Loading...
PLUMBINGr - � CLosrys BATH u T.s SNOWKR� LAVA- TORIES SINKS SLOP SINKS LAUNDR Tuns URINALS CATC aAEI FLOOR DRAIN ORINKINO FOUNT' NI TOTAL PIITURIE CONTR. LIST CHICK SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT G TRAP SOLAR NEATER Dam WILL 5 S M SWIM'O POOL CO$T R. Lin CHICK ,- 1 Permit No 73 S 7 My Commission Expires 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 specificetlons must be kept et building during progress of work. Owners Name and Addres •' L.J . 1 "L No v 2 Street -_ " " 1 � . 7 Registered Architect and/ fnotinfti P - N�c-- ,� IV� £ �,m 04. , �pi ti: : P 2 - o - •• -{) 8 iV�c Nor ilrsgl._�.��»...., �..= ..� "Y;ocation and Le gal Description / / `1` SubdivWon Street and Number where work L to be performed —No State work to be performed and purpose of building (By Floors) __ aSQ 7 New Building.._..._ __.._.........._.. Remodeling -- - - -- Addition... - - -_ __ Repair `re' No. of Stories S treet_._A[ _ ... I Size Septic Tank_._ Type of Tank 200 of Drain __Dist- Feet of Tank ar Drain Field from Well... ____ . — Nature of Water Supply: City —Well. Size of Soakage Pit 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 5988, Compiled General Laws of Florida Permanent Supplement, and has cT►m- piied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the wor`rr to he performed under this permit; and will post or cause to be posted' for inspection on the site of the ch public notice or notices as are required by the Act. The undersigned agrees to employ only such sub-contractors, on work . be -• under this permit, as are licensed by Miami Shores Village ( Si 102 `f Notary Public, State of Florida �k7 Master Plumber. STATE OF FLORIDA, } COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take aclmowledgments, 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 be bar 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 mot reispeottof+ is made 'naoassary by improper notice far 'impaction, or faulty materials and/or workmanship. BpILDING ELECTRICAL PLUMBING ROOFING Owner of Butilding Architect Contractor or Builder Legal Description Address of Building Lot MIAMI SHORES VILLAGE, FLORIDA ❑ DATE 195 ❑ PERMIT N? 14101 ❑ Work to be performed under this Permit Signed• 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 hetefor 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 pettaining 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 doge by his agents, servants or employees. ■ 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,atrvant or employee. Po CONTRACTOR OR BUILDER P' BY " AUTHORITY BUILDING ELECTRICAL •• PLUMBING Owner of Building Architect Contractor or Builder Legal Description. Address of Building Lot r. CONTRACTOR OR BUILDER MIAMI SHORES VILLAGE, FLORIDA DATE r PERMIT N° 9994 Work to be performed under this Permit Bl. Subdi- vision Value of Project $ .,y • BY Contractor's License No AUTHORITY 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 plant 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 Ai granted is the understanding that the contractor or builder named abovg, assumes the respqnsibility fqr a thorough knowledge of the ordinances and reationp pertaining to the work covered hereby whether shown on the plans or dlawings or in the tement; 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 regula ion0 ,ertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. n accepting this permit I assume responsibility for all work done by eithir myself, my agent, s ant or employee. BUILDING ELECTRICAL PLUMBING ROOFING Owner of Building Architect Contractor or Builder Legal. Description Address of Building Lot MIAMI SHORES VILLAGE. FLORIDA ❑ DATF ' 195 PERMIT N° 2606 Contractor's License No. ❑ Work to be performed under this Permit CONTRACTOR OR BUILDER B1 Subdi- vision Value of Project $ Amount of Permit $ This permit is granted to the contractor or builder named above to construc 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 ac- cepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. BY AUTHORITY satrn= BUILDING ELECTRICAL PLUMBING ROOFING CONTRACTOR OR BUILDER MIAMI SHORES VILLAGE, FLORIDA PERMIT N° 467 Owner of Building Architect Contractor or Builder Legal Lot Description Bl Address of Building Work to be performed under this Permi DATE 1 19 Contractor's License No. Subdi- vision Value of 11 Amount of Project $ 11 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 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. 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 ac• cepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. t l ; ' BY AUTHORITY ABBOT PRINT 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 specified or not. A copy of approved plans and specifications must be kept at building during progress of work. Owner's Name and Address __________ No. _____________.__ Street 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.___ —_ Street State work to be performed and purpose of building (By Floors New Building Remodeling _..___ ....... _______ Addition____ _ Repairs No. of Stories_ Size Septic Tank Feet of Drain Tile_ Nature of Water Supply: City —Well. Amount of Permit $ STATE OF FLORIDA, } COUNTY OF DADE. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Type of Tank Capacity Gals _Dist. Feet of Tank or Drain Field from Well . Size of Soakage Pit (Signed) 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 coin- 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)= _- 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 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 worlomanship. 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 Cowrie. LIST CHICK 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 specified or not. A copy of approved plans and specifications must be kept at building during progress of work. Owner's Name and Address __________ No. _____________.__ Street 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.___ —_ Street State work to be performed and purpose of building (By Floors New Building Remodeling _..___ ....... _______ Addition____ _ Repairs No. of Stories_ Size Septic Tank Feet of Drain Tile_ Nature of Water Supply: City —Well. Amount of Permit $ STATE OF FLORIDA, } COUNTY OF DADE. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Type of Tank Capacity Gals _Dist. Feet of Tank or Drain Field from Well . Size of Soakage Pit (Signed) 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 coin- 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)= _- 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 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 worlomanship. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT Permit _J No. / l. . - - / -- 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 specified or not. A copy of approved plans and specifications must be kept at building during progress of work. Owner's Name and Address. __ _> APPLICATION FOR PLUMBING PERMIT Registered Architect and /or Engineer Employing Plumber's Name. -- _ -- -------__-_--_ _____----- ---- _ _ .... __ - -/ Location and Legal Description Lot__ /2 __':___ Block_ Street and Number where work is to be performed —Into —5 2 -_ Street State work to be performed and purpose of building (By Floors) New Building STATE OF FLORIDA, COUNTY OF DADE. Remodeling. _ Addition__ ss. No. No. Street Repairs — ( Signed) ,1 ) ' — - _ _____ - Street .._. Subdivision f_ No. of Stories .. __ My Commission Expires Notary Public, State of Florida - Y T Size Septic Tank -- - -- ---Type of Tank Capacity Gals . - - - - -- ..... 'f - ' -' -- Feet of Drain Tile __ . Q - - ---- - - - - -- -- - - - - -- -Dist. Feet of Tank or Drain Field from Well ___ Nature of Water Supply: City — Well. _______ ______ _____________ _______ Size of Soakage Pit Amount of Permit $ .. \ fl � '- `- � - - a. (Signed) - -- ----- -...ir = == ----- '' '(. /. . The undersigned applicant for this building permit does hereby certify that he )riider�tands and accepts his obligation(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 arc licensed by Miami Shores Village. Plumbing Inspector. t Meter PluuSber. 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 y / / 1. CHECK SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPR KLR. SYSTEM SWIM'G POOL A/ i f /�II, / °_ —_ CONTR. LIST / 1 / 1 �* CHECK MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT Permit _J No. / l. . - - / -- 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 specified or not. A copy of approved plans and specifications must be kept at building during progress of work. Owner's Name and Address. __ _> APPLICATION FOR PLUMBING PERMIT Registered Architect and /or Engineer Employing Plumber's Name. -- _ -- -------__-_--_ _____----- ---- _ _ .... __ - -/ Location and Legal Description Lot__ /2 __':___ Block_ Street and Number where work is to be performed —Into —5 2 -_ Street State work to be performed and purpose of building (By Floors) New Building STATE OF FLORIDA, COUNTY OF DADE. Remodeling. _ Addition__ ss. No. No. Street Repairs — ( Signed) ,1 ) ' — - _ _____ - Street .._. Subdivision f_ No. of Stories .. __ My Commission Expires Notary Public, State of Florida - Y T Size Septic Tank -- - -- ---Type of Tank Capacity Gals . - - - - -- ..... 'f - ' -' -- Feet of Drain Tile __ . Q - - ---- - - - - -- -- - - - - -- -Dist. Feet of Tank or Drain Field from Well ___ Nature of Water Supply: City — Well. _______ ______ _____________ _______ Size of Soakage Pit Amount of Permit $ .. \ fl � '- `- � - - a. (Signed) - -- ----- -...ir = == ----- '' '(. /. . The undersigned applicant for this building permit does hereby certify that he )riider�tands and accepts his obligation(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 arc licensed by Miami Shores Village. Plumbing Inspector. t Meter PluuSber. 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. 4 Inspection Number: I NSP -150 Inspection Date: 04/03/2006 Inspector: Levrack, James Owner: HOMES, OM Job Address: 525 92 Street NE Project: <NONE> Friday, March 31, 2006 Miami Shores Village, FL Contractor: STATEWIDE SEPTIC CONNECTIONS Building Department Comments Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL one: (305)795 -2204 Fax: (305)756 -8972 Block: Permit Number: PL -12 -05 -1027 Permit Type: Plumbing - Residential Inspection Type: Landscaping Work Classification: Drainfield Phone Number (305)758 -0775 Parcel Number 1132060141130 Lot: Phone: 305- 661 -6633 Page 2 of 2 r � � J �z Inspector Comments Passed Failed Correction Needed Re- Inspection Fee ($75) No Additional Inspections can be scheduled until re- inspection fee is paid. 4 Inspection Number: I NSP -150 Inspection Date: 04/03/2006 Inspector: Levrack, James Owner: HOMES, OM Job Address: 525 92 Street NE Project: <NONE> Friday, March 31, 2006 Miami Shores Village, FL Contractor: STATEWIDE SEPTIC CONNECTIONS Building Department Comments Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL one: (305)795 -2204 Fax: (305)756 -8972 Block: Permit Number: PL -12 -05 -1027 Permit Type: Plumbing - Residential Inspection Type: Landscaping Work Classification: Drainfield Phone Number (305)758 -0775 Parcel Number 1132060141130 Lot: Phone: 305- 661 -6633 Page 2 of 2 i I nspection Number: INSP -151 Inspection Date: 04/03/2006 Inspector: Levrack, James Owner: HOMES, OM Job Address: 525 92 Street NE Project: <NONE> Miami Shores Village, FL Contractor: STATEWIDE SEPTIC CONNECTIONS Building Department Comments Friday, March 31, 2006 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Block: Permit Number: PL -12 -05 -1027 Permit Type: Plumbing - Residential Inspection Type: Final Work Classification: Drainfield Phone Number (305)758 -0775 Parcel Number 1132060141130 Lot: Phone: 305 - 661 -6633 Page 1 of 2 Inspector Comments Passed V Failed Correction Needed Re- Inspection Fee ($75) No Additional Inspections can be scheduled until re- inspection fee is paid. i I nspection Number: INSP -151 Inspection Date: 04/03/2006 Inspector: Levrack, James Owner: HOMES, OM Job Address: 525 92 Street NE Project: <NONE> Miami Shores Village, FL Contractor: STATEWIDE SEPTIC CONNECTIONS Building Department Comments Friday, March 31, 2006 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Block: Permit Number: PL -12 -05 -1027 Permit Type: Plumbing - Residential Inspection Type: Final Work Classification: Drainfield Phone Number (305)758 -0775 Parcel Number 1132060141130 Lot: Phone: 305 - 661 -6633 Page 1 of 2 BUILDING PERMIT APPLICATION FBC 2001 Permit Type (circle): Building Electrical Plumbing Mechanical Roofing /Owner's Name (Fee Simple Titleholder) Al-1.4 Phone # W Owner's Address 1 ?4' W ‘ Air. 4P piv City Coml. State .. Zip 'Z L Tenant/Lessee Name N !° Phone # 7 Z 1'° � rig /Job Address (where the work is being done) City Miami Shores Villa•e Is Building Historically Designated YES Qualifier Submittal Fee $ • • . Miami Shores Village Notary $ Training/Education Fee $ Total Fee Now Due $ (Continued on opposite side) Il g Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (3Q5) f#5;23B4. E3O5 }, 756.8972 I/ 80 . 4(54 80 County Miami-Dade NO l/ Contractor's Address City .�= ,.,. , ,t 1 v..n o drt State LA Po box 3 86 M ilster Permit No. �(++ 1) C3o) GC - 6G 33 Contractor's Company Name klrJ�6 � cT CA 5 Phone # Zip Permit No.PLO5 — t 0 Z Zip State Certificate or Registration No. 43fr EF 2`Q1 4 Certificate of Competency No. Architect/Engineer's Name (if applicable) N Phone # $ Value of Work For this Permit *2_c Al Square Footage Of Work: Aw 200 Type of Work: ❑Addition ['Alteration ['New (LKe air/Re lace p ❑Demolition Describe Work: T r . _ . 1 ✓x_ 3k N D-r(11 n " .e (d ` Permit Fee $ 7.S : h1 17-3 s'a CCF $ 1 CO /CC Technology Fee $ 4 -. 4-0 cam.- ,52, 9 g NOV 2 9 PAID 34 CD .G0 Scanning $ 3 • C Radon $ Zoning Bond $ co- Code Enforcement $ Structural Plan Review. $ Bonding Company's Name (if applicable) Bonding Company's Address City State / Zip Mortgage Lender's Name (if applicable) Mortgage Lender's Address City 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, FURNAGES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC • . • OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and tl at all work will be done hi compliance with all applicable laws regulating construction and zoning. • L • "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 $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature (' -LQ,AS SCt(1)--- Owl t`©rAr4 C+O r' The foregoing instrument was acknowledged before me this aq _ day of r , 26- iy LA `$ L.e who is personally known to me or who has produced NOTA Sign: Print: chc 05/13/03 APPLICATION APPROVED BY: State ei oiitra tof O W 4 dC t� The foregoing instrument was acknowledged before me this 7 day of / , 20 i)5, by Gtftl who is personally known to me or who has produced p As identification and who did take an oath. as identification and who did take an oath. O , LIC•9TATE OP FLORIDA NOTARY PUBLIC: _ t > • - 1 ey =, •, deZ Sign: ' r .f1 .!.1 Print: My Comm ssion Expires: • , :: •;` Bonded Thru Notary * ** * * * ** * * * * * * * * * * *, * * ** *************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** ` Signature k ******************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** * ** ** My Commission Expires: Zoning Zip Ail 1.401-dr;r--Aaw.e. / •:a MONICAUSSEfl1DIA D4095 MY COMMIS . • .ES: October 20, 2009 ndsrwlrers * * * * * * * * * * * * * * * * ** * * * * ** * * * * * * * * * * * * * * * * ** /,� l Z/ �/O /�_J Plans Examiner Engineer CONSTRUCTION PERMIT FOR: [ ]New System [ ]Existing System [ [ X ]Repair [ ]Abandonment APPLICANT: OM Homes Llc PROPERTY STREET ADDRESS: 525 NE 92 St Miami Shores FL 33138 LOT: 11 BLOCK: 57 PROPERTY ID #: 11- 3206 - 014 -1130 SYSTEM MUST BE CONSTRUCTED IN ACCORDANCE WITH SPECIFICATIONS AND STANDARDS OF CHAPTER 64E -6,FAC DEPARTMENT APPROVAL OF SYSTEM DOES NOT GUARANTEE SATISFACTORY PERFORMANCE FOR ANY SPECIFIC TIME PERIOD. 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 PROPERTY DEVELOPMENT. SYSTEM DESIGN AND SPECIFICATIONS T [ 900 ]Gallons SEPTIC TANK A [ 0 ]Gallons N [ 0 ]GALLONS GREASE INTERCEPTOR CAPACITY K [ 0 ]GALLONS DOSING TANK CAPACITY [ 0 ]GALLONS @ D [ 200 ]SQUARE FEET PRIMARY DRAINFIELD SYSTEM R [ 0 ]SQUARE FEET SYSTEM A TYPE SYSTEM: [ N ]STANDARD [ N ]FILLED I CONFIGURATION: [ N ]TRENCH [ N ]BED N F LOCATION TO BENCHMARK: EFF I ELEVATION OF PROPOSED SYSTEM SITE [ E BOTTOM OF DRAINFIELD TO BE L D FILL REQUIRED: [ 0.0 ]INCHES OTHER REMARKS: 1.- Install 900 gal. category -3 septic tank equipped with an approved filter. 2. -The licensed contractor installing the system is responsible for installing the minimum category of tank in accordance with sec. 64E- 6.013(3)(f), FAC. 3.- Install 200 sf of drainfield in bed configuration. 4.- Invert elevation of drainfield to be no less than 7.30' NGVD. 5.- Bottom of drainfield elevation to be no less than 6.80' NGVD. THIS PERMIT IS NOT FOR " ADDITION(s)." SPECIFICATIONS BY: Andre, Pa TITLE: TITLE: Professional Engin Dade CHD EXPIRATION DATE: 2/26/06 APPROVED BY: Andre, Paul DATE ISSUED: 11/28/05 DH 4016, 03/97 (Obsoletes previous editions which =:y not be used) (Stock Number: 5744- 001 - 4016 -0) [ostds_cons_4016 -1] STATE OF FLORIDA DEPARTMENT OF HEALTH ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM CONSTRUCTION PERMIT AGENT: SA0021074, Solomon Teresa SUBDIVISION: Miami Shores Sec 2 [Section /Township /Range /Parcel No.] [OR TAX ID NUMBER] EXCAVATION REQUIRED: [ 30.0 ] INCHES CENTRAX #: 13 -SG -27152 DATE PAID: FEE PAID : $ RECEIPT . OSTDSNBR : 05 -3719- -R ]Holding Tank [ ] Innovative Other ]Temporary [ NA ] MULTI- CHAMBERED /IN SERIES: [Y ] MULTI - CHAMBERED /IN SERIES: [Y ] [0 ]DOSES PER 24 HRS # PUMPS[ 0 ] [ N ]MOUND [ N ] [ N ] El.:11.00' NGVD 0.0 ] [ FEET ] [ BELOW BENCHMARK /REFERENCE POINT 4.2 ] [ FEET ] [ BELOW BENCHMARK /REFERENCE POINT \ Page 1 of 2 STATE OF FLORIDA DEPARTMENT OF HEALTH APPLICATION FOR ONSITE SEWAGE DISPOSAL SYSTEM CONSTRUCTION PERMIT 5 M ` Permit Application Number Scale: Each block represents 5 feet and 1 inch = 50 feet. Site Plan submitted by Plan Approved V By DH 4015, 10/96 (Replaces HRS-H Form 4015 which may be used) (Stoc( Number: 5744 -002- 4015.6) PART II - SITE PLAN- Not Approve Y1, 3 Notes: --1 kc)rvIQS ac 52S NE q2 s 38 A le ov byotsrn o per. 40 w S drOir 01 640c C:CtA4TMC-51-._ Signature Title ALL CHANGES BE APPROVED BY THE COUNTY HEALTH DEPARTMENT Date County Health Department Page 2 of 3 Issue Date: 12/1/2005 Owner's Name: OM HOMES Permit Type: Plumbing - Residential Work Classification: Drainfield Job Address: 525 92 Street NE Additional Information Miami Shores Village, FL Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Fax: (305)756 -8972 Permit Expires: 12/29/2006 Contractor(s) Phone STATEWIDE SEPTIC CONNECTION 305 - 661 -6633 Yes Primary Contractor Type of Work: NEW DRAINFIELD Type of Piping: Additional Info: 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, servants, or employes. I understand that separate permits are required for ELECTRICAL, PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work. OWNERS 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. Futhermore, I authorize the above -named contractor to do the work stated. Fees Due Amount Bond Type - Contractors Bond $300.00 CCF $1.80 Education Surcharge $0.60 Inspection Fee $75.00 Inspection Fee $75.00 Permit Fee - Additions /Alterations $100.00 Permit Fee - Additions /Alterations $100.00 Scanning Fee $3.00 Technology Surcharge $4.40 Total: $659.80 Building Department File Copy Permit Status: APPROVED Permit Number: PL -12 -05 -1027 Phone: (305)758 -0775 Parcel #: 1132060141130 Block: Lot: Section: PB: Total Square Feet: 200 Total Valuation: $ 2,500.00 Re • uired Ins s ections Rough Landscaping Final DEC 0 5 PAID Invoice Number PL - 12 - 05 - 1117 Total: Amt Due $659.80 Amt Paid $484.80 $484.80 NOTICE: In addition to the requirements of this permit, there may be additional restrictions applicable to this property that may be found in the public records of this county. AND THERE MAY BE ADDITIONAL PERMITS REQUIRED FROM OTHER GOVERNMENTAL ENTITIES SUCH AS WATER MANAGEMENT DISTRICTS, STATE AGENCIES, OR FEDERAL AGENCIES. Issue Date: 12/1/2005 Owner's Name: OM HOMES Permit Type: Plumbing - Residential Work Classification: Drainfield Job Address: 525 92 Street NE Additional Information Miami Shores Village, FL Expires: 12/29/2006 Contractor(s) Phone STATEWIDE SEPTIC CONNECTION 305 - 661 -6633 Primary Contractor Yes Type of Work: NEW DRAINFIELD Type of Piping: Additional Info: 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, servants, or employes. I understand that separate permits are required for ELECTRICAL, PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work. OWNERS 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. Futhermore, I authorize the above -named contractor to do the work stated. Fees Due Bond Type - Contractors Bond CCF Education Surcharge Inspection Fee Inspection Fee Permit Fee - Additions /Alterations Permit Fee - Additions /Alterations Scanning Fee Technology Surcharge Total: Amount $300.00 $1.80 $0.60 $75.00 $75.00 $100.00 $100.00 $3.00 $4.40 $659.80 Finance Copy Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Fax: (305)756 -8972 Permit Parcel #: Block: Section: Re Rough Landscaping Final Permit Status: APPROVED Permit Number: PL -12 -05 -1027 Phone: (305)758 -0775 1132060141130 Lot: PB: Total Square Feet: 200 Total Valuation: $ 2,500.00 uired Ins ' ections DEC 0 5 PAID Invoice Number PL - 12 - 05 - 1117 Total: Amt Due $659.80 Amt Paid $484.80 $484.80 NOTICE: In addition to the requirements of this permit, there may be additional restrictions applicable to this property that may be found in the public records of this county. AND THERE MAY BE ADDITIONAL PERMITS REQUIRED FROM OTHER GOVERNMENTAL ENTITIES SUCH AS WATER MANAGEMENT DISTRICTS, STATE AGENCIES, OR FEDERAL AGENCIES. Permit No Amount of Permit 8 Size Septic Tank._ - Feet of Drain Tile Nature of Water Supply: City—WeIL My Commiwlon Esping MIAM SHORES 'VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICA!' O ' FOR PLJMEBNG 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 piers and specifications must be kept at building during progress of work. Owner's Name and Address "' a 4 Le_ ' ° ,a Registered Architect and /or EnAtteer - Employing Plumber's lime fr. atela T'iC t afk ILJ _ Al a,...., a..�.._.�.®........ 8tr .�.s..: .. ..Or Location and Legal Description Lot Block Street and Number where work is to be performed —No S q Street_. _.._..._._ State work to be performed and purpose of building (By FIN) New Building .___._ — ------ .._......_._ Remodeling___ _ _ __ Addition Type of Tang (Signed) Repairs. _-_-__._.__ .... Gals....... Est_ Feet of Teal or Dan Field from Well Sins of Somlage Pit. / )- (Sim) L� Ci 5 Street _ Notary Public, State of Florida No. of Stories... . ....... lumbing Inspector. as an employer of labor upplement, and has corn- The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligati under the Florida Workmen's Compensation Act, being Section 5988, Compiled General Laws of Monde Pennanen plied with the provisions thereof, and will require similar compliance from all cua@ractors 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 required by the Act The undersigned agrees to employ only such rub- oontrectors on work to be performed under thb permit, as licensed by Miami Shores Village. Master Plumber. are are STATE OF FLORIDA, u. COUNTY OF DADE. Before me, the undersigned authority, a notary pubic, 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 ho 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 81.00 win be made whoa such a iaspectio® is rade'neena.ry by improper nodOe for fin, or faulty matmriai and /or workmanship. TOTAL FIXTURES CLos[Ts BATH TUDO SNOW [RS LAVA• TORIES SINK[ SLOP SILKS LAUNDRY - rum, URINAL CATCH BASIN FLOOR DRAIN DRINK NO FOUNT' N[ CONTR. LIST - CHECK SEPTIC TANK SEWER CONN. DRAIN FI LD SOAKAGE PIT GREASE TRAP SOLAR M EAT[R Dm. WELL SPRKLR. SYSTEM SW IM'G POOL CONTR. LIST __ CHECK Permit No Amount of Permit 8 Size Septic Tank._ - Feet of Drain Tile Nature of Water Supply: City—WeIL My Commiwlon Esping MIAM SHORES 'VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICA!' O ' FOR PLJMEBNG 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 piers and specifications must be kept at building during progress of work. Owner's Name and Address "' a 4 Le_ ' ° ,a Registered Architect and /or EnAtteer - Employing Plumber's lime fr. atela T'iC t afk ILJ _ Al a,...., a..�.._.�.®........ 8tr .�.s..: .. ..Or Location and Legal Description Lot Block Street and Number where work is to be performed —No S q Street_. _.._..._._ State work to be performed and purpose of building (By FIN) New Building .___._ — ------ .._......_._ Remodeling___ _ _ __ Addition Type of Tang (Signed) Repairs. _-_-__._.__ .... Gals....... Est_ Feet of Teal or Dan Field from Well Sins of Somlage Pit. / )- (Sim) L� Ci 5 Street _ Notary Public, State of Florida No. of Stories... . ....... lumbing Inspector. as an employer of labor upplement, and has corn- The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligati under the Florida Workmen's Compensation Act, being Section 5988, Compiled General Laws of Monde Pennanen plied with the provisions thereof, and will require similar compliance from all cua@ractors 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 required by the Act The undersigned agrees to employ only such rub- oontrectors on work to be performed under thb permit, as licensed by Miami Shores Village. Master Plumber. are are STATE OF FLORIDA, u. COUNTY OF DADE. Before me, the undersigned authority, a notary pubic, 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 ho 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 81.00 win be made whoa such a iaspectio® is rade'neena.ry by improper nodOe for fin, or faulty matmriai and /or workmanship. -:;--....z.--- CS ••i3 "O ATH TUBS SHOWERS LAVA- TORIES SINKS SLOP SINKS LAUNDRY TUBS URINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT'NB TOTAL FIXTURES Co rr.: LMe I t.Ena... .��.�=_ $ZPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SWIM'G POOL f.9NYd. FIST - CHECK ( 4).7_ 3pyiication is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building mother 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 baiitiinh during progress of work. &r/ s Name and Address street .9 Registered Architect and /or Engineer ____._____ — -- _- _- _--- _------ .----- ____ - Employing Plumbers Name PA- 3C / ± RP� �� "'° Street-- - Block Al2:4— Subdivisio . Beet and Number where work is to be performed —No 4 Street qc Location and Legal Description Lot.. She Septic Tank_ Feat of Drain Nature of Water Supply: City —Well. Amaunt of Permit $___ ?I____°_____ MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT (Signed) 4 4 Date._ P. :rtc , work to be performed and purpose of building (By Floors) -- -- •------- __.- -_ -_ -_ New Building---- . - -_ -_ - Remodeling_ _ Addition Repairs No. of Stories. Type of Tank_ __Dist. Feet of Tank or Drain Field from Well _Size of Soakage Pit Capacity Gals. Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obi':ations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Perin. •ent Supplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors e ployed 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 suc 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. ( &Pod) 4_Ae.45 'g.iwi KC Master Plumber. STATE OF FLORIDA, t es. COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the _.. of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts threin 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 mateiisals and /or worlmtansbip. Permit No. _ I MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT o Size- Septic Tank _ -- Feet of Drain 'Pie "^ i _ - G 0 Nature of Water Supply: City —Well. STATE OF FLORIDA, �. COUNTY OF DADE. j Amount of Permit $_ ....„ , APPLICATION FOR PLUMBING PERMIT ( Signed Date _! Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or othi i structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Floridu 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. ) Owner's Name and Address __ C A _'� Registered Architect and /or Engineer P Y�g '' . " _ Em to Plumber's Name � t ' " l �� /, � / ��� ,�_ � . � ' _ No. �� �=-- -. -�_ Street -- - ->5 -' t' = -- Location and Legal Description Lot-- _-- •------------ _ -_ -._ _ _ Block __ -- _--- ____ -_ -- ..___ - -- Subdivision _. Street and Number where work is to be erformed —No F` o� p l�,� Street._. (P � ,... .r.:.":.�.:1 State work to be performed and purpose of building (By Floors)_ New Building __.._ Remodeling Addition________________ __.__ Repairs No Street- , Tank__ Dist. Feet of Tank or Drain Field from We1L _____.._.. _.Size of Soakage Pit Capacity Gals. C ` A 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 bbor under the Florida Workmen s Compensation Act, being Section 5966, Compiled General Laws of Florida Pennanent Supplement, and hus c. re- 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 perforrr�ed under this permit, as all licensed by Miami Shores Village. L./ j Master Plumber. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally .Ippeare 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 NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or foul materials and /or workmanship. CLOSETS BATH TU88 SHOWERS LAVA. TORIES 6 1NK Tulsa SLOP SINKS LAUNDRY Tulsa I NAS URINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT' NR TOTAL FIXTURE! CONTR. LIST CHECK SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR II (ATM DEEP WELL SPRKLR. SYSTEM SWIM'G POOL CONTR. LIST CHECK Permit No. _ I MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT o Size- Septic Tank _ -- Feet of Drain 'Pie "^ i _ - G 0 Nature of Water Supply: City —Well. STATE OF FLORIDA, �. COUNTY OF DADE. j Amount of Permit $_ ....„ , APPLICATION FOR PLUMBING PERMIT ( Signed Date _! Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or othi i structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Floridu 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. ) Owner's Name and Address __ C A _'� Registered Architect and /or Engineer P Y�g '' . " _ Em to Plumber's Name � t ' " l �� /, � / ��� ,�_ � . � ' _ No. �� �=-- -. -�_ Street -- - ->5 -' t' = -- Location and Legal Description Lot-- _-- •------------ _ -_ -._ _ _ Block __ -- _--- ____ -_ -- ..___ - -- Subdivision _. Street and Number where work is to be erformed —No F` o� p l�,� Street._. (P � ,... .r.:.":.�.:1 State work to be performed and purpose of building (By Floors)_ New Building __.._ Remodeling Addition________________ __.__ Repairs No Street- , Tank__ Dist. Feet of Tank or Drain Field from We1L _____.._.. _.Size of Soakage Pit Capacity Gals. C ` A 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 bbor under the Florida Workmen s Compensation Act, being Section 5966, Compiled General Laws of Florida Pennanent Supplement, and hus c. re- 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 perforrr�ed under this permit, as all licensed by Miami Shores Village. L./ j Master Plumber. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally .Ippeare 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 NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or foul materials and /or workmanship.