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795 NE 97 St (7)R. Paul Gagnon Dean R. Claussen BUILDING PERMIT NO x REPAIRS ALTERATION ADDITION OWNER'S NAME JOB LOCATION (ST. OR AVE.) 795 N.E, 97th St. GENERAL CONTRACTOR 14461 ZONE REQUIREMENTS DRAWINGS. SPECIFICATIONS. RESTRICTIONS AND CUBE CHECKED BY: TYPE STORIES ROOF CONSTRUCTION NEW CONSTRUCTION SUBMITTED TO PLANNING BOARD RE-SUBMITTED TO PLANNING BOARD SUBMITTED TO VILLAGE COUNCIL DATE CBS 1 2 boirm.-2 baths-living room-living porch-kitchen-garage APPROVED 4-3-53 CU. FT. 8-030 7 70 REJECTED LOT PLAN CUBE PRESENT ADDRESS til ADDRESS BLOCK 20.00 PERMIT FEE 20,394 DESCR DESCRIPTION REFERRED TO COUNCIL • ' • , CERTIFICATE OF OCCUPANCY NO. J ' ISSUED BY - TO CU. FT. terrazzo floors, plaster walls REMARKS EST. COST 5 Nc s 1 54 2 BUILDING PERMIT AND INSPECTION RECORD-MIAMI SHORES VILLAGE LICENSE NO. SUBDIVISION Sec. 3 PHONE NO. • - BUILDER'S BOND REASONS DATE 16,000 INTERIOR CONSTRUCTION F)NE LICENSE NO. DATE INSPECTIONS DATE BY RE- INSPECT BY RE- INSPECT BY FOUNDATION 4/. , PERMIT NO. DATE FEE TEMPORARY SERVICE BEAMS & LINTELS H. W. HEATER CONN. S � GI AS* $ FRAMING , •.i MOTORS 5 SOLAR HEATER $ FIXTURES $ GAS FINAL I6 —/ L v • $ INSPECTIONS $ CLEAN -UP ! l/ RE- INSPECT BY RE- INSPECT BY CONTRACTOR -^�� t�l'�` PHONE PERMIT NO. J450 tf DATE li . i j S FEE $ ( NEW BLDG. ALTERATION ADDITION REPAIRS SPECIAL PERMITS PERMIT NO. DATE FEE TEMPORARY SERVICE $ . H. W. HEATER CONN. S SEPTIC TANK � GI AS* $ SEWER $ MOTORS 5 SOLAR HEATER $ FIXTURES $ GAS $ $ $ INSPECTIONS $ INSPECTIONS DATE BY RE- INSPECT BY RE- INSPECT BY ROUGHING 4 - 1.11 d-, i:i' '-.,, ROUGHING c ' GAS H. W. HEATER CONN SEWER 1 ,RANGE CONN. SEPTIC TANK SOLAR HEATER (( FIXTURES & FINAL FIXTURES ! 6 - , CONTRACTOR w '„ , -.A. �.. , PHONE 7 P! - PERMIT NO. ' � ' , o' GATE , - ` FEE $ NEW BLDG. 1 ALTERATION I ADDITION REPAIRS SPECIAL PERMITS PERMIT NO. DATE FEE TEMPORARY SERVICE $ . H. W. HEATER CONN. $ RANGE CONN. $ MOTORS $ FIXTURES $ $ INSPECTIONS DATE BY RE- INSPECT BY RE- INSPECT BY TEMP. SERVICE ROUGHING c ' ,-.-/ �, H. W. HEATER CONN 1 ,RANGE CONN. (( FIXTURES & FINAL BUILDING INSPECTIONS PLUMBING PERMITS & INSPECTIONS ELECTRICAL PERMJ,TS & INSPECTIONS APPROVAL. TO POWER CO. FOR SERVICE DATE BY N© 1798 CERTIFICATE OF OCCUPANCY MIAMI SHORES VILLAGE, FLORIDA BUILDING DIVISION Miami Sh res '' illage, Fla , Owner, Agent or Tenant of Building ' (% : ��� Lot (-" s Block _V Subdivision 'r\' 4..L 4..L . ' , Street Address i " ' t ?' Approved use by occupancy e =-t Remarks. This Certificate of Occupancy is issued to the above named for building at above named location only upon the express provision that the applicant will abide by and comply with all conditions of Ordinances Nos. 92, 93, 94 and 97, known ss the Zoning, Electrical, Plumbing and Building Ordinances of Miami Shores Village pertaining to the erection, construction, alteration orjemodeling of buildings or structures. BUILDING DIVISION • BUILDING ELECTRICAL PLUMBING ROOFING Owner of Building ❑ DATE 195 L PERMIT .N° 14504 Contractor's ❑ License No Li Work to be performed under this Permit Architect Contractor or Builder _ Legal Lot II 131. Description Address of Building CONTRACTOR OR BUILDER MIAMI SHORES VILLAGE, FLORIDA 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 her:under 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 BUILDING ELECTRICAL PLUMBING ROOFING Owner of Building Architect Contractor or Builder_ _ Li PERMIT N9 14975 U Work to be performed under this Permit__. Legal Lot II BI. Description Address of Building CONTRACTOR OR BUILDER MIAMI SHORES, VILLAGE, FLORIDA Subdi- vision Value of Project $ DATE 195 Contractor's License No Amt. of Permit $ This permit is granted to the contractor or builder named above to constr lct the building or to install the equipment or device described in the application berefor 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 pla,os or drawings or in the statements or specifications and that he assumes responsibility for work done by his agents, servants or employees. Sighted: BY INSPECTOR In consideration of the issuance to nie 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 TELEPHONED PLEASE CALL CALLED TO SEE YOU WILL CALL AGAIN WANTS TO SEE YOU URGENT I RETURNED YOUR CALL To Date Time WHILE YOU WERE OUT M of Phone Area Code Number Extension Message Operator Campbell 09301 PERMIT APPLICATION FOR MIAMI SHORES VILLAGE e 94)-6 ?3t)& No Dat -. /Job Address 9I Tax Folio //-3 Legal ption :2/ Owner/Lessee / Tenant ..V /71 u.,.------ - Master Permit # 10 3 6 1 Owner's Address e Ic �g q•-isl Phone p pp 5 Sert `r )� Address / , J A Qualifier ! f vi j � y - �! Phc Y9 SI/ g State #.�14' J 7 )iJ! �- Municipal # / 1 )) Competency # C` ,j 11 C - Ins. Co. / ' Contracting Co. Square Ft. l 1, (jo Ji Signa + of r er and/or Conde President D. KCCV y (/ i q 7 V i - c rik e_3" e Notary as o Owner and/or Co o:Psrdent My Co , ssion Expire] ,' ; , , r '.S .; FEES: PERMIT RADON APPROVED: Zoning Building Mechanical Plumbing , 0/ C.C.F. Historically Designated: Yes Estimated Cost (value) Architect/Engineer Address Bonding Company Address Mortgagor Address Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION k..) 0 't2& -: --t 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 NOTIICE 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 k stated. a ature + Co' : ct T or Own r- I; wilder i _ / atea& Si No as to Contractor or e = 1Idgr; y Commission Expire; J ;, n r `• l ,A.Tc , 77Ni\;,y.;: 0 NOTARY Electrical Structural Engineer BOND Y70 TOTAL DUE Date MIAMI SHORES VILLAG BUILDING DEPARTMEN 305- 795 -2204 Building Inspection Request Date Type Insp'n fr/t) SP Permit No. P2— V - ‘ .5) Name Address 7 95" As& `- - Company ,d , j /; Phone # - 68/ _ 6 3aa • Inspection Date ° / /61Y Approved Correction ❑ Re- Insp'n Fee ❑ PERMIT APPLICATION FOR MIAMI SHORES VILLAGE F 1 /27/95 795 NE 97 STREET Date Job Address Tax Folio Legal Description Historically Designated: Yes No Owner/Lessee / Tenant KAY Owner's Address 795 NE 97 STREET, MIAMI SHORES 33138 Phone 754 -6534 Contracting Co. NORTH DADE SEPTIC TANK Address 800 NW 111 STREETMIAMI, FL 33168 Qualifier DENNIS NEVILLE SS# Phone 754 -3375 State# 025836 -8 Architect/Engineer Address Bonding Company Address Mortgagor Address Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION INSTALL DRAINFIELD Square Ft. 200 SQ FT 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 c..- 1 actor to do the wo ated. 6 '°� 11/27/95 Signature ner and/or Condo P sident Date My Commission FEES: PERMIT APPROVED: Zoning Mechanical S`4s iSS`s«SSASN«CSRt NSi t SiSiC S«<C 'ttiN i > o oslY P oo Te°asa J. Feder > k A ` a Notary Public, Siete of clot"d3 ' > ' °"` o Commission No. CC 4':'s(r > 'or ye My Commission Expires 07/1(5/9? • ; A > 14800.34 - Pia. Notuy Service & Aond:u3 Co.. , > sees eeeaaeeeeeareeeeeeearaueaea :aeeuu< < ondo President Date ° RADON Building Plumbing 3 u !27 /A5 S C.C.F. N. r o Con My Commission NOTARY Master Permit # Municipal # Competency # 12842 Ins. Co. TRAVFT,FRS /FSTF Estimated Cost (value) $1100 r or Owner Electrical uilder Date 1 1/2 7/9 5 er- Builder Date es : > si,ti sssm mv, ,cmw,, `v,scsc «t ,,c.si, > gPpY PV© Teresa J. FeCCi:,f > ° pate' No; ry?Otic State of ',,,'.' , 01'rg Commission N0. CC 4;;;;11 ' "eor RO My Commission Expires 'D/1503 ' i r- CIIO.3- KDTARY - 7 Cb. N y �r eatre'aS Cn. ' ', ) emeeeeeemeeetweet eeeemeeeeeeaeeeemeeaer. TOTAL DUE��� Engineering LOT: T [ A [ N [ K [ APPLICANT: PROPERTY STREET ADDRESS: PROPERTY ID #: L D FILL REQUIRED: [ SPECIFICATIONS BY: APPROVED BY: DATE ISSUED: STATE OF FLORIDA DEPARTMENT OF HEALTH AND REHABILITATIVE SERVICES ONSITE SEWAGE DISPOSAL SYSTEM CONSTRUCTION PERMIT Authority: Chapter 381, FS & Chapter 1OD -6, FAC CONSTRUCTION PERMIT FOR: [ ] New System [ ] Existing System [ ] Holding Tank [ ,] Temporary /Experimental [ ] Repair [ ] Abandonment [ :] Other(Specify) BLOCK: SUBDIVISION: 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. SYSTEM DESIGN AND SPECIFICATIONS ] [GALLONS / GPD] SEPTIC TANK /A,EROBIC UNIT CAPACITY MULTI- CHAMBERED /IN SERIES:[ ] ] [GALLONS / GPD] CAPACITY MULTI- CHAMBERED /IN SERIES:( ] ] GALLONS GREASE INTERCEPTOR CAPACITY [MAXIMUM CAPACITY SINGLE TANK: 1250 GALLONS] 1 GALLONS PER DOSE DOSING TANK CAPACITY DOSE RATE [ ] PER 24 HRS NO. OF PUMPS: [ ] D [ ] SQUARE FEET PRIMARY DRAINFIELD SYSTEM R [ ] SQUARE FEET SYSTEM A TYPE SYSTEM: [. .] STANDARD [ ] FILLED [ ] MOUND [ ] I CONFIGURATION: [ ] TRENCH [ ] BED [ ] N F LOCATION OF BENCHMARK: I ELEVATION OF PROPOSED SYSTEM SITE [ E BOTTOM OF DRAINFIELD TO BE [ ] INCHES EXCAVATION REQUIRED: [ ] INCHES 0 T H E R AGENT: [SECTION /TOWNSHIP /RANGE /PARCEL NUMBER] [OR TAX ID NUMBER] ] [INCHES /FT] [ABOVE /BELOW] BENCHMARK /REFERENCE POINT ] [INCHES /FT] [ABOVE /BELOW] BENCHMARK /REFERENCE POINT TITLE: HRS -H form 4016, Mar 92 (Obsoletes previous editions which may not be used) (Stock Number: 5744 - 001 - 4016 -0) PERMIT # DATE PAID FEE PAID $ RECEIPT # TITLE: CPHU EXPIRATION DATE: Page 1 of 2 Notes: Plan Approved STATE OF FLORIDA DEPARTMENT OF HEALTH AND REHABILITATIVE SERVICES APPLICATION FOR ONSITE SEWAGE DISPOSAL SYSTEM CONSTRUCTION PERMIT Permit Application Number PART II - SITE PLAN 9 • Not Approved - - Site Plan Submitted by SIGNATURE TITLE Date 3y County Public Unit ALL CHANGES MUST BE APPROVED BY THE COUNTY PUBLIC HEALTH UNIT .83S-H Fo7rn 4015. Feb 85 (ObutIetes previous echtions wftch may not be used) Steck N: :7. 3744-002-4015-6) Page 2 of 3 LOT: PROPERTY ID #: USDA SOIL SERIES::.: SITE EVALUATED BY: STATE OF FLORIDA DEPARTMENT OF HEALTH AND REHABILITATIVE SERVICES ONSITE SEWAGE DISPOSAL SYSTEM SITE EVALUATION AND SYSTEM SPECIFICATIONS 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 PLAN: [4 YES [ ] TOTAL ESTIMATED SEWAGE FLOW: GALLONS AUTHORIZED SEWAGE FLOW: UNOBSTRUCTED AREA AVAILABLE: SOIL PROFILE INFORMATION SITE 1 BENCHMARK /REFERENCE POINT LOCATION: THE MINIMUM SETBACK WHICH CAN BE MAINTAINED FROM THE SURFACE WATER: FT DITCHES /SWALES: WELLS: PUBLIC: FT LIMITED USE: FT BUILDING FOUNDATIONS: FT PROPERTY LINES: SITE SUBJECT TO FREQUENT FLOODING: [ ] YES 10 YEAR FLOOD ELEVATION FOR SITE: Munsell #¢Color Texture Depth to to to to to to •d,2, to to to SOIL TEXTURE /LOADING RATE FOR SYSTEM SIZING: DRAINFIELD CONFIGURATION: [ ] TRENCH [r'] BED REMARKS /ADDITIONAL CRITERIA: a -, HRS -H Form 4015, Mar 92 (Obsoletes previous editions which may not be used) (Stock Number: 5744 - 003 - 4015 -1) AGENT: PERMIT # [Section /Township /Range /Parcel No. or Tax ID Number] NO NET USABLE AREA AVAILABLE: ACRES PER DAY [RESIDENCES —TABLE 1 / OTHER —TABLE 2] GALLONS PER DAY [1500 GPD /ACRE OR 2500 GPD /ACRE] SQFT UNOBSTRUCTED AREA REQUIRED: _�. SQFT ELEVATION OF PROPOSED SYSTEM SITE IS 7fl EtNCMES /FT] [ABOVE/gELOWI BENCHMARK /REFERENCE POINT PROPOSED SYSTEM TO THE FOLLOWING FEATURES: FT NORMALLY WET? [ ] YES [ 1 NO PRIVATE: FT NON — POTABLE: FT =FT POTABLE WATER LINES: FT 10 YEAR FLOODING? [ ] YES f ] NO I% ] NQ FT �MSI /NGVD SITE ELEVATION: 2 ` => , " FT MSL /NGVD SOIL PROFILE INFORMATION SITE 2 Munsell #/Color Texture Depth to to to to USDA SOIL SERIES: to to to to to OBSERVED WATER TABLE: INCHES [AB A / BELOW] EXISTING GRADE. TYPE: [PERCH / APPARENT] ESTIMATED WET SEASON WATER TABLE ELEVATION: INCHES [ A30VE / BELOW ] EXISTING GRADE. HIGH WATER TABLE VEGETATION: [ ] YES [] NO MOTTLING: [ ] YES [71 NO DEPTH: INCHES [ ] OTHER (SPECIFY) DEPTH OF EXCAVATION: INCHES DATE: Page 3 of 3 =