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870 NE 92 St (4)MIAMI SHORES VILLAGE BUILDING DEPARTMENT � �5 305- 795 -2204 Buildi g I . spection Request Date �' y Type Insp'n 4.5 ` :-/ Permit No. PC V 00 _ 5 Name Address (7 Ad 5 9 Company Phone # / a p i Inspection Date li i j � trt11 Approved Correction Re- Insp'n Fee MIAMI SHORES VILLAGE BUILDING DEPARTMENT 6 305- 795 -2204 Building Inspection Reque Date Inspection Date Approved Correction Re- Insp'n Fee n Type Insp'n Permit No. 7L ,0(7t - .P65 Name /"-� 4&;nze4_, Address F70 4/6 . Company Phone # q5Y/ 9d4 �� /D 0/ Contractor's Company Name Contractor's Address /- t - Cit {- L L- h ` 1 1_: Qualifier ' E i p $ Value of Work For this Permit Miami Shores Village Building Department 0 ;Fa BUILDING PERMIT APPLICATION FBC 2001 Permit Type (circle): Building Electrical lumbin j Mechanical Roofing Owner's Name (Fee Simple Titleholder) i! l'- 1 . °(:„ 1 l h -A. a Phone # - 13. . '_:4 " Owner's Address F' _` i . ° 2 i .0 - i i) i . i City 'ILL :.` Tenant/Lessee Name Job Address (where the work is being done) City Miami Shores Village Is Building Historically Designated YES State -_ Zip , .:i 1 - County Miami -Dade State ! - - L State NO Master Permit No. Phone # Phone # Zip Permit No. el--- AM Zip Phone # 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 rr . Architect/Engineer's Name (if applicable) Architect/Engineer's Address City Zip Square Footage Of Work: Number of: Bays Stories Families Bedrooms Baths Type of Work: ['Addition DAlteration ['New ❑ Repair/Replace ❑ Demolition Describe Work: C L.: 1 . _ i' � . 1- 2 ` :" . 1.71 7 0-1 -y -� .. i � _� � � " �: i 1 ts ; ; ',, * * * * * * * * * * * * * * * * * * * * * * * * * * ** Fe es * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** County Escrow Fee $ �� ` � Permit Fee $ Notary $ Education/Training Fee $ 'k 11 Tech $ k , 2...0 Scanning $ 7 . GC Radon $ Code Enforcement $ Bond $ Struct. $ Minus Plans Check Fee $ Total Fee Now Due $ (Continued on opposite side) Bonding Company's Name (if applicable) N 1 A Bonding Company's Address City State Zip Mortgage Lender's Name (if applicable) 33 A Mortgage. Lender's Address The foregoing ' (trument was acknowledged before me this g The fore day o who is da o496. - , 2004, by,36MAJ S • Li PIS who istrsonally owto me or who has produced NOTARY PUBLIC: Sign: APPLICATION APPROVED BY My Commission Expires: Chc7l7 /03 As identification and who did take an oath. • 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 exc promise in good faith that a ,py of he .tice of c whose property • su 'ect t ttach ent Also, a for the first i inspection wi (Certificate of Competency Holder) mencement and construction lien law broc fled •py of the recorded notice of comme the building permit is is ed. 11 be charged. Signature tiding wil 250/, the applicant must `ivered to pers e posted • t e jo zte such po e' no ;•f, the Contract oing instrument was acknowledged before me this e 20e4, b)Jvtii) S, LI D to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: Sign:. Print: RYAN R. RYDER 20806 f EXPIRES: May 18 My Commission Expires: ,.,,.°;, nTAR Fl. N Ov otary oisowm Amr i . cc *************************************************** * * * ** * * * * *,r * * * * * *r * *,r ** ** * * * * * * .'us�.� 4 ! 'J Certificate of Competency No.0 C-04 1 State Certificate or Registration No. * * * * * * * * * * * * ** * * * * * * * * * * * ** * ** ** * * * * * * *\ ***************** s***** s**** s** ** *s *• ** * *s * ** * * *s * *• *** *s * *s ** Plans Examiner Engineer Zoning ITEM BATH TW UNIT FEE ITEM SWITCH OUTLETS UNIT FEE ITEM SPACE HEATERS UNIT FEE BIDET LIGHT OUTLETS CENTRAL HEATING DISHWASHER RECEPTACLES A/C (WIND) DISPOSAL SERVICE TEMPORARY A/C (CENTRAL) DRINKING FOUNTAIN SERVICE SIZE IN AMPS DUCT WORK FLOOR DRAIN SERVICE REPAIR/METER CHANGE REFRIGERATION GREASE TRAP APPLIANCE OUTLETS PROCESS AND PRESS PIPING INTERCEPTOR RANGE TOP UNDERGROUND TANKS LAVATORY OVEN ABOVE (MOUND TANKS LAUNDRY TRAY WATER HEATER U.F. PRESSURE VESSELS CLOTHES_WASHER MOTORS 0- 1 HP STEAM BOILERS SHOWER MOTORS OVER 1- 3 HP HOT WATER BOILERS SINK, POT /3 COMP. MOTCRS OVER 3- 5 IP MECHANICAL VENTILATION SINK, RESIDENCE MOTORS OVER 5- 8 HP TRANSPORTING ASSEMBLIES SINK, SLOP MOTORS OVER 8- 10 HP ELEVATORS/ESCALATORS TEMPORARY WATER CLOSET MOTORS OVER 10- 25 HP FIRE SPRINKLER SYSTEMS URINAL MOTORS OVER 25-100 HP COOLING TOWERS WATER CLOSET MOTORS OVER 100 If VIOLATION INDIRECT WASTES A/C WIIOOW REINSPECTION WATER SUPPLY TO: AIR CONDITIONERS A/C UNIT STRIP HEATER FIRE SPRINKLER GENERATORS TRANSFORMERS HEATER -NEW INST. GENERATORS TRANSFORMERS HEATER - REPLACE GENERATORS TRANSFORMERS LAWN SPRINKLER -WELL SPECIAL PURPOSE SWIMMING POOL OUTLETS COMMERCIAL WATER SERVICE SIGN TUBES SEWER CONNECTIONS SIGN TRANSFORMERS UTILITY -SEWER SIGN TIME CLOCK UTILITY -WATER FIXTURES SEPTIC TANK ANTENNA RELAY TELEVISION OUTLETS DRAINFIELO, 4" TILE/RES. VIOLATION PUMP & ABANDON SEPTIC TANK REINSPECTION SOAKAGE PIT CU. FT. CATCH BASIN DISCHARGE WELL DOMESTIC WELL AREA DRAIN ROOF INLET SOLAR WATER HEATER FIRE STANDPIPE POOL PIPING LAWN SPRINKLER SYSTEM GAS RANGE . 11 METER SET (GAS) GAS PIPING a`l`1'G1 ) 5 - - (AN APPLICATION FOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. IF A MASTER PERMIT HAS B. OBTAINED, THE OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.) ADDENDUM TO BUILDING PERMIT APPLICATION PLUMBING ELECTRICAL MECHANICAL Survey Sheets / - Plans // Customer Name: 40 nw7t Address: City, State, Zip: , ,I, f..` Phone #: 3O f f <21 I All Work to Comply With N.F.P.A. Code #: - Xf° C° ref Estimated Job Cost: Description of Work: Piping ISO EH_ Whitson Plumbing 421 South 21st Avenue Hollywood, FL 33020 y , 6 ‚/ /, °‘r,p ,V4tv‘o_ .70;07e4 Survey Sheets / Plans Customer Name: 2!45 ilie7 Address: City, State, Zip: ,/.,407Z 5 Id�L°5 e 3J3f Phone #: 3 4 All Work to Comply With N.F.P.A. Code #: z,Pg-r; 7/ 1I 4,„/ 6Y 7/.z/ ��.�= �� ha',P 2/0 /< Estimated Job Cost: Description of Work: E.H. Whitson Plumbing 421 South 21st Avenue Hollywood, FL 33020 Piping ISO sy wvAqfqL Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Printed: 9/20/2004 Applicant: TINA Owner: PORTNER JOB ADDRESS: 870 NE 92 Contractor E H WHITSON Local Phone: 954 929 - 3599 Parcel # 1132060050140 Signed: (INSPECTOR) Plumbing Permit Permit Number: PL2004 -265 PORTNER TINA ST Page 1 of 1 Contractor's Address: 421 SOUTH 21ST AVENUE Legal Description: GOLDEN GATE PARK ADDN PB 6 -130 LOT 3 & E1/2 LOT 4 BLK 2 LOT SIZE Fees: Description Amount FEE2004 -9376 Building Fee $160.00 FEE2004 -9377 CCF $1.20 FEE2004 -9378 Training and Education Fee $0.40 FEE2004 -9379 Technology Fee $4.00 FEE2004 -9380 Scanning Fee $3.00 Total Fees: $168.60 Total Fees: $168.60 Total Receipts: Wolf 06.06 Permit Status: APPLIED Permit Expiration: 3/8/2005 Construction Value: $2,000.00 Work: RUN GAS SUPPLY 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: • Date C^J Job Address e70/06 gker Tax Folio �f 2 d'2G/ 66,6_& 6,6_& /..7c� Legal Description �d/ ft V Historically Designated: Yes No Owner's Address ?C /LI 6 9A S7 Contracting Co. 6S c i � b J l S Qualifier hViti/ C L t*-77 S t a t e # (1,c 0,y 2 3 O ? Municipal # Architect/Engineer Bonding Company Address _viortgagor Address Type (circle one): WORK DESCRIPTION My 1 ommission Expires: PERMIT APPLICATION FOR MIAMI SHORES VILLAGE / Tenant z Al A- A )P-e o s 6a FEES: PERMIT /' RADON ILDING 7ELECTRICAL ,0e.,0 a4611' Square Ft Estimated Cost (value) / 5 f 900 p f 00 1)6 c <7 (4747 drks OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurat laws regulating tion and zoning. Furthermore, I authorize the above- APPROVED: Zoning Mechanical Plumbing Co1d4?P , ScIte ;icia lfry cc T. enp. 4 y 24, 2003 CC010725 SS# Phone ?o3 - 7 c/ Master Permit # Address /8 ©a RR T/ s7l'c"Ui , v'/ 331 6? Phone 3 6,r 'I 7 oc O Cl Competency # Ins. Co. ia,4 6-,74/9 Address 93 r-2 / 14-16' j 114 j / PLUMBING ECHANICAL ROOFING PAVING FENCE SIGN 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 I CHANICAL WORK. �^ C.C.F. ` NOTARY D will b - done in compliance with all applicable o the ork stated. as to Contractor or Owner - Builder Dat M Commission Expires: Not :y Puy:.;;. SE d c ilorir l My cam. ; xp. i.(ny 24, 203 Cu�F➢. Zo. C�1r-,723 BOND 3 °® TOTAL DUE / 7 / mo � � 11 4/bo NOTICE OF COMMENCEMENT A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF FIRST INSPECTION PERMIT NO. TAX FOLIO NO. STATE OF FLORIDA: COUNTY OF DADE: 00R560328 2000 NOV 22 09:29 THE UNDERSIGNED hereby gives notice that improvements will be made to certain real property, and in accordance with Chapter 713. Florida Statutes, the following information is provided in this Notice of Commencement. �l 1. Legal description of property and street address: S7 /J e ' n 5 / /11/m e, 2. Description of improvement: t at,oL ('�GU 3. Owner(s) name and address: 77,7)4- Po ki/ J6 /L- `67o A _6, q9 ST /)1ir j Sr�o Interest in property: � ^� Name and address of fee simple titleholder: / BL 1 Too 4e 1st AA. M is .h t ,! if. 4. Contractor's name and address: 5. Surety:(Payment bond required by owner from contractor, if any) Name and address: Amount of bond $ 6. Lender's name and address: t )�. 7. Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as provided by Section 713.13(1)(a)7., Florida Statutes, Name and address: NJK 8. In addition to himself, Owner designates the following person(s) to receive a copy of the Lienor's Notice as provided in Section 713.13(1)(b), Florida Statutes. Name and address: Notary Public Pr' 9. Expiration date of this Notice of Commencement: (the ex date is 1 year from the date of recording unless a different date is specified) Print Owners Name --r lull- 4 irpt-- gnatur. al Own Sworn to and subscribed b •re this day of Atigisaliptaidft Notary Public, State of Florida My comm. exp. May 24, 2003 Print Notary's Nam STATE OF FLORIDA, COUNTY OF DADE 1 HEREBY CERTIFY that this is d true copy of the original Ned in this office on day of 1 , A D 20 0) WITNESS my hand and Official Seal. HARVEY R1111,CIA, of Circuit and County Courts 3 y A D.C. Prepared by: Ass to �l e o o kt / Address: N" / /` 1 0 • 7 U Permit No Application 1 1,ereby made for the approval of the detailed attempt of the plans and specifications herewith submitted for the build ng or other structure herein descnbed. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of th Building Dn' sion of Miami Shores Village shall be complied with, whether herein specified or not A copy of approved plans and specifications must be kept at building during progress of work. Owner's Name and Address_ Q 4 No.____ -_f2® ________ Street ./4t..5._ ! / ' Registered Architect and /or E ineer _ . -_-.__ —___ Employing Plumber's Name e � C- f� �"" � _� _ No._ (2.__ A ' P Y�g — -- _ — — _ __� Street.... . _ _ - Location and Legal Description Lot__— _ — — Block_ - Street and Number where work is to be performed —No State work to be performed and purpose of building (w y 1F llo w a* _ New Building --_ -_ _ _ --- •-- --- Remodeling—___ _ Addition_--_ Amount of Permit $ STATE OF FLORIDA, COUNTY OF DADE. j MIAMI SHORES VILLAGE PLUMING INSPECTION DEPARTMENT APPLICAU© FOR PLUMBING PERMIT ( Signed) __. . Repairs_ Size Septic Tank_._ _ -- -- -- - Type of Tanks Feet of Drain Tile_ - . - __ __ -_ . __ - _ - _ -- _Dist. Feet of Tank or Drain Field from Well.. Nature of Water Supply. City —Well. ___ _- __- _ - - _ __ _ Si of Soakage Pit Street Date Subdivision_ / 24, &Ail _ ___ No. of Stories _ -. Capacity Gals. Ph.mb In:pecto. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obhgatlons as an employer of labor under the Florida Workmen's Compensation Act, being Section 5968, Compiled General Laws of Florida Permanent Supplement, 'n:l I a am - plied with the provisions thereof, and wil_'' require similar compliance from all contractors or sub - contractors employed by hin 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 no Ices as are required by the Act. The undersigned agrees to employ only such sub contractors, on be perfo. ed u der this per nit, as are licensed by Miami Shores Village. Master Plumber. Before me, the undersigned authority, a notary public, duly anthosized to administer oaths and take acknowledge ents, personall appeared to me well known, and who, being by me first duly sworn upon ea ''r deposes and says that he is the of the above described construction, that he has carefully read the foregoing apphcation, and that he did sign the same, and that all .acts 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 sulask inspection is made•neoessary by improper notice for inspection, or faulty materials and /or workmanship. CLOSETS BATH TUBS SHOWERS LAVA- TORICB SINEW SINKS LAUNDRY TUBE URINALS CATCH BASIN FLOOR DRAIN DRINKING FOU'T NS TOTAL F %TURES C NR. /,.4 t - 41 f - /l.S CHECK SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE P IT GREASE TRAP SOLAR W EATER DEEP 1SJE.L SPRKLR. SYSTEM SWIM - G POOL COHTR. Ls sr CHECK 0 • 7 U Permit No Application 1 1,ereby made for the approval of the detailed attempt of the plans and specifications herewith submitted for the build ng or other structure herein descnbed. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of th Building Dn' sion of Miami Shores Village shall be complied with, whether herein specified or not A copy of approved plans and specifications must be kept at building during progress of work. Owner's Name and Address_ Q 4 No.____ -_f2® ________ Street ./4t..5._ ! / ' Registered Architect and /or E ineer _ . -_-.__ —___ Employing Plumber's Name e � C- f� �"" � _� _ No._ (2.__ A ' P Y�g — -- _ — — _ __� Street.... . _ _ - Location and Legal Description Lot__— _ — — Block_ - Street and Number where work is to be performed —No State work to be performed and purpose of building (w y 1F llo w a* _ New Building --_ -_ _ _ --- •-- --- Remodeling—___ _ Addition_--_ Amount of Permit $ STATE OF FLORIDA, COUNTY OF DADE. j MIAMI SHORES VILLAGE PLUMING INSPECTION DEPARTMENT APPLICAU© FOR PLUMBING PERMIT ( Signed) __. . Repairs_ Size Septic Tank_._ _ -- -- -- - Type of Tanks Feet of Drain Tile_ - . - __ __ -_ . __ - _ - _ -- _Dist. Feet of Tank or Drain Field from Well.. Nature of Water Supply. City —Well. ___ _- __- _ - - _ __ _ Si of Soakage Pit Street Date Subdivision_ / 24, &Ail _ ___ No. of Stories _ -. Capacity Gals. Ph.mb In:pecto. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obhgatlons as an employer of labor under the Florida Workmen's Compensation Act, being Section 5968, Compiled General Laws of Florida Permanent Supplement, 'n:l I a am - plied with the provisions thereof, and wil_'' require similar compliance from all contractors or sub - contractors employed by hin 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 no Ices as are required by the Act. The undersigned agrees to employ only such sub contractors, on be perfo. ed u der this per nit, as are licensed by Miami Shores Village. Master Plumber. Before me, the undersigned authority, a notary public, duly anthosized to administer oaths and take acknowledge ents, personall appeared to me well known, and who, being by me first duly sworn upon ea ''r deposes and says that he is the of the above described construction, that he has carefully read the foregoing apphcation, and that he did sign the same, and that all .acts 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 sulask inspection is made•neoessary by improper notice for inspection, or faulty materials and /or workmanship. BUILDING ELECTRICAL PLUMBING Architect Contractor or Builder Legal Description Address of Building Owner of Building Lot CONTRACTOR OR BUILDER MIAMI SHORES VILLAGE, FLORIDA , DATE -' 194' PERMIT N2 8925 Work to be performed under this Permit Bl. y h � Subdi- vision Contractor's License No. Value of Amt. of Project 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 appli- cation 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. �' r 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 State work to be performed and purpose of building (By Floors) Size Septic Tank Feet of Drain Tile ;- - Nature of Water Supply(: City; Well. Amount of Permit $ STATE OF FLORIDA, t COUNTY OF DADE. ss. My Commission Expires 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, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. A l7 Owner's Name and Address - - 4. �e�R.„ ____L L No Registered Architect and /or Engineer _____ Street and Number where work is to be performed—No Street New Building.__ ____ _______ _ _ _ _ _ __ Remodeling_. Addition. Type of Tank Dist. Feet of Tank or Drain Field from Well Size of Soakage Pit ( Signed) (Signed) Repairs Street Capacity Gals. 4 - No. of Stories - Notary Public, State of Florida GP, r T - Master Plumber. Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he u6derstands and accepts his oblig ns 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. 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 TUBBS URINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT' NS TOTAL FIXTURES CONTR. r / 1 1 1 I 1 CHECK SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SWIM'G POOL J L CONTR. LIST 1 A / �j 4 ? r CHECK State work to be performed and purpose of building (By Floors) Size Septic Tank Feet of Drain Tile ;- - Nature of Water Supply(: City; Well. Amount of Permit $ STATE OF FLORIDA, t COUNTY OF DADE. ss. My Commission Expires 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, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. A l7 Owner's Name and Address - - 4. �e�R.„ ____L L No Registered Architect and /or Engineer _____ Street and Number where work is to be performed—No Street New Building.__ ____ _______ _ _ _ _ _ __ Remodeling_. Addition. Type of Tank Dist. Feet of Tank or Drain Field from Well Size of Soakage Pit ( Signed) (Signed) Repairs Street Capacity Gals. 4 - No. of Stories - Notary Public, State of Florida GP, r T - Master Plumber. Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he u6derstands and accepts his oblig ns 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. 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. Employing Plumber's Name Owner's Name and Address _ _ ! . p k _ 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 stricture herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. Registered Architect and /or Engineer ___ __.a_ ' A- kr ESA v' No a4 No _ Street Location and Legal Description Lot. Block Subdivision Street and Number where work is to be performed —No Z / e Street 1v' E. `� %� ~� S T State work to be performed and purpose of building (By Floors) ____— 4 A d A/ A k y SUMP New Building `.._. Remodeling ._. Addition Repairs Size Septic Tank Type of Tank Feet of Drain Tile Dist. Feet of Tank or Drain Field from Well Size of Soakage Pit. 4414 ,_ Nature of Water Supply: City —Well. Amount of Permit $/-: -- _-_ -- - - - -- - -- - -- --------- - - -- -- - - - - -- ( Signed) -� STATE OF FLORIDA, t COUNTY OF DADE. ss. ( Signed) Date _ • : 2 Street - Capacity Cals. -- -- - No. of Stories ' Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligatienrt 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. Master Plmnber. 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 workmanship. CLOSETS BATH TUBS SHOWERS LAVA- TORIES SINKS SLOP SINKS LAUNDRY TUBS URINALS CATCH BASIN FLOOR DRAIN DRINK NG 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. Employing Plumber's Name Owner's Name and Address _ _ ! . p k _ 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 stricture herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. Registered Architect and /or Engineer ___ __.a_ ' A- kr ESA v' No a4 No _ Street Location and Legal Description Lot. Block Subdivision Street and Number where work is to be performed —No Z / e Street 1v' E. `� %� ~� S T State work to be performed and purpose of building (By Floors) ____— 4 A d A/ A k y SUMP New Building `.._. Remodeling ._. Addition Repairs Size Septic Tank Type of Tank Feet of Drain Tile Dist. Feet of Tank or Drain Field from Well Size of Soakage Pit. 4414 ,_ Nature of Water Supply: City —Well. Amount of Permit $/-: -- _-_ -- - - - -- - -- - -- --------- - - -- -- - - - - -- ( Signed) -� STATE OF FLORIDA, t COUNTY OF DADE. ss. ( Signed) Date _ • : 2 Street - Capacity Cals. -- -- - No. of Stories ' Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligatienrt 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. Master Plmnber. 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 workmanship.