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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 $1.00 will be made when ateeb re-inspection V mede by improper notice for inspection, ar faulty materials and /or worlonanahip. CLOSETS BATH TUBS SHOWERS LAVA• TORIES SINK{ SLOP SINKS LAUNDRY Tugs U RINAL{ CATCH BASIN FLOOR DRAIN DRINKING FOUNT'Ne TOTAL FIXTURES CONTR. •■ LIST CHECK SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR H DEEP W[LL SPRKLR. SYSTEM SWIM'O POOL CONTR. LIST M , HEC K CHECK ' Permit No / e&,&7 Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. Owner's Name and Address Kelp) PdL Registered Architect and /or Engineer Employing Plumber's Name. L.l • 6 -J4' 5 Location and Legal Description Lot. Street and Number where work is to be performed —No State work to be performed and purpose of building (By Floors) New Building - Remodeling 4 - -.._— Addition.- ._._._— Repairs Size Septic Tank_ °t A_ ______..Type of Tank__ Feet of Drain Tile — __`$ _____-- _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