PLUMBINGBUILDING
ELECTRICAL
PLUMBING
Owner of
Building
Architect
Contractor
or Builder
Legal /, Lot
Descriptitn.
Address of
Building
PERMIT N? 10548
Work to be performed under this Permit
CONTRACTOR OR BUILDER
MIAMI SHORES VILLAGE, FLORIDA
DATE -� 19
Bl.
S
, 3
Subdi-
vision
Value of
Project $
Contractor's
License No
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 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 • %, s ' 4.4. BY ' 'r
YNSP TOR
In consideration of the issuance to me of this permit I agree toe form the work covered hereunder in compliance with all ordinances and regulations
pertaining thereto and in strict conformity with the plans, drawings, stafements or specifications submitted to the proper authorities of Miami Shores Village.
In accepting this permit I assume responsibility for all work done b either, myself, my agent, servant or employee.
BY AUTHORITY
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date /4'x-9$ Job Address <5 /(/c 93 S r
Legal Description
Owner / Lessee
Owner's Address
ary as to Owner
y Commission Expires
** * * *
APPROVED:
Zoning
S o��
.�S S tiA
/ Tenant
Contracting Co. R/ A/G47tij/94/N
Qualifier f iQV4 Ri/V �w7?7/Q/v`o
State # Municipal #
WORK DESCRIPTION CAA.r�s A= o c/ p
�o y�tii��z
9 3 5 cr.
Architect /Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type(circle one): BUILDING ELECTRICAL PLUMBI MECHANICAL ROOFING PAVING FENCE SIGN
Square Ft. Estimated Cost(value) ef7 D
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.
i: nature of owner ,an er C a P e8id ,
Dat-•
?..e4
TER
Notary Public, State of Florida
My Comm. expires July 28, 1999
No. CC 468973
* Bonded Thni
)(dug Saida *
Mechanical Plumbin
SS# Phone 347 6 3‘ -1 7 / 5 7 - 6
Competency # Ins.Co.,G6,r72V /
E D zi • S oINA wA' n/k
Buildin
FEES: PERMIT CD RADON C.C.F. 16C-7
Fire
Tax Folio
Master Permit #
NOTARY
Phone 3(.2s 7 9 62 4 / co
Address 02/90 A/ Gt./ ? 4 -¢
Signature of Contra or or Owner- Builder
Date'
Notar
My Co ission :21BATRAz
NOTARY PUBLIC STATE OF FLORIDA
COMMISSION NO. CC706595
* MY C.OMMISSIQN EXP. j,�N. 27,2000
er- Builder
* **
48
TOTAL DUE �
Other
Electrical
Engineering
Permit No._ Q___,l Dat 0 (� '
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith s mitt d 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_c y` t C- C t i t - r .: ' , t ( 1., No Street t '' ` C__1' C
Registered Architect and /or Engineer
Employing Plumber's Name )L _:1___ 3 A. a`^ • No Street
I
Location and Legal Description Lot_ -_� C' �' // 1 ___1 'I I Block ■- 4' Subdivision %`/1 - " � E (! e -ti �--
Street and Number where work is to be performed —No .' 5 .. ‘ Street L �t 7 e- 1
State work to be performed and purpose of building (By Floors)
(- - New Building ,,, Remodeling Addition Repairs No. of Stories__ __1
Size Septic Tank
Feet of Drain Tile
Amount of Permit $ G
STATE OF FLORIDA, 1
COUNTY OF DADE.
ss.
,v
Nature of Water Supply City, Well / '
My Commission Expires
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Size of Soakage Pit
(Signed)
s
7
7
Type of Tank Capacity Gals
Dist. Feet of Tank or Drain Field from Well
Plumbing Inspector.
The undersign 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) y-' ! ( G l' 2 k C �-- 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.
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
T UBS
SHOWERS
LAVA-
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TUBS
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT •
4.,.....
_At 4r
f •
f � p.t ` 7
TOTAL
FIXTURES
/
CHECK
7_
�,
/..7'b
/•. J'
7-7 . .-
,f v
/, +
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SW IM'G
POOL
CONTR. / V
LIST
CHECK
Permit No._ Q___,l Dat 0 (� '
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith s mitt d 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_c y` t C- C t i t - r .: ' , t ( 1., No Street t '' ` C__1' C
Registered Architect and /or Engineer
Employing Plumber's Name )L _:1___ 3 A. a`^ • No Street
I
Location and Legal Description Lot_ -_� C' �' // 1 ___1 'I I Block ■- 4' Subdivision %`/1 - " � E (! e -ti �--
Street and Number where work is to be performed —No .' 5 .. ‘ Street L �t 7 e- 1
State work to be performed and purpose of building (By Floors)
(- - New Building ,,, Remodeling Addition Repairs No. of Stories__ __1
Size Septic Tank
Feet of Drain Tile
Amount of Permit $ G
STATE OF FLORIDA, 1
COUNTY OF DADE.
ss.
,v
Nature of Water Supply City, Well / '
My Commission Expires
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Size of Soakage Pit
(Signed)
s
7
7
Type of Tank Capacity Gals
Dist. Feet of Tank or Drain Field from Well
Plumbing Inspector.
The undersign 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) y-' ! ( G l' 2 k C �-- 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.
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.