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1040 NE 96 St (3)Name MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date ' L iP C LTime Type Insp'n Permit No.e).. U Address ' es ' Company For Inspector: Approved Correction Re- Insp'n Fee t —� 3 • PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date Job Address /01 96, sr Tax Folio Legal Description Historically Designated: Owner/Lessee / Tenant WRE Or W. . 9J Ant Owner's Address /010 l G 9 v E Contracting Co. l3 /0 �yr /A. C Qualifier s, :kia7? State # �� Co35') 2' Notary t My Co Municipal # Architect/Engineer Address Bonding Company Address Mortgagor Address Permit Type (circle one): BUILDING ELECTRICAL LUMBING MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION Z G I k • P 74 -Q C - Square Ft. Estimated Cost (value), 11, it OD • o 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- d contractor to d• • •rk stated. 1719 .ry\a_o , ("V , 6) ature of owner and/or Condo President Date 4piivile State of Florida My Commission Expires May 4, 1999 CC 459726 RADON r Date • APPROVED: Zoning Building Mechanical Plumbing SS# Address )C Notary My Co C.C.F. r . 2- NOTARY Yes No Master Permit # y ,� �/ 26 Phone ry ` /,s v —®(3 /W yJrIO/L 07, OM( ? - Phone 3S ' 6/ N9 V Competency # Ins. Co.: C. P,S Electrical Me Signature of Contractor or Owner- Builder ■ iS$'d r , •1/ STOBS JR. cry • ublic State of Florida My Commission Expires May 4. 1999 CC 459726 BOND //2/ P0( Date Date 2.0 TOTAL DUE / Engineering z C v:):3 ;li ‘ Ault",..pogroite‘ r Scope Of Work IAMI ^i7899,N.E. Bayshore Ct. Suite 6A `Miami;, FL 33138 -6324 1399'685-8787 Phone APPLICATION FOR PERMIT TO REMOVE STORAGE TANK SYSTEM The Estate of Dr. Elwin Neal, 1040 N.E. 96th Street, Miami Shores, Florida 33138 Residence, UT- Unknown, FDEP # 13 /Unknown Remove One (1) U/G 275 - gallon underground fuel - oil tank & piping grattea I I J FDEP Tk.No. Tank Size: Material: Tank Age: Product: Piping: aefibe \\\\\\W Pant /.4 CA(0/0 GRa)010 VOX (�92 6c Not Registered 275 - gallon Steel Unknown Heating fuel -oil None Steel Environmental Services PSSSC Name: PSSSC Number: Commence: Complete: Tank Disposal: Fuel Disposal: DAYTONA 703 Madison Avenue Daytona Beach, FL 32114 -1926 (904) 253 -BIOX (2469) Phone & Fax Internet Address: bioex @herald.intii.net CORPORATION JUNTY DERM JNTROL DIVISION REMEDIATION SECTION .UNMENTAL REVIEW APPROVAL ,JECT TO THE ATTACHED CONDITIONS PLAN APPROVED BY: — t . r 4itATE: INSPECTED BY: DATE: INSPECTION PASSED / FAMED BioEx, Inc. Peter PC CO55726 A.S.A.P. 30 Days Approx. Everglades Scrap Metal Cliff Berry, Inc. AO- -E- 44- - - - 1. All product piping to be properly drained and removed. 2. Tank and contents, to be sampled, manifested, pumped with pneumatic / explosion -proof equipment, checked with explosive vapor detection equipment, with appropriate fire supression equipment available, and properly disposed. 3. Closure Assessment Report to follow within 60 days, if required. OPA -LOCKA 2160 Opa -Locka Boulevard Opa- Locka, FL 33054 -4230 (305) 756 -5339 Phone & Fax PLAN TYPE (check appropriate box) Underground Storage Tank System: Aboveground Storage Tank System: Underground Hydrant Line System: Underground Oil/Water Separator System: 6-F - )041c UT# / File # U1°62- .5-79S// &353 IW# HWR # ATC 5/19/98 (Form /fees subject to change without notice. Fees to be verified prior to submittal.) 11\1 DEC 171998 cJ DERM POLLUTION REMEDIATION SECTION DEPARTMENT OF ENVIRONMENTAL RESOURCES MANAGEMENT POLLUTION REMEDIATION SECTION POLLUTANT STORAGE SYSTEM CLOSURE APPLICATION emoval 0 Abandonment in Place 0 Removal (] Removal 0 Abandonment in Place 0 Removal 0 Abandonment in Place FACILITY NAME: STREET ADDRESS: 0 — ZIP CODE: 3,-3/-3K CITY: AM 1 1 r 4- - r PROPERTY OWNER/ RESPONSIBLE PARTY: RDA-JA -O 671)6S TITLE / COMPANY NAME: 57663 -07 1,Q 1c STREET ADDRESS: iJC CITY: V . =,ij Sri r STATE: PLAN PICK -UP CONTACT PERSON: PMQA) re PHONE: X65 a7 POLLUTANT STORAGE SYSTEM SPECIALTY CONTRACTOR: (required N for UST surer o ) s, ` p� ,Te AME LICENSE #: C. C n , Q 2' EXPIRATION DATE: / ZCO() COMPANY: l3i6X jiVL. PHONE #: Gk INSTRUCTIONS: 1. This application to accompany the PRS Construction Plan Application and appropriate fee. Fee is $275/ excavation for UST and $ 150 for AST. Check made payable to Dade County DERM. 2. Attach two (2) copies minimum'of scaled site plan (8.5" x 11" minimum) showing property address, property bounderies, adjacent streets, on -site buildings, ALL on -site pollutant storage systems and monitoring wells. For each tank provide the age, composition, size, substance stored and method of closure. 3. For abandonment in place, show the locations of the proposed soil borings and monitoring wells. 4. THE SITE PLAN MUST BE SIGNED AND DATED BY THE PSSSC LICENSE HOLDER. At least one originally signed site plan must be submitted. 5. Separate applications are required for storage systems separated by more than 200' or for closures requiring more than one inspection. 6. All applicable tanks must be registered with FDEP 30 days prior to closure. Attach a copy of the I'DEP Storage Tank Registration placard or a copy of the cmpleted FDEP Form 62 761.900(2). 7. The approval of this plan will be subject to the conditions attached to it: 8. Allow approximately 14 days for the plan review process and do NOT commence any plan related activities until you have received a copy of the approved plans. Date: December 24, 1998 UT# 5795 / FILE# 16353 Responsible Party: Donald Stobs, Jr. ESQ Address: Stobs and Fitzgerald 581 N.E. 91 Street Miami Shores, Florida 33138 DEPARTMENT OF ENVIRONMENTAL RESOURCES MANAGEMENT Underground Tank System Closure Plan Approval Submitted by: Bio Ex Inc. Received: December 17, 1998 CERTIFIED MAIL NO. Z280 510 665 RETURN RECEIPT REQUESTED Facility: Estate of Dr. Edwin Neal Address: 1040 N.E. 96 Street Miami Shores, Florida 33138 Number and Size of Tanks: 1 -275 heating oil tank to be / removed ['abandoned in place. The Pollution Remediation Section (PRS) of the Department of Environmental Resources Management (DERM) has reviewed the above - referenced plans and approved said plans subject to the conditions attached to them. Be advised that this approval does not indicate regulatory compliance with any other environmental issues or outstanding violations. Based upon department records and the information submitted in the plans the applicable comments are checked: ❑ 1. Immediately implement the plans and complete all work within thirty (30) days of receipt of this letter. ❑ 2. The site has previously documented contamination, therefore all activities must be performed in accordance with the applicable requirements of Chapter 24 of the Miami -Dade County Code, Chapter 62 -770 of the Florida Administrative Code (FAC), the United States Resource Conservation and Recovery Act, and any requirements imposed by any other governmental agency having jurisdiction over the facility and/or scope of work. ❑ 3. The UST system is subject to the requirements of Chapter 62 -761, (FAC), therefore, a) a Tank Closure Assessment Report (TCAR) prepared in accordance with the Florida Department of Environmental Protection's "Pollutant Storage Tank Closure Assessment Requirements ", revised April 1998 (unless a newer version is in effect at the time of the closure) must be submitted to the DERM PRS within sixty days of the UST closure if no evidence of contamination is detected. Be advised that a minimum of one soil analytical in each source area is required. In addition, the following must be submitted with the TCAR: receipts and manifests documenting the proper disposal of all liquid and/or solid wastes (including all applicable UST system components), and • b) a FDEP Underground Storage Tank Installation and Removal Form for Certified Contractors #62- 761.900(5) must be completed and submitted directly to the FDEP within thirty days of the UST removal. 4. The UST system is not subject to the requirements of 62 -761, FAC (i.e., residential, on -site consumptive use heating oil, or hydraulic lift), or is in a contaminated area for which a Chapter 62- 770, FAC, site assessment or remedial action is being conducted, therefore, a TCAR is not required. However, the following must be submitted to the DERM PRS within sixty days of the UST system closure: receipts and manifests documenting the proper disposal of all liquid and/or solid wastes (including any applicable UST system components), all soil and groundwater sample results, and if no contamination was detected, a proposal for abandonment of any remaining monitoring wells. ® a) The UST system is to be removed, therefore, soil and groundwater analyticals from a minimum of one soil boring and monitoring well are required if groundwater is not made accessible at the time of the scheduled inspection, if the length of any underground product piping abandoned in place is greater than twenty five feet, or if evidence of new contamination is detected. ❑ b) The UST system is to be abandoned in place, therefore, soil and groundwater samples must be collected from the soil boring(s) and monitoring well(s) shown on the approved plans and analyzed for the appropriate analytical group (as defined by Chapter 62 -770, FAC). In addition, the following items apply to all sites: A. Be advised that temporary or permanent'wells installed at a site shall not be removed/abandoned until site closure is granted. B. Within one day of the discovery of any previously undocumented contamination, notify the DERM Storage Tank Section (STS) Inspection Coordinator at (305) 372 -6716 and submit a properly completed Florida Department of Environmental Protection Discharge Reporting Form #62- 761.900(1) to the DERM STS. C. Upon discovery of a new discharge, Sections 376.305(1) and 376.3071(5)(c), F.S. and Rule 62- 761.820, FAC, require the • owner or operator to "immediately undertake to contain, remove, and abate the discharge ". For sites eligible and seeking state funding assistance, the owner or operator must contact a DEP district office or contracted local program to receive authorization to begin free product recovery and follow the FDEP "Guidance for Identification of Reasonable Scope of Free Product Recovery Efforts" dated September 23, 1997. D. Chapter 376, Florida Statutes may impose substantial supplemental deductible charges on Florida Petroleum Liability and Restoration Insurance Program eligible sites if the following actions are not completed upon discovery of a new discharge: 1. Take steps to test or empty the tank within 3 days of discovery and complete these actions within seven (7) days. 2. Abate the known source of the discharge or begin free product recovery within 24 hours after testing or emptying the system. E. If the excavation water is contaminated and dewatering is to be performed, a pretreatment system must be proposed for groundwater restoration. Contact the DERM Water Control Section at (305) 372 -6681 for dewatering permit information and the Po on Remediation Section at (305) 372 -6700 for pretreatment information. Plan Approved By: • , Engineer, Pollution Remediation Section pc: Bio Ex Corpora w /Approved P1 8/11/98 Closure ERNI. OCPARDitir OF eivamitaeLatsotaxismivomect "JO 4=iZ3NZOB•L GrUZDS.N<7D Pollution Remediation Section UST SYTEM CLOSURE PLAN APPROVAL CONDITIONS August 12, 1998 AC-04 The following conditions are hereby incorporated as part of the UST System Closure Plan Approval and shall supersede the scope of work proposed in the approved plans if discrepancies exist. Additional approval may be required from other DERM sections, the local fire department and other governmental agencies having jurisdiction over the facility and/or scope of work. 1. This approval shall be valid for one year from the approval date; however, plans must be implemented in accordance with any regulatory timeframes. 2. For tank removals, an inspection must be scheduled two business days prior to commencing any UST excavation activities. For tank abandonments in place, split sampling with a DERM Inspector and DERM inspection of a clean inert UST is required. An inspection must be scheduled two business days prior to the collection of any soil/groundwater samples or the filling of the UST with 3000 psi concrete slurry or FDEP approved cellular concrete foam. Inspections are to be scheduled with the DERM Storage Tank Section (STS) Inspection Coordinator at (305) 372 -6716. 3. An original set of the most recently approved UST closure plans must be maintained on site for inspection throughout the construction procedures. 4. All work, including all applicable safety requirements, must be performed by a Pollutant Storage System Contractor (PSSC) possessing a valid license from the Florida Department of Professional Regulation and in accordance with the app roved plans, applicable requirements of Chapter 24 of the Miami -Dade County Code, Chapter 62 -761 of the Florida Administrative Code (FAC), United States Occupational Safety and Health Administration (OSHA), American Petroleum Institute (API) Recommended Practice ements o by the fire department or any Association (NFPA) Standard #30 and any requirements P other governmental agency having jurisdiction over the facility. 5. All UST contents (including liquid wastes, decontamination wastewater and sludges) must be properly recovered prior to commencing any UST closure activities. 6. All applicable underground piping must be capped, removed, or filled with concrete, and all applicable vent risers must be removed. Any UST components 3p properly cleaned, marked, and disposed of in accordance with API 604 and NFPA 7. The DERM recommends that all free flo : product and/or other liquid waste exposed in an excavation be recovered and disposed of ` • ' ° The DERM recommends that all excavated UT /File S �S t Po , Gii,T /4i,c' UST System Closure Plan Approval Conditions August 12, 1998 contaminated soil (as defined by Chapter 62 -770, FAC, effective date September 23, 1998) not be returned to the excavation and be disposed of properly if the removal will significantly impact the restoration requirement of the site. 8. If previously undocumented soil or groundwater contamination is detected, comply with item 2 of the attached plan approval. 9. All liquid wastes must be stored properly and disposed of by a DERM Permitted Liquid Waste Transporter within sixty days of recovery. All solid waste materials must be stored properly and disposed of in accordance with an approved DERM Solid Waste Disposal Plan within sixty days of excavation. Contact the DERM Liquid Waste Transporter Program Manager and Solid Waste Program Manager at (305) 372 -6804 for more information. 10. A DERM Dewatering Permit must be obtained prior to dewatering any excavation. Contact the DERM Water Control Section at 372 -6681 for more information. ATC 8/12/98 2 Pollution Control Division Miami -Dade County, Florida DtVARftSiliT OF iF: stNJii:: s %IAll�a":Uk Environmental Review Approval Pollution Remediation Section Subject to'Attached Conditions Plans approved by:. Date: ► 2-124 �`i Final Inspection ccnap'� ::ed: Date: CCOVISErq4:g9.i }.ffx2.,oetior:() re7 lined Si :GE i; is Tank Soc ion ® Tank System iquilification(s) Inspector Tank h sttallation Initials Date ® Initial Tank Inspection O Product/Vent Piping Inspection ❑ Stage 11 ping [] Sump Tightness Inspection ❑ Leak Detection Inspection anklScpar:ator h a rnoval _._...__.._ ® Tank/Separator Abandonment ® PAS- BULLTS REQUIRED D Reason: COMMENTS: DEC 171998 DERM POLLUTION REMEDIATION SECTION Permit No. Size Septic Tank__ Amount of Permit $ Date..._.. Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. Owner's Name and Address STATE OF FLORIDA, D COUNTY OF DADE. Registered Architect and /or Engineer Empl9Ying P1uiler"s NMI@ a Li-RA — ~ Location and Legal Description Lok ffii Street and Number where work is to be performed —No. Type of Tank_ MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT (Signed) No .P 0 0 Street_. ....._. _. 5r Subdivision Street ..__IL _ °._. ..... 5`�'. State work to be performed and purpose of building (By Floors) _____ l _ fr _thg. q p . b UW't ®p er New Building.____.._ —_ Remodeling— ..__._. _ .__ Addition._._... k Repairs No. of Stories..... Capacity Gals. Feet of Drain Tile -. - -_ ___- -Dist. Feet of Tank or Drain Field from Wen .-- __- - - - - -- — ._.- •---- •-- ._..___ Nature of WaS )Supply: City—Well. Size of Soakage Pit Plupibing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations aj an employer of labor under the Florida Workmen's Compensation Act, being Section 5988, Compiled General Laws of Florida Permanent Supplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted' for inspection on the site of the work such public notice or notices as are required by thie 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) Master Plumber. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the ._._._._....... of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. My Commission Expires Notary Public, State of Florida materi NOTE: Ar e inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty CLOSETS BATH Toss SHOWERS LAVA. TORIES SINKS ` SLOP SINKS LAUNDRY TUSB URINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT' NS TOTAL FIXTURES CONTR. LIST Q p U 0 ° L CHUCK --- SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR H EATER DEEP WELL SPRKLR. SYSTEM SWIM'G POOL CONTR. LIST B CHECK Permit No. Size Septic Tank__ Amount of Permit $ Date..._.. Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. Owner's Name and Address STATE OF FLORIDA, D COUNTY OF DADE. Registered Architect and /or Engineer Empl9Ying P1uiler"s NMI@ a Li-RA — ~ Location and Legal Description Lok ffii Street and Number where work is to be performed —No. Type of Tank_ MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT (Signed) No .P 0 0 Street_. ....._. _. 5r Subdivision Street ..__IL _ °._. ..... 5`�'. State work to be performed and purpose of building (By Floors) _____ l _ fr _thg. q p . b UW't ®p er New Building.____.._ —_ Remodeling— ..__._. _ .__ Addition._._... k Repairs No. of Stories..... Capacity Gals. Feet of Drain Tile -. - -_ ___- -Dist. Feet of Tank or Drain Field from Wen .-- __- - - - - -- — ._.- •---- •-- ._..___ Nature of WaS )Supply: City—Well. Size of Soakage Pit Plupibing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations aj an employer of labor under the Florida Workmen's Compensation Act, being Section 5988, Compiled General Laws of Florida Permanent Supplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted' for inspection on the site of the work such public notice or notices as are required by thie 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) Master Plumber. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the ._._._._....... of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. My Commission Expires Notary Public, State of Florida materi NOTE: Ar e inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty BUILDING ELECTRICAL PLUMBING Owner of Building Architect C latractor Builder Legal Lot Description Address of Building MIAMI SHORES VILLAGE, FLORIDA PERMIT N? 1362 Work to be performed under this Permit Bl. Subdi- vision Value of Project DATE 194 Contractor's License No. Amt. of Permit This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the application herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes responsibility for work done by his agents, servants or employees. Signed • By INSPECTOR In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regula- tions 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. CONTRACTOR OR BUILDER BY AUTHORITY Nature of Water Supp Permit No Date__ Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the buildir 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. - f te Owner's Name and Address __ .. � 1 ki No.___ r /® _ a Street. Registered Architect and /or Engle er__ t J . __ _,._ Employing Plumber's Name___ - ...../.07.W JP 1_ 2 -) N Location and Legal Description Lot _________ ........ ______ - -, Block Street and Number where work is to be performed —No New Building_ ...... ___..-__ ........ _______ Remodeling_ -_-_ My Commission Expires MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING , ;IAMIT (n/ State work to be performed and purpose of building (By Floors)______ Addition. Street__ Subdivision / 4 Street No. of Stories. Size Septic Tank Type of Tank -_ fir Capacity Gals . -- -� , Feet of Drain Tile _Dist. Feet of Tank or Drain Field from Well Well __ Size of Soakage Pit rz Amount of Permit $ �-- �------------------ - ----- (Signed)- —42 lumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and : r pts his ob as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws o orida Permanent ; Supplement, and has coin - plied with the provisions thereof, and will require similar compliance from all oontracto or . �. contractors employs�d by him in the work to be performed under this perMit; and will post or cause to be posted for inspection on the to f the work such blic notice or notices As are required by tlie Act. The signed agrees to employ only such sub- contractors, o k to be orrpru t �� licensed by Miami Shores Village. ( Signed l Plum STATE OF FLORIDA, COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. Notary Public, State of Florida NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made•necessary by improper notice for Inspection, or faulty materials and /or worlananship. CLOSETS BATH TUBS SHOWERS LAVA. TORIES SINKS SLOP SINKS LAUNDRY UB TS URINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT' NS TOTAL FIXTURES CONTR. LIST CHECK SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR H EATER i DEEP WELL SPRKLR. SYSTEM SW IM'O POOL CONTR. LIOT ` -- CHECK (e7)®0 Nature of Water Supp Permit No Date__ Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the buildir 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. - f te Owner's Name and Address __ .. � 1 ki No.___ r /® _ a Street. Registered Architect and /or Engle er__ t J . __ _,._ Employing Plumber's Name___ - ...../.07.W JP 1_ 2 -) N Location and Legal Description Lot _________ ........ ______ - -, Block Street and Number where work is to be performed —No New Building_ ...... ___..-__ ........ _______ Remodeling_ -_-_ My Commission Expires MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING , ;IAMIT (n/ State work to be performed and purpose of building (By Floors)______ Addition. Street__ Subdivision / 4 Street No. of Stories. Size Septic Tank Type of Tank -_ fir Capacity Gals . -- -� , Feet of Drain Tile _Dist. Feet of Tank or Drain Field from Well Well __ Size of Soakage Pit rz Amount of Permit $ �-- �------------------ - ----- (Signed)- —42 lumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and : r pts his ob as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws o orida Permanent ; Supplement, and has coin - plied with the provisions thereof, and will require similar compliance from all oontracto or . �. contractors employs�d by him in the work to be performed under this perMit; and will post or cause to be posted for inspection on the to f the work such blic notice or notices As are required by tlie Act. The signed agrees to employ only such sub- contractors, o k to be orrpru t �� licensed by Miami Shores Village. ( Signed l Plum STATE OF FLORIDA, COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. Notary Public, State of Florida NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made•necessary by improper notice for Inspection, or faulty materials and /or worlananship. BUILDING ELECTRICAL PLUMBING Ca 11, Work to be performed under this Permit Value of Amt. of r "' Project Permit �,�{ ti t c '�,�"` ermit is granted to the contract or builder named above to construct the building or to install the equipment or device described in the appli- r in strict compliance with all or inances pertaining thereto and with the understanding that the work will be performed in compliance with any ings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked 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 anted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes respon- ork done by his agents, servants or employees. Signed:_ j By INSPECTOR onsideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. g this permit I assume responsibility for all work done by either myself, my agent, servant or employee. CONTRACTOR OR BUILDER MIAMI SHORES VILLAGE, FLORIDA DATE &CZ w103 194 PERMIT NI.' 4776 ,±r Contractor's License No. BY AUTHORITY MIAMI *riCiES VILLAGE, FLA. JOB :0' A ,A ADDRESS N? 6108 INSPECTION TIME READY REMARKS: INSPECTOR DATE Owner's Name and Address.. 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 herein specified or not. A copy of approved plans and specifications must be kept at building during progress of the work. W6 42, - L P Registered Architect and /or Engineer... -. . ^. . q_ .r-- Name and address of licensed contractor Location and legal description of lot to be built on: Lot Street and Number where work is to be done /Z5 State work to be done and purpose of building (by floors)..hs4 -eW/e k r - 4 oD ,7 - /e`Aii Date.. Date No '' Street r Read, Sworn to and Subscribed before me. Notary Public, State of Florida , 19i.. and for no other purpose. New Building Remodeling " Addition Repairs No. of Stories To be constructed of Kind of foundation c Roof Covering y Estimated Total cost of improvements $ Y 4) e - Amount of Permit $ 2. e Zone cubage required _Plan Cubage Distance to next nearest building Size of Building Lot i Maximum live load to be borne by each floor I hereby submit all the plans and s,pecifications for said building. All notices with reference to the building and its construction may be sent to____AR t ft " - / ' �A _I 4 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 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 subr on work to lie perf9jmed under this permit, as are licensed by Miami Shores Village. ' Remarks (Signed) �i��y`% ,tea 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 he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated Permit No Disapproved _. _ _ Date (Signed) ...... �f..._.::. C Building Inspector 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. 7,3cE a . 7 1 A II-0 = lsoe' 1 f ► n- & 73d/6 :/rj GS3,°= BUILDING ELECTRICAL ►- 1 LUMBING wner of Building Architect _ Conti actor or Builder MIAMI SHORES VILLAGE, FLORIDA DATE ____ PERMIT N° 3168 Work to be performed under this Permit Subdi- vision Contractor's License No. 194 legal Lot Bl. Description Address of Building 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 c the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes responsibility for work done by his agents, servants or employees. Signed• By r _ INSPECTOR In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regula- tions 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. CONTRACTOR OR BUILDER Value of Amt. of Project Permit BY AUTHORITY ' • BUILDING ELECTRICAL PLUMBING Owner of Building Architect Contractor or Builder Legal Lot Description Address of Value of Amt. of ,. Building_ Project Permit This permit is granted to e contractor or builder named abovd to construct the building or to install the equipment or device described in the appli- cation herefor in strict compliance with all ordinances pertaining thereto and w th 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 ra:grk is not clone 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. B INSPECTOR" In ccnsideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining t_rereto and in strict conformity with the plan» drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all ork done by either myself, my agent, servant or employee. 0;10-1 BY • , CONTRACTOR' ()R BLLDER� MIAMI SHORES VILLAGE, FLORIDA PERMIT N. 4776 ork to be performed under this Permit y 4 Bl, • Subdi- vision DATE 194_ Contractor's License No HORITY I Permit No / Owner's Name and Address __ Location and Legal Description Lot New Building Size Septic Tank Feet of Drain Tile Nature of Water Supply: City —W Street and Number where work is to be performed —No. _ _r L+' State work to be performed and purpose of building (By Floors) STATE OF FLORIDA, COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly appeared s s. to me well known, and who, being by me first duly sworn, upon oath of the above described construction, that he has carefully read the therein by him stated are true. My Commission Expires MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT v 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 daring progress of work. - No. Registered Architect and /or Engineer Employing Plumber's Name __ ���1� -� � -' � No._ y_a_ Ef Street__��!__� / ��_:_� • division / � � ` Sub Street__ ; `� f Remodeling Block The undersigned applicant for this building permit does hereby ce under the Florida Workmen's Compensation Act, being Section 5966, plied with the provisions thereof, and will require similar compliance performed under this permit; and will post or cause to be posted for required by the Act. The under signed agrees to employ only such licensed by Miami Shores Village. Addition Repairs f "1 (Signed) Capacity Gals._ ___ ______________ — __ - of Tank or Drain Field from Well Size of Soakage Pit �T�S Amount of Permit $____ (Signed) Plumbing 1ispector. rtify that he understands and accepts his obligations as an employer of labor Compiled General Laws of Florida Permanent Supplement, and has com- from all contractors or sub - contractors employed by him in the work to be inspection on the site of the work such public notice or notices as are sub - contractors, on work to be performed under this permit, as are Date / Street o. of Stories — Mast Plumber. authorized to administer oaths and take acknowledgments, personally deposes and says that he is the foregoing application, and that he did sign the same, and that all facts Notary Public, State of Florida NOT3: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty materials' and /or workmanship. CLOSETS BATH TUBS SHOWERS LAVA- TORIES SINKS SLOP SINKS LAUNDRY TUBS URINALS CATCH BASIN FLOOR DRA N DRINKING FOUNT' N5 i " ,� - TOTAL FIXTURES CONTR. LIST CHECK /r SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAQ' P ft / ll GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM S?NI M'G )7 POOL CONTR. LIST CHECK Permit No / Owner's Name and Address __ Location and Legal Description Lot New Building Size Septic Tank Feet of Drain Tile Nature of Water Supply: City —W Street and Number where work is to be performed —No. _ _r L+' State work to be performed and purpose of building (By Floors) STATE OF FLORIDA, COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly appeared s s. to me well known, and who, being by me first duly sworn, upon oath of the above described construction, that he has carefully read the therein by him stated are true. My Commission Expires MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT v 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 daring progress of work. - No. Registered Architect and /or Engineer Employing Plumber's Name __ ���1� -� � -' � No._ y_a_ Ef Street__��!__� / ��_:_� • division / � � ` Sub Street__ ; `� f Remodeling Block The undersigned applicant for this building permit does hereby ce under the Florida Workmen's Compensation Act, being Section 5966, plied with the provisions thereof, and will require similar compliance performed under this permit; and will post or cause to be posted for required by the Act. The under signed agrees to employ only such licensed by Miami Shores Village. Addition Repairs f "1 (Signed) Capacity Gals._ ___ ______________ — __ - of Tank or Drain Field from Well Size of Soakage Pit �T�S Amount of Permit $____ (Signed) Plumbing 1ispector. rtify that he understands and accepts his obligations as an employer of labor Compiled General Laws of Florida Permanent Supplement, and has com- from all contractors or sub - contractors employed by him in the work to be inspection on the site of the work such public notice or notices as are sub - contractors, on work to be performed under this permit, as are Date / Street o. of Stories — Mast Plumber. authorized to administer oaths and take acknowledgments, personally deposes and says that he is the foregoing application, and that he did sign the same, and that all facts Notary Public, State of Florida NOT3: 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. JOB: BUILDING ELECTRICAL PLUMBING : WORK 110ZE B7: The following is ready for inspection:- Inspector's Report:- ADD: y 17r,'.4DESTED WILL BE READY Sirs Septic Tank 1 ,S) Nature of Water Supply: City —Well Amount of Permit $ -• STATE OF FLORIDA, COUNTY OF DADE. AMA I SHORES V/IC..,AG PLUMBING INSPECTION DEPARTMCciti'' APPLOCATION FOR PWUMBINS Permit No. ! Date_ _ l r ( / / ('); f= r Application is hereby made for the approval of the detailed statement of tai plans and specifications herewit 'bmitted' for the building or other structure herein described. This application is made in compliance and conEi :.iiy 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 " "r'>. A copy of approved plans and specifications must be kept at building during progress of work.k.� 41,4 Owner's Name and Address._.l__�_. / / "dab - - -• Registered Archlteet and /or Engineer —. Employing _ to Plumber's Name ��� .� ✓ �� / N / / � r"�t ( p leg ' C=.= o!_.__ �� — - — 9fr t_ /6 .-- 2 Type of Tank__ Location and Legal Description Lot_._.._________________ __ Block__ _.__.. _ S 4 . vision —____. _________ Street and Number where work is to be performed —No /(Ve A., ree tc »./ State work to be performed and purp�ose_� f building (By Floors) ____. 1 1 i _ t (' r' , , ` G ' /;, New Building _.. Remodelin. / __ __ Addition...__ -_... Repairs No. of Stories. _ ...._._. ...... Capacity Gals Feet of Drain Tile. -_Dist. Feet of Tank or Drain Field from Well Size of Soakage Pit lurTiingz :tor. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obli; /ions 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 - ces as are required by the Act. The undersigned agrees to employ only such sub - contractors, on work to performed under this perms as are licensed. by Miami Shores Village. Street -- - - - -- ---- -- My Cc.ucmission Expires Notary Public, State of Florida '''',;--'= - Master Plumber. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me w311 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.QB will be made when such re- inspection is made•necessary by improper notice for inspection, or faulty materials and /or workmanship. CLOOQTB BATH TUBE SHOWERS LAVA- TORIES SINKS SLOP SINKS LAUNDRY Tuns U RINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT•NS TOTAL FIXTURES CONTR. LUST �/ �V D D CHECK SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR H EATER DEEP WELL SPRKLR. SYSTEM SWIM•O POOL CONTR. L UDT CHECK Sirs Septic Tank 1 ,S) Nature of Water Supply: City —Well Amount of Permit $ -• STATE OF FLORIDA, COUNTY OF DADE. AMA I SHORES V/IC..,AG PLUMBING INSPECTION DEPARTMCciti'' APPLOCATION FOR PWUMBINS Permit No. ! Date_ _ l r ( / / ('); f= r Application is hereby made for the approval of the detailed statement of tai plans and specifications herewit 'bmitted' for the building or other structure herein described. This application is made in compliance and conEi :.iiy 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 " "r'>. A copy of approved plans and specifications must be kept at building during progress of work.k.� 41,4 Owner's Name and Address._.l__�_. / / "dab - - -• Registered Archlteet and /or Engineer —. Employing _ to Plumber's Name ��� .� ✓ �� / N / / � r"�t ( p leg ' C=.= o!_.__ �� — - — 9fr t_ /6 .-- 2 Type of Tank__ Location and Legal Description Lot_._.._________________ __ Block__ _.__.. _ S 4 . vision —____. _________ Street and Number where work is to be performed —No /(Ve A., ree tc »./ State work to be performed and purp�ose_� f building (By Floors) ____. 1 1 i _ t (' r' , , ` G ' /;, New Building _.. Remodelin. / __ __ Addition...__ -_... Repairs No. of Stories. _ ...._._. ...... Capacity Gals Feet of Drain Tile. -_Dist. Feet of Tank or Drain Field from Well Size of Soakage Pit lurTiingz :tor. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obli; /ions 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 - ces as are required by the Act. The undersigned agrees to employ only such sub - contractors, on work to performed under this perms as are licensed. by Miami Shores Village. Street -- - - - -- ---- -- My Cc.ucmission Expires Notary Public, State of Florida '''',;--'= - Master Plumber. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me w311 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.QB will be made when such re- inspection is made•necessary by improper notice for inspection, or faulty materials and /or workmanship. WIC BUILDING ELECTRICAL PLUMBING ROOFING Owner of Building Architect Contractor. or Builder PERMIT N? . 6316 Legal Lot Description I' Bl. Address of Building — CONTRACTOR OR BUILDER MIAMI SHORES VILLAGE, FLORIDA DATE 195 Contractor's f e k. q i License No. Work to be performed under this Permit Subdi- vision Value of � Project $ I Amount of Permit $ This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the application herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be evoked • at any time if the work is not done in compliance with such ordinances or if the plans are changed without autlorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above assumes the ;fesponsibility far`'" thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements specifications and that he assumes responsibility for work done by his agents, servants or employees. BY AUTHORITY Signed. BY• INSPECTOR In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In ac- cepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. BUILDING ELECTRICAL PLUMBING ROOFING Owner of Building MIAMI SHORES VILLAGE. FLORIDA DATE 195 PERMIT N? 5493 Contractor's License No. J _ Architect Contractor or Builder Legal Lot Description � Bl Address of Building CONTRACTOR OR BUILDER Work to be performed under this Pernii Subdi- vision Value of Project Amount of Permit $ This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the application herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any time if the wo_k is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes responsibility for work done by his agents, servants or employees. Signed. BY. INSPECTOR In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In ac- cepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. BY AUTHORITY " a PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date Legal Description Owner/Lessee / Tenant SO(4 f Job Address \ D C 5 Tax Folio L(O N n Master Permit # 4 Owner's Address 169c 9c k{ I', 9($$ 5 ft I Phone ! m ✓ J °' r 3 CA) Contracting Co. J .r (z, yx r f I I t o l --I - 1 0_, Qualifier 12( f 3 S 5 r) State# - 13i-11 � Municipal # Architect/Engineer Address Bonding Company Address Mortgagor Address I�U BING Historically Designated: Yes No Address /r Th I dk L r ' 34y SS# , �- - Phone 9i vi_8-2E � ) Competency # CfrjriCirgIns. Co. Permit 'Type (circle one): BUILDING ELECTRICAI(P MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION In&al nckJecg. -1C7 arvi O e Crok b./ 0 r rS 1^, KS j 04- ckh (00_06b1) 00 FEES: PERMI APPROVED: Zoning Mechanical Signature of owner and/or Condo President Date Estimated Cost Square Ft. (value) WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.) Application is hereby made to obtain a permit to do work and installation as indicated above, and on the attached addendum (if applicable). I certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits are required for ELECTRICAL, PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK. OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Furthermore, I authorize the above -named contractor to do the work stated. Sign: e of Contractor or Owner- Builder a - )6,,L Notary as to Owner and/or Condo President Date Notary as to Contractor or Owner- Builder - My Commission Expires: My Commission Expires; � ----- - ' ����Q� g FI ®ul o ' notCV g t n t ° Q5I23 p��lk$ MV corn mCC5 Com 33 m Date ate C.C.F. /• 2-0 NOTARY — BOND TOTAL DUE Building Electrical Plumbing Engineering rvcy Sheet/Plans Customer Name: Address: LO °((& 1v sz= Phone: l — 1 `Z 4 Gas Piping ISO. L) Sr' ,e /4(0 ,ou-v 4 7D So. Atlantic Service Corp 2120 Fletcher Street Hollywood, FL 33020 1 -SSS -696 -7272 s, irvey Sheet /Plans Customer Name: \ (_ g I Address: Phone: Cc, c T All work to comply with N.F.P.A. Code # So. Atlantic Service Corp 2120 Fletcher Street Hollywood, FL 33020 1 -888- 696 -7272 U r ' , i Z V L/ a Date / Z ` e' Job Address / 6 G /16 /U6 gG s f Tax Folio Legal Description / d✓, 2 1 6 -3 '7 Owner/Lessee / Tenant no i Owner's Address � M Phone .30.- --75 (4-?Qa _33 ov Contracting Co. / hh t /40A Address 6 -C6 4) Si /ec 7 LJG/ / /44f4 Qualifier / i� /�Gr /�,,.. r , SS# - Phone 3G ` 98 3 ' YP Z State # Municipal # Competency # p-c 20 Ins. Co. Architect/Engineer Address Bonding Company Address Mortgagor Address Permit Type (circle one): : UILDING LECTRI _ � p LUMBING ECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION 1�./ a CC- / CJUCD1'c( eY' '/. l) ,S / - ? /4. 7 ai « i eef w e f / /4/„ --. /zc ,C r- /., ��'o C 'd Square Ft. Estimated Cost (value) 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. OWNERS 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 atlove -named contrac to do the work stated. APPROVED: Signature of owner and/or Condo President Date Signature of Contract ., or Notary as to Owner and/or Condo President Date My Commission Expires: SO ply„,5 SO FEES PERMIT IIJ( PERMIT APPLICATION FOR MIAMI SHORES VILLAGE a %'qg RADON Durban s Historically Designated: Yes No Master Permit # 1p 7 o Date Notary as to ..ntractor or Owner- Builder Date My Commission Expires: C.C.F. / • NOTARY BOND TOTAL DUE /V/ � � Building / t y 46 Electrical Plumbing Structural Engineer IF SUBSIDIARY OR REVISION PROVIDE MASTER PERMIT NUMBER HERE /3 /U52 J Job Address /o '/D E q 6 � .5 2AD9229:20 2z2nA 22 Contractor No G - CO S-7057 Qualifier S S Folio Contractors Name /i 4 , /7 i r i i/C'. Lot Block Qualifier Name / C 4e)r r,--,..,,,;- Subdivision PBpg l/ / v Address v . ' G . Metes and bounds City z di -' Sta' 4 Zip ..30 z f [ ] New Construction on [ Vacant Land [ [ ] Alteration I r [ ] Alteration Exterior [ Relocation Structure [ [ ] Foundation Only [ [ ] Enclosure ] Repair ] Repair Due e ]Demolish ]Shell Only ] Addition Attached ] Addition Detached Current use of property �`-e S Description of Work #1./e6.-) 6f c. k C f t_ 7K Sq. Ft 5 Unit Floors Value of Wor 1 I y Building / Category° " ` z 9 3 S [ [ [ [ [ [ ] Chg Contractor ] Renewal ] Revision ] Extension ] Supplement ] Reinspection :Cn & zq2 .5 ( f � ��, / Owner Q / 6 Addres s/0 VO WE 9� 14 it [ ] Electrical [ ] Mechanical [ ] Plumbing [ ] LPGX City/W/141( 5 hIA'S Sta r( Zip /3� Phone 305=7 S (— bl 2 Social Security - - � S39 y E2 z \y � zc [: Name Name Address Address City Sta Zip City Sta Zip Phone Phone G z ::X Name • E2 22 Name Address r Address 0 City Sta Zip P City Sta Zip tl' P Phone Phone MB mi [OE COUNTY ING DEPARTMENT 111 N.W. FIRST STREET, SUE sun # low, MIAMI, FLORIDA 33128 -197A PERMIT APPLICATION (Please fill out completely) °See reverse side for Building Category 123.01 -52 10/88 Application is hereby mode to obtain a permit to do work and installation as indicated. I certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I unde tend that s;a •rote permits are required fot s.�2��!L„ , > �� .;�_S C! "iC / 2� �:� �; ✓__ �,� J c.■ La ©©.'_...,) Cs -L and there m• be addi • a permits required from other governmental entities. A gnature , . Owner or Owner ent PRINT NAME SCAP 2,0e /3 °qev STATE OF FLORIDA COUNTY OF DADE Sworn to and subscribed before me this I day of by (SEAL) Personally known or Produced Identification Type of Identification Produced foregoing information is accurate. - RD A NOTICL OF COMMENCEMENT MAY RESULT IN e bd CONSULT \'! TN YOUR AI TORNEY OR LENDER U,? IC:_ O;: Cf.MM:NG IVictl: Signature of Qualifier / PRINT NAME /L1 r /1% ?i Sworn to and subscribed before me this f NOTARYSEAL JAMES E DEMOS day of .d.," _ by /4111 •�u�_ k , (SEAL) Personally known or Produced Identification Type of Identification Produc }9 00 CATEGORY DESCRIPTION BUILDING PERMIT CATEGORIES 01 GENERAL BUILDING — COMMERCIAL 02 SUB — GENERAL BUILDING — RESIDENTIAL 08 CANVAS AWNING 10 COMMUNICATION TOWER 15 DEMOLITION 18 FENCE 19 FLAGPOLE — SATELLITE DISH 29 METAL AWNING & STORM SHUTTER 35 ORNAMENTAL IRON 48 SCREEN ENCLOSURES 51 SIGN (NON- ELECTRIC) 55 SWIMMING POOL 56 TENNIS COURTS (SURFACE PAVING) 82 WINDOWS (GF) — NEW 83 WINDOW INSTALLATION (GF) (S.F.) 84 WINDOW SCREEN (GF) (CURT WALL) 86 TRAILER TIE DOWN 87 PARKING / OPEN LOT / PAVING 88 WALK -IN COOLER 91 MARINAS 97 STAGE 2 VAPOR RECOVERY SYSTEM ATTENTION Please be advised that Roadway Impact Fee may be required for Building Permit categories "01" Commercial, "02" Residential, "18" Fence, "56" Tennis Courts and "86" Trailer Tie Down. Please complete the following if your application is for one of the above mentioned categories. Road Impact Fee, Fee Payer Name Address Phone No. Social Security/Tax Identification No. Please be advised that any existing or proposed Development served or to be served with a septic tank requires approval from the State Department of Health and Rehabilitative Services (HRS). Date Qualifier PERMIT APPLICA FOR MIAMI SHORES VILLAGE J o b A d d r e s s 10 t ) ! A C s Tax Folio 1 1 3 2 ® C o b 4 3 5 Legal Description Master Permit # /7� C C> Owner's Address '640 (N( ( I - Phone 30 796 -0 o(1 Contracting Co Nt1/1V LA I thrn i Address q0 NW W / �f fit / IS ! V l GLa h lln SS# -CK 790 Phone (505- 75/-,906 06 State # (IF?() /9 5 Municipal # Ins. C Owner/Lessee / Tenant C.p -t't r Architect/Engineer Bonding Company Mortgagor WARNING TO OWNE PAYING TWICE FO OR AN ATTORNEY t. Permit Type (clrcde one): BUILDING ELECTRIC WORK DESCRIPTION °.� � � 0 4 - 1C b 7 a iITT ommisstdn)l;xp . . Ar ® e ®m p ®oe 0Ae. U . �, % 0 000 , q 7Eoo f %.k7.> iee v l FEES: PERMIT / U/ f j� • RADON APPROVED: Zoning Building Mechanical Plumbing Historically Designated: Yes No Competency # Address Address dress PLUMBING S MECHANICAL ROOFING PAVING FENCE SIGN Square Ft. Estimated Cost (value) Z ( r' ) C) : YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY RESULT IN YOUR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER EIFORE 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 perlbrmed 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 AFFIDA ►' I certify that a : -• > ore; . p information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zo Furth above -named contractor to do the work stated. to Con =, e� My ommission e f Electrical ors 1 11111W 4 .r _ /111111/ C.C.F. [ l ( v NOTARY BOND TOTAL DUE Date Date Structural Engineer Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Printed: 10/21/2002 Applicant: DIANE Owner: DURBAN JOB ADDRESS: 1040 NE 96 Contractor THE NEW MIAMI SHORES PLUMBING Local Phone: 305 - 751 -2446 Parcel # 1132060143540 Permit Status: Approved Permit Expiration: 4/19/2003 Work: REPIPE HOT & COLD FOR TWO BATHROOMS THE NEW MIAMI SHORES PLUMBING, INC. BLUE ACCOUNT 900 N.W. 144TH ST. MIAMI F 33168 PAY TO THE ORDER OF ( COLONIAL BANK, Miami Beach, Florida 1 24 Hr 1 • iel Co r- ction 1 77- 502 -2265 � � FO' 4 1 � l / , r l NO / �6 9 il f1sr.urity enhanced doram.nr See barl for doiati, -01 11'00 L63711' 1:06700 L 5 L8i: 80 2786 30 2911° Plumbing Permit Permit Number: PL2002 -279 DURBAN DIANE ST Contractor's Address: 900 NW 144 ST Legal Description: MIAMI SHORES SEC 3 PB 10 - 37 LOTS 11 & 12 /0, Total Fees: PIM- Total Receipts: $0.00 Construction Value: $2.400.00 If there is no permit package accessible on the job -site for inspectors to verify, there will be no inspections. Re- inspection DATE 1637 I � L2/ 63- 151/670 01 DOLLARS 8 Page 1 of 1 ar BLK 81 LOT SIZE tion herefor in strict compliance with all :ations that may have been submitted to Ir if the plans are changed without nsibility for a thorough knowledge of the at he assumes responsibility for work done pertaining thereto and in strict conformity ;ponisibility for all work done by either Sery ices BforemellaSon Expense Emegenoy Resporse EnaArmesial Assessment Audis, Colsiadng. Drilling Expert resar[ty. Pemittteg, Rernetagan. % LasedClows:s Hecrtoollitc SeedOls Sage Sank Service n InstdIdiort Remoral. Relutl, Testing Sleen Water Sysla+e: Design. Inslalotin. rdaietonanee 3ening TA's* /mien es: Aereeelire Batting Gneramenl Fllssith Caro Indsslral Waste. laaeufactuing Marne Peg Canlrol Peleoteun Sold Waste Tramporialim Affiliations Bintx, Inc Draistab Syslems Inc FkeAda Cerro is industries. Inc Nuslone SepSs lank Company of Roi4a. Inn Memberships f bdaa Association of Ea ioimental Pertessionab Orestes Miami Chamber of Commerce IMrsty. Eevionn.erAa l Assodaton d rlei4a AHD SrA DATE: io/riloz 343PE'S ( FAX NUMBER: 1 7 499 ATTENTION: 8 � SUBJECT: aaa f A)O PL 2652' 2 .01 o V� COMPANY NAME (Transmittee / Intended Recipient): MESSAGE: SIGNED: CORPORATION Environmental Services FACSIMILE TRANSMITTAL LETTER Reply Requested: Yes ( I No ( J BioEx at, THE FOLLOWING TRANSMISSION IS SUBJECT TO CONSULTANT - CLIENT AND OTHER PRIVILEGES AND IS INTENDED ONLY FOR USE AND RECEIPT BY THE ABOVE -NAMED TRANSM ITTEE. ANY UNINTENDED RECIPIENT 1S NOTIFIED THAT USE, COPY, OR READING OF THE TRANSMISSION IS PROHIBITED. UNINTENDED RECIPIENTS , PLEASE NOTIFY THE SENDER IMMEDIATELY BY PHONE AND RETURN THE TRANSMISSION BY MAIL TO THE SENDER'S ADDRESS BELOW. /J This transmission consists of L� pages, including this transmittal letter. if the intended recipient does not receive all of the pages, please contact our office. Our Office phone numbers are 1305) 685 - 8767 (Miami!, 1305) 756.5339 (Ope Locke), or 19041 253.2469 (Daytona Beach). Our Office mein fax number is (3051 756 -5339 (Miami). Thank You. MIAMI DAYTONA OPA -LOCKA 7899 Days:Noce Cl. S,Ie 6A 703 Madison Avenue 2160 Opa -Lade Bosdeaarc Mirri FL 311388324 Daytona Beach, FL 32144.5925 Opa- Locka, FL 33054 -423 (385) 665 -8787 Phone (904) 253-BIOX (2469) Plscne & Fax (305) T56 -5339 Phone & Fa Internet Address: baes.@herdefinfi.net Compliance Inspection (Annual) l(Z ;.' ..,I• •� f . "�:.A�.;i t 1 (.)t �l ;'x,: 1 $ t " 5 �` �..{ 7 4.�.` .. TIN Compliance Inspection (Complaint received) TCPI _ Closure Tnspcction TXI • . Compliance Re- Inspection TCR .. J M r' / �!.i` l i, .f.< I e ' f . „ ),.:•:.:. r V • F ■• 1.• f ;........ 4 Compliance Inspection (Annual) TCI Discharge Inspection/Evaluation TDI Compliance Inspection (DRF received) TCDI Installation Inspection TIN Compliance Inspection (Complaint received) TCPI Closure Tnspcction TXI • . Compliance Re- Inspection TCR 11/2002 08:15 3057565339 Rule Cite __ Insurance Carrier: I3ake¢'up * ir tes ,Admit Ve COO 6240. A e- inspecti x cy llbe so'l e t led !or Inspetiteir Niirge— Please Driat Gir iIt' ) lnsOector Signature & Date 16LO1 -U3 3'O1 Facility ID Facility Name Latitude None L. - O „ Description / Inspector's Comments • Florida .Department of Environmental Protection Twin Towers Office Bldg. • 2600 Blair Stone Road • Tallahassee, Florida 32399 -2400 Division Of Waste Management Bureau of Petroleum Storage Systems Stortio;I)nk Progr Office 5 Lrr; •' .s )` :'mac j. f j ('.. "t f "•�_,� Storage Tank Facility Compliance Inspection Report County Longitude le a , Cam•; ENVIRONMENTAL SVCS. PAGE 02 0 „ Inspection Date Facility Type #USTs ur `opsGntor,:tW1a £ae l<,ty: ii h l ce`. 'itlio'ut, Enifbrce en aoe a taoia•14 49*c4 nphance iter s mptet Storage Tank Program Office,,FY, one Number ti .I Facility e�resentatyve I?lam�Pl Psmt •• r . -'> _i `a ;(,.L. -- _� . Facility Representative Signature & Date #ASTs Check box for .type of inspection performed and attach appropriate form(s). Provide or correct latitude/longitude when appropriate. Financial Responsibility —Verify owner's coverage. Select Insurance or Other, and provide Mechanism, if appropriate. Effective Date: Expiration Date: __ Other Coverage meeting federal financial responsibility requirements. Mechanism: Page Code u L' of City 49i4-1 /- Number of: Bays BUILDING PERMIT APPLICATION FBC 2001 Permit Type (circle): Building Electrical Owner's Name (Fee Simple Titleholder) /G/ t- Phone # Owner's Address /e N, 9ti 711 Cit /rim- // 51(6 State ¢L Tenant/Lessee Name //A- Miami Shores Village Building Department Job Address (where the work is being done) `-- City Miami Shores Village County Miami -Dade Zip Is Building Historically Designated YES NO I Contractor's Company Name 6 e r--1 -, - at/.414 /A-, / G . Phone # Contractor's Address /2e 70 5) 9 Pe.4 Qualifier 15 GiS.s. i -I- j2 State Architect/Engineer's Name (if applicable) Architect/Engineer's Address City State Zip $ Value of Work For this Permit Stories l DAlteration DNew C®///1(6 x'" 77 Type of Work: Describe Work: County Escrow Fee $ / -p o�0 Permit Fee $ 2 :CO Tech $ Code Enforcement $ Minus Plans Check Fee $ Education/Training Fee $ 1 4 0 Bond -$ Total Fee Now Due $ Master Permit No. . -- 2e-V3 — /3 9 9 Mechanical Roofmg Zip 1 'J � Phone # Zip 332-6 Square Footage Of Work: Families / Bedrooms 3 Baths ❑ Repair/Replace ❑ Demolition PZ-6 / /?d PM1(8 -- • * * * * * * * * * * * * * * * * * * * * * * * * * * ** Fees * * ** * * * * * * * * * * * * * * * * * * * * ** Scanning $ Struct. $ 5 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Permit Nu. i . ''. �� PI .2055- - Phone # Notary $ 3-05 / 759- vl�f3 365/ & 5 -/270 rad 30 .a) Radon I I f (Continued on opposite side) Bonding Company's Name (if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name (if applicable) Mortgage Lender's Address City ' State Zip Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspe 'on will not be approved and a reinspection fee will be charged. chc7/7/03 Owner o Signature Signature i- Contractor The foregoing ins . nt was ac is owledged before me this xfq The foregoing instrument was acknowledged before me this day of : 20D by day of 20e* , by - f3aJ5 . who is is personally known to m. or who has produced who •ersonally kno ,44,,':�. , � lifisikeelpioclitexitell As identifi lion and who did take an oath. X 098 as ..; ., o "` ''� �, �e93 an oath. PUBLIC: - NOTARY P NOTARY Bonded Ttra Atlantic Bo Ina Sign: Sign: Print: Print: My Commission Expires: My Commission Expires: / 7.3//Z049„5 ******** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** ************************************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** rtificate of Competency Holder) State Certificate or Registration No. Certificate of Competency No. ****** * * * * * * * *4 * * * * * * * * *• * * * * * * * * * ** * * * ** ***************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** APPLICATION APPROVED BY: i r pow— Engineer Zoning Plans Examiner Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Printed: 1/5/2004 Applicant: JOAN Owner: MAXWELL JOB ADDRESS: 1070 Contractor BELLA PLUMBING INC Local Phone: 954 - 472 -0909 Parcel # 1132060143510 NE 96 Signed: (INSPECTOR) Signed: (Contractor or Builder) Plumbing Permit Permit Number: PL2003 -274 MAXWELL JOAN ST Contractor's Address: 12870 SW 9 PLACE Page 1 of 1 Legal Description: MIAMI SHORES SEC 3 PB 10 -37 LOT 8 & E1/2 OF LOT 9 BLK 81 LOT SIZE Fees: FEE2004 -29 FEE2004 -30 FEE2004 -31 FEE2004 -32 Description Building Fee CCF Training and Education Fee Technology Fee Total Fees: Amount $250.00 $1.20 $0.40 $6.25 $257.85 Permit Status: APPROVED Permit Expiration: 3/28/2004 Construction Value: $1,460.00 Work: CONNECT SEPTIC TANK PLUMBING ROUGH FINISH FOR ADDITION BATH Total Fees: $257. s Total Receipt BY: JAN ° 7 PAB® 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 a conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responisibility for all work done by either myself, my agent, servants or employes.