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PLUMBING
Permit No. - -- / 374 Amount of Permit $- Application is hereby mad for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein described. his 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 Divisior of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept al building during progress of work. Owners Name and Address .Q ‘4 s° ° "f, No._ Street • Registered Architect and /or Engineer ____ �� F .. ., Employing Plumber's Name -- _•_ - -- - -(�1 _ ° z " ` . 4 '.__ --... -� No._____ _ . ----- - - - -_. Street_ -- - ______.___ _ Block__ - __ __ _ _ - Sub vision Street and Number where work is to be performed —No. �%L r 2 g (- 7 Street y 9 State work to be performed and purpose of building (By Floors) MIAMI SHORES VILLAGE - PLUMBING INSPECTION DEPARTMENT Location and Legal Description Lot APPLICATION FOR PLUMBING PERMIT New Building Remodeling Addition___— ___._____- ._____ Repairs_ Size Septic Tank Type of Tank____ Capacity Gals. Feet of Drain Tile Dist. Feet of Tank or Drain Field from WeIL .......... ..._.. _..__ Nature of Water Supply: City — Well. _-- -. Size of Soakage Pit (Signed) __ _- .__ -__ 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 Pennanent Supplement, and has 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 an licensed by Miami Shores Village. (Signed)._..__(, Date - - - -_1 Master Plumber. _s_._ No. of Stories Plumbing Insi: ector. STATE OF FLORIDA, ss. COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally dppeare 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 lac therein by him stated are true. My Commission Expires Notary Public, State of Florida N(]IfE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or f. ul materiaajls and /or workmanship. CLOSETS BATH TUBS SHOWERS LAVA• TORIES SINKS SLOP SINKS LAUNDRY Turns URINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT' NS (,t, , 1r77,a// TOTAL FIXTUREI _ CLNBTR .0',L., __ ___ CHECK � � f , �� 1 ` `�� J J �/ r) l /.J G 1 _ ` �O.i /I° _ -� SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP •oot -*r NEATER DEEP WILL. SPRKLR. SYSTEM SWIM•S POOL CONTR. LIST .--) 5P CHECK Permit No. - -- / 374 Amount of Permit $- Application is hereby mad for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein described. his 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 Divisior of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept al building during progress of work. Owners Name and Address .Q ‘4 s° ° "f, No._ Street • Registered Architect and /or Engineer ____ �� F .. ., Employing Plumber's Name -- _•_ - -- - -(�1 _ ° z " ` . 4 '.__ --... -� No._____ _ . ----- - - - -_. Street_ -- - ______.___ _ Block__ - __ __ _ _ - Sub vision Street and Number where work is to be performed —No. �%L r 2 g (- 7 Street y 9 State work to be performed and purpose of building (By Floors) MIAMI SHORES VILLAGE - PLUMBING INSPECTION DEPARTMENT Location and Legal Description Lot APPLICATION FOR PLUMBING PERMIT New Building Remodeling Addition___— ___._____- ._____ Repairs_ Size Septic Tank Type of Tank____ Capacity Gals. Feet of Drain Tile Dist. Feet of Tank or Drain Field from WeIL .......... ..._.. _..__ Nature of Water Supply: City — Well. _-- -. Size of Soakage Pit (Signed) __ _- .__ -__ 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 Pennanent Supplement, and has 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 an licensed by Miami Shores Village. (Signed)._..__(, Date - - - -_1 Master Plumber. _s_._ No. of Stories Plumbing Insi: ector. STATE OF FLORIDA, ss. COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally dppeare 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 lac therein by him stated are true. My Commission Expires Notary Public, State of Florida N(]IfE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or f. ul materiaajls and /or workmanship. • flp r ••• • •=' • e Yz /Yr(a So y E7T Foie A9gVies FLI te LoT t Lt<'ic 1 )411,q1-4J1 fiti6e; irLei —_ —+ BATH TUBS S LAVA. TORIES SINKS SLOP SINKS LAU NDRY Tu a Tulsa URINALS CATCH BASIN FLOOR DRAIN DRINKI NO FOUNT' NS TOTAL FIKTUREI CONTR. LIST CHECK __ SEPTIC TANK SEWER Comm. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SW IM'O POOL CONTR. LIST CHICK I I- 10 D Permit No. . __ 1 0 s `S ® Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or othei 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 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 during progress of work. Owner's Name and Address. Registered Architect and /or Engine Amount of Permit $ Employing Plumber's Name .______ MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT No. , No. Street Location and Legal Description Lot---_-_------ ........... — .......... -- -__ —_ -_- Block_ . . _.-- _---- __ - -•- -_ Subdivision Street and Number where work is to be performed —No. _E. _ Street. - State work to be performed and purpose of building (By Floors) New Building - Remodeling _ Addition Capacity Gals. Size Septic Tank Type of Tank_ Feet of Drain Tile Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: City —Well. . Size of Soakage Pit d _ _.�. (Signed) (Signed) Repairs Date 1 ; — Street No. of Stories Plumbing Tnspector. 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 Cn- 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 art licensed by Miami Shores Village. Master Plumber. STATE OF FLORIDA, ss. 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 tac therein by him stated are true. My Commission Expires Notary Public, State of Florida NOTE: A re -' spection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or Ltd materials and /kmanship. Permit No 31 __ Registered Architect and /or En ineer ..... � _ gi , k Mir Employing Plumber's Name_ o Location and Legal Description Lot__-__ Size Septic Tank Feet of Drain Tile_ - __ — Nature of Water Supply: City -Well MIAMI SHORES VIL °l PLUMBING INSPECTION DEPARTMEu4:''' APPLICATION FOR PLUMBING Application is hereby made for the approval of the detailed statement of to i 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 nut. A copy of approved plans and specifications must be kept at building during progress of work. Owner's Name and Address -_ __ -- - _ --. - __ -- No._ __1 ® _ Street.. _ /• F. 9_ S • • _ Bloch Street and Number where work is to be performed- No. �Li2J State work to be performed ) s 0 New Building Remodeling Addition_ ___ - - Date /- 3o -55( Subdivision -- -----------------_-__-- Street.* • / Repairs No. of Stories. Type of Tank__ Capacity Gals. _Dist. Feet of Tank or Drain Field from Well Size of Soakage Pit My Commission Expires Notary Public, State of Florida �4 (Signed)._ _v'S = :; c t ?_ Amount of Permit = gn )- ------ __--- __.-. - Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his • •ligations 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. (Signed) __ / I�.-� _'._ �, 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 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. CIOSETfi BATH SHOWERS LAVA- TORIES SINKS SLOP SINKS LAUNDRY T8 Timis U RINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT'N6 TOTAL FIXTURES CONTR. LIST CHECK SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SWING POOL CONTR. LIST - CHECK Permit No 31 __ Registered Architect and /or En ineer ..... � _ gi , k Mir Employing Plumber's Name_ o Location and Legal Description Lot__-__ Size Septic Tank Feet of Drain Tile_ - __ — Nature of Water Supply: City -Well MIAMI SHORES VIL °l PLUMBING INSPECTION DEPARTMEu4:''' APPLICATION FOR PLUMBING Application is hereby made for the approval of the detailed statement of to i 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 nut. A copy of approved plans and specifications must be kept at building during progress of work. Owner's Name and Address -_ __ -- - _ --. - __ -- No._ __1 ® _ Street.. _ /• F. 9_ S • • _ Bloch Street and Number where work is to be performed- No. �Li2J State work to be performed ) s 0 New Building Remodeling Addition_ ___ - - Date /- 3o -55( Subdivision -- -----------------_-__-- Street.* • / Repairs No. of Stories. Type of Tank__ Capacity Gals. _Dist. Feet of Tank or Drain Field from Well Size of Soakage Pit My Commission Expires Notary Public, State of Florida �4 (Signed)._ _v'S = :; c t ?_ Amount of Permit = gn )- ------ __--- __.-. - Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his • •ligations 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. (Signed) __ / I�.-� _'._ �, 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 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. BUILDING ELECTRICAL PLUMBING ROOFING Architect Contractor ` or Builder Address of Building MIAMI SHORES VILLAGE, FLOR.I 195+ ERMIT N? 14055 ❑ Wor to be performed under this Permit 1 Legal Lot 11 Bl. Description. Subdi- vision Value of Project $ / This permit is granted to the codtractor or builder named above to construct the building or to install herefor in strict compliance with; all ©tAnanees pertaining thereto and with the understanding that the work drawings, statements or specifications that may have been submitted to and approved by the proper muni time if the work is no done in comp lianbe with such ordinances or if the plans are changed without author granted is the understanding that! the «ntractor or builder named above assumes the responsibility for a pertaining to the work covered hereby ' hether shown on the plans or drawings or in the statements or spe done by his agents, servants or employees. Signed `'4 rl CTOR In consideration of the issuance me of this permit I agree • p•.. orm the work covered here pertaining thereto and in strict conform ty with the plans, drawings, s + +ents or specifications submitted In accepting this permit I assume resspdnsibihty for all work done by either, myself, my agent, servant or ( 144 -r+,: t CONTRACTOR O R BUI BY Amt. of Permit $ or device deeeribed in the application = in compliance with any I{ians, This Permit may be revoked ai any condition upon which this p of the ordinances and ns assumes respondbility or - ork with all ordinances and regulations piper authorities of Miami Shores Village. AUTHORITY BUILDING ❑ ELECTRICAL PLUMBING ROOFING Owner of Building Architect Contractor or Builder Legal Description Address of Building Lot ❑ E RMIT N? 13769 ❑ Work to be performed under this Permit M IAMI SHORES VILLAGE. FLORIDA DATE 7 " •5 195 II BL_ eh Y1; 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 ed in compliance with any plane, drawings, statements or specifications that may have been submitted to and approved by the proper municipal autho ek 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 farther condition upon which this permit is granted is the understanding that the contractor or builder named above assumes the respon 'bility for a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or draw qg _,:,. ;. the st e, eats or specifications and that hj ssumes reap Drib' ' for work done by his agents, servants or employees. Signed• Subdi- vision Value of Project $ In consideration of the issuance to pertaining thereto an in strict conformity In accepting this t I assume respon 1 " CONTRACTOR OR bUILDB BY Contractor's License No Amt. of Permit l 1. $1 INSPE c e of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations 'eh the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. ty all work byyg, r »elf, mom agen se employee. AUTHORITY 9 MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build- ing 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 herei'iTspecified or not. A copy of approved plans and specifications must be kept at building during progress of the work. 19 r ", Owner's Name and Address t I__R,. f . L.. Iv( AY Registered Architect and /or Engineer Disapproved Date (Signed) --- F'}---- ' - -��`` ilding Inspector Name and address of licensed contractor 0 _>l6LN a 1Z- or D ate _ _'. ,, : jj No.___ Street IV. VV /O / $ 7 Q '1 So✓% Location and legal description of lot to be built on Lot 12, Block j_$_ Subdivision _k b_ 27.17Z1_ Street and Number where work is to be done ..1_ _S_ r , - • e • '17 r State work to be done and purpose of building (by floors) °Pith I Sl s l►nc. C av� l To be constructed of__C__IS‘ I Kind of foundation 12C-'} etc Cc) lek C rtr C: Roof Covering Ct' tnete ed Estimated Total cost of improVements $ z e> 0 0 c) ei - Amount of Permit $ and for no other purpose. New Building V Remodeling Addition Rep irs No. of Stories Distance to next nearest building .I 2- 0 • Size of Building Lot q 0 x j 12. Maximum live load to be borne by each floor I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may be sent to 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 complied with the rovisions 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 o. the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such subcon • , on work tube performed under this permit, as are licensed by Miami Shores Village. Remarks _ (Signed) 3I ee @ vt CQ STATE OF FLORIDA, COUNTY OF DADE. ss Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap- peared - - - - - -- 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 h arefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. Permit No • Date__ = __ „Read, Sworn to and Subscribed before me. Notary Public, State of Florida My Commission Expires PLANNING BOARD DATE Chairman Member Member Member Member Member Council Approved Date Disapproved Date NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has been obtained from the Planning Board. A re- inspection fee of $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and /or workmanship. BUILDING ❑ .t /V Date _6C ELECTRICAL ❑ PLUMBING PERMIT N9 8031 Contractor's ROOFING ❑ License No. 3 0 Work to be performed under this Permit O of � 1 Buwner ilding 1!y' ..e. G/€ Arty Architect ,(� ( �/W► 1 -ez. L Vim I I II BI Contractor / ,( or Builder ✓ l r L Legal Description Address of Building Lot CONTRACTOR or BUILDER MIAMI SHORES VILLAGE, FLORIDA .2s '�. 3 / .• 3 TjGJ S` 5/ - Subdi- vision Sq Ft. Value of Project $ II Amount of II Permit $ This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the applica- tion herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes respon- sibility for work done by his agents, servants or employees. Signed _SL a % '. (INSPECTOR) BY �� In consideration of the issuance to me of this perja it I agree to perform the work covered hereunder in compliance with all ordinances and regulation, pertaining thereto and in strict conformity with the plada; 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 G'� Application is hereby !Hide 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 Employing Plumber's Name Size Septic Tank_______ Feet of Drain Tile__ Nature of Water Supply: City — Well..____. Amount of Permit $ MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT My Commission Expires (Signed)_ O ` ( Signed ) - ___ -_- No._— ___- --- --- .------ -__ -__ Street_ Date -6 / No. 9,). . " 4de7 Location and Legal Descri _____ _ Bloc ! - Subdivision.- - - - - -- ------- -___ -- Street and Number where work is to be performed —No __/‘V G �l $ 2 7 'T Street State work to be performed and purpose of building (By Floors) ____..._ _ -__ -- _ New Building _ Remodeling Addition. Type of Tank__ _ —Dist. Feet of Tank or Drain Field from Well Size of Soakage Pit Repairs No. of Stories. Capacity Gals - Notary Public, State of Florida Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts s obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florid�ennanent Supplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contra ors 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. 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. 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 worlmmanship. CLOSETS BATH TUBS SHOWERS LAVA muss SINKS SLOP SINKS LAUNDRY TUBS URINALS INAS CATCH BASIN FLOOR DRAIN DRINKING FOUNT'NS TOTAL FIXTURES Comte. LIST L / . CHECK SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SWIM'G POOL / LIST CHECK Application is hereby !Hide 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 Employing Plumber's Name Size Septic Tank_______ Feet of Drain Tile__ Nature of Water Supply: City — Well..____. Amount of Permit $ MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT My Commission Expires (Signed)_ O ` ( Signed ) - ___ -_- No._— ___- --- --- .------ -__ -__ Street_ Date -6 / No. 9,). . " 4de7 Location and Legal Descri _____ _ Bloc ! - Subdivision.- - - - - -- ------- -___ -- Street and Number where work is to be performed —No __/‘V G �l $ 2 7 'T Street State work to be performed and purpose of building (By Floors) ____..._ _ -__ -- _ New Building _ Remodeling Addition. Type of Tank__ _ —Dist. Feet of Tank or Drain Field from Well Size of Soakage Pit Repairs No. of Stories. Capacity Gals - Notary Public, State of Florida Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts s obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florid�ennanent Supplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contra ors 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. 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. 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 worlmmanship. 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 ;iiores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specific'..:r 'r'.. A. cop; ;f approved plans and specifications must be kept at building during progress of work. tie) Owner's Name and Address - Fro son Construction No. __.___._._____________________ Street. Registered Architect and /or Engineer — .- ----- -- ---- --- __.- -.- - -- _ -�- -- _- _- -- -. _ -- - --- _- _ -- -._ _ p Employing Plumber's Name a. , _ :3...5? � �+ ,P S _ � t ..__ No.—+4 --444-76 Street._ — Location and Legal Description Lot.____._ _ ._._ _ 14. l 1 Block_ Street and Number where work is to be performed -No N . E . 97 Street street State work to be performed and purpose of building (By Floors) New Building ___ Remodeling__.__ _ __._ Addition__ Size Septic Tank 6 0 0 - _ ..- - _ Type of Tank-_ Pre-Cas Capacity Gals Feet of Drain Tile 251 __Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: City - Well._ -._____ ....... _..... ._Size of Soakage Pit Amount of Permit $ MIAMI SHORES VI- 4,E PLUMBING INSPECTION DEPARTMEi `=' APPLICATION FOR PLUMBING `, .;'/;p 1' Repairs (Signed )- - -- c Date June 6, 1961 Subdivision __.___.— ._._..__.__..__._____.. Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his oF►. ations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Pen ent 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. No. of Stories- ( Signed). . H. HI(( INBOTHAM,JA umber. STATE OF FLORIDA, as. 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. 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 worl®anship. CLOSETS BATH TUB6 TUBS LAVA- TORIES SINKS INKS SLOP SINKS LAUNDRY TUBS U CATCH BASIN FLOOR DRAIN DRINKING FOUNT'NS TOTAL FIXTURES CONTR. LIST CHECK SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SWIM'O POOL CONTR. LIST 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 ;iiores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specific'..:r 'r'.. A. cop; ;f approved plans and specifications must be kept at building during progress of work. tie) Owner's Name and Address - Fro son Construction No. __.___._._____________________ Street. Registered Architect and /or Engineer — .- ----- -- ---- --- __.- -.- - -- _ -�- -- _- _- -- -. _ -- - --- _- _ -- -._ _ p Employing Plumber's Name a. , _ :3...5? � �+ ,P S _ � t ..__ No.—+4 --444-76 Street._ — Location and Legal Description Lot.____._ _ ._._ _ 14. l 1 Block_ Street and Number where work is to be performed -No N . E . 97 Street street State work to be performed and purpose of building (By Floors) New Building ___ Remodeling__.__ _ __._ Addition__ Size Septic Tank 6 0 0 - _ ..- - _ Type of Tank-_ Pre-Cas Capacity Gals Feet of Drain Tile 251 __Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: City - Well._ -._____ ....... _..... ._Size of Soakage Pit Amount of Permit $ MIAMI SHORES VI- 4,E PLUMBING INSPECTION DEPARTMEi `=' APPLICATION FOR PLUMBING `, .;'/;p 1' Repairs (Signed )- - -- c Date June 6, 1961 Subdivision __.___.— ._._..__.__..__._____.. Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his oF►. ations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Pen ent 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. No. of Stories- ( Signed). . H. HI(( INBOTHAM,JA umber. STATE OF FLORIDA, as. 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. 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 worl®anship. Permit No 90 31 0-e) 3 Amount of Permit $._ 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 (si ( Signed)._ Date October 13, 1966 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. Richard Doyle No._ 1015 H. E. 97th Street Owner's Name and Address Street. Registered Architect and/or Engineer ----- Employing Plumber's Name ABC SEPQ TANK SERVICE No. 31 23 _._ Location and Legal Description Lot__ Block Subdivision__ Street and Number where work is to be performed—No-___1a5_______ ___ Street_ N„E, 97th Street Repairs X No. of Stories. Size Septic Tank_ Type of Tank_ Capacity Gals. Feet of Drain Tile 251 _Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: City—Well _Size of Soakage Pit aster Plumber. PlunThing 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. STATE OF FLORIDA, as. 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. 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 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 Corm:. LIST CHUCK SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SWIM•G POOL CONTR. LIST CHECK Permit No 90 31 0-e) 3 Amount of Permit $._ 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 (si ( Signed)._ Date October 13, 1966 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. Richard Doyle No._ 1015 H. E. 97th Street Owner's Name and Address Street. Registered Architect and/or Engineer ----- Employing Plumber's Name ABC SEPQ TANK SERVICE No. 31 23 _._ Location and Legal Description Lot__ Block Subdivision__ Street and Number where work is to be performed—No-___1a5_______ ___ Street_ N„E, 97th Street Repairs X No. of Stories. Size Septic Tank_ Type of Tank_ Capacity Gals. Feet of Drain Tile 251 _Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: City—Well _Size of Soakage Pit aster Plumber. PlunThing 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. STATE OF FLORIDA, as. 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. 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 by improper notice for inspection, or faulty materials and/or workmanship. 1 y - -' CLOSETS BATH Tu• • SMOW[II• LAVA. TONSIL/ . SLOP SINKS SINKS LAUNDRY TUDS URINALS BASIN FLOOR DRAIN DRINK NO FOUNT' N• TOTAL Ft•TURES CONTR. LIST CHECK - SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT G TRAP SOLAR MEATY DEE WELL . a !Worts POOL CoNTR. LIST 2 6 �— CHECK MIAMI SHORES VILLAGE ,5 7o1/ PLUMBING INSPECTION DEPARTMENT .5-5 L 5e 50 APPLICATION FOR PLUMBING PERMIT Permit No 14 10 � :�� ... .__.__. 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 spedfied or not. A copy of approved plans and spedfications must be kept at building during progress of work. - Owner's Name and Address der"wO� No. /O /'f Street..,& 9 7 ST, ___ .. Registered Architect and /or Engineer Employin g Plumbers Name AT 4JZMuric �'cvA London a Legal Description Lot- ,Z-sa B Subdivision fig Street and Number where work is to be performed —No /e / r q 7 S Street State work to be performed and purpose of building (By Floors) -------- _ - - -_._ __� ...- ..... -.. Remodeling _ Addition.. - - - -._. Repairs New Building---------- -_ - - -- g— .— .._.._.._..._ Size Septic Tank__- Type of Tank. —_ Feet of Drain Tile 01-00 Dist_ Feet of Tank or Drain Field from Well ... -.__. Nature of Water Supply: City—Well. Size of Soakage Pit. Amount of Permit $ .g.c769 d 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 kw( com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the worn to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such p lic notice or notices as err required by the Act. The undersigned agrees to employ only such orb -contr on . k to perf . \ nder this permit, Ks are licensed by Miami Shores Village. (Si No. of Stories. 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 appeared to me well known, and who, being by me first duly sworn. upon oath deposes and says that he is the .__.._ .. _ - •- •- •-- -. -..- _ _... _. _ -- of the above described construction, that be bas 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 Publio, State of Florida NOTE: A re inspection fee of $1.00 will be made whas mob tr.iaspeetfas Y made•neoemery by improper notice for inspect on, ce faulty materials and /ar worlonanahip. STATE OF FLORIDA DEPARTMENT OF HEALTH AND REHABILITATIVE SERVICES ONSITE SEWAGE DISPOSAL SYSTEM CONSTRUCTION AND INSTALLATION PERMIT Applicant 01 . 7"� 11 Per pit Number 6 4 Z C 5' .7 4 - 0),66'r $S ' o .�, , 9 7 ,� 2 o PART II - SYSTEM INSTALLATION sT ALLATION INSPECTION AND FINAL INSTALLATION AP ---- -- Installer (Ae-e' f Proper tank legend: Yes /J '7 No Tank material Tanks watertight: Yes / ) ' 41- No Tank size• gallons gallons t-J A'J' gallons Proper tank outlet device: Yes Yes_P_A7. No Manhole or marker to grade: Yes /.1 - No Absorption Bed Length Width Length With Length o ° feet x ( feet = ° 0 ft 2 feet feet /�•� �— feet feet Length feet x — feet= — ft feet feet feet feet Proper No. drainlines: Yes l / No feet feet feet feet Proper pipe separation: Yes t/ No Total = ft Total = ft Distribution box level: Yes No,8- Systems located as permitted: Yes/ No Systems including plumbing stub -outs installed at proper elevation: Yes _4J/No Date Average depth to drainpipe invert from finished grade inches Maximum depth Inches Average depth of drainfield gravel: /J inches Minimum depth of gravel /-Z, inches Proper gravel size: Yes V No Gravel is suitable quality: Yes No Backfill or fill material as required: (Quality) Yes No (Quantity) Yes _�,' No Other findings Inspected by Ali 7` d (0 !) Approved by: Drainfield Trench HRS —H Form 4016, Feb 85 (Obsoletes previous editions which may not be used) (Stock Number. 5744 - 002. 4016.0) Tank Manufacturer A-) .7 - Tank level: Yes ' No Date e--77.e7f‘ PA T III - F N4 INSTALLATION APPROVAL--- ----------- --•---«----°--°-----°-••--°-- COUNTY PUBLIC HEALTH UNIT AN APPROVED ALLATIO DOES NOT GUARANTEE PERFORMANCE Note: Completed copies of th' fo m will be pr•vided to the applicant, installer and the building department. Page 2 of 2 Permit No............ _______ 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 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 Ri chard Doyle N 1015 Street 97 Registered Architect and /or Engineer Southeastern Natural Gas Co. _ 2540 N.W 29 Ave. Employing Plumber's Name Location and Legal Description Lot_.______________________ Street and Number where work is to be performed —No. No._ _______ ____ Street__ Blo4r 101,5 �I1T_, k: —_ Street_ 91 St • State work to be performed and purpose of building (By Floors )_--- __t�Ylrii'�1igS�- _�Si3__ New Building______•_.__ -____. Remodeling __ __. -__._ Addition._______._______ __._._ Repairs No. of Stories- _ Size Septic Tank ....... - - - - -- Type of Tank 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 $_ My Commission Expires (Signed) (Signed) Capacity Gals Date__._...eb_. - 1961 Subdivision 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. — der. STATE OF FLORIDA, COUNTY OF DADE. j 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 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. BATH CLOBETBI T TUBS SHOWERS SHOWERS LAVA• SINKS SLOP SINKS LAUNDRY TUBE URINALS IAS CATCH BASIN FLOOR DRAIN DRINKING FOUNT'NS TOTAL FIXTURES CONTR. Liar CHECK. I SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SWIM'G P001. COMTR. LIST CHECK _ - Permit No............ _______ 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 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 Ri chard Doyle N 1015 Street 97 Registered Architect and /or Engineer Southeastern Natural Gas Co. _ 2540 N.W 29 Ave. Employing Plumber's Name Location and Legal Description Lot_.______________________ Street and Number where work is to be performed —No. No._ _______ ____ Street__ Blo4r 101,5 �I1T_, k: —_ Street_ 91 St • State work to be performed and purpose of building (By Floors )_--- __t�Ylrii'�1igS�- _�Si3__ New Building______•_.__ -____. Remodeling __ __. -__._ Addition._______._______ __._._ Repairs No. of Stories- _ Size Septic Tank ....... - - - - -- Type of Tank 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 $_ My Commission Expires (Signed) (Signed) Capacity Gals Date__._...eb_. - 1961 Subdivision 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. — der. STATE OF FLORIDA, COUNTY OF DADE. j 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 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. Z 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 Management (DERM) and/or Miami -Dade Water and Sewer Department (MDWASD) approval is required for applications involving sewers. AFFIDAVIT - Please read carefully. Application is hereby made to obtain a permit to do work and installation as indicated. I, the OWNER of the property, certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits are required for ELECTRICAL, PLUMBING, POOL, EXTERIOR DOOR, MECHANICAL, WINDOW, FENCE, DRIVEWAY, ROOFING and SIGNS and there may be additional permits required from other governmental agencies. I, the OWNER of the property, have disclosed all information related to any work at the property performed in the prior twelve months to the Building Official. Further, I am fully aware that if the cumulative cost of work to my home or business under this and any other permit equals or exceeds fifty percent (50 %) of the fair market value of the structure, the entire structure must meet the present federal flood criteria for finished floor elevation. I am also fully aware that if the total cost of work to my home or business under this and any other permit exceeds fifty percent (50 %) of the replacement cost of the structure, then the entire structure must conform to the current code requirements of the Building Code. WARNING TO OWNER: Your failure to record a NOTICE OF COMMENCEMENT may result in you paying twice for improvements to your property. If you are spending more than $2,500 or intend to obtain financing, you may wish to consult with your attorney or lender before recording your Notice of Commencement. The Notice of Commencement must be recorded at: 22 N.W. 1st Street, 1°' Floor, (305) 679 -1078. Once recorded, the Notice of Commencement must be POSTED AT THE JOB SITE in accordance with Section 713 -35 of Florida Statutes. Review the brochure at Village Hall on Construction Lien Law and Choosing a Contractor. ture of STATE Si Print Name Print Name day . Sworn to and subscribed before me this day of war S bto o and subscribed before me this SEAL: Personally known Public - • to of lorida MIAMI -DADE STATE OF FLORIDA, COUNTY OF MIAMI -DADE Signature of Contractor / Qualifier Signature of Notary Public - State of Florida PERMIT APPLICATION I OFFICIAL - SEAL: ' ANGELA F9 BEC■:' : . - . copogsSor3 riutAT.L.4 CC76s^i697 OR, Prod udedddentification G/ Personally known OR, Produced Identification Type of Identification Produced:F 2.4) 5 56.3 -5 70" / k Type of Identification Produced: PROPERTY OWNER New Construction Name a i EV Addregs� / Al 2 ss . Home Telephone ( 5 Demolish Business Telephone /„D0 CL ' !1 �" �C� CP Fax Add'l Attachment TYPE OF MANAGEMENT (✓ ) New Construction Enclosure Alteration Exterior Repair Alteration Interior Demolish Relocation of Structure Shell Only Foundation Only Add'l Attachment Other Add'l Detachment Other Step 1. Job Address: ) 015 Address PERMIT TYPE (✓ ) Building Electrical Mechanical Plumbing LPGX Roofing Fence Other Folio Number Lot Block Subdivision PB PG Current Use of Property Proposed Use of Property Tenant Information PERMIT CHANGE (✓ ) Chg. Contractor Renewal Revision Extension Supplement Reinspection ARCHITECT Name License No. Address Telephone Fax Apt. City ��s rip' n of Work Master Permit No. Subsidiary Permit No. PERMIT APPLICATION INSTRUCTIONS - The following steps must be taken to obtain a permit from the Miami Shores Village: Complete the attached permit application which must be signed by the property owner and qualifier. Both signatures must be notarized. Please print or type to allow for a more accurate processing of your application. If roofing work will be done, a roofing application must be submit- ted along with this permit application. 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. A PPLICATION Zoning ►'i Feet Square Feet Units Floors 1— Vge of Wor % 1 (-12 1 9 Bldg Value Tax Assessed/Appraised Value Flood Zone Base Floor Elev. ENGINEER Name License No. Address Telephone Fax CONTRACTOR Name License No. Address Telephone Fax Qualifier Name 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 Flood Lights Plugmold/Strip Subfeeds, No. of Amps A/C Window FPL - Load Central Posts Swim Pool, Commercial Air Conditioners Garbage Disposal Range/Range Top Swim Pool, Residential Chiller Generators, etc. Receptacles Switchboards Clear Violations Heat Recovery Refrigerator, Comm. (p/PH) Temp Serv., Construction Compactor Low -volt, Burglar Refrigerator, Domestic Temp for Test - 30 days Deep Freezer Low -volt, Fire Renew - Temp Service Water Closet Demolition Low -volt, Intercom/Teleph. Repair Circuits Water Heater Dishwasher Low -volt, Television Service, Number of Amps Water Heater New NIECHANICAL TYPE Minimum Fee QTY. TYPE Condensate Drain QTY. TYPE: Generator QTY. TYPE Refrigeration, Tons Q'I'Y. 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 Sprinlder 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. "rvi'i; Miscellaneous Fixture QTY. 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 Drains, French Miscellaneous Equipment Sink Well, Supply Page 3 PERMIT APPLICATION INSTRUCTIONS: Please indicate the type of work being performed and quantity(ies) in the space provided below. RECEIVED AND REVIEWED BY: DATE: Page 4 OFFICE USE ONLY CHECKLIST ❑ OWNER - BUILDER FORM (Attach) ❑ FIRE DEPARTMENT APPROVAL (Commercial / multi - family) ❑ CONCURRENCY (New Construction) ❑ OTHER (Specify & Attach) $3.00 per page (Scanning Fee) Miami Shores Village Bond. Metropolitan Dade County (C.C.F.) Inspector State Educational Fund State DCA (Radon) Code Enforcement Fine Zoning Review Notary ❑ PROOF OF OWNERSHIP (Attach) ❑ HRS / DERM APPROVAL (Septic / Sewer) ❑ IMPACT FEE (New Construction) ❑ OTHER (Specify & Attach) PERMIT FEES $ L'(X) $ . a ( sq.ft. = x/1000 x ¢.60) $ (¢.005 /sq.ft.) $ (¢.01 /sq.ft.) $ -D U SECTION Zoning Electrical Mechanical Plumbing Fire Public Works Structural Building Official BY DATE PERMIT APPLICATION ❑ CONDO ASSOCIATION APPROVAL (Attach) ❑ BPR APPROVAL (Restaurants) ❑ CONTRACTOR REGISTRATION (On File) TOTAL $ ISSUING OFFICIAL REVIEWED AND PREPARED BY: 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 • s) Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Permit Number: BP2002 -1370 Printed: 8/6/2002 Applicant: 1 JOEL AMSTELL Owner: AMSTELL 1 JOEL JOB ADDRESS: 1015 NE 97 ST Contractor Local Phone: Parcel # 1132050170120 Fees: Description Amount FEE2002 -4370 Building Permit Application Fee $60.00 FEE2002 -4371 Notary Fee $5.00 FEE2002 -4372 CCF $1.20 Total Fees: $66.20 Total Fees: $66.20 Total Receipts: $0.00 Permit Status: Approved Permit Expiration: 2/2/2003 Construction Value: $1,618.00 Work: TAKE OUT BATHROOM REMODELING (CHANGE FIXTURES & TILE FLOOR) 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 rrd 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: Signed: Building Permit Contractor's Address: Legal Description: 5 6 53 42 Page 1 of 1 PB 43 -51 REV PL MIAMI SHORES SEC 8 LOT 12 BLK 180 (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, state _ent 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, s •rvants o REG IC01 080902 1146 MC #01 000246 SUBTOTAL 366.20 (Contractor or Builder) BY: Date 8:6 (c9 PERMIT AP FOR MIAMI SHORES VILLAGE �D /✓ T Job Address C HSireet Tax Folio Legal Description Historically Designated: Yes No Owner/Lessee / Tenant Srv4 Owner's Address Contractin Co.1lam JoesPliethin9 v Quaer 3)gJ2fl/ S JW LC2Lg19 /1(7 State #01001900G — My Commission Ex4if Qe FEES: PERMIT APPROVED: Zoning Mechanical RADON Municipal # Fl Date Master Permit # c Z ' Phone Address 'MO AIN /0 ss# Phone t : - 75[ Competenc # I ns. Co. `U 7 Architect/Engineer ? Address Bonding Company Mortgagor Permit Type (circle one): BUILD I G ELECTRICAL _ LUMBIN ECHANICAL ROOFING PAVING FENCE SIGN Address Square Ft. Estimated Cost (value) (q(JC/ 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 nstruction and zoning. Furthermore, I authorize the above -named contractor to do the work stated. My Commission Exp1ji• Electrical BOND TOTAL DUE l Z Date Structural Engineer O Miami Shores Village 10050 NE 2nd Avenue Phone: 305- 795 -2204 Permit Number: PL2002 -208 Printed: 8/14/2002 Applicant: 1 JOEL Owner: AMSTELL JOB ADDRESS: 1015 Contractor THE NEW MIAMI Local Phone: 305 - 751 - 2446 Parcel # 1132050170120 Q Permit Status: Approved Permit Expiration: 2/9/2003 Construction Value: Work: KITCHEN RE -PIPE AND RELOCATE WATER HEATER an.r gib ,.0 u SHORES PLUMBING Contractor's Address: 900 NW 144 ST NE 97 Legal Description: INC. THE NEW MIAMI UE ACCOUN PLUMBING, 900 N.W. 144TH ST. Q.05riS1` •-2A4G MIAMI, FL 33168 PAY / ,�� 1 ' TO THE , , II ORDER OF 1 \ l I ' C Plumbing Permit AMSTELL 1 JOEL ST DATE 565342 PB 43 -51 REV PL MIAMI SHORES SEC 8 LOT 12 BLK 180 $2,400.00 1536 DOLLARS. 8 63-151167 Page 1 of 1 12_0, OD Total Fees: $x`00 Total Receipts: $0.00 01 . Re- inspection .plication herefor in strict compliance with all cifications that may have been submitted to :es or if the plans are changed without .sponsibility for a thorough knowledge of the d that he assumes responsibility for work done ins pertaining thereto and in strict conformity responisibility for all work done by either COLONIAL BANK 1� . Miami Beach. F can 1.8800- 4 Hr . 1:06 ?00 L 5 LB 80 2 ? 86 30 291 u' L S 3611 ,® -- BY: ITEM BATH TUB UNIT • FEE ITEM SWITCH CURETS UNIT FEE ITEM SPACE HEATERS UNIT FEE B I OET LIGHT OUTLETS CENTRAL HEATING DISHWASHER RECEPTACLES A/C (WINO) OISAOSAL SERVICE TEMPORARY A/C (CENTRAL) DRINKING FOUNTAIN SERVICE SIZE IN AAPS DUCT WORK , FLOCK DRAIN SERVICE REPAIR4€TER CHANGE REFRIGERATION GREASE TRAP APPLIANCE CUTLETS PROCESS AN0 PRESS PIPING INTERCEPTOR 0 RANGE TOP UNOERGICUI*0 TANKS LAVATORY OVEN ABOVE GROUND TANKS LAUNDRY TRAY i WATER HEATER U.F. PRESSURE VESSELS CLOTHES WASHER 0 MOTORS 0- 1 HP STEAM BOILERS SHOWER i MOTORS OVER 1- 3 HP HOT WATER BOILERS SINK. POT /3 COMP. MOTORS OVER 3- 5 FP MECHANICAL VENTILATION SINK, RESIDENCE i MOTORS OVER 5- 8 HP TRANSPORTING ASSEMBLIES SINK. SLOP MOTORS OVER 8- 10 HP ELEVATORS/ESCALATCRS TEMPORARY WATER CLOSET MOTORS OVER 10- 25 HP FIRE SPRINKLER SYSTEMS . URINAL MOTORS OVER 25-100 HP COOLING TOWERS WATER CLOSET ` MOTORS OVER 100 HP VIOLATION INDIRECT WASTES A/C WINDOW REINSPECTION WATER SUPPLY TO: AIR CONDITIONERS • A/C UNIT STRIP HEATER FIRE SPRINKLER GENERATORS TRANSFORMERS HEATER -NEW INST. ` GENERATORS TRANSFORMERS HEATER - REPLACE 1 GENERATORS TRANSFORMERS • LAWN SPRINKLER -WELL SPECIAL PURPOSE SWILLING POOL OUTLETS COMMERCIAL WATER SERVICE SIGN TUBES SEWER CONNECTIONS SIGN TRANSFORMERS UTILITY -SEWER SIGN TIME CLOCK UTILITY -WATER FIXTURES SEPTIC TANK ANTENNA ' RELAY TELEVISION OUTLETS GRAINFIELD, 4' TILE/RES. VIOLATION PUMP & ABANDON SEPTIC TANK REINSPECTION SOAKAGE PIT CU. FT. CATCH BASIN DISCHARGE WELL DOMESTIC WELL AREA DRAIN , ROOF INLET SOLAR WATER HEATER FIRE STANDPIPE , POOL PIPING LAWN SPRINKLER SYSTEM GAS RANGE METER SET (GAS) . __. GAS PIPING ADDENDUM TO BUILDING PERMIT APPLICATION (AN APPLICATION FOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. IF A MASTER PERMIT HAS BEEN OBTAINED, THE OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.) PLUMBING ELECTRICAL MECHANICAL PRO WNE Name ca ' � - (e Name C EC r D a1C- o License No S 3 t ac Age Address ` . -X , t f (_ -) 3 t -5 Telephone005)425_' ()) Faao j'Z— oS) 6 35-1413 Qualifier Name_- ,, 3 ( L .,F�.d PRO WNE Name ca ' � - (e Address rYl l - Irr) ; --t- ( 3:3 I --1 Home Telephone (3o5) 95,-_d 63 3 Business Telephone 9 ,5-6,- a0 l P-Y .7,1?-- Fax TYPE OF MANAGEMENT (✓ ) New Construction Enclosure Alteration Exterior Repair Alteration Interior ij Demolish Relocation of Structure Shell Only Foundation Only Add'1 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 submit- ted 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. Job Address: (0 1 S �' • Address PERMIT TYPE (✓ ) Building Electrical Mechanical Plumbing LPGX Roofing Fence Other PB PG Apt. Folio Number Lot Block Subdivision Current Use of Property Proposed Use of Property Tenant Information DWI -Jet - t'1 5 , PERMIT CHANGE (✓ ) Chg. Contractor Renewal Revision Extension Supplement Reinspection ARCHITECT Name License No. Address Telephone l Zoning Square Feet Value of Work Master Permit No. Subsidiary Permit No. PERMIT APPLICATION v ° City State Zip 3 uog- c 5 Description of Work JV \R 0/45.1 Dz-e S -Meer- Linear Feet Units Floors Bldg Value Tax Assessed/Appraised Value Flood Zone Base Floor Elev. ENGINEER Name License No. Address Telephone Fax Page 2 IMPORTANT NOTICES 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 Management (DERM) and/or Miami -Dade Water and Sewer Department (MDWASD) approval is required for applications involving sewers. 1. AFFIDAVIT - Please read carefully. Application is hereby made to obtain a permit to do work and installation as indicated. I, the OWNER of the property, certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits are required for ELECTRICAL, PLUMBING, POOL, EXTERIOR DOOR, MECHANICAL, WINDOW, FENCE, DRIVEWAY, ROOFING and SIGNS and there may be additional permits required from other governmental agencies. I, the OWNER of the property, have disclosed all information related to any work at the property performed in the prior twelve months to the Building Official. Further, I am fully aware that if the cumulative cost of work to my home or business under this and any other permit equals or exceeds fifty percent (50 %) of the fair market value of the structure, the entire structure must meet the present federal flood criteria for finished floor elevation. I am also fully aware that if the total cost of work to my home or business under this and any other permit exceeds fifty percent (50 %) of the replacement cost of the structure, then the entire structure must conform to the current code requirements of the Building Code. WARNING TO OWNER: Your failure to record a NOTICE OF COMMENCEMENT may result in you paying twice for improvements to your property. If you are spending more than $2,500 or intend to obtain financing, you may wish to consult with your attorney or lender before recording your Notice of Commencement. The Notice of Commencement must be recorded at: 22 N.W. 1st Street, 1" Floor, (305) 679 -1078. Once recorded, the Notice of Commencement must be POSTED AT THE JOB SITE in accordance with Section 713 -35 of Florida Statutes. Review the brochure at Village Hall on Construction Lien Law and Choosing a Contractor. STATE C FLORIDA( OUNTYAOF MIAMI -DADE X ignature of Owner Print Name Sworn to SEAL: subscribed before me this ¢' day of tary Public - State of F(ptida Marianela C Teixeira * *MY Commission CC862540 "�x nI Expires August 12, 2003 ST Signat$re of SEAL: alifier AI 6we-A) PERMIT APPLICATION F MIAMI -DADE Print Name S1vorRyq and subscribed before me this �� day of , O'A\ Marianela C Teixeira l Q *My Commission CC802549 wo e Expires August 12, 2003 Personally known OR, Produced Identification Personally known OR, Produced Identification Type of Identification Produced: Type of Identification Produced: ELECTRICAL .l.vl,l,: Minimum Fee QTY. TYPE Dryer QTY. TYPE Outlet, Appliance QTR .. . Service Repair Q A/C Central 1 -3 Ton Dryer Vents, Number of Fan Ventilation, Cost Outlet, Wall Ductwork, Cost of Service, Temporary Periodic Inspections A/C Central 4 -7 Ton Fire Sprinkler System Fire Pump Outlet, Switch Fireplaces, Number of Signs A/C Central 8 -15 Ton Fixture - Fluorescent Oven Space Heater (kw) A/C Central 16-20 Ton Fixture Light Parking Lot Lights Spas/Hot Tubs A/C Central 20+ Ton Flood Lights Plugmold/Strip Subfeeds, No. of Amps A/C Window FPL - Load Central Posts Swim Pool, Commercial Air Conditioners Garbage Disposal Range/Range Top Swim Pool, Residential Chiller Generators, etc. Receptacles Switchboards Clear Violations Heat Recovery Refrigerator, Comm. (p/PH) Temp Serv., Construction Compactor Low -volt, Burglar Refrigerator, Domestic Temp for Test - 30 days Deep Freezer Low -volt, Fire Renew - Temp Service Pump, Sump Demolition Low -volt, Intercom/Teleph. Repair Circuits Indirect Wastes Dishwasher Low -volt, Television Service, Number of Amps Disposal MECHANICAL TypE QTY Minimum Fee nil: QTY. Condensate Drain .rYpl.: Generator QTY. . rYl , l , : QTV Refrigeration, Tons 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 Bath Fan - Vented, # Fireplaces, Number of Pressure Vessel PLUMBING TYPE A/C Condensate QTY TYI Drains, Roof QTY T \.l,l,: Miscellaneous Fixture (fry. .111,l•: Soakage Pit ()Ty. Bath Tub I 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 3 Domestic Well Laundry Tray Septic Connection r" 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 1 Water Service Drains, French Miscellaneous Equipment Sink 5 Well, Supply Page 3 • PERMIT APPLICATION INSTRUCTIONS: Please indicate the type of work being performed and quantity(ies) in the space provided below. RECEIVED AND REVIEWED BY: DATE: SECTION BY DATE Zoning Electrical Mechanical 90z5 Plumbing Fire Public Works Structural Building Official Page 4 OFFICE USE ONLY CHECKLIST ❑ OWNER - BUILDER FORM (Attach) ❑ FIRE DEPARTMENT APPROVAL (Commercial / multi - family) ❑ CONCURRENCY (New Construction) ❑ OTHER (Specify & Attach) ❑ PROOF OF OWNERSHIP (Attach) ❑ HRS / DERM APPROVAL (Septic / Sewer) ❑ IMPACT FEE (New Construction) ❑ OTHER (Specify & Attach) PERMIT FEES $3.00 per page (Scanning Fee) $ Miami Shores Village Bond Metropolitan Dade County (C.C.F.) Inspector State Educational Fund $ State DCA (Radon) Code Enforcement Fine $ Zoning Review Notary die $ (s .ftt. = x/1000 (¢.005 /sq.ft.) (¢.01 /sq.ft.) PERMIT APPLICATION ❑ CONDO ASSOCIATION APPROVAL (Attach) ❑ BPR APPROVAL (Restaurants) ❑ CONTRACTOR REGISTRATION (On File) TOTAL $ a 0 a ISSUING OFFICIAL REVIEWED AND PREPARED BY: 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 4 PAY TO THE ORDER OF MEMO Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Printed: 9/25/2002 Applicant: -LIQ n EL (- Owner: - "=T__t. Sp.avt JOB ADDRESS: 1015 NE 97 Contractor ALL PRO SEPTIC & SEWER INC Local Phone: (305)635 -3002 Parcel # 1132050170120 ALL PRO SEPTIC & SEWER, INC. 06-99 2747 NW 17TH ST MIAMI. FL 33125 S 4a e-eS `. 00 C7� \ k_S j 5 -- 99 S4- 000649 1 :0670 L8 251: 605L2L680611' Plumbing Permit Permit Number: PL2002 -252 - eawsTE14��r ST Contractor's Address: 1531 NW 26 AVE Page 1 of 1 Legal Description: 5 6 53 42 PB 43 -51 REV PL MIAMI SHORES SEC 8 LOT 12 Fees: FEE2002 -5367 Description Building Fee Total Fees: Amount $90.00 $90.00 Total Fees: $90.00 Total Receipts: $0.00 Permit Status: Approved Permit Expiration: 3/24/2003 Construction Value: $2,800.00 Work: SET 3 WATER CLOSETS 5 SINKS ROUGH IN ONE SHOWER ONE TOILET \PIck. TRANSATLAN flC BANK HIALEAH, FL 33012 63- 1182/670 6492 ? DOLLARS w t hP nspection BLK 180 n herefor in strict compliance with all ons that may have been submitted to the plans are changed without bility for a thorough knowledge of the ie assumes responsibility for work done rtaining thereto and in strict conformity risibility for all work done by either CONTRACTOR ' � h Name A/ t li VareS 1 ' License No. iv r •, J ' Address 0 At t) 1 /4// / _free/ imam/ SIZa. l Tdephon oh Fax Z5 Qualifier Name: to 2M S 1 1 6 1.11 IA 1 in PROPERTY � OWNER --7i Address /Q /5 ,t C Home Telephone Business Telephone Fax 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. 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: Folio Number Complete the attached permit application which must be signed by the property owner and qualifier. Both signatures must be notarized. Please print or type to allow for a more accurate processing of your application. If roofing work will be done, a roofing application must be submit- ted along with this permit application. 1(1 NC q 11.5 Address /1 a Apt. Lot Block Subdivision P PG Current Use of Property Ke l aci 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 Description of Work PERMIT APPLICATION Master Permit No. ' Pt ae . .cXg Zoning Square Feet Subsidiary Permit No. Achy) mos j '. _ 3/3g? City State Zip ellifthi rim Linear Feet Units Floors (Value of Work 15 0 0 . Bldg Value Tax Assessed/Appraised Value Flood Zone Base Floor Elev. ENGINEER Name 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 Management (DERM) and/or Miami -Dade Water and Sewer Department (MDWASD) approval is required for applications involving sewers. AFFIDAVIT - Please read carefully. Application is hereby made to obtain a permit to do work and installation as indicated. I, the OWNER of the property, certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits are required for ELECTRICAL, PLUMBING, POOL, EXTERIOR DOOR, MECHANICAL, WINDOW, FENCE, DRIVEWAY, ROOFING and SIGNS and there may be additional permits required from other governmental agencies. I, the OWNER of the property, have disclosed all information related to any work at the property performed in the prior twelve months to the Building Official. Further, I am fully aware that if the cumulative cost of work to my home or business under this and any other permit equals or exceeds fifty percent (50 %) of the fair market value of the structure, the entire structure must meet the present federal flood criteria for finished floor elevation. I am also fully aware that if the total cost of work to my home or business under this and any other permit exceeds fifty percent (50 %) of the replacement cost of the structure, then the entire structure must conform to the current code requirements of the Building Code. WARNING TO OWNER: Your failure to record a NOTICE OF COMMENCEMENT may result in you paying twice for improvements to your property. If you are spending more than $2,500 or intend to obtain financing, you may wish to consult with your attorney or lender before recording your Notice of Commencement. The Notice of Commencement must be recorded at: 22 N.W. 1st Street, 1" Floor, (305) 679 -1078. Once recorded, the Notice of Commencement must be POSTED AT THE JOB SITE in accordance with Section 713 -35 of Florida Statutes. Review the brochure at Village Hall on Construction Lien Law and Choosing a Contractor. STATE OF gnature of Owner Signature of Notary Public - State of Florida SEAL: COUNTY OF MIAMI -DADE Print Name Sworn to and subscribed before me this day of Personally known OR, Produced Identification STA • ORIDA, y OF Si ature of Contractor / Print Name Signature of Notary Pub ICI SEAL: Personally known 1 PERMIT APPLICATION OR, Produced Identification Type of Identification Produced: Type of Identification Produced: ELECTRICAL TYPE, Minimum Fee QTY. TYPE. Dryer QTY. 'Fyn Outlet, Appliance vv. Tv1,I.: Service Repair QTY. A/C Central 1 -3 Ton 1 Fan Outlet, Wall Service, Temporary A/C Central 4 -7 Ton Fire Pump Outlet, Switch Signs A/C Central 8 -15 Ton Fixture - Fluorescent Oven Space Heater (kw) A/C Central 16-20 Ton Fixture Light Parking Lot Lights Spas/Hot Tubs A/C Central 20+ Ton Flood Lights Plugmold/Strip Subfeeds, No. of Amps A/C Window FPL - Load Central Posts Swim Pool, Commercial Air Conditioners Garbage Disposal Range/Range Top Swim Pool, Residential Chiller Generators, etc. Receptacles Switchboards Clear Violations Heat Recovery Refrigerator, Comm. (p/PH) Temp Serv., Construction Compactor Low -volt, Burglar Refrigerator, Domestic Temp for Test - 30 days Deep Freezer Low -volt, Fire Renew - Temp Service Water Closet roap Demolition Low -volt, Intercom/Teleph. Repair Circuits Water Heater J Dishwasher Low -volt, Television a Service, Number of Amps Water Heater New 1IECHANICAL TYPE Minimum Fee Q•i'Y TIT Condensate Drain Q'l'V' TypE Generator QTti TYPE Refrigeration, Tons Q'IY. A/C Central, Tons 1 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. TYPE Miscellaneous Fixture QTY. 'TYPE Soakage Pit ()Ty. Bath Tub rOU h 1 Drinking Fountain Miscellaneous Repairs Solar Water Heater Bidet J 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 roap Domestic Well Laundry Tray Septic Connection Water Heater J Drainfield, 4" Tile/Res. Lavatory rO(h a Septic Tank Water Heater New Drains, Area Meter Set (Gas) f Sewer Connection Water Re -pipe Drains, Floor Minimum Fee Shower Valve, I Water Service Drains, French Miscellaneous Equipment Sink Well, Supply Page 3 PERMIT APPLICATION INSTRUCTIONS: Please indicate the type of work being performed and quantity(ies) in the space provided below. S ' 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 LI PROOF OF OWNERSHIP (Attach) ❑ HRS / DERM APPROVAL (Septic / Sewer) ❑ IMPACT FEE (New Construction) ❑ OTHER (Specify & Attach) $ Metropolitan Dade County (C.C.F.) (sq.ft. = x/1000 x ¢.60) Inspector State Educational Fund $ (¢.005 /sq.ft.) State DCA (Radon) $ (¢.O1 /sq.ft.) Code Enforcement Fine $ Zoning Review $ Notary $ SECTION Zoning Electrical -- wyd Mechanical Plumbing Fire Public Works Structural Building Official BY DATE PERMIT APPLICATION ❑ CONDO ASSOCIATION APPROVAL (Attach) ❑ BPR APPROVAL (Restaurants) ❑ CONTRACTOR REGISTRATION (On File) PERMIT FEES TOTAL $ t_C) ISSUING OFFICIAL REVIEWED AND PREPARED BY: 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 PAY TO THE ORDER OF Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Parcel # 1132050170120 COLONIAL BANK Permit Status: Approved Permit Expiration: 2/16/2003 Work: BATHROOM REMODEL THE NEW MIAMI SHORES PLUMBING, INC. BLUE ACCOUNT 900 N.W. 144TH ST. MIAMI, FL 33168 (3 05) ''1 SI -a.4-46 sfinzi smai:f Plumbing Permit Permit Number: PL2002 -219 Printed: 8/20/2002 �-¢ Applicant: �� 4 rn (.� Owner: --4183EIL LJOE - JOB ADDRESS: 1015 NE 97 ST Contractor THE NEW MIAMI SHORES PLUMBING Contractor's Address: 900 NW 144 ST Local Phone: 305 - 751 - 2446 Legal Description: 5 6 53 42 Total Fees: —$070.0 Total Receipts: $0.00 Construction Value: DATE PB 43 -51 REV PL MIAMI SHORES SEC 8 LOT 12 BLK 180 $1,500.00 If thPrA is no nermit nackaae accessible on the job -site for inspectors to verify, there will be no inspections. Re- inspection f net.,k>. !Aka _ .,,.. I$ 1553 S U0 x . 0 leoDOLLARS 8 63- 151/670 Miami Beach, Florida 33140 �jy I X L // 244 Hr.. Bankingg CCatID1- 800 -897 - 6935 �i + FOR -' �� la !iu ' /'v 9� / v/ G� 5 146 °��ISf �y " II'00L553u' 0:06700 5 L8c: 80 2 786 30 2 911' � 01 Page 1 of 1 Iication herefor in strict compliance with all cifications that may have been submitted to es or if the plans are changed without sponsibility for a thorough knowledge of the J that he assumes responsibility for work done tons pertaining thereto and in strict conformity e responisibility for all work done by either