1250 NE 95 St (6)Permit No..._.__ .._ Date
of the plans and specifications herewith su��i'iitted for the building or other
Application is hereby mad for the approval of the detailed statement p p
structure herein described. his application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida,
and all provisions of the L ws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division
of Miami Shores Village s all be complied with, whether herein specified or not. A copy of approved plans and specifications must he kept at
building during progress of work.
Owner's Name and Address__ .......... �� No Street
CONTR.
LIST
CHECK
CONTR.
LIST
CHECK
CLOSETS
SEPTIC
TANK
Size Septic Tank
Registered Architect and /or Engineer p r
Employing Plumber's Name ..�--N - 644,
-- - vis No .I JJ-? c Street__ /-:. /e -'
Location and Legal Description Lot _ __________ Subdivision
---------------- -_—. --
Street and Number where work is to be performed —No /.2 4 - — Street N l 93 .f7`
State work to be perforned and purpose of building (By Floors) 2w+' UQ_ee.,•:-t _.. <e - 4 I y ._..2•-. --
New Building Remodeling Addition Repairs ..... . _ _. No. of Stories .......... . ..
BATH
TUBS
SEWER
CONN.
Nature of Water Supply:
SHOWERS
DRAIN
FIELD
LAVA-
TORIES
SOAKAGE
PIT
My Commission Expires
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
SINKS
GREASE
TRAP
SLOP
SINKS
SOLAR
HEATER
LAUNDR
TUBS
DEEP
WELL
URINALS
SPRKLR.
SYSTEM
( Signed)
CATCH
BASIN
SWIM'G
POOL
FLOOR
DRAIN
Amount of Permit $ .. - - - - ( Signed)
DRINKING
FOUNT 'NS
Type of Tank__ _ Capacity Gals G O O
Feet of Drain Tile Dist. Feet of Tank or Drain Field from Well
ell — Size of Soakage Pit
TOTAL
FIXTURES
Plumbing Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has corn-
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be
performed under this permit; and will post or cause to he 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, a who, being by me first duly sworn, upon oath deposes and says that he is the
of the above de < •ed construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by hin . ated are true.
Notary Public, State of Florida
NOTE: A re- inspect' ee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty
materials and /or wor ship.
IN/
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RE.Property : 1250 N.E. 93rd St.
Miami Shores, Fl 33138
Dear Mr. Lubian,
ely,
Donna Dalton
mortgage Processor
DO
Guarantee Corp.
LICENSED MORTGAGE BANKER
Miami Shores Village Building & Zoning Dept.
10050 N.E. 2nd Avenue
Miami Shores, F1 33138
ATT: Frank Lubian
3/25/92
This letter is to reauest an inspection of the above reference
property for a compliance letter for a conversion of the garage to a
4th bedroom. Please be advised this conversion was completed 18 years ago.
Or a letter stating this conversion has been grandfathered in.
Enclosed is a check for $37.50 for the cost of this inspection.
Your prompt attention will be greatly appreciated.
9700 N.E. 2nd AVENUE - MIAMI SHORES, FLORIDA 33138 - 1305] 751 -3232 - FAX (3051 757 -2929
TO:
RE:
DATE:
FROM:
FL /sm
A iam/ti/
10050 N.E. SECOND AVENUE
MIAMI SHORES, FLORIDA 33138-2382
TELEPHONE (305) 758 - 8000
FAX (305) 756 -8972
WHOM IT MAY CONCERN
1250 N.E. 93 STREET
MARCH 31, 1992
FRANK LUBIEN, BUILDING AND ZONING DIRECTOR
On March 20, 1992, I inspected the above captioned property which
is a three bedroom residence with a garage which has been con-
verted into a habitable room.
Frank LuBien
Building Official
Permit No.
Application is hereby mad for the approval of the detailed statement of the plans and specifications herewith sub i tted for the building or other
structure herein described. his application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida,
and all provisions of the L ws 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 Q.� __._ Q_'.! No Street
Registered Architect and /or Engineer
Employing Plumber's Name _' No 1 - 9 Street .N/ /6
Location and Legal Description Lot -- ______ Block_
Amount of Permit $
STATE OF FLORIDA, 1
COUNTY OF DADE.
,a-
ss.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
•
Street and Number where work is to be performed —No /_.e? s;0 Street N J= 9 J J'
State work to be performed and purpose of building (By Floors)____ - - - - - -- 00 ----P '-.
New Building Remodeling Addition Repairs No. of Stories
Size Septic Tank Type of Tank
( Signed)
(Signed)
Date ._/2 19)
Subdivision
Capacity Gals G O
Feet of Drain Tile Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: ell Size of Soakage Pit
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 perniit, 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, a who, being by me first duly sworn, upon oath deposes and says that he is the
of the above de ed construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by hin ated are true.
My Commission Expires Notary Public, State of Florida
NOTE: A re- inspect' - fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty
materials and /or wor ship.
CLOSETS
BATH
TUBS
SHOWERS
LAVA
TORIES
SINKS
SLOP
SINKS
LAUN DRY
TUBS
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT'NS
TOTAL
FIXTURES
CONTR.
LIST
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SWIM 'G
POOL
CONTR.
LIST
CHECK
Permit No.
Application is hereby mad for the approval of the detailed statement of the plans and specifications herewith sub i tted for the building or other
structure herein described. his application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida,
and all provisions of the L ws 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 Q.� __._ Q_'.! No Street
Registered Architect and /or Engineer
Employing Plumber's Name _' No 1 - 9 Street .N/ /6
Location and Legal Description Lot -- ______ Block_
Amount of Permit $
STATE OF FLORIDA, 1
COUNTY OF DADE.
,a-
ss.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
•
Street and Number where work is to be performed —No /_.e? s;0 Street N J= 9 J J'
State work to be performed and purpose of building (By Floors)____ - - - - - -- 00 ----P '-.
New Building Remodeling Addition Repairs No. of Stories
Size Septic Tank Type of Tank
( Signed)
(Signed)
Date ._/2 19)
Subdivision
Capacity Gals G O
Feet of Drain Tile Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: ell Size of Soakage Pit
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 perniit, 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, a who, being by me first duly sworn, upon oath deposes and says that he is the
of the above de ed construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by hin ated are true.
My Commission Expires Notary Public, State of Florida
NOTE: A re- inspect' - fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty
materials and /or wor ship.
New Building
® " 4 -7 -67
Permit No Date__ ________
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida,
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at
building during progress of work.
Owner's Name and Address D LithgovQ No. ___ 1250NeEe __ Street 95 St.
Registered Architect and /or Engineer
Employing Plumber's Name TI'O i a3
Location and Legal Description Lot.-___-_ ______ Block_ Subdivision
Street and Number where work is to be performed —No Street
State work to be performed and purpose of building (By Floors)_
Amount of Permit $_- _ _______ _ a 00
STATE OF FLORIDA, t
COUNTY OF DADE. 1
INSTALLED 3 GAS OUTLETS
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
(Signed) _
No..__ 540 N . W . Street_ 29 Av e e
Remodeling__________________ Addition_________.______ ____._ Repairs No. of Stories _
Type of Tank__ Capacity Gals ..__-.....
Size Septic Tank____
Feet of Drain Tile__- _- .__Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City — Well._______ ....... ____-_______-... -_____ -- _____Size of Soakage Pit
(Signed)._ 1 -y's_
353
lumbing Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligatio s an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent 'ji . plement, and has com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be
performed under this permit; and will post or cause to be posted' for inspection on the site of the work such public notice or notices as are
required by the Act. The undersigned agrees to employ only such sub- contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the
of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
My Commission Expires Notary Public, State of Florida
Master Plumber.
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
RINALS
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT•NS
TOTAL
FIXTURES
CONTR.
LIST
-
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SWIM•G
POOL
CONTR.
LIFT
CHECK
_
New Building
® " 4 -7 -67
Permit No Date__ ________
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida,
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at
building during progress of work.
Owner's Name and Address D LithgovQ No. ___ 1250NeEe __ Street 95 St.
Registered Architect and /or Engineer
Employing Plumber's Name TI'O i a3
Location and Legal Description Lot.-___-_ ______ Block_ Subdivision
Street and Number where work is to be performed —No Street
State work to be performed and purpose of building (By Floors)_
Amount of Permit $_- _ _______ _ a 00
STATE OF FLORIDA, t
COUNTY OF DADE. 1
INSTALLED 3 GAS OUTLETS
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
(Signed) _
No..__ 540 N . W . Street_ 29 Av e e
Remodeling__________________ Addition_________.______ ____._ Repairs No. of Stories _
Type of Tank__ Capacity Gals ..__-.....
Size Septic Tank____
Feet of Drain Tile__- _- .__Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City — Well._______ ....... ____-_______-... -_____ -- _____Size of Soakage Pit
(Signed)._ 1 -y's_
353
lumbing Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligatio s an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent 'ji . plement, and has com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be
performed under this permit; and will post or cause to be posted' for inspection on the site of the work such public notice or notices as are
required by the Act. The undersigned agrees to employ only such sub- contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the
of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
My Commission Expires Notary Public, State of Florida
Master Plumber.
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
MIAMI SHORES VILIAOE
PLUMBING INSPECTION DEPARTMEN
APPLICATION FOR PLUMBING MLAIT
Date September 28 1 959
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____k-4_ant_-_CralSfir tti.QIL- Qali..._._ _..__ No.___ 260 N TV, Street--_ 2 /th Avenue
Registered Architect and /or Engineer ______
--_...--------- -
Employing Plumber's Name STERN & JAFFER CONSTRUCTION CO . _ N __21111 S. W. Street 3rd Street
Location and Legal Description Subdivision_-__,__
Street and Number where work is to be performed —No 1 250 Street 95th Street
State work to be performed and purpose of building (By Floors) __.._._ _ x.1.311 11y_IT£11i.
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....? SUPPli _____ _ _____Size of Soakage Pit
Amount of Permit $ 3 00
Capacity Gals
(Signed)_ kA- V
Plumbing Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and acre is obligations as an employer of Tabor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Flori %. 'ertnanent Supplement, and has com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contra • ors employed by him in the work to be
performed under this permit; and will post or cause to be posted' for inspection on the site of the •rk 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
Hemmed by Miami Shores Village.
(signed)--- T.ER L= _CtONSTRUCTION CAL
Master Plumber.
STATE OF FLORIDA,
COUNTY OF DADE. I
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take ac owledgments, personally appeared
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the
of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
My Commission Expires Notary Public, State of Florida
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made •necessary by improper notice for inspection, or faulty
materials and /or worlananship.
CLOSETS
BATH
TUBS
SHOWER.
LAVA-
TORIES
SINKS
N
SLOP
SINKS
LAUNDRY
TUBS
UR INAL.
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT•NS
TOTAL
FIXTURES
CONTR.
LIST
CHECK
t
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SW IM'G
POOL
co,. TR
LI ST
CHECK
219 t
X
'•
Permit No
MIAMI SHORES VILIAOE
PLUMBING INSPECTION DEPARTMEN
APPLICATION FOR PLUMBING MLAIT
Date September 28 1 959
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____k-4_ant_-_CralSfir tti.QIL- Qali..._._ _..__ No.___ 260 N TV, Street--_ 2 /th Avenue
Registered Architect and /or Engineer ______
--_...--------- -
Employing Plumber's Name STERN & JAFFER CONSTRUCTION CO . _ N __21111 S. W. Street 3rd Street
Location and Legal Description Subdivision_-__,__
Street and Number where work is to be performed —No 1 250 Street 95th Street
State work to be performed and purpose of building (By Floors) __.._._ _ x.1.311 11y_IT£11i.
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....? SUPPli _____ _ _____Size of Soakage Pit
Amount of Permit $ 3 00
Capacity Gals
(Signed)_ kA- V
Plumbing Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and acre is obligations as an employer of Tabor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Flori %. 'ertnanent Supplement, and has com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contra • ors employed by him in the work to be
performed under this permit; and will post or cause to be posted' for inspection on the site of the •rk 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
Hemmed by Miami Shores Village.
(signed)--- T.ER L= _CtONSTRUCTION CAL
Master Plumber.
STATE OF FLORIDA,
COUNTY OF DADE. I
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take ac owledgments, personally appeared
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the
of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
My Commission Expires Notary Public, State of Florida
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made •necessary by improper notice for inspection, or faulty
materials and /or worlananship.
BUILDING
DATE - 195
ELECTRICAL 0
PERMIT N° 9360 Contractor's
PLUMBING License No.
ROOFING
Work to be performed under this Permit
Owner of
Building
Architect
Contractor
or Builder
Legal
Description
Lot
Address of
Building
CONTRACTOR OR BUILDER
MIAMI SHORES VILLAGE, FLORIDA
Signed:
Subdi-
vision
Sq. Ft
Value of
Project
To 13Y
(A!
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.
INSPECTOR
In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations
pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village.
In accepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee.
BY AUTHORITY
AERN 17
BUILDING ❑
ELECTRICAL ❑ o
PLUMBING ❑ PERMIT N. 8592
ROOFING
Owner of
Building_
Architect
Contracto
or Builder
Legal
Descriptic
Address
Building
This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the application
herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in :compliance with any plans,
drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any
time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is
granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations
pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes responsibility for work
done by his agents, servants or employees.
Signed • BY
INSPECTOR
In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances. and regulations
pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village.
In accepting this permit I assume responsibility for all work done ,liy either, myself, my agent, servant or employee.
CONTRACTOR OR BUILDER
MIAMI SHORES VILLAGE. FLORIDA
Work to be performed under this Permit
DATE
Contractor's
License No
BY AUTHORITY
195
f ,
1
✓
.. c .. / r
r
n
Lot
1
gl
Subdi-
vision
if
t f
+
, '
sq. Ft
Amt. of
Permit
$
1 `— —
Value of
Project
$
BUILDING ❑
ELECTRICAL ❑ o
PLUMBING ❑ PERMIT N. 8592
ROOFING
Owner of
Building_
Architect
Contracto
or Builder
Legal
Descriptic
Address
Building
This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the application
herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in :compliance with any plans,
drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any
time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is
granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations
pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes responsibility for work
done by his agents, servants or employees.
Signed • BY
INSPECTOR
In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances. and regulations
pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village.
In accepting this permit I assume responsibility for all work done ,liy either, myself, my agent, servant or employee.
CONTRACTOR OR BUILDER
MIAMI SHORES VILLAGE. FLORIDA
Work to be performed under this Permit
DATE
Contractor's
License No
BY AUTHORITY
195
BUILDING ❑
ELECTRICAL ❑
MIAMI SHORES VILLAGE,
PLUMBING PERMIT ■° 8663
ROOFING ❑
Owner of
Building
Architect
Contractor
or Builder
Legal
Description
Address of
Building
Lot
CONTRACTOR OR BUILDER
Bl.
r
Subdi-
vision
Sq. Ft
Value of
Project $
FLORIDA
r
DATE .
Contractor's
License No
Amt. of
Permit $
BY AUTHORITY
v
lgs
Work to be perfonned under this Permit
This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the application
herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans,
drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any
time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is
granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations
pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes responsibility for work
done by his agents, servants or employees.
Signed: - BY
INSPECTOR
In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations
pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village.
In accepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee.
7
APJ-7
Permit No
Size Septic Tank
Feet of Drain Tile--_-- -__
Amount of Permit $_
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida,
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at
building during progress of work.
Owner's Name and Address 9v!_ .__ Z- r_r/> !_ _.__ No. Street
Registered Architect and /or Engineer ---
______ — __ 'e
43= - ` ------ - No.- _ `9 I� a
Employing Plumber's Name_ _ / e- E ® 4! 92G ' '
Location and Legal Description Lot.___ _____— ____ —____. Block
Street and Number where work is to be performed —No /0- St ��S Street
State work to be performed and purpose of building (By Floors)
New Building -- ✓ - - -- Remodeling____ - -_ - -- Addition_________ Repairs No. of Stories_
Nature of Water Supply: City — Well.-____— _______ _ ..... _---- _----- ...... - _ --- -- ._Size of Soakage Pit
My Commission Expires
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING €b,, to
Type of Tank
__Dist. Feet of Tank or Drain Field from Well
( Signed) _
(Sign
Capacity Gals.
Street_
Date r
The undersigned applicant for this building permit does hereby certify that he understands and accepts his o
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Peri
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors e
performed under this permit; and will post or cause to be posted' for inspection on the site of the work su
required by the Act. The undersigned agrees to employ only such sub- contractors, on work to be performed u
licensed by Miami Shores Village.
ezia-k iv
`R.
Notary Public, State of Florida
Plumbing Inspector.
li :i ons as an employer of labor
nt Supplement, and has com-
loyed by him in the work to be
public notice or notices as are
permit, as are
Master Plumber.
STATE OF FLORIDA, 1
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the_ _ --
of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
-rein by him stated are true.
-tion fee of $1.00 will be made when such re- inspection Is made •necessary by improper notice for inspection, or faulty
'-ip.
CLOSET6
BATH
TUBS
SHOWER•
LAVA-
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TueB
U RINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT'NS
f4/i
Ci _„.
/,V 04
A l i scH
TOTAL
FIXTURES
CONTR.
LILT
' O
o�
3
6,
2,,,
/
/
/
CHECK
SEPTIC
TANK
. SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SW I M' 6
POOL
11
15 11
Sias ati
k
ile,ctad
2 l %
_—
-
Corm.
LIST
/
/
CHECK
APJ-7
Permit No
Size Septic Tank
Feet of Drain Tile--_-- -__
Amount of Permit $_
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida,
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at
building during progress of work.
Owner's Name and Address 9v!_ .__ Z- r_r/> !_ _.__ No. Street
Registered Architect and /or Engineer ---
______ — __ 'e
43= - ` ------ - No.- _ `9 I� a
Employing Plumber's Name_ _ / e- E ® 4! 92G ' '
Location and Legal Description Lot.___ _____— ____ —____. Block
Street and Number where work is to be performed —No /0- St ��S Street
State work to be performed and purpose of building (By Floors)
New Building -- ✓ - - -- Remodeling____ - -_ - -- Addition_________ Repairs No. of Stories_
Nature of Water Supply: City — Well.-____— _______ _ ..... _---- _----- ...... - _ --- -- ._Size of Soakage Pit
My Commission Expires
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING €b,, to
Type of Tank
__Dist. Feet of Tank or Drain Field from Well
( Signed) _
(Sign
Capacity Gals.
Street_
Date r
The undersigned applicant for this building permit does hereby certify that he understands and accepts his o
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Peri
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors e
performed under this permit; and will post or cause to be posted' for inspection on the site of the work su
required by the Act. The undersigned agrees to employ only such sub- contractors, on work to be performed u
licensed by Miami Shores Village.
ezia-k iv
`R.
Notary Public, State of Florida
Plumbing Inspector.
li :i ons as an employer of labor
nt Supplement, and has com-
loyed by him in the work to be
public notice or notices as are
permit, as are
Master Plumber.
STATE OF FLORIDA, 1
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the_ _ --
of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
-rein by him stated are true.
-tion fee of $1.00 will be made when such re- inspection Is made •necessary by improper notice for inspection, or faulty
'-ip.
514 tyge:
cf
afa
(
0
Permit No
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMEN'..
APPLICATION FOR PLUMBING r:MIT
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_LithgaW No a25.0 Street Isla_ E. 95th St.reet
Registered Architect and/or Engineer___ —
STERN & JAFFER CONSTRUCTION CO. N 2500
Employing Plumber's Name Street..N° • Mia
Location and Legal Description
Street and Number where work is to be performed—No._____4-_?5° __ Street N. E. 95th Street
State work to be performed and purpose of building (By Floors).
New Building Remodeling Addition
Size Septic Tank
Feet of Drain Tile.
Nature of Water Supply: City—Well. City
.......... ...... ....
Type of Tank
Amount of Permit $..._14.t° ( Signed)_
(Signed).
Date June 1 52 1959
Subdlvision._._ -------
Repairs No. of Stories
Capacity Gals
__Dist. Feet of Tank or Drain Field from Well
...Size of Soakage Pit
Plumbing Inspector.
The undersigned applicant for this building permit does hereby certify that he understands an accepts his obligations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws o 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.
STATE OF FLORIDA, }
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the
of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
My Commission Expires Notary Public, State of Florida
Master Plumber.
NOTE: A re-inspection fee of $1.00 will be made when such re-inspection is made by improper notice for inspection, or faulty
materials and/or workmanship.
CLOSETS
BATH
TUI3S
SHOWERS
LAVA.
TORIES
SINKS
SLOP
SINKS
LAUNDRY
Tues
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT' NS
TOTAL
FIXTURES
CONTR.
LIST
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
Fri ELI)
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SW IM•G
POOL
Drain
Well
x
1
comm.
Lin.
X
X
CHECK
Permit No
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMEN'..
APPLICATION FOR PLUMBING r:MIT
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_LithgaW No a25.0 Street Isla_ E. 95th St.reet
Registered Architect and/or Engineer___ —
STERN & JAFFER CONSTRUCTION CO. N 2500
Employing Plumber's Name Street..N° • Mia
Location and Legal Description
Street and Number where work is to be performed—No._____4-_?5° __ Street N. E. 95th Street
State work to be performed and purpose of building (By Floors).
New Building Remodeling Addition
Size Septic Tank
Feet of Drain Tile.
Nature of Water Supply: City—Well. City
.......... ...... ....
Type of Tank
Amount of Permit $..._14.t° ( Signed)_
(Signed).
Date June 1 52 1959
Subdlvision._._ -------
Repairs No. of Stories
Capacity Gals
__Dist. Feet of Tank or Drain Field from Well
...Size of Soakage Pit
Plumbing Inspector.
The undersigned applicant for this building permit does hereby certify that he understands an accepts his obligations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws o 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.
STATE OF FLORIDA, }
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the
of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
My Commission Expires Notary Public, State of Florida
Master Plumber.
NOTE: A re-inspection fee of $1.00 will be made when such re-inspection is made by improper notice for inspection, or faulty
materials and/or workmanship.
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
Registered Architect and /or Engineer
Employing Plumber's Name_YL/ � =
Location and Legal Description Lot__
Street and Number where work is to be performed -No L 3"`r 0 °'vim / 1' Street_
State work to be performe8 and purpose of building (By Floors) _______
New Building Remodeling Addition
Size Septic Tank
Feet of Drain Tile.
3t
Nature of Water Supply: City -Well.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
PPLICATION FOR PLUMBING " ;�M
Amount of Permit $ (Signed)-
A-oz D _- -__ L i T14- S, _o�
My Commission Expires
No. - - - - - - Street
No.. ._- -- - —
Street..
v Block _ ___________..__. Subdivision
_Size of Soakage Pit
Date -
Repairs No. of Stories
Type of Tank_ Capacity Gals 0--d
Dist. Feet of Tank or Drain Field from Well
Plumbin ctor.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as employer of labor
under the Florida Workmen's Compensation Act, being Section 5988, Compiled General Laws of Florida Permanent Su - . ement, 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.
( Signed) _-
Notary Public, State of Florida
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 worlcmanship.
CLOSETS
BATH
TUBS
SHOWERS
LAVA-
TORIES
SINKS
SLOP
SINKS
LAUNDRY
Twos
U RINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT'N8
TOTAL
FIXTURES
CONTR.
LIST
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SWIM•G
POOL
1--
CONTR.
LIST
CHICK
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
Registered Architect and /or Engineer
Employing Plumber's Name_YL/ � =
Location and Legal Description Lot__
Street and Number where work is to be performed -No L 3"`r 0 °'vim / 1' Street_
State work to be performe8 and purpose of building (By Floors) _______
New Building Remodeling Addition
Size Septic Tank
Feet of Drain Tile.
3t
Nature of Water Supply: City -Well.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
PPLICATION FOR PLUMBING " ;�M
Amount of Permit $ (Signed)-
A-oz D _- -__ L i T14- S, _o�
My Commission Expires
No. - - - - - - Street
No.. ._- -- - —
Street..
v Block _ ___________..__. Subdivision
_Size of Soakage Pit
Date -
Repairs No. of Stories
Type of Tank_ Capacity Gals 0--d
Dist. Feet of Tank or Drain Field from Well
Plumbin ctor.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as employer of labor
under the Florida Workmen's Compensation Act, being Section 5988, Compiled General Laws of Florida Permanent Su - . ement, 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.
( Signed) _-
Notary Public, State of Florida
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 worlcmanship.
VJP:
FLORIDA STATE BOARD OF HEALTH
PERMIT TO DRILL DRAINAGE WELL
Issued to Stern & . *ffar COaatruCtiQA&iler) For £ • L
2500 SO. MAUI Avenue (Address) 4S5 M. E. c' tb "t resit
vf4Anf i•'.. r4lz r:i�pi� : larir:s?
In accordance with the provisions of Chapter 381, Section 387.251, and Chapter 387 orida S •tutes of
1955 and amendments thereto, together with Chapter XXI, Florida State Sanitary Code, perms gr• ted for
A aKtor as pia c
drilling a drainage well at ' '. c•'"'
Proposed Diameter 3" Proposed Well Depth t ;t' Proposed Casing . •.th
Inspection has been made of the site of proposed drainage well by a dul • thoriz
the State Board of Health and permission is granted for drilling the well with
(1) L.31 - 3 •: i : ; 3 141i La LUA:144u oa Jual.L:.i 1riljjlaLiAL'
•
Upon its completion this well shall in no case be placed in ser
has been completed, signed by a duly authorized representative o
the Owner.
This permit is revokable at any time for failure to comply wit .e •rovisions as stated herein.
Granted this
Issued
BUREAU' OF ( INE
Director
FLORIDA STA
PERMIT TO 0
In accordance with the provisi
1955 and amendments thereto, togethe
Daum Liti.9vaw
to operate a drainage well located at
Subject to the following provi
(ti) `oie1 L L:) La ::sthi
This
feet, drilled
T
drainage we
(Not vali
D B. LEE
e well is
Directo , = eau of Sanitary Engineering
BUREAU OF SANITARY ENGINEERING 13- 7822 -59
Jacksonville 1, Florida Permit No
r ,
day
A
of a yris•ate Maraud ng pon' ran 7.,
By State Health Officer
State Health Officer
RD OF HEALTH
inches in diameter, feet deep, cased to a depth of
60'
epresentative of
on that
La State Board of
until the attached permit to operate
St • - Board of Health, and delivered to
j a Ly 19 'IL
BUREA OF SANITARY ENGINEERING
nville 1, Florida Permit No 13 - 2822 -
TE DRAINAGE WELL
ter 381, Section 381.251 and Chapter 387, Florida Statutes of
hapter XXI, Florida State Sanitary Code, permit is granted
Owner) 485 N. Z. 54th ;traet, Miami, F1._ (Address)
(Name of Driller) (Address of Driller)
evokable at any time for failure to comply with the provisions stated herein, or if this
at any time contaminate or otherwise affect other waters in the vicinity, or for other cause.
is 7th day of t , 19__
ntil countersigned by a duly authorized representative of the Florida State Board of Health.)
Approved:
WILSON T. SOWDER, M.D.
Fla.
CUMBIE. PH.G., VICE PRESIDENT
QUINCY
F. P. MEYER. D.D.S.. MEMBER
ST. PETERSBURG
BUREAU OF SANITARY ENGINEERING
DAVID B. LEE, M.S. IN ENG.
DIRECTOR
Dear Mr. Well Driller:
CHARLES J. COLLINS, M.D., PRESIDENT
ORLANDO
3Flortha '#atr guar? of Eraltil
WILSON T. SOWDER, M.D., M.P.H., STATE HEALTH OFFICER
JACKSONVILLE 1
IN REPLY PLEASE REFER TO
n:
Enc. (3) - x ,at
cc: Owner IY /enc. '"�s �. I1.
cc: State Geologist W /enc.
C : y Tiff Ilc s tie ATT: rr„ QJ3i °�i
cc: ' d elli ShOres Kutibtn?, t�riaio
Very truly yours,
David 3. ee
Director
SULLIVAN G. BEDELL. M.D.. MEMBER
JACKSONVILLE
JOHN D. MILTON. M.D.. MEMBER
MIAMI
Your application for drainage well at the address shown on the attached form has
been approved under the provisions stated on the form. Please notice that the
form you are receiving is in two parts; the upper being the drilling permit and
the lower one being a permit to operate drainage well. The provisions stated on
the drilling permit are intended to guide you in drilling the well in accordance
with the regulations of this office. The provisions stated on the operating
permit inform the owner of the purpose for which the well is permitted, and of
any special treatment which must be provided before waste can be discharged into
the drainage well.
TELEPHONE
ELGIN 4 -0181
POST OFFICE
BOX 210
After the well has been completed in accordance with the provisions of the drill-
ing permit, you should fill in the blank spaces in the operating permit so that
this form will show the actual diameter and depth of casing and the actual depth
to which the well is drilled instead of the estimated diameter and depths as
given on the upper half of the form. The completed form should then be detached
from your drilling permit, which is for your files, and forwarded to the County
Health Department of the county in which the well is located in order that they
may inspect the well and countersign the permit before delivery to the owner.
Information copies of both the drilling and operating permits have been furnished
to the owner, to the County Health Department and the State Geologist.
You are required to make a record of the log of the well, one copy of which must
be furnished to the State Geologist and the other copy to the County Health Depart-
ment at the time of the inspection. The State Geologist may also require that you
save cuttings from the well for his u;;::.
You are requested to notify this office of any change from the provisions of this
permit prior to placing them into effect.
MIAMI SHORES VILLAGE, FLORIDA
BUILDING ❑
ELECTRICAL ❑ DATE 11 ' -
PLUMBING ❑ PERMIT N9 8 8 9 5 Contractor's , V ROOFING ❑ License No.
Owner of
Building
Architect
Contractor
or Builder
Legal
Description
Address of
Building
Lot
CONTRACTOR OR BUILDER
Bl.
Work to be performed under this Permit—
Subdi-
vision
Sq. Ft
Value of
Project $
Amt. of
Permit $
BY AUTHORITY
195 5
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 • ' `
1
- 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.
17
^.--^
CLOSETS
TUBS
TUBS
SHOWERS
LAVA
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TUBS
INAS
URINALS
CATCH
BASIN
FLOOR
DRAIN
NKI N6
FO
FOUNT' NS
TOTAL
FIXTURES
CONTR.
LIST
/
C am.- --
-
--
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SW IM•G
POOL
CONTR.
LIST
CHECK
Size Septic Tank
Application is hereby iuude 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 Street-! a'! E
Registered Architect and /or _------ .-- __ _- _ -._ -_
_ No._�______ Stree
Employing Plumber's Name �,[ U�__�1L�T
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Location and Legal Description Block_ S - - —� - - _/�_- - - - --
Street and Number where work is to be performed —No ��� �? Street. ._-1_A /._ r -___/ v "' S,1
State work to be performed and purpose of building (By Floors)_ -__
New Building _ -- Remodeling -- _- -___ -- Addition
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
Amount of Permit $
Capacity Gals._
(Signed)_
Repairs No of Stories
Plumbing Inspector.
The undersigned applicant for this building pennit does hereby certify that he understands and a ts his obligations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Flonda 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 , Q 'rr
required by the Act. The undersigned agrees to employ only such sub - contractors, on work to be performe. . nder this permit, a
licensed by Miami Shores Village.
(Sign
STATE OF FLORIDA, ( �.
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take aclmowledgments.
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 ti-
therein by him stated are true.
My Commission Expires Notary Public, Stai
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made•necessary by improper n
materials and /or workmanship.
Date. /
Master "