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 +`
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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: