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379 NE 94 St (7)CLOncTn BATH rues SHOWER/ LAVA• Tonics SIN SLOP SINKS LAUNDRY Tun• URINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT'Nn rte- y TOT,.L FIETt RES CL LI T TA. ' / r - & o V �r 2 CHECK / 40 T SEPTIC TANK SEWLR CONN. DRAIN FIELD SOAKAOL PIT G TRAP SOLAR H DEEP WILL SPRKLR. S SWIM'° POOL Cowrie. LIST CHECK �,^'{r,— K,1 !'cnni No.... _— Date..._ ._../ . U o Application is hereby made for the approval of the detailed statement of the plans and specifications herewith subrni,..-1 for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of M1 ± Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulatic of the Building Division of Atiami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and spec. fications must be kept at wilding during progress of work. ��JJ _—_ __.._.. —. No._._ 1 2�._.__.__._ Street_.A . 'l ':hvnei s Name and Address.._. __!. , "�'V / 4. ___ .. � 9 9 Yeef .egist !red Architect and /or Engineer : �� pp m p l o y i n g Plumber's Name C. m ,e . 2 Qf` "A.41; No.. 22 6tfeet.,42. .1 Location and Legal Description Lot. Block '�•'S Subdivision._- �e� _ - - - - Street and Number where work is to be performed — %.? / / Street_.. __• -- .. . d T YVie. . —. -- State work to be performed and purpose of building (By Floors) — /Flay New Building Remodeling Size Septic Tank__. .__..____...---- •- .--- _-- __ -__- .__Type of Tank__ _ . Capacity ^ ,als... _..... 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 $ o .1 — Plumbin:{ Inspector The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an a n;IIoyer of lah o under the Florida Workmen's Compensation Act, being Section 5988, Compiled General Laws of Florida Permanent .upi lenient, and cuts • a t -. ti•.1ied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed 1 y him In ' 1; .AI rk a b� performed under this permit; and will post or cause to be posted' for inspection on the site of the work such pub!: notice T. no icer • +s ar required by the Act. The undersigned agrees to employ only such sub - contractors, on work to be performed ?a this . r rl.til ..t . licensed by Miami Shores Village. STATE OF FLORIDA, ! sa• COUNTY OF DADE. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Addition ..._..✓ Repairs No of Stories (Signed)_ L'' / . (Signed) My Commission Expires Notary Public, State of Florida • Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take ackesowledaments, t ppear!ti to me well known, and who, being by me first duly sworn, upon oath deposes and Rays that he is the . ......................... .. .. of the above described construction, that be has carefully read the foregoing application, and that he did sign the tame, and Riot all acts therein by him stated are true. NOTE: A re- inspection fee of $1.00 will be made when such re - Inspectfoo V mede•necewry by Improper notice for inspection, ptr tvuily materials and/or workmanship. Application is hereby made for the approval of the detailed statement on me plans and specifications herewith submitted for the build ine or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida. and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of the work. Dr-. nn /� Date..............--- / - -2./--..— .—-..,19.E2' __...» ».. ,19.9 0. Ow'ner's Namc and Address /�dk /T h .3 eet_b,, 1L Registered Architect and /or Engineer ............ F.:,,,,. ∎P. h . WA r'/'Q- L.:. ,,,,,,,,,,..„,.,, Name and address of licensed contractor A.40 /tie ms........ l h /I Its d' .579.��r9/4 A. ems.... I. 4 - S' A4•11" 1 Location and legal description of lot to be built on: / .34 L ot...g..,t..l.. .�.. /..7 Block y� Subdivision p See C f'i oss _ /.,,,,.._ ».... Street and Number where work is to be done _.. T �l K.:. _.» q.Y_ _._.._» ....__..�._...._. — State work to be done and purpose of building (by floors) ... »_ di N./i A eg. t.% fy2. »... ..... ..,1_.I.lo°1-..-. »_. New Building. yyReniq dcling Addition Repairs No. of Stories / To be constructed of Labte.....,, oekKind of foundation. (. .A$C- ` Vering.fiak tie ...%pP.;f .e..1.i 15 . Estimated Total cost of improvements $ 4100 D Amount of Permit $....t, i l Zone cubage required plan Cubage Distance .to next nearest building.. Size of Building Lot _ ..... - Maximum live load to be borne by each floor I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may be sent to.. 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 \Vorkmen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Supplement, and has complied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by hint 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 subcontractors, on work to be performed under this permit, as are licensed by Miami Shores Village. Remarks STATE OF FLORIDA, 1 . COUNTY OF DADE. j ss. MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap- peared —_ 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 //ru� e true.. Permit No ' stated Date 1) N A V......_._ Read, Sworn to and Subscribed before me. Disapproved . l� Date.._........_ •• Notary Public, State of Florida (Signed) .... _ » » ». » .. ..... .and for no other purpose. (Signed) ,./(4U Building Inspector My Commission Expires PLANNING BOARD DATE Chairman ... Member Member Member _ M ember .. ... .... Member __.. »..... Council Approved Date Disapproved Date NOTE:: A charge of $1.00 will be made for making corrections or changes to this application after approval has been obtained from the Planning Board. A re.inspeetion fee of 51.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials anti /or workmanship.