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720 NE 94 St (10)CONTRACT R New Construction ' .,�1� Name S c . ■ � j�j �/J� +- i` < r 2 License N 4� n m r `� Repair Business Telepbolfe Addres /2?-dN /5T Fax ...----"! Telephone S '' / X Fax G Relocation of Structure O t p ? U Qualifier Nam 7, vI ii Foundation Only PROPERTY OWNER New Construction Name I ✓, Address 7ao Ng 9945( Alteration Exterior Home Telephone Repair Business Telepbolfe Alteration Interior Fax Demolish TYPE OF MANAGEMENT (✓ ) New Construction Enclosure Alteration Exterior Repair Alteration Interior Demolish Relocation of Structure Shell Only Foundation Only Add'l Attachment Other Add'I Detachment Other INSTRUCTIONS - The following steps must be aken to obtain a permit from the Miami Shores Village: Step 1. 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. . 24-0 j)6 9 'r d –S45. Address /� / Apt. City State Folio Numb / l / - ..3 601 0/ / �'-• 1 700 V Description of Work Lot / Block 6 5 Subdivision /�/jyy� I 4 S/ .$ 3 PB PG Zoning Linear Feet Current Use of Property Square Feet U I,jnits Floors Proposed Use of Property Value of Work c ,)-; -. 66 ,, Bldg Value Tenant Information Tax Assessed/Appraised Value Job Address: Complete the attached permit application which must be signed by the property owner and qualifier. Both signatures must be notarized. Please print or type to allow for a more accurate processing of your application. If roofing work will be done, a roofing application must be submit- ted along with this permit application. PERMIT TYPE (✓ ) Building Electrical Mechanical Plumbing LPGX Roofing Fence Other ARCHITECT • Name License No. Address Telephone Fax PERMIT CHANGE Ch: Contractor Renewal Revision Extension Supplement Reinspection (✓) PERMIT APPLICATION Master Permit No. P 1 ' a 3 Subsidiary Permit No. Zip 4i /L4 > Flood Zone Base Floor Elev. ENGINEER Name License No. Address Telephone Fax Page 2 _ PERMIT APPLICATION IMPORTANT NOTICES 1. DO NOT BEGIN ANY WORK WITHOUT HAVING RECEIVED YOUR VALIDATED PERMIT AND PERMIT CARD. Applying for a permit does not grant the right to begin construction. HOURS OF CONSTRUCTION are limited 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 areas MUST BE MAINTAINED IN A CLEAN, NEAT AND SANITARY CONDITION free from construction debris. 3. STREETS AND NEIGHBORING PROPERTIES SHALL BE KEPT FREE FROM DIRT AND DEBRIS. 4. SWALES MUST BE PROTECTED FROM BEING DAMAGED BY EQUIPMENT OR VEHICLES, AND MAY NOT BE USED FOR A bond is required for work in or near the street/sidewalk. 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. Departmeiit of Environmental Resources Management (DERM) and/or Miami -Dade Water and Sewer Department (MDWASD) approval is required for applications involving sewers. 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, 1°` 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. • , t!% . u .i ST Pri nt N ame F FLOR gnature of Owner LINTY OF MIAMI -DADE ' ( ' 7 Sworn to and subscribed before me this , ( day of 7 gnature j Notary Pub ' State of orida r o Angela M Becker My Commission DD150048 00 Expires November 15, 2006 Personally known OR, Produced Identifi cation �� L Type of Identification Produced: 1 ''w 7 'O 1 /04-° ¢ R / /- SEAL: STATE OF Signature Print Name Sworn nd subscribed before me this AeM afore o . ry Public Sta of onda 1er rL Angela M Becker My Commission D0 150048 V Expires November 15, 2008 SEAL: Personally known v OR, Produced Identification Type of Identification Produced: ELECTRICAL TYPE QTY. 'fYI'L TYPE Drains, Roof QTY. TYPE QTY. 'f\PI: Q'I'Y. Minimum Fee QTY. Dryer Outlet, Appliance Service Repair A/C Central 1 -3 Ton Fan Outlet, Wall Service, Temporary A/C Central 4 -7 Ton Fire Pump Outlet, Switch Signs A/C Central 8 -15 Ton Fixture - Fluorescent Oven Space Heater (kw) A/C Central 16 -20 Ton Fixture Light Parking Lot Lights Spas/Hot Tubs 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 Septic Connection Demolition Low -volt, IntercomPleleph. Repair Circuits Septic Tank Dishwasher Low -volt, Television Service, Number of Amps Sewer Connection MECHANICAL "fVPF QTY. TV'1'E Minimum Fee Condensate Drain QTY. TYI'li QTY. TYPI'. QTY. TYPE Drains, Roof QTY. Generator QTY. Refrigeration, Tons QTY. A/C Central, Tons Cooling Tower Heating Strips, each Vent Hood, Cost A/C Wall/Win. Tons Dryer Vents, Number of Paint Booth Ventilation, Cost Air Handler, Tons Ductwork, Cost of Piping, Flammable Liquid Periodic Inspections Barbecue Fire Sprinkler System Process/Pressure Piping Sprinkler System Bath Fan - Vented, # Fireplaces, Number of Pressure Vessel Pump, Domestic PLUMBING TYPE A/C Condensate QTY. TYPE Drains, Roof QTY. TYPE. Miscellaneous Fixture QTY. 1 'YI'1 ; Soakage Pit QTY. 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 W Closet Domestic Well aundry Tray Septic Connection ater Heater Drainlield, 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 PERMIT APPLICATION INSTRUCTIONS: Please indicate the type of work being performed and quantity(ies) in the space provided below. RECEIVED AND REVIEWED BY: DATE: Page 4 OFFICE USE ONLY CHECKLIST ❑ OWNER - BUILDER FORM (Attach) ❑ FIRE DEPARTMENT APPROVAL (Commercial / multi - family) ❑ CONCURRENCY (New Construction) ❑ OTHER (Specify & Attach) PERMIT 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 Cl PROOF OF OWNERSHIP (Attach) ❑ HRS / DERM APPROVAL (Septic / Sewer) ❑ IMPACT FEE (New Construction) Cl OTHER (Specify & Attach) s30 za iA'() ISSUING OFFICIAL REVIEWED AND PREPARED BY: DATE: SECTION Zoning Electrical Mechanical Plumbing Fire Public Works Structural Building Official BY DATE (s . t. x/1000 x (¢.005 /sq.ft.) (¢.01 /sq.ft.) PERMIT APPLICATION ❑ CONDO ASSOCIATION APPROVAL (Attach) ❑ BPR APPROVAL (Restaurants) ❑ CONTRACTOR REGISTRATION (On File) TOTAL 1136,F0 s/t.'m(7Ias.—w CONDITION OF APPROVAL Revised July 2001 10050 N.E. 2ND AVE., MIAMI SHORES, FL • (305) 795 -2207 • FAX (305) 756 -8972 • http : / /www.miamishoresvillage.com APPLICANT: AGENT : . 0 9 12.__✓ / / 7 / PROPERTY ADDRESS: /2 I , ' t / %. < �`� LOT: / t J BLOCK: } SUBDIVISION: / t.. .r; ryr PROPERTY ID # CHECKED [X] ITEMS ARE NOT XS COMPLIANCE BITE STATUTE TANK INSTALLATION [ 1 [01] TANK SIZE [1] / D . [2] .- [ [ ] (02] TANK MATERIAL S' �, -> , ,,,x -, , ,, [ [ ] [03] OUTLET DEVICE ` [ [ ] [04] MULTI - CHAMBERE[ Y / N ] [ [ 1 (05] OUTLET FILTER - .b A-> f [ [ 1 [06] LEGEND J 7 - / 3 - c') ,7- a /1 [ [ ] (07) WATERTIGHT ;�,, / J [ [ ) (08) LEVEL 7p.-e,,, c -- [ [ ) [09] DEPTH TO LID 1 1 1 1 l 1 1 1 1 1 1 1 DRAINFIELD INSTALLATION [10] [11] [12] [13] [14] [15] [16] [ [18] [19] [20] [21] CONSTRUCTION PROVED/ FINAL SYSTEM( (APPROVED STATE OF FLORIDA DEPARTMENT OF REALM ONSITE SEWAGE TREATMENT AND DIPOSAL SYSTEM[ CONSTRUCTION INSPECTION AND FINAL APPROVAL tc a _�+ �.4 -L/y �• f / - ?' // . • 2 y` .-. AREA [ 1142 XR '[ 2 ] SC' OSQFT / DISTRIBUTION BOX HEADER ✓ NUMBER OF DRAINLINES _ 4 J [ DRAINLINE SEPARATION _7 6 - DRAINLINE SLOPE DEPTH OF COVER/2 ELEVATION [ABOVE/ LBELEW] BM [ SYSTEM LOCATION [ DOSING PUMPS /V) ✓�, [ AGGREGATE SIZE ..yt 5; [ AGGREGATE EXCESSIVE FINES /�,[ AGGREGATE DEPTH / -- [ [ .[ FILL / EXCAVATION MATERIAL [22] FILL AMOUNT—_Z / [23] FILL TEXTURE [24] EXCAVATION DEPTH [25] AREA REPLACED [26] REPLACEMENT MATERIAL DH 4016, 10/97 (Previous Editions May Be Used) 1 1 1 1 l 1 1 1 l PERMIT NO. O3 - x O 7 % / DATE PAIN FEE PAID: RECEIPT #: /1- 3).O4 / :r ' ' (1 OR RULE AND MUST BE CORRECTED. ========_=== SETBACKS [27].. SURFACE - WATER [28] DITCHES (29] PRIVATE WELLS- [30] PUBLIC WELLS FILLED / MOUND SYSTEM [36] DRAINFIELD COVER [37] SHOULDERS [38] SLOPES [39] STABILIZATION l [31] IRRIGATION WELLS 7 S' [32) POTABLE WATER LINES i (33.] BUILDING FOUNDATION [34] PROPERTY LINES [ OTHER . ADDITIONAL INFORMATION [40] UNOBSTRUCTED AREA [41] STORMWATER RUNOFF [42] ALARMS [43] MAINTENANCE AGREEMENT [44] BUILDING AREA [45] LOCATION CONFORMS WITH [46] FINAL SITE GRADING [47) CONTRACTOR [48] OTHER ' ,m+, '� c �• -, SITE ABANDONMENT ] [49] TANK PUMPED 2 ] (50] TANK CRUSHED A FILLED 7. PT 1: Applicant PT 2: Installer /Contractor PT 3: Building Department PT 4: Health Department S Cl Y ?' I FT FT FT FT FT FT FT FT FT PLAN yr Off. EXPLANATION OF VIOLATIONS / REMARKS: 1 1 BAPPROVED] s ✓�.F, >Y� c�- -!� �..._, CHD DATEs,? " �� -d .7 I BAPPROVED ] Y ' t- DATE : - 2 2 — Page 2 of 3 FLORIDA DEPARTMENT OF HEALTH 3 ° tea -03 ROVED . 4 (305) 513.3459 - ,�..,.� ```� Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Printed: 3/20/2003 Applicant: CAROL Owner: HOUSTON JOB ADDRESS: 720 NE 94 Contractor BOBS SEPTIC & DRAIN INC Local Phone: 305 - 558 -5818 Parcel # 1132060141700 Permit Status: APPROVED Permit Expiration: tcnnuacaor or owner) Plumbing Permit Permit Number: PL2003 -80 HOUSTON CAROL ST Contractor's Address: 1020 NE 130 ST Legal Description: MIAMI SHORES SEC 3 PB 10 -37 LOTS 14 & 15 8/12/2003 Construction Vali $2.500.00 I1 FOR BOB'S SEPTIC & DRAIN, INC. 1020 NE 130TH ST. PH. 305 -558 -5818 NORTH MIAMI, FL 33161 -4211 PAY TO THE ORDER OF 7)2 ! / 77 c tibank° c 6 445 i ' / /-49. DATE s 33'680 LLARS 8 TIBANK, F.B.B. BR. 037 VE rOULEVAR ` O ` � 70 -V' _ ' � �' / J 11'00559311' - In 266086554 2 LO 270606911' 5593 63- 865537 2660 BY: Page 1 of 1 BLK 65 LOT SIZE 100.000 X Fees: FEE2003 -1674 FEE2003 -1675 FEE2003 -1676 FEE2003 -1677 Description Builder's Bond CCF Notary Fee Building Fee Total Fees: Amount $300.00 $1.80 $5.00 $160.00 $466.80 Total Fees: $466.80 Total Receipts:. $0.00 :e- inspection ration herefor in strict compliance with all ications that may have been submitted to or if the plans are changed without onsibility for a thorough knowledge of the iat he assumes responsibility for work done Is pertaining thereto and in strict conformity asponisibility for all work done by either CONSTRUCTION PERMIT FOR: ' [ )New System [ ]Existing System ( X ]Repair [ ]Abandonment APPLICANT: ',erase, Guillermo & Silvia PROPERTY STREET ADDRESS: 720 NE 94 St Miami FL 33138 LOT: 14 BLOCK: 65 PROPERTY ID #: 11 -3206- 014 -1700 SYSTEM MUST BE CONSTRUCTED IN ACCORDANCE WITH SPECIFICATIONS AND STANDARDS OF CHAPTER 64.E -6,FAC DEPARTMENT APPROVAL OF SYSTEM DOES NOT GUARANTEE SATISFACTORY PERFORMANCE FOR ANY SPECIFIC TIME PERIOD. 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. ISSUANCE OF THIS PERMIT DOES NOT EXEMPT THE APPLICANT FROM COMPLIANCE WITH OTHER FEDERAL, STATE OR LOCAL PERMITTING REQUIRED FOR PROPERTY DEVELOPMENT. SYSTEM DESIGN AND SPECIFICATIONS T A K D R A I N F I E L D [ [ [ 03/15/2003 11:55 3055133472 STATE OF FLORIDA .- CENTRAX t'' 13 -86 -15875 • DEPARTMENT OP HEALTH ' DATE PAID: =SITE SEWAGE TREATMENT ANI )ISPOSAL SYSTEM FEB PAID : $ _ CONSTRUCTION PERMIT ' ; - g r l:n _ RECEIPT OSTDSNBR: : 03 -0791- -R 900 ]Gallons SEPTIC TANK 0 ] Gallene 0 ]GALLONS GREASE INTERCEPTOR CAPACITY 0 ]GALLONS DOSING TANK CAPACITY [ 0 ]GALLONS @ ( 300 ]SQUARE 0 'SQUARE TYPE SYSTEM: CONP I CURATION : SPECIFICATIONS BY: tcaaa, Carlos APPROVED BY Iease, Carlos DATE ISSUED: 3/14/03 OSTDS SUBDIVISION: Miami Shoran Sec 3 [Section/Township/Range/Parcel No.] [OR TAX ID NUMBER] ]Temporary FEET PRIMARY DRAIN'IELD SYSTEM FEET SYSTEM [ ]STANDARD ( N ] FILLED N ]TRENCH [ l BED LOCATION TO BENCHMARK: Top of Bottom ELEVATION OF PROPOSED SYSTEM SITE [ 1.5 ] [ FEET BOTTOM OF DRAINPIELD TO BE [ 4.0 ) [ FEET FILL REQUIRED: [ 0.0 ]INCHES EXCAVATION rr]QUIRED : OTHER REMARKS: permit is not for addition(s). *Replace existing broken septic tank by a new 900 g1. C -2 outlet filter. *Install 300 sq.ft. of drainfiald. *Invert elevation to be no lase than 8.30' NGVD. *Bottom elevation to be no leas than 7.80' NGVD. DH 4018, 03/97 (Obsolete° previous editiOne which may not be used) (stook Number, 5744- 001.4016••0) [nwkal. :one 6C•lf - 1! ]Holding Tank [ ] Innovative Other [ NA PAGE 01 AGENT: SR0921116, PARILLA ROBERT Floor 11.80' NGVD. TITLE: TITLE: Engineer I MULTI-CHAMBERED/IN SERIES: [Y MULTI - CHAMBERED /IN SERIES: [Y [ 0 ]DOSES PER 24 HRS # PUMPS[ 0 I N ]MOUND [ N ] [ N ] 1 [ BELOW] BENCHMARK /REFERENCE POINT ] [ BE4CW BENCHMARK /REFERENCE POINT [ 30.0 ] INCHES peptic tank with ita approved 'MS PERMIT T3NGl F O P . !INERT EL E VAMU ,. • 3 `s . mo BOTTOM OP ARAINETE. L =1 , , _ ] ] ] Dade EXPtRAT =ON DATE: 6/12/03 CHD Page 1 of 2 Permit No 5597 Registered Architect and /or Engineer -------------__ .- ------ _- _------------ -- _ -- --• SA4AXAgkes Nam /Sun Gold Septic Tank. Inc. No._ New Building X Remodeling Addition Repairs Nature of Water Supply: City — Well._._ Amount of Permit $ 4 • 00 STATE OF FLORIDA, COUNTY OF DADE. as. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING . PERMIT (Signed)_ (Signed)._ 4 S-1` (P'� __c � � OS ( ?Elo ,t � D 5 1 Date August 28, 1964 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 _ Varkas__Construetion _ _Co.___ _ No.3224 street W. Flagler -- -___ -- _ Street__ Location and Legal Description ..... —_ __ Block Subdivision 7 0 � . 94th St. Street and Number where work is to be performed— No..L__ . -_ _ ___.� __ Street State work to be performed and purpose of building (By Floors)_ Installing_ 1 - 700 gal. septic a 2' - r- -ai�lf Seld . Size Septic Tank 700 gal. _ Type of Tank_ Pre-cast Feet of Drain Tile___ __ -Dist. Feet of Tank or Drain Field from Well Capacity Gals ... _._...__ No. of Stories.. ....................... _. __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-contractor s^pmployed 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 ork required by die Act. The undersigned agrees to employ only such sub- contractors, o grk to be ormed undet this permit, as are licensed by Miami Shores Village. h public notice or notices as are 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 hin, 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 TUBS U 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 5597 Registered Architect and /or Engineer -------------__ .- ------ _- _------------ -- _ -- --• SA4AXAgkes Nam /Sun Gold Septic Tank. Inc. No._ New Building X Remodeling Addition Repairs Nature of Water Supply: City — Well._._ Amount of Permit $ 4 • 00 STATE OF FLORIDA, COUNTY OF DADE. as. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING . PERMIT (Signed)_ (Signed)._ 4 S-1` (P'� __c � � OS ( ?Elo ,t � D 5 1 Date August 28, 1964 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 _ Varkas__Construetion _ _Co.___ _ No.3224 street W. Flagler -- -___ -- _ Street__ Location and Legal Description ..... —_ __ Block Subdivision 7 0 � . 94th St. Street and Number where work is to be performed— No..L__ . -_ _ ___.� __ Street State work to be performed and purpose of building (By Floors)_ Installing_ 1 - 700 gal. septic a 2' - r- -ai�lf Seld . Size Septic Tank 700 gal. _ Type of Tank_ Pre-cast Feet of Drain Tile___ __ -Dist. Feet of Tank or Drain Field from Well Capacity Gals ... _._...__ No. of Stories.. ....................... _. __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-contractor s^pmployed 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 ork required by die Act. The undersigned agrees to employ only such sub- contractors, o grk to be ormed undet this permit, as are licensed by Miami Shores Village. h public notice or notices as are 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 hin, 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. MIAMI SHORES VILLAGE, FLORIDA PERMIT N? 5657 BUILDING ELECTRICAL PLUMBING ROOFING Owner of , t Building Architect Contractor or Builder Lot Legal Description CONTRACTOR OR BUILDER DATE 19 Contractor's License No. Work to be performed under this Permit - y Subdi- vision Address of , Value of of Building ° ' ' "' Project $— 1I 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 applica- tion 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 and that he assumes respon- sibility for work done by his agents, servants or employees. Signed INSPECTOR In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances arid regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In as cepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. BY AUTHORITY MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Reque Date Time Type Insp --- Permit N Name Address -- Company Phone # m'7_ For inspector: ' i U Approves ° 3 Correction ❑ Re- Insp'n Fee ❑ MIAMI SHORES VILLAGE BUILDING DEPARTME 305- 795 -2204 Building Inspection Requ Date Type Insp'n Permit No. Name Address Compa Phone # For Inspect ri j � ' ;2- / App ,oved Correctio ❑ Re- Insp'n Fee ❑ �j