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ADDITIONPERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date a 6 _ T Job Address B Q bS C . Q S S . Tax Folio Legal Description Historically Designated: Yes No Owner/Lessee / Tenant s ► ►� S C Master Permit # 4 6b (,S Cj 71u / 3 Owner's Address l CJ lo N1(7i— ` \ S �� _ Phone to W L OcI h , 4ni e(( 7 a v✓ ? Contracting Co. Or j Z c � ' /fi ' �/' ( y � Address 79 f✓ 7'1�� Qualifier (I�G led 1 �/� � /1 A / ss# Phone ( 30 r) 02- 6(41 State #CF C (('' 72, Municipal # Competency # Ins. Co. Architect/Engineer Address Bonding Company Address Mortgagor 6UMBD...3 Address Permit Type (circle one): BUILDING ELECTRICAL ] MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION Are LI L/If' H i "1 /7167; V i e/II y;f rt i f 1 Square Ft. Estimated Cost (value) (4 ir,LS 00 WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.) Application is hereby made to obtain a permit to do work and installation as indicated above, and on the attached addendum (if applicable). I certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits are required for ELECTRICAL PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK. OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Furthermore, I authorize the above -named contractor to do the work stated. Signature of owner and/or Condo President Notary as to Owner and/or Condo President Date My Commission Expires: FEES: PERMIT / I RADON Date Signature of Contractor or Owner- Builder /2-1 - 1' 9 Date Notary as to Contractor or Owner- Builder Date My Commission Expires: ,0 r po Rolando Coccera c r, Commission # CC 774387 Q Expires SEP. 13, 2002 BONDED THRU �O F P ATLANTIC BONDING CO., INC. C.C.F. NOTARY •"" D °'' BOND APPROVED: TOTAL DUE Zoning Building Electrical Mechanical Plumbing / 2 ' \t' / Structural Engineer ITEM BATH TUB UNIT 1 FEE ITEM SWITCH OUTLETS UNIT FEE ITEM SPACE HEATERS UNIT FEE BIDET LIGHT OUTLETS CENTRAL HEATING DISHWASHER RECEPTACLES A/C (WIND) DISPOSAL SERVICE TEMPORARY A/C (CENTRAL) DRINKING FOUNTAIN SERVICE SIZE IN AMPS DUCT WORK FLOOR DRAIN SERVICE REPAIR/ ETER CNAIGE REFRIGERATION GREASE TRAP APPLIANCE OUTLETS PROCESS AND PRESS PIPING INTERCEPTOR RANGE TOP UNDERGROUND TANKS LAVATORY f OVEN ABOVE GRO M) TANKS LAUNDRY TRAY WATER HEATER U.F. PRESSURE VESSELS CLOTHES WASHER MOTORS 0- 1 HP STEAM BOILERS SHOWER MOTORS OVER 1- 3 HP HOT WATER BOILERS SINK, POT /3 COMP. MOTORS OVER 3- 5 HP MECHANICAL VENTILATION SINK. RESIDENCE MOTORS OVER 5- 8 HP TRANSPORTING ASSEMBLIES SINK. SLOP MOTORS OVER 8- 10 HP ELEVATORS/ESCALATORS TEMPORARY WATER CLOSET MOTORS OVER 10- 25 HP FIRE SPRINKLER SYSTEMS URINAL MOTORS OVER 25-100 HP COOLING TOWERS WATER CLOSET / MOTORS OVER 100 If VIOLATION INDIRECT WASTES A/C WINDOW REINSPECTION WATER SUPPLY TO: AIR CONDITIONERS A/C UNIT STRIP HEATER FIRE SPRINKLER GENERATORS TRANSFORMERS ' HEATER -NEW INST. GENERATORS TRANSFORMERS HEATER - REPLACE GENERATORS TRANORMERS LAWN SPRINKLER -WELL SPECIAL PURPOSE SWIWING POOL CUTLETS COMMERCIAL WATER SERVICE ' + SIGN TUBES SEWER CONNECTIONS SIGN TRANSFORMERS - UTILITY -SEWER SIGN TIME CLOCK UTILITY -WATER FIXTURES . SEPTIC TANK _ ,ANNA RELAY TELEVISION OUTLETS ORAINFIELO, 4" TILE/RES. VIOLATION . PUMP & ABANDON SEPTIC TANK RE INSPECT ION SOAKAGE PIT CU. FT. . CATCH BASIN ' DISCHARGE WELL . DOMESTIC WELL AREA DRAIN . ROOF INLET SOLAR WATER HEATER _ FIRE STANDPIPE POOL PIPING . LAWN SPRINKLER SYSTEM GAS RANGE METER SET (GAS) GAS PIPING (AN APPLICATION FOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. IF A MASTER PERMIT HAS B. OBTAINED, THE OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.) PLUMBING ADDENDUM TO BUILDING PERMIT APPLICATION ELECTRICAL MECHANICAL Frming LUMIR1146 Temporary T®iiet tic TTah TRIS BARD MUST BE DISPLAYED ON FRONT OF JON. Miami eYg■ar 401/4) Pt Gan Contractor NT Lel ELECTRICAL Terry Servico 5 PTO. SPECIAL walks and Cbaa o Dp Ward Space° glob Funkwoo itoe Dom Subdivision Address NOTICE: All Seb o Bonirsclors last Oblain LICENSES and PERMITS Before Work is Starlet No Work on Sunday o Work Before 7:30 A. M. No Night Work. Fovadoffoo Pool —lFlom Walls Ring Final Block q sTb Top Oaf and nib latom Fermi Sew. Efothmied Sig NOME TO BIRDER: Prod This Card aas Relate To %ilding Osparbsonl For rertifecols of Occupancy I herewith submit the following application for a permit covering the installation of a: .o New Building has: Owner or Agent: Address of work: Size of Soakage Pit Approved by: Remarks: PERMIT NO. Septic Tank iffrP 00 Additional information • Stores; LOT NO. BLOCK NO. No. of Plumbing Fixtures ° 67, DEPARTMENT OF PUBLIC SERVICE DIVISION OF PLUMBING INSPECTION CITY OF MIAP:MI, NROPIDA..� Soakage Pit �ie ( New y Old Story Oa Addition ( For a ( Store Gara gq Apt. ( ( Garage wash floor Offices; Feet of drain tile Laundry Tubs Ready for Inspection - Date 'Y" a Apts.; Date Address: 4ei / Hotel Office Bldg. Res . Waste water from a: Address: SUBDIVISION /7-4- /`' Purpose of same Condemned by: Hotel Rooms; . Bedrooms / ®_"A. 9 S21- d c4 Relaying Eemodeled Nature of water supply: City Well Feet distant from all wells Type of tank installed:(7/Ce. Tank capacity in gallons as-0. ' Time acyf . Floor Drains dd✓�J�S, V', CLOSETS BATH TUBS SHOWERS LAVA. TORIES SINKS SLOP SINKS LAUNDRY TUBS URINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT'NS TOTAL FIXTURES / / 2 I 7 WEST Sketch position of building and lot lines in square (which represents an entire city block) , showing on which street the building and lot faces; also show exact locations of "Y" in street and position of lateral or septic tank. Show sewer and any change in direction same may make. The purpose of this plan is to have an accurate layout of all underground pipes for future references. NORTH A EAST SOUTH Remarks: NORTH SOUTH II IA A•244 SM 3.38 For a Lot No. Address Ground DIVISION OF PLUMBING DEPARTMENT OF PUBLIC MIAMI, FLORIDA I herewith submit the following plan of plumbing for approval: Employing Plumber N e w Dwelling X Owner or Agent Builder or Contractor is Sewer Connections � Plan No. Block No. Old ❑ Store ❑ /1 '1 At center of St. ❑ Date ROUGH -IN INSPECTION Rough -In Rain Leader AM P M Approved by Condemned by REMARKS / At curb ❑ AM Work executed by Story pl Garage ❑ Apartment ❑ Address Address Subdivision v Sewer Permit No INSPECTION SERVICE Date SEWER INSPECTION P M. Approved by Condemned by REMARKS Addition ❑ Hotel ❑ Office Bldg. ❑ At property line ❑ Existing in alley ❑ Existing bldg. sewer ❑ To septic tank Existing bldg. drain ❑ To dry well ❑ A charge of $1.00 will be made for correcting any inaccuracies in the foregoing information. DO NOT WRITE IN SPACE BELOW. THIS IS FOR THE USE OF THE DIVISION OF PLUMBING INSPECTION ONLY. l9 Remodeled ❑ Date FINAL INSPECTION AM P M Approved by Condemned by REMARKS THIS SPACE FOR ELEVATION SKETCH In alterations to existing work show the old work in red ink and the new in black ink. Letter each stack to correspond with the opening shown in floor plan or ground plan on opposite page. A PERSPECTIVE SKETCH WILL BE SUFFICIENT THIS SPACE FOR PLAN SKETCH Show location of stacks and horizontal drains inside building, lettering each opening to correspond with the stock con- nections as shown on the elevation sketch on opposite page. Where ground work is concealed, draw floor plan of build- ing showing location of walls, partitions, columns, etc., and the location of all horizontal soil and waste pipes, in ref- erence to same. PROVIDED THE WORK CAN BE CLEARLY SHOWN OWNER Gi !i to install the following described plumbing, in lations of Miami Shores Village, Florida and the State drainage work done in Miami Shores Village, Florida. For a / story �f ' � "3 building at / 6.; ' Issued to Fixtures + aiami cSlzores9llage F L O R ID A PLUMBING PERMIT N° . 1053 Total Received Payment by LOT < accordance of • F' a Fixtures $ Sewer $ ° t •tic Tank $ Village Plumbing Inspector 4 . / BLOCK with the `laws, statutes and regu- Florida, governing plumbing and • a " "" mss. SUBDIVISION PLUMBING PERMIT 7',1/2'''rif / I Issued to 71.4/''' '" f 7 OW �-� NER f to install the following described plumbing, in accordance with the laws, statutes and regu- lations of Miami Shores Village, Florida and the State of Florida, governing plunging and drainage work done in Miami Shores Village, Florida. For a_/story 1 1 building at fib/ /J =‘. Fixtures Fixtures aiami =fhores FL OR ID A $ ♦ ��' Sewer , 1 $ •tic Tank $ Total $ Village Plumbing Inspector Received Payment by LOT BLOCK N? 1140 SUBDIVISION BUILDING ELECTRICAL PLUMBING Owner of Building Architect Contractor or Builder Legal Description Lot MIAMI SHORES VILLAGE, FLORIDA DATE PERMIT N? 4777 \Work to be performed under this Permit i Bl. Address of 7, , t:� 4 +� Value of Amt. of Building_ i V' ' r \ of 1< ft 1 - ., Project Permit . Li (.; This permit is granted to the contract4 or builder named above to construct the building or to install the equipment or device escribed in the appli- cation herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any time if the work is not done in compliance with such ordinances or if the plans ,are changed without authorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes respon- sibility for work done by his agents, servants or employees. / Signed. e. �� v I 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. Subdi- vision Contractor's License No. 19. CONTRACTOR OR BUILDER BY AUTHORITY Permit No 1 6, 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 , 4' Soy Registered Architect and /or Engineer ��yy Employing Plumber's Name.. i /A&L CC _ -_ .. �1✓ X o,. --.,, ., ,,,! lhtr®et.. -2.1 ..,..,,......_..... -... Location and Legal Description Lei Street and Number where work is to be performed —No M9 M9 SNORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION dui PLUMBING PERMIT /v 7q —) Y' — 9/2 - /2 Bloc& Date . � l 140.1.O t. a LY- street_._ 15' Street. State work to be performed and purpose of building (By Floors)__.._.--•-•-------------_.-_--- New Building _.._.._.- ._....- . -_ - -- Remodeling _ _ _-__ Addition..._- -.__ Repairs No. of Stories Size Septic Tank---- - - - - -- -- — - - -- - aype 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 $ r2 (Signed)- _ _ ---- -----••- The undersigned applicant for this building permit does hereby certify that he understands and accepts his oblige ins as an employer of labor under the Florida Workmen's Compensation Act, being Section 5888, Compiled General Laws of Florida Pernan - 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 perf under this permit, as are licensed by Miami Shores Village. (Signed) 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 r osas and says that he is the.._.._....... -. -- .•----- -_ - -.- _ -- ..._ _ -- of the above described construction, that he bass carefully >d the regaling application, and that he did sign the same, and that all facts therein by him stated are true. My Commission Empires Notary Public, State Merida NOTE: A re- inspection fee of 01.03 will be made Cahn M.Dea 1.112123=Zillat to medeleaceseary by tanprcpoa MAIM fos inspection, or faulty materials and /or workmanship. LAUNDRY TUBS URINALS CATCH BAOIN FLOOR DRAIN DRINKING FOUNT'NO V&..4... � A ,f��{ TOTAL FIXTURH6 CLOOIXTO BATH TUBO SHOWRRO LAVA- TORIQO SINRO SLOP OINRO CONTR. LI OT LI6T _ `' g' c Haca SQPTIC TANK SaWaR Comm. DRAIN PRILD SOAKAGa PIT GRIM:ID TRAP SOLAR HCATQR DeeP WALL SPRRLR. SYSTeM SWIM'O POOL CONTR. LIOT e _ -.... . CHaCR Permit No 1 6, 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 , 4' Soy Registered Architect and /or Engineer ��yy Employing Plumber's Name.. i /A&L CC _ -_ .. �1✓ X o,. --.,, ., ,,,! lhtr®et.. -2.1 ..,..,,......_..... -... Location and Legal Description Lei Street and Number where work is to be performed —No M9 M9 SNORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION dui PLUMBING PERMIT /v 7q —) Y' — 9/2 - /2 Bloc& Date . � l 140.1.O t. a LY- street_._ 15' Street. State work to be performed and purpose of building (By Floors)__.._.--•-•-------------_.-_--- New Building _.._.._.- ._....- . -_ - -- Remodeling _ _ _-__ Addition..._- -.__ Repairs No. of Stories Size Septic Tank---- - - - - -- -- — - - -- - aype 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 $ r2 (Signed)- _ _ ---- -----••- The undersigned applicant for this building permit does hereby certify that he understands and accepts his oblige ins as an employer of labor under the Florida Workmen's Compensation Act, being Section 5888, Compiled General Laws of Florida Pernan - 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 perf under this permit, as are licensed by Miami Shores Village. (Signed) 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 r osas and says that he is the.._.._....... -. -- .•----- -_ - -.- _ -- ..._ _ -- of the above described construction, that he bass carefully >d the regaling application, and that he did sign the same, and that all facts therein by him stated are true. My Commission Empires Notary Public, State Merida NOTE: A re- inspection fee of 01.03 will be made Cahn M.Dea 1.112123=Zillat to medeleaceseary by tanprcpoa MAIM fos inspection, or faulty materials and /or workmanship. I OWNER LOT BLOCK SUBDIVISION p .„:2 ,- ci f R' iami cfhores9illage F L O R D A PLUMBING PERMIT to install the Hollowing described plumbing, in accordance with the laws, s tes and regu- lations of Miami Shores Village, Florida and the State of Florida, governing plumbing and drainage work done in Miami Shores Village, Florida. For a_story 4 .:�` building at /a Fixtures Fixtures $ Sewer $ .tic Tank $ / C o Total $ /) `d N? 1215 Village Plumbing Inspector Received Payment by .' 77( OWNER LOT BLOCK SUBDIVISION ' Date 91iami cShores9llage L O R I D A PLUMBING PERMIT N° 1053 Issued to to install the following described plumbing, in accordance with the laws, statutes and regu- lations of Miami Shores Village, Florida and the State of Florida, governing plumbing and drainage work done in Miami Shores Village, Florida. For a_story building at Fixtures Fixtures $ Sewer $ Septic Tank $ Total $ Village Plumbing Inspector Received Payment by Date /liami c_fhores F 1. 0 R I D A PLUMBING PERMIT N? 1140 Issued to to install the following described plumbing, in accordance with the laws, statutes and regu- lations of Miami Shores Village, Florida and the State of Florida, governing plumbing and drainage work done in Miami Shores Village, Florida. For a_story . building at e a Fixtures Fixtures $a, rt 4 ' Sewer $ J Septic Tank $ Total $ Village Plumbing Inspector '. Received Payment by OWNER LOT " BLOCK SUBDIVISION r a _ f Date /liami c_fhores F 1. 0 R I D A PLUMBING PERMIT N? 1140 Issued to to install the following described plumbing, in accordance with the laws, statutes and regu- lations of Miami Shores Village, Florida and the State of Florida, governing plumbing and drainage work done in Miami Shores Village, Florida. For a_story . building at e a Fixtures Fixtures $a, rt 4 ' Sewer $ J Septic Tank $ Total $ Village Plumbing Inspector '. Received Payment by BUILDING ❑ ELECTRICAL PLUMBING 0 ROOFING Owner of Building ❑ PERMIT N? 14231 ❑ Work to be performed under this Permit Architect Contractor or Builder Legal Lot II BI. Description Address of Building CONTRACTOR OR BUILD-Mt MIAMI SHORES VILLAGE, FLORIDA DATE Subdi- vision Value of Project $ 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 195 Contractor's License No Amt. of Permit $ 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 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._ I d_l._ E - P E `er g _ No. __d _ 4_® .g ' LiStreet.. _ 7c:5 Registered Architect and /or Engineer - ---- -- --_ - - -�- Employing Plumber's Name �� / __ _ I vLL� / _____.- No. 4?Z 0 _ 41 ki!- StreeL.2 Ti Location and Legal Description Lot---_.- ._- .... _______ _.,____ Block_.__ _.._ Subdivision E Street and Number where work is to be performed —No ® 6 �i e StreeL._�� ';5 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 i 1 z The undersigned applicant for this building permit does hereby certify that he understands and a .. his obligations as an employer of labor under the Florida Workanen's'Compensation Act, being Section 5966, Compiled General Laws of F. da Permanent Supplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors el performed under this permit; and will post or cause to be posted for inspection on the site wor required by the Act. The undersigned agrees to employ only such sub- contractors, o licensed by Miami Shores Village. d J Amount of Permit $ My Commission Expires MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT (Signed).. (Signed). Date Capacity Gals Plumbing Inspector. oyed by ublic im in the work to be or notices as are this permit, as are 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. 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 TUBS TUBS SHOWERS LAVA. TORIES SINKS SLOP SINKS LAUNDRY TUBS URINALS LS B BASIN IN FLOOR DRAIN DRINKING FO FOUNT' NS • u1, '= �. /6� 1� rr ifG TOTAL FIXTURES CONTR. `- _LILT CHECK _ _ V / rs.Y SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SW IM'G POOL COMM. LIST _ CHECK 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._ I d_l._ E - P E `er g _ No. __d _ 4_® .g ' LiStreet.. _ 7c:5 Registered Architect and /or Engineer - ---- -- --_ - - -�- Employing Plumber's Name �� / __ _ I vLL� / _____.- No. 4?Z 0 _ 41 ki!- StreeL.2 Ti Location and Legal Description Lot---_.- ._- .... _______ _.,____ Block_.__ _.._ Subdivision E Street and Number where work is to be performed —No ® 6 �i e StreeL._�� ';5 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 i 1 z The undersigned applicant for this building permit does hereby certify that he understands and a .. his obligations as an employer of labor under the Florida Workanen's'Compensation Act, being Section 5966, Compiled General Laws of F. da Permanent Supplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors el performed under this permit; and will post or cause to be posted for inspection on the site wor required by the Act. The undersigned agrees to employ only such sub- contractors, o licensed by Miami Shores Village. d J Amount of Permit $ My Commission Expires MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT (Signed).. (Signed). Date Capacity Gals Plumbing Inspector. oyed by ublic im in the work to be or notices as are this permit, as are 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. 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. BUILDING ELECTRICAL PLUMBING Owner of Building fl Architect • Contractor ' or Builder 4 (/, tom Legal Lot r ._ Description MIAMI SHORES VILLAGE, FLORIDA DATE `. •1944- PERMIT N? 4777 Work to be performed under I this Permit (1 - 9 i ;< <7� Subdi- vision Value of Project Contractor's License No. Address of R ; ,f J, Amt. of .,. Building ' Ee ' �1 Permit Q This permit is granted to the contract r or builder named above to construct the building or to install the equipment or device described in the appli- cation herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the state ents or specifications and that he assumes respon- sibility for work done by his agents, servants or employees. Signed By INSPECTOR c 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 - Hereto and in s ipt conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. pertainMg this permit I e responsibilityfor all rk done by either myself, my agent, servant or employee. ' p /, s� ' .1‘"V •CONTRACTOR OR BUILDER. „ f BY r c r A 1 . rAIHORITY