Loading...
749 NE 95 St (7)Permit No q ° �1✓ Amount of Permit $ G L- �^ My Commission M@AMO SHORES VDU, GE PLUMING INSPECTION DEPARTMENT APPLICATION F02 PdUC BV l© PER IT (ste °- (Signed) 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 ordinanoao of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether be ein specified or mat. A copy of approved plans and specifications mud be kept at building during progress of work. Owner's Name and Address �d C' �i � No / l S t Registered Architect and /or EnKirteer - - . Employing Plumber's Name Y". 1 �t we O 1 ..5� -- E49.,2-"°.3S A/ k/ gS` ®f t . ° �`.�.�...... Location and Legal Description Lot. � `/ Blerh Subdivision Street and Number where work is to be performed —No C q 9 N E 9 strea2. _Pi . ! 01 `— ._. - - State work to be performed and purpose of building (By Floor) -_. -._ _._? 2 d U New Building- - - -.._ _------- ...... -• - -- Remodeling —_. __ __ Addition. Repairs Size Septic Tank — Typo of Ti e+ Feet of Drain Tile __Dist. Feet of Tank at Drain Field from Well- . -._ - . - __. Nature of Water Supply: City —Well. sip of Soakage Pie The undersigned applicant for this building permit does herby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5989, Compiled General Laws of Florida Permanent Supplement, and hint 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. so rl 3 6 /(t 2_4v- /// s 3 1_ -3 _x" 3 No. of Stories ...... ........ Notary Public, State of Florida Plumbing Inspector. Mader Plumber. STATE OF FLORIDA, 1 COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take aclmowledgments, personally appeared to me well known, and who, being by me first duly swarm, upon oath dope= and says that he is the - - -- of the above described construction, that be has carefully reed the foregeim 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.t0 will mode whoa reek szetreurraake Pe emir by inipeoper notice fea inspection, ate faulty materials and/at wrod®anahrp. 5 f�INKp SLOP SINKS LAUNDRY TUGS UR INALS CATCH OA[IN FLOOR DRAIN DRINK! NO FOUNT'1411 TOTAL FIXTURE[ [I CLOTa BATH Tuns SHOWERS LAVA• TORIIO CONTR. LIST CN[CK SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAOQ PIT GRRADQ TRAP 6OLAP HATER map 'WELL OPRKLR. OYSTERS SW I m•G POOL I CONTR. LIST �- CHICK Permit No q ° �1✓ Amount of Permit $ G L- �^ My Commission M@AMO SHORES VDU, GE PLUMING INSPECTION DEPARTMENT APPLICATION F02 PdUC BV l© PER IT (ste °- (Signed) 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 ordinanoao of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether be ein specified or mat. A copy of approved plans and specifications mud be kept at building during progress of work. Owner's Name and Address �d C' �i � No / l S t Registered Architect and /or EnKirteer - - . Employing Plumber's Name Y". 1 �t we O 1 ..5� -- E49.,2-"°.3S A/ k/ gS` ®f t . ° �`.�.�...... Location and Legal Description Lot. � `/ Blerh Subdivision Street and Number where work is to be performed —No C q 9 N E 9 strea2. _Pi . ! 01 `— ._. - - State work to be performed and purpose of building (By Floor) -_. -._ _._? 2 d U New Building- - - -.._ _------- ...... -• - -- Remodeling —_. __ __ Addition. Repairs Size Septic Tank — Typo of Ti e+ Feet of Drain Tile __Dist. Feet of Tank at Drain Field from Well- . -._ - . - __. Nature of Water Supply: City —Well. sip of Soakage Pie The undersigned applicant for this building permit does herby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5989, Compiled General Laws of Florida Permanent Supplement, and hint 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. so rl 3 6 /(t 2_4v- /// s 3 1_ -3 _x" 3 No. of Stories ...... ........ Notary Public, State of Florida Plumbing Inspector. Mader Plumber. STATE OF FLORIDA, 1 COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take aclmowledgments, personally appeared to me well known, and who, being by me first duly swarm, upon oath dope= and says that he is the - - -- of the above described construction, that be has carefully reed the foregeim 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.t0 will mode whoa reek szetreurraake Pe emir by inipeoper notice fea inspection, ate faulty materials and/at wrod®anahrp. 5 STATE OF IL RODA EDIT OF HEALTH AND - ;E(1A 'ILITATOVE SERVICES ONSITE SEWAGE DISPOSAL SYSTEM CONSTRUCTION AND MST. = LLATION PERMIT Applic nk Permit Number f5 �0 3 PART II - SYS Ell INSTALLATION INSPECTION AND FINAL INSTJLLTION APPROVAL Installer GF4ai 4 Zn ' C � /fbi ,( e/ Tank Manufacturer // /A Proper tank legend: Yes ° No Tank material iV/ Tank level: Yes Tanks watertight: Yes 00 No Tank size: 4 gallons gallons gallons Proper tank outlet device: Yes No Drainfield Trench Absorption Bed Length Width Length Width Length 3 c' feet x /Q feet= 30 8 ft2 feet feet feet feet Length feet x feet= ft feet feet feet feet Proper No. drainlines: Yes a■o feet feet feet feet Proper pipe separation: Yes Xlo Total = ft Total = ft Distribution box level: Yes Systems located as permitted: Yes I. / No Systems including plumbing stub -outs installed at proper elevation: Yes Average depth to drainpipe invert from finished grade 2 Maximum depth 02 y Inches Average depth of drainfield gravel: /4' inches Minimum depth of gravel: 12- inches Proper gravel size: Yes 11qo Gravel is suitable quality: Yes _J� No Backfill or fill material as required: (Quality) Yes f No (Quantity) Yes i,. Other findings: Inspected by: Date Approved by -41tivo / HRS —H Form 4016, Feb 85 (Obsoletes previous editions which may not be used) (Stock Number. 5744-002-4016-0) PART III - F . L NSTAL ' TOON APPROVAL Manhole or marker to grade: Yes No Date y AN APPROVED INSTALLATION DOES NOT GUARANTEE PERFORMANCE 4 k — C HEALTH UNIT Note: Completed copies of this form will be provided to the applicant, installer and the building department. Page 2 of 2