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PLUMBING4 4c , ,.\ -- 7 mit 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 _____ ank_S „Monroe No. 575 N.E. s street Registered Architect and/or Engineer _____ Employing Plumber's Name ____ ____ Sik lank.. Co,E._0_. B.ax N34.4 all street_ 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 Repairs No. of Stories. .. Size Septic Tank__________ Type of Tank Capacity Gals... Feet of Drain _______________ _ ____ Feet of Tank or Drain Field from Well Nature of Water Supply: City—Well. _Size of Soakage Pit Amount of Permit $__ STATE OF FLORIDA, ss. COUNTY OF DADE. $4 . 00 NOG\MO SNORES VOLLGE PLUMBING INSPECTION DEPARTMENT APPLICAVOM FOR PLUMEIONG PER' AY ( Signed). ( Signed )_ ) Date_ 2-29-72 Subdivision _ Street Plumb g Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his oJliations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5868, 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. My Commission Expires Notary Public, State of Florida / . • Master Plumber. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. NOTE: A re-inspection fee of $1.00 will be made when such re-inspection is made necessary by improper notice for insr n, or faulty materials and/or workmanship. CLOSERS BATH TUBS SHOWERS LAVA- TORIES SINKS SLOP SINKS LAUNDRY TUBS URINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT' N6 TOTAL FIXTURES corm. LIST CHECK SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SW IM'G POOL own:. LIST CHECK 32' -I-- _ 4 4c , ,.\ -- 7 mit 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 _____ ank_S „Monroe No. 575 N.E. s street Registered Architect and/or Engineer _____ Employing Plumber's Name ____ ____ Sik lank.. Co,E._0_. B.ax N34.4 all street_ 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 Repairs No. of Stories. .. Size Septic Tank__________ Type of Tank Capacity Gals... Feet of Drain _______________ _ ____ Feet of Tank or Drain Field from Well Nature of Water Supply: City—Well. _Size of Soakage Pit Amount of Permit $__ STATE OF FLORIDA, ss. COUNTY OF DADE. $4 . 00 NOG\MO SNORES VOLLGE PLUMBING INSPECTION DEPARTMENT APPLICAVOM FOR PLUMEIONG PER' AY ( Signed). ( Signed )_ ) Date_ 2-29-72 Subdivision _ Street Plumb g Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his oJliations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5868, 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. My Commission Expires Notary Public, State of Florida / . • Master Plumber. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. NOTE: A re-inspection fee of $1.00 will be made when such re-inspection is made necessary by improper notice for insr n, or faulty materials and/or workmanship. BUILDING ELECTRICAL PLUMPING Owner of Building . Address of Q` J Building CONTRACTOR OR BUILDER MIAMI SHORES VILLAGE, FLORIDA PERMIT N? 8010 Work to be performed under this Permit . 1 _ .ti,, 1."7 Architect Contractor ) or Builder /. ^ ",6/% Legal Description Value of Project This permit is granted the contractor or builder named above to construct the building or to install the equipment or device described in appli- cation herefor in strict compliance with all ordinances pertaining thereto and w th the understanding that the work will be performed in compliance ith 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. Signed. _� By INSPECTOR In consideration of the issuance to me of this permit I agree to perform the, ork covered hereunder in compliance with all rin ances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authoritie of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servant or employee. Subdi- vision BY DATE �� `r'` 194 t i ractor's L'i`cense No. Amt. of Permit L� AUTHORITY BUILDING ELECTRICAL PLUMBING Owner of Building ArchitT Contra or or Builder Legal Descripti Address of MIAMI SHORES VILLAGE, FLORIDA DATE PERMIT N? 7254 Work to be performed under this Permi ;d`a Bwldulg � � �.— a ' 75 �' .1,-; This permit is gr/nted to the contractor or builder named above t construct the building or to install the equipment f device described in the appli- cation herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be erformed 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 respons �lity or a thorough knowledge a ordinances and regulations pertaining to the work covered hereby whether shown on the plrs-or-draws init ents or specifications a sibility for work done by his agents, servants or employees. Signed � ,l' ' ��� f'' .4 � . F INSPECTOR In consideration of the issuance to me of this permit I agree to pe orm 1 \work covered hereunder in compliance with all ordinances and r pertaining thereto and in strict conformity with the plans, drawings, s tents or specifications submitted to the proper authorities of Miami Shores Village. In accepting this j4 it I assume respon4bility for all work done by eii myself, my agent, servant o r e ployee. i� / ri ,r ' ' � , Qom/ .i e CON OR BUILDER r BY _All„, B1. 6f Subdi- vision Value of Project //- Contractor's License No Pe AUTHORITY 194 at4e respon- BUILDING ELECTRICAL PLUMBING PERMIT N? 7280 Work to be performed under this Permit Owner of Building MIAMI SHORES VILLAGE, FLORIDA DATE Architect Contractor = or Builder Legal Lot Bl. Description Address of Building This permit is granted to the contractor or builder named above to construct the building or to install the equipment or devic p described in the appli- cation herefor in strict compliance with all ordinances pertaining thereto and w th the understanding that the work wil 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. Subdi- vision Value of Project Contractor's License No. d Amt. of Permit l 194 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. Ipaccepting this permit I assume responsibility for- all wprk done by either myself, my agent, servant or employee. CONTRACTOR OR BUILDER BY AUTHORITY Permit No Registered Architect and /or Engineer s i Employing Plumber's Name Location and Legal Description Lot ss. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Date Application i / hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. Owner's Name and Address No Street o Street Block_ Subdivision_ Street and Number where work is to be erformed —No p a 4 Street State work to be performed and purpose of building (By Floors) New Building Remodeling Addition Repairs No. of Stories Size Septic Tank Type of Tank Capacity Gals Feet of Drain Tile Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: City—Well .__ Size of Soakage Pit i Amount of Permit $______�____ (Signed) The undersigned app‘ ant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such sub - contractors, on work to be performed • under this permi as are licensed by Miami Shores Village. _ ($gnettj • Master Plwnber. 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 therein by him stated are true. My Commission Expires Notary Public, State of Florida Plumbing Inspector. 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 �) � -i SINKS SLOP SINKS LAUNDRY TUBS -1 URINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT' NS TOTAL FIXTURES LNT R. CLNT CHECK / ,I - -- - SEPTIC T SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SW IM'G POOL , 9 • 2 , ^ " -� q CONTR. LIST • CHECK Permit No Registered Architect and /or Engineer s i Employing Plumber's Name Location and Legal Description Lot ss. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Date Application i / hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. Owner's Name and Address No Street o Street Block_ Subdivision_ Street and Number where work is to be erformed —No p a 4 Street State work to be performed and purpose of building (By Floors) New Building Remodeling Addition Repairs No. of Stories Size Septic Tank Type of Tank Capacity Gals Feet of Drain Tile Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: City—Well .__ Size of Soakage Pit i Amount of Permit $______�____ (Signed) The undersigned app‘ ant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such sub - contractors, on work to be performed • under this permi as are licensed by Miami Shores Village. _ ($gnettj • Master Plwnber. 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 therein by him stated are true. My Commission Expires Notary Public, State of Florida Plumbing Inspector. 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. BUILDING ELECTRICAL PLUMBING Owner of Building Architect Contractor or Builder ° - .' /- Legal Lot Description Building of `y ;/. ii =„ //. MIAMI SHORES \/11 ■ AGE FLORIDA DATE .`� Co tractor's Lice se No Work to be performed under this Permit PERMIT N? 7370 r i Bl. O Subdi- vision Value of Project 77 e Amt. of Permit 194 vice described in the appli- This permitAs granted to the contractor o .uirde• named above to &instruct the building or to install the equipment or cation herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be per rimed 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'respopsibiiity for a thorough knowledge of =lhe ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in 6 statements or specifications and at he sumes respon- sibility for work done by his agents, servants or employees. �� �� Signed. - >/ , !` /7 i � INSPECTOR ` ' %�'. By � ' ° O 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 r ponsibility for all work done by either myself, my agent, serval or employee. AI 1 �,,� '7 M .' _'1} 4 0 2.44 �� �^ .rte ;�i�..: ;.6'1, '' CONTRACTOR OR BU a v `" -,U , BY ` !e% —,,,--z\s., AUTHORITY MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT i 7 /7 , r Permit No 1' Date Application ii hereby for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. Owner's Name and Address No Street Registered Architect and /or Engineer Employing Plumber's Name No Street Location and Legal Description Lot Block Subdivision„ , - Street and Number where work is to be performed —No. Street_ State work to be performed and purpose of building (By Floors) New Building Remodeling Addition Repairs No. of Stories r r Size Septic Tank Type of Tank ,.-- ,, ^ '.L. 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 Amount of Permit $ (Signed) y STATE OF FLORIDA, ) COUNTY OF DADE. ss. ( Signed) My Commission Expires Notary Public, State of Florida Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida /Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or • sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such sub - contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. / Master Plmnber. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty materials and /or workmanship. CLOSETS BATH TUBS SHOWERS LAVA- TORIES SINKS SLOP SINKS LAUNDRY TUBS URINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT' NS TOTAL FIXTURES CONTR. LIST CHECK SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR, SYSTEM SW IM'G POOL CONTR. LIST CHECK MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT i 7 /7 , r Permit No 1' Date Application ii hereby for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. Owner's Name and Address No Street Registered Architect and /or Engineer Employing Plumber's Name No Street Location and Legal Description Lot Block Subdivision„ , - Street and Number where work is to be performed —No. Street_ State work to be performed and purpose of building (By Floors) New Building Remodeling Addition Repairs No. of Stories r r Size Septic Tank Type of Tank ,.-- ,, ^ '.L. 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 Amount of Permit $ (Signed) y STATE OF FLORIDA, ) COUNTY OF DADE. ss. ( Signed) My Commission Expires Notary Public, State of Florida Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida /Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or • sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such sub - contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. / Master Plmnber. 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. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Permit No 4 a = Date f ErT Application V. 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 a4y' Size Septic Tank O 6 Amount of Permit $ STATE OF FLORIDA, 1 COUNTY OF DADE. s s. Type of Tank J 6 b (Signed). (Signed) No Registered Architect and /or Engineer Employing Plumber's Name No Street Location and Legal Description Lot _ fC y Block �� / Subdivision. 1 44 " 11 " A° < „ 4. Street and Number where work is to be performed —No __/ ___ Street State work to be performed and purpose of building (By Floors) New Building Remodeling Addition Repairs No. of Stories Dist. Feet of Tank or Drain Field from Well Feet of Drain Tile Nature of Water Supply: City —Well Size of Soakage Pit Street Capacity Gals e e My Commission Expires Notary Public, State of Florida The undersigns applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida orkmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has com- plied with the pr visions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such sub - contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. Master Plumber. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. NOTE: A re- inspection fee of $1.00 will be made when such re- in slection 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 HEATER DEEP WELL SPRKLR. SYSTEM SW IM'G POOL CONTR. LIST CHECK MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Permit No 4 a = Date f ErT Application V. 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 a4y' Size Septic Tank O 6 Amount of Permit $ STATE OF FLORIDA, 1 COUNTY OF DADE. s s. Type of Tank J 6 b (Signed). (Signed) No Registered Architect and /or Engineer Employing Plumber's Name No Street Location and Legal Description Lot _ fC y Block �� / Subdivision. 1 44 " 11 " A° < „ 4. Street and Number where work is to be performed —No __/ ___ Street State work to be performed and purpose of building (By Floors) New Building Remodeling Addition Repairs No. of Stories Dist. Feet of Tank or Drain Field from Well Feet of Drain Tile Nature of Water Supply: City —Well Size of Soakage Pit Street Capacity Gals e e My Commission Expires Notary Public, State of Florida The undersigns applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida orkmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has com- plied with the pr visions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such sub - contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. Master Plumber. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. NOTE: A re- inspection fee of $1.00 will be made when such re- in slection is made necessary by improper notice for inspection, or faulty materials and /or workmanship. Permit No m s 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 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 C Registered Architect and /or Engi er Employing Pl ber's Name__ /V/ e P ! AI"- 6° No 3 a / Location and Legal Description Lot Block Street and Number where work is to be performed —No. ' 1J ,/ f State work to be performed and purpose of building (By Floors) _� 0 #1 f - Nature of Water Supply: City —Well C _U AFVI De (4,1 o — Amount of Permit $ STATE OF FLORIDA, COUNTY OF DADE. ss. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT No Street // ( Signed) ( Signed) ___A Date Jul / 7.r - j Street Street Subdivision New Building Remodeling Addition Repairs No. of Stories Size Septic Tank Type of Tank Capacity Gals Feet of Drain Tile Dist. Feet of Tank or Drain Field from Well Size of Soakage Pit Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such sub - contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. ,VL= 74 Ls 7J ft My Commission Expires Notary Public, State of Florida fir. 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. 1, C. 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 HEATER DEEP WELL SPRKLR. SYSTEM SWIM 'G POOL CONTR. LIST CHECK Permit No m s 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 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 C Registered Architect and /or Engi er Employing Pl ber's Name__ /V/ e P ! AI"- 6° No 3 a / Location and Legal Description Lot Block Street and Number where work is to be performed —No. ' 1J ,/ f State work to be performed and purpose of building (By Floors) _� 0 #1 f - Nature of Water Supply: City —Well C _U AFVI De (4,1 o — Amount of Permit $ STATE OF FLORIDA, COUNTY OF DADE. ss. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT No Street // ( Signed) ( Signed) ___A Date Jul / 7.r - j Street Street Subdivision New Building Remodeling Addition Repairs No. of Stories Size Septic Tank Type of Tank Capacity Gals Feet of Drain Tile Dist. Feet of Tank or Drain Field from Well Size of Soakage Pit Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such sub - contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. ,VL= 74 Ls 7J ft My Commission Expires Notary Public, State of Florida fir. 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. 1, C. BATH CLOSETS TUBS SHOWERS LAVA- TORIES SINKS SLOP SINKS LAUNDRY TUBS URINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT' NS S }.0. , e 9 TOTAL F %TURES Camara. LIST H CHECK H �r SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SW IM'G POOL CoNTG. LIST - -- CHECK NM JJ6-5 1% ermir Ne �'`�" �. -___ -- Employing Plumber's Name A Location and Legal Description Lot._____- _______________ Size Septic Tank____- ...... -- Amount of Permit $ STATE OF FLORIDA, } COUNTY OF DADE. 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 not. A copy of approved plans and specifications must be kept at building during progress of work. l Owners Name and Address t ____1__7.t Metz lcf. l___ No._- _ Street__ __..7 5- Registered Architect and /or Engineer _____ ___ ------------- __ - __ -- _ - __- _ No._ NF Street and Number where work is to be performed- No._____ State work to be performed and purpose of building (By New Building------------- ._. - - -. -__ -- . Remodeling Subdivision -_____ -..... - -- - - - Addition Street Repairs No. of Stories. 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 — (Signed) - ---- 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 worn to be performed under this permit, as are licensed by Miami Shores Village. ( Signed )-._- - Date f 2 r- (° Street_____, ,V6 9S s5 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 Plumbing Inspector. Master Plumber. NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made•neoessary by improper notice for inspection, or faulty materials and /or workmanship. 25W MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date oLWO5 Type Insp'n FMA LL c 11 Permit No. I 1 Name CI �iJI) � IId ( t43 Address 5 g. 0 ■ 5 Company f1( JJ�C1��1 Phone # Inspection Date Approved Correction Re- Insp'n Fee 2_51-0 MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date 607_00 Type Insp'n FiAttk 1.61)AR q\ Permit No. 9-7 w's ll 5 ll Name �.6A\)9 `1U *C`r' Address 1) l�� CA >Company Di(i)Vf� \( Phone # 1 Approved Correction Re- Insp'n Fee Inspection Date 6(91-11 )ki Date Type Insp'n Permit No. MIAMI SHORES VILLAGE BUILDING DEPARTMEN 305- 795 -2204 Building Inspection Reque Name ,c- Address • ' l 9 s e Company u)) -- P j Phone # lS q — — `-t`-1 For Inspector: ( I i 1 / r Name & Date Approved Correction Re- Insp'n Fee 0 o Page 2 DO NOT BEGIN ANY WORK WITHIDIX HAWN 3 RECEIVEDYpUR VALIDATED PERMIT AND PERMIT CARD. Applying for a permit does not grant the right to begin construction. H)URS bF CONSTRUCTION afe'lfmited to: Monday through Friday from 7:30 a.m. to 6:00 p.m., and Saturday from 8:00 a.m. to 5:00 p.m. No inspections will be conducted on weekends or holidays. 2. All construction of demolition areask4UST» MiLNT AINED IN A CLEAN, NEAT AND SANITARY CONDITION free from construction debris. 3. STREETS AND NEIGHBORING PI;OPEP f E9 SI4A!•L flE44T EE FROM DIRT AND DEBRIS. 4. SWALES MUST BE PROTECTEI2 FROM aEINO:DAMi4 BeEQUIPMENT OR VEHICLES, AND MAY NOT BE USED FOR STORAGE. A bond is required for work in or near the streedsidewark. • • '.' ; ; ',. 5. CONSTRUCTION TRAILERS ARE PROHIBITED ON SINGLE FAMILY RESIDENTIAL CONSTRUCTION SITES. Other construction may have a trailer which requires a separate permit. 6. PORTABLE TOILETS for a construction site require a separate permit. 7. DO NOT DISCHARGE WATER INTO THE RIGHT OF WAY OR STORM DRAINS without approval from the Building, Planning and Zoning Department. 8. EQUIPMENT AND MATERIALS SHALL BE STORED at least 10 feet from the edge of pavement. 9. Department of Health and Rehabilitative Services (HRS) approval is required for applications involving septic tanks. Department of Environmental Resources Management (DERM) and/or Miami -Dade Water and Sewer Department (MDWASD) approval is required for applications involving sewers. IMPORTANT NOTICES AFFIDAVIT - Please read carefully. Application is hereby made to obtain a permit to do work and installation as indicated. I, the OWNER of the property, 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, POOL, EXTERIOR DOOR, MECHANICAL, WINDOW, FENCE, DRIVEWAY, ROOFING and SIGNS and there may be additional permits required from other governmental agencies. I, the OWNER of the property, have disclosed all information related to any work at the property performed in the prior twelve months to the Building Official. Further, I am fully aware that if the cumulative cost of work to my home or business under this and any other permit equals or exceeds fifty percent (50 %) of the fair market value of the structure, the entire structure must meet the present federal flood criteria for finished floor elevation. I am also fully aware that if the total cost of work to my home or business under this and any other permit exceeds fifty percent (50 %) of the replacement cost of the structure, then the entire structure must conform to the current code requirements of the Building Code. WARNING TO OWNER: Your failure to record a NOTICE OF COMMENCEMENT may result in you paying twice for improvements to your property. If you are spending more than $2,500 or intend to obtain financing, you may wish to consult with your attorney or lender before recording your Notice of Commencement. The Notice of Commencement must be recorded at: 22 N.W. 1st Street, P' Floor, (305) 679 -1078. Once recorded, the Notice of Commencement must be POSTED AT THE JOB SITE in accordance with Section 713 -35 of Florida Statutes. Review the brochure at Village Hall on Construction Lien Law and Choosing a Contractor. STATE OF FLORIDA, COUNTY OF MIAMI -DADE 5 Signature of Print Name Sworn to and subscribed before me this 0 27 day of FDA . Signature of Notary Public - State of Florida SEAL: `PEY PUd OFFICIAL O ARLENE 0 ROSNER v tV ; » COMMISSION NUMBER S1 �'e ; a < 00058667 4, � OF F 1, l MY COMMISSION EXPIRES r � p OCT. 12.2005 Personally known V • • • • • ... • . • • •.. • • • • • • • ...... • OR, Produced Identification • S ST •.Y_ OF ORID Signature of Contractor / Qualifier / Print Name Sworn to and subscribed before me this a 7 day of ,2 4,03 Signature of kfrst. y Ruhlir - state of Florida 0 aF v e/ OFFICIAL NE D l SEAL: • - • COMMISSION NUMBER 4 ova. < 00058687 "T F`Op MY COMM ISSON EXPIRES OF OC, f. 12.2005 PERMIT APPLICATION F MIAMI -D c%�lA e / ,e 51°4(q L . G 4 Personally known OR, Produced Identification Type of Identification Produced: Type of Identification Produced: CONTRACTOR Name ( ///Q5 ,h1 7 ( License No. (.9,9i../0 i 90 / X Address 1470$ 51.4.1 $ I/ fyt �eerne e ,Uor Lau der oole 3e68 �C3 Telephone q592/;'62S q q Fax 95v-7/8 _696w Qualifier Name g /_ £ „5 _/ PROPERTY OWNER Name /'IJ�JT/1vp /5hei q LDpez. Address 575 /l r q * 5 rill orn here 5 FL 33 /94 7 23/ Home Telephone 3O5 , ? , $),2_,-.-- a .7997 Business Telephone Fax TYPE OF MANAGEMENT (✓ ) New Construction Enclosure Alteration Exterior Repair Alteration Interior Demolish Relocation of Structure Shell Only Foundation Only Add'l Attachment Other Add'l Detachment Other INSTRUCTIONS - The following steps must be taken to obtain a permit from the Miami Shores Village: Step 1. Complete the attached permit application which must be signed by thaproparty:ownes ai i arifier. $oth signatures must be notarized. Please print or type to allow for a more accurate processing of your applicatidlL donepa roofing application must be submit- with this permit application. ' g P ••' • • '.'. • • • ted along •• Step 2. ,Submit the completed application with all necessary documents to the Building, Planning and Zoning Department for processing. During the processing of your application, you may be asked to submit additional information. APPLICATION Job Address: 5 AIF 95 fJ'1t 5haieS FL Folio Number 1 1 -- ' 34176_ t')/ 1— 0760 Lot a2 Block 5 Address Apt. City Subdivision PB PG Current Use of Property Proposed Use of Property Tenant Information PERMIT TYPE (✓ ) Building Electrical Mechanical Plumbing LPGX Roofing Fence Other PERMIT CHANGE (✓ ) Chg. Contractor Renewal Revision Extension Supplement Reinspection ARCHITECT Name License No. Address Telephone Fax • • • • • • • • ••• • • • • • • • • • • • • ••••••• : • : • PERMIT APPLICATION Master Permit No. ) to • Subs�c�ia y Per> 1iL No :: '. • •. ..•• •.• • • • - 33/38 -a?3/ State Zip Description of Work 7 O l r' / ` ✓fi g // /x//2 O/'R/;),5 Linear Feet Zoning Square Feet Units Floors Value of Work 500 / Qt Bldg Value Tax Assessed/Appraised Value Flood Zone Base Floor Elev. ENGINEER Name License No. Address Telephone Fax Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Printed: 3/4/2003 Applicant: GUSTAVO & SHEILA Owner: LOPEZ JOB ADDRESS: 575 NE 95 Contractor MARS POOL Local Phone: 954 - 214 -2844 Parcel # 1132060140760 IITJkk n C/ D.O Total Fees: 46790 $0.00 Total Receipts: Permit Status: APPROVED Permit Expiration: Work: POOL PIPING & MAIN DRAINS If there is no permit package accessible on the job -site for inspectors to verify, there will be no inspections. Re- inspection Security enhanced MARS POOLS'INC. j \ . j1000 E ATLANTIC`BLVD, STE 11'. , • /. POMPANO. BEACI -t FL 33060 :, ,,1954-946-4596.,, .' 't b See hack for detail DATE e2 7 7/a Do 61 1.014 63- 8376/2670 021 'DOLLARS e,t°' PAY7 TO THE, ORDER OF FOR ankAt /antic 61 Legal Description: MIAMI SHORES SEC 2 PB 10 -37 LOT 22 & W1/2 OF 23 BLK 54 LOT SIZE 75.000 doe U .1 e n .• Plumbing Permit Permit Number: PL2003 -64 8/31/2003 LOPEZ GUSTAVO & SHEILA ST Contractor's Address: 1908 SW 84 TERR Construction Value: ie $500.00 . ..'; "Tamarac #021 %• 5600 N. Unlverstly Dr. • . Tamaroc�351 Z i41,1 opez • 0055 ?.2 ?9011' , 1 �...- .•..+.• ;ew- Sa-r raw. .tsax: ∎.. �> �Y , •- c -. t: irc6�msc'+.L.[4ti¢ c air ;.is tT.mamrs -%. 3om'i =? m>t- ai�a_�c Fmnui �i kar�v'r antroaG.m..fa v7i1S_Fi imwmr: -rani ra Page 1 of 1 ation herefor in strict compliance with all cations that may have been submitted to or if the plans are changed without Dnsibility for a thorough knowledge of the at he assumes responsibility for work done is pertaining thereto and in strict conformity ssponisibility for all work done by either ELECTRICAL TYPE Minimum Fee ()Ty. TYPE Dryer &yrY . Outlet;A:rp mace. • • • • • • • Q .,. Y , _ • - ' .: Service Repair Q1 ' 1 ' A/C Central 1 -3 Ton Cooling Tower Fan Heating Strips, each Outlet, Waif • • Vent Hood, Cost Service, Temporary A/C Central 4 -7 Ton Fire Pump Outlet, Switch Air Handler, Tons Signs Ductwork, Cost of A/C Central 8 -15 Ton Piping, Flammable Liquid Fixture - Fluorescent Periodic Inspections Oven Space Heater (kw) A/C Central 16-20 Ton Fixture Light Bath Fan - Vented, # Parking Lot Lights Fireplaces, Number of Spas/Hot Tubs Pressure Vessel A/C Central 20+ Ton Flood Lights Plugmold/Strip Subfeeds, No. of Amps A/C Window FPL - Load Central Posts Swim Pool, Commercial Air Conditioners Garbage Disposal Range/Range Top Swim Pool, Residential Chiller Generators, etc. Receptacles Switchboards Clear Violations Heat Recovery Refrigerator, Comm. (p/PH) Temp Serv., Construction Compactor Low -volt, Burglar Refrigerator, Domestic Temp for Test - 30 days Deep Freezer Low -volt, Fire Renew - Temp Service Water Closet Demolition Low -volt, Intercom/Teleph. Repair Circuits Water Heater Dishwasher Low -volt, Television Service, Number of Amps Water Heater New MECHANICAL TYi,l.: Minimum Fee QTY. Typl, Condensate Drain QTV. "NIT Generator QTY • Refrigeration, Tons A/C Central, Tons Bath Tub Cooling Tower Drinking Fountain Heating Strips, each Miscellaneous Repairs Vent Hood, Cost A/C Wall/Win. Tons Dryer Vents, Number of Paint Booth Ventilation, Cost Air Handler, Tons Sprinkler Repair Ductwork, Cost of Cap - Fixture Piping, Flammable Liquid Fountain Periodic Inspections Barbecue Fire Sprinkler System Process/Pressure Piping Gas - Appliance Bath Fan - Vented, # Pump, Domestic Fireplaces, Number of Supply, AC Well Pressure Vessel Cap - Sewer PLUMBING - FITS A/C Condensate Qi'V .1.Y.pp Drains, Roof QTy .1.x.1,1•: Miscellaneous Fixture (?.1.l. .1.x.1,1.: Soakage Pit `lTy. Bath Tub Drinking Fountain Miscellaneous Repairs Solar Water Heater Bidet Filter Replace Pool Piping / Sprinkler Repair Cap - Fixture Fountain Pump and Abandon Sprinkler System Cap - Water Gas - Appliance Pump, Domestic Supply, AC Well Cap - Sewer Gas - Natural Pump, Fire Stand Temporary Toilet Catch Basin Gas - Propane Pump, Re- circulate Temporary Water Closet Clothes Washer Gas Piping Pump, Replace - Pool Urinal Dental Chair Grease Trap Pump, Sprinkler Utility - Sewer Discharge Well Ice Maker Pump, Sump Utility - Water Dishwasher Indirect Wastes Relay Repair Vacuum Pump Disposal Interceptor Roof Inlet Water Closet Domestic Well Laundry Tray Septic Connection Water Heater Drainfield, 4" Tile/Res. Lavatory Septic Tank Water Heater New Drains, Area Meter Set (Gas) Sewer Connection Water Re -pipe Drains, Floor Minimum Fee Shower Water Service Drains, French Miscellaneous Equipment Sink Well, Supply Page 3 • a • • • • • • • • ••• • • • • • • • • • • • • • • • •• • • • • • : •: • PERMIT APPLICATION •• • • • • • • INSTRUCTIONS: Please indicate the type of work being perforwed and quDttty(iel) Sn.the space provided below. • - RECEIVED AND REVIEWED BY: DATE: SECTION BY DATE Zoning Electrical Mechanical Plumbing 0 2- - ID' 0 3 Fire Public Works Structural Building Official Page 4 OFFICE USE ONLY • ❑ OWNER - BUILDER FORM (Attach) O FIRE DEPARTMENT • • APPROVAL (Commercial / • • multi - family) ❑ CONCURRENCY (New Construction) ❑ OTHER (Specify & Attach) ••• • • • • • • • • • .•• • • •• • • • • • • • ••• • • • • • • • • • • • • • •• • • • . • CHECKLIST • O PROOF OF OWNERSHIP (Attach) ••• •• • • • •• • • • q IMR€ tope APPROVAL • • • • • (septic•/ Sewer) ❑ IMPACT FEE (New Construction) ❑ OTHER (Specify & Attach) PERNII'f FEES $3.00 per page (Scanning Fee) $ Miami Shores Village Bond Metropolitan Dade County (C.C.F.) Inspector State Educational Fund $ State DCA (Radon) Code Enforcement Fine $ Zoning Review Notary ISSUING OFFICIAL REVIEWED AND PREPARED BY: (s .6. x/1000 x (¢.005 /sq.ft.) (¢.01 /sq.ft.) PERMIT APPLICATION ❑ CONDO ASSOCIATION APPROVAL (Attach) ❑ BPR APPROVAL (Restaurants) ❑ CONTRACTOR REGISTRATION (On File) TOTAL $ c D -> DATE: CONDITION OFAPPRO\AL Revised July 2001 10050 N.E. 2ND AVE., MIAMI SHORES, FL • (305) 795 -2207 • FAX (305) 756 -8972 • http : / /www.miamishoresvillage.com Type Insp'n Permit No. Name Address Company Phone # MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Re Date /3 - c 3 Time For Inspector: d Approved Correction Re- Insp'n Fee ❑ 1 2//- 2S ate MIAMI SHORES VILLAGE BUILDING DEPART 305- 795 -2204 Building Inspection Req D a 3 )7 )i; Time Type Ins p' P Permit No.2 003- K) 7 Name Address 5 in, 6, c( Co . any Phone # For Inspectors Approved Correction Re- Insp'n Fee Date X Type Insp'n Permit No. Nam Address 1 Company Phone # For Inspector: MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Approv Correction Re- Insp'n Fee