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533 NE 92 St (8)PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date O/ q )Job Address 533 iV • E. 92 6 T. Tax Folio Legal Description 107,5 /3 c PI BL 1 M' 57 A414/41(3 5ECT /&1./ AP! 2 Owner / Lessee / Tenant /teS/ �i jDy4tir G44ei.9 Owner's Address 535 ALE. 92" S? / /14/%4H/ c5/iO'E 3 Signature of owner and /or Condo President Date: Date: Master Permit # 3e'S- 7 Phone 75g- 2 (8 Contracting Co. ,QeD,Sr4 TX 41 1e,ae5 ,, JC• Address 2 /4/6,5713r2 Ca/ �/' a7' 4 / /i Qualifier fill / Al COSTA SS# Phone 13O7 / State # Municipal # Competency # E-4 3q Ins.Co. Te Architect /Engineer ``�L15 De. V Ve'O Address 5 8(741 /V Kf,(JDALL Bonding Company A04 Address Mortgagor Address Permit Type(circle one): BUILDING ELECTRICAL �LUMBING) MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION TAJY74U-4277W Cy r Mew WO GAIL LSEPT /C 74A JC 4A// 000 (5f L24 /uP /EW Square Ft. Estimated Cost(value) # 43-00. WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT). Application is hereby made to obtain a permit to do work and installation as indicated above, and on the attached addendum (if applicable). I certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits are required for ELECTRICAL, PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK. OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating c•.:truction : = zon g. Furthermore, I authorize the above -named contractor to do the work s Signature of Contrac r or Owner- Builder Notary as to Owner and /or Condo President Notary s to Contractor of Cb+ Bi Ilea My Commission Expires: My Commission Expires: =R „ � • *= 25 ; #CC 399493 to 1 • , / o on /e ** * * * * * * * * * * * * * ' , � U ,/ �� 1 l /l l ll 111 ` FEES: PERMIT ® RADON C.C.F. NOTARY TOTAL DUE APPROVED: Fire Other Zoning Buildin Electrical Mechanical Plumbin ✓ Engineering APPW.ATION FOR: [VI ] New System [ 7/1 Existing System ( I Repair (J 1 Abandonment APPLICANT: AGENT: MAILING ADDRESS: TO BE COMPLETED BY APPLICANT OR APPLICANT'S AUTHORIZED AGENT. ATTACH BUILDING PLAN AND TO -SCALE SITE PLAN SHOWING PERTINENT FEATURES REQUIRED BY CHAPTER 10D -6, FLORIDA ADMINISTRATIVE CODE. PROPERTY INFORMATION [IF LOT IS NOT IN A RECORDED SUBDIVISION, ATTACH LEGAL DESCRIPTION OR DEED] F LOT: C= , �;•• BLOCK: PROPERTY ID #: PROPERTY SIZE: ACRES [Sgft /43560] PROPERTY STREET ADDRESS: DIRECTIONS TO PROPERTY: BUILDING INFORMATION f >1 RESIDENTIAL Unit Type of No Establishment 1 2 3 4 • APPLICANT'S SIGNATURE: STATE OF FLORIDA DEPARTMENT OF HEALTH AND REHABILITATIVE SERVICES ONSITE SEWAGE DISPOSAL SYSTEM APPLICATION FOR CONSTRUCTION PERMIT Authority: Chapter 381, FS & Chapter 10D -6, FAC S °.' °<`'0 A4 e7o , X /6 S. [ T Garbage Grinders /Disposals [3't_ Ultra -low Volume Flush Toilets SUBDIVISION: / ' 4 J , 4 4 / 6/_/oRc, �5 c r i a k 1 fig? DATE OF /1 %O r SUBDIVISION.' [Section /Township /Range /Parcel No.] ZONING: / No. of Bedrooms [ ] Holding Tank [ ,;,-] "Other(Specify) 42 PROPERTY WATER SUPPLY: [ ] PRIVATE [ �� PUBLIC Building Area Sctft HRS-H Form 4015, Mar 92 (Obsoletes previous editions which may not be used) (Stock Number: 5744 - 001- 4015 -1) TELEPHONE: � � �_, v6/ ] COMMERCIAL PERMIT I DATE PAID FEE PAID $ RECEIPT I Temporary /Experimental I Persons Business Activity Served For Commercial Only p— ] Spas /Hot Tubs I }' Other (Specify) DATE: A Floor /Equipment Drains Page 1 of 3 rs • • • :._.,.•:, o� C :• •Cur. t:* at:: :o - . •.� ;. 7 J c . J • 7. cs Iio ,. ., _ .. ,' •73.: ViC.f: ." _ ., '.CC • -J LOT: PROPERTY ID #: BLOCK: TO BE COMPLETED BY ENGINEER, HEALTH UNIT EMPLOYEE, OR OTHER QUALIFIED PERSON. ENGINEER'S MUST PROVIDE REGISTRATION NUMBER AND SIGN AND SEAL EACH PAGE OF SUBMITTAL. COMPLETE ALL ITEMS. PROPERTY SIZE CONFORMS TO SITE PLAN: [v] TOTAL ESTIMATED SEWAGE FLOW: ( AUTHORIZED SEWAGE FLOW: UNOBSTRUCTED AREA AVAILABLE: BENCHMARK /REFERENCE POINT LOCATION: THE MINIMUM SETBACK WHICH SURFACE WATER: FT WELLS: PUBLIC: FT BUILDING FOUNDATIONS: SOIL PROFILE INFORMATION SITE 1 SITE EVALUATED BY: / • S FLORIDA ,�VARTMENT OF HEALTH AND REHABILITATIVE SERVICES ONSITE SEWAGE DISPOSAL SYSTEM SITE EVALUATION AND SYSTEM SPECIFICATIONS 10 YEAR FLOOD ELEVATION FOR SITE: SUBDIVISION: t ; SITE SUBJECT TO FREQUENT FLOODING: [ ] YES [ Munsell # /Color Texture Depth to to to' to to o USDA SOIL SERIES: to SOIL TEXTURE /LOADING RATE FOR SYSTEM SIZING:: DRAINFIELD CONFIGURATION: [ ] TRENCH [ !'] REMARKS /ADDITIONAL CRITERIA: AGENT: PERMIT # [Section /Township /Range /Parcel No. or Tax ID Number] YES [ ] NO NET USABLE AREA AVAILABLE: U - "? .' "; i;'itCRES GALLONS PER DAY [RESIDENCES -TABLE 1 / OTHER -TABLE 2] GALLONS PER DAY [1500 GPD /ACRE OR 2500 GPD /ACRE] SQFT UNOBSTRUCTED AREA REQUIRED: A n : SQFT ELEVATION OF PROPOSED SYSTEM SITE IS [INCHES /FT] [ABOVE /$ELO q B NCHMOK /REFERENCE POINT CAN BE MAINTAINED FROM THE PROPOSED SYSTEM TO THE FOLLOWING FEATURES: DITCHES /SWALES: %'u FT NORMALLY WET? [ [ ] NO LIMITED USE: a FT PRIVATE: ( ✓, FT NON- POTABLE: <� �. ° e FT FT PROPERTY LINES: FT POTABLE WATER LINES: u() FT 10 YEAR FLOODING? [ ] YES [ 010 FT MSZ /NGVD SITE ELEVATION: OT M UNGVD SOIL PROFILE INFORMATION SITE 2 • Munsell # /Color Tex Depth (, - - �° to tO to Ito 0 to F.+RvJ `)E A9-1 to -- ;/1 USDA SOIL SERIES: `_> /'±. °h ,fw • OBSERVED WATER TABLE: INCHES [ABOVE / BELOW] EXISTING GRADE. TYPE: (PERCHED / APPARENT] ESTIMATED WET SEASON WATER TABLE ELEVATION: INCHES [ ABOVE / BELOW/) EXISTING GRADE. HIGH WATER TABLE VEGETATION: [ ] YES [A NO MOTTLING: [ ] YES [A' NO DEPTH: I', ' • ' DEPTH OF EXCAVATION: /7; INCHES BED `[ ] OTHER (SPECIFY) DATE: HRS -H Form 4015, Mar 92 (Obsoletes previous editions which may not be used) Page 3 of 3 (Stock Number: 5744- 003 - 4015-1) • • .:y v.:. • " . : :: : • 1_1 .1 :: . : 1. I 1•1 ' '1" ' '2,0V1"; C.:: 1 ) : ; ' Si ' • • 7.17. C " 1:7 Of: i,ny C;; ?...1)1 t.:.....7. fLen;:i C r LI 1" i 7 ' '1771 1. • 1 .•' :1 ". • • /S. .3 C !!1.1 W170 • • -- 11l:1. :,11 '• - , : CONSTRUCTIOK\,PERMIT F [ New System [ [' ] Repair • STATE OF FLORIDA ERMIT # DEPARTMENT OF HEALTH AND REHABILITATIVE SERVICES DATE PAID ONSITE SEWAGE DISPOSAL SYSTEM CONSTRUCTION PERMIT Authority: Chapter 381, FS & Chapter 10D -6, FAC R, Existing System Abandonment APPLICANT: e '.6 --T q / ia5' GENT: 4 PROPERTY STREET ADDRESS: r ` , 1V6; oc?!4 e4 . }P if �' . . '' --- - - ---- - C , .. c PROPERTY ID #: [SECTION /TOWNSHIP /RANGE /PARCEL NUMBER] [OR TAX ID NUMBER] SYSTEM MUST BE CONSTRUCTED IN ACCORDANCE WITH SPECIFICATIONS AND STANDARDS OF CHAPTER 10D -6, FAC REPAIR PERMITS AND HOLDING TANK PERMITS EXPIRE 90 DAYS FROM THE DATE OF ISSUE. ALL OTHER PERMITS EXPIRE ONE YEAR FROM THE DATE OF ISSUE. HRS APPROVAL OF SYSTEM DOES NOT GUARANTEE SATISFACTORY PERFORMANCE FOR ANY SPECIFIC PERIOD OF TIME. ANY CHANGE IN MATERIAL FACTS WHICH SERVED AS A BASIS FOR ISSUANCE OF THIS PERMIT, REQUIRE THE APPLICANT TO MODIFY THE PERMIT APPLICATION. SUCH MODIFICATIONS MAY RESULT IN THIS PERMIT BEING MADE NULL AND VOID. SYSTEM DESIGN AND SPECIFICATIONS [GALLONS / GPD] SEPTIC TANK /AEROBIC UNIT CAPACITY MULTI- CHAMBERED /IN SERIES: [GALLONS / GPD] CAPACITY MULTI- CHAMBERED /IN SERIES:[ ] GALLONS GREASE INTERCEPTOR CAPACITY [MAXIMUM CAPACITY SINGLE TANK: 1250 GALLONS] GALLONS PER DOSE DOSING TANK CAPACITY DOSE RATE [ ] PER 24 HRS NO. OF PUMPS: [ ] D [C)] SQUARE FEET PRIMARY DRAINFIELD SYSTEM R [ ] SQUARE FEET A TYPE SYSTEM: I CONFIGURATION: N F LOCATION OF BENCHMARK: I ELEVATION OF PROPOSED SYSTEM SITE [ "`.- CH FT] [ABOVE E BOTTOM OF DRAINFIELD TO BE [ - ) 3 4][ INCHES T] [ABOVE ] INCHES O 4F 1 ' 4 1 R FILL REQUIRED: [ SPECIFICATIONS BY: cC APPROVED BY: DATE ISSUED: 2 SYSTEM [ ST [ ] TRENCH [ ] FILLED [401 BED 5 'Mice CPHU -White Applicant- Canary [ �� [ � EXCAVATION REQUIRED: [ / /. , TITLE: HRS-H Form 4016, Mar 92 (Obsoletes previous editions which may not be used) (Stock Number: 5744 - 001 - 4016 - 0) I " Installer /Contractor -Pink FEE PAID $ RECEIPT # Holding Tank [I Temporary /Experimental ] Other(Specify) ] MOUND [ ] ] el INCHES FERENCE POINT EFERENCE POINT ��- TITLE: 7it � �%�� " �� a Q ,PHU Page 1 of 2 Building Department - Goldenrod EXPIRATION DATE: INSTRUCTIONS: • !. • PERMIT NUMBER: Permit tracking number assigned by CPHU. APPLICATION 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. (CPHU may require property appraiser ID 8 or section/township /range /parcel number) SYSTEM DESIGN AND SPECIFICATIONS: TANK: Minimum specifications from Chapter 10D-6, FAC. DRAINFIELD: Minimum specifications from Chapter 10D-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 Public Health Unit (CPHU) personnel reviewing and approving permit. DATE ISSUED: Date permit is issued by CPHU. 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. al h A WATER LINE PPL POLE EXI_ 0 TO °MA EX 15 . CBS 12/. NEW ASPHALT DRIVEWAY ex -T N6 - � -1 0" l EXIST. 6ERV I GE NEW GATE VEF GATE OPERATOR II' PAVEMENT PULL WIDTH or DRIVEWAY 15' ALLEY ' INTR. SERVICE REMOVE EXISTING CBS WALL EXIS TO = - ABANDONED A PILL ►HOLE iN/ COMP EXISTING HOUS EXIST. GONG. WALK 5' 5 DEINALK PARKWAY PAVEMENT 100' N. 92ND STREET CI ITE PL AN #555 EXIST. GIBS WALL NEY4 EXIST. POD EXIT. LAWN TO BE PROTECTED MOVED GTE, GLEAN 5A .G 21'-6" EXIST. EXIST. CBS WALL 4 p + /- HI6HTOBE Y PI `GREASED TO 5' -0" HIGH TYPICAL THRJOUT SEE CBS PENCE WALL SECTION. 1213' Permit No Owner's Name and Address Sr)..SPracn MIAMI SHORES VILLAGE CC #12842 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. Size Septic Tank_. _Type of Tank__ Feet of Drain Tile ___.3.90_$q_e_f t_ Feet of Tank or Drain Field from Well____ Nature of Water Supply: City—Well. Size of Soakage Pit. Value $1450 No 533 N.9a. street_Miami Shores Registered Architect and/or Engineer ------ ------- --- - EmploYleg Plumber's Name O Septic Tank Ser.., N 800 NW 111 .... Miami 33168 Location and Legal Description Lot. Block Subdivision Street and Number where work is to be performed—No 533 NE 92 Street. Miami Shores State work to be performed and purpose of building (By Floors)__. New Building. Remodeling-- .....__ Addition. _ Repairs No. of Stories. .. .... . ..... ... Amount of Permit $ (Signed) Plumbing lnipector. 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, nod Ilan com- plied with the provisions thereof, and will require similar compliance from all contractors or sub-contractors employed b 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 pubi or notices as su-e licensed by Miami Shores Village. to be perf. are d required by the Act. The undersigned agrees to employ only such sub-contractors, (Si....) .-r STATE OF FLORIDA, I se. COUNTY OF DADE. I 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 be 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 $1.00 will be made when seek rspeodoe is mede by insproper notice for inspection, or faulty materials and/or workmanship. CLOSETS BATH T SHOwipts LAVA. T SINKS SLOP SINKS LAUNDRY Tuna URINALS CATCH BASIN FLOOR DRAIN DRINKING FouNT'N• TOTAL Pis Tuna, CONTR. LIST — CHICK —.. ..— SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT G TRAP SOLAR HEATER DEEP WELL SPRKLR. 6 N SWIM • 0 POOL. C WTI . LIST CHECK Permit No Owner's Name and Address Sr)..SPracn MIAMI SHORES VILLAGE CC #12842 PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. Size Septic Tank_. _Type of Tank__ Feet of Drain Tile ___.3.90_$q_e_f t_ Feet of Tank or Drain Field from Well____ Nature of Water Supply: City—Well. Size of Soakage Pit. Value $1450 No 533 N.9a. street_Miami Shores Registered Architect and/or Engineer ------ ------- --- - EmploYleg Plumber's Name O Septic Tank Ser.., N 800 NW 111 .... Miami 33168 Location and Legal Description Lot. Block Subdivision Street and Number where work is to be performed—No 533 NE 92 Street. Miami Shores State work to be performed and purpose of building (By Floors)__. New Building. Remodeling-- .....__ Addition. _ Repairs No. of Stories. .. .... . ..... ... Amount of Permit $ (Signed) Plumbing lnipector. 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, nod Ilan com- plied with the provisions thereof, and will require similar compliance from all contractors or sub-contractors employed b 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 pubi or notices as su-e licensed by Miami Shores Village. to be perf. are d required by the Act. The undersigned agrees to employ only such sub-contractors, (Si....) .-r STATE OF FLORIDA, I se. COUNTY OF DADE. I 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 be 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 seek rspeodoe is mede by insproper notice for inspection, or faulty materials and/or workmanship. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT 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, yvhether herein specified or not. A copy of approved plans and specifications must be kcpt at build' d of work building during progress Owner's Name and Address 1?.ijt_ 3egistsred Architect and /or Engineer "Employing Plumber's Name Blorlr Location and Legal Description Lot. Street and Number where work is to be performed —No State work to be performed and purpose of building (By Floors )_._._____...___.._.__..______ New Building Remodeling___ —._.__ Addition...__.___ Repairs No. of Stories Size Septic Tank__. - _------ ___- -. —___ _...Type of Tank__ .. ...........-- _. - - - -- Capacity Gals ..._...--- ••-- - -.... Feet of Drain Tile._ ' — _- -Dist. Feet of Tank or Drain Field from Well.. ._...--- •• - - - -._ Nature of Water Supply: City —Well. ._— ._____.— ._.Size of Soakage Pit Amount of of Permit $ STATE OF FLORIDA, I COUNTY OF DADE. lumbing n. The undersigned applicant for this building permit does hereby certify that he understands and accepts his oblig ions as an employer of labor under the Florida Workmen's Compensation Act, being Section 5968, Compiled General Laws of Florida Permanent uPplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub-contractors employed l:y him in t`.-e wcrk ^o be performed under this permit; and will post or cause to be posted' for inspection on the site of the work such publi : notice ar no: ice^ as arc required by the Act. The undersigned agrees to employ only such sub - contractors, jn work to be perfo /-- ' ca this wnnit, as aro licensed by Miami Shores Village. (Signed No. i13. L� 5 Street yip — Subdivision.._. Street Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personalty 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 Masten Plumber. NOTE: A re- inspection fee of $1.00 will be made when such reinspeetlon is made•neoessary by improper notice for inspection, or faulty materials and /ce workmanship. CLOSrrs BATH TUBS bNOW[RB LAVA• y on mg SINK• SLOP SINKS LAUNDRY TuvB URINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT•NS TOTAL FI[Tl'.RES CONTR. L I'.T CHECK SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SW IOC POOL CONTR. LIST CHECK MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT 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, yvhether herein specified or not. A copy of approved plans and specifications must be kcpt at build' d of work building during progress Owner's Name and Address 1?.ijt_ 3egistsred Architect and /or Engineer "Employing Plumber's Name Blorlr Location and Legal Description Lot. Street and Number where work is to be performed —No State work to be performed and purpose of building (By Floors )_._._____...___.._.__..______ New Building Remodeling___ —._.__ Addition...__.___ Repairs No. of Stories Size Septic Tank__. - _------ ___- -. —___ _...Type of Tank__ .. ...........-- _. - - - -- Capacity Gals ..._...--- ••-- - -.... Feet of Drain Tile._ ' — _- -Dist. Feet of Tank or Drain Field from Well.. ._...--- •• - - - -._ Nature of Water Supply: City —Well. ._— ._____.— ._.Size of Soakage Pit Amount of of Permit $ STATE OF FLORIDA, I COUNTY OF DADE. lumbing n. The undersigned applicant for this building permit does hereby certify that he understands and accepts his oblig ions as an employer of labor under the Florida Workmen's Compensation Act, being Section 5968, Compiled General Laws of Florida Permanent uPplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub-contractors employed l:y him in t`.-e wcrk ^o be performed under this permit; and will post or cause to be posted' for inspection on the site of the work such publi : notice ar no: ice^ as arc required by the Act. The undersigned agrees to employ only such sub - contractors, jn work to be perfo /-- ' ca this wnnit, as aro licensed by Miami Shores Village. (Signed No. i13. L� 5 Street yip — Subdivision.._. Street Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personalty 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 Masten Plumber. NOTE: A re- inspection fee of $1.00 will be made when such reinspeetlon is made•neoessary by improper notice for inspection, or faulty materials and /ce workmanship. T Y f MIAMI RES VILLAGE, FLA. N? 5979 JOB i ..., , 1 ADDRESS `S !' . INSPECTION TIME READY REMARKS: /0 INSPECTOR DATE oa" CLOSETS BATH TUS6 SHOWERS LAVA- TORIES SINKS SLOP SINKS LAUNDRY Tues U RINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT'N6 TOTAL FIXTURES C.ONT . LIST CHICK SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SWIM•G POOL CONTR. LIST CHECK Size Septic Tank Feet of Drain Tile a Permit No ` 3 3 Amount of Permit $ MIAMI SHORES VIL AG PLUMBING INSPECTION DEPARTMEN`: APPLICATION FOR PLUMBING °' . , ,V107 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 Euilding Ordinance of Miami Shores Village, Florida, and ell 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 Mimi Shores Village shall be complied with, whether herein specified or rut. A copy of approved plans and specifications must be kept at building during progress of work. j� n °wncfc Name and Address °`-' .: ��'^' No._..— Street.. A Registered Architect and /or Engineer �� Da Employing Plumber's Name E. 23rd ST., HIAIEAH No. Street-_ Location and Legal Description Lot .________________________ -_ -- �� —lo 9 d � ,- 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 Type of Tank-_ Capacity Gals. 'st. Feet of Tank or Drain Field from Well Nature of Water Supply: City —Well . Size of Soakage Pit (Signed) Date e, Plum ling 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. Master Plumber. STATE OF FLORIDA, t es. c GUTTY OF DADE. BE;o:e me, the undersigned authority, a notary. public; duly authorized to administer oaths and take acknowledgments, personally appeared is me w,r. 1 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 Ay 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 am /or workmanship. BUILDING ELECTRICAL PLUMBING Owner of Building Architect Contractor ti' or Builder 1 Legal Lot r Description / y Address of Building " Ij J RMIT N? 5288 • CONTRACTOR OR BUILDER ;MIAMI SHORES VILLAGE, FLORIDA f � w /31 47 Work to be performed under this Permit V t t/ 1tf / s✓ e �� Bl. r , 7 permit is granted is the understanding that the contractor or builder named above regulations pertaining it the work covered hereby whether shown on the plans o sibility for work done by his agents, servants or employees. Signed. Subdi- vision Value of Project DATE 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 d &vice 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 conditigR upon rich this pines the a onsibility for a thorough knowledg o t or nces and the statements or specifications and t e o stlmes respon- By J 194 7 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 pert ng thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper autliaritlbs of Miami ShbitsiViilage. In cc pting this ge 't I assume responsibility for all work done by e yself, my agent, servant or employee. AUTHORITY