PLUMBING- -�
CLOSET$
BATH
T
rjNOWa11a
LAVA-
TORIES
SINKS
SLOP
•INKS
LAUNDRY
Tun•
URINALS
CATCH
DAAIN
FLOOR
DRAIN
DRINK NO
FOUNT' NE
TOTAL
FISTURER
CONTR.
LIST
CHICK
_.
-
-
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
G
TRAP
SOLAR
HEATER
DEEP
WILL
SPRKLR.
$ N
SW IM M
POOL
CONTK.
LIST
CHICK
►
Permit No
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida,
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division
of Miami Shores Village shall be complied with, whether herein specified or notdrsgo4C A copy of approved plans and specifications must be kept at
1104 PP building during progress of wor /
q—z S— Street NE9 '(SZ
Owner's Name and Address
Registered Architect and /or Engineer n
Em login Plu n
Na ,._ .
Loco od n � and 'I.bgr�ISescti °n 'I.oC - B b —
Street and Number where work is to be performed —No Street. N t - ._ 9 S S _
State work to be performed and purpose of building (By Floors)__-_._ O_, .X _490.5_ Er. 0 1 f. art. W..M. ......04!J 1 out
New Building.-_.--_.-- _._.. .... ...._.. Remodeling__ ____ Addition.. ___— ...... -_ Repairs V No. of Stories
Amount of Permit $
�•S
My Commission Expires
Size Septic Tank__ _Type of Tank. —_
Feet of Drain Tile Dirt. Feet of Tank or Drain Field from Well. .._.__._
Nature of Water Supply: City—Well. Size of Soakage Pit.
1
..... _....__...Capadty Gals..._..._._.__ _._..-
(Signed _ J r I-WtlQ C. = - - -Q �
_ subdhvldon,ffig�
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 5986, 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 woe*. to 1x
performed under this permit; and will post or cause to be posted' for inspection on the site of the rr
ch public notice or notices as a
required by the Act. The undersigned agrees to employ ouly surd, sub- contractors, on work to - ormed er this permit, as are
licensed by Miami Shores Village, � 14,
(SI.. ►- �I
T Master Plumber.
STATE OF FLORIDA, 1 es.
COUNTY OF DADE. I
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, penorielly 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 be has carefully read the foregoing application, and that be did sign the same, and that all facts
therein by him stated are true.
Notary Public, State of Timid.
Plumbing Inspector.
NOTE: A re- inspection fee of $1.00 will be mods whoa nob swiupaottos io mods asoemomy by improper soda, fair laspercdon, or faulty
materials Sad /or wmlananship.
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 cot. A copy of approved plans and specifications must be kept at
building during progress of work.
Owner's Name and Addres
Registered Architect and /or Engineer
Employing Plumber's Name t i'
Amount of Permit $ /r J '
STATE OF FLORIDA, 1
COUNTY OF DADE. I
ss.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
4Ja
r�iL✓
(Signed)
No
No.
k y X V Type of Tank
(Signed)
i-3.3e z v .
Date d" r
J Street t.5
Street
Location and Legal Description Lot Block Subdivision
Street and Number where work is to be performed —No ) 1. 2 .3 e Street ,9s '
State work to be performed and purpose of building (By Floors)
New Building Remodeling Addition Repairs No. of Stories
Capacity Gals
Feet of Drain Tile Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City —Well Size of Soakage Pit
Plumbing Inspector.
The undersigned applicant for this building permit does hereby certify that he u rstands and accepts his obhi:g" s 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.
My Commission Expires Notary Public, State of Florida
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty
materials and /or workmanship.
CLOSETS
BATH
TUBS
SHOWERS
LAVA-
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TUBS
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT' NS
TOTAL
FIXTURES
CONTR.
LIST
-
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
H EATER
DEEP
WELL
SPRKLR.
SYSTEM
SW IM'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 cot. A copy of approved plans and specifications must be kept at
building during progress of work.
Owner's Name and Addres
Registered Architect and /or Engineer
Employing Plumber's Name t i'
Amount of Permit $ /r J '
STATE OF FLORIDA, 1
COUNTY OF DADE. I
ss.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
4Ja
r�iL✓
(Signed)
No
No.
k y X V Type of Tank
(Signed)
i-3.3e z v .
Date d" r
J Street t.5
Street
Location and Legal Description Lot Block Subdivision
Street and Number where work is to be performed —No ) 1. 2 .3 e Street ,9s '
State work to be performed and purpose of building (By Floors)
New Building Remodeling Addition Repairs No. of Stories
Capacity Gals
Feet of Drain Tile Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City —Well Size of Soakage Pit
Plumbing Inspector.
The undersigned applicant for this building permit does hereby certify that he u rstands and accepts his obhi:g" s 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.
My Commission Expires Notary Public, State of Florida
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty
materials and /or workmanship.
OWNER
LOT
BLOCK
SUBDIVISION
r
'
Date
aiami chores9llage
F L O R ID A
PLUMBING PERMIT N9 728
Issued to
to install the following described plumbing, in accordance with the laws, statutes and regu-
lations of Miami Shores Village, Florida and the State of Florida, governing plumbing and
drainage work done in Miami Shores Village, Florida.
For a_./. —story . ' building at
Fixtures
Fixtures / $ , 7
Sewer $
Septic Tank $
Total $
Village Plumbing Inspector
Received Payment by
OWNER
LOT
BLOCK
SUBDIVISION
; O,A.024/
, l
ii •l9'
lid j'
4)- _
Date
Issued
/0./0 —J4.
,!fit
•st
PLUMBING PERMIT N° 748
to install the following scribed plumbing, in acco ance with the laws, statutes and regu-
lations of Miami Shor ` Village, Florida and the State of Florida, governing plumbing and
drainage work done in Miami Shores Village, Florida.
For a _ / story 1 /‘, building at I/ 1 J' ,P i 2
Fixtures
Fixtures $ C.\*,- -1
k`\
Sewer $ VY� ��,
Septic Tank / $
Total $ / r •
Village Plumbing Inspector
Received Payment by
aiami Jhorenillage
F L O R ID A
OWNER
LOT
BLOCK
SUBDIVISION
Issued to (`�
aiami cShores9 llage
F L 0 A 1 D A
PLUMBING PERMIT
to install the folfoiving described plumbing, in accordance with the laws, statutes and regu-
lations of Miami Shores Village, Florida and the State of Florida, governing plumbing and
drainage work done in Miami Shores Village, Florida.
building at
N9 728
For a_ /story
Fixtures
Fixtures
Sewer / $
.ic Tank $
Total $
Village Plumbing Inspector
Received Payment by
Issued
Jhores9' llage
F L O & D A
PLUMBING PERMIT
N9 748
to install the following scribed plumbing, in acco dance with the laws, statutes and regu-
lations of Miami Sho Village, Florida and the State of Florida, governing plumbing and
drainage work done in Miami Shores Village, Florida.
For a _ / story l building at
Fixtures
Fixtures $
Sewer $
*tic Tank / $ /n n
Total $ / 0 0 •
Village Plumbing Inspector
Received Payment by frZ�F 1
OWNER
LOT
BLOCK
Xi
SUBDIVISION
121 • . i
1 / UL/i1
?
..• `7.
11 r107
Issued
Jhores9' llage
F L O & D A
PLUMBING PERMIT
N9 748
to install the following scribed plumbing, in acco dance with the laws, statutes and regu-
lations of Miami Sho Village, Florida and the State of Florida, governing plumbing and
drainage work done in Miami Shores Village, Florida.
For a _ / story l building at
Fixtures
Fixtures $
Sewer $
*tic Tank / $ /n n
Total $ / 0 0 •
Village Plumbing Inspector
Received Payment by frZ�F 1
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
3-26-70
Permit No .1 �!
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 Miami Shores Baptist Church No 425 N.E. 95th t et
Registered Architect and /or En eer.._
-Rose Septic Tank P. • x 3 b Hialeali
Employing Plumber's Name ._..._._ No.
.__.
Location and Legal Description Lot Subdivision .____.___.._______ _......_
425 N.E. s r�'
Street and Number where work is to be performed —No. Street. ._..._.._... -_ -.-
State work to be performed and purpose of building (By Floon)_ _
New Building Remodeling Addition Repair.._ No. of Stories.
Size Septic Tank_ Type of Tank
Feet of Drain Tile Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City —Well. Size of Soakage Pit_
Amount of Permit $ 4 - �---
— bing Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his o bons as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Perm ent 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 rise 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, C
COUNTY OF DADE. I
( Signed)
My Commission Expires Notary Public, State of Florida
ha -
Mastr 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 snob rednapeetion L made•neoessary by improper notice for inspection, or faulty
materials and /or workmanship.
CLOSETS
OATH
TUGS
aHOWE11s
LAVA.
TORIES
1114
GLOP
SINKS
LAUNDRY
Tuna
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT'NS
TOTAL
FIXTURES
CONTR.
LIST
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GRIMM'
TRAP
SOLAR
NEATER
DECP
WELL
SPRKLR.
SYSTEM
IWIN•O
POOL
CONTR.
LIST
CHECK
32'
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
3-26-70
Permit No .1 �!
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 Miami Shores Baptist Church No 425 N.E. 95th t et
Registered Architect and /or En eer.._
-Rose Septic Tank P. • x 3 b Hialeali
Employing Plumber's Name ._..._._ No.
.__.
Location and Legal Description Lot Subdivision .____.___.._______ _......_
425 N.E. s r�'
Street and Number where work is to be performed —No. Street. ._..._.._... -_ -.-
State work to be performed and purpose of building (By Floon)_ _
New Building Remodeling Addition Repair.._ No. of Stories.
Size Septic Tank_ Type of Tank
Feet of Drain Tile Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City —Well. Size of Soakage Pit_
Amount of Permit $ 4 - �---
— bing Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his o bons as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Perm ent 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 rise 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, C
COUNTY OF DADE. I
( Signed)
My Commission Expires Notary Public, State of Florida
ha -
Mastr 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 snob rednapeetion L made•neoessary by improper notice for inspection, or faulty
materials and /or workmanship.
BUILDING
ELECTRICAL
PLUMBING
Owner of
Building
Architect
Contractor
or Builder
Legal
Description
Address of d i 4
Building
This pun* b
application bazar in
with any blit
be rev nay pas ii
upon which this p!init
the ordinances and
that he assumes responsiiel
In consideration of
bons pertaining tissew o
Village. la
0
MIAMI SHORES VILLAGE, FLORIDA
DATE ( (f / ° 164
Contractors
License No. r
o be performed under this Permit '��
PERMIT ITT° 3923
l.I
BL
if )1
Subdi-
vision
Value of
Project
contractor or builder named above to construct the building l r to install the equipment or device describ d in the
ace with all ordinances pertaining thereto and with the underseaaiding that the work will be performed in cc sspiiance
or specifications that may have been submitted to and appro ed by the proper municipal authorities. This Permit may
is not done in compliance with such ordinances or if the plaqs are changed without authorization. A further condition
d is the understanding that the contractor or builder named ab assumes the responsibility for a tho = b kno�'e1edge sk�
main' to the work covered hereby whether shown on the plans o awings or in the statements or . acei an
r w ork done by his agents, servants or employees.
Signed.
BY
u
Amt. of
Permit
By
INS
1
to me of this permit 1 agree to perform the work covered hereunder in compliance with aH
rmity w ith the plans, drawings, statements or specifications submitted to the proper authorities
for all work done by either myself, my egent, servant or employee.
T s'i0
•
BUILDING
ELECTRICAL
PLUMBING
ROOFING
MIAMI SHORES VILLAGE, FLORIDA
❑ DATE Y i 19
J PERMIT N9 5768 Contractor's
License No
Owner of
Building ts
❑ Work to be performed under this Permit
Architect
Contractor
or Builder E i 4:...... _ .t_j. i c ____-0....
Legal Lot
Description II Bl
ic
t t J E/tr t k L ew { A 14 -1.44.P
Subdi-
vision
Address of - Value of 11 Amount of
Building 1 Project $ 11 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 applica-
tion herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any
plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked
at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this
permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and
regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes respon-
sibility for work done by his agents, servants or employees.
In consideration of ,the is
pertaining thereto and stric
cepting this pe
Signed 1 - _ , _ A 4 ; ►. _ r INSPECTOR
ante to me of this permit I agree to perform the work covered hereunder in compliance with all ordinanc and regulations
onformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In as
ibility for all work done by either, myself, my agent, servant or employee.
Permit No
griG4
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____, If______ 7 67-
_ - - Street- _ __ -� '6 L
•
Registered Architect and /or Engineer —__
Employing Plumber's Name___ni_A- v_Y_I�— i�1A'�l�_�c is 7 :4- * / f_ No._
Location and Legal Description Lot_
Street and Number where work is to be performed —No.
New Building Remodeling_
Size Septic Tank_
Feet of Drain Tile
Nature of Water Supply: City —Well
Amount of Permit $
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contracto
performed under this permit; and will post or cause to be posted' for inspection on the of the wo
required by the Act. The undersigned agrees to employ only such sub- contractors, . ork to
licensed by Miami Shores Village.
ss.
My Commission Expires
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
7f
_L76 _ -- Street��! J LSZ
Block _ Subdivision____
Street._ l!_k SS
State work to be performed and purpose of building (By Floors)_ i ta rk -- ALAI _
Addition_________ Repairs No. of Stories_
— Type of Tank__— Capacity Gals.
_ —Dist. Feet of Tank or Drain Field from Well
._Size of Soakage Pit
(Signed)_ --
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-
oyed by him in the work to be
public notice or notices as are
ed under this permit, as are
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.
Notary Public, State of Florida
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made•necessary by improper notice for inspection, or faulty
materials and /or workmanship.
CLOSETS
BATH
TUBS
SHOWERS
LAVA-
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TUBS
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT•NS
TOTAL
FIXTURES
CONTR.
LIST
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
H EATER
DEEP
WELL.
SPRKLR.
SYSTEM
SW IM•G
POOL
CONTR.
LIST
CHECK
Permit No
griG4
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____, If______ 7 67-
_ - - Street- _ __ -� '6 L
•
Registered Architect and /or Engineer —__
Employing Plumber's Name___ni_A- v_Y_I�— i�1A'�l�_�c is 7 :4- * / f_ No._
Location and Legal Description Lot_
Street and Number where work is to be performed —No.
New Building Remodeling_
Size Septic Tank_
Feet of Drain Tile
Nature of Water Supply: City —Well
Amount of Permit $
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contracto
performed under this permit; and will post or cause to be posted' for inspection on the of the wo
required by the Act. The undersigned agrees to employ only such sub- contractors, . ork to
licensed by Miami Shores Village.
ss.
My Commission Expires
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
7f
_L76 _ -- Street��! J LSZ
Block _ Subdivision____
Street._ l!_k SS
State work to be performed and purpose of building (By Floors)_ i ta rk -- ALAI _
Addition_________ Repairs No. of Stories_
— Type of Tank__— Capacity Gals.
_ —Dist. Feet of Tank or Drain Field from Well
._Size of Soakage Pit
(Signed)_ --
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-
oyed by him in the work to be
public notice or notices as are
ed under this permit, as are
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.
Notary Public, State of Florida
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made•necessary by improper notice for inspection, or faulty
materials and /or workmanship.
lit
. 4 „
4,1 V -
v. 4 4 •s f4
• T' ; ,Ts ''.. •
r," "
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date 12451 I CI Co Job Address X2.5 PEE 0 15 5 T Tax Folio 11- 32 O 6-0114-b6
Legal Description Historically Designated: Yes No vi
Owner/Lessee / Tenant MCI P;t-ki ottorzeS ' 9T& crtu te GI-C Master Permit #
Owner's Address 370 GRAND COMC ou2SE / MS1-402 33138 Phone
758 -OS
C o n t r a c t i n g Co. i-LOy D - 1 • 1 02Tli DRDE S "rl C A d d r e s s eo N v J I I I S E T M1/' t
Qualifier DE N Nt s N CJ t t,l_E SS# Phone 75i -16'76
State # 015836-8 Municipal # Competency # 1 284-2 Ins. Co. TizAis ?s/ 5. I F
Architect/Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type (circle one): BUILDING ELECTRICALCPIUMBIZO MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION I W311'\ LL. D v3 F 1 E.-)
Square Ft 300 Estimated Cost (value) *15C
WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY
RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTEND TO OBTAIN FINANCING,
CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.)
Application is hereby made to obtain a permit to do work and installation as indicated above, and on the attached addendum (if applicable). I
certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate
permits are required for ELECTRICAL, PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK.
OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate
laws regulating construction and zoning. Furthermore, I authorize the above -n
Signature of owner and/or Condo Presid
Not as to Owne
ommission
FEES: PERMIT
12 3i q
or. ond• President Date
� P i 4 ^ Teresa J. Felder
Notary Public State of Fiari�'a '
, j Commis,;'un No. CC 4 Ot >7
RT MY Commission E :pins C'1/16; y ( ><
f 1400.34zoTARY. Pia Notary agrvite ectta8 co.
ateateeeteeeee eeeereeeeeeeeeetwireeeteetereeee o
33--, RADON C.C.F.
APPROVED:
Zoning Building
Mechanical
ate
®cure of C
at all work will be done m compliance with all applicable
to Contracto
ommission
actor to . • the work stated.
ntractor or : er- Builder
NOTARY
Electrical
2/ 3/ /C C
Date
31 96
uilder ate
oct
9'7'4 Noan,� PubI',
0 ^,ortmi �`c :. P
oF:La 13 iy('�iG'..I;3.3.
1- 30-3•ACTARY• FLiC:a'^y ._
'at!fl weetete!!etteeefere eez areeeeetete fie!• %
BOND 30D.
as
TOTAL DUE 33C e
Plumbing ( iI/I Engineering
CONS •
T RUCTION PERMIT FO �
[ �/] New System [/j/j�xisting System [ A /` lding Tank [ ,,Temporary /Experimental
[J Repair [ Abandonment [her(Specify) �'(-'
APPLICANT: - j — 4 r / "'AGENT 2-/C))/ T - x 1,�,[0^7774( I UL
PROPERTY STREET ADDRESS: ' r t-+ y ). <7E- .,
LOT: , A / BLOCK: I � SUBDtt V /v
PROPERTY ID # : 0 0 U / 4 0 c, ,. lJ [SECTION /TOWNSHIP /RANGE /PARCEL NUMBER]
[OR TAX ID NUMBER]
SYSTEM MUST BE CONSTRUCTED IN ACCORDANCE WITH SPECIFICATIONS AND STANDARDS OF CHAPTER 10D -6, FAC
REPAIR PERMITS AND HOLDING TANK PERMITS EXPIRE 90 DAYS FROM THE DATE OF ISSUE. ALL OTHER PERMITS
EXPIRE ONE YEAR FROM THE DATE OF ISSUE. HRS APPROVAL OF SYSTEM DOES NOT GUARANTEE SATISFACTORY
PERFORMANCE FOR ANY SPECIFIC PERIOD OF TIME. ANY CHANGE IN MATERIAL FACTS WHICH SERVED AS A
BASIS FOR ISSUANCE OF THIS PERMIT, REQUIRE THE APPLICANT TO MODIFY THE PERMIT APPLICATION. SUCH
MODIFICATIONS MAY RESULT INt THIS PERMIT BEING MADE NULL AND VOID.
SYSTEM DESIQN AND SPE rFICATIONS
0
T
H
E
R
T [ /] ALLONS ''i SEPTIC TANKE
-• /1jrROBIC UNIT CAPACITY MULTI- CHAMBERED /IN SERIES:[ j
A [ ] [GALLONS / GPD] '' CAPACITY MULTI- CHAMBERED /IN SERIES:( ]
N [ ] GALLONS GREASE INTERCEPTOR CAPACITY [MAXIMUM CAPACITY SINGLE TANK: 1250 GALLONS]
K ( ] GALLONS PER DOSE DOSING TANK CAPACITY DOSE RATE [ ] PER 24 HRS NO. OF PUMPS: ( ]
D [ ..!E3 ' QUARE FEET PRIMARY DRAINFIELD SYSTEM
R [ ] SQ E FEET SYSTEM
A TYPE SYSTEM: [ ] STANDARD [ ] FILLED [ ] MOUND [ ]
I CONFIGURATION: [ ] TRENCH [[
F LOCATION OF BENCHMARK: l f E. '/ .1 Se g2,001
I ELEVATION OF PROPOSED SYSTEM SITE [ .5.7 [INCHE /FT`}- [ABOVE /BELOW4 gENeffMARK4REFERENC
E BOTTOM OF DRAINFIELD TO BE [
L
D FILL REQUIRED: [ ] INCHES EXCAVATION REQUIRED: ( INCHES
SPECIFICATIONS BY:
APPROVED BY:
DATE ISSUED:
f 7
STATE OF FLORIDA
DEPARTMENT OF HEALTH AND REHABILITATIVE SERVICES
ONSITE SEWAGE DISPOSAL SYSTEM
CONSTRUCTION PERMIT
Authority: Chapter 381, FS & Chapter 10D -6, FAC
HRS -H Form 4016, Mar 92 (Obsoletes previous editions which may not be used)
(Stock Number: 5744 - 001 - 4016 -0)
Y 7 -000
7.--
$ S
/‘ s/)
PERMIT #
DATE PAID
FEE PAID
RECEIPT #
(2 ( 4] rNCHES /Er] [ABOV <EELOW])ENCHMARK/ FERENCE POINT
TITLE:
TITLE:
II
IN77.01 e. n /CCMT -1ACTCr
CPHU
EXPIRATION DATE: a_ 2 ,-77
Page 1 of 2
Company
Job
REQUEST FOR INSPECTION
6
Address '
_t n
4 , e , .1.� y,
PHONE
t 41 1
Inspection
Time Ready
Date Ready CJ
A.M. P.M.
Li
41
le 4 04, REQUEST FOR INSPECTION
Company n
cirt
Job
Address 4 -i l s- 1
J'3 0 )
Inspection
Time Ready
Date Ready
•
( t -
PHONE
t
A.M.
P.M.
MIAMI SHpES VILLAGE, FLA. N? 6126
JOB RA t h �. CLAA--ek - Itit
ADDRESS `- a E S
TIME READY [ t 9 - . t •
INSPECTOR DATE
REMARKS •
v • VI
Permit No
State work to be performed and purpose of building (By Floors)
New Building Remodeling Addition Repairs
Amount of Permit $ / -
STATE OF FLORIDA, 1
COUNTY OF DADE. I
ss.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
(Signed)
✓
Datono 5, 7 / ' S 0
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 / 5 77 v A/_,x No /7/ 1 5 -
Street/ T
Registered Architect and /or Engineer � /�
Employing Plumber's Name .g• C ,. / c G / No 7 J Street / '- �__
Location and Legal Description Lot Block / Subdivision _
Street and Number where work is to be performed—No ,,.5 / ' Street____ S ' s 7 '
Go .1f.'/ T- 70 F/i/ ii tz
No. of Stories
Size Septic Tank Type of Tank Capacity Gals
Feet of Drain Tile Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City —Well Size of Soakage Pit
My Commission Expires Notary Public, State of Florida
( 1
. /t7v c/%9N
( Signed)
Master Plumber.
./ , plumbing Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligatipns 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.
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 land /or workmanship.
CLOSETS
BATH
TUBS
SHOWERS
LAVA-
TORIES
SINKS
SLOP
SINKS
LAUNDR
TUBS
URINALS
CATCH
BASIN
F LOOR
DRAIN
DRINKING
FOUNT' NS
TOTAL
FIXTURES
CONTR.
LIST
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
H EATER
DEEP
WELL
SPRKLR.
SYSTEM
SW IM'G
POOL
" V 1....
`eWAI
CONTR.
LIST
�-
/
/
CHECK
v • VI
Permit No
State work to be performed and purpose of building (By Floors)
New Building Remodeling Addition Repairs
Amount of Permit $ / -
STATE OF FLORIDA, 1
COUNTY OF DADE. I
ss.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
(Signed)
✓
Datono 5, 7 / ' S 0
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 / 5 77 v A/_,x No /7/ 1 5 -
Street/ T
Registered Architect and /or Engineer � /�
Employing Plumber's Name .g• C ,. / c G / No 7 J Street / '- �__
Location and Legal Description Lot Block / Subdivision _
Street and Number where work is to be performed—No ,,.5 / ' Street____ S ' s 7 '
Go .1f.'/ T- 70 F/i/ ii tz
No. of Stories
Size Septic Tank Type of Tank Capacity Gals
Feet of Drain Tile Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City —Well Size of Soakage Pit
My Commission Expires Notary Public, State of Florida
( 1
. /t7v c/%9N
( Signed)
Master Plumber.
./ , plumbing Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligatipns 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.
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 land /or workmanship.