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1215 NE 97 St (4)Approved Correction Re- Insp'n Fee MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date a) / Type Insp'n f 1 no ' Permit No. PL - 5c1 Name r or ICI TO r `mob Address IZ 15 ME 37 Company Steve Do v( > P i urn b l f Phone # (305 ) Z — Inspection Date b-U / Q / / Permit No i 1 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, wether erein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. e. �� -�? . „ Owner's Name and Address No. Street Registered Architect and /or Engineer Employing Plumber's Name 1_- Location and Legal Descripticdu,Aot Street and Number where work is to be performed —No. if Street 4, : ' s State work-te be performed and purpose of building (By Floors) / (New Building Remodeling Addition Repairs No. of Stories ! Size Septic Tank_ Feet of Drain Tile Nature of Water Supply' (iityj -Well. Amount of Permit $ ss. Tj MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT . Block Subdivision Type of Tank Capacity Gals Date No Street Dist. Feet of Tank or Drain Field from Well __Size of Soakage Pit ( Signed) Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the' Act. The undersigned agrees to employ only such sub - contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. ( Signed) � c- 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. My Commission Expires Notary Public, State of Florida Master Plumber. NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty materials and /or workmanship. CLOSETS BATH TUBS SHOWERS LAVA- TORIES SINKS SLOP SINKS LAUNDRY TUBS URINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT' NS I4` r .. ( , ^6 �� �- TOTAL FIXTURES CONTR. . f � ,J , ' 7` ' 1 .� 6 ' I� � ' ' J 1-- �i f • v' t �i CHECK �� ! � SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SWIM 'G POOL '. �� d 2 .. '�'� '. CONTR. LIST / 1 / ✓ `/ ^ (j) CHECK / . / Permit No i 1 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, wether erein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. e. �� -�? . „ Owner's Name and Address No. Street Registered Architect and /or Engineer Employing Plumber's Name 1_- Location and Legal Descripticdu,Aot Street and Number where work is to be performed —No. if Street 4, : ' s State work-te be performed and purpose of building (By Floors) / (New Building Remodeling Addition Repairs No. of Stories ! Size Septic Tank_ Feet of Drain Tile Nature of Water Supply' (iityj -Well. Amount of Permit $ ss. Tj MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT . Block Subdivision Type of Tank Capacity Gals Date No Street Dist. Feet of Tank or Drain Field from Well __Size of Soakage Pit ( Signed) Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the' Act. The undersigned agrees to employ only such sub - contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. ( Signed) � c- 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. My Commission Expires Notary Public, State of Florida Master Plumber. NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty materials and /or workmanship. • o Co T .9 Permit No _ � b-,o 4 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 during progress of wor Owner's Name and Address ( __� Registered Architect and /or n ineer_____— _______�__�, I ^^ ••ll Employing Plumber's Name G �?�r /� 1 � ' �!'� /I/� NO.L ,_ a-- /00 S3 __.a 7 Location and Legal Descripti Subdivision Amount of Permit $• Nature of Water Supply: City—Well. Street and Number where work is to be performed— No.__ State work to be performed and purpose of building (By Floors)___. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING t,>, IIT Date ° 6 No. -__J d k_ 0__ Street 9- (Signed). My Commission Expires Notary Public, State of Florida Street New Building __ Remodeling___._ ____ Addition____ Repairs No. of Stories. Size Septic Tank _ Type of Tank____._ Capacity Gals. Feet of Drain Tile __Dist. Feet of Tank or Drain Field from Well _Size of Soakage Pit Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his ob igations 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 - contractor:; 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 peened 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 aclmowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the _.. of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made .necessary by improper notice for inspection, or faulty materials and /or workmanship. CLOSETS BATH TUBE SHOWERS LAVA- TORIES SINKS SLOP SINKS LAUNDRY TUBE URINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT•NS g p ' � , ) mow, o TOTAL FIXTURES -- CONTR. LIST CHECK --- / O �9 SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR WATER DEEP WELL. SPRKLR. SYSTEM SWIM'S POOL CONTR. LIST CHECK Permit No _ � b-,o 4 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 during progress of wor Owner's Name and Address ( __� Registered Architect and /or n ineer_____— _______�__�, I ^^ ••ll Employing Plumber's Name G �?�r /� 1 � ' �!'� /I/� NO.L ,_ a-- /00 S3 __.a 7 Location and Legal Descripti Subdivision Amount of Permit $• Nature of Water Supply: City—Well. Street and Number where work is to be performed— No.__ State work to be performed and purpose of building (By Floors)___. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING t,>, IIT Date ° 6 No. -__J d k_ 0__ Street 9- (Signed). My Commission Expires Notary Public, State of Florida Street New Building __ Remodeling___._ ____ Addition____ Repairs No. of Stories. Size Septic Tank _ Type of Tank____._ Capacity Gals. Feet of Drain Tile __Dist. Feet of Tank or Drain Field from Well _Size of Soakage Pit Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his ob igations 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 - contractor:; 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 peened 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 aclmowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the _.. of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made .necessary by improper notice for inspection, or faulty materials and /or workmanship. BUILDJNG ❑ ELECTRICAL PLUMBING Architect Contractor or Builder Legal Description. Address of Building Lot ROOFING ❑ Work to be performed under this Pe Owner of Building 1 This permit It gralhted to the contractor or b uilder named above to constru herefor in strict compliance with all ordinances pertaining thereto and with the u drawings, statements or specifications that may have been submitted to and approv time if the work is not done in compliance with such ordinances or if the plans are 'ranted is the understanding that the contractor or builder named above assumes t ertaining to the work covered hereby whether shown on the plans or drawings or .;one by his agents, servants or employees. CONTRACTOR OS BUILDER MIAMI SHORES VI PERMIT N? 112 Signed: In consideration of the issuance to me of this permit I agree to perform t pertaining thereto and in strict conformity with the plans, drawings, statements or In accepting this permit I assume responsibility for all work done by either, myse LACE, FLORIDA 7 ubdi- vision alue of roject $ BY DATE—. 195 - Contractor s License No Amt. of i1 Permit $ �"•" '"'" t the building or to install the equipment or device described in the application nderstanding that the work will be performed in compliance with any plans, ed by the proper municipal authorities. This Permit may be revoked at any anged without authorization. A further condition upon which this permit is e responsibility for a thorough knowledge of the ordinances and regulations in the statements or specifications and that he assumes responsibility for work a ,. 13Y , INVE6''rOk e work covered hereunder in compliance with all ordinances and regulations specifications submitted to the proper authorities of Miami Shores Village. f, my agent, servant or employee. AGiH • BUILDING ELECTRICAL PLUMBING ROOFING 0 Fa- 0 Owner of Building Architect Contractor or Builder Legal Lot Description BL Address of Building CONTRACTOR OR BUILDER MIAMI SHORES VILLAGE, FLORIDA PERMIT N9 5350 Work to be performed under this Permit DATE Contractor's License No. Subdi- vision Value of Project $ This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the applica- tion herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes respon- sibility for work done by his agents, servants or employees. Signed. , -, 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 as cepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. BY AUTHORITY Amount of Permit $ A II 30, 'Aeilt • Permit No. Amount of Permit $ MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLIC TION FOR PLUMBING PERMIT Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Divisior of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. Owner's Name and Address. '' -- - -__ -- _.._ - No Street ------ -• - -._ Registered Architect and /or Engineer - -. -_- - -- `-- •- •-- - -_.._ ._.._� - - -- - -_• _ .,,_ Employing Plumber's Name_ Street Location and Legal Description Lot__ \n 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 Block__,..__--- _._..___ ._ Subdivision Repairs. Capacity Gals. Feet of Drain Tile ___.- _._..- _--- -- -- - -- -------------- - - - - -- -Dist. Feet of Tank or Drain Field from Well Na tu>e of Water Supply: City —Well _ _.____Size of Soakage Pit ( Signed (Signed) _ Date _. Street - No. of Stories ...... A4 Plumbing ns;�er:tor. 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 . i n- 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. Master Plumber. STATE OF FLORIDA, . COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeare to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all lac 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 foul materials and /or workmanship. CLOSETS BATH rues SHOWERS LAVA- TORIES SINKS SLOP SINKS LAUNDRY Tune URL URINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT •NS TOTAL FIXTUREI CONTR. LIST _^ CHECK __ SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM $WIM'G POOL GONTR. LIST CHECK - • Permit No. Amount of Permit $ MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLIC TION FOR PLUMBING PERMIT Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Divisior of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. Owner's Name and Address. '' -- - -__ -- _.._ - No Street ------ -• - -._ Registered Architect and /or Engineer - -. -_- - -- `-- •- •-- - -_.._ ._.._� - - -- - -_• _ .,,_ Employing Plumber's Name_ Street Location and Legal Description Lot__ \n 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 Block__,..__--- _._..___ ._ Subdivision Repairs. Capacity Gals. Feet of Drain Tile ___.- _._..- _--- -- -- - -- -------------- - - - - -- -Dist. Feet of Tank or Drain Field from Well Na tu>e of Water Supply: City —Well _ _.____Size of Soakage Pit ( Signed (Signed) _ Date _. Street - No. of Stories ...... A4 Plumbing ns;�er:tor. 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 . i n- 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. Master Plumber. STATE OF FLORIDA, . COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeare to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all lac 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 foul materials and /or workmanship. BUILDING fl ELECTRICAL l PLUMBING ROOFING ❑ Work to be performed under this Pormi Owner of Building Architect Contractor or Builder Legal Description Address of Building Lot This permit is granted to the contractor or builder named above to construct herefor in strict compliance with all ordinances pertaining thereto and with the and drawings, statements or specifications that may have been submitted to and approved time if the work is not done in compliance with such ordinances or if the plans are ch granted is the understanding that the contractor or builder named above assumes the pertaining to the work covered hereby whether shown on the plans or drawings or in done by his agents, servants or employees. In consideration of the issuance to me of this permit I agree to perform the pertaining thereto and in strict conformity with the plans, drawings, statements or sp In accepting this permit I assume responsibility for all work done by either, myself, ww . CONTRACTOR OR BUILDER MIAMI SHORES VILLS AGE, FLORIDA■ PERMIT N° 1388 V Pr Signed bdi- sion lue of ject $ e building or to install the equipment or device described in the application rstanding that the work will be performed in compliance with any plans, by the proper municipal authorities. This Permit may be revoked at any nged without authorization. A further condition upon which this permit is esponsibility for a thorough knowledge of the ordinances and regulations the statements or specifications and that he assumes responsibility for work BY " 1 I INSPECTOR ork covered hereunder in compliance with all ordinances and regulations cifications submitted to the proper authorities of Miami Shores Village. my agent, servant or employee. BY DATE_ Con'tractor's License No Amt. of Permit AUTHORITY 195 BUILDING PERMIT APPLICATION == FBC 2001 Owner's Address City / /i14 1 5 44' 4 L State �— Job Address (where the work is being done) Contractor's Address I t 2( S 1 4 Z s T' Qualifier S /mac - Pater )2 .tv 1 S State Certificate or Registration No. C f C. tJ''72 59 Architect/Engineer's Name (if applicable) $ Value of Work For this Permit Code Enforcement $ Total Fee Now Due $ (Continued on opposite side) )1(7/ 'al Miami Shores Village Building Department 10050 N.E.2nd A enue,. Miami Shores, Florida 33138 Tel: (305) 79,6.'404 F ',(3Q5 756.8972 Permit Type (circle): Building Electrical " Mechanical Roofing Owner's Name (Fee Simple Titleholder) P/1 4 /c 7L /4 /2/5 / tic Phone # Tenant/Lessee Name Phone # Moo s /O l ? 5 Zip City Miami Shores Village County Miam' Pade Is Building Historically Designated YES NO Contractor's Company Name S T E - k . DA t i t s Pt_ vvi 8 [1 Phone # 3o 5 2 5 City State FC- Zip 33( Permit No. TL,0-5--L67 Structural Plan Review. $ Master Permit No. 05- - 0 Certificate of Competency No. Phone # Square Footage Of Work: Zip Type of Work: ❑Addition ❑Alteration ❑New Repair/Replace ❑Demolition Describe Work: r ><// - //4 /�Ge✓ / l R )4 // ►'�, , 1 Lt,J 6. ( Z L r4r i 1 R D ( 5 t r i o i - 5 -e/4 aig ci( 1// (cL- f Z . (( r y e j Submittal Fee $ , �� Permit Fee $ 1 CCF $ CO /CC Notary $ Training/Education Fee $ 0 e Technology Fee $ Scanning $ Radon $ Zoning Bond $ T � Bonding Company's Name (if applicable) Bonding Company's Address .� City State Zlp� Mortgage Lender's Name (if applicable) / Mortgage Lender's Address City St 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 $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature Signature Owner or Agent Chc 05/13/03 DD 275191 Pr t . Contractor The foregoing instru ent was acknowledged before me this The foregoing 'n trument was acknowledge before me this day of 20 by day of f , 20 d7, by L, a9 S who is personally known to • or who has produced who is personally known to me or who has produced a /....-- As identific '..n and who did take an oa l4a�` ++t+ z -� sit identification and who did take an oath. NOTARY PUBLIC: . ' loAc .Y Pif$LIC: a .4 �acy 20 , `'� �t . •. �� 4 Sign: .. Print: My Commission Expires: CY ,P/1 S9� ••�PUanou�0;�: y �"mmission Expires: ************************ * * * * * * * * * * * * * * * * * * * * ** * * * * *044 1' ************ * * * * * * * * * * * * ** * * * * * * * * * ** * * * * ** i ntn+a +` ***** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** * ************************************ * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** APPLICATION APPROVED B /`L /a g- 0 5 Plans Examiner Engineer Zoning ITEM BATH TUB UNIT 1 FEE ITEM SWITCH OUTLETS UNIT -_ FEE ITEM SPACE HEATERS UNIT FEE BIDET LIGHT OUTLETS CENTRAL HEATING DISHWASHER if RECEPTACLES A/C (WIND) DISPOSAL SERVICE TEMPORARY A/C (CENTRAL) DRINKING FOUNTAIN SERVICE SIZE IN AMPS -_ DUCT WORK FLOOR DRAIN SERVICE REPAIR/METER CHANGE REFRIGERATION GREASE TRAP APPLIANCE OUTLETS PROCESS AND PRESS PIPING INTERCEPTOR RANGE TOP UNDERGROUND TANKS LAVATORY OVEN ABOVE GROUND TANKS LAUNDRY TRAY // WATER HEATER U.F. PRESSURE VESSELS CLOTHES WASHER / MOTORS 0- 1 HP STEAM BOILERS SHOWER MOTORS OVER 1- 3 HP HOT WATER BOILERS SINK, POT /3 COMP. MOTORS OVER 3- 5 If MECHANICAL VENTILATION SINK, RESIDENCE / MOTORS OVER 5- 8 HP TRANSPORTING ASSEMBLIES SINK, SLOP MOTORS OVER 8- 10 HP ELEVATORS/ESCALATORS TEMPORARY WATER CLOSET MOTORS OVER 10- 25 HP FIRE SPRINKLER SYSTEMS URINAL MOTORS OVER 25-100 HP -_ COOLING TOWERS WATER CLOSET / MOTCRS OVER 100 HP VIOLATION INDIRECT WASTES- A/C WINDOW _- REINSPECTION WATER SUPPLY TO: AIR CONDITIONERS A/C UNIT STRIP HEATER FIRE SPRINKLER GENERATORS TRANSFORMERS 'HEATER -NEW INST. GENERATORS TRANSFORMERS - _ HEATER - REPLACE / GENERATORS TRANSFORMERS LAWN SPRINKLER -WELL SPECIAL PURPOSE SWIMMING POOL OUTLETS COMMERCIAL WATER SERVICE 1 SIGN TUBES SEWER CONNECTIONS .SIGN TRANSFORMERS UTILITY -SEWER SIGN TIME CLOCK UTILITY-WATER FIXTURES SEPTIC TANK ANTENNA -_ RELAY TELEVISION OUTLETS DRAINFIELD, 4' TILE/RES. VIOLATION PUMP & ABANDON SEPTIC TANK REINSPECTION SOAKAGE PIT CU. FT. CATCH BASIN DISCHARGE WELL DOMESTIC WELL -� AREA DRAIN ROOF INLET SOLAR WATER HEATER FIRE STANDPIPE POOL PIPING LAWN SPRINKLER SYSTEM [ �� GAS RANGE METER SET (GAS) GAS PIF'INL - l 1 ADDENDUM TO BUILDING PERMIT APPLICATION (AN APPLICATION FOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. IF A MASTER PERMIT HAS B. OBTAINED, THE OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.) PLUMBING ELECTRICAL MECHANICAL Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Printed: 3/10/2005 Permit Number: PL2005 -59 Applicant: FERNANDO GODINEZ Owner: GODINEZ FERNANDO JOB ADDRESS: 1215 NE 97 ST Plumbing Permit Contractor DAVIS PLUMBING Contractor's Address: 16026 S. W. 147 ST. Local Phone: 305 - 232 -7669 Parcel # 1132050090380 Legal Description: 5 53 42 EARLETON SHORES Fees: Description Amount FEE2005 -3157 Building Fee $160.00 FEE2005 -3158 CCF $2.40 FEE2005 -3159 Technology Fee $4.00 FEE2005 -3160 Training and Education Fee $0.80 FEE2005 -3161 Submittal Fee ($50.00) Total Fees: $117.20 Page 1 of 1 PB 43 -80 LOT 12 BLK 3 LOT SIZE Total Fees: $117.20 Total Receipts: $0.00 Permit Status: APPROVED Permit Expiration: 8/17/2005 Construction Value: $3,500.00 Work: REPIPE 2 BATH H, REPLACE 1 HWH, 1 BATH TUB, 1 WATER CLOSET, 2 LAVATORIES, DISHWASHER, WATER SERVICE AND Signed: (INSPECTOR) In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responisibility for all work done by either myself, my agent, servants or employes. Signed: (Contractor or Builder) BY: