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445 NE 96 St (4)BUILDING ELECTRICAL PLUMBING ROOFING Owner of Building Architect Contractor or Builder PERMIT f F• Legal Lot Description Address of ,� Value of 1 Amount of Building 4 `' 1 ' = Project $ 1 Permit $ This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the 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 ytith all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In ac- cepting this permit I assume responsibility for ell work done by either, myself, my agent, servant or employee. MIAMI SHORES VILLAGE, FLORIDA N9 5280 Work to be performed under this Permit DATE. 19 Contractor's , License No. Subdi- vision BY AUTHORITY ABBOT ••E' °' F ' Permit No.___ 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 Engineer___ —_ Employing Plumber's Name_.i_i''?.1f,jR �`/ 4 C/t1r✓<No._ Location and Legal Description Lot B1 Street and Number where work is to be performed —No �� State work to be performed and purpose of building (By Floors)_____RC_k �_`L__ � New Building ___ Remodeling —___._ _.__ Addition___________________ Repairs Le."'" No. of Stories Size Septic Tank _____T_ -_- _- -_�_ _______ ______Type of Tank__ ___ Feet of Drain Tile ______ _______Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: City— Well._—____ _ _ __ ��_ _____Size of Soakage Pit The undersigned applicant for this building permit does hereby certify that he understands and accepts his obli under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Penman plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors e performed under this permit; and will post or cause to be posted' for inspection on the si : . e work required by tlie Act. The undersigned agrees to employ only such sub- contractors, i n work to be licensed by Miami Shores Village. STATE OF FLORIDA, 1 COUNTY OF DADE. j MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT No. 4 4 6— Street. F 9 Date --- . 16. j Street.__! 1. Subdivision..._. �G �,� -_ 1 � Street � . x.�dt�_�.,At. 1e .t 5 ` L5LocK Capacity Gals. 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 Plumbing Inspector. ns as an employer of labor pplement, and has corn- y him in the work to be notice or notices as are under this permit, as are 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 workmanship. CLOSETS BATH TUBS SHOWERS LAVA. TORIES INKS SINKS SLOP SINKS LAUNDRY TUBE URINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT'NS TOTAL FIXTURES CONTR. LIST CHECK SEPTIC TANK SEWER CONN. DRAIN FIELD . SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SWIM'G POOL CONTR. LIST CHECK F ' Permit No.___ 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 Engineer___ —_ Employing Plumber's Name_.i_i''?.1f,jR �`/ 4 C/t1r✓<No._ Location and Legal Description Lot B1 Street and Number where work is to be performed —No �� State work to be performed and purpose of building (By Floors)_____RC_k �_`L__ � New Building ___ Remodeling —___._ _.__ Addition___________________ Repairs Le."'" No. of Stories Size Septic Tank _____T_ -_- _- -_�_ _______ ______Type of Tank__ ___ Feet of Drain Tile ______ _______Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: City— Well._—____ _ _ __ ��_ _____Size of Soakage Pit The undersigned applicant for this building permit does hereby certify that he understands and accepts his obli under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Penman plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors e performed under this permit; and will post or cause to be posted' for inspection on the si : . e work required by tlie Act. The undersigned agrees to employ only such sub- contractors, i n work to be licensed by Miami Shores Village. STATE OF FLORIDA, 1 COUNTY OF DADE. j MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT No. 4 4 6— Street. F 9 Date --- . 16. j Street.__! 1. Subdivision..._. �G �,� -_ 1 � Street � . x.�dt�_�.,At. 1e .t 5 ` L5LocK Capacity Gals. 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 Plumbing Inspector. ns as an employer of labor pplement, and has corn- y him in the work to be notice or notices as are under this permit, as are 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 workmanship. 114 ., 1 /6P.i.zwerm - • Date 3 / -1`4 Job Address Legal Description Owner/Lessee / Tenant J o t - Owner's Address Contracting Co. Qualifier State # Architect/Engineer Bonding Company Mortgagor PERMIT APPLICATION FOR MIAMI SHORES VILLAGE (4- s ,.rte 96 c Q„ 4 //�� tt — !} er .1 S (10(— I rvG [ 4 _, hob- N 1/4 �ff Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION Square Ft. Lf- Off. \ce y 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-names con, ac ',Ito do the work stated. SignAkg Date � " fo "�> SACCv'" �; �' °Slott of lot u % ,Kj, J:;: t ti `..1 C . -; Err C! ) »it;o . 7 _ 3 / -, G • Notar ;4s' 4(gr, Yor}doe,Wde rt Date My Commission Expires: �) 54� 61.A., /ob. 0 FEES: PERMIT 70. OE) RADON APPROVED: Zoning Building Mechanical Plumbing Tax Folio Historically Designated: Yes SS# Municipal # Competency # Ins. Co. Address Address Address Address Estimated Cost (value) / S O O Master Permit # Ay/4- 4/1/4- Electrical No void Phone '7J ) .2_11( C4 2 S 35 r T f44!'rQ �.. a •- Phone C / 4 / 4 / - of Contractor or Owner - Builder Date Notary as to Contractor or Owner- Builder' Date My Commissioi 12 pes: ` " ` C.C.F. /. O c' NOTARY TOTAL DUE / 7/. O 0 Engineering CONSTRUCTION PERMIT F9R: [/V] New System [�/ Existing System [ 01ding Tank [ ] Repair [1] Abandonment [Other(Specify) APPLICANT: Te • d e. AGENT: t 4 41 , G s . PROPERTY STREET ADDRESS: LOT: / 1_ ) BLOCK: U SUBDIVISION: PROPERTY ID #: SPECIFICATIONS BY: APPROVED BY: DATE ISSUED: 7 -ate FC STATE OF FLORIDA PERMIT # DEPARTMENT OF HEALTH AND REHABILITATIVE SERVICES ONSITE SEWAGE DISPOSAL SYSTEM CONSTRUCTION PERMIT Authority: Chapter 381, FS & Chapter 1OD -6, FAC SYSTEM DESIGN AND SPECIFICATIONS SYSTEM MUST BE CONSTRUCTED IN ACCORDANCE WITH SPECIFICATIONS AND STANDARDS OF CHAPTER 1OD -6, FAC REPAIR PERMITS AND HOLDING TANK PERMITS EXPIRE 90 DAYS FROM THE DATE OF ISSUE. ALL OTHER PERMITS EXPIRE ONE YEAR FROM THE DATE OF ISSUE. HRS APPROVAL OF SYSTEM DOES NOT GUARANTEE SATISFACTORY PERFORMANCE FOR ANY SPECIFIC PERIOD OF TIME. ANY CHANGE IN MATERIAL FACTS WHICH SERVED AS A BASIS FOR ISSUANCE OF THIS PERMIT, REQUIRE THE APPLICANT TO MODIFY THE PERMIT APPLICATION. SUCH MODIFICATIONS MAY RESULT IN THIS PERMIT BEING MADE NULL AND VOID. T [ ] [GALLONS / GPD] SEPTIC TANK /AEROBIC UNIT CAPACITY MULTI- CHAMBERED /IN SERIES:[ ] A [ ] [GALLONS / GPD] CAPACITY MULTI- CHAMBERED /IN SERIES:[ ] N [ ] GALLONS GREASE INTERCEPTOR CAPACITY (MAXIMUM CAPACITY SINGLE TANK:`'125O GALLONS] K [ ] GALLONS PEJt DOS DOSING TANK CAPACITY DOSE RATE [ ] PER 24 HRS NO. OF PUMPS: [ ] ,pp eta 4 D [C 2,] SQUARE FEET PRIMARY DRAINFIELD SYSTEM SYSTEM [ ] STANDARD [ ] FILLED [ ] TRENCH [1/4_4—BED R [ ] SQUARE FEET A TYPE SYSTEM: I CONFIGURATION: N F LOCATION OF BENCHMARK: I ELEVATION OF PROPOSED SYSTEM SITE [ E BOTTOM OF DRAINFIELD TO BE [ G' [SECTION /TOWNSHIP /RANGE /PARCEL NUMBER] [OR TAX ID NUMBER] L D .FILL ?U � n Sj�T .G,HF$p C; g ( O REQUIRED: T <Y r i, I,I..... t C = L - ^S TITLE: [ ] MOUND [ ] [ ] ] [ABOVE /BELOW] BENCHMARK FERENCE POI T] [ABOVE BELOW BENCHMARK EFERENCE POINT DATE PAID FEE PAID RECEIPT # Temporary /Experimental ] INCHES k-m))7 CPHU EXPIRATION DATE: ag o ` a ` ;f1r i ec, rt r:� �, HRS -H Form 4016, Mar 92 (Obsoletes previous editions which may not be used) Page 1 of 2 (Stock Number: 5744 - 001- 4016 -0) )`' iv\ 1t p 1i;1) i ... i APPLICATION FOR: [OA New System [rn] Existing System [6z] Holding Tank f ] Temporary /Experimental [/ j Repair [?c ] Abandonment [ue ] Other(Specify) APPLICANT: t° ✓v✓n AGENT: 1 MAILING ADDRESS: c TO BE COMPLETED BY APPLICANT OR APPLICANT'S AUTHORIZED AGENT. ATTACH BUILDING PLAN AND TO -SCALE SITE PLAN SHOWING PERTINENT FEATURES REQUIRED BY CHAPTER 10D-6,/FLORIDA ADMINISTRATIVE CODE. PROPERT INFORMATION [IF LOT IS NOT IN A RECQRDED SUBDIVISION, ATTACH LEGAL DESCRIPTION OR DEED] LOT: `�� BLOCK: G SUBDIVISION: PROPERTY ID #: PROPERTY SIZE: PROPERTY STREET DIRECTIONS TO PROPERTY: BUILDING INFORMATION Unit Typ; of No Establishment 1 2 3 4 6 - c STATE OF FLORIDA DEPARTMENT OF HEALTH AND REHABILITATIVE SERVICES ONSITE SEWAGE DISPOSAL SYSTEM APPLICATION FOR CONSTRUCTION PERMIT Authority:, Chapter 381, FS & Chapter 1OD -6, FAC T ACRESo /43560] PROPERTY WATER SUPPLY: ADDRESS: C / L1 5 wcL ■ [ LJ RESIDENTIAL +e [ ] COMMERCIAL - No. of ' Building # Persons Business Activity Bedrooms Area Sqft Served For Commercial Onlv [u ] Garbage Grinders /Disposals [l2 ° ] Spas /Hot Tubs (] Floor /Equipment Drains [,,] Ultra -low Volume Flush Toilets Vu) - Qther (Specify) APPLICANT'S SIGNATURE: 7 , 7 7/ /v DATE OF f - SUBDIVISION: [Section /Township /Range /Parcel No.] ZONING: 3 (f__ isoo PERMIT # DATE PAID FEE PAID $ RECEIPT # s TELEPHONE: PRIVATE [e1> PUBLIC DATE: 7 HRS-H Form 4015, Mar 92 (Obsoletes previous editions which may not be used) Page 1 of 3 (Stock Number: 5744 - 001 - 4015 -1) STATE OF FLORIDA _DEPARTMENT OF HEALTH AND REHABILITATIVE SERVICES ONSITE SEWAGE DISPOSAL SYSTEM SITE EVALUATION AND SYSTEM SPECIFICATIONS Cpl a�•cav�,. PROPERTY ID #: USDA SOIL SERIES: V �JC�v✓+ i= APPLICANT.(• LOT: BLOCK: ,,, /SUBDIVISION: TO BE COMPLETED BY ENGINEER, HEALTH UNIT EMPLOYEE, OR OTHER QUALIFIED PERSON. ENGINEER'S MUST PROVIDE REGISTRATION NUMBER AND SIGN AND SEAL EACH PAGE OF SUBMITTAL. COMPLETE ALL ITEMS. - PROPERTY SIZE CONFORMS TO SITE " AN: TOTAL ESTIMATED SEWAGE FLOW; L 9c) AUTHORIZED SEWAGE FLOW: UNOBSTRUCTED AREA AVAILABLE: BENCHMARK /REFERENCE POINT LOCATION: i 6 Re Act d / 6 , ELEVATION Op PROPOSED SYSTEM SITE IS e;, e) [INCHES /FT] [ABOVE /BELOW] BENCHMARK /REFERENCE POINT THE MINIMUM SETBACK WHICH CAN BE MAINTAINED FROM THE PRO �OSED SYSTEM TO THE FOLLOWING FEATURES: 2URFACE WATER: A FT DITCHES /SWALES: / / /-d FT NORMALLY WET? [ ] YES [A] NO WELLS: PUBLIC: _ FT LIMITED USE: FT PRIVATE: FT NON - POTABLE: 4/4 FT BUILDING FOUNDATIONS: /0/- FT PROPERTY LINES: (U?. POTABLE WATER LINES: 'Oh- FT SITE SUBJECT TO FREQUENT FLOODING: [ ] YES y1\1410 10 YEAR FLOOD ELEVATION FOR SITE: #,4 FT MSL /NGVD SOIL PROFILE INFORMATION SITE 1 V� L IP SOIL PROFILE INFORMATION SITE 2 Munsell # /Color Texture\ Depth to to (, to + f to 6 � \ to to 3t t ti OBSERVED WATER TABLE: INCHES [ABOVE / ESTIMATED WET SEASON WATER TABLE ELEVATI'ONr HIGH WATER TABLE VEGETATION: [ ] [(] NO a SOIL TEXTURE /LOADING RATE FOR SYSTEM SLING: i V DRAINFIELD CONFIGURATION: [ ] TRENCH BED REMARKS /ADDITIONAL CRITERIA: SITE EVALUATED BY: AGENT: //J PERMIT 1 P t_. ✓ [Section /Township /Range /darcel No. or Tax ID Number] YES [ ] NO NET USABLE AREA AVAILABLE: `)a( (y ACRES GALLONS PER DAY [RESIDENCES -TABLE 1 / OTHER -TABLE 2] GALLONS PER DAY [1500 GPD /ACRE OR 25.0 GPD /ACRE] SQFT UNOBSTRUCTED AREA REQUIRED: " FS SQFT 10 YEAR FLOODING? [ ] YES NO SITE ELEVATION: FT MSL /NGVD Munsell # /Color Texture Depth to to to to to to to to USDA SOIL SERIES: XISTING GRADE. TYPE: [PERCHED / APPARENT] INCHES [ ABOVE / BELOW ] EBI:pG GRADE. ING: [ ] YES [S) NO DEPTH: INCHES bEPTH OF EXCAVATION: 754a INCHES [ ] OTHER (SPECIF DATE: ,2 HRS-H Form 4015, Mar 92 Qb olet s previous /editions which may not be used) Page 3 of 3 (Stock Number: 5744 -00 - 4015 -15 Li J _ - ■ ■■ � 1 r ■ ■■ J 1 I �l� 1 1 ! - �-_ 1 I- I -- I ■ ■ Dal 1 1 ( I 1 I ILLLL L- - - - - � - L1 J 1 Notes: • STATE OF FLORIDA DEPARTMENT OF HEALTH AND REHABILITATIVE SERVICES APPLICATION FOR ONSITE SEWAGE DISPOSAL SYSTEM CONSTRUCTIONAERMIT Permit Application Number (/ i9'° Each block represents 5 feet and 1 inch = 50 feet. Site Plan submitted by: Plan Approved PART II - SITE PLAN SIGNATURE 40 fit..) r Not Approved r' TITLE r Date j- By �� -� County Public Unit ALL CHANGES MU BE APPROVED BY THE COUNTY PUBLIC HEALTH UNIT HRS -H Form 4015, Feb 85 (Obsoletes previous editions which may not be used) (Stock Number. 5744- 002- 4015-6) Page 2 of 3 ''� Tl- ■ ■■ ■ ■ ■ ■ • • T ■■ ■■ ■ ■Y M ME 1:17 — N N ■ 1 1.__I ' .. - - ...IU ■ ■ ■■■■■■■.- ■ . - -- _ 1 ■ MN - ■ ■ ■ ■R U U . - . .■ . ri ■ ► ► ■■ . .. i f i i i ii • • 1 . mows i im E • I 1 " E ■■ C a • I :':_ : :._ " El ■ i I �..� C .■ m I J - - • --- 11_____:=E - - -- - - - - I - - - . .. • II 1 111•1 f_ I T.. ■ . . . . . I I 11 i i ■ ■ I.C. . ■ 1 ■ 11 . ■■ ■ ■ ■. ■ ■. T T 1 1 i I • ■ ■ s . ■■ ■ ■ T 1 1 .ii ' ■■ �' % %' �_ - - ■ T - • • - 1 : I - T • • -- - _ _- : II T 1 ■ T _ _ i - _ , J ,_ r y t r r r r r - = = T ' - I I 1 I I IJ _ 1 - 1 j! J y t- _ _ 1 _ , 1 ! I _. ._ I I i 1 L ft--t I I C C i - L-_ -I _ '- l l I 1 f ! ,-+ - � � 1 ' 1 1 1 I 1 �. J - - -_ - - _ _ 1 1 r r T1 L r 1 � = H H _ 1 i 1 I I F� I I 1 I 1 _ I — _I _ - I 7 7 L ■ h 1 _ F . f ► I 1 I I / � 1 1 1 "' II_i_, / �� 1 _ - - 1 1 - I +�` l 1 ( (- i ! I f f- _ I- ■ I JL L 1 1 1 1 �� � L - ij 1 J 1 L J l L_I_ I l._I _ ■ ■■ J I 1 C - 1 1 _ 1 i _ _. _L_ _I - A � ! I - - - I.- C - - - I Notes: • STATE OF FLORIDA DEPARTMENT OF HEALTH AND REHABILITATIVE SERVICES APPLICATION FOR ONSITE SEWAGE DISPOSAL SYSTEM CONSTRUCTIONAERMIT Permit Application Number (/ i9'° Each block represents 5 feet and 1 inch = 50 feet. Site Plan submitted by: Plan Approved PART II - SITE PLAN SIGNATURE 40 fit..) r Not Approved r' TITLE r Date j- By �� -� County Public Unit ALL CHANGES MU BE APPROVED BY THE COUNTY PUBLIC HEALTH UNIT HRS -H Form 4015, Feb 85 (Obsoletes previous editions which may not be used) (Stock Number. 5744- 002- 4015-6) Page 2 of 3