477 NE 92 St (2)Date
Type Insp'n
Permit No.
Name
MIAMI 'SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
Building Inspection Reque
Inspection Date
Approved
Correction
Re- Insp'n Fee
Address9 1 t \i 3
Company, A 1 00-4
'(— 3
Phone #
Building Inspection Request
Date
Type Insp'n ?`'/ ,o
Permit No.
Name
Address
Company
Phone #
Inspection Date
Approved
Correction
Re- Insp'n Fee
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204 C`N
o
o
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
BuilIing Inspectiptt R6quest •
-�� ire-( \
Date
Phone #
Inspection Date
Approved
Correction
Re- Insp'n Fee
Type Insp >n �., °' ,`row
I —" P Permit No. I QS
Name C)cl 1 n
Address 4 NE cir2.,
Company O
D
Type Insp'n
Permit No.
Name
Address
Compan
Phone #
Inspection Date
Approved
Correction
Re- Insp'n Fee
MIAMI SHORES VILLAGE
BUILDING DEPARTM
305- 795 -2204
Building Inspection Request
Approved
Correction
Re- Insp'n Fee
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
Building Inspection Requ
Address
Compa
Phone #
Inspection Dat
Type Insp'
Permit N
Name i
Miami Shores Village
BUILDING `gin
PERMIT APPLICATION
FBC 2001
Permit Type (circle): Building Electrical Plumbing Mechanical Roofing
Owner's Name (Fee Simple Titleholder) 4) /f - /G°K / (12)//1J Phone # L:3 V.S Y ') //A
Owner's Address q . )7 A- _ -- % L -
City I'4 i11 ill , - ' (Pi: State * L-L � / Zip 23;6.
Tenant/Lessee Name Phone #
Job Address (where the work is being done) /0" t ` - ��J� /mil �~ f
City Miami Shores Village County Miami -Dade Zip
Is Building Historically Designated YES NO
Contractor's Company Name / - r-C- 'L rte' t'P / / /)I i . J LP "/Cs Phone # Jl .Z / � - ` 7 . 4
Contractor's Address ') - / (y ' i/ 1 a4 7
City State / Zip :- 3 - 3 /61'' .
Qualifier t ' al L - • L ; 7
Architect/Engineer's Name (if applicable) Phone #
$ Value of Work For this Permit
Type of Work: ❑Addition
Describe Work: AY / t /it
Fee Now Due $
(Continued on opposite side)
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
/ 9,
* * * * * * * * * * * * * * * * * * * * * * * * * * ** F ees * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
Submittal Fee $ Permit Fee $ � 7 c. //,, Z
Notary $ S p 0 Training/Education Fee $ V
Scanning $ Radon $
Code Enforcement $ Structural Plan Review. $
Permit NPL 0 ‘-.1:
o�
Master Permit No.
Square Footage Of Work: I Z'.'
❑Alteration ❑New [Repair/Replace ❑ Demolition
r' J;( /Y (/J/ -,L Li)
Zoning
CCF $ � Q� CO /CC
Technology Fee $
i
Bond $306 , 07)
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.
Signature
Owner or Agent
The foregoing instrument was acknowledged before me this 20 72/ The for going instrument was ackno • edged before me this D
day of ,
IMA/ V , 20 0 `t, by DEC fL'R ) (.. Z /A.1 , day of is personally known tome r who has produced who is personally known to me or who has produced
As identification and who did take an oath.
NOT I' Y P
Sign:
Print:
My Commission Expires:
Chc 12/15/03
Signature
as identification and who did take an oath.
r
gela M Becker
, 20d. b
My Conunission Expires:
Contractor
***************************************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
(Certificate of Competency Holder)
State Certificate or Registration No. Certificate of Competency No.
***************************************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
APPLICATION APPROVED BY: Plans Examiner
Engineer
Zoning
LOT: »(
APPLICANT: / ',r
<,/
PROPERTY ID #: y;/
STATE OF FLORIDA
DEPARTMENT OF HEALTH
ONSITE SEWAGE DISPOSAL SYSTEM
SITE EVALUATION AND SYSTEM SPECIFICATIONS
»6
. BLOCK: (
` - 1
TO BE COMPLETED BY ENGINEER, HEALTH UNIT
PROVIDE REGISTRATION NUMBER AND SIGN AND
PROPERTY SIZE CONFORMS TO SITE PLAN:
TOTAL ESTIMATED SEWAGE FLOW:
AUTHORIZED SEWAGE FLOW:
UNOBSTRUCTED AREA AVAILABLE:
EMPLOYEE,
SEAL EACH
YES [ ]
GALLONS
GALLONS
SQFT
BENCHMARK /REFERENCE POINT LOCATION: i 101,5 _6!.P A:A /14
ELEVATION OF PROPOSED SYSTEM SITE IS , fir, j77 C INCHE) FT ] [ ABOV' fiBELOW
THE MINIMUM SETBACK WHICH CAN BE MAINTAINED FROM THE
SURFACE WATER: FT DITCHES /SWALES: _
WELLS: PUBLIC: FT LIMITED USE: G FT
BUILDING FOUNDATIONS: FT PROPERTY LINES:
SITE SUBJECT TO FREQUENT FLOODING: [ ] YES [ NO
10 YEAR FLOOD ELEVATION FOR SITE: 3
SOIL PROFILE INFORMATION SITE 1
Munsell # /Color Texture
USDA SOIL SERIES:
Depth
to
to V Y�
to
to
to
to
to
to
to 4
OBSERVED WATER TABLE: A ;.1
ESTIMATED WET SEASON WATER TABLE ELEVATIO
HIGH WATER TABLE VEGETATION: [ ] YES [ 4 NO
INCHES [ABOVE
DH 4015, 10/96 (Replaces HRS -H Form 4015 [Page 3) which may be used)
(Stock Number: 5744- 003 - 4015 -1)
/
SOIL TEXTURE /LOADING RATE FOR SYSTEM SIZING:
DRAINFIELD CONFIGURATION: [ ] TRENCH [t/]
REMARKS ADDITIONAL CRITERIA:
f / , / ' , { �
S ITE EVALUATED BY: A 1 ,9/j ?/,'",'
/ c ✓ '/.!" / /
AGENT: ' a
a 0 ��.' %i J �� :•�
pi /� t -��- �F ..��, ..� ✓:
SUBDIVISION: ' � i / w l kyi 1 s' 6
y t ..
[Section /Township /Range /Parcel No. or Tax ID Number]
OR OTHER QUALIFIED PERSON. ENGINEER'S MUST
PAGE OF SUBMITTAL. COMPLETE ALL ITEMS.
NO NET USABLE AREA AVAILABLE: oc ACRES
PER DAY ((RESIDENCES-TABLE j), OTHER -TABLE 2]
PER DAY [1500 GPD /ACRE OR 2500 GPD /ACRE];
UNOBSTRUCTED AREA REQUIRED: / t »/' SQFT
PROPOSED SYSTEM TO THE FOLLOWING FEATURES:
A∎/ /' / FT NORMALLY WET? [ ] YES / [ ] NO
PRIVATE: /, e,. FT NON- POTABLE: ,> FT
FT POTABLE WATER LINES: dff) FT
10 YEAR FLOODING? [ ] YES [ ] NO
NGVD SITE ELEVATION: (; ' ( M$, /NGVD
�i
SOIL PROFILE INFORMATION SITE 2
Munsell # /Color Texture
1 )//:' /7b b 7 f
11
/1
1'
USDA SOIL SERIES:
BELOW] EXISTING GRADE. TYPE: - PERCHED / APPARENT]
[ ABOVE ' ELOW- EXISTING GRADE.
�- 1 (. _ 44';. INCHES
MOTTLING: YES NO DEPTH:
DEPTH OF EXCAVATION: INCHES
BED [ ] OTHER (SP FY )
/ /A.1.4 " I/I
/;
'
Or
BENCHMARK /REFERENCE POINT
Depth
mil to
to r,
/ to
to
to
to
to
to
to
DATE:
•
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.
LOT, BLOCK, SUBDIVISION: Lot, block, and subdivision for lot.
PROPERTY ID NUMBER: 27 character number for property (property appraiser ID number or section /township /range /parcel number).
PROPERTY SIZE: Check if property at site conforms to submitted site plan. Record net usable area available - lot area exclusive of
all paved areas and prepared road beds within public rights -of -way or easements and exclusive of streams, lakes,
normally wet drainage ditches, marshes, or other such bodies of water.
SEWAGE FLOW:
UNOBSTRUCTED AREA:
Record the estimated sewage flow for the establishment from Table 1 (residence) or Table 2 (non - residential),
Chapter 10D-6, FAC. Record the authorized sewage flow for the lot based on net usable area and water supply
(1500 gallons per day per acre for private water supplies and 2500 gpd per acre for public water supplies). If
authorized sewage flow does not equal or exceed the estimated sewage flow, the application must be denied.
Record the square feet of unobstructed area available and the amount required. Unobstructed area must be at
least 2 times as large as the drainfield absorption area and at least 75 percent of the unobstructed area must meet
minimum setbacks in Chapter 1OD -6, FAC. The unobstructed area must be contiguous to the drainfield.
BENCHMARK INFORMATION: Record the location of the benchmark. If using a surveyor's benchmark record the actual elevation. Record the
elevation of the proposed system site in relation (above or below) to the benchmark.
MINIMUM SETBACKS:
Record minimum setbacks which can be meet to all listed features. Actual measurements must be recorded or
"NA" for nonapplicable features. Features on site plan or within 75 feet of the applicant lot must be measured.
The location of any public drinking well within 200 feet of the applicant's lot must also be verified.
FLOOD INFORMATION: Record information on lot's subject to flooding. For lots subject to flooding record 10 year flood elevation for
site and actual site elevation.
SOIL PROFILE INFORMATION: Two soil profiles within the proposed absorption area to a minimum depth of 6 feet or refusal are required. Soil
identification will use USDA Soil Classification methodology (Munsell colors and USDA soil textures). Refusals
must be clearly documented. Provide USDA soil series if available, record "UNK" if the series cannot be
determined.
WATER TABLE: Record the depth of the observed water table at the time of the evaluation. Mark "perched" or "apparent" as
appropriate. Record the estimated wet season water table elevation based on site evaluation, USDA soil maps,
and historical information. Indicate if there is high water table vegetation present. Indicate if mottling is present
and depth.
SOIL TEXTURE: Record soil texture or loading rate for system sizing.
DEPTH OF EXCAVATION: If applicable record depth of excavation required. Record "NA" if not applicable.
DRAINFIELD CONFIGURATION: Check drainfield configuration required. If other, specify type.
ADDITIONAL CRITERIA: Record any additional remarks pertinent to site or installation. Ex. dosing required.
SITE EVALUATED BY: Signature of evaluator, title, and date of evaluation. Professional engineers must seal all documents submitted.
ELEVATION WORKSHEET ELEVATION OF BENCHMARK / REFERENCE POINT IS:
BENCHMARK SITE 1 SITE 2 SITE 3
[ + ] SHOT H.I. H.I. H.I.
H.I. [ - ]SHOT [ - ]SHOT [ - ]SHOT
PROPERTY ID #:
0
T
H
E
R
CONSTRUCTION PERMIT FOR:
[N] New System [ ° Existing System [ ] Holding Tank [(>2] Innovative
[.;] Repair [ 1 Abandonment r-] Temporary [ ]
? �
APPLICANT: b
PROPERTY ADDRESS: . 71 I / fit °
of ° •
LOT: � 'Z c a / y BLOCK: � SUBDIVISION: t' -
SYSTEM DESIGN AND SPECIFICATIONS
SPECIFICATIONS BY:
STATE OF FLORIDA
DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM
CONSTRUCTION PERMIT
f 9-
APPROVED BY:
DATE ISSUED: <"
F.'
•
[SECTION, TOWNSHIP, RANGE, PARCEL NUMBER]
[OR TAX ID NUMBER]
SYSTEM MUST BE CONSTRUCTED IN ACCORDANCE WITH SPECIFICATIONS AND STANDARDS OF SECTION 381.0065,
F.S., AND CHAPTER 64E -6, F.A.C. DEPARTMENT APPROVAL OF SYSTEM DOES NOT GUARANTEE SAFTISFACTORY
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. ISSUANCE OF THIS PERMIT
DOES NOT EXEMPT THE APPLICANT FROM COMPLIANCE WITH OTHER FEDERAL, STATE, OR LOCAL PERMITTING
REQUIRED FOR DEVELOPMENT OF THIS PROPERTY.
T (i/, D ] GALLONS / GPD SEPTIC TANK /AEROBIC UNIT CAPACITY MULTI- CHAMBERED /IN- SERIES [ ]
A ['? ] GALLONS / GPD CAPACITY MULTI- CHAMBERED /IN- SERIES [ ]
N [ ] GALLONS GREASE INTERCEPTOR CAPACITY [MAXIMUM CAPACITY SINGLE TANK: 1250 GALLONS]
K [ ] GALLONS DOSING TANK CAPACITY [ ]GALLONS @ [ ] DOSES PER 24 HRS # PUNS [ ]
D [/ ] SQUARE FEET PRIMARY DRAINFIELD SYSTEM
R [ ] SQUARE FEE SYSTEM
A TYPE SYSTEM: [ ] STANARD [] FILLED [ ] MOUND [ ] _
I CONFIGURATION: [ ] TRENCH [ -1 BED [ ]
N
F LOCATION OF BENCHMARK: , ' -' �' ` � I �' ��� ' / (' C °
I ELEVATION OF PROPOSED SYSTEM SITE [? f] [INCHES /FT] [ABOVE /BELOW] BENCHMARK /REFERENCE POINT
E BOTTOM OF DRAINFIELD TO BE [,,g k '] [INCHES /FT] [ABOVE /BELOW] BENCHMARK /REFERENCE POINT
L
D FILL REQUIRED: [' ` ] INCHES EXCAVATION REQUIRED: (( / ] INCHES
t 2``
PERMIT NO. ( ° 1
DATE PAID: '
FEE PAID: < 'y <;
RECEIPT #:
•
TITLE:
TITLE: ■ . .� r - ; W. i.d. 2 CHD
EXPIRATION DATE: ! 4 t '
DE 4016, 12/99 (Page 1) (Previous Editions May Be Used) Page 1 of 3
INSTRUCTIONS:
PERMIT NUMBER: Permit tracking number assigned by CPHU.
CONSTRUCTION
PERMIT FOR: Check type of permit, if "Other" specify type in blank.
APPLICANT: Property owner's full name.
TELEPHONE: Telephone number for applicant or agent
AGENT: Property owner's legally authorized representative.
MAILING ADDRESS: P.O. Box or street mailing address for applicant or agent.
LOT, BLOCK, SUBDIVISION or
PROPERTY ID #: 27 character id number for property. (CHD may require property appraiser ID # or section /township /range/parcel number)
SYSTEM DESIGN AND
SPECIFICATIONS:
TANK: Minimum specifications from Chapter 64E-6, FAC.
DRAINFIELD: Minimum specifications from Chapter 64E-6, FAC.
OTHER: Other specifications, such as operating permit requirements, low- volume flush toilets, variance provisos.
SPECIFICATIONS BY: Name of individual providing specifications. If designed by a registered engineer must be sealed.
APPROVED BY: County Health Department (CHD) personnel reviewing and approving permit.
DATE ISSUED: Date permit is issued by CHD
EXPIRATION DATE: One year from date issued if the system has not been installed. Permits for system repairs become void 90 days from the date
issued.
•
•
By
•••
Scale: Each block represents 5 feet and 1 inch = 50 feet.
Plan Approved
STATE OF FLORIDA
DEPARTMENT OF HEALTH
APPLICATION FOR ONSITE SEWAGE DISPOSAL SYSTEM CONSTRUCTION PERMIT ;
Permit Application Number
Site Plan submitted by
DH 4015. 10/96 (Replaces HRS-H Form 4015 which may be used)
(Stock Nuffter: 5744-002-40154)
•
'; •i
L..
•,
-) A
- 7/Z
Notes:
. • ;
„
PART II SITE PLAN-
.ginature
Not Approved
/21->°
.
J o
s/ •
'`.; • r `•iN
•,• .
"•:r
, r /,` 4- 1 •
1
ALL CHANGES MUST BE APPROVED BY THE COUNTY HEALTH DEPARTMENT
, - -_ ,• •• .•.••••••4.0 , •—••••••*
4-)
( 1 ;"
Title
Date t.(
County Health Department
Page 2 of 3
•
Miami Shores Village
10050 NE 2nd Avenue
Phone: 305 - 795 -2204 Permit Number: PL2004 -24
Printed: 1/20/2004 Page 1 of 1
Applicant: DIETER RUDIN
Owner: RUDIN DIETER
JOB ADDRESS: 477 NE 92 ST
Contractor LLOYD NORTH DADE SEPTIC TANK SERVIOTdNtbactor's Address: 750 NW 107 ST
Local Phone: 305 - 754 - 3375
Parcel # 1132060140270 Legal Description: MIAMI SHORES SEC 2 PB 10 -37 LOTS 21 & 22 & W15FT OF LOT 23
Fees: Description Amount
FEE2004 -575 Building Fee $175.00
FEE2004 -576 CCF $1.20
FEE2004 -577 Notary Fee $5.00
FEE2004 -578 Training and Education Fee $0.40
FEE2004 -579 Technology Fee $4.37
FEE2004 -580 Builders Bond $300.00
Total Fees: $485.97
Permit Status: APPROVED Permit Expiration: 7/18/2004 Construction Value: $1,900.00
Work: REPLACE DRAINFIELD
Signed: (INSPECTOR)
Plumbing Permit
Total Fees: $485.97
Total Receipts: $485.97
--e k.o
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:
Permit No
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitte r 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
Registered Architect and/or ngineer__ —
Employing Plumber's Name ° 0 rrJoi oc a-clitt No. 2 %vet_ /ULU 1- 1
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Location and Legal Description Lot Bloelf
Street and Number where work is to be performed—No. LI, v1 1
State work to be performed and purpose of building (By Floors)_
New Building _ _ Remodeling Addition.
Si2O Septic Tanlc_
Feet of Drain Tile
Type of Tank
__Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City—WelL_____________________________Size of Soakage Pit
Amount of Permit $
Date
0
\ ,
Q
C A(Vva, - 0 - icts..s7
No. L in I Street_ Ta•
Subdivision.
3:11
Repairs No. of Stories.
Capacity Gals
The undersigned applicant for this building permit does hereby certify that he understands and accepts his oblig tions as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Pennanent Supplement, and bus 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)
t 7 /4
P1
STATE OF FLORIDA, I
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
bing Inspector.
Master Plumber.
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the__
of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
My Commission Expires Notary Public, State of Florida
NOTE: A re-inspection fee of $1.00 will be made when such re-inspection is made • necessary by improper notice for inspection, or faulty
materials and/or workmanship.
CLOSETS
BATH
Tu Bs
SHOWERS
LAVA-
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TUBS A
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT'NS
TOTAL
FIXTURES
CONTR.
LIST
1
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 hereby made for the approval of the detailed statement of the plans and specifications herewith submitte r 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
Registered Architect and/or ngineer__ —
Employing Plumber's Name ° 0 rrJoi oc a-clitt No. 2 %vet_ /ULU 1- 1
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Location and Legal Description Lot Bloelf
Street and Number where work is to be performed—No. LI, v1 1
State work to be performed and purpose of building (By Floors)_
New Building _ _ Remodeling Addition.
Si2O Septic Tanlc_
Feet of Drain Tile
Type of Tank
__Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City—WelL_____________________________Size of Soakage Pit
Amount of Permit $
Date
0
\ ,
Q
C A(Vva, - 0 - icts..s7
No. L in I Street_ Ta•
Subdivision.
3:11
Repairs No. of Stories.
Capacity Gals
The undersigned applicant for this building permit does hereby certify that he understands and accepts his oblig tions as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Pennanent Supplement, and bus 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)
t 7 /4
P1
STATE OF FLORIDA, I
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
bing Inspector.
Master Plumber.
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the__
of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
My Commission Expires Notary Public, State of Florida
NOTE: A re-inspection fee of $1.00 will be made when such re-inspection is made • necessary by improper notice for inspection, or faulty
materials and/or workmanship.
Permit No 1
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida,
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at
building during progress of work.
Owner's Name and Address ° � � -_- N o . StreeL4 E.' . � 11.
Registered Architect and /or Engineer___— ___— __ —_____ _.-_. ____ - -_ --
Employing No.__ `�_
Emplo Plu mber's Name -- ��- --���%���__� _�._._ .t��.3. Street_ -- . �.� = -��_ ®'‘
Location and Legal Description Lot ____...______.._.______.__. —_ Block 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 No. of Stories .. ..... ..... ............
Size Septic Tank
Feet cf Drain Tile
Nature ei Water Supply: City —Well
STATE OF FLORIDA,
COUNTY OF DADE. J
Amount of Permit $
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING
Street
Type of Tank— Capacity Gals.
__Dist. Feet of Tank or Drain Field from Well
__Size of Soakage Pit
(Signed) -
(r)
Date t ,(
Plumbing Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accep is obligations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florid ermanent 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 a are
required by the Act. The undersigned agrees to employ only such sub- contractors, on work to be perforged'under this - permit, As are
licensed by Miami Shores Village.
My Commission Expires Notary Public, State of Florida
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 /ox workmanship.
CLOSETS
BATH
TUBS
SHOWERS
LAVA-
TORIES
SINKS
6
SLOP
SINKS
LAUNDRY
TUBS
UR
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT'NB
TOTAL
FIXTURES
CONTR.
LIST
! J
/
CHECK
{/
-
- - --
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SW IM'G
POOL
CONTR.
L1ET
CHECK
Permit No 1
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida,
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at
building during progress of work.
Owner's Name and Address ° � � -_- N o . StreeL4 E.' . � 11.
Registered Architect and /or Engineer___— ___— __ —_____ _.-_. ____ - -_ --
Employing No.__ `�_
Emplo Plu mber's Name -- ��- --���%���__� _�._._ .t��.3. Street_ -- . �.� = -��_ ®'‘
Location and Legal Description Lot ____...______.._.______.__. —_ Block 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 No. of Stories .. ..... ..... ............
Size Septic Tank
Feet cf Drain Tile
Nature ei Water Supply: City —Well
STATE OF FLORIDA,
COUNTY OF DADE. J
Amount of Permit $
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING
Street
Type of Tank— Capacity Gals.
__Dist. Feet of Tank or Drain Field from Well
__Size of Soakage Pit
(Signed) -
(r)
Date t ,(
Plumbing Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accep is obligations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florid ermanent 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 a are
required by the Act. The undersigned agrees to employ only such sub- contractors, on work to be perforged'under this - permit, As are
licensed by Miami Shores Village.
My Commission Expires Notary Public, State of Florida
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 /ox workmanship.
BUILDING
ELECTRICAL ,rpRI'
:
•
•
I)O,'E BY:
PLUMBINB •
The following is ready for inspsetion:-
Inspector's Report:-
r', ,RESTED WILL HE READY
Permit No.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida,
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at
building during progress of work.
f //-1-1 Street._ A/ ;r. s 37
Owner's Name and Address • '-i j No
Registered Architect and /or Engineer
Employing Plumber's Name . _- - No Street __
Location and Legal Description Lot ._.___.. Block Subdivision__.__ ______
Street and Number where work is to be performed —No. '� ' .r r : , 16ltrzet
State work to be performed and purpose of building (By Floors) _________
New Building_. _...._ Remodeling Addition Repairs _.__ .__
Type of Tank
Date
Size Septic Tank
Feet of Drain Tile Dist. Feet of Tank or Drain Field from Well.
Nature of Water Supply: City —Well. Size of Soakage Pit
Amount of Permit $
STATE OF FLORIDA, 1
COUNTY OF DADE.
ss.
( Signed)
No. of Stories
Capacity Gals
My Commission Expires Notary Public, State of Flor:da
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 h im 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.
r
P
(Signed) : i - , a 1 ,
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.
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
Permit No.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida,
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at
building during progress of work.
f //-1-1 Street._ A/ ;r. s 37
Owner's Name and Address • '-i j No
Registered Architect and /or Engineer
Employing Plumber's Name . _- - No Street __
Location and Legal Description Lot ._.___.. Block Subdivision__.__ ______
Street and Number where work is to be performed —No. '� ' .r r : , 16ltrzet
State work to be performed and purpose of building (By Floors) _________
New Building_. _...._ Remodeling Addition Repairs _.__ .__
Type of Tank
Date
Size Septic Tank
Feet of Drain Tile Dist. Feet of Tank or Drain Field from Well.
Nature of Water Supply: City —Well. Size of Soakage Pit
Amount of Permit $
STATE OF FLORIDA, 1
COUNTY OF DADE.
ss.
( Signed)
No. of Stories
Capacity Gals
My Commission Expires Notary Public, State of Flor:da
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 h im 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.
r
P
(Signed) : i - , a 1 ,
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.
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty
materials and /or workmanship.
(
Permit No.__ Date i' -= - - - -- =
1 /
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village ' --
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Buildins
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be
building during progress of work.
Owner's Name and Address " 1'1, . No. L i ) ) 1 C Street
Registered Architect and /or Engineer
Employing Plumber's Name •.- - ._ = ,_1___
Location and Legal Description Lot
Street and Number where work is to be performed —No
Amount of Permit $ -
STATE OF FLORIDA,
COUNTY OF DADE.
ss.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
1)
No.__
_Block
(Signed) __ ____
/
State work to be performed and purpose of building (By - M:_ — ti:a _ _ _-
New Building Remodeling Addition
Size Septic Tank- ______Type of Tank
Feet of Drain Tile __Dist. Feet of Tank or Drain Field from Well __ __
Nature of Water Supply: City—Well. Size of Soakage Pit
Signed
Repairs
Street - `
Subdivision
Street_. --
Capacity Gals.
No. of Stories
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 undersigned agrees to employ only such sub - contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village.
Commission Expires 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
herein 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
iaterials and /or workmanship.
CLOSETS
BATH
TUBS
SHOWERS
LAVA-
TORIES
S
SLOP
SINKS
LAUNDRY
TUBS
U
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT NS
TOTAL
FIXTUF
CONTR.
LIST
CHECK
JD
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SWIM'
POOL
CONTR.
LIST
CHECK
(
Permit No.__ Date i' -= - - - -- =
1 /
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village ' --
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Buildins
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be
building during progress of work.
Owner's Name and Address " 1'1, . No. L i ) ) 1 C Street
Registered Architect and /or Engineer
Employing Plumber's Name •.- - ._ = ,_1___
Location and Legal Description Lot
Street and Number where work is to be performed —No
Amount of Permit $ -
STATE OF FLORIDA,
COUNTY OF DADE.
ss.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
1)
No.__
_Block
(Signed) __ ____
/
State work to be performed and purpose of building (By - M:_ — ti:a _ _ _-
New Building Remodeling Addition
Size Septic Tank- ______Type of Tank
Feet of Drain Tile __Dist. Feet of Tank or Drain Field from Well __ __
Nature of Water Supply: City—Well. Size of Soakage Pit
Signed
Repairs
Street - `
Subdivision
Street_. --
Capacity Gals.
No. of Stories
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 undersigned agrees to employ only such sub - contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village.
Commission Expires 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
herein 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
iaterials and /or workmanship.
BUILDING
ELECTRICAL
PLUMBING
Architect
Contractor
or Builder
Legal
Description
Address of
Building
Lot
Owner of �, l
Building f.1
rl
1
MIAMI SHORES VILLAGE, FLORIDA
L! PERMIT N? 10777
Work to be performed under this Permit
Bl.
This permit is granted to the contractor oi* 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. J"
Signed: /.1,- ., �, .. ,r / s r BY ' ::ter 7,1
'-- INSPFCTOR !'� w . •
In consideration of the issuance to me of this permit I agree; perform the work covered hereunder in compliance with all ordinances and regulations
pertaining thereto and in strict conformity with the plans, drawir910, statements or specifications submitted to the proper authorities of Miami Shores Village.
In acceptin this permit I assume responsibility for all work dne by either, myself, my agent, servant or employee. ....,_
CONTRACTOR TRAcCTOR Ott 1361 - 15.` , s ` BP7 AUTHORITY
Subdi-
vision
Value cf
Project $
2
DATE // —■' , � 7 195 ? 4_
Contractor's
License No
' i y
Amt. of
Permit
BUILDING
ELECTRICAL
PLUMBING
Owner of
Building
Architect
Contractor
or Builder
Legal
Description.
Address of
Building
Lot
1 MIAMI SHORES VILLAGE, FLORIDA
I DATE
I 1 PERMIT N° 9751
Work to be performed under this Permit
Bl.
Subdi-,
vision
Value of
Project $
Signed•
INSPECTOR
CONTRACTOR OR BUILDER BY
Contractor's
License No
Amt. of
Permit $
t
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,pr specifications and that he assumes responsibility for work
done by his agents, servants or employees. �+'
In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordiyf►ances 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 responsibility for all work done by either, myself, my agent, servant or employee.
AUTHORITY
BUILDING
ELECTRICAL
PLUMBING
Owner of /
Building
CONTRACTOR OR BUILDER
MIAMI SHORES VILLAGE, FLORIDA
DATE f
PERMIT N? 6808
Contractor's, /
License N i./
Wor to be performed under this Permit
194_
Architect
O � �
Contractor, °, r `� r
or Builder �;; -- l r t e . i
Legal Lot Bl. Subdi
Description vision
Address of Value of Amt. of
Building __, .__ Project . Permit
This permit i granted to the contractor or b der named a ove to construct the building or to install the equipment or device described in the appli-
cation herefor in strict compliance with all ordinances pertaining thereto and w th 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 oulinances and
regulations pertaining to the work covered hereby whether shown on the plans or in the stients or specifications and thRt�enes respon-
sibility for work done by his agents, servants or employees. s °y f /� , , ,--9
Signed: IN +'` E c dR �� By j-
In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and /e
pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authori`fits of Mimi Shoiks* Vili�ge.
In accepting this permit I assume responsibility for a work done by either myself, my agent, servant or employee.
BY AUTHORITY
BUILDING
ELECTRICAL
PLUMBING
Owner of
Building
Architect
Contractor
or Builder
Legal
Description
Address of
Building
Lot
MIAMI SHORES VILLAGE, FLORIL,.
DATE f
PERMIT ■° 3241
Contractor's
License No.
Work to be performed under this Permit 1f
Bl.
Subdi-
vision
Value of
Project
•
Amt. of
Permit
r
CONTRACTOR OR BUILDER BY AUTHORITY
WPOIFIIM
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 specificatio s and
that he assumes responsibility for work done by his agents, servants or employees. F
Signed• By
INSPECTOR
In consideration of the issuance to me of this permit I ag to perfgrm the work covered hereunder in compliance with all ordinances and regula-
tions pertaining thereto and in strict conformity with the plan win ;statements or specifications submitted to the proper authorities of Miami Shores
Village. In accepting this permit I assume responsibility for wo r e 1y either myself, my agent, servant or emplo
BUILDING ❑
ELECTRICAL ❑ P E R M I T N9
PLUMBING 0 N e 9601
ROOFING ❑
Owner of
Building
Architect
Contractor
or Builder
Legal Lot
Description
Address of
Building
CONTRACTOR OR BUILDER
MIAMI SHORES VILLAGE.
Bl.
Work to be performed under this Permit
Subdi-
vision
FLORIDA
DATE
Contractor's
License No
Sq. Ft
Value of
Project $
Aunt. 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: BY
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 accepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee.
BY AUTHORITY
195_,-
BUILDING
ELECTRICAL
PLUMBING
ROOFING
MIAMI SHORES VILLAGE, FLORIDA
PERMIT
Owner of
Building —
Architect
Contractor
or Builder
Legal Lot
Description II Bl
N° 6424
Work to be performed under this Perini
DATE
Contractor's r
License No.
.1 19
0
Subdi-
vision
Building of Project of I I Permit n$ of . ,, +�...."
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 applica-
tion herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any
plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked
at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A :further condition upon which this
permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and
regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes respon-
sibility for work done by his agents, servants or employees.
s
Signed. -; i ' 1 ` , ) .. _ fig, INSPECTOR
In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinMTEes aad regulations
pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In ae
cepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee.
CONTRACTOR OR BUILDER
BY AUTHORITY
AUBOT "`�'