262 NE 96 St (7)PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date 9-6- O+ Job Address 2-6 2 C �6 S . Tax Folio 1 I • a 0C ' 0(5- 3g 7'0
Legal Description Historically Designated: Yes No
Owner/Lessee / Tenant PQ. r r pc ��� �� c� oc/ Master Permit # ' 1 4e
Owner's Address '@ - -L C- ? b c t Phone ' 5— -7 57- ( 9- 3
Address j q flq b N- 1V , c� 1 / 1 p , / ) q n i
Contracting Co. o(A. ts3 - ' k (I
g�v :IA (/ .I
Qualifier 4L` L A . So k sat, ss# - Phone 3 5- '66Y-3702_
State# ,►lt7'�
Architect/Engineer
Bonding Company
3 /ai
Signature 7wner and/or Cond. ' esident Date
d/3 ��1
Notary as to (Itvner and/or Condo PresidCht Date
My Commission E Huay S Maloney
r MY COMMISSION # 00011279 EXPIRES
July 15, 2005
BONDED /ROY RAIN INSURANCE, INC
APPROVED:
Zoning
Mechanical
Municipal # Competency #
Address
Address
Mortgagor Address
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING ECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION Dv-z L c7`` ,uS ek,t 3 0 H
Square Ft. Estimated Cost (value) 41, ? L f 0 J• 0 b
WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY RESULT IN YOUR
PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER
OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.)
Application is hereby made to obtain a permit to do work and installation as indicated above, and on the attached addendum (if applicable). I certify that all work
will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits are required for ELECTRICAL
PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK.
OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
construction and zoning. Furthermore, I authorize the above -named contractor to do the work stated.
ture of Co
1
w
o Con
C 2- 6
er- Build Date
ol — S�j ~
o
Owner-Builder P
.� P U6 ANC-E12
''
E
F OFF��
otary
tractor or
ctor
My Commission Expir
FEES: PERMIT 1 .b RADON C.C.F. J ,» 0 NOTARY _. O O BOND
Ins. Co.
8) 6
Building Electrical
Plumbing Structural Engineer
ITEM
BATH T1B
UNIT
FEE
ITEM
SWITCH OUTLETS
UNIT
FEE
ITEM
SPACE HEATERS
UNIT
FEE
BIDET
LIGHT OUTLETS
CENTRAL HEATING
DIShYIASHER
RECEPTACLES
A/C (WIND)
DISF'OSAL
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 FP
HOT WATER BOILERS
SINK, POT /3 COMP.
MOTORS OVER 3- 5 HP
MECHANICAL VENTILATION
SINK, RESIDENCE
MOTORS OVER 5- 8 HP
TRANSPORTING ASSEM6LIES
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
MOTORS 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
SIGN TUBES
SEWER CONNECTIONS
SIGN TRANSFORMERS
UTILITY -SEWER
SIGN TIME CLOCK
UTILITY -WATER
FIXTURES
SEPTIC TANK
ANTENN -
RELAY
TELEVISION OUTLETS
DRAINFIELD, 4 - TILE/RES.
VIOLATION
PUMP & ABANDON SEPTIC TANK
REINSPECTION
SOAKAGE PIT CU. FT.
CATCH BASIN
DISCHARGE WELL
DOMESTIC WELL,c1 t,
d
AREA DRAIN
ROOF INLET
SOLAR WATER HEATER
FIRE STANDPIPE
POOL PIPING
LAWN SPRINKLER SYSTEM
30
t-€_
GAS RANGE
METER SET (GAS)
GAS PIPING
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
Permit No g/Ti'tt
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION 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 Miand 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
Owner's Name and Address E2 -. st
Registered Architect and/or Engineer
roxin /
gl L umbr i Niune
tion an eg Description Lodi j.
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
Size Septic Tank— Type of Tank___
Feet of Drain Tile 2J _Dist. Feet of Tank oc Drain Field from Well .
Ibint-
Repairs No. of Stories ..... ..........
(Signed)
............... .....
---CaPaoltY Cals.-- D
Amount of Permit $ ( Signed )_ ‘
Nature of Water Supply: City—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 Worlanen's Compensation Act, being Section 5968, Compiled General Laws of Florida Permanent Supplement, and liav own-
plied with the provisions thereof, and will require similar compliance from all contractors or sub-contractors employed by him in the worm 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 as ail-
required by tlie Act. The undersigned agrees to employ only such sub-contractors, on work to be performed under .
this .1 K1 ILES
licensed by Miami Shores Village. e,-
-
STATE OF FLORIDA, ss.
COUNTY OF DADE.
Before me, the undersigned authority, • 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 careful* read the foregoing application, and that be did sign the PM% 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 mode whoa wsob relnepeotion is madeneoeseery by improper sake kw Imps:etas er faeky
materials and/or workmanship.
TOTAL
PIETURES
Ctoorrs
BATH
Tuns
Smovians
LAVA.
Toma
SINK*
SLOP
sip"
LAUNOR
Tuns
URINALS
CATCH
BASIN
Pr Loon
DRAIN
OINKING
FOUNT•N•
Comm.
LIST
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
tillO.12
SOAKAGE
PIT
G
TRAP
SOLAR
HEATER
DaBP
WELL
1 .
$
Swiwo
POOL
CONTR.
LIST
---
CHICK
Permit No g/Ti'tt
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION 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 Miand 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
Owner's Name and Address E2 -. st
Registered Architect and/or Engineer
roxin /
gl L umbr i Niune
tion an eg Description Lodi j.
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
Size Septic Tank— Type of Tank___
Feet of Drain Tile 2J _Dist. Feet of Tank oc Drain Field from Well .
Ibint-
Repairs No. of Stories ..... ..........
(Signed)
............... .....
---CaPaoltY Cals.-- D
Amount of Permit $ ( Signed )_ ‘
Nature of Water Supply: City—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 Worlanen's Compensation Act, being Section 5968, Compiled General Laws of Florida Permanent Supplement, and liav own-
plied with the provisions thereof, and will require similar compliance from all contractors or sub-contractors employed by him in the worm 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 as ail-
required by tlie Act. The undersigned agrees to employ only such sub-contractors, on work to be performed under .
this .1 K1 ILES
licensed by Miami Shores Village. e,-
-
STATE OF FLORIDA, ss.
COUNTY OF DADE.
Before me, the undersigned authority, • 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 careful* read the foregoing application, and that be did sign the PM% 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 mode whoa wsob relnepeotion is madeneoeseery by improper sake kw Imps:etas er faeky
materials and/or workmanship.
Permit No
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Date...
lie?ca`
2sz 4/vis
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submit:A for the building or other
structure herein described. This application b made in compliance and conformity with the Building Ordinance of Mia 71 Shores Village, Florida,
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulatica: 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.
Owners Name and Address
.7tegistexed Architect and/or Engineer
Zmploying Plumber's Name .m -
Location and Legal Description Lot_
111914/1 5N0,--...1... 3 2. 6 Stietit.4
81o& Subdivision__
Street and Number where work is to be perfon„ed—No R6 2_ 41Z f6. d set
Az4tc44,
State work to be performed and purpose of building (By Floars )_.", 0. , ...
New Building Remodeling Addition._ Repairs No. of Stones..
SiZe Septic Tank_ 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
Amount of Permit $ I DO
STATE OF FLORIDA, }
is.
COUNTY OF DADE.
My Commission Expires
Si
No
streetliz
Capacity Gals.
(signed) .7C4ii3A9I 3Y
Notary Public, State of Florida
Plumbing Inspect(); —
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an e-nployer of labor
under the Florida Workmen's Compensation Act, being Section 5968, Compiled General Laws of Florida Permanent Cupllement, and has con-
plied with the provisions thereof, and will require similar compliance from all contractors or sub-contractors employed I y him in : wcrk
performed under this permit; and will post or cause to be posted for inspection on the f the work suc • bli otice or no ice!. s a.
required by the Act. The undersigned agrees to employ only such tub-contractors, k to be per this pniaiL, ar
licensed by Miami Shores Village.
Plumber.
Before me, the undersigned authority. a notary public, duly authorized to administer oaths and take acknowledgments, personat ppearec .
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 'acts
therein by him stated are true.
NOTE: A re-inspection fee of 0.00 will be made when such re-iuspecdon made by improper notice for inspection, or faulty
materials and/or workmanship.
CLOSETS
BATH
TUBS
SHOwER•
LAVA.
TORIES
SINKS
SLOP
SINKS
LAUNORT
T„,
URINALS
CATCH
BASIN
FLOOR DRiNK ■ No
DRAIN FOUNT•NS
i f./01,7 —
To Ti.t.
FIXTt RES
CONTR.
LIOT
/
—
CHECK
I
.....,
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
G
TRAP
SOLAR
H
DEEP
WELL
SPRKLR.
SYSTEM
SWIM•0
POOL
.....
CoNTR.
LIST
-....._
CHICK
Permit No
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Date...
lie?ca`
2sz 4/vis
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submit:A for the building or other
structure herein described. This application b made in compliance and conformity with the Building Ordinance of Mia 71 Shores Village, Florida,
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulatica: 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.
Owners Name and Address
.7tegistexed Architect and/or Engineer
Zmploying Plumber's Name .m -
Location and Legal Description Lot_
111914/1 5N0,--...1... 3 2. 6 Stietit.4
81o& Subdivision__
Street and Number where work is to be perfon„ed—No R6 2_ 41Z f6. d set
Az4tc44,
State work to be performed and purpose of building (By Floars )_.", 0. , ...
New Building Remodeling Addition._ Repairs No. of Stones..
SiZe Septic Tank_ 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
Amount of Permit $ I DO
STATE OF FLORIDA, }
is.
COUNTY OF DADE.
My Commission Expires
Si
No
streetliz
Capacity Gals.
(signed) .7C4ii3A9I 3Y
Notary Public, State of Florida
Plumbing Inspect(); —
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an e-nployer of labor
under the Florida Workmen's Compensation Act, being Section 5968, Compiled General Laws of Florida Permanent Cupllement, and has con-
plied with the provisions thereof, and will require similar compliance from all contractors or sub-contractors employed I y him in : wcrk
performed under this permit; and will post or cause to be posted for inspection on the f the work suc • bli otice or no ice!. s a.
required by the Act. The undersigned agrees to employ only such tub-contractors, k to be per this pniaiL, ar
licensed by Miami Shores Village.
Plumber.
Before me, the undersigned authority. a notary public, duly authorized to administer oaths and take acknowledgments, personat ppearec .
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 'acts
therein by him stated are true.
NOTE: A re-inspection fee of 0.00 will be made when such re-iuspecdon made by improper notice for inspection, or faulty
materials and/or workmanship.
CLD•tT•
1
B ATH
TUB
SHOWER•
LA VA•
TORIES
SINK•
SLOP
SINKS
LAUNDRY
Tu••
URINALS
CATCH
DRAIN
FLOOR
DRAIN
DRINKING
FOUNT'N•
TOT..L
PIXY( RES
CONTR.
LIT
-
CHECK
-•
- _
I
SEPTIC
TANK
SEWER
CONN.
•DRAIN
FIELD
SOAKAGE
PIT
G
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SWIM'O
POOL
LIST
_ --•
—
CHICK
•
Penh: No... ...-
Size Septic Tank__.
Feet of Drain Tile.
Amount of Permit
STATE OF FLORIDA. ss.
COUNTY OF DADE.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
(Signed)_
(Signed)—
Date ..._
.I;phr :liun, is hereby made for the approval of the detailed statement of the plans and specifications herewith subr 1:•. ,'I for the building or other
-tructure herein described. This application is made in compliance and conformity with the Building Ordinance of Mi.: ! Shores Village, Florida,
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulatic— of the ,Building Division
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and spec Ucations Must be kept at
'.)uilding during progress of work.
'.Avnei s Name and Address — J_. No c2__co Street.
.egict _red Architect and /or Engineer. 42/ ` xa n
?mploying Plumber's Name / , (a. PiJ €J
Location and Legal Description Lot- Bloch_ Subdivision
Street 9 6 "r7--
Street and Number where work is to be performed —No
State work to be performed and purpose of building (By Floors) I'e 7/9-e< ar°e‘4 Per
New Building Remodeling__ _ _....._._ Addition._._...__ Repairs No of Stones
— ._... of Tank— Capacity ^ ,a1s._
___.Dist. Feet of Tank or Drain Field from Well.
Nature of Water Supply: City — Well.___ ____._.._.._.__.___ ____._____ _._Size of Soakage Pit
Plumbin:i Inspector
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an a n, loyei of laho
under the Florida Workrnen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent rum lement, and ila. •�n•�•
lied with the provisions thereof, and will require similar compliance from all contractors or sub- contractors employed 1 y him in • e X41 rk b
performed under this permit; and will post or cause to be posted' for inspection on the site of the work such pub': notice 3. no icrr is a.'
required by the Act. The undersigned agrees to employ only such sub - contractors, on work to be performed 'a this > 111 111, ;.r .
licensed by Miami Shores Village.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, periorr: , ppearec.
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 tint all acts
therein by him stated are true.
My Conunission Expires Notary Public, State of Florida
NOTE: A re- inspection fee of 11.00 will be made when such rs.lnspectfoe is mede-necessary by hnproper notice for tnspert'.on, tr fruit)
materials and /or workmanship.
Mast a Plumber.
)caner of
uiiding
—rob/feet
]ontracto
r Builder
UILDING
LECTRICAL
, LUMBING
v
M
AMU SHORES VILLAGE, FLORIDA
DATE
PERMIT N ? 4103
Work to he perfo
(t
ed under this Permit
Subdi-
vision
BY
Contractor's
License No
4
egal Lot
)esciption .,..'
1ddress of '- y. c '� + ' 7 2 : •'halve of Amt. of �"
tiding i. ` -^ 1' f r A ; # e , Project ll Permit
This permit is granted to the contract or bulb named above to construct the building or to install the equi or device dMar the apph
ation herefor in strict compliance with all or ances rtaining thereto and with the understanding that the work wi be performed fa ooi■pilaooe with aany�
=tans, drawings statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked
t any time i the work is not done in Compliance with such ordinances or if the plans are changed without authorization. A further condition ripen this
permit is granted is the understanding that tie contractor or builder named above assumes the responsibility for a thorough kno wledge of the ttod
l otions pertaining to the work covered hereby whether shown on the plans or drawings kr in the statements or specifications "Om'
ibility for work done by his agents, ser4ants or employees.
Signed. ( , I '` By
INSPOCYOR
In consideration of the issuance to me f this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations
:ertaioing thereto and in strict conformity w th the pa drawings, statements or specifications submitted to the proper authorities of Miami Shores Village.
n accepting this �orn�it some responsibility for vork done by either myself, my agent, servant or employee.
f.
AimioHITT
d- ::.rest No. Z d
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida,
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at
building during progress of work.
Owner's Name and Address
Registered Architect and /or Enginee / r-__
Employing Plumber's Name C.���
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
— _— street.2i'__ < L ' cf
Location and Legal Description Lot___---__ - -____ __. .__._ - -_ Block
Street and Number where work is to be performed— No.___— _ M
State work to be performed and purpose of budding (By Floors) _ -- /- - _- _ — .__
New Building ________ ..... ... . Remodeling_--___ _____ Addition--- _____.__........... Repairs No. of Stories.
Feet of Drain Tile_ — __
Nature of Water Supply: City—Well
Amount of Permit $
My Commission Expires
(Signed)_
—.. Street.
Date. 6
N0.4 z-7 ... !_ Street-- -f --c- •........
-,3
L
/%Size Septic Tank _ Type of Tank
_-Dist. Feet of Tank or Drain Field from Well
Size of Soakage Pit
Capacity Gals
Plumbing Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his o . ' . Lions as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5988, Compiled General Laws of Florida Peri . ent Supplement, and has com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be
performed under this permit; and will post or cause to be posted' for inspection on the site of the work such public notice or notices as are
required by the Act. The undersigned agrees to employ only such sub- contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village.
STATE OF FLORIDA, t es.
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments , personally appeared
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the _ of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
Notary Public, State of Florida
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made•necessary by improper notice for inspection, or faulty
materials and /or workmanship.
CLOSETS
_� ~
1..............T
BATH
TUBS
SHOWERS
LAVA•
TORIES
SINKS
SLOP
SINKS
LAUNORY
Tufs
U RINALS
CATCH
BASIN
FLOOR
DRAIN
DRINK NO
FOUNT' NS
TOTAL
FIXTURES
COMM
LIST
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
'WK.1
HEATER
V
DEEP
WELL
SPRKLR.
SYSTEM
SWIM'O
POOL
COMB.
LIST
` CHECK
d- ::.rest No. Z d
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida,
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at
building during progress of work.
Owner's Name and Address
Registered Architect and /or Enginee / r-__
Employing Plumber's Name C.���
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
— _— street.2i'__ < L ' cf
Location and Legal Description Lot___---__ - -____ __. .__._ - -_ Block
Street and Number where work is to be performed— No.___— _ M
State work to be performed and purpose of budding (By Floors) _ -- /- - _- _ — .__
New Building ________ ..... ... . Remodeling_--___ _____ Addition--- _____.__........... Repairs No. of Stories.
Feet of Drain Tile_ — __
Nature of Water Supply: City—Well
Amount of Permit $
My Commission Expires
(Signed)_
—.. Street.
Date. 6
N0.4 z-7 ... !_ Street-- -f --c- •........
-,3
L
/%Size Septic Tank _ Type of Tank
_-Dist. Feet of Tank or Drain Field from Well
Size of Soakage Pit
Capacity Gals
Plumbing Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his o . ' . Lions as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5988, Compiled General Laws of Florida Peri . ent Supplement, and has com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be
performed under this permit; and will post or cause to be posted' for inspection on the site of the work such public notice or notices as are
required by the Act. The undersigned agrees to employ only such sub- contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village.
STATE OF FLORIDA, t es.
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments , personally appeared
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the _ of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
Notary Public, State of Florida
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made•necessary by improper notice for inspection, or faulty
materials and /or workmanship.
...s
13 TUBS
CLQSIR6 TUB6
SHOWER/
LAVA.
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TueB
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT' NS
TOTAL
FIXTURES
CONTR.
LOFT
CHECY
,
B
I_ _
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE'
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SWIM'G
POOL
- - --
CONTR.
LIST
) C - 6
!!
c.,a J'
CHECK
Amount of Permit
Permit No.__ -. _-- ___ —_— Date
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submittedJor the building or. other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida,
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at
building during progress of work. n r r - Ds Owner's Name and Address____- _. ±_!_^__�`'_ `^ !_`'"_� No. °� (-D-__ _.. Street__"' 9 A b
Registered Architect and /or Engineer_________
Employing Plumber's Name L e-0 S P \ J"'"./3 t r�
Location and Legal Description Lot.
Street and Number where work is to be performed —No
STATE OF FLORIDA, ( as.
COUNTY OF DADE• J •
My Commission Expires
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
No. - -- ---_._ ..� _ -- Street_.
Block
s Subdivision
street_ 1 "
Size Septic Tank --------- - - - - -- Type of Tank
Feet of Drain ................ Feet of Tank or Drain Field from Well
Nature of Water Supply: City— Well .____ _____._._______._Size of Soakage Pit
(Signed)
(Signed)._
Notary Public, State of Florida
liGD-
State -work to be performed and purpose of building (By Floors) New Building--- .- -_ - -•- -- - -•_ - -• .- - - - -.. Remodeling Addition..- _ -_._.. Repairs No. of Stories ......................
Capacity Gals ....
4 k
Plumbing Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accept • obligations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Flori .: ' •.nnanent Supplement, and has coin -
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contrac ors 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.
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.
NOTE: A re- inspection fee of 81.00 will be made when such re- inspection is made •necessary by improper notice for inspection, or faulty
materials and /or worlonanahip. 4
n
�t I_1'3 0
�� Name and Address _A4 /� �.F_! __________ _1A L
deg'stered Architect and /or Engine
e
�w Building Remodeling
Size Septic Tank
Feet of Drain Tile
Nature of Water Supply: City—Well
Amount of Permit $
STATE OF FLORIDA,
COUNTY OF DADE.
,5to
ss.
My Commission Expires
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
dlication is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other
.ucture herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida,
\d 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
Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at
ling during progress of work.
No 246g E
g Street / ?‘s
`�
01/11 S No !_ Street_
BBlock___ —____ Subdivision
Street A r �l O
ploying Plumber's Name !1_ fiEftr aq
ocation and Legal Description Lot
Street and Number where work is to be performed —No ` ,
State work to be performed and purpose of building (By Floors) ehA I £ R1114/1"/t 4.L
Addition Repairs 1„ No. of Stories
Type of Tank Capacity Gals
Dist. Feet of Tank or Drain Field from Well
Size of Soakage Pit
( Signed)
( Signed) __
Date , PRA __- X , 95 )
Notary Public, State of Florida
' - 'w�v ' "r •
Plumbing Inspector. /
The undersigned applicant for this building permit does hereby certify that he understands an accepts his obligations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Law of lorida Permanent Supplement, and has com-
plied with the provisions thereof, and will require similar compliance from all contractors or sit ntractors 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 w. k to e performed u this permit, as are
licensed by Miami Shores Village.
•
er 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 dulylsworn, upon oath deposes and says that he is the
of the above described construction, that he has carefully read the fo regoing 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
TUBS
SHOWERS
LAVA-
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TUBS
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT'NS
TOTAL
FIXTURES
TIC
INK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SWIM•G
POOL
- JTR.
n
�t I_1'3 0
�� Name and Address _A4 /� �.F_! __________ _1A L
deg'stered Architect and /or Engine
e
�w Building Remodeling
Size Septic Tank
Feet of Drain Tile
Nature of Water Supply: City—Well
Amount of Permit $
STATE OF FLORIDA,
COUNTY OF DADE.
,5to
ss.
My Commission Expires
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
dlication is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other
.ucture herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida,
\d 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
Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at
ling during progress of work.
No 246g E
g Street / ?‘s
`�
01/11 S No !_ Street_
BBlock___ —____ Subdivision
Street A r �l O
ploying Plumber's Name !1_ fiEftr aq
ocation and Legal Description Lot
Street and Number where work is to be performed —No ` ,
State work to be performed and purpose of building (By Floors) ehA I £ R1114/1"/t 4.L
Addition Repairs 1„ No. of Stories
Type of Tank Capacity Gals
Dist. Feet of Tank or Drain Field from Well
Size of Soakage Pit
( Signed)
( Signed) __
Date , PRA __- X , 95 )
Notary Public, State of Florida
' - 'w�v ' "r •
Plumbing Inspector. /
The undersigned applicant for this building permit does hereby certify that he understands an accepts his obligations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Law of lorida Permanent Supplement, and has com-
plied with the provisions thereof, and will require similar compliance from all contractors or sit ntractors 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 w. k to e performed u this permit, as are
licensed by Miami Shores Village.
•
er 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 dulylsworn, upon oath deposes and says that he is the
of the above described construction, that he has carefully read the fo regoing 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.
BUILDING ❑
ELECTRICAL ❑ PERMIT IT? 11301
PLUMBING
ROOFING ❑ Work to be performed under this Permit
Owner of
Building
Architect,
Contractor
or Builder
Legal
Description,
Address of
Building
\\\) tilkhe
4e
Lot
.t �
CONTRACTOR OR BUILDER
MIAMI SHORES VILLAGE, FLORID
DATE 1951_
Subdi-
vision
Value of
Project $
INSPECTOR
Contractor's
License No
4 t \-/ '%‘.'4W%) Lyss-Q
Amt. of
Permit
BY -L
$
%Ur strop
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 a
herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any
drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at
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 per**
granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and re
pertaining to the work covered hereby whether shown on the plans or drawi , or in the
rt
en}nts or specificati•, s and that he assumes responsibility For
done by his agents, servants or employees. I ,
In consideration of the issuance to me of this permit I agree perform the work covered hereunder in compliance with all ordinances and regulations
pertaining thereto and in strict conformity with the pl s, drawl s tements or specifications submitted to the proper authorities of Miami Shores Village.
In accepting this permit I assume responsibility f work Ether, .elf, my agent, servant or employee.