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PLUMBINGPermit No. Application is Lereby 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 Miar.xi Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. Owner's Name and Address No. Street_ Registered Architect and/or Engineer..... -_ Employing Plumber's Name . No. Street----- - -- - -- ---- -- - - -- Location and Legal Description Lot ._ Block Subdivision. _. Street and Number where work is to be performed—No. ____ Street__ State work to be performed and purpose of building (By Floors) New Building Remodeling Addition_ - -- - Repairs No. of Stories CONTR. LIST CHECK CONTR. LIST CHECK 4P BATH CLOSETS TUBS SEPTIC SEWER DRAIN SOAKAGE TANK CONN. FIELD i PIT Size Septic Tank Feet of Drain Tile Nature of Water Supply: City —Well. STATE OF FLORIDA, } COUNTY OF DADE. LAVA - SHOWERS TORIES ss. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT SINKS GREASE TRAP SLOP SINKS SOLAR H EATER LAUNDRY TUBS DEEP WELL URINALS Amount of Permit $- y-' - -- -- - - - -- (Signed) SPRKLR. SYSTEM CATCH FLOOR DRINKING BASIN DRAIN FOUNT•NS SWIM'G POOL Date N Type of Tank_________ __ _ ._ - . Capacity Gals. Dist. Feet of Tank or Drain Field from Well Size of Soakage Pit Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Work-men'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 arc licensed by Miami Shores Village. (Signed) - Master Plumber. i TOTAL. FIXTURES Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the -_ of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. My Commission Expires Notary Public, State of Florida NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty materials and /or workmanship. BUILDING ELECTRICAL PLUMBING,,, Owner of Building Architect Contractor or Builder Legal Description Address of Building Lot 1 CONTRACTOR OR BUILDER MIAMI SHORES VILLAGE, FLORIDA DATE °` t PERMIT N? 6112 Work to be performed under this Permit / y'r r" Bl. Signed: Subdi- vision l Value of - Amt. of 1° .. E Project 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 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 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, Ssunies respon- sibility for work done by his agents, servants or employees. 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 th o nd in strict conformity with the plans, drawings, statpnients or specifications submitted to the proper authorities of Miami Shores Village. In accepting emit I assum responsibility for a work done by . myself, my set, servant or employee. / fJ Ly e;"1 t . BY , Contractor's License No. 1 1942 • By INSPECTOR AUTHORITY Permit No. Date / C P Application is Lereby 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 he complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. Owner's Name and Address( Registered Architect and /or Engineer ..1 Employing Plumber's Name MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Location and Legal Description Lot __ ___ � Block d__ _L_ Subdivision Street and Number where work is to be performed —No. / t L � z Street _ =f E. l - 7. State work to be performed and purpose of building (By Floors) New Building I/T Remodeling Addition CONTR. LIST CHECK CONTR. LIST CHECK BATH CLOSETS TUBS SHOWERS 2 / SEPTIC SEWER DRAIN TANK CONN. FIELD Amount of Permit $ STATE OF FLORIDA, COUNTY OF DADE. ss. LAVA- TORIES 2 SOAKAGE PIT L - - Y1 No 7 - Street 7 7- - SINKS GREASE TRAP SLOP SINKS SOLAR HEATER LAUNDRY TUBS DEEP WELL No - f .l Street 177 S URINALS SPRKLR. SYSTEM (Signed) Repairs No. of Stories CATCH BASIN SW I M'G POOL FLOOR DRINKING DRAIN FOUNT•NS Size Septic Tank _. ___ _ Type of Tank Capacity Gals. Feet of Drain Tile _ _. _ Dist. Feet of Tank or Drain Field from Well _ . Nature of Water Supply: City—Well. _ _ ____ '�` 1 . - ''1 Size of Soakage Pit TOTAL FIXTURES p 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. f , (Signed) L L- 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 hint stated are true. My Commission Expires Notary Public, State of Florida NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty materials and /or workmanship. A - ' " • 1 BUILDING ELECTRICAL PERMIT N2 PLU!'4'1ING f Owner of Building Architect Contractor or Builder Legal Description Lot MIAMI SHORES VILLAGE, FLORIDA Work to be performed under this Permit Bl. 6235 Subdi- vision DATE 194— Contractor's � License No. Address of Value of Amt. of Building . N , ; ___. Project 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 appli- cation 1 erefor 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- sioility 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 rulatic3ns pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. Ins accepting this permit I assume responsibility for all work done by either myself, my agent, servant or employee. CONTRACTOR OR BUILDER BY AUTHORITY , arai F FHA - - 2 ar.:: icGovrzzl 235 - t: V' T. CC, ti cDrKll: :t , )r . 1u C e. v7.7.;r:r tr ri: :a ■■•■•■••■■■•■••••••■••■•■■••■••••■•■••••••■••••■• j 7. G A:70 i DTL.'; CTGR. We attach plumbing card covering the above case. Please forward certificate of Approval, in duplicate, to this office, after inspection has been made. Dear Sir: BA: Enclosure August 25,1948 Very truly yours, NELSON MORTGAGE COMPANY, INC. Re: FHA 09- 032183 Gustafson, Albion 1042 N.E. 97th St. Manager / PERMI T APPLICATION FOR MIAMI SHORES VILLAGE Date /� -2 ! JU / f Job Address l / O7e F/ `L/ Tax Folio ! )3' c10 „S 0 1r ; YZ Legal Descriptio y _S, c -� W 4.,_ Historically Designated: Yes No Owner/Lessee / Tenant DO U - P12 6- 7 Master Permit # r, Owner's Address JO 96 /1/ 5 7 / ' Phone 7 / crn Contracting Co. L- / J f C /" U ?/ / Address oPeP J A/C /3 `f Qualifier O 4 ss# - - Phone -30.1- `M-3- 7l1/& State # C- re Od / � Municipal # - ' c d-a U { / Competency # Architect/Engineer Bonding Company Mortgagor Address Permit Type (circle one): BUILDING ELECTRIC ECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION 174 / )\ Sitd_ature of owner and/or Condo President Notary as to Owner and/or Condo President My Commission Expires: FEES: PERMIT RADON Address Address C 62ur1,62,cd. APPROVED: Zoning Building Electrical GOOD /3 -r.7 Ins. Co. 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 com 'liance all applicable laws regulating construction and zoning. Furthermore, I authorize the above -named contractor to do the Date Signature of Contractor or Owner- Builder Date Notary as to Contractor or Owner- Builder My Conuni .. CHRISTINA PORRAS MY COMMISSION # CC 997648 a?3 Bcn Pinto EXPIRES: ry U ndare w idtera C.C.F NOTARY — BOND TOTAL DUE Date Date Mechanical Plumbing Structural Engineer ITEM BATH TUB TWIT FEE ITEM SWITCH OUTLETS UNIT FEE I1EM SPACE HEATERS UNIT • FEE DIDET LIgfT CUTLETS CEIHRAL HEAT IIC DI MUST IER RECEPTACLES A/C (TT 111()) DISPOSAL SERVICE 1EhPUVRY A/C (CENTRAL) DR INK NIG FOUNTAIN SERVICE SIZE IN AhPS DUCT WORK FLOOR GRAIN SERVICE REPAIR/11E1ER CHANGE REFRIGERATION GREASE TRAP APPLIANCE OUTLETS PROCESS AU PRESS PIPIIPG ' ' INTERCEPTOR RANGE TC(' UINDERGR(X1tD TANKS LAVATORY / OVEN N30VE GROUIU 1NIKS LAUNDRY TRAY RATER IIEATER U.F. PRESSURE VESSELS CLOTHES - 1TASH ER -- -� 1TJTORS 0- 1 IP STEAM BOILERS S 10111_ fr ', - / U)T0RS OVER 1- 3 IP h01ORS OVER 3- 5 IP PUT WATER BOILERS MECHANICAL VEI {IILATION SINK, POT /3 COMP. SINK, RESIDEICE MOTORS OVER 5- 8 IP TRANSPORTI ASSEMt3LIES SItIK, SLOP TUTORS OVER 8- 10 IP ELEVATORS/ESCALATORS TEWORMY WATER CLOSET MUTORS OVER 10- 25 IP FIRE SPRINKLER SYSTEMS UTIINAL hUTORS OVER 25-100 IP COOLING TOTTERS WATER CLOSET �Z�� ) 1I01 ORS OVER 11)0 IP VIULA1ION INDIRECT WASTES "-°�(/ A/C WINDOW RE INSPECTION WATER SUPPLY T0: AIR COTO ITI0NERS A/C UNIT STRIP IIEATER F IRE SPRINKLER GENERATORS TRANSFORMERS HEATER -NEW IHST. GENERATORS TRANSFORMERS HEATER- REPLACE GENERATORS TRANSFORMERS LAM SPRINKLER-WELL SPECIAL PURPOSE SRIM41ING P001 OUTLETS CI bERCIAL WATER SERVICE SIGH TIDES SEWER CONNECTIONS SIGN TRANSFORMERS ' UTILITY -SEWER SIGI{ TIME CLOCK UTILITY -RATER FIXILRES SEPTIC TANK ANTENNA ' :RELAY TELEVISION OUTLETS GRAINFIELD, 4" TILE/RES. VIOLATION FUhP & ABAM)011 SEPTIC TANK RE INSPECTION SOAKAGE PIT CU. FT. CATCH BASIN _ D ISOIMGE WELL DOMEST WELL AREA DRAIN ROOF INLET SOLAR WATER HEATER F IRE STAMP IPE _I _._ ' — POOL PIPING LAWN SPRINKLER SYSTEM GAS RNCE _ METER SET (GAS) GAS PIPING ADDENDUM TO BUILDING PERMIT APPLICATION (AN APPLICATION FOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. IF A MASTER PERMIT HAS BEr OBTAINED, THE OWNER'S NOTAR):ZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.) PLUMBING ELECTRICAL MECHANICAL Page 2 IMPORTANT NOTI CES 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 F gnat of Owner Swom .o and subscribed before me this day Print Name Type of Identification Produced: Y OF MIAMI -DADE ( 10 - 14/11-0 0 STATE OF FLORIDA, COUNTY OF MIAMI -DADE Signature of Contractor / Qualifier Print Name Sworn to and subscribed before me this day of Signature of Notary Public - State of Florida PERMIT APPLICATION c SEAL: <' nUC(1 1a:'. :L. SEAL: cf.. Personally known OR, Produced Identification Personally known OR, Produced Identification Type of Identification Produced: PROPERTY OWNER New Construction Name y n _S 1:=A-1.-ell A jp s c, Nc_ n 'S'T Home Telephone abS ---76 Z _ 3-7 Alteration Interior Business Telephone 30 s - _ ^-) 1 ' - _ q3'( 1 Fax ' S0 S ° — )LP Z °" 7 3 Shell Only TYPE OF MANAGEMENT (✓ ) New Construction Enclosure Alteration Exterior Repair Alteration Interior Demolish Relocation of Structure Shell Only Foundation Only Add'l Attachment Other Add'I Detachment Other Master Permit No. _ Subsidiary Permit No. P1/ "A90.) • / C INS7iRUCTIONS - The following steps must be taken to obtain a permit from the Miami Shores Village: Step 1. Complete the attached permit application which must be signed by the property owner and qualifier. Both signatures must be notarized. Please print or type to allow for a more accurate processing of your application. If roofing work will be done, a roofing application must be submitted along with this permit application. Step 2. Submit the completed application with all necessary documents to the Building, Planning and Zoning Department for processing. During the processing of your application, you may be asked to submit additional information. APPLICATION ! Job Address: o%0 96 //E Address Folio Number Lot Subdivision PB Current Use of Property Proposed Use of Property Tenant Information Block PERMIT TYPE (✓ ) Building Electrical Mechanical Plumbing LPGX Roofing Fence Other ARCHITECT Name License No. Address Telephone Fax q 9 771 5 2 7 -- A 312 PG Chg. Contractor Renewal Revision Extension Supplement Reinspection Apt. City State _ Zip Description of Work PERMIT APPLICATION 0- 1N1 .e — ` S Zoning Linear Feet k Square Feet Units Floors da lue of Wo' Bldg Value Tax Assessed/Appraised Value Flood Zone Base Floor Elev. PERMIT CHANGE (✓ ) ENGINEER Name License No. Address Telephone Fax CONTRACTOR Name License No. Address Telephone Fax Qualifier Name 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 ❑ PROOF OF OWNERSHIP (Attach) ❑ FIRS / DERM APPROVAL (Septic / Sewer) ❑ IMPACT FEE (New Construction) ❑ OTHER (Specify & Attach) $ q 69 $ h V S. 0 � (sq.ft. = x/1000 x ¢.60) (¢.005 /sq.ft.) (¢.01 /sq.ft.) REVIEWED AND PREPARED BY: SECTION Zonin: Electrical Mechanical Plumbin Public Works Structural Building Official MEM PERMIT APPLICATION ❑ CONDO ASSOCIATION APPROVAL (Attach) ❑ BPR APPROVAL (Restaurants) ❑ CONTRACTOR REGISTRATION (On File) PERMIT FEES TOTAL $ ISSUING OFFICIAL DATE: CONDITION OF APPROVAL Revised July 2001 10050 N.E. 2ND AVE., MIAMI SHORES, FL • (305) 795 -2207 • FAX (305) 756 -8972 • http : / /www.miamishoresvillage.com ELECTRICAL TYPE Minimum Fee Q'fY. '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 MECHANICAL TYPE Minimum Fee QTY. TYPE Condensate Drain QTY. TYPE Generator QTY. TYPE Refrigeration, Tons QTV. A/C Central, Tons Cooling Tower Heating Strips, each Vent Hood, Cost A/C Wall/Win. Tons Dryer Vents, Number of Paint Booth Ventilation, Cost Air Handler, Tons Ductwork, Cost of Piping, Flammable Liquid Periodic Inspections Barbecue Fire Sprinkler System Process/Pressure Piping Supply, AC Well Bath Fan - Vented, # Fireplaces, Number of Pressure Vessel Temporary Toilet PLUMBING TYPE I A/C Condensate QTY. TYPE Drains, Roof QTY. TYPE Miscellaneous Fixture QTY. TYPE: Soakage Pit Ql'Y. 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: Miami Shores Village 10050 NE 2nd Avenue Printed: 5; 3, 2002 Applicant: —M ' o pt,U Owner: NARDO- MARTIN U MARIA JOB ADDRESS: 1096 NE 97 ST Contractor Local Phone: Parcel # 1132050170180 Perrnit Status: Approved Permit Expiration: 10/30/2002 Construction Value: Work: SPRINKLER SYSTEM Signe Signed: ium f:. in er * it Contractor's Address: Legal Description: REV PL MIAMI SHORES SEC 8 (INSPECTOR) BY: (Contractor or Builder) BY rN $500.00 Phone: 305 - 795 -2204 • Permit Number: PL2002 -115 Page 1 of 1 PB 43 -51 LOT 6 Fees: Description Amount FEE2002 -2512 CCF P cf 0:Q $0.60 FEE2002 -2513 Notary Fee $5.00 Total Fees: $5.60 95 -60 Total Fees: $5;60 Total Receipts: $0.00 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. BLK 181 This Permit is granted 1 h 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 t .e understanding that the work will be performed in cornpriance with any plans, drawings. statements or specifications that may have been submitted to and approved by the proper municipal authoriti ==. 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 !inter condition upon which this permit is ant is the understanding that the contractor or builder named above assumes the responsihiltyy for a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby wh er s own on the plans or drawings or in the statements or specifications and that he assumes responsibility tot work done by his agents, servants or employees suance 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 In consider plans. drawings, spa nents or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responrsibiltty for all work done by either myself, my agent, servants or emplo} J Permit No Application is hereby made for the approval of the detailed statement of the playas 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 specification must be kept at building during progress of work. Owner's Name and Addae Lem" ' 8� / Registered Architect and /or Ereer 9 - 7E5 }5 Street and Number where work is to be performed -No State work to be performed and purpose of building (By Floors) New Building -•_ -- - --..... - - - -.. Remodeling__- ._.__...__.__ Addition 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 277" L - Amount of Permit $ My Common Expires ) rff-As' MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT (Signed)_ (Signed) No./ 6- Street... 7 s 7 Subdi,ia6on. z1 7 , ,%- / .7 5 Street Repairs No. of Stories 0 t- 3' Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5988, Compiled General Laws of Florida Permanent Supplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the wort. to he 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. Master Plumber. STATE OF FLORIDA, COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take ac 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 be did sign the same, and that all facts tberein by hires stated are true. Notary Public, State of Florida NOTE: A re inspection fee of 51.00 will ba made whom nob ninapeetfata fr wade . neoeesary by improper notion for impaction, es faulty materials and/or wee CLOSrTS BATH Tua$ SHOWER/ LAVA• TORIES SINK) SLOP SINKS LAUNDR TUNIS URINALa CA K N ®AS IN FLOOR DRAIN DRINKING FOUNT 'NS T 7AL TOTAL CONTR. LIST CHECK SEPTIC TANK SEWER CONK. DRAIN FIELD SOAKAeE PIT GREASE TRAP SOLAR NEATER DREP WILL SPRKLR. SYSTEM SW IM•O POOL CONTR. LIFT ,-- CHECK J Permit No Application is hereby made for the approval of the detailed statement of the playas 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 specification must be kept at building during progress of work. Owner's Name and Addae Lem" ' 8� / Registered Architect and /or Ereer 9 - 7E5 }5 Street and Number where work is to be performed -No State work to be performed and purpose of building (By Floors) New Building -•_ -- - --..... - - - -.. Remodeling__- ._.__...__.__ Addition 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 277" L - Amount of Permit $ My Common Expires ) rff-As' MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT (Signed)_ (Signed) No./ 6- Street... 7 s 7 Subdi,ia6on. z1 7 , ,%- / .7 5 Street Repairs No. of Stories 0 t- 3' Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5988, Compiled General Laws of Florida Permanent Supplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the wort. to he 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. Master Plumber. STATE OF FLORIDA, COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take ac 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 be did sign the same, and that all facts tberein by hires stated are true. Notary Public, State of Florida NOTE: A re inspection fee of 51.00 will ba made whom nob ninapeetfata fr wade . neoeesary by improper notion for impaction, es faulty materials and/or wee PgS r 237 Rev 11/79 SECTION 3a SCALE NS DWG. BY Cow[ RE tE wALL r 6 0 1 .0" t)°5 t1 1- aoo Le 14 oRta. dONNECT TD EfaSTING T6 RAN6E NNly T f. (37 STRCET 0% NE 97 5r LOT: 6 BLK: ISI Suably: SrroRE5 3ECTIoN S op1 G1°i5 SYST PROpo5ED L 41 CA5 TO I0% NE 77 5r DATE SHEET J.O. A.F.E. 3116 of I