PLUMBING4
No r •
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 alLpravisions 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. n
Owner's Name and Address ttil P.� 4 • No. 410 Ai' t' • Street.._?. ._. C �7..._..
Registered Architect and /or Engineer
J 57 D A!E
Employing Plumhoas Afattte L�i7C l Abi� �qj No Street--./(2.K�. S .
Location and Legal Description Lot
Street and Number where work is to be performed —No
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
State work to be performed and purpose of building (By Floors) New Building_ _ ..__ .- ------ -•- -.- - -._._ Remodeling___ . _ __ Addition -_
Block
4 /io N.E E.
Subdivision
Street. 9.51 -57- •
•
Repairs No. of Stories .......
Size Septic Tank_ .Type of Tank.__
Feet of Drain Tile. 3 a. Pr:. 6eock &p,�
. ist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City—Well. Size of Soakage PIt
STATE OF FLORIDA,
COUNTY OF DADE.
(Signed)
Capacity Cals.
(Signed)_ —� t-- �� Plumafg Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts hi obligations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5968, Compiled General Laws of Florida P . manent 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 d e p o s e s 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' improper
materials and /or wa�rl�anship.
necessary b proper notice for inspection. or faulty
CLOSRS
BATH
TUBE
SHOWERS
LAVA-
TORIES
SINKS
SLOP
SINKS
LAUNDRY
Tugs
U RINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT'NS
TOTAL.
FIXTURES
Comm.
LIST
CHECK
•
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
NEATER
DEEP
WELL
SPRKLR.
SYSTEM
BWIM'O
POOL
CONTR.
LIST
3 2 Pr.
CHECK
oto cky
'� , Ia - ^ 1
4
No r •
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 alLpravisions 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. n
Owner's Name and Address ttil P.� 4 • No. 410 Ai' t' • Street.._?. ._. C �7..._..
Registered Architect and /or Engineer
J 57 D A!E
Employing Plumhoas Afattte L�i7C l Abi� �qj No Street--./(2.K�. S .
Location and Legal Description Lot
Street and Number where work is to be performed —No
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
State work to be performed and purpose of building (By Floors) New Building_ _ ..__ .- ------ -•- -.- - -._._ Remodeling___ . _ __ Addition -_
Block
4 /io N.E E.
Subdivision
Street. 9.51 -57- •
•
Repairs No. of Stories .......
Size Septic Tank_ .Type of Tank.__
Feet of Drain Tile. 3 a. Pr:. 6eock &p,�
. ist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City—Well. Size of Soakage PIt
STATE OF FLORIDA,
COUNTY OF DADE.
(Signed)
Capacity Cals.
(Signed)_ —� t-- �� Plumafg Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts hi obligations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5968, Compiled General Laws of Florida P . manent 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 d e p o s e s 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' improper
materials and /or wa�rl�anship.
necessary b proper notice for inspection. or faulty
'r
Permit No. ___ 0
Date "2 "
r 7
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida,
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at
building during progress of work.
Owner's Name and Address
Feet of Drain Tile
Amount of Permit $__
, �
.Q GLv4
My Commission Expires
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
ais
att141/i„A. 1 No Street
Registered Architect and /or Engineer
7 Employing Plumber's Name "4,, „ No � Street
Location and Legal Description Lot_____ -r 9.5" _�-
:/ Block 5‘) Subdivision__,__S___ — 42
Street and Number where work is to be performed— No.___ .... __ •�C_,4___________ " Street 9 S J
State work to be performed and purpose of building (By Floors)
New Building Remodeling Addition____ Repairs No. of Stories
Size Septic Tank Type of Tank Capacity Gals
Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply City *Well Size of Soakage Pit
Plumbing Inspector.
s .
The undersigned applicant for this building permit does hereby certify that nderstands and accepts his obligat s as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Pennanen 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,
ss.
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly au orized to administer oaths nd 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
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
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT 'NS
14/0
I.�
TOTAL
FIXTURES
GUST
LIST
3
J
_._L___
/
_,Z. -_
_
--
CHECK
SEPTIC
TANK
SE:WER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
EATER
DEEP
WELL
SPRKLR.
SYSTEM
SW IM'G
POOL
CONTR.
LIST
�J
L
_
CHECK
'r
Permit No. ___ 0
Date "2 "
r 7
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida,
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at
building during progress of work.
Owner's Name and Address
Feet of Drain Tile
Amount of Permit $__
, �
.Q GLv4
My Commission Expires
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
ais
att141/i„A. 1 No Street
Registered Architect and /or Engineer
7 Employing Plumber's Name "4,, „ No � Street
Location and Legal Description Lot_____ -r 9.5" _�-
:/ Block 5‘) Subdivision__,__S___ — 42
Street and Number where work is to be performed— No.___ .... __ •�C_,4___________ " Street 9 S J
State work to be performed and purpose of building (By Floors)
New Building Remodeling Addition____ Repairs No. of Stories
Size Septic Tank Type of Tank Capacity Gals
Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply City *Well Size of Soakage Pit
Plumbing Inspector.
s .
The undersigned applicant for this building permit does hereby certify that nderstands and accepts his obligat s as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Pennanen 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,
ss.
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly au orized to administer oaths nd 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
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 e
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 s!/6i
Registered Architect and /or Engineer ___ �_____ _ /
Employing Plumber's Name___
No..
Location and Legal Description Lot___._ _ ___________ _._ _ Block
Streit and Number where work is to be performed —No 4 / ® N 9 y Street
State work to be performed and purpose of building (By Floors)__
New Building __ ___ Remodeling____
Size Septic Tank D
Feet of Drain Tile__ 3 /°
Nature of Water Supply: City —Well.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING °r"kI. IiIT
Type of Tank.
Addition j.
No._ ¢ -_____ Street
Repairs -
Date 1 7 4 4 2 - ' • 5(.
-- - - - - -- Subdivision _- -- -- -_ - __ _ --
No. of Stories..
Capacity Gals
Dist. Feet of Tank or Drain Field from Well
Size of Soakage Pit
( Signed) _
Amount of Permit $
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
requirr,3 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.
aster Plumber.
STATE OF FLORIDA, 1
IL
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 swom, 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
TUBE
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT'NS
TOTAL
FIXTURES
CONTa.
LIST
CHECK
_-
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SWIM'S
POOL
CONTR.
LIST
CHECK
Permit No e
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 s!/6i
Registered Architect and /or Engineer ___ �_____ _ /
Employing Plumber's Name___
No..
Location and Legal Description Lot___._ _ ___________ _._ _ Block
Streit and Number where work is to be performed —No 4 / ® N 9 y Street
State work to be performed and purpose of building (By Floors)__
New Building __ ___ Remodeling____
Size Septic Tank D
Feet of Drain Tile__ 3 /°
Nature of Water Supply: City —Well.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING °r"kI. IiIT
Type of Tank.
Addition j.
No._ ¢ -_____ Street
Repairs -
Date 1 7 4 4 2 - ' • 5(.
-- - - - - -- Subdivision _- -- -- -_ - __ _ --
No. of Stories..
Capacity Gals
Dist. Feet of Tank or Drain Field from Well
Size of Soakage Pit
( Signed) _
Amount of Permit $
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
requirr,3 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.
aster Plumber.
STATE OF FLORIDA, 1
IL
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 swom, 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.
Pe Date
App tion is lie eby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other
structure erem described. This application is made in compliance and confor..ity 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
Size Septic Tank
Feet of Drain Tile__
Registered Architect and /or Engineer,___________
Employing Plumber's Name
Location and Legal Description Block
Street and Number where work is to be performed— No. .___�
State work to be performed and purpose of building (By Floors)
New Building Remodeling _ -__-- ........ ---- ____ -- Addition__.--_.
Nature of Water Supply: City —Well.
Amount of Permit $ (Signed) _ ZA A,
MIAMI SHORES VIL'.AGE
PLUMBING INSPECTION DEPARTMEii:':
APPLICATION FOR PLUMBING
No. __________-- _-- ____ -_ Street_
Type of Tank Capacity Gals
Dist. Feet of Tank or Drain Field from Well
__Size of Soakage Pit
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligat s as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5968, Compiled General Laws of Florida Pennane Supplement, and has cs re-
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors empl yed 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 perfo e4 under this permit, as are
licensed by Miami Shores Village.
(Signed)_
Repairs No. of Stories..
•
My Commission Expires Notary Public, State of Florida
Street.-
Subdivision
Street-. _.
STATE OF FLORIDA, 1 ss.
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the
of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made •necessary by improper notice for inspection, or faulty
materials and /or workmanship.
CLOSETS
, BATH
' TUBS
SHOWERS
LAVA
TORIES
S INKS
SLOP
SINKS
LAUNDRY
TUBE
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
SWIM'G
POOL
—_
CONTR.
LIST
(
CHECK
Pe Date
App tion is lie eby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other
structure erem described. This application is made in compliance and confor..ity 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
Size Septic Tank
Feet of Drain Tile__
Registered Architect and /or Engineer,___________
Employing Plumber's Name
Location and Legal Description Block
Street and Number where work is to be performed— No. .___�
State work to be performed and purpose of building (By Floors)
New Building Remodeling _ -__-- ........ ---- ____ -- Addition__.--_.
Nature of Water Supply: City —Well.
Amount of Permit $ (Signed) _ ZA A,
MIAMI SHORES VIL'.AGE
PLUMBING INSPECTION DEPARTMEii:':
APPLICATION FOR PLUMBING
No. __________-- _-- ____ -_ Street_
Type of Tank Capacity Gals
Dist. Feet of Tank or Drain Field from Well
__Size of Soakage Pit
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligat s as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5968, Compiled General Laws of Florida Pennane Supplement, and has cs re-
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors empl yed 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 perfo e4 under this permit, as are
licensed by Miami Shores Village.
(Signed)_
Repairs No. of Stories..
•
My Commission Expires Notary Public, State of Florida
Street.-
Subdivision
Street-. _.
STATE OF FLORIDA, 1 ss.
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the
of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made •necessary by improper notice for inspection, or faulty
materials and /or workmanship.
Owner of
Building
Architect
Contractor
or Builder
Legal
Description
Address of
Building
Lot
MIAMI SHORES VILLAGE. FLORIDA
BUILDING ❑
ELECTRICAL ❑ DATE
PLUMBING ® PERMIT N° 8634 Contractor s
License No
ROOFING ❑
❑ Work to be performed under this Permit
Bl.
7
•
Subdi-
vision
dJ p
BY
6 l7
Sq. Ft
Value of
Project $
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 knowledg of the ordinances and regulations
pertaining to the work covered hereby whether shown on the plans or drawings or f i the statements or specifications and that a assumes responsibility for work
done by his agents, servants or employees. f 1 /
/ ! __ ,�
Signed: i , :::. _ , .. = .�'` - � .�� _
INSPECTOR
In consideration of the issuance to me of this permit I agree to perform the work covered he under in compliance with all ordinances and regulations
pertaining thereto and in strict conformity with the plans, drawings, statements or specifications su fitted to the proper authorities of Miami Shores Village.
In accepting this permit I assume responsibility for all work done by either, myself, my agent, ro ant or employee.
!f
CONTRACTOR OR BUILDER AUTHORITY
ISWI7
MIAMI SHORES VILLAGE. FLORIDA
BUILDING " ❑
ELECTRICAL ❑ DATE
PLUMBING o PERMIT N° 8 616
ROOFING ❑
❑ Work to be performed under this Permit
Owner of
Building
Architect
Contractor
or Builder
Legal
Description
Address of
Building
Lot
4 /
utr.0.,
..,d
P . f _. ,,
NTRACTOR Olt BUILDER
Bl.
/
Signed: /
Subdi-
vision
Contractor's
License No.
Sq. Ft
Value of
Project $
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 an at 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 hereundey'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 r snibility for all work done by either, myself, my agent, servant of employee.
BY AUTHORITY
195
17
BUILDING ❑
ELECTRICAL C]
PLUMBING
ROOFING [] Work t
Owner of
Building
MIAMI SHORES VILLAGE, FLORID
PERMIT N? 15528
Architect
Contractor
or Builder
Legal Lot
Description.
Address of
Building
This permit is granted to the contractor or buil der ed above to
herefor in strict compliance with all ordinances p raining thereto and
drawings, statements or specifications that may hate been submitted to
time if the work is not done in compliance with such ordinances or if t
granted is the understanding that the contractor or builder named ab
pertaining to the work covered hereby whether shown on the plans
done by his agents, servants or employees.
In consideration of the issuance to me of phis per
pertaining thereto and in strict conformity with the plane, d
In accepting this permit I responsibility for all work done by ei
CONTRACTOR OR BUILDER
DATE'
Contractor's
d under this Permit
License No
t the building or to install the equipment or device described in the applies
g that the work wi be performed in compliance with any plans,
roper municipal au rides. This Permit may be at an
about authorization A further condition u w permit is
sibility f., •f the .; ancee regulations
atemen r stecifications a • a ,t l ty f or work
iNSP
th work covered hereunder in compliance all ordinances
or specifications submitted to the proper authorities of Miami
er, myself, my agent, servant or employee.
BY
AUTHORITY
195
dm'
Village.
BUILDING
ELECTRICAL
PLUMBING
Owner of
Building
Architect
Contractor
or Builder
Work to be pe formed under this Perini
(,,
MIA I SHORES .VILLAGE, FLORIDAy
DATE
PERMIT N - 8944
Legal Lot ! ' BL ;'/ Subdi-
Description vision
Address of value of �'
Permit Amt. of
Building // / t ., '- 1 ' `' Project 1 yf" .� t
This permit is granted to the contractor or uilder named above to construct the building or to install the equipment or device described in the appli-
cation herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any
plans, drawin s, statements or specifications that rhay have been submitted to and approved by the proper municipal authorities. This Permit may be revoked
at any time if work is not done in compliance ith such ordinances or if the plans are changed without authorization. A further condition upon which this
permit is granted is the understanding that the c tractor or builder named above assumes the responsibility or a thorough knowledge of the ordinances and
regulations pertaining to the work covered hereb whether shown on the plans or drawing or in the state nts or specifications an that he assumes respon-
sibility for work done by his agents, servants or loyees.
. %h."!
TRACTOR OR BUILDER
•
t�
Signed.
Z.`
•
Contractor's
cense No.
4... By
INSPECTOR
In consideration of the issuance to me of t j is permit I agree to perform thl; , ork covered hereunder in compliance.with all erdins
pertaining thereto and in strict conformity with he plans drawings, statements or specifications submitted to the proper authorities of
In accepting this permit I assume responsibility for all work done bypiiier myself, agent, servant or eloyee.
194_..vo
AUTHORITY
and i Shores Village.
Permit No.
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or ot
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 Divisior
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept al
building during progress of work.
Owner's Name and Address /1 ' No e lij — Street f __ ?
Registered Architect and /or E
Employing Plumber's Name
Amount of Permit $_
Size Septic Tank_ Type of Tank_
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
( Sign
(Signed)
Cee
State work to be performed and purpose of building (By Floors) ? A :�:_ ' _
New Building _ ._. Remodeling Addition__ ___.__..____..__
A
Capacity Gals.
Feet of Drain Tile Dist. Feet of or Drain Field from Well
Nature of Water Supply: City —Well._ > Size of Soakage
------- - - - - --
My Commission Expires Notary Public, State of Florida
`,� s
Street 22; �'J / Z ......
Subdivision
Location and Legal Description Lot_._ _.._ ..... _._...... _.....
Street and Number where work is to be performed —No WO ___ Ve Stree
1s OF
No. of Stories ...... .. _
umbing I i:ector.
The undersigned applicant for this building permit does hereby certify that he un erstands and accepts his obligations as an emplo er of labor
under the Florida Workmen's Compensation Act, being Section 5988, Compiled General Laws of Florida Pennanent Supplement, and has ccm-
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 an
licensed by Miami Shores Village.
Master Plumber.
STATE OF FLORIDA, } ss.
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally .,ppeare
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 lac
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 foul
materials and /or workmanship.
CLOSETS
BATH
TUBS
SHOWERS
LAVA.
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TUBS
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
POUNT•NS
TOTAL
FIXTURE
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
v
q
�c
- 1---
Permit No.
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or ot
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 Divisior
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept al
building during progress of work.
Owner's Name and Address /1 ' No e lij — Street f __ ?
Registered Architect and /or E
Employing Plumber's Name
Amount of Permit $_
Size Septic Tank_ Type of Tank_
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
( Sign
(Signed)
Cee
State work to be performed and purpose of building (By Floors) ? A :�:_ ' _
New Building _ ._. Remodeling Addition__ ___.__..____..__
A
Capacity Gals.
Feet of Drain Tile Dist. Feet of or Drain Field from Well
Nature of Water Supply: City —Well._ > Size of Soakage
------- - - - - --
My Commission Expires Notary Public, State of Florida
`,� s
Street 22; �'J / Z ......
Subdivision
Location and Legal Description Lot_._ _.._ ..... _._...... _.....
Street and Number where work is to be performed —No WO ___ Ve Stree
1s OF
No. of Stories ...... .. _
umbing I i:ector.
The undersigned applicant for this building permit does hereby certify that he un erstands and accepts his obligations as an emplo er of labor
under the Florida Workmen's Compensation Act, being Section 5988, Compiled General Laws of Florida Pennanent Supplement, and has ccm-
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 an
licensed by Miami Shores Village.
Master Plumber.
STATE OF FLORIDA, } ss.
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally .,ppeare
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 lac
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 foul
materials and /or workmanship.
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date ZO k Job Address 9 1 0 N L J $ f Tax Folio
Legal Description Historically Designated: Yes / No
Owner/Lessee / Tenant A , L , Pv G ' 1 Master Permit # L / 4 3 6S 3 3
Owner's Address ¥/ C /v / ' 7 y r Phone 3 0 s - y 9-2 1 tc- y k 3 Contracting Co. Sir P � 2 7 G Tu ti r 74 c Address ' 7 7a 1 ,✓ / k //I, 3
e 3 D f 1
Qualifier /j,1 d r- e ‘t-' 1< / SS# Phone 3 or 7 Z L g
State # 091'0 0 5 2 9 Municipal # Competency # Ins. Co.
Architect/Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type (circle one): BUILDING ELECTRICAL PLUMBIN MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION fit °I i — t , /
Square Ft. 7 0 d Estimated Cost (value) /Z. 0 0
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 and that all work will be done in compliance with all applicable
laws regulating construction and zoning. Furthermore, I authorize the above -named contractor to do the work stated.
OL D
Signature of owner and/or Condo President
LORRAINE J. ZERO
Notary Public, State of Florida
i Yy Comm_ " pyres Oct 24 1099
Notary as tolQhv zo it Condo President
My Commissi j Expires:
Cr
FEES: PERMIT RADON
/0 -- fk
Date
/-2t
Date
APPROVED:
Zoning Building
Mechanical Plumbing
Signs e of Cons . o •r Owner - Builder
LORRAINE J. ZERO
Notary Public, State f Florida
My Comm. expires nct?4,1999
Notary as to Contfifbt0669204ier- Builder
My Commission F spires:
C.C.F. I ? 0 NOTARY
Electrical
BOND 3 C a
/0-Za - S�
Date
-
Date
2
n
TOTAL DUE 3 3
Engineering
APPLICANT:
LOT:
:t : d
PROPERTY ID #:
0
T
H
E
R
SPECIFICATIONS BY:
APPROVED BY:
DATE ISSUED:
STAKE OF FLORIDA
DEPARTMENT OF HEALTH
ONSITE SEWAGE DISPOSAL SYSTEM
CONSTRUCTION PERMIT
Authority: Chapter 381, FS &
CONSTRUCTION PERMIT FOR:
[ , J New System [ . f] Existing System
[ ] Repair [ A Abandonment
BLOCK:
N
PROPERTY STREET ADDRESS:
Pa
D ( , r ) SQUARE FEET
R [ `')] SQUARE FEET
A TYPE SYSTEM:
I CONFIGURATION:
N
F LOCATION OF BENCHMARK: f j id , `_ f % 9, t , ,f t
I ELEVATION OF PROPOSED SYSTEM SITE [ � J [,INCHES)FT
E BOTTOM OF DRAINFIELD TO BE [ 2 7 t j ) [ ?NCNE
L
D FILL REQUIRED: ( !j €,' ) INCHES
,
SUBDIVISION:
DH 4016, 10/96 (Replaces HRS -H Form 4016 [page 11 which may be used)
(Stock Number: 5744 -001- 4016 -0)
Chapter 10D -6, FAC
[ ;fi g] Holding Tank [ Temporary /Experimental
( J] Other(Specify)
Appeicant
AGENT:
TITLE:
TITLE:
[SECTION /TOWNSHIP /RANGE /PARCEL NUMBER)
"' Ci' - :3 (', 0 [ OR TAX ID NUMBER]
EXCAVATION REQUIRED: ( ) INCHES
PERMIT #
DATE PAID
FEE PAID $
RECEIPT #
y, sc'
+
(•'
SYSTEM MUST BE CONSTRUCTED IN ACCORDANCE WITH SPECIFICATIONS AND STANDARDS OF CHAPTER 1OD -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. DEPARTMENT OF HEALTH 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 IN THIS PERMIT BEING MADE NULL AND VOID.
SYSTEM DESIGN AND SPECIFICATIONS
o r bs . ;
T [` J kGGALLONS-/ GPD] SEPTYC TANK /EROBIC UNIT CAPACITY MULTI- CHAMBERED /IN SERIES:[ ]
A [ /'*) ) [ P1141M "/ 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 [ J PER 24 HRS NO. OF PUMPS: [ ]
PRIMARY DRAINFIELD SYSTEM
SYSTEM
[
J. STANDARD [ ] FILLED [ ) MOUND
[ ) TRENCH [ „J/BED [ 3
]
] [ ABOI/E /,BELOW j; BENCHMARK / 6 REFERENCE -POINT
]
[ABOVE/ $ELO BENCHMARK /REPS ELNCE OTN'r
EXPIRATION DATE:
CHD
Page 1 of 2
INSTRUCTIONS:
PERMIT NUMBER: Permit tracking number by County Health Department.
APPLICATION FOR: Check type of permit; if "Other" specify type in blank.
APPLICANT: Property owner's full name.
TELEPHONE: Telephone number for applicant or agent.
AGENT: Property owner's legally authorized representative.
MAILING ADDRESS: P.O. box or street mailing address for applicant or agent.
LOT, BLOCK, SUBDIVISION or
PROPERTY ID #: 27 character ID number for property. (Health Department may require property appraiser ID# or
section /township /range /parcel number.)
SYSTEM DESIGN AND
SPECIFICATIONS:
TANK: Minimum specifications from Chapter 10D -6, FAC.
DRAINFIELD: Minimum specifications from Chapter 1OD -6, FAC.
OTHER: Other specifications, such as operating permit requirements, low- volume flush toilets, variance provisos.
SPECIFICATIONS BY: Name of individual providing specifications. If designed by a registered engineer must be sealed.
APPROVED BY: County Health Department personnel reviewing and approving permit.
DATE ISSUED: Date permit is issued by County Health Department.
EXPIRATION DATE: One year from date issued if the system has not been installed. Permits for system repairs become void 90 days from the
date issued.