PLUMBINGPermit No ! _`s__-_
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 wor
Owner's Name and Address.___
Registered Architect and /or Engineer
Employing Plumber's Name_/.
Location and Legal Description Lot________ _______ Block___ ____________ Subdivision
Street and Number where work is to be performed —No
State work to be performed and purpose of building (By Floors)
New B Remodeling_____ _ Addition Repairs No. of Stories.
Size Septic Tank Type of Tank_—_ Capacity Gals
Feet of Drain Tile Dist. Feet of Tank or Drain Field from Well
-Size of Soakage Pit
Nature of Water Supply: City —Well
Amount of Permit $___
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Date
No. ___ _JO -___ Street.._! C / � #
-- -------- - -- - - -- -
------ - -- - - -- -- -- - p - �y�
�___— No. _ - Q_1 Street___ /1
(Signed)
( Signed) _
Street
My Conunission Expires Notary Public, State of Florida
Plum Bing nspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be
performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are
required by the Act. The undersigned agrees to employ only such sub- contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village.
Master Plumber.
STATE OF FLORIDA,
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
WERS
SHOWERS
LAVA-
TORIES
IN
SINKS
SLOP
SINKS
LAUNDRY
TUBE
U
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
co...
LIST
3X
CHECK
Permit No ! _`s__-_
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 wor
Owner's Name and Address.___
Registered Architect and /or Engineer
Employing Plumber's Name_/.
Location and Legal Description Lot________ _______ Block___ ____________ Subdivision
Street and Number where work is to be performed —No
State work to be performed and purpose of building (By Floors)
New B Remodeling_____ _ Addition Repairs No. of Stories.
Size Septic Tank Type of Tank_—_ Capacity Gals
Feet of Drain Tile Dist. Feet of Tank or Drain Field from Well
-Size of Soakage Pit
Nature of Water Supply: City —Well
Amount of Permit $___
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Date
No. ___ _JO -___ Street.._! C / � #
-- -------- - -- - - -- -
------ - -- - - -- -- -- - p - �y�
�___— No. _ - Q_1 Street___ /1
(Signed)
( Signed) _
Street
My Conunission Expires Notary Public, State of Florida
Plum Bing nspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be
performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are
required by the Act. The undersigned agrees to employ only such sub- contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village.
Master Plumber.
STATE OF FLORIDA,
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 No
M8AM8 SNORES VOLL' GE
PLUMBING INSPECTION DEPARTMENT
APPLICATI R PWWMAI PERMIT
j Z 2
I Date. - -- 3 — ?
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 b 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 g4c:ned{C6T� /Pi
Registered Architect and /or Engineer
Employing Plumber's Name ' U w
Location and Legal Description Lot. 2 6 2
Street and Number where work is to be performed -No / 7 /
State work to be performed and purpose of building (By Floors)_
New Building.._-. _ _ _ - _ . Remodeling____._.._. —
Bloch 4'/
Size Septic Tank__
Feet of Drain Tile
2 '-
.,k CAE& -, •- Ca /.Z a a .0
Type of Ta _._.__— ._------ • - - - - -- pity �+•---- • - - - - --
, Olst. Feat of Tank es Drain Field from Well. - -- ✓`1 1..�-- - - - - -_ _�
Nature of Water Supply: City- Well.._-- .�'.. /.ry Size of Soakage Pit
Amount of Permit $ 1 L . 5
No / 7 / Street.. . .2
Repairs No. of
SubdivldonC�l?�'% S /e'6s Sear, 3 ,
Street. _...2s_ sf _
The undersigned applicant for this building permit does hereby certify that he understands and accepts hi .bligations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5968, Compiled General Laws of Florida Permanent Supplement, and haw 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.
Plumbing Inspector.
Muter Plumber.
STATE OF FLORIDA, I as
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 awe that he is the .---- .._.--- .._..._.... - -.
of the above described construction, that be has easefully mad the foregetsag application, and that be 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 nu& vista sasslr, rtsdisapeotim V amada•neoeasary by improper notice for inspection, at faulty
materials and /or workmanship.
CLOSiTS
BATH
TU DO
84°W11
LAVA.
T0671Ea
SINK®
SLOP
SINK
LAUNDRY
TUBES
URINALa
CATCH
BASIN
FLOOR
DRAIN
DRINK NO
FOUNT - NS
TOTAL
RI
Corm.
LIST
/
J
CHECK
_
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
eOAKAGE
PIT
GREASE'
TRAP
DOLAR
HATER
DEEP
WELL
OPPKLR.
SYSTEM
$wIM•G
POOL
CONTR.
LIST
CHECK
Permit No
M8AM8 SNORES VOLL' GE
PLUMBING INSPECTION DEPARTMENT
APPLICATI R PWWMAI PERMIT
j Z 2
I Date. - -- 3 — ?
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 b 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 g4c:ned{C6T� /Pi
Registered Architect and /or Engineer
Employing Plumber's Name ' U w
Location and Legal Description Lot. 2 6 2
Street and Number where work is to be performed -No / 7 /
State work to be performed and purpose of building (By Floors)_
New Building.._-. _ _ _ - _ . Remodeling____._.._. —
Bloch 4'/
Size Septic Tank__
Feet of Drain Tile
2 '-
.,k CAE& -, •- Ca /.Z a a .0
Type of Ta _._.__— ._------ • - - - - -- pity �+•---- • - - - - --
, Olst. Feat of Tank es Drain Field from Well. - -- ✓`1 1..�-- - - - - -_ _�
Nature of Water Supply: City- Well.._-- .�'.. /.ry Size of Soakage Pit
Amount of Permit $ 1 L . 5
No / 7 / Street.. . .2
Repairs No. of
SubdivldonC�l?�'% S /e'6s Sear, 3 ,
Street. _...2s_ sf _
The undersigned applicant for this building permit does hereby certify that he understands and accepts hi .bligations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5968, Compiled General Laws of Florida Permanent Supplement, and haw 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.
Plumbing Inspector.
Muter Plumber.
STATE OF FLORIDA, I as
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 awe that he is the .---- .._.--- .._..._.... - -.
of the above described construction, that be has easefully mad the foregetsag application, and that be 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 nu& vista sasslr, rtsdisapeotim V amada•neoeasary by improper notice for inspection, at faulty
materials and /or workmanship.
�a a
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Permit No Date X .. \�Z2
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 \ - s Name and Address C No \ Q I l
Registered Architect and /or Engineer l�
£mployln Plumber's Name` C �i _ C Na.�. 5... ..... 8 :. ....g2....��� t__..
Location and Legal Description
Street and Number where work is to be performed —No \ ( \
810
State work to be performed and purpose of building (By Floors) __ New Building -_ - -_ _ - •----- ........_.. Remodeling___ _ ._.—_ __ Addition.. ___ .. — Repairs.
Subdivision__
Street .._... S
Size Septic Tank__ Type of Ta
Feet of Drain Tile Di Feet of Tank or Drain Field from Well N..—._
Nature of Water Supply: City —Well. Size of Soakage Pit.
Amount of Permit $ • CC
(Signed)_
umbing In
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obliga ' s as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Perinanen 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
licensed by Miami Shores Village.
(Signed)
Street. (sl
No. of Stories.
• ... • •••
Plumber.
STATE OF FLORIDA, l u
COUNTY OF DADE. I
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
to me well known, and who, being by me first duly sworn, upon oath dep oses and says that he is the _.._..._.._...- _ -_ -.• _ _'- -. —• -. _
of the above described construction, that be has carefully read the foregoing appli cation, and that be did sign the same, and that all facts
therein by him stated are true.
My Commission Expires Notary Public, State of Fkoelda
NOTE: A re- inspection fee of $1.00 will be made when at rsispeotlan is soade . asosssary by improper notice for inspection, or faulty
materials and/or workmanship.
- -^
CLOSETS
BATH
Tulsa s
LAVA.
TORIES
KINK[
SLOP
SINKS
LAUNDRY
TUes
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINK NG
FOUNT'N[
TOTAL
FIXTURES
CONTR.
LIST
— ..
CHECK
_
SOLAR
NEATER
DEEP
WELL
SPRKLR.
SYSTEM
SW1M•13
POOL
SEPTIC
TANK
SEWER
CONN.
DRAIN
FI ELD
SOAKAGE
PIT
GREASE
TRAP
CONTR.
LIST
CHECK
r --
�a a
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Permit No Date X .. \�Z2
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 \ - s Name and Address C No \ Q I l
Registered Architect and /or Engineer l�
£mployln Plumber's Name` C �i _ C Na.�. 5... ..... 8 :. ....g2....��� t__..
Location and Legal Description
Street and Number where work is to be performed —No \ ( \
810
State work to be performed and purpose of building (By Floors) __ New Building -_ - -_ _ - •----- ........_.. Remodeling___ _ ._.—_ __ Addition.. ___ .. — Repairs.
Subdivision__
Street .._... S
Size Septic Tank__ Type of Ta
Feet of Drain Tile Di Feet of Tank or Drain Field from Well N..—._
Nature of Water Supply: City —Well. Size of Soakage Pit.
Amount of Permit $ • CC
(Signed)_
umbing In
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obliga ' s as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Perinanen 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
licensed by Miami Shores Village.
(Signed)
Street. (sl
No. of Stories.
• ... • •••
Plumber.
STATE OF FLORIDA, l u
COUNTY OF DADE. I
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
to me well known, and who, being by me first duly sworn, upon oath dep oses and says that he is the _.._..._.._...- _ -_ -.• _ _'- -. —• -. _
of the above described construction, that be has carefully read the foregoing appli cation, and that be did sign the same, and that all facts
therein by him stated are true.
My Commission Expires Notary Public, State of Fkoelda
NOTE: A re- inspection fee of $1.00 will be made when at rsispeotlan is soade . asosssary by improper notice for inspection, or faulty
materials and/or workmanship.
BUILDING
ELECTRICAL
PLUMBING
ROOFING
Owner of
Building
Contractor
or Builder
D
PERMIT 'N° 11832
n
fl
Work to be performed under this Permit
Architect
Legal Lot
Description
Address of
Building / /1 1. , E
MIAMI SHORES VILLAGE, FLORIDA
BI.
• "k
ire
Subdi-
vision
Value of
Project $
DATE ,' t • 195
Contractor's
License No
Amt. of
Permit $
This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the application
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.
CONTRACTOR OR BUILDER
Sign w 5 BY . r
v INSPECTOR
In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all 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 No Street_
Registered Architect and /or Engineer
Employing Plumber's Name No Street_
Location and Legal Description Lot Block Subdivision
Street and Number where work is to be performed —No % 77 ______ Street c ___
r —
State work to be performed and purpose of building (By Floors)
New Building Remodeling Addition _ Repairs No. of Stories
Size Septic Tank — Type of Tank__— Capacity Gals
Feet of Drain Tile Dist. Feet of Tank or Drain Field from Well
Size of Soakage Pit
Nature of Water Supply: City We11.
Amount of Permit $
STATE OF FLORIDA,
COUNTY OF DADE.
ss.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
(Signed)
(Signed)
Date ______. /
My Commission Expires Notary Public, State of Florida
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
TUBS
SHOWERS
LAVA-
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TUBS
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT'NS
`
TOTAL
FIXTURES
CONTR.
LIST
'
� '
H
.
CHECK
u •
6 , h '.
!
e
f . f"'
/ 1.7e
1
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SWIM•G
POOL
CONTR.
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 No Street_
Registered Architect and /or Engineer
Employing Plumber's Name No Street_
Location and Legal Description Lot Block Subdivision
Street and Number where work is to be performed —No % 77 ______ Street c ___
r —
State work to be performed and purpose of building (By Floors)
New Building Remodeling Addition _ Repairs No. of Stories
Size Septic Tank — Type of Tank__— Capacity Gals
Feet of Drain Tile Dist. Feet of Tank or Drain Field from Well
Size of Soakage Pit
Nature of Water Supply: City We11.
Amount of Permit $
STATE OF FLORIDA,
COUNTY OF DADE.
ss.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
(Signed)
(Signed)
Date ______. /
My Commission Expires Notary Public, State of Florida
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 $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty
materials and /or workmanship.
Permit No / e&,&7
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida,
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at
building during progress of work.
Owner's Name and Address Kelp) PdL
Registered Architect and /or Engineer
Employing Plumber's Name. L.l • 6 -J4' 5
Location and Legal Description Lot.
Street and Number where work is to be performed —No
State work to be performed and purpose of building (By Floors)
New Building - Remodeling 4 - -.._— Addition.- ._._._— Repairs
Size Septic Tank_ °t A_ ______..Type of Tank__
Feet of Drain Tile — __`$ _____-- _Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City — Well , —/._7 -- --------Size of Soakage Pit
Amount of Permit $
STATE OF FLORIDA, }
u.
COUNTY OF DADE.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
(Signed)-
5°
Date - T - --
No._. Street ._ /. / 1 E 4
Street-12 Sik
Block
Street j °2J Aide. S
No. of Stories
(Signed)
Capacity Gals.
mbing Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations /s an employer of labor
undcr the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Stipplement, 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 hire stated are true.
My Commission Expires Notary Public, State of Florida
NOTE: A re inspection fee of $1.00 will be made when ateeb re-inspection V mede by improper notice for inspection, ar faulty
materials and /or worlonanahip.
CLOSETS
BATH
TUBS
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'
Permit No / e&,&7
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida,
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at
building during progress of work.
Owner's Name and Address Kelp) PdL
Registered Architect and /or Engineer
Employing Plumber's Name. L.l • 6 -J4' 5
Location and Legal Description Lot.
Street and Number where work is to be performed —No
State work to be performed and purpose of building (By Floors)
New Building - Remodeling 4 - -.._— Addition.- ._._._— Repairs
Size Septic Tank_ °t A_ ______..Type of Tank__
Feet of Drain Tile — __`$ _____-- _Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City — Well , —/._7 -- --------Size of Soakage Pit
Amount of Permit $
STATE OF FLORIDA, }
u.
COUNTY OF DADE.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
(Signed)-
5°
Date - T - --
No._. Street ._ /. / 1 E 4
Street-12 Sik
Block
Street j °2J Aide. S
No. of Stories
(Signed)
Capacity Gals.
mbing Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations /s an employer of labor
undcr the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Stipplement, 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 hire stated are true.
My Commission Expires Notary Public, State of Florida
NOTE: A re inspection fee of $1.00 will be made when ateeb re-inspection V mede by improper notice for inspection, ar faulty
materials and /or worlonanahip.
MIAMI SHORES VILLAG
BUILDING DEPARTME
305- 795 -2204
Building Inspection Request
Dae2 ,c)(,{
Type Insp'n 1 �f
Permit No. p 0 / ` - d�
Name D q
Address D 1 l , C. l _
Comps y
Phone #
Inspection Date
Approved
Correction
Re- Insp'n Fee
Miami Shores Village
10050 NE 2nd Avenue
Phone: 305 - 795 -2204
Printed: 5/26/2004
Applicant:
Owner:
JOB ADDRESS: 1071 NE 95
Contractor MR C'S SEPTIC TANK
Local Phone: 305 - 651 -7859
Parcel # 1132060143610
Signed:
(INSPECTOR)
Plumbing Permit
Permit Number: PL2004 -152
ST
Contractor's Address: P 0 BOX 693239
Permit Status: APPROVED Permit Expiration: 11/17/2004 Construction Value: $2,400.00
Work: REPLACE DRAINFIELD
Page 1 of 1
Legal Description: MIAMI SHORES SEC 3 PB 10 -37 E1/2 OF LOT 25 & LOT 26 & 27
Fees: Description Amount
FEE2004 -5307 Building Fee $175.00
FEE2004 -5308 CCF $1.80
FEE2004 -5309 Notary Fee $5.00
FEE2004 -5310 Training and Education Fee $0.60
FEE2004 -5311 Technology Fee $4.37
FEE2004 -5312 Builders Bond $300.00
Total Fees: $486.77
Total Fees: $486.77
Total Receipts: $486.77
In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict
conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responisibility for all work
done by either myself, my agent, servants or employes.
Signed: (Contractor or Builder) BY:
BLK
C CEDVE]
1AV 2 9 20
BUIL-I _?�s
PERMIT APPLICATION
FBC 2001
Permit Type (circle): Building
Owner's Name (Fee Simple Titleholder)
Owner's Address / /V C
City /4141244 543; State
Tenant/Lessee Name 00,0•11110
Job Address (where the work is being done)
City Miami Shores Village
Is Building Historically Designated
Contractor's Company Name 24 (7 i/ k
Contractor's Address 79/,'"2.. - 7
City ' � ` State
Qualifier ✓1 C,"3 . 1
$ Value of Work For this Permit
Type of Work: ❑Ad_yawl
Describe Work: /
(Continued on opposite side)
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
YES NO
['Alteration
1 e42
vex/
Electrical
Zip 33 i 3�
frt- Z4 r7 ci) et e a k a Phone #
County Miami -Dade
['New
Submittal Fee $ Permit Fee $
Notary $ s 0 0 Training/Education Fee $
Scanning $ Radon $
Code Enforcement $ Structural Plan Review. $
Total Fee Now Due $ � -44 13 3 1
574-e-a--41
Zip 3 3 /3S
Zoning
Permit No. t t2. 4 1 5,2
Master Permit No.
Architect/Engineer's Name (if applicable) Phone #
Mechanical Roofing
Phone # SOS .952 X33
Phone #
Zip 77h;
Square Footage Of Work: c
fRepair/Replace Demolition
e
❑
* * * * * * * * * * * * * * * * * * * * * * * * * * ** F ees * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
CCF$ )dr CO /CC
Technology Fee $ U, 3
Bond
Bonding Company's Name (if applicable)
Bonding Company's Address
City State Zip
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
City State Zip
Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has
commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating
construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS,
WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC
OWNER'S AFFIDAVIT: I certify that all the foregoing inforniation is accurate and that all work will be done in compliance with all
applicable laws regulating construction and zoning.
"WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR
PAYING TWICE FOR UVIPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING,
CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
COMMENCEMENT."
Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is• issued. In the absence of such posted notice, the
inspection will not be proved and a reinspection fee will be charged.
Signature
Owner or g-nt
The foregoing instrument was acknowledged before me this
day of Ay 2 , 200,, by
who is personally known to me or who has produced
NOTARY PUBL
Sign:
Print:
My Commission Expires:
***************************************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
State Certificate or Registration No.
* * * * * * * * * * * * * * * * * * * * * * * * * * * **
APPLICATION APPROVED BY:
Chc 12/15/03
As identification and who did take an oath.
Contractor
The foregoing instrument was acknowledgedbefore me thi
who is personally known to me or who h produced
as `fici entification and who did take an oath.
NOTARY P
Sign:
P
My Commis
(Certificate of Competency Holder)
Certificate of Competency No.
Angel. Becker
1,1y :.v1I���iiysiu�I va r5uO,t�
xpires>:s November 15, 2008
* ** ********************************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
7;19:11/0 Plans Examiner
fr r
Engineer
Zoning
STATE OF FLORIDA
DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM
CONSTRUCTION PERMIT
CONSTRUCTION PERMIT FOR:
[ ]New System [ ]Existing System [ ]Holding Tank [ ] Innovative Other
[ X ]Repair [ ]Abandonment [ ]Temporary [ NA ]
APPLICANT: McCorquodale, Donald AGENT: SR0931119, COCKING MSTEPHEN
PROPERTY STREET ADDRESS: 1071 NE 95 St Miami FL 33138
LOT: 25 BLOCK: 81 SUBDIVISION: Miami Shores Sec 3
[Section /Township /Range /Parcel No.]
PROPERTY .ID #: 11- 3206 -014 -3610 [OR TAX ID NUMBER]
SYSTEM MUST BE CONSTRUCTED IN ACCORDANCE WITH SPECIFICATIONS AND STANDARDS OF CHAPTER 64E -6,FAC
DEPARTMENT APPROVAL OF SYSTEM DOES NOT GUARANTEE SATISFACTORY PERFORMANCE FOR ANY SPECIFIC TIME
PERIOD. ANY CHANGE IN MATERIAL FACTS WHICH SERVED AS A BASIS FOR ISSUANCE OF THIS PERMIT,
REQUIRE THE APPLICANT TO MODIFY THE PERMIT APPLICATION. SUCH MODIFICATIONS MAY RESULT IN THIS
PERMIT BEING MADE NULL AND VOID. ISSUANCE OF THIS PERMIT DOES NOT EXEMPT THE APPLICANT FROM
COMPLIANCE WITH OTHER FEDERAL, STATE OR LOCAL PERMITTING REQUIRED FOR PROPERTY DEVELOPMENT.
SYSTEM DESIGN AND SPECIFICATIONS
T [ 1050 ]Gallons SEPTIC TANK MULTI- CHAMBERED /IN SERIES: [Y ]
A [ 0 ]Gallons MULTI - CHAMBERED /IN SERIES: [Y ]
N [ 0 ]GALLONS GREASE INTERCEPTOR CAPACITY
K [ 0 ]GALLONS DOSING TANK CAPACITY [ 0 ]GALLONS @ [0 ]DOSES PER 24 HRS # PUMPS[ 0 ]
D [ 400 ]SQUARE FEET PRIMARY DRAINFIELD SYSTEM
R [ 0 ]SQUARE FEET SYSTEM
A TYPE SYSTEM: [ N ]STANDARD [ N ]FILLED [ N ]MOUND [ N ]
I CONFIGURATION: [ N ]TRENCH [ N ]BED [ N
N
F LOCATION TO BENCHMARK: 13.3' NGVD/ FF of Residence
I ELEVATION OF PROPOSED SYSTEM SITE [ 3.0 ] [ FEET ] [ BELOW ]BENCHMARK /REFERENCE POINT
E BOTTOM OF DRAINFIELD TO BE [ 5.4 ] [ FEET ] [ BELOW 1BENCHMARK /REFERENCE POINT
D FILL REQUIRED: [ 0.0 ]INCHES EXCAVATION REQUIRED: [ 29.0 ] INCHES
OTHER REMARKS:
1- Install 400 sq. ft. of drainfield in bed configuration.
2- Existing 1050 gals. septic tank, certified by Mr. C's Septic and Drain, Inc., is to
remain in service.
3- Invert elevation of drainfield to be no less than 8.18' NGVD.
4- Bottom of drainfield elevation to be no less than 7.68' NGVD.
5- This permit is not for additions.
kPPROVED BY: Andre, Paul
)ATE ISSUED: 5/7/04
SPECIFICATIONS BY: Andre, Paul TITLE:
CENTRAX #: 13 -SG -20790
DATE PAID:
FEE PAID : $
RECEIPT .
OSTDSNBR : 04 -1740- -R
THE SEPTIC TANK SHALL BE PUMPED AND SOLID
DEFLECTION DEVICE INSTALLED ON THE OUTLET TEE
TITLE: Professional Engin Dade CHD
EXPIRATION DATE: 8/5/04
STATE OF FLORIDA
DEPARTMENT OF HEALTH
ONSI'TE SEWAGE TREATMENT AND DISPOSAL SYSTEM
CONSTRUCTION PERMIT
CONSTRUCTION PERMIT FOR:
[ ]New System [ ]Existing System
[ X ]Repair [ ]Abandonment
APPLICANT: McCorquodale, Donald
PROPERTY STREET ADDRESS: 1071 NE 95 St Miami FL 33138
LOT: 25 BLOCK: 81
PROPERTY ID #: 11- 3206 - 014 -3610
SYSTEM DESIGN AND SPECIFICATIONS
APPROVED BY: Andre, Paul
DATE ISSUED: 5/7/04
[ ]Holding Tank ( ] Innovative Other
[ ]Temporary [ NA ]
AGENT: SR0931119, COCKING MSTEPHEN
SUBDIVISION: Miami Shores Sec 3
[Section /Township /Range /Parcel No.]
[OR TAX ID NUMBER]
SYSTEM MUST BE CONSTRUCTED IN ACCORDANCE WITH SPECIFICATIONS AND STANDARDS OF CHAPTER 64E -6,FAC
DEPARTMENT APPROVAL OF SYSTEM DOES NOT GUARANTEE SATISFACTORY PERFORMANCE FOR ANY SPECIFIC TIME
PERIOD. ANY CHANGE IN MATERIAL FACTS WHICH SERVED AS A BASIS FOR ISSUANCE OF THIS PERMIT,
REQUIRE THE APPLICANT TO MODIFY THE PERMIT APPLICATION. SUCH MODIFICATIONS MAY RESULT IN THIS
PERMIT BEING MADE NULL AND VOID. ISSUANCE OF THIS PERMIT DOES NOT EXEMPT THE APPLICANT FROM
COMPLIANCE WITH OTHER FEDERAL, STATE OR LOCAL PERMITTING REQUIRED FOR PROPERTY DEVELOPMENT.
T [ 1050 ]Gallons SEPTIC TANK MULTI- CHAMBERED /IN SERIES: [Y ]
A [ 0 ]Gallons MULTI - CHAMBERED /IN SERIES: [Y ]
N [ 0 ]GALLONS GREASE INTERCEPTOR CAPACITY
K [ 0 ]GALLONS DOSING TANK CAPACITY [ 0 ]GALLONS @ [0 ]DOSES PER 24 HRS # PUMPS( 0 ]
D [ 400 ]SQUARE FEET PRIMARY DRAINFIELD SYSTEM
R ( 0 )SQUARE FEET . SYSTEM
A TYPE SYSTEM: [ N ]STANDARD [ N ]FILLED
I CONFIGURATION: [ N )TRENCH ( N ]BED
N
F LOCATION TO BENCHMARK: 13.3' NGVD/ FF of Residence
I ELEVATION OF PROPOSED SYSTEM SITE [ 3.0 ] [ FEET
E BOTTOM OF DRAINFIELD TO BE [ 5.4 ] [ FEET
L
D FILL REQUIRED: [ 0.0 ]INCHES
EXCAVATION REQUIRED: [ 29.0 ] INCHES
SPECIFICATIONS BY: Andre, Rgul t i l` TITLE:
TITLE: Professional Engin
CENTRAX #: 13 -SG -20790
DATE PAID:
FEE PAID : $
RECEIPT .
OSTDSNBR : 04 -1740- -R
[ N ]MOUND [ N ]
[ N ]
] [ BELOW] BENCHMARK /REFERENCE POINT
] ( BELOW] BENCHMARK /REFERENCE POINT
OTHER REMARKS:
1- Install 400 sq. ft. of drainfield in bed configuration.
2- Existing 1050 gals. septic tank, certified by Mr. C's Septic and Drain, Inc.,
remain in service.
3- Invert elevation of drainfield to be no less than 8.18' NGVD.
4- Bottom of drainfield elevation to be no less than 7.68' NGVD.
5- This permit is not for additions.
Dade
is to
EXPIRATION DATE: 8/5/04
CHD
STATE OF FLORIDA
DEPARTMENT OF HEALTH
APPLICATION FOR ONSITE SEWAGE DISPOSAL SYSTEM CONSTRUCTION PERMIT IT
Permit Application Number( (/! - "/ 7L/b
Scale: Each block represents 10 feet and 1 inch = 40 feet.
S
K •
J
YdePC
s �.
Site Plan submitt- • by
Plan Approved
By
DH 4015, 10/96 (Replaces HRS -H Form 4016 which may be used)
(Stock Number. 5744 -002 - 4015 -6)
PART II - SITEPLAN
' Not Approved
7
Date
County Health Departmen
ALL CHANG =S MUST BE APPROVED BY THE COUNTY HEALTH DEPARTMENT
Page 2 of
APPLICANT:
LOT: 1-,S
PROPERTY ID
PROPERTY SIZE CONFORMS TO SITE PLAN: [ ]
TOTAL ESTIMATED SEWAGE FLOW: Cern)
AUTHORIZED SEWAGE FLOW: q 22_
UNOBSTRUCTED AREA AVAILABLE: 8(jD
10 YEAR FLOOD ELEVATION FOR SITE:
SOIL PROFILE INFORMATION SITE 11 •
MUNSELL /COLOR TEXTURE DEPTH
C� T
IL
USDA SOIL SERIES: (vr(K A LAO,
TO
1
1
T •
TO
TO
SITE EVALUATED BY:
STATE OF FLORIDA
DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM
SITE EVALUATION AND SYSTEM SPECIFICATIONS
i bt14.(ct A/a - 014/e- AGENT: 41i(.
BLOCK: U SUBDIVISION: 4ZC(G S✓nx'-- 3
#: -5 afy -1 4/ D _
�Il
DH 4015, 10/96 (Replaces HRS -H Form 4015 Ipage 31 which may be used)
/3.s' rerld N fTo
MUNSELL # /COLOR TEXTURE
-o S
PERMIT #O-/f-i Nt
DATE:
[Section /Township /Parcel No. or Tax ID Number
TO BE COMPLETED BY ENGINEER, HEALTH DEPARTEMENT EMPLOYEE,OR OTHER QUALIFIED PERSON. ENGINNEER
MUST PROVIDE REGISTRATION NUMBER AND SIGN AND SEAL EACH PAGE OF SUBMITTAL. COMPLETE ALL ITEMS
YES [ ] NO NET USABLE AREA AVAILABLE; O - 3 y3 ACRE;
GALLONS PER DAY [RESIDENCES -TABLE 1 /OTHER- TABLE2]
GALLONS PER DAY [1500 GPD /ACRE OR 2500 GPD /ACRE]
SQFT UNOBSTRUCTED AREA REQUIRED: aD SQF3
BENCHMARK /REFERENCE POINT LOCATION: �---
ELEVATION OF PROPOSED SYSTEM SITE IS 3 -0 [INCHESIFT] [ABOVE EB LOW] ENCHMARK /REFERENCE POINT
THE MINIMUM SETBACK WHICH CAN BE MAINTAINED FROM THE PROPOSED SYSTEM TO THE FOLLOWING FEA
SURFACE WATER: GIOT FT DITCHES /SWALES: /yt -r) FT NORMALLY WET? [ ] YES [vI NC
WELLS: PUBLIC:A)FT LIMITED USE: // FT PRIVATE: dp" FT NON - POTABLE : !' - FT
BUILDING FOUNDA IONS: S FT PRO ERTY LINES: /S FT POTABLE WATER LINES: — FT
SITE SUBJECT TO FREQUENT FLOODING: [ ] YES [VINO 10 YEAR FLOODING? [ ] YES [-riN
FT MSL /NGVD SITE ELEVATION: (p•S FT MSL /NGVD
SOIL PROFILE INFORMATION SITE 2
USDA SOIL SERIES: (r{�fS fa / Z ‘)
DEPTH
TO
„a TO ?7"
TO
TO'
TO
TO
TO
OBSERVED WATER TABLE:fIIIt INCHES [ABOVE / BELOW] E NG GRADE. TYP CHED / APPARENT
ESTIMATED WET SEASON WATER TABLE ELEVATI 't 5.6 INC [ABOVE / EL EXISTING GRAD
HIGH WATER TABLE VEGETATION: [ ] YES [l1NO MOTTLING: [ ] YES [ NO DEPTH: INCHE
SOIL TEXTURE /LOADING RATE FOR SYSTEM SIZINGy TAVSLETT DEPTH OF EXCAVATION: INCHE
DRAINFIELD CONFIGURATION: [ ] TRENCH [ (:4' BED [ ] OTHER (SPECIFY) ',-..--
REMARKS /ADDITIONAL CRITERIA:
Page 3 of 4