statements ' r specifications and that he assumes responsibility for Work done by his agents, servants or employee Si ned • f i r. ! B ' INSPECTOR In consideration of the issuance to me of this permit I agree to perform the Vork covered hereunder in compliance with all ordinances and regula- tions 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 pe t u r nsibi,lity for aW'work done by either myself, my agent, servant or employee. AUTHORITY BUILDING ELECTRICAL PLUMBING Owner of Building Architect Contractor or Builder Legal Description Address of Building Lot i This permit is granted to the c cation herefor in strict cornpliance wit plans, drawings, statements or specific at any time if the work is not done in permit is granted is the understanding regulations pertaining to the work cov sibility for work done by his agents, se consideration of the issuanc pertaining thereto and in strict confo In accepting this permit I assume res CONTRACTOR OR BUILD MIAMI SHORES VILLAGE, FLORIDA DATE ,, `. ._g, Contractor's License No. ERMIT N° 8708 Wort# to be performed under this Permit Bl. Signed• to me of this permit I ee to "perfo mity with the plans, wings, stat onsibility for all work ne by ei R BY y Subdi- vision Value of Amt. of Project Permit AUTHORITY o ntractor or builder named above to construct the building or to install the equipment or device described in the appli- s all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any ations that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and ered hereby whether shown on the plans or • yawing$ or in the statemments or specifications and that he eivants or employees. assumes respon- By. INSPECTOR eunder in cornpliance with all orllmailces and regulations itted to the proper authorities of Miami Shores Village. employee. BUILDING ELECTRICAL PLUMBING ROOFING Owner of Building Architect Contractor or Builder Legal Lot II Bl. Description Address of Building l " 44 CONTRACTOR OR BUILDBR MIAMI SHORES VILLAGE, FLORIDA DATE PERMIT •9 15368 Work to be performed under this Permit Signed: Subdi- vision Value of Project $ f This permit is granted to the con ractor or builder named above to construct the building or to install the equipment or device described in the application herefor in strict compliance with all or inances pertaining thereto and with the understanding that the work will be performed in compliance with any plans, drawings, statements or specifications th t 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 complian with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is _ranted is the understanding that the co tractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations .ertaining to the work covered hereby w ether shown on the plans or drawings or in the statements or specifications and that he assumes responsibility for work one by his agents, servants or employes. INSPECTOR R �f Contractor's License No. _ Amt. of Permit $ ' BY ‘ 1 In consideration of the issuance t me of this permit I agree to perfor� the work covered hereunder in compliance with all ordinances and regulations rtaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. accepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. BY AUTHORITY 195 BUILDING ELECTRICAL PLUMBING Owner of Building Architect Contractor or Builder Legal Description Address of Building r Lot / ,r ric PEiRMIT 1'° 4520 Work to leperformed _ yy / './A..' . ( , n✓ R 4) IAMI SHORES VILLAGE, FLORIDA DATE L.e Bl. This permit is granted to the contrac cation herefor in strict compliance with all plans, drawings, statements or specification at any time if the work is not done in comr permit is granted is the understanding that regulations pertaining to the work covered sibility for work done by his agents, servant or employees. under this Permit /„s/ 5 7' Subdi- vision Contractor's License No. Value of Amt. of Project Permit tC. 19 4..- i ,r tor or builder named above to construct the building or to install the equipment or device described in the appli- rdinances pertaining thereto and with the understanding that the work will be performed in compliance with any that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked Hance with such ordinances or if the plans are changed without authorization. A further condition upon which this the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes respon- -' Signed , r.. INSPECTOR By ` / I \, In consideration of the issuance to nne of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict confo • 'ty with the •I ns, drawings, state nts,or specifications submitted to the proper authorities of Miami Shores Village. In accep ng this Rem*, 1 assumes' cam' . lity fo a Lt u rk done by e a mys = a , serva or employee. „,.......„ ,,,,,,, CONTRACTOR OR BUILDER ,” BY AUTHORITY Permit No Owner's Name and Address MA d74.) Registered Architect and /or Engineer Employing Plumber's Name a • Loc ation and Legal Description Lot______ Street and Number where work is to be performed —No Size Septic Tank Feet. of Drain Tile____ Nature of Water Supply: ty —Well. Amcunt of Permit $___ ..... __ t:t.? My Commission Expires MIAMI SHORES VILPLAGE PLUMBING INSPECTION DEPARTMEN'i' APPLICATION FOR PLUMBING ` °` ;b *MIT Application is hereby made for the approval of the detailed statement of the plans and specifications herewith ubmitted for the building or other stricture 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. Ste e work to be performed and purpose of building (By Floors) New Building -------- - -_• -- Remodeling_ --- _- _--- _--- _- ___ - -- Addition Date No. _l= 1____. ' Street. 93 Street Subdivision Street Repairs No. of Stories Type of Tank___ Capacity Gals C .Dist. Feet of Tank or Drain Field from Well .Size of Soakage Pit (Signed)_ uttib g 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 5966, Compiled General Laws of Florida Permanent Supplement, and has eom- plieu 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, / oil work to be o • ormed under this permit, as are licersed by :39faml Shores Village. 1 ( Signed )____ :aster Plumber. STATE OF FLORIDA, } ss. CO s NTY 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 tl.e above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts thersin by him stated are true. 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 mateials and /or workmanship. CLOSETS BATH TUBS SNOW R! ¢ LAVA- TORIES SINKS SLOP SINKS LAUNDRY Tuns URINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT TOTAL FIXTURES COT TR. LU3T CH! CK SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SWIM'O POOL COKTR. LISA' CHICK Permit No Owner's Name and Address MA d74.) Registered Architect and /or Engineer Employing Plumber's Name a • Loc ation and Legal Description Lot______ Street and Number where work is to be performed —No Size Septic Tank Feet. of Drain Tile____ Nature of Water Supply: ty —Well. Amcunt of Permit $___ ..... __ t:t.? My Commission Expires MIAMI SHORES VILPLAGE PLUMBING INSPECTION DEPARTMEN'i' APPLICATION FOR PLUMBING ` °` ;b *MIT Application is hereby made for the approval of the detailed statement of the plans and specifications herewith ubmitted for the building or other stricture 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. Ste e work to be performed and purpose of building (By Floors) New Building -------- - -_• -- Remodeling_ --- _- _--- _--- _- ___ - -- Addition Date No. _l= 1____. ' Street. 93 Street Subdivision Street Repairs No. of Stories Type of Tank___ Capacity Gals C .Dist. Feet of Tank or Drain Field from Well .Size of Soakage Pit (Signed)_ uttib g 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 5966, Compiled General Laws of Florida Permanent Supplement, and has eom- plieu 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, / oil work to be o • ormed under this permit, as are licersed by :39faml Shores Village. 1 ( Signed )____ :aster Plumber. STATE OF FLORIDA, } ss. CO s NTY 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 tl.e above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts thersin by him stated are true. 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 mateials and /or workmanship. JOB: BUILDING ELECMICAL PL UNIB:aT5 • WORK • DO BY: / RIITJSTED WILL BE READY • A „ .7 The following is ready for inspection:- / Inspector s Report :- Permit No. - _ _ Application is Lereby 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 ate of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be comp ''ed with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. Owner's Name and Address Registered Architect and / o'IJngineer • Employing Plumber's Name r ' 'I C ` No. Street Location and Legal Descripti9rl Lot Block _ ; Subdivision .5'Freet STATE OF FLORIDA, } ss. COUNTY OF DADE. Amount of Permit $ ____ /- `` r 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 MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT No. __ - I Street ' i � / r . / Sig Type of Tank .Dist. Feet of Tank or Drain Field from Well Size Septic Tank Feet of Drain Tile Nature of Water Supply: City —Well. Size of Soakage Pit (Signed)_ ,' Repairs // 1y_ Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he ur5derstands and accepts his ohli n•as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida I'erman nt•Supplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractor rrr n loved by him in the work to be perfonned under this permit; and will post or cause bo be posted for inspection on r e of the o such p notice or notices as are required by the Act. The undersigned agrees to employ only such sub -contr ors, on work k .e performed u this permit, as are licensed by Miami Shores Village. , Date My Commission Expires Notary Public, State of Florida / -- V No. of Stories Capacity Gals._.. ster 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 URINAL 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. - _ _ Application is Lereby 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 ate of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be comp ''ed with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. Owner's Name and Address Registered Architect and / o'IJngineer • Employing Plumber's Name r ' 'I C ` No. Street Location and Legal Descripti9rl Lot Block _ ; Subdivision .5'Freet STATE OF FLORIDA, } ss. COUNTY OF DADE. Amount of Permit $ ____ /- `` r 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 MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT No. __ - I Street ' i � / r . / Sig Type of Tank .Dist. Feet of Tank or Drain Field from Well Size Septic Tank Feet of Drain Tile Nature of Water Supply: City —Well. Size of Soakage Pit (Signed)_ ,' Repairs // 1y_ Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he ur5derstands and accepts his ohli n•as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida I'erman nt•Supplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractor rrr n loved by him in the work to be perfonned under this permit; and will post or cause bo be posted for inspection on r e of the o such p notice or notices as are required by the Act. The undersigned agrees to employ only such sub -contr ors, on work k .e performed u this permit, as are licensed by Miami Shores Village. , Date My Commission Expires Notary Public, State of Florida / -- V No. of Stories Capacity Gals._.. ster 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. REQUEST FOR INSPECTION Company .! PHON E Job Address Inspection Date Ready Time Ready A.M. P.M. Permit No. ) Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or otlwl 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 Divisior 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. Owners Name ard Address Registered Architect and /or Engineer MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT No._. • r �' No. Date Employing Plumber's Name - _ _ _ _ -- __ -• -- Street.____ Location and Leg it Description Lot -___ _._.._ _________ _ __ __ Block__.___.. 7 4 -z - 4 1 -s - _ Subdivision_ - Street fl' • ! �•' Street and Number where work is to be performed -No. . _ _ $ _ Street . 5 • State work to be performed and purpose of building (By Floors)_ New Building _ Remodeling_ _________________- -______ Addition. Repairs_ Size Septic Tank- . Type of Tank__ Feet of Drain Tile ___ L -_ l 3-. . " , Dist. Feet of Tank or Drain Field from Well _ - Nature of Water Supply: City -Well . _.__.___.____.____.__ _____.._.___ _ ___ Size of Soakage Pit vC Amount of Permit $. STATE OF FLORIDA, I as. COUNTY OF DADE. __ (Signed) ______ Capacity Gals. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as au 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 thi; 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 an licensed by Miami Shores Village. (Signed)___ -_ -- - - - - -- - ----- - - - - -- - - -- ---- - - - - -- Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeare 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 tac therein by him stated are true. My Commission Expires Notary Public, State of Florida No. of Stories Plumbing Inspector. NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or hall materials and /or workmanship. CLOSETS BATH TUBS SHOWER6 LAVA. TORIES SINKS SLOP SINKS LAUNDRY TUSK URL URINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT•NS ' -- TOTAL FIXTURE! CONTR. UST - - -_ CHECK SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SWIM 0 POOL CONTR. 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 otlwl 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 Divisior 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. Owners Name ard Address Registered Architect and /or Engineer MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT No._. • r �' No. Date Employing Plumber's Name - _ _ _ _ -- __ -• -- Street.____ Location and Leg it Description Lot -___ _._.._ _________ _ __ __ Block__.___.. 7 4 -z - 4 1 -s - _ Subdivision_ - Street fl' • ! �•' Street and Number where work is to be performed -No. . _ _ $ _ Street . 5 • State work to be performed and purpose of building (By Floors)_ New Building _ Remodeling_ _________________- -______ Addition. Repairs_ Size Septic Tank- . Type of Tank__ Feet of Drain Tile ___ L -_ l 3-. . " , Dist. Feet of Tank or Drain Field from Well _ - Nature of Water Supply: City -Well . _.__.___.____.____.__ _____.._.___ _ ___ Size of Soakage Pit vC Amount of Permit $. STATE OF FLORIDA, I as. COUNTY OF DADE. __ (Signed) ______ Capacity Gals. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as au 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 thi; 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 an licensed by Miami Shores Village. (Signed)___ -_ -- - - - - -- - ----- - - - - -- - - -- ---- - - - - -- Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeare 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 tac therein by him stated are true. My Commission Expires Notary Public, State of Florida No. of Stories Plumbing Inspector. NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or hall materials and /or workmanship. t 5) Employing Plurabe;'s Name ABC SEPTIC TANK Size Septic Tank._ _ _ Feet of Drain Tile._ __ Nature of Water Supply. City—Well. Amount of Permit $ C. _ STATE OF FLORIDA, } COUNTY OF DADE. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Permit No ?. 20. _ Application i hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build ng or other structure herein descnbed. 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 th Building Di sion 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. JOHN. A TAIA LL Registered Architect and/or Engineer _ . 511) M.E. 93rd _ ... Street_ . Location and Legal Description Lot__ _ _ _ _ __Block_ SF Subdivision. 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_ __ _Dist Feet of Tank or Drain Field from Well. Si .e of Soalcage Pit (Signed)_ The undersigned applicant for this building permit does hereby certify that he understands and ece-cpts his obligations as an e nployer of labor under the Florida Wo icmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, eni I as nm plied with the provisions thereof, and will require similar compliance from all contractors or sub-contractors employed by hin in the wink 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 no ices as are required by the Act. The undersigned agrees to employ only such sub contractors, on work to be perfo. ed under this per nit, as are licensed by Miami Shores Village. (Signed)._ _. No. 3123 N.W. 5/ithstreet Street _ No. of Stories . _ Capacity Gals.. My Commission Expires Notary PubliC, State of Florida Master Plumber. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgn ents, personall 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 •acts therein by hun 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. TS CLOUTS BATH TUBS SHOWERS LAVA- TORIES SINKS SLOP SINKS LAUNDRY TUBS URINALS CATCH BASIN FLOOR DRAIN DRINKING FOIX"T' NS TOTAL F XTURES CONTR. LIST CHICK SEPTIC TANK 13EW ER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SWIM G POOL CONTR. LIST -- CHICK t 5) Employing Plurabe;'s Name ABC SEPTIC TANK Size Septic Tank._ _ _ Feet of Drain Tile._ __ Nature of Water Supply. City—Well. Amount of Permit $ C. _ STATE OF FLORIDA, } COUNTY OF DADE. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Permit No ?. 20. _ Application i hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build ng or other structure herein descnbed. 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 th Building Di sion 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. JOHN. A TAIA LL Registered Architect and/or Engineer _ . 511) M.E. 93rd _ ... Street_ . Location and Legal Description Lot__ _ _ _ _ __Block_ SF Subdivision. 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_ __ _Dist Feet of Tank or Drain Field from Well. Si .e of Soalcage Pit (Signed)_ The undersigned applicant for this building permit does hereby certify that he understands and ece-cpts his obligations as an e nployer of labor under the Florida Wo icmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, eni I as nm plied with the provisions thereof, and will require similar compliance from all contractors or sub-contractors employed by hin in the wink 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 no ices as are required by the Act. The undersigned agrees to employ only such sub contractors, on work to be perfo. ed under this per nit, as are licensed by Miami Shores Village. (Signed)._ _. No. 3123 N.W. 5/ithstreet Street _ No. of Stories . _ Capacity Gals.. My Commission Expires Notary PubliC, State of Florida Master Plumber. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgn ents, personall 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 •acts therein by hun 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.