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975 NE 94 St (10)
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date &,/ / O / Address 7 7S xi , Tax Folio Legal Description Owner / Lessee / Tenant V L � 2� /S LE 2 - Master Permit _ � GL3& ' Owner's Address Phone Contracting Co. ' O L4 //� � 1i/(i c f/ Z Address a- 7.C T( J ?CT flits. Qualifier /'7/ 3,9 , 2 6 4--8 P0i --1 - 7-- State # Cf C � 3 Municipal # Competency # Ins.Co. Architect /Engineer Address Bonding Company Address Mortgagor Address Permit Type(circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION / E764 c ,f- 7/'7' 7 /3 / _4/9"(/ Signature o --owner and /or Condo President Date: „%/ / /ice, JP C /.- ` / / Notary as to Owner and /or Condo Preside My Commission Expires' NOTARY PU IC, STATE' FLOn DA. • i iy cor✓.IUdxssxow EXPIRES: Dec. 29, 1999. BONDED Mau NOTARY PUBLIC UNDERWCIRTE` . ** * * FEES: PERMIT APPROVED: * Zoning Buildin Mechanical Plumbin %G Square Ft. Estimated Cost(value) 70 d WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO 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). Application is hereby made to obtain a permit to do work and installation as indicated above, and on the attached addendum (if applicable). I 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, SIGNS, POOLS, ROOFING and MECHANICAL WORK. 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. Furthermore, I authorize the above-named contractor to do the work stated. Sign ture ( .�- g of Contractor or Owner - :wilder Date: a Notary as to C ntractor or Owner-Bui My Commission Expi BOT j y PUBLIC, STATE OF L'd.O: 12,.% MY COMMISSION EXPIRES: Dec. 29, 15395. BONDED TIIRU NOTARY PUBLIC UNDERWRTgIMS * * * * * * * * * * * ** ) RADON C.C.F. I NOTARY TOTAL DUE Fire Other Electrical Engineering MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING - ; k•>, IIT Permit No q 6 Date ‘t=, 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______________ i._--_---____._____ ______ __ -_____.____ No.___ Registered Architect and /or Engineer FOR DEPOSIT ONLY L SEPI1C TAB CQ, Employing Plumber's Name p� In���:?��F�±at» �.� - - -4 Vy„ .._ l9J:.� G NJAttFAH __._ III � p�� Location and Legal Description Loth y` � r � � sA atifock Subdivision t3 /�j Street and Number where work is to be performed— No.___��$ �_-J-.J / Y' Street State work to- be performed and purpose of building (By Floors) ____ New Building —_ _.. Remodeling ____._ Addition________._ Repairs No. of Stories...... Size Septic Tank Feet of Drain Tile__ (7 Nature of Water Supply: City —Well Amount of Permit $ STATE OF FLORIDA, } COUNTY OF DADE. -------------------------- - - - - -- Type of Tank__ itif Dist. Feet of Tank or Drain Field from Well __Size of Soakage Pit (Signed)- _ Street Capacity Gals. Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his o . g+ Lions as an employer of labor under the Florida Workmen's Compensation Act, being Section 5968, Compiled General Laws of Florida Peri ent Supplement, and has cmn- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors : nployed 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. (Signed) __/(i( Gi Master Plumber. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the _.. of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. My Commission Expires Notary Public, State of Florida NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made•necessary by improper notice for inspection, or faulty materials and /or workmanship. CLOSETS BATH TUBS SHOWERS LAVA- TORIES NK6 SINKS SLOP SINKS LAUNDRY TUBS RINALS URINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT' NS TOTAL FIXTURES CONTR. LIOT CHECK SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL. SPRKLR. SYSTEM SW IM'G POOL CONTR. LI DT CHacK MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING - ; k•>, IIT Permit No q 6 Date ‘t=, Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. Owner's Name and Address______________ i._--_---____._____ ______ __ -_____.____ No.___ Registered Architect and /or Engineer FOR DEPOSIT ONLY L SEPI1C TAB CQ, Employing Plumber's Name p� In���:?��F�±at» �.� - - -4 Vy„ .._ l9J:.� G NJAttFAH __._ III � p�� Location and Legal Description Loth y` � r � � sA atifock Subdivision t3 /�j Street and Number where work is to be performed— No.___��$ �_-J-.J / Y' Street State work to- be performed and purpose of building (By Floors) ____ New Building —_ _.. Remodeling ____._ Addition________._ Repairs No. of Stories...... Size Septic Tank Feet of Drain Tile__ (7 Nature of Water Supply: City —Well Amount of Permit $ STATE OF FLORIDA, } COUNTY OF DADE. -------------------------- - - - - -- Type of Tank__ itif Dist. Feet of Tank or Drain Field from Well __Size of Soakage Pit (Signed)- _ Street Capacity Gals. Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his o . g+ Lions as an employer of labor under the Florida Workmen's Compensation Act, being Section 5968, Compiled General Laws of Florida Peri ent Supplement, and has cmn- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors : nployed 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. (Signed) __/(i( Gi Master Plumber. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the _.. of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. 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. BUILDING ELECTRICAL PLUMBING ROOFING Owner of Building G� Architect Contractor or Builder Legal Description Address of Building Lot MIAMI SHORES VILLAGE, FLORIDA CONTRACTOR OR BUILDER PERMIT N° 6800 Work to be performed under this Permit B1 el �,. DATE =' '" 195 Contractor's License No. 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 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 authoritie9. 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 responsibility for work done by his agents, servants or employees. Signed " � / BY INSPECTOR In consideration of the issuance to me of this permit I agree to perform the 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 ac- cepting this permit I assume responsibility for all work done by either, myself, my agept,{'serv=ant or employee. ., - 4 i 0 BY AUTHORITY 6 BUILDING ELECTRICAL PLUMBING ROOFING Owner of Building ' a Architect Contractor ' or Builder Legal Description Address of Building Lot MIAMI SHORES VILLAGE. FLORIDA PERMIT N° 6872 Work to be performed under this Permit v B1 Value of Project $ DATE Contractor's z , Q License No. 195 e Subdi- vision 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 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 responsibility for work done by his agents, servants or employees. Signed. 4 o s LY INSPECTOR In consideration of the issuance to me of this permit I agree to perform the work covered hereiirider 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 ac- cepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. CONTRACTOR OR BUILDER - BY AUTHORITY BUILDING ELECTRICAL PLUMBING ROOFING Owner of Building Architect Contractor or Builder Legal Description Address of Building Lot MIAMI SHORES VILLAGE. FLORIDA 0 DATF r ° - a , 195 P ER M 1 T N9 4638 Contractor's License No. ❑ Work to be performed under this Permit Bl. Signed. Subdi- vision Value of Project $ es, 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 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 responsibility for work done by his agents, servants or employees. BY INSPECTOR ,'' In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In ac- cepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. CONTRACTOR OR BUILDER BY AUTHORITY MIAMI SHORES VILLAGE, FLORIDA BUILDING ❑ DATE 195 ELECTRICAL ❑ PERMIT 'N? 12278 Contractor's PLUMBING "'k•] License No ROOFING n Work to be performed under this Permit Owner of r Building +` ;. Architect Contractor or Builder Legal Description. Address of Building Lot CONTRACTOR OR BUILDER Subdi- vision kj BY AUTHORITY Value of Amt. of IF,„.,1 Project $ Permit $ � �+ This ermf is �' p d' ga�anted to the contractor or bui7dec "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 Ify 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 pccifi ations. and •tf - 6e tnastrm epeee ibilityc fpr work • done by his agents, servants or employees. Signed: INSPgCTOR In consideration of the issuance to me of this permiLj a ree to -perform the work covered hereunder in compliance with all ordinances and regulations ii 1 pertaining thereto and in strict conformity with the plans, drawi atements 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, servant or employee. 4U1LD1NG `- LPCTRICAL I LUMBNG -GOOFING Owner of Building Architect Contractor or Builder 11 El Work to be performed under this Permit Legal Lot 1 BL Description Address of y / Building , rr r, This per is ranted to the contractor or builde named above u to construct the building or to install the equipment or device described in the application herefor in strict comp iance 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 responsibility for work done by his agents, servants or employees. F CONTRACTOR OR BUILDER MIAMI SHORES VILLAGE, FLORI 'pAT PERMIT IT? 11251 Signed• Subdi- vision Value of Project $ Con Lice INSPECTOR BY A A ois No Amt. of Permit 195/ 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 responsibility for all work done by either, myself, my agent, servant or employee. ■•• ,, .���.. BY AUTHORrIT 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 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._ . 975 11.E. Street_ 94 St., Registere514,4b 1 ttci 1(or Engineer- --- - - -- - -- - -- - - -- _---------_----- Employing lElatillfaliCs NameASQL1tkl.aril_12g__i & Equip. No. ._.__& - Lae_ .- Street.. 2nd Ave. 50, Location and Legal Description Lot. _._.._...___.— ..___.______..___ Block Street and Number where work is to be performed —No._ 975 N . E . State w o r k to be performed and purpose of building (By Floors)_ 1—lit" sup 0 _well & 1 -2" drain well for air Repairs No. of Stories. condo New Building — Remodeling ____ Addition_ Sias Septic Tank. ...... Type of Tank Capacity Gals Feet of Drain Tile Dist. Feet of Tank or Drain Field from Well Nature o Water Supply: City — Well._ __. _____ —Size of Soakage Pit Amount of Permit $ STATE OF FLORIDA, t es. COUNTY OF DADE. My Commission Expires M AMI SHORES V5LlAGZ PLUMBING INSPECTION DEPARTMEi APP L CATEON FOR PLUMBING (Signed)- Street (Signed)._ Date 37,12/58 subdivision 94th St., Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his oblige • .ns as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Perinanen Supplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be "performed under this permit; and will post or cause to be posted' for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such sub - contractors, on work to be performed under this permit, as are ]roused by Miami Shores Village. Master Plumber. Be'_ore 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. 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 SHERS OW LAVA. TORIES SINKS SLOP SINKB LAUNDRY rues I URINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT' NS TOTAL FIXTURES CONTR. LIST CHUCK SEPTIC TANK. SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SWIM'G POOL CONTR. L I OT _. CHUCK 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 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._ . 975 11.E. Street_ 94 St., Registere514,4b 1 ttci 1(or Engineer- --- - - -- - -- - -- - - -- _---------_----- Employing lElatillfaliCs NameASQL1tkl.aril_12g__i & Equip. No. ._.__& - Lae_ .- Street.. 2nd Ave. 50, Location and Legal Description Lot. _._.._...___.— ..___.______..___ Block Street and Number where work is to be performed —No._ 975 N . E . State w o r k to be performed and purpose of building (By Floors)_ 1—lit" sup 0 _well & 1 -2" drain well for air Repairs No. of Stories. condo New Building — Remodeling ____ Addition_ Sias Septic Tank. ...... Type of Tank Capacity Gals Feet of Drain Tile Dist. Feet of Tank or Drain Field from Well Nature o Water Supply: City — Well._ __. _____ —Size of Soakage Pit Amount of Permit $ STATE OF FLORIDA, t es. COUNTY OF DADE. My Commission Expires M AMI SHORES V5LlAGZ PLUMBING INSPECTION DEPARTMEi APP L CATEON FOR PLUMBING (Signed)- Street (Signed)._ Date 37,12/58 subdivision 94th St., Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his oblige • .ns as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Perinanen Supplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be "performed under this permit; and will post or cause to be posted' for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such sub - contractors, on work to be performed under this permit, as are ]roused by Miami Shores Village. Master Plumber. Be'_ore 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. 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. Size Septic Tank_ Amount of Permit $ Location and Legal Description Lot ________________.___ Street and Number where work is to be performed —No State work to be performed and purpose of building (B Floors) New Building _ Remodeling_ _.. IAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT PPUICATION FOR PLUMBING r' :MMilT Permit No °' ®a Date.. • 3 4 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 Registered Architect and /or Engineer__ ___._— ____- -___. .- -__ � ._ - Employing Plumber's Name :.��___ =� -- -- ..._3._,. �� � �' No. __ - Street__ -- lock Type of Tank._ N° 4i —• Street Addition_________________ ______ Repairs No. of Stories. . Feet of Drain Tile_ Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: City — Well.____-__.- ....... -....... - ...... ___ ......... _ -- -_- ._Size of Soakage Pit ( Signed) - _ ...ta - Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted' for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such sub- contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. _ �r ( Signed)__ e Street ?1 cY Subdivision Capacity Gals My Commission Expires Notary Public, State of Florida A STATE OF FLORIDA, ss. 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 hin, stated are true. NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made•necessary by improper notice for inspection, or faulty materials and /or workmanship. CLOSETS BATH TUBS SHOWERS LAVA. TORIES SINKS SLOP SINKS LAUNDRY TUBS I NAS URINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT' NS TOTAL FI %TURES CONTR. LIST // G� 1 CHECK SEPTIC TANK SEWER CONN. DRAIN FI ELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SW IM•G POOL CONTR. LIOT CHECK Size Septic Tank_ Amount of Permit $ Location and Legal Description Lot ________________.___ Street and Number where work is to be performed —No State work to be performed and purpose of building (B Floors) New Building _ Remodeling_ _.. IAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT PPUICATION FOR PLUMBING r' :MMilT Permit No °' ®a Date.. • 3 4 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 Registered Architect and /or Engineer__ ___._— ____- -___. .- -__ � ._ - Employing Plumber's Name :.��___ =� -- -- ..._3._,. �� � �' No. __ - Street__ -- lock Type of Tank._ N° 4i —• Street Addition_________________ ______ Repairs No. of Stories. . Feet of Drain Tile_ Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: City — Well.____-__.- ....... -....... - ...... ___ ......... _ -- -_- ._Size of Soakage Pit ( Signed) - _ ...ta - Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted' for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such sub- contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. _ �r ( Signed)__ e Street ?1 cY Subdivision Capacity Gals My Commission Expires Notary Public, State of Florida A STATE OF FLORIDA, ss. 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 hin, 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. 7 : 1 1/ • CU - •■•■ I C' Permit No.— ( ==J /— ` _ '---1. c 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. ,p Owner's Name and Address.._ , No. Street Registered Architect and /or Engi eer Employing Plumber's Name. r ' .__ __ • s = " v No c+� �� Stre 2 Location and Legal Description Lot Block Subdivision n . Street and Number. where work is to be performed —No Street ��� State work to be performed and purpose of building (By Floors) _ ,/,..._. i ° - New Building / Remodeling Addio Repairs No. of Stories Nature of Water Supply: City —Well STATE OF FLORIDA, 1 COUNTY OF DADE. ss. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT My Commission Expires Notary Public, State of Florida 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 2 . Amount of Permit $ // (Signed)_____J____\' t a, k__M ; /# 1 ` Plumbing pector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of la or under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has om- 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. ( Signed) mil Master Plumber. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty materials and /or workmanship. CLOSETS BATH TUBS SHOWERS LAVA- TORIES SINKS SLOP SINKS LAUNDRY TUBS URINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT'NS , TOTAL FIXTURES CONTR. LIST _ CHECK K -- SEPTIC ,TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SWIM'G POOL CONTR. LIST CHECK Permit No.— ( ==J /— ` _ '---1. c 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. ,p Owner's Name and Address.._ , No. Street Registered Architect and /or Engi eer Employing Plumber's Name. r ' .__ __ • s = " v No c+� �� Stre 2 Location and Legal Description Lot Block Subdivision n . Street and Number. where work is to be performed —No Street ��� State work to be performed and purpose of building (By Floors) _ ,/,..._. i ° - New Building / Remodeling Addio Repairs No. of Stories Nature of Water Supply: City —Well STATE OF FLORIDA, 1 COUNTY OF DADE. ss. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT My Commission Expires Notary Public, State of Florida 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 2 . Amount of Permit $ // (Signed)_____J____\' t a, k__M ; /# 1 ` Plumbing pector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of la or under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has om- 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. ( Signed) mil Master Plumber. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty materials and /or workmanship. T Size Septic Tank Feet of Drain Tile ___ j `1 /I n Permit No.__ /� % / 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. Owner's Name and Address � / /� � � et u ' ��� � -,'� i� �) ee� ? /r j �� ` ' Registered Architect and /or Engineer Employing Plumber's Name No i Street' Location and Legal Description Lot______ d�_ ckd ✓ � ' ' Subdivision Street and Number where work is to be performed —No. Street s State work to be performed and purpose of building (By Floors) Repairs New Building Remodeling Addition !%J Nature of Water Supply: City —Well Amount of Permit $__ STATE OF FLORIDA, 1 ;AUNTY OF DADE. • My Commission Expires MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Type of Tank Dist. Feet of Tank or Drain Field from Well d 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 corn- 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 caise t /o/��be posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees ko of sploy only such sub - contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. a . £> 0 Master Plumber. / � it b ss. I Before me, the undersigned authority, a notary lc, duly authorized to administer oaths and take acknowledgments, personally appeared ie well known, and who, being by me firtcdttLySikort upon oath deposes and says that he is the he above described construction, that he`lias carefully read the fo regoing application, and that he did sign the same, and that all facts in by him stated are true. OTE: A re- inspection fee of $1.00 will be made when such re - inspection is made necessary by improper notice for inspection, or faulty %Is and /or workmanship. Capacity Gals — — — — (Signed) / V • Notary Public, State of Florida No. of Stories CLOSETS BATH TUBS SHOWERS LAVA- TORIES SINKS SLOP SINKS LAUNDRY TUBS URINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT 'NS TOTAL FIXTURES CONTR. LIST �' �I / q G'� - _/' 4 .�� f < �� • CHECK /9 % .I SCI • ° l ')i 4 /ii ,i , < i SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLA HEATER DEEP WELL SPRKLR. SYSTEM SW IM'Gio POOL O°3,Tr14 - - CONTR. LIST /'/ •. n Li CHECK / _. (/' : ___ . / eA <1 7 -7 5 r Size Septic Tank Feet of Drain Tile ___ j `1 /I n Permit No.__ /� % / 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. Owner's Name and Address � / /� � � et u ' ��� � -,'� i� �) ee� ? /r j �� ` ' Registered Architect and /or Engineer Employing Plumber's Name No i Street' Location and Legal Description Lot______ d�_ ckd ✓ � ' ' Subdivision Street and Number where work is to be performed —No. Street s State work to be performed and purpose of building (By Floors) Repairs New Building Remodeling Addition !%J Nature of Water Supply: City —Well Amount of Permit $__ STATE OF FLORIDA, 1 ;AUNTY OF DADE. • My Commission Expires MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Type of Tank Dist. Feet of Tank or Drain Field from Well d 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 corn- 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 caise t /o/��be posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees ko of sploy only such sub - contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. a . £> 0 Master Plumber. / � it b ss. I Before me, the undersigned authority, a notary lc, duly authorized to administer oaths and take acknowledgments, personally appeared ie well known, and who, being by me firtcdttLySikort upon oath deposes and says that he is the he above described construction, that he`lias carefully read the fo regoing application, and that he did sign the same, and that all facts in by him stated are true. OTE: A re- inspection fee of $1.00 will be made when such re - inspection is made necessary by improper notice for inspection, or faulty %Is and /or workmanship. Capacity Gals — — — — (Signed) / V • Notary Public, State of Florida No. of Stories r 0 • Permit No 4 f ° Owner's Name and Address .`1 /v1_2a � Sias Septic Tank — Type of Tank_ Amount of Permit $ My Commission Expires M AMI SHORES VR lAG PLUMBING INSPECTION DEPARTME F PLUMM r G 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 net. A copy of approved plans and specifications must be kept at building during progress of work. No. _.__9.._ N • Liz_ Street_ 9 S-F, Registered Architect and /or Engineer_______. -- _.. ..___.._____._— __ _--- •____ - , Employing Plumber's Name- t• o nk s S p�� � � 1 e r C ti ' No S 8 o Ai • t.V . .. S fi ---- - - - -._ ......__ _. Street Location and Legal Description Lot..._ ____ ......... __ ..... ______ —._— Block__ __ _...__..... Subdivision Street and Number where work is to be performed —No__9_ 7 ,S /1/,..1•E • Street 9 ` 4- 1:4-, S t State work to be performed and purpose of building (By Floors) _ JAS a,11_ L a w r 5V" t .rn_ l _ . _ _ S . s . New Building .__ ____ Remodeling____-_ __________ Addition_________ Repairs No. of Stories.... ............. ____ Capacity Gals. Feet of Drain Tile _____Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: City — Well.__._ I - 2 ' 1 ` _Size of Soakage Pit __-- — -- - -- 3 ° Q— '_o n- 0 f 4' - - e- U a 1 „ 3 4, �— (Signed)_ 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 Pennanent 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. t c k s SFr( I + le_ C o. (Signed) _._ -/--�f. • 1 Date Aia ✓. 1(0 I G STATE OF FLORIDA, 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. 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 workmanship. CLOSETS BATH TUBS SHOWERS LAVA- TORIES SINKS SLOP SINKS LAUNDRY TUBE URINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT' NS TOTAL FIXTURES CONTR. LIST CHECK SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL. SPRKLR. SYSTEM SWIM'G POOL CoNTR. LIOT — CHECK I 4-3 hA Permit No 4 f ° Owner's Name and Address .`1 /v1_2a � Sias Septic Tank — Type of Tank_ Amount of Permit $ My Commission Expires M AMI SHORES VR lAG PLUMBING INSPECTION DEPARTME F PLUMM r G 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 net. A copy of approved plans and specifications must be kept at building during progress of work. No. _.__9.._ N • Liz_ Street_ 9 S-F, Registered Architect and /or Engineer_______. -- _.. ..___.._____._— __ _--- •____ - , Employing Plumber's Name- t• o nk s S p�� � � 1 e r C ti ' No S 8 o Ai • t.V . .. S fi ---- - - - -._ ......__ _. Street Location and Legal Description Lot..._ ____ ......... __ ..... ______ —._— Block__ __ _...__..... Subdivision Street and Number where work is to be performed —No__9_ 7 ,S /1/,..1•E • Street 9 ` 4- 1:4-, S t State work to be performed and purpose of building (By Floors) _ JAS a,11_ L a w r 5V" t .rn_ l _ . _ _ S . s . New Building .__ ____ Remodeling____-_ __________ Addition_________ Repairs No. of Stories.... ............. ____ Capacity Gals. Feet of Drain Tile _____Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: City — Well.__._ I - 2 ' 1 ` _Size of Soakage Pit __-- — -- - -- 3 ° Q— '_o n- 0 f 4' - - e- U a 1 „ 3 4, �— (Signed)_ 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 Pennanent 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. t c k s SFr( I + le_ C o. (Signed) _._ -/--�f. • 1 Date Aia ✓. 1(0 I G STATE OF FLORIDA, 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. 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 workmanship. BUILDING ELECTRICAL PLUMBING ROOFING Owner of Building_ Architect Contracto or Builder Legal Descriptic Address Building 0 0 0 0 done by his agents, servants or employees. CONTRACTOR OR BUILDER MIAMI SHORES VILLAGE. FLORIDA PERMIT N? 9998 Work to be performed under this Permit DATE Contractors ,. License No 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 in the statements or specifications and that he assumes responsibility for work Signed � BY INSPECTOR In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to 'the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either, myself, 'my agent{ servant or employee. BY AUTHORITY ' - . _ . , . r .. r n , Lot Bl Subdi- vision I f c Sq. Ft Amt. of Permit $ , Value of Project $ BUILDING ELECTRICAL PLUMBING ROOFING Owner of Building_ Architect Contracto or Builder Legal Descriptic Address Building 0 0 0 0 done by his agents, servants or employees. CONTRACTOR OR BUILDER MIAMI SHORES VILLAGE. FLORIDA PERMIT N? 9998 Work to be performed under this Permit DATE Contractors ,. License No 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 in the statements or specifications and that he assumes responsibility for work Signed � BY INSPECTOR In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to 'the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either, myself, 'my agent{ servant or employee. BY AUTHORITY BUILDING PERMIT APPLICATION FBC 2001 Permit Type (circle): Building Electrical Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Master Permit No. Owner's Name (Fee Simple Titleholder) JOHN DILLON Phone # 305 758 - 1985 Owner's Address 975 N.E. 94th St. Cit Miami SHores State FLorida Tenant/Lessee Name $ Value of Work. For this Permit 2000 Zip 33138 Phone # Job Address (where the work is being done) 975 N.E. 94th St. City M' S. Miami Shores Village County Miami -Dade Zip Is Building Historically Designated YES NO 1 - Contractor's Company Name LASSETER PLUMBING CO. Phone # 305 - 893 - 7180 Contractor's Address 865 N.E. 130th St. City N. Miami State Fl. Zip 33161 Qualifier John M. Lasseter Architect/Engineer's Name (if applicable) Phone # Code Enforcement $ Structural Plan Review. $ Total Fee Now Due $ r7 I / k< / (Continued on opposite side) Square Footage Of Work: C t IO554 * * * * * * * * * * * * * * * * * * * * * * * * * * ** F ees * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Permit No. pi =L -4a. Mechanical Roofing Type of Work: ['Addition EAlteration ['New ® Repair/Replace ❑ Demolition Describe Work: RE –ROUTE MAIN SANITARY LINE UNDER HOUSE FOR NEW SEPTIC TANK AND DRAINFIELD. Submittal Fee $ 53 .00 Permit Fee $ � 1 )te CCF $ I eZ ) CO /CC Notary $ Training/Education Fee $ f Li Technology Fee $3 . () 0 Scanning $ Radon $ Zoning Bond $ Bonding Company's Name (if applicable) Bonding Company's Address 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 IIVIPROVEMENTS 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. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued n the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. // its" of ., Co tractor The foregoing instl4rment was acknowledged before me this 9th The foregoing instrument was acknowledged before me this 9th day of Feb _ , 20 04 knyw b John M Lasseter who is (rsonally - me or who has produced who is p rsonallZknotb me or who has produced Signature ; Owner or Agent day of February20 04 , by John Dillon As identification and who did take an oath. 4 11%.* ? ''' MY COMMISS " '� 200 .__ 5 ' • c��� - EXPIRES: May dtd A ��` p o n dod Thou Notary Pubilc Undorw NOTARY PUBIC: Sign: Print: CHRISTIN My Commission E * * * * * * * * * * * * * * * ** State Certificate or Registration No.( - * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** * APPLICATION APPROVED B Chc 12/15/03 (Certificate of Competency Holder) l * C6 Signature ** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** as identification and who did take an oath. NOTARY PUBLIC: Sign: T^ -td Print: CHRIST My Commission E Certificate of Competency No. ******************************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** � 0 Z '' V Plans Examiner Engineer Zoning UTILITY -SEWER SIGN TIME CLOCK U TILITY -WATER FIXTURES - - EPTIC TAN( ANTENNA -- ELAY TELEVISION OUTLETS = D M IITFIELD, 4' TILE/RES. VIOLATION AND -- --- WAGE & ABANDON SEPTIC TANK REINSPECTION - SO AKAGE PIT W. FT. ARCH BASIN SD RGE WELL ME O _ STIC WELL EA. DRAIN OOF INLET _ .AR WATER HEATER =� RE STANDPIPE '= U OL PIPING IN SPRINKLER SYSTEM i ER SET (GAS) - PIPItIG = S S R DI R A T ET +S ADDENDUM TO BUILDING PERMIT APPLICATIO (AN APPLICATIQPFOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. IF A MASTER PERMIT HAS BET OBTAINED, 'THE OWNER'S NOTARJZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.) PLUMBING ELECTRICAL MECHANICAL ITEM U UNIT F FEE I ITEM U UNIT F FEE I ITEM U UNIT F FEE BIDET L LIGHT OUTLETS C CE HEATING DISHWASHER R RECEPTACLES A A/C (WINO) DISPOSAL S SERVICE TEMPORARY A A/C (CENTRAL) DRINKING FOUNTAIN S SERVICE SIZE IN AMPS D DUCT WORK FLOOR DRAIN S SERVICE REPAIR/1,CTER U WIDE R REFRIGERATION GREASE MAP A APPLIANCE OUTLETS P PROCESS NO PRESS PIPING INTERCEPTOR R RAT& E TUP _ _ U UNDERGROUND LAVATORY _ _ O OVEN ' A ABOVE CROON) TAN WATER HEATER U U.F. PRESSURE VESSELS CLOTHES WASHER M MOTORS 0- 1 IP S STEAM BOILERS SIOWER M MOTORS OVER 1- 3 IP H HOT. WATER BOILERS SINK, P01/3 COMP. M MOTORS OVER 3- 5 FP M MECHANICAL VENTILATION SINK, RESIDENCE M MOTORS OVER 5- 8 IP T TRANSPORTING ASSEMBLIES SINK, SLOP M MOTORS OVER 8- 10 IP E ELEVATORS /ESCALATORS TEMPORARY WATER CLOSET M MOTORS OVER 10- 25 HP F FIRE SPRINKLER SYSTEMS UR I IK M MOTORS OVER 25-100 If' COOLING TOWERS WATER CLOSET C r G OVER 100 IP V VIOLATION STRIP HEATER - ! ! ET +S ADDENDUM TO BUILDING PERMIT APPLICATIO (AN APPLICATIQPFOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. IF A MASTER PERMIT HAS BET OBTAINED, 'THE OWNER'S NOTARJZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.) PLUMBING ELECTRICAL MECHANICAL f Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Printed: 2/11/2004 Applicant: JOHN Owner: DILLON JOB A r D ESS: 975 E 94 9LrnbLr &rn ?t Permit Number: PL2CO4 - 42 DILLON JOHN ST Contractor LASSETER PLUMBING CO INC Contractor's Address: 865 NE 130 ST Local Phone: 305 - 893 - 7180 Parcel # 1132060350020 Legal Description: MAGEE & HAWKINS SUB PB 51 -5 LOT 2 LOT SIZE 15361 SQUARE FEET OR Fees: Description Amount FEE2004 -1424 Building Fee $120.00 FEE2004 -1425 CCF $1.20 FEE2004 -1426 Training and Education Fee $0.40 FEE2004 - 1427 Technology Fee $3.00 Total Fees: $124.60 Permit Status: APPROVED Permit Expiration: 8/7/2004 Construction Value: $2,000.00 Work: RE -ROUTE MAIN SANITARY LINE UNDER HOUSE FOR NEW SEPTIC TANK AND DRAINFIELD Page 1 of 1 Total Fees: $124.50 Total Receipts: 1600 t© Ss� 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) BY: Date Type Insp Permit No Name Address Company MIAMI SHORES VILLAGE BUILDING DEPARTMEN 305- 795 -2204 Building Inspection Request Phone # US Inspection Date Approved Correction Re-Insp'n Fee i MIAMI SHORES VILLAGE BUILDING DEPARTME 305- 795 -2204 Building Inspection Request Date 1 Type Insp'n ) tU Y 1 I Permit No 1" I p'VU 1 Name Address q L s - Company (3 Phone # Inspection Date Approved Correction Re- Insp'n Fee Dat Inspection Date Approved Correction Re- Insp'n Fee MIAMI'SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Type Insp'nfl�1 Permit No. u - q a Name 1 . Address qn S Company �� C1J e ' _ ' Phone # L "� )� KS'- 14 n