80 NE 94 St (18)Miami Shores Village
10050 NE 2nd Avenue
Phone: 305 - 795 -2204 . Permit Number: PL2002 -237
Printed: 9/9/2002
Applicant: AUGUST WOLFE
Owner: WOLFE AUGUST
JOB ADDRESS: 80 NE 94 . ST
Contractor ALEMAN PABLO
Local Phone: 308 - 681 - 5788
Parcel # 1132060130300
Permit Status: Permit Expiration: 3/8/2003
Work: INSTALL WELL FOR SPRINKLER SYSTEM
\ Sign
Signed
Plumbing Permit
Contractor's Address: 1405 NW 121 ST
Legal Description: MIAMI SHORES SEC 1 AMD PB 10 -70 LOT 1 & LOT 2 & E1/2 OF LOT 3 BLK 3 LOT
O..
u, 6n
Total Fees: $6:90
Total Receipts: $0.00
Construction Value: $300.00
Page 1 of 1
If there is no permit package accessible on the job -site for inspectors to verify, there will be no inspections. Re- inspection
fee is $50.00, which must be paid in advance before calling for another inspection.
This Permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the application herefor in strict compliance with all
ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans, drawings, statements or specifications that may have been submitted to
and approved by the proper municipal authorities. This Permit may be revoked at any time if the work is not done in compliance with such ordinances or if the plans are changed without
authorization. A further conditiqn 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 pe aining 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 done
by his agents, servants or em loyees.
(INSPECTOR) BY:
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 responisibility for all work done by either
myself, my agent, servants or employes.
(Contractor or Builder) BY:
r
PAY
TO THE
ORDER OF
FOR
PABLO ALEMAN WELL DRILLING
1405 N.W. 121st Si 681-5788
Miami, FL 33167
Pt-
;3 9
Firs Union National Bank
N J firstunion.com
Org. 003 R/T 067006432
PABLO ALEMAN WELL DRILLING
1405 N.W. 121st Si 681-5788
Miami, FL 33167
f /705 OR FS 7Z4
PAY
TO THE
ORDER OF
First Union National Bank
firstunion.com
Org. 003 R/7 067006432
FOR
0 513 7 211° 1:06 70064 3 21: 2 L66 S03407 L940
1000 586 30 1:06 700 6 4 3 21: 2 L66503407 L9411°
DATE
_
DOLLARS
PABLO ALEMAN WELL DRILLING
q DATE
PABLO ALEMAN WELL DRILLING
5872
63-643/670
BRANCH 13093
5863
DOLLARS
LJ
DV
63-643/670
BRANCH 13093
NP
00
Socurily
fl-
Features
CONTRACTOR
Name 4/i� p0 At, 4 �
License No. �/ J9 eiLy 77 3 q
Address r� .> rn 'iA / 0 (
Telephone / Fax 5 cc( _ • 7 p
Qualifier Name 1:443 1 A( Q At ,lln
PROPERTY OWNER
A
rr..�� r te^
Name AU V E+ 1 - W6ITt
Address -t k t'-"t
84 N � �}
WI 4 Shate F(. 331
Home Telephone 3 8-0840
�
Business Telephone 30 S 6 p 7 _ G A l i z x (Z7
C!
Fax 3 8bs 2-828
TYPE OF MANAGEMENT (✓ )
New Construction
Enclosure
Alteration Exterior
Repair
Alteration Interior
Demolish
Relocation of Structure
Shell Only
Foundation Only
Add'I Attachment
Other
Add'I 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 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 submitted
along with this permit application.
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:
8o Ne cu ti �L
City State
Description of Work T N S t 4 I 1 LA) E� I For
S Pc1t.)kler S.s.tEwl
Zoning Linear Feet
Square Feet Units Floors
Value of Work 30 0 ' d Bldg Value
Tax Assessed/Appraised Value
Flood Zone X
Address Apt.
Folio Number 1 - 3 20 , -o13-03013
Lots , /it E � (T 3 Block 3
Subdivision PB 0 PG 7 0
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
Master Permit No.
Subsidiary Permit No.
(n S korEs F .
PERMIT APPLICATION
3315$
Zip
Base Floor Elev.
ENGINEER
Name
1
License No.
Address
Telephone
Fax
Page 2
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 STORAGE. 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. Department of Environmental Resources
Maf'dgt:mtnc7$ERM) and/or'Miaihi -Dade Wa(ler and'Sewer Department (MI WASD) approval,isrequired:fof apphcations•involving sewers.
?'t*a - tit
J J ., •• ■ •.. . t r- J •'
AFFIDAVIT - Please read carefully.
m 1 •." r , • • ^ .� . T'•
Application is hereby made to obtain a permit td do•work and installation as indicated: I, the.OWNER' tlre.property, certify that all
work will be performed to meet the standards of all lavys regulattn `cpnstruction in this jurisdiction. I understand•' ha>.sep�ate,get
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.
ST
Signat = .. wner
Wk
Print Print Namb
Signature of No
SEAL:
Personally known
Type of Identification Produced:
UNTY OF MIAMI -DADE
S t. a d subscribe
f A
F. GUARDIA
ISSION ODD 091884
S ell, 2006
Notary Public Underwriters
*tiaY�rEiBEk
OR, Produced Identification
Fl. pt. W4(0-- org- 63 SO-
a
STATE OF FLORIDA, CO Y OF MIAMI -DADE
Signature of Contractor / Qualifier
Print Name
(- ()
SS
ERTO F. GUARDIA
OMMISSION,# DD 091884 i
EXPIRES: June 11, -20 c;
Bonded Thru Notary Public t)I
PersonallyA:nown, . • OR�� \' u dSldendi
SEAL:
Type of Identification;Prttreed: _ et L'
PERMIT APPLICATION
e.,fri,t A '' to
me this / 'r day of✓CS4 44
ELECTRICAL
TYPE
Minimum Fee
QTY.
TYPE
Dryer
QTY.
TYPE
Outlet, Appliance
QTY.
TYPE
Service Repair
QTY.
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
Hood 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
TYPF.
Minimum Fee
QTY.
TYPE
Condensate Drain
QTY.
TYPE.
Generator
QTY.
TYPE:
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
Supply, AC Well
Bath Fan - Vented, #
Fireplaces, Number of
Pressure Vessel
Temporary Toilet
PLUMBING
TYPE
A/C Condensate
QTY.
TYPE
Drains, Roof
QTY.
TYPF:
Miscellaneous Fixture
Q"1'Y.
TYPE
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
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
1
Drains, French
Miscellaneous Equipment
Sink
Well, Supply 5 ,1'Jij'�
�a,
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)
$3.00 per page (Scanning Fee)
Miami Shores Village
Bond
Metropolitan Dade County (C.C.F.) $ 6
Inspector State Educational Fund
State DCA (Radon)
Code Enforcement Fine
Zoning Review
❑ PROOF OF OWNERSHIP
(Attach)
❑ HRS / DERM APPROVAL
(Septic / Sewer)
❑ IMPACT FEE
(New Construction)
❑ OTHER
(Specify & Attach)
$ g
$ (¢.01 /sq.ft.)
REVIEWED AND PREPARED BY:
SECTION
Zoning
Electrical
Mechanical
Plumbing
Fire
Public Works
Structural
Building Official
BY
DATE
(sq.ft. = x/1000
x ¢.60)
(¢.005 /sq.ft.)
PERMIT APPLICATION
❑ CONDO ASSOCIATION APPROVAL
(Attach)
❑ BPR APPROVAL (Restaurants)
❑ CONTRACTOR REGISTRATION
(On File)
PERMIT FEES
TOTAL 8_9_,A U
ISSUING OFFICIAL
DATE:
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
MIAMI SHORES VILLAGE, FLA. N9 2039
JOB
ADDRESS
INSPECTION - -
TIME READY
REMARKS.
INSPECTOR _ _
BUILDING
ELECTRICAL
PLUMBING
ROOFING
Owner of
Building
PERMIT N? 13232
Architect
Contractor
or Builder
Legal Lot II BL
Description.
Address of a'�
Building ,, ) - (/,/
MIAMI SHORES VILLAGE, FLORIDA
❑ Work to be performed under this Permit
t
Subdi-
vision
Value of
Project $
/ c.
DATF . 2 3 ' ' L 195
Contractor's
License No.
Amt. of
Permit $
AUTHORITY
This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the application
herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans,
drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any
time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is
granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations
pertaining to the work covered hereby whether shown on the plans or drawings or ' the statgihents or specifications and t he assumes rfsponubility for work
done by his agents, servants or employees.
Signed r - fie > � ' BY
INSPECTOR
In consideration of the issuance to me of this permit I agree to2sribrm 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 responsibility for all work done by either, myself, my agent,AefflRlneresployee.
•
CONTRACTOR OR BUILDER BY
Permit 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 Mianu Shores Village shall be complied with, whether herein specified Or nnt. A copy of approved plans and specifications must be kept at
building during progress of work.
Owner's Name and Address M. LOEHR
Registered Architect and/or Engineer ----- LASSE TER PLUMBING _
CORP _
Employing Plumber's Name No._ .13 Q6
Location and Legal Description Lot.
Street and Number where work is to be performed—No 8 0
State work to be performed and purpose of building (By Floors)_
New Building Remodeling_
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
Nature of Water Supply: City—Well
Amount of Permit $
The undersigned applicant for this building permit does hereby certify that he understands and accepts h* obligations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida manent Supplement, and has com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub-contractors employed by him in the work to be
performed under this permit; and will post or cause to be posted for inspection on the s .f the work such public notice or notices as are
required by the Act. The undersigned agrees to employ only such sub-contractors, ork to be performed un this permit, are
licensed by Miami Shores Village.
STATE OF FLORIDA, 1
as.
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly auth
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.
4,0
j
MIAMI SHORES VIL1AGE
PLUMBING INSPECTION DEPARTMEK.'
APPLICATION FOR PLUMBING r''';iipNiT
Addition__
My Commission Expires Notary Public, State of Florida
No 80 Stmet IL__ E.. 94 at..
Block_
(Signed)._
Date. lei
StreeLLE
Subdivbion_
streetil.a. 9i. St.
Repairs No. of Stories. one,.
Plumbing Insp -. -tor.
U
ster oaths and take admowledgments, personally appeared
CLOSETS
BATH
TUBS
S
LAVA-
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TUBS
URINALS
CATCH
BASIN
FLOOR
DRAIN
DR I NK I NG
FOUNT• NS
TOTAL
FIXTURES
CONTR.
L 1ST
/
/
/
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
-•••■■
SPRKLR.
SYSTEM
SW I M '0
POOL
1
I
Comm.
UST
CHECK
‘•_
____
_._
Permit 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 Mianu Shores Village shall be complied with, whether herein specified Or nnt. A copy of approved plans and specifications must be kept at
building during progress of work.
Owner's Name and Address M. LOEHR
Registered Architect and/or Engineer ----- LASSE TER PLUMBING _
CORP _
Employing Plumber's Name No._ .13 Q6
Location and Legal Description Lot.
Street and Number where work is to be performed—No 8 0
State work to be performed and purpose of building (By Floors)_
New Building Remodeling_
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
Nature of Water Supply: City—Well
Amount of Permit $
The undersigned applicant for this building permit does hereby certify that he understands and accepts h* obligations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida manent Supplement, and has com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub-contractors employed by him in the work to be
performed under this permit; and will post or cause to be posted for inspection on the s .f the work such public notice or notices as are
required by the Act. The undersigned agrees to employ only such sub-contractors, ork to be performed un this permit, are
licensed by Miami Shores Village.
STATE OF FLORIDA, 1
as.
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly auth
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.
4,0
j
MIAMI SHORES VIL1AGE
PLUMBING INSPECTION DEPARTMEK.'
APPLICATION FOR PLUMBING r''';iipNiT
Addition__
My Commission Expires Notary Public, State of Florida
No 80 Stmet IL__ E.. 94 at..
Block_
(Signed)._
Date. lei
StreeLLE
Subdivbion_
streetil.a. 9i. St.
Repairs No. of Stories. one,.
Plumbing Insp -. -tor.
U
ster oaths and take admowledgments, personally appeared
Date
OWNER
iami �hores9llage
F L O R D A
PLUMBING PERMIT N9 813
Issued to
LOT
BLOCK
SUBDIVISION
to install the following described plumbing, in accordance with the laws, statutes and regu-
lations of Miami Shores Village, Florida and the State of Florida, governing plumbing and
drainage work done in Miami Shores Village, Florida.
For a story building at
Fixtures
Fixtures $
Sewer $
Septic Tank $
Total $
Village Plumbing Inspector
Received Payment by
BUILDING
ELECTRICAL
PLUMBING
Owner of
Building `
Architect
Contractor
or Builder
v
Legal Lot Bl.
Description
frf-4
CONTI ACTOR OR BUILDER
MIAMI SHORES VILLAGE, FLORIDA
PERMIT N? ' 4181
Subdi-
vision
DATE
Contractor's
License No.
Work to be perfortrd under this Permit
BY AUTHORITY
194..
Address of ""4 r
) 044_ ✓ s J �,,,, Value of Amt. of
Building , • A /e ^Z. � o Project Permit C --- "'' ' -- /
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 appli-
cation herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any
plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked
%t 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 du, statements or specifications that he respon-
sibility for work done by his agents, servants or employees. J , i . -.. • ' 1 . ,k
Signed. �C_ By.•r
I „
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 ins t conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village.
In accepting this permit I dss me res 'bility for all work done by either yself, my agent, servant or employee. .
Permit No.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Application 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
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
Size Septic Tank Type of Tank Capacity Gals.
Feet of Drain Tile Dist. Feet of Tank or DraM Field from Well
Nature of Water Supply: City—Well Size of Soakage Pit
Amount of Permit $ (Signed)
Plumbing Inspector.
Th un d e rsigned 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 pennit, as are
licensed by Miami Shores Village.
SS.
(Signed)
Repairs.
Date
My Commission Expires Notary Public, State of Florida
No. of Stories
Master Plumber.
STATE OF FLORIDA, t
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the
of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
NOTE: A re-inspection fee of $1.00 will be made when such re-inspection is made necessary by improper notice for inspection, or faulty
materials and/or worlunanship.
OSETS
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
Permit No.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Application 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
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
Size Septic Tank Type of Tank Capacity Gals.
Feet of Drain Tile Dist. Feet of Tank or DraM Field from Well
Nature of Water Supply: City—Well Size of Soakage Pit
Amount of Permit $ (Signed)
Plumbing Inspector.
Th un d e rsigned 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 pennit, as are
licensed by Miami Shores Village.
SS.
(Signed)
Repairs.
Date
My Commission Expires Notary Public, State of Florida
No. of Stories
Master Plumber.
STATE OF FLORIDA, t
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the
of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
NOTE: A re-inspection fee of $1.00 will be made when such re-inspection is made necessary by improper notice for inspection, or faulty
materials and/or worlunanship.
Permit No._ __E��
Amount of Permit $
STATE OF FLORIDA, t
COUNTY OF DADE.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
State work to be performed and purpose of building (By Floors)_ _________
New Building- _-- _ -__ -- _ -- Remodeling_ ___ __ __ Addition_
Owner's Name and Address No. _ __..— _ _ Street
Registered Architect and /or
Employing Plumber's Name - -_� - --
(Signed )
Date
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.
No..___ _.__._.. Street._.__
Location and Legal Description Lot Block Subdivision. ._._`__ -
Street and Number where work is to be performed —No R 0 Street cs- /�'^ - -- - - --
Repairs e � No. of Stories.
Size Septic Tank_._ _.__.__-- - - - - -- __- ,____.___..._ Type of Tank_._ Capacity Gals.
Feet of Drain Tile_ ■ _ . 0/"‘" •-_Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City— Well...._ ____________________ _____ Size of Soakage Pit
._.._ __......_...._;...c
(Signed)_ ._._• -- � ----------- -• - -•- - -- `- •� ar
Plui bang 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 die Act. The undersigned agrees to employ only such sub- contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
to me well known, and who, being by me first duly sworn, upon oath 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
Master Plumber.
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty
materials and/or worlananship.
CLOSETS
BATH
T UBS
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'O
POOL
CONTR.
LIST
CHECK
Permit No._ __E��
Amount of Permit $
STATE OF FLORIDA, t
COUNTY OF DADE.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
State work to be performed and purpose of building (By Floors)_ _________
New Building- _-- _ -__ -- _ -- Remodeling_ ___ __ __ Addition_
Owner's Name and Address No. _ __..— _ _ Street
Registered Architect and /or
Employing Plumber's Name - -_� - --
(Signed )
Date
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.
No..___ _.__._.. Street._.__
Location and Legal Description Lot Block Subdivision. ._._`__ -
Street and Number where work is to be performed —No R 0 Street cs- /�'^ - -- - - --
Repairs e � No. of Stories.
Size Septic Tank_._ _.__.__-- - - - - -- __- ,____.___..._ Type of Tank_._ Capacity Gals.
Feet of Drain Tile_ ■ _ . 0/"‘" •-_Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City— Well...._ ____________________ _____ Size of Soakage Pit
._.._ __......_...._;...c
(Signed)_ ._._• -- � ----------- -• - -•- - -- `- •� ar
Plui bang 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 die Act. The undersigned agrees to employ only such sub- contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
to me well known, and who, being by me first duly sworn, upon oath 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
Master Plumber.
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty
materials and/or worlananship.
.......„_._„,
CLOS6YG
BATH
TUBS
SHOWERS
LAVA-
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TUBS
URINALS
U
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT'N6
TOTAL
FIXTURES
CONTR.
LIGT
CHCCK
'- -'-'_
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SWIM'G
POOL
LIST
CHECK
SEPTIC
TANK
S
-
Appiih:ation is betel)) rlacia for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other
5;rac ?ure 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
bi.iiding during progress of work
Chh, nee a Name and Address No p - -- Street._ i t
I'le istered Architect and /or E�tgineer___ —___ _
Employing t Plumbers Name__1( : No.._ �__ /`
Location and Legal Description Lot__ Block
Street and Number where work is to be performed— No._ —____ �'--- - - -_�
State wore to be performed and purpose of building (By Floors) ___._- _----- _..__________..._._
New Building _._ Remodeling -- __ -___ Addition
Size Septic Tank
Feet of Drain Tile-_
Nature of Water Suppl : City—Well.
J
Amount of Permit $ - --
ss.
My Commission Expires
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
(Signed)-
Type of Tank__
_._ .t.!.1_Dist. Feet of Tank or Drain Field from Well
_Size of Soakage Pit
Date
Street__ .
lam
r� f%
Subdivi pn_
al Li
Street
Repairs No. of Stories
Capacity Gals.__
Plumbing Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligat ) ns as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Pennanen upplement, and has com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors emplo 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 p is notice or notices as are
required by the Act. The undersigned agrees to employ only such sub- contractors, on work to be performed under his permit, as are
licensed by Miami Shores Village.
if
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the
of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
Notary Public, State of Florida
STA r E; OF FLORIDA, I
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
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
rric toils and /or workmanship.
Permit No. '
--t .''
Owner's Name and Address _ . _f 4
Registered Architect and /or Engineer
n
Employing Plumber's Name
Location and Legal Description Lot
Amount of Permit $
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 aiplication is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florid.t
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Divisior
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at
building dur ng progress of work.
No.
__ Block
(Signed).
t •
Date
_ - �_ --
(Signed)
Street - - -- --- - - - - - . .
No � �. Street
Subdivision
Street and Number where work is to be Street
State work to be performed and purpose of building (By Floors)
NLw Building . Remodeling Addition____ Repairs__ -4—.___ _ ___ No. of Stories -.-
Si Septic Tank Type of Tank_ — Capacity Gals._
Feet of Drain Tile_ ___f_ Dist. Feet of Tank or Drain Field from WeIL
Nature of Water Supply: City —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 5988, 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 arc
licensed by Miami Shores Village.
Master Plumber.
STATE OF FLORIDA, 1
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeare
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 fin'
therein by him stated are true.
My Commission Expires Notary Public, State of Florida
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or Paul
materials and /or workmanship.
CLOSETS
BATH
TUBS
SHOWERS
LAVA-
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TUBS
I NAS
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT 'NS
TOTAL
FIXTURE:
CONTR.
LIST
- _
Cmack
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SWIM'G
POOL
CONTR.
LIST
CHECK
Permit No. '
--t .''
Owner's Name and Address _ . _f 4
Registered Architect and /or Engineer
n
Employing Plumber's Name
Location and Legal Description Lot
Amount of Permit $
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 aiplication is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florid.t
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Divisior
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at
building dur ng progress of work.
No.
__ Block
(Signed).
t •
Date
_ - �_ --
(Signed)
Street - - -- --- - - - - - . .
No � �. Street
Subdivision
Street and Number where work is to be Street
State work to be performed and purpose of building (By Floors)
NLw Building . Remodeling Addition____ Repairs__ -4—.___ _ ___ No. of Stories -.-
Si Septic Tank Type of Tank_ — Capacity Gals._
Feet of Drain Tile_ ___f_ Dist. Feet of Tank or Drain Field from WeIL
Nature of Water Supply: City —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 5988, 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 arc
licensed by Miami Shores Village.
Master Plumber.
STATE OF FLORIDA, 1
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeare
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 fin'
therein by him stated are true.
My Commission Expires Notary Public, State of Florida
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or Paul
materials and /or workmanship.
BUILDING
ELECTRICAL
PLUMBING
Owner of
Building__._
Architect
Contractor
or Builder ° Legal Lot
Description
i
CONTRACTOR OR BUILDER
MIAMI SHORES VILLAGE, FLORIDA
/a
DATE ` 194
PERMIT N? 7306
Work to be performed under this Permit s, 3
Bl.
Subdi-
vision
Address of Value of Amt. of
Building Project Permit .• y . ,
lr
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 appli-
cation herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any
plans, 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 coq&tion upon which this
permit is granted is the understanding that the contractor or builder named above assumes the resppoonsibility for a thorough knowledg of the ordinances and
regulations pertaining to the work covered hereby whether shown on the plans or drawings or in statements or specifications ar}d Skit he assumes respon-
sibility for work done by his agents, servants or employees.
Signed . BY
INSPECTOR
Contractor's
License No.
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 sponsibility for a work done by either myself, my agent, servant or employee.
BY AUTHORITY
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
BUILDING
PERMIT APPLICATION
FBC 2001
Permit Type (circle): Building Electrical
$ Value of Work For this Permit
Type of Work: ❑ Addition ❑Alteration
Describe Work: \� r� t i v.k -t-r
Total Fee Now Due $
(Continued on opposite side)
Miami Shores Village
Permit No. P I2oo3 ' 3o .
Master Permit No.
Mechanical Roofing
Owner's Name (Fee Simple Titleholder) '' " 1 � `rl 1 � c r ii tPhone # (;'c. 07164_ (.. 7 SC
Owner's Address a') 06 Q
Cit IU M j -, eS State FL. Zip 5a t 'SP)
Tenant/Lessee Name Phone #
Job Address (where the work is being done) `s C% Cr i `( S
City Miami Shores Village County Miami -Da Zip 3 1 3
Is Building Historically Designated YES NO
Contractor's Company Name a re U t Y °„l�twk( Phone # _ a`ts2')1 - 6f? ?j�
Contractor's Address c 1( . L) - p
City ,eak State EC, Zip 9 1 LP / � r
Qualifier rr( l 1 v y �''VJ020I e-2-
Architect/Engineer's Name (if applicable) Phone #
Square Footage Of Work:
❑ Repair/Replace ❑ Demolition
ch
etc r = c;:,1c ' /fit .
A r i : '4 LI
* * * * * * * ** * * * * * * * * * * * * * * * *_,k,* F ees * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
Submittal Fee $ 5CD CO Permit Fee $ / f ( / CCF $ ) 1 ()
Notary $ Training/Education Fee $ -. A 0 Technology Fee $ it, Z7
Scanning $ Radon $ Bond $
Code Enforcement $ Structural Plan Review. $
Bonding Company's Name (if applicable) Its
Bonding Company's Address r
City State Zip
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
City State Zip
Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has
commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating
construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS,
WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC
OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all
applicable laws regulating construction and zoning.
"WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR
PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING,
CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
COMMENCEMENT."
Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Alss e tifred copy of the recorded notice of commencement must be posted at the job site
for the first inspection which occurs s' n (7) says after the building permit is issued In the absence of such posted notice, the
inspection will not be approved and • ein;= tion fee will be charged
Signature
(
Owner or
The foregoing � instrument
^twas acknowledged before me this -4
day of Dec., W
, 20 by 1ph
who is personally known to me or who has prod ced 'cD,
My Commission Expires:
* * * * * * * * * * * * * * * * * * * * * * * **
APPLICATION APPROVE
Chc 10/14/03
As identification and who did take an oath.
Mabel Vargas
'on #DD23198
********************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
Signatur
Contractor
The foregoing instrument was acknowledged before me this 4
day of bea, , 20 12, by
who is personally knopt 1fttipbEho has produced
'astlun j who did take an oath.
NOTARY PUBL�` f' .��� •. /'��
— t-ei
Sign:
Prim• CGJ79G77 �
v
My Com Ar
� " • ti•Pamnls
(Certificate of Competency Holder)
plll 11111
State Certificate or Registration No. / Certificate of Competency No.
*************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
Plans Examiner
Engineer
Zoning
1, Rene A. Eckert, authorize Rodney H. Rolph to act on my behalf and sign on my behalf
all documents and permits for any installations, improvements and property management
related to 80 NE 94 Street, Miami Shores, FL 33138.
Rene A. Eckert
SWORN TO and subscribed before me this ✓ ay of kC b , 2003.
N.rary Public p,�
My commission expires 07/3 3 0 0
Power of Attorney
1.)a.t (
U iidspr l
nof 42_1-s -
1 A-ep/ionr.A- ,//4-
0
G
31
Around The Clock Gas Services
LPG01 ?3551 CCN 02P000359
2216 West 80th Street, Bay # 3
Hialeah, FI. 33016
Phone: (305) 231-3532 t Fax: (305) 231 -4180
Installation done in accordance with FBC 2001, NFPA 54 & 58
regulations as well as all local codes
Job Address: *) c14 *.
±:
pot v-
Around The Clock Gas Services
LPG017356 l CCN 02P000359
2216 West 80th Street, Bay 4 3
Hialeah, Fl. 33016
Prone: (305) 231 -3632 / Fax: (305) 231 -4180
Installation done in accordance with FBC 2001, NFPA 54 & 58
regulations as well as all local codes
Job Address: SO E 9
1
Miami Shores Village
10050 NE 2nd Avenue
Phone: 305 - 795 -2204
Printed: 12 /5/2003
Applicant: RENE
Owner: ECKERT
JOB ADDRESS: 80
Contractor AROUND THE CLOCK
Local Phone: 305 - 556 -7667
Parcel # 1132060130300
NE 94
Fees:
FEE2003 -7998
FEE2003 -7999
FEE2003 -8000
FEE2003 -8001
Description
Building Fee
CCF
Training and Education Fee
Technology Fee
Total Fees:
Amount
$180.00
$1.80
$0.60
$4.50
$186.90
Total Fees: $14%
Total Receipts: $0.00
c) 13 LT b C
Permit Status: APPROVED Permit Expiration: 6/1/2004 Construction Value:
Work: RUN LINE TO POOL HEATER AND BBQ OUTLET CONNECT NEW POOL HEATER UNDERGROUND 2 LINE AND 1/2 "BBQ
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 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 responisibility for all work
done by either myself, my agent, servants or employes.
Signed: (Contractor or Builder)
Plumbing Permit
Permit Number: PL2003 -325
ECKERT
RENE
ST
Contractor's Address: 16361 NW 57
Page 1 of 1
Legal Description: MIAMI SHORES SEC 1 AMD PB 10 -70 LOT 1 & LOT 2 & E1/2 OF LOT 3 BLK 3 LOT
BY:
r