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PLUMBINGBUILDING ELECTRICAL PLUMBING ROOFING Owner of Building Architect Contractor or Builder Legal Lot Description Address of Building MIAMI SHORES VILLAGE, FLORIDA ❑ DATP 195 I� PERMIT N? 12885 Contractor's License No ❑ Work to be performed under this Permit CONTRACTOR OR BUILDER Bl. Subdi- vision Value of Project $ Amt. of 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 application 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 responsibility for work done by his agents, servants or employees. Signed • BY INSPECTOR In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and 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 responsibility for all work done by either, myself, my agent, servant or employee. BY AUTHORITY Village of Miami Shores 10050 NE 2nd Avenue Miami Shores, FL 33138 Phone: 305 - 795 -2204 Printed: 3/5/2002 Applicant: MYRON Owner: NOVAK Contractor TOLEDO PLUMBING Local Phone: 305 - 551 -4735 Parcel ## 1132060131010 Job Address: 71 NE 97 ST Permit Status: Approved Permit Expiration: Work: REMODEL KITCHEN 1 ROUGH & SET OF SINK & DISHWASHER This Permit is granted to the contractor or builder named above to construct the bi ordinances pertaining thereto and with the understanding that the work will be perforr and approved by the proper municipal authorities. This Permit may be revoked at an authorization. A further condition upon which this permit is granted is the understand ordinances and regulation pertaining to the work covered hereby whether shown on by his agents, sery is o employees. Sign Fees: FEE2002 -1321 Description Building Fee Total Fees: 9/1/2002 (INSPECTOR) In consid:•.ti -,n • the issuance to me of this permit, I agree to perform the work c with the plans, drawings, statements or specifications submitted to the proper autho myself, my agent, servants or employes. Signed: (Contractor or I Plumbing Permit Permit Number: PL2002 -64 NOVAK MYRON CORPORATIOdress: 10825 SW 84 AVENUE Cellular: Legal Description: MIAMI SHORES SEC 1 AMD PB 10 -70 LOT 20 & 21 BLK 7 LOT SIZE 100.000 mount $110.00 $110.00 Construction Value: Pay to the Order of ACH R/T 063100277 $1,750.00 If there is no permit package accessible on the job -site for inspectors to verify, there will be no inspections. fee is $50.00, which must be paid in advance before calling for DIOSDADO RODRIGUEZ OR MARIA E. RODRIGUEZ 510 S.W. 62 AVENUE MIAMI, FL 33144 Total Fees: $110.00 Total Receipts: $0.00 Page 1 of 1 Re- inspection Date Bank of America, For / 2 r- - / /V2 / 31;y10/aedd�i" 1:06 300004 71: 00 l 19 78 7098411' 30111 Dollars 8 V 3041 63 - 4/630 FL Bank of America Advantage' 1607 Type Insp'n Permit No. Name Address Company MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date 9 ' - P2 Time / DO - �� //. 7/N E y Approved Correction Re- Insp'n Fee Phone #( ij 8 Y .7,2 For pe Ins o � g ~ �v � Na Ir Date —_TION FOR MIAMI SHORES VILLAGE Yvd�U N.E. 2nd Avenue • Miami Shores, Florida 33138.305- 795 -2204 Job Address 7/7 �7 Tax Folio Legal Description Historically Designated: Yes 200a ' ce o Master Permit # O L` Owner/Lessee Owner's Address Phone f Contracting Co. et a LAN\ Qualifier /7/7/t (27676 ss# &93 - O 99? Ar Phone°') SSA g State # ?fe 4L34:0 3 Municipal # IF THERE IS NO PERMIT PACKAGE ACCESSIBLE ON THE JOB SITE FOR INSPECTORS TO VERIFY, THERE WILL BE NO IiN. APE TION. RE- INSPECTION FEE IS $50.00 AND MUST BE PAID IN ADVANCE BEFORE CALLING FOR ANOTHER INSPECTION. Permit Type (circle one): BUILDING ELECTRICAL WORK DESCRIPTION: A : 4 )7 d ' ' / TC / S6), / V "3/ j 67. 7 O C Square Ft. Estimated Cost (value) WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR ANY 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 all disciplines. OWNERS 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. Signature of owner and/or Condo President Date Notary as to Owner and/or Condo President My Commission Expires age 6e_JAL..L a/ FEES: PERMIT 11® RADON APPROVED: Zoning Building Mechanical Plumbing Address NOTARY 8 / // /O 7 Competency # / �a Ins. Co. MECHANICAL ROOFING Signature of Contractor or Owner Builder Date Date Notary as to Contractor or Owner Builder Date My Commission Expires BOND TOTAL DUE Electrical Structural Engineer ,u I .�tCA'H'YON FO Date 21 L ob Address -7 / A/6 9 7,A Legal Description Owner/Lessee / Tenant Master Permit # 2 0 32 -- 2Y2_ Owner's Address / Phone Contracting Co. LE j 0 w,. tg l /fJ • Qualifier Q S ill/1. IV i O 2' J l4 State # Municipal # Architect/Engineer Bonding Company Mortgagor Permit Type (circle one): :; UIILDING ELECTRICA WORK DESCRIPTION Square Ft. Signature of owner and/or Condo President - 114 'L Notary as to Owner and/or Condo President Date My Commission Expires: yt FEES: PERMIT ,`U RADON C.C.F. APPROVED: Zoning Building Mechanical Plumbing Date IUD Historically Designated: Yes No SS# & ? J - 3 O - / J Phone -5 V 73 y Competency # I `/' 2- Ins. Co. Address Address Address PLUMBING I MECHANICAL ROOFING PAVING FENCE SIGN i (Pc- 1 Poo) H 7)-4 SLR OF il•MO D I ,5 N 1444,S#01, Estimated Cost (value) WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY RESULT IN YOU PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDS: 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 ccrtify that all wor 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 inlbimation is accurate and that all work will be done in compliance with all applicable laws regulatin construction and zoning. Furthermore, I authorize the above - named contractor to do the work stated. awe; ii 'r or at r - , tl ,/ Signat Tax Folio MiAlWil SHORES VILL \GE Address L 2 1, 5G-t77 p ')C.7 Notary as to Contr . or or Owner Builder My Commission Expires: F ` U'" No;ory Pubic - State of Florida My Com.mi; ion Expires Apr 25, 2003 Commis # CC829911 NOTARY Electrical Structural Engineer BOND TOTAL DUE Date D to 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 EEnggin Employing Plumber's Name .. J.t 1d1 Location 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) New Building Remodeling_.___ Amount of Permit $ MOz O SNORES VOddZ©E PLUMBING INSPECTION DEPARTMENT zWIPLICAVOON FO E2 PLUMSON© PEL°3MOT Type of Tank__ Addition.. No Sims Septic Tank_ - .___.-- _---- _ — -- Feat of Drain Tile. —_ - -- -- __ t. Feet of Tank or Drain Field from Well. Nature of Water Supply: City — Well.— _--- .-- •---- •----- - - - - -- -Siva of Soakage Pit Date..._ ... Street_ OvGa .� .1 Street_ (Signed) _ Repairs No. of Stories Capacity Calla..._...- ....... - .... ..._._.... 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 5888, 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) ` r Plumbing Inspector. Master Plumber. STATE OF FLORIDA, 1 COUNTY OF DADE. j Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, penally appeared to me well known, and who, being by me first duly sworn, upon oath ors and soya that he is the ._- ___..._ _ of the above described construction, that be has carefully read the 1. regeing application, and that did sign the acme, and that all facts therein by him stated are true. My Commission Eupires Notary Public, State of Florida NOTE: A re- inspection fee of 01.00 will be made ai mi spa b arcizrz=aaanuy by improper notice for inepection, oa faulty materials and/ca workmanship. CLOOS.TO BATH TUBS SNOWSRO LAVA- TORISO SINKO SLOP 01,4,0 LAUNDRY TUDO U RINALO CATCH BACON FLOOR DRAIN DRINKING FOUNT'NO TOTAL PIarunao CONTR. LIST CHRCK SRPTIC TANK SeweR CONN. DRAIN PICLO SOAKAGE PIT GReAse TRAP SOLAR MCATER DeeP WELL SPRKLR. SYOTSu SwIN'G POOL Co. NTR °-- LIST CHOCK 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 EEnggin Employing Plumber's Name .. J.t 1d1 Location 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) New Building Remodeling_.___ Amount of Permit $ MOz O SNORES VOddZ©E PLUMBING INSPECTION DEPARTMENT zWIPLICAVOON FO E2 PLUMSON© PEL°3MOT Type of Tank__ Addition.. No Sims Septic Tank_ - .___.-- _---- _ — -- Feat of Drain Tile. —_ - -- -- __ t. Feet of Tank or Drain Field from Well. Nature of Water Supply: City — Well.— _--- .-- •---- •----- - - - - -- -Siva of Soakage Pit Date..._ ... Street_ OvGa .� .1 Street_ (Signed) _ Repairs No. of Stories Capacity Calla..._...- ....... - .... ..._._.... 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 5888, 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) ` r Plumbing Inspector. Master Plumber. STATE OF FLORIDA, 1 COUNTY OF DADE. j Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, penally appeared to me well known, and who, being by me first duly sworn, upon oath ors and soya that he is the ._- ___..._ _ of the above described construction, that be has carefully read the 1. regeing application, and that did sign the acme, and that all facts therein by him stated are true. My Commission Eupires Notary Public, State of Florida NOTE: A re- inspection fee of 01.00 will be made ai mi spa b arcizrz=aaanuy by improper notice for inepection, oa faulty materials and/ca workmanship. ---------- CLOSZTO BATH TUBS SHOWERS LAVA. TORIES S SLOP SINKO LAUNDRY TUBS URINALS CATCH BASIN FLOOR DRAIN DRINKING rrOUNT'NS TOTAL FIKTURHI CONTR. LIST • -- Cmactl Srunic TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP EATER DEEP WELL SPRKLR. SYSTEM SW IM GI POOL. mm. Co LICIT CHEICR Permit No. AO Employing Plumber's Name _____ Amount of Permit 8. mabkm SNORES V011,11, GE PLUMBING INSPECTION DEPARTMENT APPLOCMOCk9 FOR PLUM ONG PERM7 -o No (Signed) (Signed) Date 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 _ ale-eeetetie Street Registered Architect and/or Engine Street Location and Legal Description . _ _____ ...... _________Block__—. Subdivision Street and Number where work is to be performed—No. 7 L g .4 Street State work to be performed and purpose of building (By Floors)_ New Building Remodeling Addition. Repairs No. of Stories Capacity Cals. Size Septic Tank Type of Tank_ _ Feet of Drain Tile Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: City—Well _ Size of Soakage Pit Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as si, employer of labor under the Florida Workmen's Compensation Act, being Section 5986, Compiled General Laws of Florida Pennanent Supplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or subcontractors 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, as. COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ..ppeare 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 tat. therein by him stated are true. • My Commission &Tires 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 Lel materials and/or workmanship. Permit No. - - - -{ ` TR 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. Registered Architect and /or Engineer Employing Plumber's Name. /14� r Location and Legal Description Lot Street and Number where work is to be performed —No 2 ___21'__— State work to be performed and purpose of building (By Floors) New Building Remodeling Addition__ Amount of Permit $ / RUA 0 SNORES ES VOLDQ©I PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMILINO PERMIT Block Repairs Dist. Feet of Tank or Drain Field from WelL Size of Soakage Pit (Sign No (Signed). _. - - - -- Date Street ,29 Street Subdivision Street d_ - 2 U / � No. of Stories Size Septic Tank Type of Tank___ Capacity Gals /7 ain Tile I a ° Nature of Water Supply: City —Well The undersigned applicant for this building permit does hereby certify that ' understands and accepts his obliga.' • s as an employ :. of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Perim / t Supplement, an has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the ork 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 n ' ices as are required by the Act. The undersigned agrees to employ only such sub- contractors, on work to be performed under this p ' rit, as an licensed by Miami Shores Village. / ) • Master Plumber. STATE OF FLORIDA, 1 as. 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 fac 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 faul materials and /or workmanship. CLOSETS BATH TUBS SHOWERS LAVA- TORIEe SINKS SLOP SINKS LAUNDRY Toes URINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT' NS TOTAL FIXTURE! 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 Permit No. - - - -{ ` TR 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. Registered Architect and /or Engineer Employing Plumber's Name. /14� r Location and Legal Description Lot Street and Number where work is to be performed —No 2 ___21'__— State work to be performed and purpose of building (By Floors) New Building Remodeling Addition__ Amount of Permit $ / RUA 0 SNORES ES VOLDQ©I PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMILINO PERMIT Block Repairs Dist. Feet of Tank or Drain Field from WelL Size of Soakage Pit (Sign No (Signed). _. - - - -- Date Street ,29 Street Subdivision Street d_ - 2 U / � No. of Stories Size Septic Tank Type of Tank___ Capacity Gals /7 ain Tile I a ° Nature of Water Supply: City —Well The undersigned applicant for this building permit does hereby certify that ' understands and accepts his obliga.' • s as an employ :. of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Perim / t Supplement, an has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the ork 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 n ' ices as are required by the Act. The undersigned agrees to employ only such sub- contractors, on work to be performed under this p ' rit, as an licensed by Miami Shores Village. / ) • Master Plumber. STATE OF FLORIDA, 1 as. 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 fac 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 faul materials and /or workmanship. Type Insp'n Permit No. MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date D i • Time Name Address l F . ci - LP' Compa Phone # 3 For Inspector: Approved Correction Re- Insp'n Fee is (97/0(0 N: in aiami Aores F L 0 ft A D A PLUMBING PERMIT Issuecito to install' the following described plumbing, in accordance with the laws, statutes and regu-, lations of Miami Shores Village, Florida and the State of Florida, governing plumbing and drainage work done in Miami Shores Village, Florida. For a / story 4 . building at --,,-, Fixtures ''' ,, ' Fixtures $ c Sewer $ to C ' •tic Tank $ Total $ Village Plumbing Inspector Received Payment by o N? 1107 (2r2IEL1 LOT BLOCK SUBDIVISION P j. 4 n • . , , ' '..*' l i ' i //' • . , aiami Aores F L 0 ft A D A PLUMBING PERMIT Issuecito to install' the following described plumbing, in accordance with the laws, statutes and regu-, lations of Miami Shores Village, Florida and the State of Florida, governing plumbing and drainage work done in Miami Shores Village, Florida. For a / story 4 . building at --,,-, Fixtures ''' ,, ' Fixtures $ c Sewer $ to C ' •tic Tank $ Total $ Village Plumbing Inspector Received Payment by o N? 1107 el OWNER LOT BLOCK SUBDIVISION ��. n V "/Q /� /d �h' °j. ,. , , ,At- 24 7 I ' �X�l.„ ."�" a . Issued to t _, PLUMBING PERMIT aiami cShores9 llage F L 0 & I D A ■• to install the following described plumbing, in accordance lations of Miami Shores Village, Florida and the State of drainage work done in Miami Shores Village, Florida. For a story 1 ii = building at Fixtures Fixtures Sewer tic Tank Received Payment by N9 1141 with the laws, statutes and regu- Florida, governing plumbing and Total $ � 7 Village Plumbing Inspector 7, * < - ` "l , (Signed) r MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build- ing 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 the work. Date June ...1.6 , 1956 , 19 Owner's Name and Address ._......J. .. ._Jaffieson ° 71 ._.N.E. 97 St No Street Registered Architect and /or Engineer Name and address of licensed contractor Monarch Pump & Ea pt o 1532 N o W o 62nd St/ Miami, Fla o Location and legal description of lot to be built on: Lot Block Subdivision Street and Number where work is to be done State work to be done and purpose of building (by floors inch well for sprinklers - about 4.0 feet deeps and for no other purpose. New Building Remodeling Addition Repairs No. of Stories To be constructed of Kind of foundation Roof Covering Estimated Total cost of improvements $ Amount of Permit $ Zone cubage required .Plan Cubage Distance to next nearest building..__ Size of Building Lot Maximum live load to be borne by each floor I hereby submit all the plans and specifications for said building, All notices with reference to the building and its construction may be sent to 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 complied 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 s ontractors, on wor , , m ,.erfored under this permit, as are licensed by Miami Shores Village. i / Remarks (Signed) /� e. STATE OF FLORIDA, COUNTY OF DADE. ss Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap- peared 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. Permit No Date Read, Sworn to and Subscribed before me. Disapproved Date Notary Public, State of Florida Building Inspector My Commission Expires PLANNING BOARD DATE Chairman Member Member Member Member Member Council Approved Date Disapproved Date NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has been obtained from the Planning Board. A re- inspection fee of $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and /or workmanship. BUILDING ELECTRICAL PLUMBING ROOFING MIAMI SHORES VILLAGE, FLORIDA ❑ ❑ DATE / 195 PERMIT N? 3842 Contractor's License No. r Owner of Building Architect Contractor or Builder N Legal Lot Description 11 Bl Address of Building Work to be performed under this Permit Subdi- vision Value of Amount of Project $ Permit $ This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the application 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 responsibility for work dono by his agents, servants or employees. Signed- BY INSPECTOR In consideration of the issuance to me of this permit I.agree to perform the work covered hereunder in compliance with all ordinances and 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 all work done by either, myself, my agent, servant or employee. CONTRACTOR OR BUILDER BY AUTHORITY , 6 te'= Permit No... 71'60 Amount of Permit 6 My Commission Eeplztca Raoz 0 SMORES VOLILA,GE PLUMBING INSPECTION DEPARTMENT APPLOCATIOM Gy©! PLURA OCJ© PC QMOT Location and Legal Description Lag pp� Street and Number where work is to be performed —No 7 /V. 6• Street.. - .�. State work to be performed and purpose of building (By Finces)_ —... -- -- ._- _— __ - - New Building.. -. -- - -. Remodeling..-- --. -- Addition -. - Sierra Septic 'Tank Type of Tank__ Feet of Drain Tile. _ D1 t Feat of Tank ca Drain Field from Well .. - - - - .._ Nature of Water Supply: City —Well. Size of Soakage Pit_ ( Sigd ) Blorh Subdivision Capacity Gals. Nolary Pssbll, Ztato o nwkh NOTE: A re-inspection fee of 61.00 will ho =a w Ge2,123 b =20T ^?7 i i tpruper matzo for matcmis and /err warms. Application is hereby made for the approval of the detailed statement of the piano 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 hewn opfied err not A copy of approved plans and spficatians man be kept at building during progress of work. aa Owners s Name and Address l ?410fsza. No. 7 / Strut - -- €' . 7 G7 Registered Architect and /or Engi Ir�tployinfj $lttattl3 'o Nata►v EW/14Q/A 1Ua4_}�r/G .��Z w@,..t 4- s� .....e�....... 0 . �I. .. � Repairs No. of Stories (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 5888, Compiled General Laws of Flo . a ' anent Supplement, and liav com- plied with the provisions thereof, and will require similar compliance from all contractors or su. •rtrnctors em. Ioyed by him in the wor' to br performed under this permit; and will post or cause to be posted' for inspection on the site t, k ouch ublic „,„ . cue or notices as are required by the Act. The undersigned agrees to employ only such sub- �tractars, . u work ,.-v .. ,M this permit, as are lionis by Miami Shores Village. STATE OF FLORIDA, } en- 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 el ct^es and says that he is the - .__.._ .. - - •-- . -- -. - _ _ of the above described construction, that be bona carefully mad the ifogtzt3cctme applicators, end that he did Di s .,' the canna, and that all foals therein by him stated are true. CLDOQTO ®ATM TUDO 6M01p¢RO LAVA. YORI¢O 01"0 S LOP a lanO Y LAUNDR Tuoo URINAL() C DAMN PLOOR DRAIN DRINKING U H PO � � TOTAL PILTURao C LI DY LIOT p CH¢Ctt SaPTIC TANK O¢C1aR Coma. DRAIN PIal° BOAKAOS PIT GR¢AOa TRAP GOLAR HaAT¢R DGRP WELL OPRRLR. OTOTarl Ol11u O Pool. - -- ) COQ LIST CHDCS Permit No... 71'60 Amount of Permit 6 My Commission Eeplztca Raoz 0 SMORES VOLILA,GE PLUMBING INSPECTION DEPARTMENT APPLOCATIOM Gy©! PLURA OCJ© PC QMOT Location and Legal Description Lag pp� Street and Number where work is to be performed —No 7 /V. 6• Street.. - .�. State work to be performed and purpose of building (By Finces)_ —... -- -- ._- _— __ - - New Building.. -. -- - -. Remodeling..-- --. -- Addition -. - Sierra Septic 'Tank Type of Tank__ Feet of Drain Tile. _ D1 t Feat of Tank ca Drain Field from Well .. - - - - .._ Nature of Water Supply: City —Well. Size of Soakage Pit_ ( Sigd ) Blorh Subdivision Capacity Gals. Nolary Pssbll, Ztato o nwkh NOTE: A re-inspection fee of 61.00 will ho =a w Ge2,123 b =20T ^?7 i i tpruper matzo for matcmis and /err warms. Application is hereby made for the approval of the detailed statement of the piano 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 hewn opfied err not A copy of approved plans and spficatians man be kept at building during progress of work. aa Owners s Name and Address l ?410fsza. No. 7 / Strut - -- €' . 7 G7 Registered Architect and /or Engi Ir�tployinfj $lttattl3 'o Nata►v EW/14Q/A 1Ua4_}�r/G .��Z w@,..t 4- s� .....e�....... 0 . �I. .. � Repairs No. of Stories (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 5888, Compiled General Laws of Flo . a ' anent Supplement, and liav com- plied with the provisions thereof, and will require similar compliance from all contractors or su. •rtrnctors em. Ioyed by him in the wor' to br performed under this permit; and will post or cause to be posted' for inspection on the site t, k ouch ublic „,„ . cue or notices as are required by the Act. The undersigned agrees to employ only such sub- �tractars, . u work ,.-v .. ,M this permit, as are lionis by Miami Shores Village. STATE OF FLORIDA, } en- 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 el ct^es and says that he is the - .__.._ .. - - •-- . -- -. - _ _ of the above described construction, that be bona carefully mad the ifogtzt3cctme applicators, end that he did Di s .,' the canna, and that all foals therein by him stated are true. �:.xc'rrit�ci ;,'or. Tractor OT 6u1..aCr .- - - -- -- — — — — . 1 c 1 Lot II BI. 1: .7,.._ iiiion tl.CTCSS of 1iaJ. WA F41 C S VILLAGE, FLORIDA a��sa?1�(ar ❑ DATE 195. — ELECTRICAL PERMIT N? 1 Contractor's t I :1 7 ]3JNG ❑ License No. �3C CFMG ❑ Woy?e to be porsorned under this Permit_ Ovr'.er of Subdi- vision Value of Project $ Amt. of 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 application c or in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans, ctatzments or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any t : L: 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 !xante•d is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations pc r tain ng to the work: covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes responsibility for work nr by his agents, servants or employees. Signed • BY INSPECTOR In consideration of t':e i suance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations ^.finin■• thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In .'rcepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. CONTRACTOR OR BUILDER BY AUTHORITY OWNER LOT BLOCK SUBDIVISION v / r Date aiami A o F L O PLUMBING PERMIT N° 1141 Issued to to install the following described plumbing, in accordance with the laws, statutes and regu- lations of Miami Shores Village, Florida and the State of Florida, governing plumbing and drainage work done in Miami Shores Village, Florida. For a L story " building at Fixtures Fixtures $ Sewer $ Septic Tank !' $ ~� Total $ Village Plumbing Inspector Received Payment by OWNER iami �hores D llage F L O A I A PLUMBING PERMIT N? 1107 Date Issued to LOT BLOCK SUBDIVISION to install the following described plumbing, in accordance with the laws, statutes and regu- lations of Miami Shores Village, Florida and the State of Florida, governing plumbing and drainage work done in Miami Shores Village, Florida. Fora story building att I Fixtures Fixtures $ Sewer $ Septic Tank $ Total $ Village Plumbing Inspector Received Payment by CLOSETS BATH TUBS SHOWERS LAVA. TORIES SINKS SLOP SINKS LAUNDRY TUBS URINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT'NS TOTAL FIXTURES �j t / � /:(''' A -244 SM S -SB Plan No. I herewith submit the following plan of plumbing for approval: Employing Plumber New ❑ '� For a Dwelling Owner or Agent Builder or Contractor is Lot No. 4 Block No. Address Sewer Connections , Date ROUGH -IN INSPECTION Ground Rough -In Rain Leader A M _... P M �9 Approved by ,c1 � Condemned by REMARKS A t ,7 DIVISION OF PLUMBING INSPECTION DEPARTMENT OF PUBLIC SERVIC MIAMI, FLORIDA n / , Store ❑ At center of St. ❑ �,� / Work executed by Old ❑ / Story Addition ❑ Garage ❑ Apartment ❑ At curb ❑ Subdivision Address Address / // // Sewer Permit No At property line ❑ Existing in alley ❑ Existing bldg. sewer ❑ To septic tank Existing bldg. drain ❑ To dry well ❑ A charge of $1.00 will be made for correcting any inaccuracies in the foregoing information. DO NOT WRITE IN SPACE BELOW. THIS IS FOR THE USE OF THE DIVISION OF PLUMBING INSPECTION ONLY. Date SEWER INSPECTION A M P M. Approved by Condemned by REMARKS , 192. Remodeled ❑ Hotel ❑ Office Bldg. ❑ Date FINAL INSPECTION AM P M Approved by Condemned by REMARKS THIS SPACE FOR ELEVATION SKETCH In alterations to existing work show the old work in red ink and the new in black ink. Letter each stack to correspond with the opening shown in floor plan or ground plan on opposite page. 5� p I. ! ` 1/ 1 • y !' � r t) , r! 11 A 'PERSPECTIVE SKET PRIpVIDED THE WORK Sketch position of building and lot lines in square (which represents an entire city block) , showing on which street the building and lot faces; also show exact locations of "Y" in street and position of lateral or septic tank. Show sewer and any change in direction same may make. The purpose of this plan i to have an accurate layout of all underground pipes for future references. WEST NORTH A EAST Remarks: NORTH SOUTH WILL BE SUFFICIENT THIS SPACE FOR PLAN SKETCH N BE CLEARLY SHOWN Show location of stacks and horizontal drains inside building, lettering each opening to correspond with the took con- nections as shown on the elevation sketch on opposite page. Where ground work is concealed, draw floor pla>of build- ing showing location of walls, partitions, columns, etc., and the location of all horizontal soil and waste pipes, in ref- erence to same. CONTRACTOR New Construction Name } ( f/�/j ,031 6 [ t d c /� ✓ i�- D/ ° l� , e V p u Name /1 v I ,[( License No. e e ., �� Address ° �� Fax O .5 __._. r Telephone , 4 16 .--•-e . /g ax Qualifier Name me � W /� / e 1, , f1 PROPERTY OWNER New Construction Name } ( f/�/j ,031 6 [ t d c /� ✓ i�- D/ ° l� , e V p u Address NE 9- `- S ` s Home Telephone 3 133 (aS) ,J ��//�� _ i oc r, Business Telephone - 5 _ !i. g — 2 Fax O .5 __._. r ',- 5c, �- Doc) TYPE OF MANAGEMENT (/ ) New Construction Enclosure Alteration Exterior Repair Alteration 'Interior Demolish Relocation of Structure Shell Only Foundation Only Add't Attachment Other Add'l Detachment Other /�m1;$ 0000 QNTo 6 �oeteo% 1 TRUC7'IO The' folio .i tng,stGps must fr ken to, obla,in.,ayerm it the 1\iiami $hoses Village: from Step 1. Complete the attached permit application which must be signed by the property owner and qualifier. Both signatures must be notarized. Please print or type to allow for a more accurate processing of your application. If roofing work will be done, a roofing application must be submitted along with this permit application. Step 2. Submit the completed application with all necessary documents to the Building, Planning and Zoning Department for processing. During the processing of your application, you may be asked to submit additional information. p p n p Apt. City n Folio Number D I( ,lJ ( 01 3 / Q../ 1 O b \ Description of Work A ) 6O2 1 n OQ Address PERMIT TYPE ( ) Building Electrical Mechanical Plumbing LPGX Roofing Fence Other Block Lot Subdivision PB PG Current Use of Property Proposed Use of Property Li y`C- Tenant Information Chg. Contractor Renewal Revision Extension Supplement Reinspection PERMIT CHANGE ('1) ARCHITECT Name License No. Address Telephone Fax Master Permit No. PERMIT APPLICATION Subsidiary Permit No. p G ' - 0 • 51 : q ) � . - 3133 Stat/ Zip Zoning Linear Feet Square Feet Units Floors Value of Work I (7 () P Bldg Value Tax Assessed/Appraised Value Flood Zone Base Floor Elev. ENGINEER Name License No. Address Telephone Fax Page 2 IJI NOTICES 1. DO NOT BEGIN ANY WORK WITHOUT HAVING RECEIVED YOUR VALIDATED PERMIT AND PERMIT CARD. Applying for a permit does not grant the right to begin construction. HOURS OF CONSTRUCTION are limited to: Monday through Friday from 7:30 a.m. to 6:00 p.m., and Saturday from 8:00 a.m. to 5:00 p.m. No inspections will be conducted on weekends or holidays. 2. All construction of demolition areas MUST BE MAINTAINED IN A CLEAN, NEAT AND SANITARY CONDITION free from construction debris. 3. STREETS AND NEIGHBORING PROPERTIES SHALL BE KEPT FREE FROM DIRT AND DEBRIS. 4. SWALES MUST BE PROTECTED FROM BEING DAMAGED BY EQUIPMENT OR VEHICLES, AND MAY NOT BE USED FOR STORAGE. A bond is required for work in or near the street/sidewalk. 5. CONSTRUCTION TRAILERS ARE PROHIBITED ON SINGLE FAMILY RESIDENTIAL CONSTRUCTION SITES. Other construction may have a trailer which requires a separate permit. 6. PORTABLE TOILETS for a construction site require a separate permit. 7. DO NOT DISCHARGE WATER INTO THE RIGHT OF WAY OR STORM DRAINS without approval from the Building, Planning and Zoning Department. 8. EQUIPMENT AND MATERIALS SHALL BE STORED at least 10 feet from the edge of pavement. 9. Department of Health and Rehabilitative Services (HRS) approval is required for applications involving septic tanks. Department of Environmental Resources Management (DERM) and/or Miami -Dade Water and Sewer Department (MDWASD) approval is required for applications involving sewers. A FFI DAN' IT - Please read carefully. Application is hereby made to obtain a permit to do work and installation as indicated. I, the OWNER of the property, certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits are required for ELECTRICAL, PLUMBING, POOL, EXTERIOR DOOR, MECHANICAL, WINDOW, FENCE, DRIVEWAY, ROOFING and SIGNS and there may be additional permits required from other governmental agencies. I, the OWNER of the property, have disclosed all information related to any work at the property performed in the prior twelve months to the Building Official. Further, I am fully aware that if the cumulative cost of work to my home or business under this and any other permit equals or exceeds fifty percent (50 %) of the fair market value of the structure, the entire structure must meet the present federal flood criteria for finished floor elevation. I am also fully aware that if the total cost of work to my home or business under this and any other permit exceeds fifty percent (50 %) of the replacement cost of the structure, then the entire structure must conform to the current code requirements of the Building Code. WARNING TO OWNER: Your failure to record a NOTICE OF COMMENCEMENT may result in you paying twice for improvements to your property. If you are spending more than $2,500 or intend to obtain financing, you may wish to consult with your attorney or lender before recording your Notice of Commencement. The Notice of Commencement must be recorded at: 22 N.W. 1st Street, 1" Floor, (305) 679 -1078. Once recorded, the Notice of Commencement must be POSTED AT THE JOB SITE in accordance with Section 713 -35 of Florida Statutes. Review the brochure at Village Hall on Construction Lien Law and Choosing a Contractor. STATE OF FLORIDA, COUNTY OF MIAMI -DADE C Signature of 0 j,er Print Name Swo o and subscribed before me thi VA, 0 , & ure of No i ,. " lAt 'Ol'A V ♦Pn PUe( AN ELA M BECKf:FI 0,�r'�, � O COMXC '1ou Kua+ r+ nN CC7CGG97 SEAL: Personally known " OR, Produced Identification STATE OF FL gnature of Contractor / Qualifier b <7 %6 45 • ('4) /1/ Print Name Sworn to and subscribed before me this Si: aofNo SEAL: PERMIT APPLICATION UNTY OF MIAMI -DADE ofllfd lia• auw n � : �+ ~ ti`y, 4 e /u;iti97 r a .. ca p, O F f V° NOV. 9 s, . day of Personally known R, Produced Identification Type of Identification Produced: Type of Identification Produced: CONTRACTOR New Construction Name i C , (.. � 1/ I, I /IS / ai l. `� License No. - —. S 3 Address Alteration IInterior Telephone 3 , G J 1 ,. ` ®S�Fax -s d 7 Qualifier Name e ! / / /°'_ f PROPERTY OWNER New Construction Name ai l. `� i � /� v � Address Alteration IInterior Home Telephone 341..5%. 7 _ ( Business Telephone Foundation Only Fax Other TYPE OF MANAGEMENT (/ ) New Construction Enclosure Alteration Exterior Repair Alteration IInterior Demolish Relocation of Structure Shell Only Foundation Only Add'I Attachment Other Add'I Detachment Other STR VON The fo11owin steps;must.betaken r to obtain ;a )\i i 4 nti Shre lla Step 1. Job Address: Complete the attached permit application which must be signed by the property owner and qualifier. Both signatures must be notarized. Please print or type to allow for a more accurate processing of your application. If roofing work will be done, a roofing application must be submitted along with this permit application. Step 2. Submit the completed application with all necessary documents to the Building, Planning and Zoning Department for processing. During the processing of your application, you may be asked to submit additional information. i 1 . 7 Address / /— s C" .0�3 - / /D T �� Folio Number Description of Work / G„-.! Lot Block 7 Subdivision PB PG Zoning Linear Feet Current Use of Property Square Feet Units Floors Proposed Use of Property ,Value of Work 0 d ('') / Bldg Value J Tenant Information Tax Assessed/Appraised Value Flood Zone Base Floor Elev. PERMIIT TYPE (J ) Building (Electrical Mechanical Plumbing LPGX Roofing Fence Other Apt. ]PERMIT CHANGE ('1) Chg. Contractor Renewal Revision Extension Supplement Reinspection ARCHIITECT Name License No. Address Telephone Fax Master Permit No. Subsidiary Permit No. ? 1' c't) ot Makalamkft City State PERMIT APPLICATION Zip ENGIINEER Name License No. Address Telephone Fax Page 2 1NIPOR'I'ANT NOTICES 1. DO NOT BEGIN ANY WORK WITHOUT HAVING RECEIVED YOUR VALIDATED PERMIT AND PERMIT CARD. Applying for a permit does not grant the right to begin construction. HOURS OF CONSTRUCTION are limited to: Monday through Friday from 7:30 a.m. to 6:00 p.m., and Saturday from 8:00 a.m. to 5:00 p.m. No inspections will be conducted on weekends or holidays. 2. All construction of demolition areas MUST BE MAINTAINED IN A CLEAN, NEAT AND SANITARY CONDITION free from construction debris. 3. STREETS AND NEIGHBORING PROPERTIES SHALL BE KEPT FREE FROM DIRT AND DEBRIS. 4. SWALES MUST BE PROTECTED FROM BEING DAMAGED BY EQUIPMENT OR VEHICLES, AND MAY NOT BE USED FOR STORAGE. A bond is required for work in or near the street/sidewalk. 5. CONSTRUCTION TRAILERS ARE PROHIBITED ON SINGLE FAMILY RESIDENTIAL CONSTRUCTION SITES. Other construction may have a trailer which requires a separate permit. 6. PORTABLE TOILETS for a construction site require a separate permit. 7. DO NOT DISCHARGE WATER INTO THE RIGHT OF WAY OR STORM DRAINS without approval from the Building, Planning and Zoning Department. 8. EQUIPMENT AND MATERIALS SHALL BE STORED at least 10 feet from the edge of pavement. 9. Department of Health and Rehabilitative Services (HRS) approval is required for applications involving septic tanks. Department of Environmental Resources Management (DERM) and/or Miami -Dade Water and Sewer Department (MDWASD) approval is required for applications involving sewers. AF 'IDA\'IT - Please read carefully. Application is hereby made to obtain a permit to do work and installation as indicated. I, the OWNER of the property, certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits are required for ELECTRICAL, PLUMBING, POOL, EXTERIOR DOOR, MECHANICAL, WINDOW, FENCE, DRIVEWAY, ROOFING and SIGNS and there may be additional permits required from other governmental agencies. I, the OWNER of the property, have disclosed all information related to any work at the property performed in the prior twelve months to the Building Official. Further, I am fully aware that if the cumulative cost of work to my home or business under this and any other permit equals or exceeds fifty percent (50 %) of the fair market value of the structure, the entire structure must meet the present federal flood criteria for finished floor elevation. I am also fully aware that if the total cost of work to my home or business under this and any other permit exceeds fifty percent (50 %) of the replacement cost of the structure, then the entire structure must conform to the current code requirements of the Building Code. WARNING TO OWNER: Your failure to record a NOTICE OF COMMENCEMENT may result in you paying twice for improvements to your property. If you are spending more than $2,500 or intend to obtain financing, you may wish to consult with your attorney or lender before recording your Notice of Commencement. The Notice of Commencement must be recorded at: 22 N.W. 1st Street, 1" Floor, (305) 679 -1078. Once recorded, the Notice of Commencement must be POSTED AT THE JOB SITE in accordance with Section 713 -35 of Florida Statutes. Review the brochure at Village Hall on Construction Lien Law and Choosing a Contractor. STATE OF FLORIDA, COUNTY OF MIAMI -DADE STATE OF 0 ID; , COUNTY ►� OF : : yes' _ Signature of Owner Signature of Contractor / Qualifier Print Name Sworn to and subscribed before me this day of Signature of Notary Public - State of Florida SEAL: Personally known OR, Produced Identification SEAL: PERMIT APPLICATION Print Name '� ,r ry o and subscribed before me this 2 --V day of _ • .1/ I1 11� gnature o N � ry u lic . ta5e o� � QF'RLA ` F� r]t:Git kv N ,s�lylYlua ' l OF F%.O �1:,V, 4 i ti ` �Ur Personally known / OR, Produced Identificati on Type of Identification Produced: Type of Identification Produced: Page 4 OFFICE USE ONLY O OWNER - BUILDER FORM (Attach) ® FIRE DEPARTMENT APPROVAL (Commercial / multi- family) • CONCURRENCY (New Construction) CI OTHER (Specify & Attach) $3.00 per page (Scanning Fee) Miami Shores Village Bond Metropolitan Dade County (C.C.F.) Inspector State Educational Fund State DCA (Radon) Code Enforcement Fine Zoning Review la PROOF OF OWNERSHIP (Attach) HRS / DERM APPROVAL (Septic / Sewer) CI IMPACT FEE (New Construction) ® OTHER (Specify & Attach) �PE12`IIT FEES c 0 - $ (sq.ft. = x/I000 x ¢.60) $ (¢.005 /sq.ft.) $ (¢.01 /sq.ft.) REVIEWED AND PREPARED BY: SECTION Zoning Electrical Mechanical Plumbing Fire Public Works Structural Building Official BY DATE PERMIT APPLICATION LI CONDO ASSOCIATION APPROVAL (Attach) BPR APPROVAL (Restaurants) CONTRACTOR REGISTRATION (On File) TOTAL $ V (, DATE: GONDITi'ON OFAP OVA'L���'�� - � Revised July 2001 10050 N.E. 2ND AVE., MIAMI SHORES, FL o (305) 795 -2207 a FAX (305) 756 -8972 a http : / /www.miamishoresvillage.com ELECTRICAL 'FITE. Minimum Fee QTY. TYPE Dryer QTY. TYPE. Outlet, Appliance QTY. TYPE. Service Repair QTY. A/C Central 1 -3 Ton Fan Outlet, Wall Service, Temporary A/C Central 4 -7 Ton Fire Pump Outlet, Switch Signs A/C Central 8 -15 Ton Fixture - Fluorescent Oven Space Heater (kw) A/C Central 16 -20 Ton Fixture Light Parking Lot Lights Spas/Hot Tubs A/C Central 20+ Ton Flood Lights Plugmold/Strip Subfeeds, No. of Amps A/C Window FPL - Load Central Posts Swim Pool, Commercial Air Conditioners Garbage Disposal Range/Range Top Swim Pool, Residential Chiller Generators, etc. Receptacles Switchboards Clear Violations Heat Recovery Refrigerator, Comm. (p/PH) Temp Serv., Construction Compactor Low -volt, Burglar Refrigerator, Domestic Temp for Test - 30 days Deep Freezer Low -volt, Fire Renew - Temp Service Water Closet Demolition Low -volt, Intercom/Teleph. Repair Circuits Water Heater Dishwasher Low -volt, Television Service, Number of Amps / Water Heater New MECHANICAL , LVI , l; Minimum Fee QTY ,►.Y►,►; Condensate Drain QTY. i ' % i , ► , Generator QTy. TYPE Refrigeration, Tons QTV A/C Central, Tons Cooling Tower Heating Strips, each Vent Hood, Cost A/C Wall/Win. Tons Dryer Vents, Number of Paint Booth Ventilation, Cost Air Handler, Tons Ductwork, Cost of Piping, Flammable Liquid Periodic Inspections Barbecue Fire Sprinkler System Process/Pressure Piping Supply, AC Well Bath Fan - Vented, # Fireplaces, Number of Pressure Vessel Temporary Toilet PLUMBING TYPE A/C Condensate QTY TypE Drains, Roof QTY. TYPE Miscellaneous Fixture QTY .►.y►,►,, Soakage Pit QTY. Bath Tub Drinking Fountain Miscellaneous Repairs Solar Water Heater Bidet Filter Replace Pool Piping Sprinkler Repair Cap - Fixture Fountain Pump and Abandon Sprinkler System Cap - Water Gas - Appliance Pump, Domestic Supply, AC Well Cap - Sewer Gas - Natural Pump, Fire Stand Temporary Toilet Catch Basin Gas - Propane Pump, Re- circulate Temporary Water Closet Clothes Washer Gas Piping Pump, Replace - Pool Urinal Dental Chair Grease Trap Pump, Sprinkler Utility - Sewer Discharge Well Ice Maker Pump, Sump Utility - Water Dishwasher Indirect Wastes Relay Repair Vacuum Pump Disposal Interceptor Roof Inlet Water Closet Domestic Well Laundry Tray Septic Connection Water Heater Drainfield, 4" Tile/Res. Lavatory Septic Tank / Water Heater New Drains, Area Meter Set (Gas) Sewer Connection Water Re -pipe Drains, Floor Minimum Fee Shower Water Service Drains, French Miscellaneous Equipment Sink Well, Supply Page 3 PERMIT APPLICATION INSTRUCTIONS: Please indicate the type of work being performed and quantity(ies) in the space provided below. RECEIVED AND REVIEWED BY: DATE: APPLICANT: Novak, Buddy LOT: 20 OTHER REMARKS: STATE OF FLORIDA DEPARTMENT OF HEALTH ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM CONSTRUCTION PERMIT CONSTRUCTION PERMIT FOR: [ ]New System [ ]Existing System [ [ X ]Repair [ ]Abandonment PROPERTY STREET ADDRESS: 70 NE 97 St Miami FL 33138 BLOCK: 7 SUBDIVISION: Miami Shores SYSTEM DESIGN AND SPECIFICATIONS Existing 900 Gallons Septic Tank To remain. Install 300 Square feet Drainfield . Invert Elevation of the D/F to be NLT 9.6' NGVD Bottom Elevation of the D/F TO BE NLT 9.1' NGVD This permit is not for addition. SPECIFICATIONS BY: Andre, Paul APPROVED BY: Andre, Paul DATE ISSUED: 2/19/02 DH 4016, 03/97 (Obsoletes previous editions which may not be used) (Stock Number: 5744- 001 - 4016 -0) Iostds_cons_4016 -1) ]Holding Tank [ ] Innovative Other ] Temporary [ NA ] AGENT: SR0931119, COCKING MSTEPHEN [Section /Township /Range /Parcel No.] PROPERTY ID #: 11- 3206 -013 -1010 [OR TAX ID NUMBER] D [ 300 ]SQUARE FEET PRIMARY DRAINFIELD SYSTEM R [ 0 ]SQUARE FEET SYSTEM A TYPE SYSTEM: [ N ]STANDARD [ N ]FILLED I CONFIGURATION: [ N ]TRENCH [ N ]BED N F LOCATION TO BENCHMARK: Finish Floor of E /Residence Elev. 13. I ELEVATION OF PROPOSED SYSTEM SITE ( 2.2 ) [ FEET ] [ E BOTTOM OF DRAINFIELD TO BE ( 4.2 ] [ FEET ] [ L D FILL REQUIRED: [ 0.0 ]INCHES EXCAVATION REQUIRED: [ 24 TITLE: TITLE: Professional Engin CENTRAX #: 13 -SG -11870 DATE PAID: FEE PAID : $ RECEIPT . OSTDSNBR : 02 -0477- -R SYSTEM MUST BE CONSTRUCTED IN ACCORDANCE WITH SPECIFICATIONS AND STANDARDS OF CHAPTER 64E -6,FAC DEPARTMENT APPROVAL OF SYSTEM DOES NOT GUARANTEE SATISFACTORY PERFORMANCE FOR ANY SPECIFIC TIME PERIOD. 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. ISSUANCE OF THIS PERMIT DOES NOT EXEMPT THE APPLICANT FROM COMPLIANCE WITH OTHER FEDERAL, STATE OR LOCAL PERMITTING REQUIRED FOR PROPERTY DEVELOPMENT. T [ 900 ]Gallons SEPTIC TANK MULTI- CHAMBERED /IN SERIES: [Y ] A [ 0 ]Gallons MULTI- CHAMBERED /IN SERIES: [Y ] N [ 0 ]GALLONS GREASE INTERCEPTOR CAPACITY K [ 0 ]GALLONS DOSING TANK CAPACITY [ 0 ]GALLONS @ [0 ]DOSES PER 24 HRS # PUMPS[ 0 ] [ N ] MOLND [ N ] [ N ] 3 'NGVD BELOW] BENCHMARK /REFERENCE POINT BELOW] BENCHMARK /REFERENCE POINT .0 ] INCHES Dade 1-L EXPIRATION DATE: 5/20/02 CHD Page 1 of 2 STATE OF FLORIDA DEPARTMENT OF HEALTH APPLICATION FOR ONSITE SEWAGE DISPOSAL SYSTEM CONSTRUCTION PER T Permit Application Number Notes: q f 4q %4k- Site Plan submitt Plan Approved By n LL CHANGE MUST DH 4015, 10/96 (Replaces HRS -H Form 401\5 which may be used) (Stock Number: 5744 -002 - 4015 -6) PART II - SITEPLAN Scale: Each block represents 10 feet and 1 inch = 40 feet. E APPROVED Not Approved v ` Y THE COUNTY HEALTH DEPA Date di /5/ "a• - County Health Department T JiiENT Page 2 of 4 • l , �1*■ ii ■ 1 _I r12 1 ._ Ai i A .� l lr r 1 , i 1 / -� I 1 ■ +11'1 ■� Li" .! � i ■11 ■ J I Q l� {y , 'fS) , r r . . v f 4 11 IL ■ I i I L. l B Y . . ..1_ _...L .1. STATE OF FLORIDA DEPARTMENT OF HEALTH APPLICATION FOR ONSITE SEWAGE DISPOSAL SYSTEM CONSTRUCTION PER T Permit Application Number Notes: q f 4q %4k- Site Plan submitt Plan Approved By n LL CHANGE MUST DH 4015, 10/96 (Replaces HRS -H Form 401\5 which may be used) (Stock Number: 5744 -002 - 4015 -6) PART II - SITEPLAN Scale: Each block represents 10 feet and 1 inch = 40 feet. E APPROVED Not Approved v ` Y THE COUNTY HEALTH DEPA Date di /5/ "a• - County Health Department T JiiENT Page 2 of 4 ELECTIVE , I`YPI. Minimum Fee QTY. TYPE Dryer QTY. 1 ... TYPE Outlet, Appliance QTY 'I'YPI. Service Repair QTY. A/C Central 1 -3 Ton Dryer Vents, Number of Fan Ventilation, Cost Outlet, Wall Ductwork, Cost of Service, Temporary Periodic Inspections A/C Central 4 -7 Ton Fire Sprinkler System Fire Pump Outlet, Switch Fireplaces, Number of Signs A/C Central 8-15 Ton Fixture - Fluorescent Oven Space Heater (kw) A/C Central 16-20 Ton Fixture Light Parking Lot Lights Spas/Hot Tubs AJC Central 20+ Ton Flood Lights Plugmold/Strip Subfeeds, No. of Amps A/C Window FPL - Load Central Posts Swim Pool, Commercial Air Conditioners Garbage Disposal Range/Range Top Swim Pool, Residential Chiller Generators, etc. Receptacles Switchboards Clear Violations Heat Recovery Refrigerator, Comm. (p/PH) Temp Serv., Construction Compactor Low -volt, ]Burglar Refrigerator, Domestic `� U Temp for Test - 30 days Deep Freezer Low -volt, Fire Renew - Temp Service Water Closet Demolition Low -volt, IIntercom/II'eleph. Repair Circuits Water Heater Dishwasher Low -volt, Television Service, Number of Amps Water Heater New MECHANICAL •IA,I,l: Minimum Fee QTY. 'nil: Condensate Drain ()Ty. T TE Generator ()Ty. .LYLE QTY. Refrigeration, Tons A/C Central, Tons Cooling Tower Heating Strips, each Vent Hood, Cost AJC Wall/Win. Tons Dryer Vents, Number of Paint Booth Ventilation, Cost Air Handler, Tons Ductwork, Cost of Piping, Flammable Liquid Periodic Inspections Barbecue Fire Sprinkler System Process/Pressure Piping Bath Fan - Vented, # Fireplaces, Number of Pressure Vessel PLUMBING .I.yI,I,, A/C Condensate OTy. .I.I.I,I, Drains, Roof QTY ' Miscellaneous Fixture Q.I'Y TYPE Soakage Pit Q.LY ath Tub Drinking Fountain Miscellaneous Repairs Solar Water Heater Bidet Filter Replace Pool Piping Sprinkler Repair Cap - Fixture Fountain Pump and Abandon Sprinkler System Cap - Water Gas - Appliance Pump, Domestic Supply, AC Well Cap - Sewer Gas - Natural Pump, Fire Stand Temporary Toilet Catch Basin Gas - Propane Pump, Re- circulate Temporary Water Closet Clothes Washer Gas Piping Pump, Replace - Pool Urinal Dental Chair Grease Trap Pump, Sprinkler Utility - Sewer Discharge Well Ice Maker Pump, Sump Utility - Water Dishwasher Indirect Wastes Relay Repair `� U Vacuum Pump Disposal Interceptor Roof Inlet Water Closet Domestic Well Laundry Tray Septic Connection Water Heater Drainfield, 4" Tile/Res. Lavatory Septic Tank Water Heater New Drains, Area Meter Set (Gas) Sewer Connection Water Re -pipe Drains, Floor Minimum Fee Shower Water Service Drains, French Miscellaneous Equipment Sink Well, Supply 1 Page 3 PERMIT APPLICATION INSTRUCTIONS: Please indicate the type of work being performed and quantity(ies) in the space provided below. c RECEIVED AND REVIEWED BY: DATE: SECTION BY DATE Zoning Electrical Mechanical Plumbing , 9 -21-0Z, Fire Public Works Structural Building Official Page 4 OFFICE USE ONLY 0111 ?C K ❑ OWNER - BUILDER FORM (Attach) LI FIRE DEPARTMENT APPROVAL (Commercial / multi- family) ❑ CONCURRENCY (New Construction) ❑ OTHER (Specify & Attach) $3.00 per page (Scanning Fee) Miami Shores Village Bond Metropolitan Dade County (C.C.F.) Inspector State Educational Fund State DCA (Radon) Code Enforcement Fine Zoning Review ❑ PROOF OF OWNERSHIP (Attach) ❑ HRS / DERM APPROVAL (Septic / Sewer) ❑ IMPACT FEE (New Construction) ❑ OTHER (Specify & Attach) PI ?R111'1' FEES (sq.ft. = x/1000 x0.60) $ (0.005 /sq.ft.) $ (0.01 / sq.ft.) _s, D o REVIEWED AND PREPARED BY: PERMIT APPLICATION ❑ CONDO ASSOCIATION APPROVAL (Attach) ❑ BPR APPROVAL (Restaurants) ❑ CONTRACTOR REGISTRATION (On File) TOTAL $ - Z b D DATE: CONDITION OF APPROVAL Revised July 2001 10050 N.E. 2ND AVE., MIAMI SHORES, FL • (305) 795 -2207 • FAX (305) 756 -8972 • http : / /www.miamishoresvillage.com MIAMI SHORES VILLAGE, FLA. APPLICATION FOR SEPTIC TANK PERMIT • DIVISION OF PLUMBIN•NSPECTION / Date/(„ I herewith submit the following applicat n for a permit covering the installation of a Septic Tank, Soakage Pit: Relaying: New:, /k Feet of drain tile: Installed by: • (NEW: X Old: Story: / Addition: Remodeled: For a (Store: Garage: Apt: Hotel: Office Bldg. (Res: X Garage wash floor: Waste water from a: Building has: Stores; Offices; Apts; Hotel Rms; Bedrums 1 Owner or Agent: v Lot No. G� Block No. 1L SUBDIVISION =---� Address of work: !`\ _24 No. of Plumbing Fixtures: Laundry Tubs: Nature of water supply: City Well: wells: Type of tank installed/;,; PERMIT NO. Additional information: Ready for Inspection: Date: APPROVED BY: Remarks: 0 � - 6 2 2. 3 ?, Address: c, AW:_4 Address: gallons: Size of Soakage Pit: Purpose of same: CONDEMNED BY: Floor Drains: Feet Distant from all Tank capacity in Time: ' rim • • Date Type Insp'n Permit No. MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Address Company Phone # 3 vs'°' For In . pectorM )3 Appr.ved Correction Re- Insp'n Fee