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602 NE 96 St (3)3 c i ( 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 wo Owner's Name and Address Registered Architect and /or E Employing Plumber's Nam Size Septic Tank ______ _177 Feet of Drain Tile. _ Amount of Permit $ STATE OF FLORIDA, COUNTY OF DADE. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Location and Legal Description —__B1 Street and Number where work is to be performed—No. � `� State work to be performed and purpose of building (By Floors)____ New Building -- _-_-- --- _.-- - --_ --- Remodeling _ --__.____ ... _______ __ Addition v v _ ....,Type of Tank____ Capacity Gals __. __Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: City — Well._________.._____._ _____.___ — _______ ________ ___Size of Soakage Pit (Signed)_ (Signed)_ Date o. _----------- ___ - -- Street. 3 Street Repairs No. of Stories .. ..... Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has cmn- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such sub - contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. & Master Plumber. � 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 NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty materials and /or worlananship. CLOSETS BATH TUBS SHOWERS LAVA_ TORIES SINKS SLOP SINKS LAUNDRY TUBS URINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT'N6 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 _ 3 c i ( 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 wo Owner's Name and Address Registered Architect and /or E Employing Plumber's Nam Size Septic Tank ______ _177 Feet of Drain Tile. _ Amount of Permit $ STATE OF FLORIDA, COUNTY OF DADE. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Location and Legal Description —__B1 Street and Number where work is to be performed—No. � `� State work to be performed and purpose of building (By Floors)____ New Building -- _-_-- --- _.-- - --_ --- Remodeling _ --__.____ ... _______ __ Addition v v _ ....,Type of Tank____ Capacity Gals __. __Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: City — Well._________.._____._ _____.___ — _______ ________ ___Size of Soakage Pit (Signed)_ (Signed)_ Date o. _----------- ___ - -- Street. 3 Street Repairs No. of Stories .. ..... Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has cmn- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such sub - contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. & Master Plumber. � 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 NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty materials and /or worlananship. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT State work to be performed and purpose of building (By Floors) -_ -__ _ - - -_ New Building___. _ _ ... . Remodeling____.._._....__ Addition Size Septic Tank__ Type of Tanfr Feet of Drain Tile __._Diet. Feet of Tank or Drain Field from Well.__._ —_ ___ -- _--- • - -.__ _ Nature of Water Supply: City—Well. S -- of Amount of Permit = 4 (Signed) Capacity C..[._._.._... _. Permit No / L X3 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 71 Registered Architect and /or Engineer - Employing Plumber's Nam .1 •", , ° Na �� -� ,.... itr ! Location and Legal Description Lot. Bloom Subdivisio .____ ;� Street and Number where work is to be performed —No Street._.. . .. � = I / ./r,. Repairs. No. of Stories. ... 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 5968, 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 - ormed under as are licensed by Miami Shores Village. STATE OF FLORIDA, COUNTY OF DADE. j Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take aclmowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the ..._.._.--- ..._.---- -..... _ _...._._ _.. of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. M Commission Expires Notary Public, State of Florida NOTE: A re fee of $LOO will bs mads what nice iapaotlas As anads by lmpuper notice for Inspection, ar faulty materials and /or workmanship. CLOStra BATH TUBS 15 LAVA. TOR1Ea SINK[ SLOP LAUNDRY Tun[ URINAL. • SINKS CATCH BASIN FLOOR DRAIN DRINKING FOUNT' NS TOTAL FIATUR[S CONTR. LIST CHICK SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER Div WELL SPRKLR. SYSTEM SWIM POOL CONTR. LIST CHICK MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT State work to be performed and purpose of building (By Floors) -_ -__ _ - - -_ New Building___. _ _ ... . Remodeling____.._._....__ Addition Size Septic Tank__ Type of Tanfr Feet of Drain Tile __._Diet. Feet of Tank or Drain Field from Well.__._ —_ ___ -- _--- • - -.__ _ Nature of Water Supply: City—Well. S -- of Amount of Permit = 4 (Signed) Capacity C..[._._.._... _. Permit No / L X3 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 71 Registered Architect and /or Engineer - Employing Plumber's Nam .1 •", , ° Na �� -� ,.... itr ! Location and Legal Description Lot. Bloom Subdivisio .____ ;� Street and Number where work is to be performed —No Street._.. . .. � = I / ./r,. Repairs. No. of Stories. ... 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 5968, 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 - ormed under as are licensed by Miami Shores Village. STATE OF FLORIDA, COUNTY OF DADE. j Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take aclmowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the ..._.._.--- ..._.---- -..... _ _...._._ _.. of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. M Commission Expires Notary Public, State of Florida NOTE: A re fee of $LOO will bs mads what nice iapaotlas As anads by lmpuper notice for Inspection, ar faulty materials and /or workmanship. Date i01(01C M Job Address 6 I6 9(e g7 Tax Folio Legal, Description Temuf," Owner / Lessee / Tenant MA ,\ S\r10(L c--. PQ.,\ - iY -(`UAti'.a CµU aster Permit # 3- Phone 25 9i{ f Owner's Address t76d c 7/ q 1 P Contracting Co. tt 2,© - Address ( 22 i °3SC Ts(11{LM 44 ;f4.1 Phone 1 G Qualifier i` rnulg SS# - - State # Municipal # Competency # Ins.Co. Architect /Engineer Address Bonding Company Address Mortgagor Address Permit Type(circle one): BUILD]:NG ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING PENCE SIGN WORK DESCRIPTION DQ'A'1 \Q-Cri6i1 Square Ft. Estimated Cost(value) V;00.0 WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT). Application is hereby made to obtain a permit to do work and installation as indicated above, and on the attached addendum (if applicable). I certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits are required for ELECTRICAL, PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK. OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Furthermore, I authorize-, the above -na e 'tractor to do the work stated. Signat �� owner and Date: / M No ry a to Owner and /or My Commission Expires: ** * FEES: PERMIT gety RADON C.C.F. /`p APPROVED: * PERMIT APPLICATION FOR MIAMI SHORES VILLAGE * mormage Zoning Buildin Mechanical /7 or ondo President ''s` "'A <<. JOSEPHINE CHURCH "-.' • Mntlr Pub�iC gt2to of Fiords r.Piiksidentn Exp. April 30, i 4- No. CC19754$ * Signature VV of ntraC for or Owner - Date: Notary as to on actor;or Owner- Builder My Commission Expires: &.:C a7 From, Sido of fl Qarmaahm L2tT 16,19 4 * * * * * * 8ondod ThW Troy Fain. ruranco Inc, * /9 /' ** NOTARY Sr2/ TOTAL DUE ✓ lam' Pe Fire Other Electrical Engineering 'ATE OF FLORIDA PARTMENT OF HEALTH AND REHABILITATIVE SERVICES ONSITE SEWAGE DISPOSAL SYSTEM CONSTRUCTION PERMIT Authority: Chapter 381, FS & Chapter 10D -6, FAC PERMIT # 1 )47 DATE PAID Ail--A% FEE PAID $ (L(D' a) RECEIPT # ,7 CONSTRUCTION PERMIT FOR: [ ] New System [ ] Existing System [ ] Holding Tank [ ] Temporary /Experimental [`/] Repair [ ] Abandonment [ ] Other(Specify) APPLICANT: m ` AG NT: ' PROPERTY STREET ADDRESS: /'„ to.1 ) s r° 4 / LOT: A/ A BLOCK: �/ I��SUBDIVISION: PROPERTY ID #: SYSTEM DESIGN AND SPECIFICATIONS L D FILL REQUIRED: [ - --^'I INCHES O / /, J-.- T SPECIFICATIONS BY: APPROVED BY: f C -C, ` w DATE ISSUED: /e) _ (2,- 3 HRS -H Form 4016, Mar 92 (Obsoletes previous editions which may not be used) (Stock Number: 5744 - 001 - 4016 -0) [SECTION /TOWNSHIP /RANGE /PARCEL NUMBER] [OR TAX ID NUMBER] EXCAVATION REQUIRED: [ _J INCHES TITLE: TITLE: [ SYSTEM MUST BE CONSTRUCTED IN ACCORDANCE WITH SPECIFICATIONS AND STANDARDS OF CHAPTER 10D -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: 1250 GALLONS] K [ ] GALLONS PER DOSE DOSING TANK CAPACITY DOSE RATE [ ] PER 24 HRS NO. OF PUMPS: [ ] D [4I SQUARE FEET PRIMARY DRAINFIELD SYSTEM R [ ] SQUARE FEET SYSTEM A TYPE SYSTEM: [ ] STANDARD [ ] FILLED [ ] MOUND I CONFIGURATION: [ ] TRENCH [ -]'BED [ ] N F LOCATION OF BENCHMARK: 4 4 I ELEVATION OF PROPOSED SYSTEM SITE [ e--- -] [INCHES /FT] [ABOVE /BELOW] BENCHMARK /REFERENCE POINT E BOTTOM OF DRAINFIELD TO BE [ ] [INCHES /FT] [ABOVE /BELOW] BENCHMARK /REFERENCE POINT ] .�� MCPHU EXPIRATION DATE: / 6( Page 1 of 2 c: irIr r...k;c1:icr.:icn-, from Cilzp'..or IFAC. f:cm Cliaro:r !.?..14:1: ci IlIde:71.;:::!! 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J 5 55 ' n / R ■ ' n R ; ; • • � nl _[ L L 1.. r ) • * J' / /� / MOM a a•' ■ ■• a a i i ■ ■ � � ( ( { *• J / i 1 ' i Notes"' /'9 /�,9 / - STATE OF FLORIDA DEPARTMENT OF HEALTH AND REHABILITATIVE SERVICES APPLICATION FOR ONSIT'E- SEWAGE DISPOSALtSYSTEM CONSTRUCTION PERMIT Permit Application NI r -5 < r�� r� , ' r �� PART II - SITE PLAN, " - '; 0 2 Site Plan Submitted Oy' Plan Approved By , At> No >App bved ALL CHANGES MUST BE APPROVED BY NRS -H Form 4015, Feb 85 (Obsoletes previous editions which may not be used) (Stock Number: 5744- 002 - 4015 -6) (� r - PUL tC � CO " Y ) EALTH UNIT • 'TITLE ✓, rl Date /off'/ 3 County Public Unit Page 2 of 3 Permit No /17 6- Amount of Permit $ ss. My Commission Expires MIAMI SHORES VILLAGE , PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT M a' 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 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. % o ,t ,G Owner's Name and Address y- 2 Z.�'J /. �' No -77 Street / ' i Registered Architect and /or Engineer____ 1 e�„ Employing Plumber's Name_ 4 No. Z Street__ f �_�� i L r - - t.Z1 - it L. Location and Legal Description Lo Block Subdivision Street and Number where work is to be performed —No Street State work to be performed and purpose of building (By Floors) New Building Remodeling Addition Repairs No. of Stories Size Septic Tank Type of Tank Capacity Gals Feet of Drain Tile Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: City —Well Size of Soakage Pit ( Signed) Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act: The undersigned agrees to employ only such sub - contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. ( Signed) Master Plumber. STATE OF FLORIDA, 1 COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are. true. Notary Public, State of Florida NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty materials and /or workmanship. CLOSETS BATH TUBS SHOWERS LAVA- TORIE' :s SINKS SLOP SINKS LAUNDRY TUBS URINALS CATCH BASIN FLOOR DRAIN DRINKING FOU NT' NS TOTAL FIXTURES CONTR. LIST CHECK SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SW IM'G POOL CONTR. LIST CHECK Permit No /17 6- Amount of Permit $ ss. My Commission Expires MIAMI SHORES VILLAGE , PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT M a' 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 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. % o ,t ,G Owner's Name and Address y- 2 Z.�'J /. �' No -77 Street / ' i Registered Architect and /or Engineer____ 1 e�„ Employing Plumber's Name_ 4 No. Z Street__ f �_�� i L r - - t.Z1 - it L. Location and Legal Description Lo Block Subdivision Street and Number where work is to be performed —No Street State work to be performed and purpose of building (By Floors) New Building Remodeling Addition Repairs No. of Stories Size Septic Tank Type of Tank Capacity Gals Feet of Drain Tile Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: City —Well Size of Soakage Pit ( Signed) Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act: The undersigned agrees to employ only such sub - contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. ( Signed) Master Plumber. STATE OF FLORIDA, 1 COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are. true. Notary Public, State of Florida NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty materials and /or workmanship. REQUEST FOR INSPECTIO ompany 4) 7 Address 7 Inspection Time Ready Date Ready r / A.M. P.M. k*°°. REQUEST FOR INSPECTIO Company _ Job 9 -" t il Address 0 Inspection \-6 Time Ready Date Ready / PHONE A.M. P.M. ap Permit No. _ - (E' f ___ x e/ Date__ Applica tion 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. ' ! �/ A R ®X ' � No 4* �e 7 4°-.0 r Owner's Name and Address • __ treet Registered Architect and /or Engineer Employing Plumber's Name f6»'' le, F1 r it__ t t *e_tA4 NNo Location and Legal Description Lot Block ® Sub 'vision I_ h t Street 6 __ Street and Number where work is to be performed—No. State work to be performed and purpose of building (By Floors) Size Septic Tank Feet of Drain Tile Nature of Water Supply: City —Well Amount of Permit $ ss. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT (Signed) A 0 Street__ New Building Remodeling Addition Repairs _be" No. of Stories Type of Tank Capacity Gals __Dist. Feet of Tank or Drain Field from We1L Size of Soakage Pit t - A_ 'J -- 114 b. Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such sub - contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. (Signed) STATE OF FLORIDA, t COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths anti' take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. My Commission Expires Notary Public, State of Florida Master Plumber. 41 • NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty materials and /or workmanship. CLOSETS BATH TUBS SHOWERS LAVA• TORIES SINKS SINKS SLOP LAUNDRY TUBS URINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT' NS TOTAL FIXTURES CONTR. LIST e CHECK SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SWIM'G POOL CONTR. LIST CHECK ap Permit No. _ - (E' f ___ x e/ Date__ Applica tion 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. ' ! �/ A R ®X ' � No 4* �e 7 4°-.0 r Owner's Name and Address • __ treet Registered Architect and /or Engineer Employing Plumber's Name f6»'' le, F1 r it__ t t *e_tA4 NNo Location and Legal Description Lot Block ® Sub 'vision I_ h t Street 6 __ Street and Number where work is to be performed—No. State work to be performed and purpose of building (By Floors) Size Septic Tank Feet of Drain Tile Nature of Water Supply: City —Well Amount of Permit $ ss. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT (Signed) A 0 Street__ New Building Remodeling Addition Repairs _be" No. of Stories Type of Tank Capacity Gals __Dist. Feet of Tank or Drain Field from We1L Size of Soakage Pit t - A_ 'J -- 114 b. Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such sub - contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. (Signed) STATE OF FLORIDA, t COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths anti' take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. My Commission Expires Notary Public, State of Florida Master Plumber. 41 • NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty materials and /or workmanship. Inspection Date Approved Correction Re- Insp'n Fee 45`4 OCT a .r MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 OCT 1 8 2005 Building Inspection Request DateI 0 l 1- 1 [ Q5 Type Insp' n C_ Ce::)Y.44'4Di CD N. Permit No. � — 14 4 Name! c / 02JA1 Address �O2 S T" • C --m.4 Company Phone # ( I ojts BUILDING E MIAMI SHORES VILLAGE, FLORIDA ELECTRICAL ❑ PLUMBING ❑ PERMIT N? 10471 ROOFING ❑ 0 Date 1 Contractor's Liicense No. 19 Y Work to be performed under this Permit Owner of f � Building /47:#4,42.i. ; s ►/'mac "t°'� f rt 6 10. kar.rs,. t" Architect II � i s t f,G '5 ci Contractor / r ! j (" ' ^' �✓ f or Builder a ! .b > >� .� ..... ,r - (:. 4�.s�. %�. i"' <.�+ CONTRACTOR or BUILDER Legal Lot Description 11 B1. Address of vCo- E. Building 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 employ f s. ,t >,,,. Signed • f.' • • ` • — , -, INSPECTOR) BY In consideration of the issuance to me of this permit I agree tb 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 either, myself, my agent, servant or employee. 0 Subdi- 4 ,0. vision ai4C IV* •, , t tZ o towel r. iro. r: 1 � . Sq. Ft. jF ii s . f -* tj / 'his " . 4 :14. ".7 Value of 11 Amount of Aor C .46 Project $ II Permit $ BY AUTHORITY