PLUMBINGPERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Dec 4 -9 -99 Job address 1045 N.E. 97th Street
Legal Description Historically Designated: Yes No
Owner/Lessee /Tenant Richard Winckler Master Permit#
Owner's Address 1045 N.E. 97th Street, Miami Shores, F1 Phone 305 - 758 -9030 Work 305 - 751 -1020
Contracting Co. Coastal Plumbing Co. of Miami Address 285 N.E. 185th Street, Miami, F1 33179
Queer Robert E. Brincefield
state # CFCO -19042 Municipal# 6264
Architect/Engineer
Bonding Company
WORK DESCRIPTION Replace existing electric water heater
Square Ft. Estimated Cost (value) $200.00
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Signature of owner and/or Condo President
/ -
otary as to Owner an d( k �t
Sze
•" % ondedty - ac
FEES: PERMIT 4 J/ RADON
Date / j("
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My Commission Expi sQ•• ��
® 28 49 7'°•
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0 #CC 477159
Tax Folio
ss#
Phone 305 - 651 -4429
Competency # 6264 Ins. Co. Acord i a Ins. Co.
Mortgagor Address
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
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.
� � �
Signature of Contractor or Owner - -alder �a \CI ST i ate
1.\(,, D 28, °
. �J
Notary as to Contractor or a wner - Builder g 1/CC 47 1 9 or ate
..." ° • e nnded th e v : pQ
C.C.F. r 6 0 NOTARY
Electrical
BOND
TOTAL DUES
Engineering
BUILDING
ELECTRICAL
PLUMBING
ROOFING
Owner of
Building
Architect
Contractor
or Builder
Legal
Description
Address of
Building
Lot
CONTRACTOR OR BUILDER
MIAMI SHORES VILLAGE, FLORIDA
PERMIT IV? 13599
Work to be performed under this Permit
Bl.
Subdi-
vision
Value of
Project $
DATE 195
Contractor's
License No
Amt. of
Permit $
BY AUTHORITY
This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the application
herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans,
drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any
time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is
granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations
pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that be assumes responsibility for work
done by his agents, servants or employees.
4 a..
Signed 4— •"''.. BY
I273PECTOIt
In consideration of the issuance to me of this permit I agree to tfeeferm 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.
Permit No.. - - -- . - - - -- -- - -� - --
Size Septic Tank__- -__ -`.
Feet of Drain Tile
Nature of Water Supply: City —Well
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Type of Tank_ ______
Si e
Amount of Permit $_ -� - __ �_ — ( gn d )-
(Signed)- - -----
Date
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building 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.
Owner's Name and Address No Street
Registered Architect and /or Engineer
Employing Plumber's Name. —_ No._,.__--- __-- - -___- _ Street__
Location and Legal Description Lot_ - -__ Block _--- _----- _--- _ -__ -- Subdivision _-------- -___ --
Stcet and Number where work is to be performed —No _ ________.____ Street
State work to be performed and purpose of building (By Floors)_
New Building Remodeling____ Addition_. Repairs No. of Stories
Capacity Gals._
Dist. Feet of Tank or Drain Field from We1L
'-1 •'-° 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 Perinanent 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, }
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 fac
therein by him stated are true.
My Commission Expires Notary Public, State of Florida
Master Plumber.
V NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faul
materials and /or workmanship.
CLOSETS
BATH
TUBS
SHOWERS
LAVA•
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TUBS
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING DRINK
FOU NT' NS
TOTAL
FIXTURE!
CONTR.
LIST
—_
CHECK
/
'�L
A
c ,.
. (
'''°
, .�� —..
a .
DRAI
FIELD
SOAKAGE
PIT
GREASE
TRAP
`SVGLA'-'
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SW IM'G
POOL
SEPTIC
TANK
SEWER
CONN.
CONTR.
LIST
1
CHECK
Permit No.. - - -- . - - - -- -- - -� - --
Size Septic Tank__- -__ -`.
Feet of Drain Tile
Nature of Water Supply: City —Well
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Type of Tank_ ______
Si e
Amount of Permit $_ -� - __ �_ — ( gn d )-
(Signed)- - -----
Date
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building 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.
Owner's Name and Address No Street
Registered Architect and /or Engineer
Employing Plumber's Name. —_ No._,.__--- __-- - -___- _ Street__
Location and Legal Description Lot_ - -__ Block _--- _----- _--- _ -__ -- Subdivision _-------- -___ --
Stcet and Number where work is to be performed —No _ ________.____ Street
State work to be performed and purpose of building (By Floors)_
New Building Remodeling____ Addition_. Repairs No. of Stories
Capacity Gals._
Dist. Feet of Tank or Drain Field from We1L
'-1 •'-° 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 Perinanent 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, }
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 fac
therein by him stated are true.
My Commission Expires Notary Public, State of Florida
Master Plumber.
V NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faul
materials and /or workmanship.