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711 NE 94 St (3)UILDING ' :LECTRICAL 'LUMBING :OOFING )wrier of wilding PERMIT N° 3853 D Irchitect ontractor )r Builder .egal Lot )ascription address of wilding CONTRACTOR OR BUILDER MIAMI SHORES VILLAGE. FLORIDA DATE 195 Contractor's License No. Work to be performed under this Permit Bl. Subdi- vision Value of Project $ Amount 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 ierefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans, rawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any me 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 ranted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations .ertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes responsibility for work one by his agents, servants or employees. 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 •ertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In ac- epting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. BY AUTHORITY ate. 4illge of Miami Shores JOB ADDRESS E-a 0 c= - S 7 /( /U - 91 INSPECTION TIME RE kDY REMARKS 0 INSPECTOR N9 4656 a e:, k- -eAt", DATE f Jqo5 MOAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Date... _ Permit o _— 2�_ �°..— _..._.— 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. - ff� Q ;71 Owner 6 s Name and Address 1 /10"9 7 " 4 y 1/4-11;6 7 1 i ` A 6 e' Street_..— ' 7 J Registered Architect and /or Engineer E n ,l 1 i t N77.4 'ip �e _ _ ��� T >K _ �. . f . 6 0 ._...�.. sure[ et Location and Legal Description Lot.. � t /i Bk 1 / Subdivision /& Street and Number where work L to be performed —No // N ` � ' Street. .9 State work to be performed and purpose of building (By Floors)__. _G __. ....D44'.N. New Building_.___._ _ _..- .........._.. Remodeling_._—_ - -- Addition.- - _.— ......__ Repairs t' No. of Stories Size Septic Tank_ .� _Type of Tangy _._.------ ..----- •. - -_ - -- Capacity Gal,..•_--- - Feet of Drain Tile ,q0 D -i-sn Feet of Tank or Drain Field from Well . Nv -- Nature of Water Supply: City —Wells Size of Soakage Pit Amount of Permit $ k5'° od Signed My Commission Expires Notary Public, State of Florida aster Plumber. 3 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 5988, Compiled General Laws of Florida Permanent Supplement, and Itur com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the worlr 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 err required by the Act. The undersigned agrees to employ only such sub- contractors, on to be performed under this permit, as are lionised by Miami Shores Village. STATE OF FLORIDA, I ea. 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 be has carefully read the foregoing application, and that be 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 wt snob Meapsotlae is moos nscomery by Improper nodes for inspection, or faulty materials and /or wrork®anahip. CLOSETS BATH TUBS SNOwtRS LAVA- TORIES SINKS SLOP RINK[ LAUNDRY TU[e RINALS BAN BASIN FLOOR DRAIN NKINO FO FOVNT'NS TOTAL FIXTURES CONTII. LIST CHICK SEPTIC TANK SKY/KR CONN. DRAIN FIELD SPAKAO[ PIT GREASE TRAP SOLAR NEATER Mar WILL a SYSTEM SW /M•O POOL CONTR. LIST r- CN[CK f Jqo5 MOAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Date... _ Permit o _— 2�_ �°..— _..._.— 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. - ff� Q ;71 Owner 6 s Name and Address 1 /10"9 7 " 4 y 1/4-11;6 7 1 i ` A 6 e' Street_..— ' 7 J Registered Architect and /or Engineer E n ,l 1 i t N77.4 'ip �e _ _ ��� T >K _ �. . f . 6 0 ._...�.. sure[ et Location and Legal Description Lot.. � t /i Bk 1 / Subdivision /& Street and Number where work L to be performed —No // N ` � ' Street. .9 State work to be performed and purpose of building (By Floors)__. _G __. ....D44'.N. New Building_.___._ _ _..- .........._.. Remodeling_._—_ - -- Addition.- - _.— ......__ Repairs t' No. of Stories Size Septic Tank_ .� _Type of Tangy _._.------ ..----- •. - -_ - -- Capacity Gal,..•_--- - Feet of Drain Tile ,q0 D -i-sn Feet of Tank or Drain Field from Well . Nv -- Nature of Water Supply: City —Wells Size of Soakage Pit Amount of Permit $ k5'° od Signed My Commission Expires Notary Public, State of Florida aster Plumber. 3 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 5988, Compiled General Laws of Florida Permanent Supplement, and Itur com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the worlr 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 err required by the Act. The undersigned agrees to employ only such sub- contractors, on to be performed under this permit, as are lionised by Miami Shores Village. STATE OF FLORIDA, I ea. 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 be has carefully read the foregoing application, and that be did sign the same, and that all facts therein by him stated are true. NOTE: A re-inspection fee of $1.00 will be made wt snob Meapsotlae is moos nscomery by Improper nodes for inspection, or faulty materials and /or wrork®anahip. Installer Other findings: Inspected by STATE OF FLORIDA DEPARTMENT OF HEALTH AND REHABILITATIVE SERVICES ONSITE SEWAGE DISPOSAL SYSTEM CONSTRUCTION AND INSTALLATION PERMIT Applicant 4 7. 14 be_s- 2/1 41 9.s27 PART II - SYSTEM INSTALLATION INSPECTIO 0�✓, WA. Proper tank legend: Yes Tanks watertight: Yes es✓ f No Proper tank outlet device: Length width feet feet feet feet feet feet Total = ft Tank size gallons gallons allons Manhole or marker to grade: Yes No Absorption Bed Length width Length 33 .' feet x y. 7$ feet = ft feet feet Length feet x feet= ft feet feet Proper No. drainlines: Yes feet feet Proper pipe separation: Yes Total = ft Distribution box level: Yes Ai Yes____ No Drainfield Trench Systems located as permitted: Yes t� No Systems including plumbing stub -outs installed at proper elevation: Yes No Average depth to drainpipe invert from finished grade: e 9 inches Maximum depth Average depth of drainfield gray l: 11., inches HRS —H Form 4016, Feb 85 (Obsoletes previous editions which may not be used) (Stock Number. 5744-002-4016-0) Tank material Pe ember r AND FINAL INSTA PA PROVAL Tank Manufacturer Tank level: Yes Minimum depth of gravel /2- inches Proper gravel size: Yes `-" No Gravel is suitable quality: Yes c/ - No Backfill or fill material as required: (Qu. lit ) Yes (/No (Quantit , Yes No Date Inches PART III - IN T TION APPROVAL Date Approved by: Irs S COUNTY PUBLIC HEALTH UNIT AN APPROVED INSTALLATION DOES NOT UARANTEE PERFORMANCE Note: Completed copies of this form will be provided to the applicant, installer and the building department. 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