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PLUMBINGPermit No. /? / fount of Permit $____ r . STATE OF FLORIDA, COUNTY OF DADE. MIAMI SHORES VIV.,ertGL PLUMBING INSPECTION DEPARTMEI • : APPLICATION FOR PLUMBING ' . •..dP Application is hereby made for the approval of the detailed statement of they 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 n- ore. A copy of approved plans and specifications must be kept at building during progress of work. .1 1 / .! 9 - � Owner's Name and Address .- .--- •- ._.— -- ' -_ --_ -- _ - No.-------- ..... Street. Registered Architect and /or Engineer__ _ �ti_„_� (� Ng Employing Plumber's Name - __-_1 _4 T 7d ST,,, Hif*,1 j _ No. Street-_ Location and Legal Description Lot_ _.._________.___ Block _-, Subdivision_ Street and Number where work is to be performed —No / 0 A 72 1 � �� '�"'r Y Street State work to be performed and purpose of building (By Floors) _ _.___ New Building _.. Remodeling____ ___ Addition--- ___._._ Repairs ( Slned)- - ?� � - -: -.� Z = (Signed ) Date /-)7- � No. of Stories My Commission Expires Notary Public, State of Florida Size Septic Tank Type of Tank Feet of Drain Tile d) ' ✓r� "' ist. Feet of Tank or Drain Field from Well - Nature of Water Supply: City — 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 obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5968, 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. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for Inspection, or faulty materials and /or workmanship. CLOSETS BATH TUBS SHOWERS LAVA TORIES SINKS SLOP SINKS LAUNDRY TUBS URINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT'NS TOTAL FIXTURES CONTR. LIST CHECK SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SWIM'G POOL CONTR. LIST _____ CHECK Permit No. /? / fount of Permit $____ r . STATE OF FLORIDA, COUNTY OF DADE. MIAMI SHORES VIV.,ertGL PLUMBING INSPECTION DEPARTMEI • : APPLICATION FOR PLUMBING ' . •..dP Application is hereby made for the approval of the detailed statement of they 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 n- ore. A copy of approved plans and specifications must be kept at building during progress of work. .1 1 / .! 9 - � Owner's Name and Address .- .--- •- ._.— -- ' -_ --_ -- _ - No.-------- ..... Street. Registered Architect and /or Engineer__ _ �ti_„_� (� Ng Employing Plumber's Name - __-_1 _4 T 7d ST,,, Hif*,1 j _ No. Street-_ Location and Legal Description Lot_ _.._________.___ Block _-, Subdivision_ Street and Number where work is to be performed —No / 0 A 72 1 � �� '�"'r Y Street State work to be performed and purpose of building (By Floors) _ _.___ New Building _.. Remodeling____ ___ Addition--- ___._._ Repairs ( Slned)- - ?� � - -: -.� Z = (Signed ) Date /-)7- � No. of Stories My Commission Expires Notary Public, State of Florida Size Septic Tank Type of Tank Feet of Drain Tile d) ' ✓r� "' ist. Feet of Tank or Drain Field from Well - Nature of Water Supply: City — 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 obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5968, 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. 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 APPLICATION FOR MIAMI SHORES VILLAGE Date 6/26/96 Contracting Co. Square Ft. 300 Signatur of owner Job Address 102 NE 94 STREET LLOYD =NORTH DADE SEPTIC TANK WORK DESCRIPTION INSTALL DRAINFEILD laws regulating construction and zoning. Furthermore, I authorize the above- (12 f %(/ dent Date Notary s to O er and/. • o Presi ent Dale My Commission Expire ;t• 0‘3,v vie Tema J. Feldsr 4j 3 fi e ' Notary Pa!!c, e1 : ?P ^f 0 Q My Commi... ion i. :p a 07/166:') 1- LW- 3- KOTARY - Fla. Noy '4M c L Eo:Wd::3 Co. « tert tt eeect a aateeeeikeeeefrera'trttrt(tatt ?, FEES: PERMIT � - RADON APPROVED: Zoning Building Mechanical Plumbing q qc C.C.F. No M Tax Folio Legal Description Historically Designated: Yes No Owner/Lessee / Tenant MARK SAIZ Master Permit # Owner's Address 102 NE 94 STREET, MIAMI SHORES 33138 Phone 759 -9679 Address 800 NW 111 STREET, MIAMI 33168 Q DENNIS NEVILLE SS# Phone 751 -7676 State # 025836 -8 Municipal # Competency # 12842 Ins. Co. TRAVELERS /ESIF Architect/Engineer Address Bonding Company Address Mortgagor Address Permit Type (circle one): BUILKINEDOEIXIIETRICAL PLUMBING IMECHAAQI MYXAOININDJPXX111NGXEEMZEX IWK Estimated Cost (value) $1400.00 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. permits are required for ELECTRICAL, PLUMBING, SIGNS, POOLS, ROOFING i HANICAL WORK. OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurat= .. • at 1 work will be done in compliance with all applicable Poo ontractor or ission Expires gpAY PG® NOTARY o do the work stated. ontractor • r 'i wner -Build p Ter^sa elder Y { �ro 4 �) Notarry Pui•!:,;,'. =,. ' c'.7:. -aria 1(y D ` Q ' F OF Fe My Cornni..::ca a~fi 07/i :ii..;') Z; 1- £00- 343TA11Y -F BI.NCw7. :E& ...),' Electrical A -Buil TOTAL DUE I understand that separate G 6 Dat / q6 Engineering 96 Notes Site Plan Submitted by Plan Approved By STATE OF FLORIDA DEPARTMENT OF HEALTH AND REHABILITATIVE SERVICES APPLICATION FOR ONSITE SEWAGE DISPOSAL SYSTEM CONSTRUCTION PERMIT Permit Application Number PART II - SITE PLAN SIGNATURE TITLE Not Approved Date' County Public Unit ALL CHANGES MUST BE APPROVED BY THE COUNTY PUBLIC HEALTH UNIT HRS -H Form 4015, Feb 85 (Obsoletes previous editions which may not be used) (Stock Number: 5744- 002- 4015 -6) Page 2 of 3 APPLICATION FOR: [ ] New System [ 1 Repair 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 TELEPHONE: APPLICANT: AGENT: ✓c' :.:u '.';; 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] LOT: BLOCK: PROPERTY ID #:„ PROPERTY SIZE: 1 2 3 4 ° DIRECTIONS TO PROPERTY: Unit Type of No Establishment [i ] Existing System [. ] Holding Tank [i! ] Abandonment [ • ] Other(Specify) SUBDIVISION: PROPERTY STREET ADDRESS: : i 2 . : ' , BUILDING INFORMATION [t .] RESIDENTIAL No. of Bedrooms HRS-H Form 4015, Mar 92 (Obsoletes previous editions which may not be used) (Stock Number: 5744- 001 - 4015 -1) [ ] COMMERCIAL APPLICANT'S SIGNATURE: e' a DATE: PERMIT # DATE PAID FEE PAID $ RECEIPT # Temporary /Experimental DATE OF SUBDIVISION: [Section /Township /Range /Parcel No.] ZONING: ACRES [Sqft /43560] PROPERTY WATER SUPPLY: [ ] PRIVATE [ ] PUBLIC Building # Persons Business Activity Area Sqft Served For Commercial Only [. ] Garbage Grinders /Dispo [.: ] Spas /Hot Tubs ['. ] Floor /Equipment Drains Ultra -low .Volume F1usb i t' . ] ,Other (Specify) l Page 1 of 3 INSTRUCTIONS: APPLICA'T'ION 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, city, state and zip code mailing address for applicant or agent. LOT, BLOCX, SUBDIVISION: DATE OF SUBDIVISION: Official date of subdivision recorded in county plat books (month /day /year) or date lot originally recorded. Dividing an approved lot into two or more parcels for the purpose of conveying ownership shall be considered a subdivision of the lot. PROPERTY ID//: 27 character number for property. (CPHU may require property appraiser ID 0 or section/township /range /parcel number. PROPERTY SIZE: Lot, block, and aubdivision for lot (recorded or unrecorded subdivision). If lot is not in a recorded subdivision, a copy of the lot legal description or deed must be attached. Net usable area of property in acres (square footage divided by 43,560 square feet) exclusive of all paved areas and prepared rood beds within public rights -of way or eaaementa and exclusive of streams, lakea, normally wet drainage ditches, marches, or other such bodies of water. Contiguous unpaved and noncompacted toad rights - of-way and easements with no subsurface obstruction may be included in calculating lot area. WATER SUPPLY: Check private or public. PROPERTY ADDRESS: Street address for property. For lots without an assigned street address, indicate street or road and lactic in county. DIRECTIONS: Provide detailed instructions to lot o- attach an area map showing lot location. BUILDING INFORMATION: Check residential or commercial. TYPE ESTABLISHMENT: List type of establishment from Table II, Chapter t0D-6, FAC. Examples: single family, single wide mobile home, restaurant, doctor's office. NO. BEDROOMS: Count all rooms designed primarily for sleeping and those areas expected to routinely provide sleeping accommodations for occupants. BUILDING AREA: Total square footage of enclosed habitable area of dwelling unit, excluding garage, carport, exterior storage shed, or open or fully screened patios or decks. Based on outside measurements for each story of structure. n PERSONS: Number of persons residing, using, or working in establishment. For residential establishment, 2 persons per bedroom are assumed. BUSINESS ACTIVITY: For commercial applications only. List number of employees, shifts, and hours of operation, or other information required by Table II, Chapter 1OD -6, FAC. FIXTURES: Mark each listed fixture with number installed or °NA° if not applicable. SIGNATURE: Signature of applicant or agent. Date application one day submitted to the CPHU with appropriate fees and attachments. ATTACHMENTS: A site plan drawn to scale, showing boundaries with dimensions, locations of residences or buildings, swimming pools, recorded easements, onsite sewage disposal system components and location, slope of property, any existing or proposed wells, drainage features, filled areas, obstructed areas, and surface water. Location of wells, onsite sewage disposal systems, surface waters, and other pertinent facilities or features on adjacent property, if the features are with 75 feet of the applicant lot. Location of any public well within 200 feet of lot. For residences, a floor plan (residences) showing number of bedrooms and building area of each unit. For nonresidential establishments, a floor plan showing the square footage of the establishment, all plumbing drains and fixture types, and other features necessary to determine composition and quantity of wastewater. LOT: S A :: �il.,u PROPERTY ID #: kg77 STATE OF FLORIDA DEPARTMENT OF HEALTH AND REHABILITATIVE SERVICES ONSITE SEWAGE DISPOSAL SYSTEM SITE EVALUATION AND SYSTEM SPECIFICATIONS BLOCK: SUBDIVISION: 7) gal ) 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: [ ] TOTAL ESTIMATED SEWAGE FLOW: 2,7 AUTHORIZED SEWAGE FLOW: UNOBSTRUCTED AREA AVAILABLE: BENCHMARK /REFERENCE POINT LOCATION: ----' ELEVATION ELEVATION OF PROPOSED SYSTEM SITE IS 2.2 [INCHES /0# [ OyE /BELOW] BE f REFERENCE POINT THE MINIMUM SETBACK WHICH SURFACE WATER: '? r FT WELLS: PUBLIC: FT BUILDING FOUNDATIONS: 10 YEAR FLOORING? [ ] YES [g, ] NO 10 YEAR FLOOD ELEVATION FOR SITE T7, FT msL/N9yEl SITE ELEVATION: . FT MSL /NGVD SITE SUBJECT TO FREQUENT FLOODING: [ ] YES [z] NO SOIL PROFILE INFORMATION SITE 1 Mansell # /Color Texture USDA SOIL SERIES: ,,TL!; Depth to to to to to to to to to CAN BE MAINTAINED FROM THE PROPOSED SYSTEM TO THE FOLLOWING FEATURES: DITCHES /SWALES: z, FT NORMALLY WET? [ ] YES 1 NO LIMITED USE: _. -• FT PRIVATE: FT NON- POTABLE: FT FT PROPERTY LINES: FT POTABLE WATER LINES: FT OBSERVED WATER TABLE: ' INCHES [WYE / BELOW] EXISTING GRADE. TYPE: :v RCY= / APPARENT] ESTIMATED WET SEASON WATER ABLE ELEVATION: - ":17 INCHES [ ABOVE / BELOW ] EXISTING GRADE. HIGH WATER TABLE VEGETATION: [ ] YES LK] NO MOTTLING: [ ] YES U] NO DEPTH: INCHES SOIL TEXTURE /LOADING RATE FOR SYSTEM SIZING: 2 DEPTH OF EXCAVATION: INCHES DRAINFIELD CONFIGURATION: .. ] TRENCH [;;g;] BED [ ] OTHER (SPECIFY) REMARKS /ADDITIONAL CRITER SITE EVALUATED BY: /1 HRS-H Form 4015, Mar 92 (0 s (Stock Number: 5744 -003-4 es previous 1' editions whic REORDER FROM APEX BUSINESS FORMS. [Section /Township /Range /Parcel No or ax ID Numb: YES [ ] NO NET USABLE AREA AVAILABLE: ,j ACRES GALLONS PER DAY [RESIDENCES -TABLE 1 / OTHER -TABLE 2] GALLONS PER DAY [1500 GPD /ACRE OR 2500 GPD /ACRE] SQFT UNOBSTRUCTED AREA REQUIRED: `` -> SQFT ci mpy not be used) AGENT: PERMIT # SOIL PROFILE INFORMATION SITE 2 Munsell //Color Texture USDA SOIL SERIES: ;j „t? Depth to •,; • to to to to to to to to DATE: Page 3 of 3 INSTRUCTIONS: PERMIT h: Permit tracking number assigned by CPHU. APPLICANT: Property owner's full name. AGENT: Property owner's legally authorized reprecentative. LOT, BLOCK, SUBDIVISION: Lot, block, and subdivision for lot. PROPERTY IDH: 27 character number for property. (property appraiser ID (/ or section/township /range /parcel number) PROPERTY SIZE: Check if property size at site conforms to submitted site plan. Record net usable area available - lot area exclusive of all paved areas and prepared road beds within public rights -of -way or easements and exclusive of streams, Ekes, normally wet drainage ditches, marshes, or other such bodies of water. SEWAGE FLOW: UNOBSTRUCTED AREA: MINIMUM SETBACKS: Record the estimated sewage flow for the establishment from Table 1 (residences) or Table 2 (non - residential), Chapter 10D-6, FAC. Record the authorized sewage flow for the lot based on net usable area and water supply (1500 gallon per day per acre for private water supplies and 2500 gpd per acre for public water supplies). If authorized sewage flow does not equal or exceed the estimated sewage flow, the application must be denied. • Record the square feet of unobstructed area available and the amount required. Unobstructed area must be at least 2 tunes as large as the drainfield absorption area and at least 75 percent of the unobstructed area must meet minimum setbacks in Chapter IOD -6, FAC. The unobstructed area must be contiguous to the drainfield. BENCHMARK INFORMATION: Record the location of the benchmark. If using a surveyor's benchmark record the actual elevation. Record the elevation of the proposed system site in relation (above or below) to the benchmark. Record minimum setbacks which can be meet to all listed features. Actual measurements must be recGrded or "NA" for non applicable features. Features on site plan or within 75 feet of the applicant lot must be measured. The location of any public drinking well within 200 feet of the applicant's lot must also be verified. FLOOD INFORMATION: Record information on lot's subject to flooding. For lots subject to flooding record 10 year flood elevation for site and actual site elevation. SOIL PROFILE INFORMATION: Two soil profiles within the proposed absorption area to a minimum depth of 6 feet or refusal are required. Soil identification will use USDA Soil Classification methodology (Munsell colors and USDA soil textures). Refusals must be clearly documented. Provide USDA soil series if available, record "UNK" if the series cannot be determined. WATER TABLE: Record the depth of the observed water table at the time of the evaluation. Mark "perched" or "apparent" as appropriate. Record the estimated wet season water table elevation based on site evaluation, USDA soil maps, and historical information. Indicate if there is high water table vegetation present. Indicate if mottling is present and depth. SOIL TEXTURE: Record soil texture or loading rate for system sizing. DEPTH OF EXCAVATION: If applicable record depth of excavation required. Record "NA" if not applicable. DRAINFIELD CONFIGURATION: Check drainfield configuration required. If other, specify type. ADDITIONAL CRITERIA: Record any additional remarks pertinent to site or installation. Ex. dosing required. SITE EVALUATED BY: Signature of evaluator, title, and date of evaluation. Professional engineers must seal all documentation submitted. ELEVATION WORKSHEET ELEVATION OF BENCHMARK / REFERENCE POINT IS: BENCHMARK SITE 1 SITE 2 SITE 3 [+] SHOT: H.I. H.I. H.I. H.I. [ -J SHOT [ -J SHOT [ -] SHOT CONSTRUCTION PERMIT FOR: [ :: ] New System [ ] Repair APPLICANT: PROPERTY STREET ADDRESS: LOT: /i \ PROPERTY ID #: SYSTEM MUST BE CONSTRUCTED IN ACCORDANCE WITH SPECIFICATIONS AND STANDARDS OF CHAPTER 1OD -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 STATE OF FLORIDA DEPARTMENT OF HEALTH AND REHABILITATIVE SERVICES ONSITE SEWAGE DISPOSAL SYSTEM CONSTRUCTION PERMIT Authority: Chapter 381, FS & Chapter 1OD -6, FAC BLOCK: [ ] Existing System [. ] Holding Tank [ , ] Temporary /Experimental [ :] Abandonment [ :] Other(Specify) AGENT: G` [GALLONS / GP D] 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 [ ] SQUARE FEET PR DRAINFIELD SYSTEM R [ ] SQUARE FEET SYSTEM A TYPE SYSTEM: [z]? STANDARD [ ] FILLED I CONFIGURATION: [ ] TRENCH (?v( BED N F LOCATION OF BENCHMARK: I ELEVATION OF PROPOSED SYSTEM E BOTTOM OF DRAINFIELD TO BE [ L D FILL REQUIRED: [ H E R SPECIFICATIONS BY: APPROVED BY: DATE ISSUED: -; s a ] INCHES EXCAVATION REQUIRED: [ ] INCHES SUBDIVISION: 'r..... -. ' ° C✓�, it HRS -H Form 4016, Mar 92 (Obsoletes previous editions which may not be used) (Stock Number: 5744 - 001 - 4016-0) TITLE: [ TITLE: _ e PERMIT # DATE PAID FEE PAID $ RECEIPT # [ SECTION /TOWNSHIP /RANGE /PARCEL NUMBER] [OR TAX ID NUMBER)) ] MOUND [ ] ] SITE [ j Y] [INCHES /FT] ['ABOVE /BELOW] BENCHMARKK /REFERENCE POINT ✓ � ] [INCHES /FT] [`ABOVE /BELOW] BENCHMARK /REFERENCE POINT EXPIRATION DATE: - / , CPHU Page 1 of 2 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 t/ or section /township /range /parcel number) SYSTEM DESIGN AND SPECIFICATIONS: • :f TANK: Minimum specifications from Chapter 10D-6, FAC. DRAINFIELD: Minimum specifications from Chapter 1OD-6, FAC. OTHER: Other specifications, such as operating permit requirements, low - volume flush toilets, variance provisos. SPECIFICATIONS 13Y: 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. Date PERMIT APPLICATION FOR MIAMI SHORES VILLAGE CY Job Address 103 kic qq &f: • Tax Folio Legal Description &/C)Cv Historically Designated: Yes No Owner/Lessee / Tenant �-� TIb ) Owner's Address iO3 I J E `l q } b ST• Contracting Co. • . ∎ T3N Qualifier JO t4I i S . Lt P (A State # C pCo _I l 1 1 Municipal # Competency # Address Bonding Company Address Architect/Engineer Mortgagor Address Permit Type (circle one): BUILDING ELECTRICABIN MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION GAS f.la FPM IMF .R 1 �i t.PPcL - NiC C & AI u3 ,e 1-01 • kI b (A)11-1 o:akic . Square Ft. Estimated Cost (value) 1 530 CO 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 fo ELECTRICAL PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK. OWNERS AFNll)AVIT: I certify that all the foregoing information is accurate and that construction and zoning. Furthermore, I authorize the above -named contractor to do S / /34-L of owner and/or Condo President Date Owner and/or Condo President My Commission Expires: FEES: PERMIT APPROVED: Zoning Mechanical Plumbing Building Date JENNIFER STAMENKOVIC MY COMMISSION # CC 961200 f '`' XPIRES: Aug 14, 2004 1-13,10-3-NO . 7 FL Notary Service & Bonding, Inc. RADON C.C.F. Signaturepf Notary as to Con My Commission Electrical Master Permit # / � 0c= ' /o�- Phone 305 959 , a r) Address Los S. 315-1- AVE,, HVt-:l-`/t i SS # Phone R9- C O ?) (D5 0h) BOND Ins. Co. fJ h 1i¼ r t • • 1 1 wor' e work s WI i nfractor or rn com ' ance wr er- Builder I � I wR t ' RAMBIS a MY COMMISSION # CC 961450 'tOF 0. EXPIRES: August 26, 2004 1 - 800 FL Notary Soma 8 Bonding, Inc. cable laws regulating Date D ate TOTAL DUE4_1 ` ' " Survey Sheets / Plans Customer Name: H Address: IuE qq ST. City, State, Zip: 1 (AM I SH3S PL Phone #: 3a6 C 159 I D@ All Work to Comply With N.F.P.A. Code #: Estimated Job Cost: Description of Work: 4s E.H. Whitson Plumbing 421 South 21st Avenue Hollywood, FL 33020 /d ,40 Piping Cx�¢� Piping ISO SurvevSheets / Plans Customer Name: or N G�I4" ST. Address: t'Y, City, State, zip: M AM ( SH- -10k5 �L Phone #: 95'1 1 aari All Work to Comply With N.F.P.A. Code #: ^,6 Estimated Job Cost: /- 5=3 B tit> Description of Work: 65 Gds Ti? Ye.ry /' # o Piping ISO E.H. Whitson Plumbing 421 South 21st Avenue Hollywood, FL 33020 Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Printed: 5/23/2002 Applicant: JOHN Owner: SALDEN JOB ADDRESS: 102 Contractor E H WHITSON AIR CONDITIONING Local Phone: Parcel # 1132060132990 Fees: FEE2002 -2954 FEE2002 -2958 Permit Status: Approved Permit Expiration: 11/16/2002 Construction Value: $1,530.00 Work: RUN GAS LINE FROM METER TO SUPPLY 1 RANGE 1 BBQ & 1 WATER INSTALL 1 W /H,1 RANGE, 1 BBQ If there is no permit package accessible on the job -site for inspectors to verify, there will be no inspections. Re- inspection fee is $50.00, which must bi This Permit is granted to the contr. ordinances pertaining thereto and wit and approved by the proper municipz authorization. A further condition upc ordinances and regulations pertaininc by his agents, servants or employee: Signed: Signed: In consideration of the issuance to o with the plans, drawings, statements myself, my agent, servants or emplo' ORDER OF �° ' `^' �W one h,wn a1ii d kuentc, - on,e thgauo suNTRUsr PAY TO THE NE 94 Description Building Fee CCF Total Fees: AL & JOHN ENTERPRISES INC os /2000 C/ 4- Z3 - 6saS 421 S 21st Avenue Hollywood, FL 33020 - 5013 SunTrust Bank Legal Description: FOR too kit q(-( Plumbing Permit Permit Number: PL2002 -123 SHEVOCK CLAUDEEN ST Contractor's Address: 423 SOUTH 21ST AVENUE 1 53 41 6 53 42 MIAMI SHORES SEC 1 AMD PB 10 -70 LOTS 13 & 14 BLK 22 Amount $120.00 $1.20 $121.20 Page 1 of 1 Total Fees: $121.20 Total Receipts: $0.00 0 / iov ' i DOLLARS 0101 63- 607/670 DATE L5JJOc9 1 $ l& I .a9 8 9•.ur y f•alur•. x "11• on MIAMI SHORES VILLAGE. FLORIDA BUILDING ❑ ELECTRICAL ❑ DATE 195 PLUMBING ❑ PERMIT N° g 21 Contractor's License No - ROOFING ❑ Architect Contractor or Builder Legal Description Lot Owner of Building Address of Building ❑ Work to be performed under this Permit CONTRACTOR OR BUILDER Bl. Subdi- vision Sq. Ft Value of Project $ Amt. of Permit $ This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the application herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes responsibility for work done by his agents, servants or employees. Signed • 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 17 BUILDING ELECTRICAL PLUMBING ROOFING Owner of t r Building A I El ❑ DATE / Z / % 195j.,.� i] PERMIT N9 4824 Contractor's ❑ License No. 1 t Z- ❑ Work to be performed under this Permit MIAMI SHORES VILLAGE, FLORIDA a ? j , f r _` Architect ` . r , Contractor or Builder , I i . ! r ; /1 i „ _ , Legal Lot 1 Subdi- Description Bl vision Address of ; �, It �r'` Value of 'I Amount of i Building /, L - 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 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 cr in the statements or specifications and that he assumes responsibility for work done by his agents, servants or employees. 1 Signed• j 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. CONTRACTOR OR BUILDER BY AUTHORITY 6 i UILDING ECTRICAL LUMBING MIAMI SHORES VILLAGE, FLORIDA PERMIT N2 5329 caner of uilding rchitect . f DATE Work to be performed under this Permit Contractor's License No - - T 194" ontractor r' Builder egal Lot Bl. Subdi- escription vision ddress of Value of Amt. of uilding > 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- ttion herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any ans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked 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 -rmit is granted is the understanding that the contractor or builder named above assumes the sooponsibrility for -a thorough knowledge of the..ordinances and .gulations pertaining to the work covered hereby whether shown on the plans or drAivfngs of in the statements 'or specifications and that he assumes respon- bility for work done by his agents, servants or employees. r/ 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 rtaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. accepting this permit I assume responsibility for all work done by either myself, my agent, servant or employee. CONTRACTOR OR BUILDER BY AUTHORITY UILDING LECTRICAL LUMBING wner of uilding rchitect : ontractor Builder MIAMI SHORES VILLAGE, FLORIDA PERMIT N2 5327 DATE Work to be performed under this Permit 194 1 Contractor's License No. egal Lot Bl. 'escription ddress of uilding 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- ttion herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any ans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked 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 °rmit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and :gulations pertaining to the work covered hereby whether shown on the plans di drawings or in the statements or specifications,and that he respon- bility for work done by his agents, servants or employees. Subdi- vision Value of Project Amt. rm o f # Pe Signer 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 :rtaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shares Village. accepting this permit I assume responsibility for all work done by either myself, my agent, servant or employee. CONTRA 011 BUILDER BY AUTHORITY BUILDING ELECTRICAL PLUMBING Owner of Building MIAMI SHORES VILLAGE, FLORIDA ERMIT N? 5420 Work to be performed under this Permit Ne — l3 t/ A11/ Cr. Architect Contractor or Builder f ,�, / N 4 % t , �, • V �`... Legal oS I D Desscrr iption Address of + +� L � V alue of Amt. of °, , "'. 0 Building "'T • Project Permit e} ,, This permit is granted to the contractor or .wilder 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 ar change withou authorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above a ,_. - t i ponsib qty f a thorough knowledge • t - ordinances and regulations pertaining to the work covered hereby whether shown on the plans or . n_ the s or specifications and tha.a - s respon- sibility for work done by his agents, servants or employees. Signed. By ECT_ Qlt In consideration of the issuance to me of this permit I agree to perform the work covered ereunder compliance with pertaining thereto and in strict conformity with the plans, drawings, statements or specificatio . . submitted to the proper authors In accepting this perjnit I assume responsibility for all work done by either myself, my agent, servant or employee. CON'TRXCTOR OR BUILDE Bl. I- DATE Subdi- 717 5 /oft f vision C ractor's License No. os rdinances aqd g }ii2ns i of Miami AtorA•TIThige. AUTHORITY IP 4 ' ' r rS0 BUILDING ELECTRICAL PLUMBING MIAMI SHORES VILLAGE, FLORIDA PERMIT N? 5329 Work to be performed under this Permit [ 9 , Owner of , r Building Arcl. 'act Contractor or Builder Legal Lot Description Address of Building 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 assyunes the fesponsibility for a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings op. in the statements or specifications and that he assumes respon- sibility for work done by his agents, servants or employees. r - q a Signed:, By INSPECTOR In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servant or employee. CONTRACTOR OR BUILDER Bl. t, Subdi- vision Value of Project BY DATE 194— Contractor's License No. Amt. of Penult AUTIiORITY Permit No. _.___'._ Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted Mr 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, wh ther herein specified or not. A copy of approved plans and specifications must be kept at building g d umg progress of work. ,�:� Owner's Name and Address � — No. Street Registered Architect and /or Engi 1/"�O ' _ ''" Employing Plumber's Name ee > Amount of Permit $ / ( Signed) ss. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Date No / -- a Street-__g (Signed) r Location and Legal Description Lot Block Subdivision �- �_ i - Street and Number where work is to be performed —No Street • ', L State work to be performed and purpose of building (By Floors) New Building Remodeling Addition Repairs No. of Stories Size Septic Tank 3 x Type of Tank - �`' e _" Capacity Gals. t, e5, 600 Feet of Drain Tile i Nature of Water Supply: City —Well. — Size of Soakage Pit Dist. Feet of Tank or Drain Field from Well 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 corn- 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. STATE OF FLORIDA, 1 COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared Master Plumber. to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the ____________________ _.._____ ..___ _.____ of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. My Commission Expires Notary Public, State of Florida NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty materials and /or workmanship. CLOSETS BATH 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 SW IM'G POOL CONTR. LIST CHECK �. . 1 Permit No. _.___'._ Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted Mr 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, wh ther herein specified or not. A copy of approved plans and specifications must be kept at building g d umg progress of work. ,�:� Owner's Name and Address � — No. Street Registered Architect and /or Engi 1/"�O ' _ ''" Employing Plumber's Name ee > Amount of Permit $ / ( Signed) ss. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Date No / -- a Street-__g (Signed) r Location and Legal Description Lot Block Subdivision �- �_ i - Street and Number where work is to be performed —No Street • ', L State work to be performed and purpose of building (By Floors) New Building Remodeling Addition Repairs No. of Stories Size Septic Tank 3 x Type of Tank - �`' e _" Capacity Gals. t, e5, 600 Feet of Drain Tile i Nature of Water Supply: City —Well. — Size of Soakage Pit Dist. Feet of Tank or Drain Field from Well 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 corn- 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. STATE OF FLORIDA, 1 COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared Master Plumber. to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the ____________________ _.._____ ..___ _.____ of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. My Commission Expires Notary Public, State of Florida NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty materials and /or workmanship. w * .o / • BUILDING ELECTRICAL PLUMBING Owner of Building Architect Contractor or Builder to► CONTRACTOR OR BUILDER MIAMI SHORES VILLAGE, FLORIDA DATE • 194 PERMIT Nn 5327 Work to be performed under this Permit Legal Lot Bl. Description fi Address of Building 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 plan are changed without authorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above a sumeWfthe responsibility for a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans ef•'drawidgs 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 dinances gegulations 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. 4 "10 Subdi- vision Value of Project Contractor's . License No. • Amt. of Permit BY AUTHORITY Et- 0 O. X I New Building X Permit No. 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 Earle it.._ _Shattuck_ No Street Registered Architect and/or Engineer Employing Plumber's Name. Horace Z. 13runeon No. 17'77 street__S.A.13thAvit._,Miand , Fla . 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) 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 Permit $ STATE OF FLORIDA, t COUNTY OF DADE, SS. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT _ Remodeling Addition_ (Signed).-/ (Signed) Repairs Date May 9, 1947 My Commission Expires Notary Public, State of Florida ; No. of Stories. Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub-contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such sub-contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. Master Plumber. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. NOTE: A re-inspection fee of $1.00 will be made when such re-inspection is made necessary by improper notice for inspection, or faulty materials and/or workmanship. CLOSETS BATH Tuss SHOWERS LAVA- TORIES SINKS SLOP SINKS LAUNDRY TUBS URINALS CATCH BASIN FLOOR DRAIN DRINKING FOU NT' NS Sill c 3 TOTAL FIXTURES CONTR. LIST 3 1 2 ___3___ _A.__ _a____ CHECK SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SW I M 'G POOL .. ...f . , ,' - ;\ CONTR. LIST X CHECK New Building X Permit No. 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 Earle it.._ _Shattuck_ No Street Registered Architect and/or Engineer Employing Plumber's Name. Horace Z. 13runeon No. 17'77 street__S.A.13thAvit._,Miand , Fla . 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) 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 Permit $ STATE OF FLORIDA, t COUNTY OF DADE, SS. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT _ Remodeling Addition_ (Signed).-/ (Signed) Repairs Date May 9, 1947 My Commission Expires Notary Public, State of Florida ; No. of Stories. Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub-contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such sub-contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. Master Plumber. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. NOTE: A re-inspection fee of $1.00 will be made when such re-inspection is made necessary by improper notice for inspection, or faulty materials and/or workmanship. Permit No. Registered Architect and /or Enfineer_____ — n Size Septic Tank Feet of Drain Tile Nature of Water Supply: City —Well Amount of Permit $ My Commission Expires MIAMI SHORES VIL.AGE PLUMBING INSPECTION DEPARTMENT: APPLICATION FOR PLUMBING " 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 Employing Em to Plumbers Name_. :.4. + + � /' G c. � . __ -- -- No._� �� _ Street t -- � Location and Legal Description Lot-- ____ -- '--- ----- ____ -- �— Block— r Subdivision: - - -_.. _ _------- _ - -__ -_ , J • 1, ., �, P • Street and Number where work is to be performed —No ''� , , ° , Street �_ r , State 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 (Signed)_ Date <: Capacity Gals Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accept is obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Flori • : Permanent Supplement, and bus com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contr a ors 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). - - -- Notary Public, State of Florida Master Plumber. STATE OF FLORIDA, I COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared 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 S INKS SLOP SINKS LAUNDRY Turns URINALS CATCH BASIN FLOOR DRAIN DRINK NO FOUNT' NB TOTAL FIXTURES CONTR. LIST / / f � u /� ( CHECK — -- SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SW IM'G POOL CONTR. LIST CHECK Permit No. Registered Architect and /or Enfineer_____ — n Size Septic Tank Feet of Drain Tile Nature of Water Supply: City —Well Amount of Permit $ My Commission Expires MIAMI SHORES VIL.AGE PLUMBING INSPECTION DEPARTMENT: APPLICATION FOR PLUMBING " 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 Employing Em to Plumbers Name_. :.4. + + � /' G c. � . __ -- -- No._� �� _ Street t -- � Location and Legal Description Lot-- ____ -- '--- ----- ____ -- �— Block— r Subdivision: - - -_.. _ _------- _ - -__ -_ , J • 1, ., �, P • Street and Number where work is to be performed —No ''� , , ° , Street �_ r , State 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 (Signed)_ Date <: Capacity Gals Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accept is obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Flori • : Permanent Supplement, and bus com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contr a ors 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). - - -- Notary Public, State of Florida Master Plumber. STATE OF FLORIDA, I COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared 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 APPLICATION FOR MIAMI SHORES VILLAGE Date Q f Job Address l2) '/i1,J 9y ,S' //z / Tax Folio / ( 3206 / 3 9 O Legal Description z% % / 7 PLjy 734X" Z 4% i 1, isTon�ally Designated: Yes No 1 l� Owner/i essee / Tenant �, c V o c. 1 3 Ct P C (cck '° aster Permit # , `/ 33 3 Owner's Address / 2 S g Phone 27c 7 7 Y Contracting Co. ? 5 ,a I/Lecj, S = Qualifier C-6‘,./.0'. ' doZiA , 5 SS# • Phone 3 i 2.7' 7/ Z State # Municipal # Architect/Engineer /< e n - , //- 71- 1 i4/ 1 471, Square Ft. -�7) FEES: PERMIT X(7 U RADON APPROVED: Zoning Building Mechanical Plumbing C.C.F. Address > 1/ ' /7 . Competency # Ins. Co. Address -- 7 S' t4/ 77 /Ai /. U F Bonding Company Address Mortgagor Address Permit Type (circle one): BUILDING ELECTRICA M MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION D 4 Estimated Cost (value) f S 0 WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.) Application is hereby made to obtain a permit to do work and installation as indicated above, and on the attached addendum (if applicable). I certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits are required for ELECTRICAL, PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK. OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Furthermore, I authorize the above -named contractor o do the work stated. S2 finks pA4- 1 ` '?C2 . ,e,_(\c: 8/s /4 R S ignature of owner and/or Condo Presi nt Date Signature ontra or or wner - Builder . ate Notary as to Owner and/or Condo President Date No - to Contractor or Owner - Build& Date My Commission Expires: My ommission Expires: 4/3/66 NOTARY BOND Electrical • ---= /6/? Engineering Permit No. r 2 Employing Plumber's Name 1123- E. -2 c%-,i - New Building Remodeling_____ ______ Addition._______._ Repairs MIAMI SHORES VIL lAGZ PLUMBING INSPECTION DEPARTMEi■':' APPLICATION FOR PLUMBING "' ;b,I,MIT PTG TANK CO.-- f No. z1' Amount of Permit $_ (Signed)_ (Signed). Date /a - 7 _ J� 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 trr not. A copy of approved plans and specifications must be kept at building during progress of work. J� Owner's Name and Address Registered Architect and /or Engineer.___-__ Street Street__-__.--- - _- _ ..... . ........ _ - • - -- Location and Legal Description Lot.-------------- - - -___ __ Block_ _ Subdivision. - - -__. _. _ _._ Street and Number where work is to be performed —No / ° 1 91- /� � - Street State work to be performed and purpose of building (By Floors) _______ _ No. of Stories Capacity Gals Siva Septic Tank. n Type of Tank_ Feet of Drain Tile _ - i!! '� "''' .AzDist. Feet of Tank or Drain Field from Well Nature of Water Supply: City —Well _.__.._.___._ __•_Size of Soakage Pit My Commission Expires Notary Public, State of Florida ,/V 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 Pennanent 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 die Act. The undersigned agrees to employ only such sub- contractors, on work to be performed under this permit, as are lioanssd by Miami Shores Village. Master Plumber. STATE OF FLORIDA, 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 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 worlananship. CLOSETS BATH TUBS SHOWERS LAVA. TORIES SINKS SLOP SINKS LAUNDRY TU88 U RINALS CATCH BASIN FLOOR DRAIN DRINK NO FOUNT' NS TOTAL FIXTURES CONTR. LIST CHECK SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL. SPRKLR. SYSTEM SW IM'O POOL CONTR. LIOT CHECK - i q Permit No. r 2 Employing Plumber's Name 1123- E. -2 c%-,i - New Building Remodeling_____ ______ Addition._______._ Repairs MIAMI SHORES VIL lAGZ PLUMBING INSPECTION DEPARTMEi■':' APPLICATION FOR PLUMBING "' ;b,I,MIT PTG TANK CO.-- f No. z1' Amount of Permit $_ (Signed)_ (Signed). Date /a - 7 _ J� 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 trr not. A copy of approved plans and specifications must be kept at building during progress of work. J� Owner's Name and Address Registered Architect and /or Engineer.___-__ Street Street__-__.--- - _- _ ..... . ........ _ - • - -- Location and Legal Description Lot.-------------- - - -___ __ Block_ _ Subdivision. - - -__. _. _ _._ Street and Number where work is to be performed —No / ° 1 91- /� � - Street State work to be performed and purpose of building (By Floors) _______ _ No. of Stories Capacity Gals Siva Septic Tank. n Type of Tank_ Feet of Drain Tile _ - i!! '� "''' .AzDist. Feet of Tank or Drain Field from Well Nature of Water Supply: City —Well _.__.._.___._ __•_Size of Soakage Pit My Commission Expires Notary Public, State of Florida ,/V 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 Pennanent 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 die Act. The undersigned agrees to employ only such sub- contractors, on work to be performed under this permit, as are lioanssd by Miami Shores Village. Master Plumber. STATE OF FLORIDA, 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 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 worlananship. Date 6/26/96 Job Address 102 NE 94 STREET Tax Folio t ' � J206'- 01 3 " 2 -9 C , Q Legal Description Historically Designated: Yes No Owner/Lessee / Tenant MARK SAIZ Master Permit # Owner's Address 102 NE 94 STREET, MIAMI SHORES 33138 Phone 759 -9679 Contracting Co. LLOYD =NORTH DADE SEPTIC TANK Address Qualifier DENNIS NEVILLE Phone 751 -7676 State # 025836 -8 Municipal # Competency # 12842 Ins. Co. TRAVELERS /ESIF Architect/Engineer Address Bonding Company Address Mortgagor Address Permit Type (circle one): BEILDINGOIDERKTRICCAL PLUMBING 152WHAITICL,YXNCOD&7[AEMPOCXAgGXXXiiM WORK DESCRIPTION INSTALL DRAINFEILD Square Ft. 300 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 . • F HANICAL WORK. OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate • at . 1 work will be done in compliance with all applicable laws regulating construction and zoning. Furthermore, I authorize the above- ed contr. ct• o do th, work stated. d2 fq Date 4269/q& Notary to O er and/•; • o Presi ent Da e My Commission Expire lttatt. at cm's% imms• ttttattmvi o� pAr P ia , Terosa J. Felder �+ g 6 Notary Public, ate ^f. Florida 9 1 P - f o Commission D+�. CC 480737 ' OF riST My Commission Expires 07/I6/99 ) 1- 803-3- NOTARY • Fla. Notary ! ¢vice & DoadSog Co. 5� > eteeemaatuuaeuaffi eeNwualrueleCat! ?, FEES: PERMIT &S • RADON C.C.F. PERMIT APPLICATION FOR MIAMI SHORES VILLAGE APPROVED: Zoning Building Mechanical Plumbing Estimated Cost (value) $1 _nn 1 800 NW 111 STREET, MIAMI 33168 Noas to 'ontractor or > ..Ay Po > � � Terksa . elder > a �t`E l ' Notary Public, g.i7,te • crda , 9w vi. Commission }b. CC 4802?7 "eoF My Commis ;icn Erpims 07/16/39 14O»-3- NOOTARY - Fla. Nct.ry rvicc & Dc: E:cs Co. }4 eamweeeteeeeeeereeeteteeeeMyeeerereeeeteeeeth NOTARY Electrical TOTAL DUE Engineering 1411 ; 1 LI ID 1 I I LI ,11111 1 *- 1 7-* , L 11 u Ear . i!! ; I 1 1 1 I 'I By _1_, 4jrLL II I _P i tnTi_r*CD 11,1■1;111 :_t_i_t_l_l_ ; *1 I [ j ; 12E92 Li( ; , L L__ _ L' r r-H-Pn Fr-'■ 1 1- P ; ' : 1_1 _ 1 Lc- ; I _LI = --- - ----::-!, - - -1-1-111 - ; - I I- Li I LI 4 I 1 11 1:111 L-1- ; r Notes I I - .1 1_, 1_, 1_1_, I . I I ' I I . ;- ; 1T", ' 1 .' 1 1 ; ! ' 1 .-Ij i I e -1 1'•1 7 ;41 1 ' i 13 • ----- 1 1 I --cm- - 1 - ; - -- 1 - ; - "t ri**1 1 i ; ■; 1 ! , . ;- ; - -;-- ; , - 1 I,17C, ; 1 ■ I-; : '` 1 1 - ‘ ' • : i -: -'' i i ' ' ruil I I 1 I . I I 1 ; 1 • Li - STATE OF FLORIDA DEPARTMENT OF HEALTH AND REHABILITATIVE SERVICES APPLICATION FOR ONSITE SEWAGE DISPOSAL SYSTEM CONSTRUCTION PERMIT 96 /2 - , ; 1 , . _I _ I - 1 — ; MARK FkAT7, 102 NE 94 STREET. 33138 OLD SYSTEli OVERFLOWING. WATER COHSffit SEPTIC 1= Site Plan Submitted by Plan Approved ••■■•■■■■ - ..- Rau a lam u • L fl i * -FI- NK . 17-1 A i- r---,:c !!--4 , ,...t-20__LI , ,,,,-, -Fri ,. 1 ,..ELLI---;---1---1_:2 _;:f.--1. a _u i I I 1 I ' ' 1,: U I 1 ' ;,11, • ; 11_1_ I 1 1,21_f1_, 1 , , _1 1 __1_1_, 1 _. _1_ _ I i2ED g HRS-H Form 4015, Feb 85 (Obsoletes previous editions which may not be used) (Stock Number: 5744-002-4015-6) - - IN not availabn (46 Permit Application Number PART II SITE PLAN 1 +i r ( JT 11 1 II ! 111 -1:hi I 1 n 1 ! ; , Ft* ! IT( *". 1 - 1 1 I 1 1- Li 1 ; ; 0 - 32_1 - 1:1 LL; H ; 1-1 c , n 1 1 - 1i -1-1 f1l 11 lhi__J1 . ; 11 1 - '• * 111 '11 1 11_1__• , 1 1 1 !, - , ; • • ; - I ;.11111 ' 1 ; V • , .1 ! ij ' l'_11 11 - 11.1•1 T:Jit i :iL: ; I I ; 7.7:17> SIGNATURE Not Approved I 1 I. • ffe: ALL Cl-tWES MUST BE APPROVED BY THE COUNTY PUBLIC HEALTH UNIT TITLE Date ci ; . • , ; I L I i A • 1' ' I.. I ' 1 ' 1 1 1 1_1_ 1 : ,-!.- , t 1 ; 1 . 11 ' .; .t , . ; I 1 1 ,-; - I - 1 1 ; " L_ I __Li 1 '-,_; - LI... 1____, . _ ,,._ .11;ii '1 111 1 1 1 1' 1 - 1* 1 1 I - 0 1 . 1 -1 , , . ... . . ' , 11,;,. ,- 1 • 1 1 1 '1.1. 11 ' 11 11 11 .. •1 , • 1 I . , 1 _ . __ 1 1 !._k_. 1 ._l__ __,■ 1 - 1 1 1 1 I • . ' 1 ; 1 1 1 ; • 1 1 1 ' , - ' 1 ' 1 1 1 1 1 ___ ___' 1__L=.1 1 1 C ; 1 i_ ; i 1 - I ; ; ' -- I . , 1 ; 1 1 __ 1 1 ; I ; _ , __J 01l_LI IT 7 - - 1 - ! - IIIII' ' — ' - -- - - "-- 4 7 --'-- I - - 1 - L . T • t ,-,_4_1. - I l' **; 1 1 I i 1 , , 1 -- - ' , ; • ,- , ;-:-'. 1 '- I ' ' - , ' - - 11 -- 1-1- . ; 17_1 I . 1 ; _; . ; - • • • ; . ' " 1 ' I • ■ I ' I i. i i_t_1' i_ _ ___ — _ _ _1_ _j_ _ L ' 1 • (-. ' , ,_, 1 — — — • . • 1 1 ' ' ' _Li_.' ' 1 ; ; flfl 1flfl - •- — -;- - - • -. ' 1 [ 1 ' 1 1 1.1 ;1, ' 1 - - 1 1 ;--` i± CflTTh 1 1 2 ; — ; r I , . LI -H iJ1 tllIlr 1 1 H 7 ;1111 1 1.1 f_JI=2 j jc. `.; ,• 1 1 - 1_ _ ; - ! 1 DD CC 1 1 I 1 1 _j 1 11 1 1 - - 1 - 1 1r i ! 1- 1 i- 11 • (7); C — 2 , 2 —z County Public Unit Page 2 of 3 APPLICATION FOR: [ N] New System [N ] Existing System [N ] Holding Tank (N ] Temporary /Experimental [ Y] Repair [N ] Abandonment IN ] Other(Specify) APPLICANT: HAT( :Y( :'BIZ AGENT: Y.LOY»- NOR.TIA :)ADE SEPTIC TANIC MAILING ADDRESS: GOO NJ 9 11 STREET, MIAMI 33168 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] LOT: A BLOCK: /44 SUBDIVISION: / V J PROPERTY ID #: ��® PROPERTY SIZE: o n ACRES [Sqft /43560] PROPERTY STREET ADDRESS: 102 NE e4 STREET, 33138 DIRECTIONS TO PROPERTY: BUILDING INFORMATION Unit Type of No Establishment 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 11 039.D t0 3 1 SFR 3 BEDROOMS 2 3 4 (A� ] Garbage Grinders /Dispo; "als [h ] Ultra -low v Flus 9ilet PERMIT # DATE PAID FEE PAID $ RECEIPT # TELEPHONE: 759 -9679 74L r� s 751 -7676 DATE OF BEFORE 70 SUBDIVISION: [Section /Township /Range /Parcel No.] ZONING: PROPERTY WATER SUPPLY: [ ] PRIVATE [XX] RESIDENTIAL [ ] COMMERCIAL No. of Building # Persons Business Activity Bedrooms Area Sqft Served [N ] Spas /Hot Tubs N ] Other (Specify) For Commercial Only [N ] Floor /Equipment Drains APPLICANT'S SIGNATURE: 1�!/ �-" MX DATE: 6/26/90 [ x] PUBLIC HRS -H Form 4015, Mar 92 (Obsoletes previous editions which may not be used) Page 1 of 3 (Stock Number: 5744- 001 - 4015 -1) LOT: SAIZ PROPERTY ID #: o ?.n V; p OI ° 2q THE MINIMUM SETBACK WHICH SURFACE WATER: ion+ FT WELLS: PUBLIC: 100 FT BUILDING FOUNDATIONS: SOIL PROFILE INFORMATION SITE 1 SITE EVALUATED BY: HRS -H Form 4015, Mar 92 (0 (Stock Number: 5744 -003-4 STATE OF FLORIDA DEPARTMENT OF HEALTH AND REHABILITATIVE SERVICES ONSITE SEWAGE DISPOSAL SYSTEM SITE EVALUATION AND SYSTEM SPECIFICATIONS BLOCK: SUBDIVISION: REORDER FROM APEX BUSINESS FORMS. TO BE COMPLETED BY ENGINEER, !'EALTH UNIT EMPLOYEE, O" OT [Section /Township /Range /Parcel ]o. or PROVIDE REGISTRATION NUMBER AND SIGN AND SEAL EAC,: PAGE OFF SUBMITTAL. COMPLETE ALL ITEMS. PROPERTY SIZE CONFORMS TO SITE PLAN: [ ] TOTAL ESTIMATED SEWAGE FLOW: 200 AUTHORIZED SEWAGE FLOW: UNOBSTRUCTED AREA AVAILABLE: q B C9 BENCHMARK /REFERENCE POINT LOCATION: FFE ELEVATION OF PROPOSED SYSTEM SITE IS 12 Munsell # /Color BROWN USDA SOIL SERIES: BROWN Texture SANDY Depth to to to to to to to to 72" OBSERVED WATER TABLE: INCHES [mom / ESTIMATED WET SEASON WA ER TABLE ELEVATION: HIGH WATER TABLE VEGETATION: [ ] YES f(x] NO es previous editions whic y not be used) AGENT: LLOYD - NORTHDADE SEPTIC ;E. YES [ ] MO MET USABLE AREA AVAILABLE: ,1 ACRES GALLONS PER DAY [RESIDENCES -TABLE 1 / OTHER -TABLE 2] GALLONS PER DAY [11500 GPD /ACRE O:° 2500 GPDjACRE] SQFT UNOBSTRUCTED AREA REQUIRED: 400 SQFT 9.3 .1 [INCHES / [N /BELOW] _ SITE SUBJECT TO FREQUENT FLOODING: [ ] YES [x] NO 10 YEAR FLOOD 10 YEAR FLOOD ELEVATION FOR SITE: W„T„ 3,0 lj FT MSL /tiger SITE ELEVATION: PERMIT # 9412-163a QUALIFIED PERSON'. ENGINEER 'S MUST SOIL PROFILE INFORMATION SITE 2 REFERENCE POINT CAN BE MAINTAINED FROM THE PROPOSED SYSTEM TO THE FOLLOWING FEATURES:, DITCHES /SWALES: — FT NORMALLY WET? [ ] YES ma NO LIMITED USE: --- FT PRIV.',TE: --- FT NON- POTABLE: — FT 5 FT PROPERTY LINES: 5 FT POTABLE WATER LINES: 15 FT G? [ ] YES [g] NO FT MSL /NGVD Munsell #/Color Texture Depth BROWN SANDY USDA SOIL SERIES:SANDY : to to to to to to to to to 72 ELOW] EXISTING GRADE. TYPE: ugAgggp / APPARENT] 108 INCHES [ ABOVE / BELOW ] EXISTING GRADE. MOTTLING: [ ] YES ix] NO DEPTH: INCHES SOIL TEXTURE /LOADING RATE FOR SYSTEM SIZING: 1„25 DEPTH OF EXCAVATION: 36 INCHES DRAINFIELD CONFIGURATION: ] TRENCH [xx] BED [ ] OTHER (SPECIFY) REMARKS /ADDITIONAL CRITER Page 3 of 3 STATE OF FLORIDA PERMIT # 1 Q- / 5 DEPARTMENT OF HEALTH AND REHABILITATIVE SERVICES DATE PAID ONSITE SEWAGE DISPOSAL SYSTEM FEE PAID $ CONSTRUCTION PERMIT RECEIPT #" 713 Authority: Chapter 381, FS & Chapter 10D -6, FAC CONSTRUCTION PERMIT FOR: [H] New System [N] Existing System [N ] Holding Tank [ �]i Temporary /Experimental [Y ] Repair [H] Abandonment [N] Other(Specify) APPLICANT: SIIZ PROPERTY STREET ADDRESS: j LOT: A BLOCK: i/ SUBDIVISION: 47, PROPERTY ID #: o 52 c) . a o o1 /Il(7j ® 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 EXISTING T [ 750 ] [GALLONS / gm SEPTIC TANK /AEROBIC UNIT CAPACITY MULTI CHAMBERED /IN SERIES:[ ] A [ ) [GALLONS / GPD] CAPACITY MULTI CHAMBERED /IN SERIES:[ ] N [ ] GALLONS. GREASE INTERCEPTOR CAPACITY [MAXIMUM CAPACITY SINGLE TANK: 1250 GALLONS] K [ ] GALLONS PER DOSE DOSING TANK CAPACITY DOSE RATE [ ] PER 24 HRS NO. OF PUMPS: [ ] D [ 300 ] SQUARE FEET F I k Y DRAINFIELD SYSTEM R [ ] SQUARE FEET SYSTEM A TYPE SYSTEM: [j STANDARD. [ ] FILLED [ ] MOUND [ ] I CONFIGURATION: [ ] TRENCH lax] BED [ 1 N F LOCATION OF BENCHMARK: T1,T (j ., m41 I ELEVATION OF PROPOSED SYSTEM SITE [8 [INCHES/ Ell] I.(yyg/BELOW] 1 oNALWREFERENCE POINT E BOTTOM OF DRAINFIELD TO BE [ � I (>�' p ] [INCHES /ER] W BELOW] L�Lj� /REFERENCE POINT L D FILL REQUIRED: [ ] INCHES EXCAVATION REQUIRED: [ 36 ]. INCHES o INSTALL 12v OF LOAD COARSE SAND TINDER BOTTOM OF DRAINFIELD T SU T BENCMAIE BEFORE INSPECTION, Tff S PERMIT IS NOT FOR ADDITIONS H NIN )►.-RE INVERT EL? VAT)tON g 5 E MINI UN BOT YT Off' D? AINFIEJG]D ELEVATION g - {.. -ii R SPECIFICATIONS BY: APPROVED BY: 102 NE 94 STREET, 33138 HRS -H Form 4016, Mar 92 (Obsoletes previous editions which may not be used) (Stock Number: 5744- 001 - 4016 -0) appmcmv AGENT: LLOYD -N DADS, SEPTIC T'ANI [SECTION TOWNSHIP /RANGE /PARCEL NUMBER] [OR TITLE: DATE ISSUED -2jTC T E SEPTIC TANK SHALL BE mar AND A SOLID DEFLECTION DEVICE INSTALLED ON THE OUTLET TAE, TITLE: � EXPIRATION DATE :iy .27 Page 1 of 2 assignee.' b5: IPP of pety...tit, • .! : ow'r; • .%11/(11 :Cc" rjj,ijcar.1 o: owriez 07 • ' !..fy id dra cf:1171 '.;■74 -6 NF; .3: :_tza L!; epel::t:iis,.; a .7 V ::■ 'ay a 'Jnit anti zaamlit. issueil. by • 3: V..- ciat.; veY: the date 1 Owner/Lessee / Tenant Owner's Address FEES: PERMIT / A RADON PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date 7 4 2 -4 1--- Job Address (v Z 4 / C S Bonding Company Address Mortgagor Address 02- tie 9Ls m I r A- X 1 �� 0 S' li e- of owner and/or ondi,Prz� d . � mate a i f ,or,ty " LUIS MONTERO It Notary Public - State of Florida 3 . • a my WrrmissEon E> es Jan 2T 2008 p* /�, f c f '� • � Jmml 66}yn A vuuni l Notary as to • .1 d/or ! o -y +- R. da C By Rati&al Notary Man, My Commis 01 Expires: I(fO1_ APPROVED: Zoning Building Mechanical Plumbing C.C.F. Tax Folio l { 32 - 0 6 ( "3 ) 7 9 Legal Dese'iption ' 10 7 - ( 3/t 4 os f' c.17 .. 2 - Historically Designated: Yes 11/ CNo. -- 0 7 S 14 K Master Permit # JL oO 2 ' V g /0 'e 9 4('S ) f2 Phone 3 0 j— ' 7 f-7 - / 7,2/ Contracting Co. T�e-0 Peri& k2 Address /57 7 C Ul/ Ol C l / 6 :( , ) ( Qualifier e s' LA Ve GA rt p'\ 34 f 7 - A'S - 7 Kc7 2 (7 State # Municipal # Competency # % a G/ 3 Ins. Co. "j'e Q 6 Architect/Engineer Address Permit Type (circle one): BUILDING ELECTRICAL PLUMB I1 CHANICAL RAE,II PAV1NG FENCE SIGN WORK DESCRIPTION /l%Q X//1 - z - ii L u t CcQ 7' d Square Ft. Estimated Cost (value) OJ WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR. LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.) Application is hereby made to obtain a permit to do work and installation as indicated above, and on the attached addendum (if applicable). I certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits are required for ELECTRICAL, PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK. OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Furthermore, I authorize the above -named contractor to do the work stated. •ignature of Contractor or Own&Builder Notary My Co 3, ■ • • LUIS MONTERO Notary Public - State of Florida My G'mitlasbn Emotes Jan V, 2005 �'•;; -' ommisalon a DD08 • ontractor or .p;„;6i • : one By National Notary ssion ExVires: G 3 /l i NOTARY BOND Electrical TOTAL DUE Date Engineering N. f ATLAS: M 5 SCALE: NTS DRAWN BY: LM N. R 6" PLASTIC GAS MAIN S.R /W 12' \ I c° 0 4 WALL Nor CONSRUCTION NOTES: 94TH STREET - E /MARKER/ TRANS FITTING 9' 10' SW ALE. 1. ALL CAS PIPELINE CONSTRUCTION TO FOLLOW TECO PEOPLES CAS STANDARDS. 2. TRAFFIC CONTROL SHOULD BE MAINTAINED AND COORDINATED WITH THE APPRORIATE GOVERNMENTAL AGENCY. 3. ALL DISTRUBED ASPHALT /CONCRETE /SOD AREAS TO BE RESTORED TO PRIOR CONDITION, UNLESS OTHERWISE SPECIFIED. 5' SIDEWALK (102) PROPOSED GAS RISER. TECO NEW 1/2" NATURAL GAS SERVICE TO: 102 NE 94 STREET, MIAMI SHORES. N.R/W S.R/W 48 HOURS BEFORE DIGGING CALL SUNSHINE 1- 800 - 432 -4770 DATE: 2/28/02 SHEET: 1/1 JO: 9436' N. t CONSRUCTION NOTES: ATLAS: M 5 • SCALE: NTS DRAWN BY: LM 94TH STREET - E /MARKER/ TRANS FITTING " PLASTIC GAS MAIN N. R 1 4; S.R/W 1 w 2' \ WALL 9' 10' SWALE. 5' 1. ALL CAS PIPELINE CONSTRUCTION TO FOLLOW TECO PEOPLES CAS STANDARDS. 2. TRAFFIC CONTROL SHOULD BE MAINTAINED AND COORDINATED WITH THE APPROR/ATE GOVERNMENTAL AGENCY. 3. ALL DISTR ISTR.UBED ASPHALT /CONCRETE /SOD AREAS TO BE RESTORED TO PRIOR CONDITION. UNLESS OTHERWISE SPECIFIED. SIDEWALK (102) PROPOSED GAS RISER. TECO NEW 1/2" NATURAL GAS SERVICE T0: 102 NE 94 STREET, MIAMI SHORES. N. R/W S. R/W 48 HOURS BEFORE DIGGING CALL SUNSHINE 1- 800 - 432 -4770 DATE: 2/28/02 SHEET: 1/1 JO: 9436 Village of Miami Shores 10050 NE 2nd Avenue Miami Shores, FL 33138 Phone: 305- 795 -2204 Printed: 3/6/2002 Applicant: CLAUDEEN Owner: SALDEN Contractor TECO PEOPLES GAS SYSTEM Local Phone: 957 - 3857 X7383 Parcel # 1132060132990 Job Address: 102 NE 94 ST Permit Status: Approved Permit Expiration: Work: NEW NATURAL GAS SERVICE LINE This Permit is granted to the contractor or builder named above to construct the bt ordinances pertaining hereto and with the understanding that the work will be perfon and approved by the I roper municipal authorities. This Permit may be revoked at ar authorization. A furth:r condition upon which this permit is granted is the understanc ordinances and regula • ns pertaining to the work covered hereby whether shown on by his agents, servants .r -mployees. 9/2/2002 If there is no permit package accessible on the job -site for inr ^ ..^ * ^r fee is $50.00, which must be paid in advance before calling for ; Signed '�:! (INSPECTOR) Address: Cellular: In considera o su: nce to me of this permit, I agree to perform the work c with the plans, drawl . . tatements or specifications submitted to the proper author myself, my agent, s: ants or employes. Signed: (Contractor or E Plumbing Permit Permit Number: PL2002 -68 SALDEN CLAUDEEN Legal Description: 1 53 41 6 53 42 MIAMI SHORES SEC 1 AMD PB 10 -70 LOTS 13 & 14 Construction Value: P• TO THE Or 11 MEMO — co . cam $650.00 there will ha art- inanCGtio116.=R6ell SpectiQn HUBERT NUNEZ OR MONICA NUNEZ DBA THE PERMIT CONNECTION P.O. BOX 366 PH. 561 - 706 -7201 ORT LAUDERDALE, FL 33 02 Page 1 of 1 Total Fees: $0.00 Total Receipts: $0.00 DA' Washington Mutual Wstungton Mutul Bk is Boca RoNLyons Financt.t Center 1670 885 Glades Rod 1 800. 7887000 B �• Mon. on. Fl. 0 334 4 )4 " Cstomer Sevice 1:26 084 3 11:8I 1Iu3582srl' 889 BLK 22 63- 8413/267 8 8 9 1 n � r: � .LAKS a es Date CY .1rob Address lo ' kJ qq Tax Folio Legal Description Owner/Lessee / Tenant T5O-M St-ianCh Master Permit # PL A9/7,=0.- /o?2 Owner's Address 1 ME q q +h ST. Phone 305 q 59 1aa n Contracting Co. a • W • W-1 I TZ /\/C Address Los S • al 5+ Ave.) H0LL)UJb Qualifier J U W K S • Lt P KA ss# Phone -1 9 co 3 ( 05 05 State # C PCO4 ( r1 l ( Municipal # Competency # Ins. Co. y ,) h (KtalieniTt Architect/Engineer Address Bonding Company Address Mortgagor Address Permit Type (circle one): BUILDING ELECTRIC PLUMBIN !s MECHANICAL ROOFING PAVING FENCE ( SIGN Q WORK DESCRIPTION (Akio © LoA - 7 sh u9 Go/ (- a Square Ft. Estimated Cost (value) 1530 •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 re uired fo ELECTRICAL PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK. OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that construction and zoning. Furthermore, I authorize the above -named contractor to do ture of owner and/or Condo President Owner and/or Condo President My Commission Expires: FEES: PERMIT PERMIT APPLICATION FOR MIAMI SHORES VILLAGE 5//34 Date Date 1$00 -3-N01 JENNIFER STAMENKOVIC MY COMMISSION # CC 961200 EXPIRES: Aug 14, 2004 FL Notary Service S Bonding, Inc. RADON C.C.F APPROVED: Zoning Building Mechanical Plumbing Historically Designated: Yes No • • - as . 1\ 1: •• wRRcflik 'KARAMBIS MY COMMISSION # CC 961450 4•0,0,0 EXPIRES: August 26, 2004 1-800-3-NOTARY FL Notary Boma r& Bonding, Inc. I wor e work s wr tractor or m com ' ance wl er- Builder Sign Notary as to Con My Commission Electrical Structural Engineer BOND "3 " \) Date ate icable laws regulating Survey Sheets / Plans Customer Name: Nc c vC-li-) Address: )09 kiE "1 `1 - fh ST. City, State, zip: N41M �i -ir�2 s FL Phone #: 3')5 q5r t a @r1 All Work to Comply With N.F.P.A. Code #: Estimated Job Cost: Description of Work: E.H. Whitson Plumbing 421 South 21st Avenue Hollywood, FL 33020 Piping ISO E.H. Whitson Plumbing 421 South 21st Avenue Hollywood, FL 33020 Survey Sheets / Plans Customer Name: se --.>"O c Address: oa N G (.1 ST city, tate zip: M AM t SkO k Y, P Phone #: :'LS 959 Oar( All Work to Comply With N.F.P.A. Code #: ^5 Estimated Job Cost: '43:36 — — ,e `i/2 %z 7 /Y‹ a , ' ' a91// z f` Description of Work: 6 2/44e' }"l zw) A vf3/ / �'9acei / % & /i* b 194'2 /. -', /. 4 , 84) Piping ISO j L 1,cf 69s /02)94 , x, 46y Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Permit Number: PL2002-123 Printed: 5/23/2002 Page 1 of 1 Applicant: JOHN SHEVOCK Owner: SALDEN CLAUDEEN JOB ADDRESS: 102 NE 94 ST Contractor E H WHITSON AIR CONDITIONING Contractor's Address: 423 SOUTH 21ST AVENUE Local Phone: Parcel # 1132060132990 Fees: Description Amount FEE2002 -2954 Building Fee $120.00 FEE2002 -2958 CCF $1.20 Total Fees: $121.20 Permit Status: Approved Permit Expiration: 11/16/2002 Construction Value: $1,530.00 Work: RUN GAS LINE FROM METER TO SUPPLY 1 RANGE 1 BBQ & 1 WATER INSTALL 1 W /H,1 RANGE, 1 BBQ If there is no permit package accessible on the job -site for inspectors to verify, there will be no inspections. Re- inspection fee is $50.00, which must Ix This Permit is granted to the contr, ordinances pertaining thereto and wit and approved by the proper municipa authorization. A further condition upc ordinances and regulations pertaininc by his agents, servants or employee: Signed: Signed: In consideration of the issuance to 0 with the plans, drawings, statements myself, my agent, servants or emplo: II Plumbing Permit Total Fees: $121.20 Total Receipts: $0.00 Legal Description: 1 53 41 6 53 42 MIAMI SHORES SEC 1 AMD PB 10 -70 LOTS 13 & 14 BLK 22 AL & JOHN ENTERPRISES INC os /2000 L S 92-3 PAY SQ4 TO THE ORDER OF Vin? h no �d ,uer -au deOaj SUNTRUST SunTrust Bank 421 S 21st Avenue Hollywood, FL 33020 -5013 FOR (Oa kit q -1- DATE /' OV 1 $ la a 9 c O/ ) v" / S DOLLARS 0101 63- 607/670 BUILDING ❑ MIAMI SHORES VILLAGE. FLORIDA DATE 195 PLUMBING L PERMIT P ❑ N9 9212 Contractor's PLUMBING ❑ License No ROOFING ❑ ❑ Work to be performed under this Permit Owner of Building Architect Contractor or Builder Legal Description Address of Building Lot CONTRACTOR OR BUILDER Bl. Subdi- vision Sq. Ft Value of Project $ Amt. of Permit $ This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the application herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes responsibility for work done by his agents, servants or employees. Signed: 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 BUILDING ELECTRICAL PLUMBING ROOFING Owner of Building r Architect Contractor or Builder Legal Lot Description Address of Building /r° MIAMI SHORES VILLAGE. FLORIDA PERMIT 0 Bl. N? 4824 DATE / Contractor's License No. Work to be performed sander this Permit , Subdi- vision Value of Project $ Amount of Permit $ ( A 195 This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the application herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings cr in the sto ements or specifications and that he assumes responsibility for work done by his agents, servants or employees. . r Signed. -" IIIj PECTOR BY 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. CONTRACTOR OR BUILDER BY AUTHORITY e� UILDING ECTRICAL LUMBING MIAMI SHORES VILLAGE, FLORIDA PERMIT N2 5329 Work to be performed under this Permit_ wner of uilding rchitect DATE 194_ Contractor's License No ontractor Builder egal Lot Bl. Subdi- 'escription vision ddress of Value of Amt. of uilding_ 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- ition herefor in strict compliance with all ordinances pertaining thereto and w th the understanding that the work will be performed in compliance with any ans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked 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 emit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and ,gulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes respon- bility 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 staining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. accepting this permit I assume responsibility for a work done by either myself, my agent, servant or employee. CONTRACTOR OR BUILDER BY AUTHORITY UILDING LECTRICAL LUMBING MIAMI SHORES VILLAGE, FLORIDA PERMIT N2 5327 Work to be performed under this Permit_ -wner of uilding rchitect DATE 194_ Contractor's , License No. - ontractor = Builder egal Lot Bl. Subdi- )escription vision ddress of Value of Amt. of uilding 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- ition herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any :ans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked 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 °rmit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and :gulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes respon- bility 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 :‘rtaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. 1 accepting this permit I assume responsibility for all work done by either myself, my agent, servant or employee. CONTRACTOR OR BUILDER BY AUTHORITY il • MIAMI SHORES VILLAGE, FLA. JOB ��- N9 5459 ADDRESS S° ?- INSPECTION C TIME READY / Z J 7,L2 REMARKS INSPECTOR m DATE BUILDING ELECTRICAL PLUMBING Owner of Building Architect Contractor ,43 ., f N 1 th or Builder �' 7F`� # Legal 1 Bl. Description ti Address of Value of Building r ` Project This permit is granted to the contractor or fffuilder 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 ar- change withot authorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above a ponsib ty a- thorough knowledge .. t ordinances and regulations pertaining to the work covered hereby whether shown on the plans or .' m_,: the s :hem - or specifications and tha _ a�eff s respon- sibility for work done by his agents, servants or employees. �� IN ' ECT v In consideration of the issuance to me of this permit I agree to perform the work od ereunder , n compliance with o�rdinances aAd gt_ ns ' pertaining thereto and in strict conformity with the plans, drawings, statements or specificatio submitte. to the proper authoi'ftie`s of Miami Stioi •Viltfge.. In accepting this perjnit I assume responsibility for all work done by either myself, my agent, servant or employee. T � 9 CONfi I CTOR OR BUILD MIAMI SHORES VILLAGE, FLORIDA DATE !� ` s 194 ERMIT N2 5420 Work to be performed under this Permit o °" e ' v / L it by Signed- Subdi- vision J 1 C tractor's License No. Amt. ofd Permit ,, By. AUTHORITY • BUILDING ELECTRICAL PLUMBING Owner of Building Contractor's License No Work to be performed under this Permit 1 `P f *'/ ; �� J f °// a Q Ca90.l� �' J Arct jact Contractor 6 ' f r ' r' or Builder ,� � , b Legal Lot Bl. Description Address of Building 1 ' 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 then ons }iiility fpra thorough knowledge of the..ordinances and regulations pertaining to the work covered hereby whether shown on the plans or dr'aTngs '45, in th or specificatio anj that ,assumes respon- sibility for work done by his agents, servants or employees. y ', ,���' ; -� ' �; %- t B PERMIT N? 5329 CONTRACTOR OR $UILDER MIAMI SHORES VILLAGE, FLORIDA Subdi- vision Value of Project BY 31A 'A, DATE n 194 L .; /, Amt. of Permit " • J Pk f4 ivi .4 el 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 assu:ne responsibility for all work done by either myself, my agent, servant or employee. AT)THORITY ry Permit No Date /c7 / r4 Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted r the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, wh ther 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 Engine Employing Plumber's Name Location and Legal Description Lot Block____.. SSubdivjsion Street and Number where work is to be performed—No / 0 Street / � L / ' �'J y 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 Feet of Drain Tile Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: City —Well . Size of Soakage Pit Off_ Amount of Permit $ ( Signed) e . Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub- contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such sub - contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. ss. 0 it MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT ( Signed) No. l - -- o Street___ f P" i ' My Commission Expires Notary Public, State of Florida Capacity Gals • & (®O Master Plumber. STATE OF FLORIDA, t 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 therein by him stated are true. NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty materials and /or workmanship. CLOSETS BATH TUBS SHOWERS LAVA- TORIES SINKS SLOP SINKS LAUNDRY TUBS URINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT' NS TOTAL FIXTURES CONTR. LIST !_ CHECK SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SW IM'G POOL. CONTR. LIST • . CHECK _ ry Permit No Date /c7 / r4 Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted r the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, wh ther 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 Engine Employing Plumber's Name Location and Legal Description Lot Block____.. SSubdivjsion Street and Number where work is to be performed—No / 0 Street / � L / ' �'J y 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 Feet of Drain Tile Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: City —Well . Size of Soakage Pit Off_ Amount of Permit $ ( Signed) e . Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub- contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such sub - contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. ss. 0 it MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT ( Signed) No. l - -- o Street___ f P" i ' My Commission Expires Notary Public, State of Florida Capacity Gals • & (®O Master Plumber. STATE OF FLORIDA, t 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 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. BUILDING ELECTRICAL PLUMBING Owner of ; Building i,� ; ; , : . . Contractor or Builder -7, ' t MIAMI SHORES VILLAGE, FLORIDA DATE - ; Contractor's �. /". License No. 1 ...{ 4 .4APe;t4-4.4 . PERMIT N? 5327 Work to he performed Architect Legal Lot' if Description It, �` n of 1 � Address of o , ‘ il e , , r' , � � f Value of Amt. of d; Building / f o 's ' 2/ ', _ . Project Permit ' ' , ,4 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 plan§ are changed without authorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above ssuT.e�Fthe-hespgnsibility for a thorough knowledge of the prdinances and regulations pertaining to the work covered hereby whether shown on the plans ordravetYgs or `in th statements or specifications�,and that herassumes respon- sibility for work done by his agents, servants or employees. f.,, iy '/ ,` �; ; %•' Signed; , ' :/. ; B C G INSPECTOR Bl. under this Permit_ s • Subdi -� vision fr d 194 In consideration of the issuafice`to me of this permit I agree to perform the work covered hereunder in compliance with all- grdinances d egulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper, authorities- of Miami Shores' Village. In accepting 4his permit I assume responsibility for a work done by either myself, my agent, servant or employee. CO■TRACTQ OR BUILDER BY AUTHORITY Permit No MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT • APPLICATION FOR PLUMBING PERMIT Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. Owner's Name and Address Earle__ W..__.Shattuck. No Street Registered Architect and /or Engineer B Z Horace Z. Brunson 1777 N 13th__Ave._ Miami Employing Plumber's Name H No Street_..___. F1a. � - � Location and Legal Description Lot_ — Block___.____ Subdivision Street and Number where work is to be performed —No. Street _ r State work to be performed and purpose of building (By Floors) New Building X 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 77 }� Amount of Permit $__ f'_ f _____ _ ss. Remodeling Addition_______.._. Repairs _ No. of Stories ( Signed ) • Date May 9, 1947 My Commission Expires Notary Public, State of Florida S 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 corn- 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, 1 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 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 workinanship. CLOSETS BATH TUBS SHOWERS LAVA- TORIES SINKS SLOP SINKS LAUNDRY TUBS URINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT' NS Sill Cocks 3 TOTAL FIXTURES 11`f�/ JLCC�Y.Y " CONTR. LIST 3 1 ___3_______1_. ___1___ CHECK SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SWIM'G POOL �V f %�- CONTR. LIST CHECK Permit No MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT • APPLICATION FOR PLUMBING PERMIT Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. Owner's Name and Address Earle__ W..__.Shattuck. No Street Registered Architect and /or Engineer B Z Horace Z. Brunson 1777 N 13th__Ave._ Miami Employing Plumber's Name H No Street_..___. F1a. � - � Location and Legal Description Lot_ — Block___.____ Subdivision Street and Number where work is to be performed —No. Street _ r State work to be performed and purpose of building (By Floors) New Building X 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 77 }� Amount of Permit $__ f'_ f _____ _ ss. Remodeling Addition_______.._. Repairs _ No. of Stories ( Signed ) • Date May 9, 1947 My Commission Expires Notary Public, State of Florida S 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 corn- 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, 1 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 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 workinanship. v '' L e I 07 OD _11 Permit No _PM X MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING °";bMIT 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 Shares 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. 0 Owner's Name and Address ° D j Registered Architect and /or En / ineer______-_- -_-_ ____--_ Employing Plumber's Name _ ! :__ LE �� �' No._i Location and Legal Description Lot_- ___.._ Block Street and Number where work is to be performed—No.../...P _2_ a J State work to be performed and purpose of building (By Floors) _ New Building Remodeling_ Addition__ Amount of Permit $ PA G1! No 0 (2 2 _ L ! — - - _ Street_ P4' 5 (Signed)_ l � •• Street-- -� - - . Subdivisions ' ( 1-; . ?; 1 C Street Repairs No. of Stories Size Septic Tank Type of Tank Feet of Drain Tile Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: City — Well.______— ____._Size of Soakage Pit Capacity Gals. Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accept is obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5986, Compiled General Laws of Flori . Pennanent Supplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub -contr a tors 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 t}ie 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. Date Signed �� /✓' _ �/rr �� Master Plumber. STATE OF FLORIDA, 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 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•neeessary by improper notice for inspection, or faulty materials and /or workmanship. CLOSETS BATH TTufts SHOWERS LAVA- TORIES SINKS SLOP SINKS LAUNDRY Toss URINALS A CATCH BASIN FLOOR DRAIN DRINKING POUNT'Nfi TOTAL FIXTURES CONTR. LIST lJ JL / CHECK U // y -- -� SEPTIC TANK SOWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SWIM'O POOL CONTR. Lim CHECK Permit No _PM X MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING °";bMIT 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 Shares 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. 0 Owner's Name and Address ° D j Registered Architect and /or En / ineer______-_- -_-_ ____--_ Employing Plumber's Name _ ! :__ LE �� �' No._i Location and Legal Description Lot_- ___.._ Block Street and Number where work is to be performed—No.../...P _2_ a J State work to be performed and purpose of building (By Floors) _ New Building Remodeling_ Addition__ Amount of Permit $ PA G1! No 0 (2 2 _ L ! — - - _ Street_ P4' 5 (Signed)_ l � •• Street-- -� - - . Subdivisions ' ( 1-; . ?; 1 C Street Repairs No. of Stories Size Septic Tank Type of Tank Feet of Drain Tile Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: City — Well.______— ____._Size of Soakage Pit Capacity Gals. Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accept is obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5986, Compiled General Laws of Flori . Pennanent Supplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub -contr a tors 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 t}ie 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. Date Signed �� /✓' _ �/rr �� Master Plumber. STATE OF FLORIDA, 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 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•neeessary by improper notice for inspection, or faulty materials and /or workmanship. e e Date c �' f Legal Description �n WORK DESCRIPTION PERMIT APPLICATION FOR MIAMI SHORES VILLAGE l� .Z 1 V/rP�o� Tax Folio /( 32&6 / 3 y ' r i ' a ally Designated: Yes c o C r G ►� / U c, t C I P 1 C (co,(Pi Master Permit # (43Z Phone 270 7 y Job Address 7 y [ Owner/Lessee / Tenant Owners Address / Y S S4- Contracting Co. d u 5 S Qualifier _AL"- dh �/roty S State # Municipal # Architect/Engineer / , S , 2 Z /- / v(940 0 Bonding Company Mortgagor Permit Type (circle one): BUILDING ELECTRICA Square Ft. .76-7) Estimated Cost (value) 4 S b D WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.) Application is hereby made to obtain a permit to do work and installation as indicated above, and on the attached addendum (if applicable). I certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits are required for ELECTRICAL, PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK. OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Furthermore, I authorize the above -named contractor to do the work stated. See VYl&cs I& `� Signature of owner and/or Condo Presidbnt Date Notary as to Owner and/or Condo President Date My Commission Expires: GiK FEES: PERMIT X GI U RADON APPROVED: Zoning Building Mechanical z., o © `. 1 47 C.C.F. SS# ' NOTARY BOND I/ 33 3S Address > 2 Z `i S S (.cam /I 1, c .et T - ,4 f7 Phone j Q`•7 7m7 Competency # Ins. Co. Address 7-37c ' '77- Piu, 4/4 n-04 //c/ Address Address MECHANICAL ROOFING PAVING FENCE SIGN Date dT 8 /t/hM to °Contractor . ='' ' n ' Date ommission Expires: 4 r/3 /64