846 NE 97 St (9)Miami Shores Village
BUILDING
PERMIT APPLICATION
FBC 2001
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
Permit Type (circle): Building Electrical Plumbing Mechanical Roofing
Owner's Name (Fee Simple Titleholder) 514, �Q- � r� Phone #
Owner's Address 3 ti z&' •
City / 1 /74 -int o, > State �G
Tenant/Lessee Name Phone #
Job Address (where the work is being done)
City Miami Shores Village
Is Building Historically Designated YES
Submittal Fee $
Notary $
Scanning $
(Continued on opposite side)
Type of Work: 17/ . ddition ❑Alteration
Describe Work:
�o ex(s /,1
Permit Fee $
Fi ai 2 7
County Miami -Dade
NO
❑New
Zip 3 S /Acr
Permit No.
Master Permit No.2&.,_ - / "7_7s'
CCF$
Training/Education Fee $ Technology Fee $
Radon $ Zoning Bond $
Code Enforcement $ Structural Plan Review. $
Total Fee Now Due $
105 ,3 20 /t
Zip S ? ) ff
Phone # �mS 75 2D /
Contractor's Company Name
Contractor's Address
City State Zip
Qualifier
Architect/Engineer's Name (if applicable) Phone #
$ Value of Work For this Permff7'
Square Footage Of Work:
Repair/Replace ❑ Demolition
CO /CC
4.4 1.0011E111111Et' .4
Aff
* * * * * * * * * * * * * * * * * * * * * * * * * ** *F * * * * ** * * * * * * * * * * * * * * * * * * * * * **
Bonding Company's Name (if applicable)
Bonding Company's Address
City State Zip
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
City State Zip
Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has
commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating
construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS,
WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC
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.
"WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT 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."
Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachrnent. Also, a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is •issued. In the absence of such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
Signature Signature
Owner or Agent Contractor
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
day of , 20 _ , by , day of , 20 by
who is personally known to me or who has produced who is personally known to me or who has produced
As identification and who did take an oath. as identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
Sign: Sign:
Print: Print:
My Commission Expires: My Commission Expires:
***************************************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
(Certificate of Competency Holder)
State Certificate or Registration No. Certificate of Competency No.
***************************************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
APPLICATION APPROVED BY:
Chc 12/15/03
Plans Examiner
Engineer
Zoning
0/'
03/21/2006 13:58 3054776264
• Date Installed:
TES AGENCY INC PAGE 03/05
CITIZENS PROPERTY INSURANCE CORPORATION
FLORIDA BUILDING CODE SHUTTER MITIGATION VERIFICATION AFFIDAVIT
f()
Property Address:
Policy No: 8 r
A c 71
, ;„w, 54ve
I2
A. Specify the type of protection installed:
Class A (Hurricane Protection)
All exterior wall and roof openings in bungs (doors, windows, skylights and vents, other than roof ridge,
gable, soffit and plumbing vents) must be fully protected with impact resistant coverings (e.g. shutters),
impact resistant doors, and/or impact resistant glazing that meet the requirements of one of the following:
check One;
❑ SSTD 12
❑ E 1888 and ASTM E 1996 (Missile Level C — 9 lb)
Miami -Dade PA 201, 202, and 203
❑ Florida Building Code TAS 201, 202. and 203
[J Class B (Basic impact) .
All exterior wall and roof openings in buildings (doors, windows, skylights and vents, other than roof ridge,
gable, soffit and plumbing vents) must be fully protected with impact resistant coverings (e.g. shutters),
impact resistant doors, and/or impact resistant glazing that meet the requirements of ASTM 1888 and ASTM
E 1998 (Missile Level 8 — 4.5 ib).
❑ Class C (Ordinary Non - impact)
All glazed openings (wows, skylights, sliding glass doors, doors with windows, etc.) must be protected
with shutter devices or wood structural panels that have the following characteristics-
a. Corrugated storm panels made of Steal, Aluminum, or Polycarbonate in which individual panels are no wider than
14' and have a nominal profile of 2" or greater.
b. Roll -Up shutters with aluminum slats.
c. Accordion shutters with aluminum slats.
d. Colonial or Bahama shutters with all the following features:
i. Heavy gauge metal frames,
rr. Extruded aluminum scats that are anchored to both sides of the frame, or solid metal backing plate in place
behind slats,
Structural hinges, and
iv. A mechanism to lode shutters dosed during a stomr.
e. Wood Structural Panels — Plywood or O58 (oriented strand board) with a minimum thickness of 7/18 inch and
maximum panel span of 8 feet Panels must be precut to cover the grazed openings with attachrnent hardware
provided Panels must be fastened aocording to the Florida 8ulkfrry Code Table 1606.1.4 for locations where
design wind speed is 130 mph or less. For locations with design wind speed greater than 130 mph, attachments
shall be designed to resist component and cladding loads of the FBC.
Up to two small windows (each 4 square feet or less) may be protected with polycarbonate flat panels used
as a cover,
CI T-26 (07/2004) i of 2 pages
.1'
•
03/21/2006 13:58 3054776264
TORRES AGENCY INC PAGE 04/05
CITIZENS PROPERTY INSURANCE t ORPORAT;EON
FLORIDA BUILDING CODE SHUTTER NlIfi1GATION VERIFICATION AFFIDAVIT
B. Certify the type of protection installed:
I hereby certify that I am (CHECK • i : ❑ a State of Florida registered Architect, or ❑ an Engineer,
proficient In structural design, or .= a Building Code Official (who is duly authorized by the State of
Florida or its county's municipalities, to verify building code compliance); and that shutters, on the building or
unit ai th ad dress indicated abov c omply with:
Class A OR ❑ Class B OR ❑ Class C
Hurricane Im • t = :: It a Online —Non-
am d o Germany
da l dri '!1! ! !
sere
Nana Of Company
sanaaue
CERTIFICATION OF APPLICANT
I hereby certify that I am a State of Florida registered Building Inspector and that shutters on the buliding
or unit at the address indicated above comply with:
❑ Class C (Ordinary — Non - Impact,)
Date
Signature of Applicant(s): Date:
1.10010 No
This Affidavit and the information set forth in it are provided solely for the purpose of verifying that certain structural or
physical characteristics exist at the Location Address fisted above and for the purpose of perminkv the Named
Insured to receive a property insurance premium discount on insurance provided by Citizens Property Insurance
Corporation and for no other purpose. The undersigned does not make a health or safety certification or warranty,
express or Implied, of any Idnd, and nothing In this Affidavit shall be construed to impose on the undersigned or on
any entity to which the undersigned is affiliated any liability or obrrgation of any nature to the named insured or to any
other person or entity.
NOTICE TO APPLICANTS: if unable to obtain the appropriate signature(s) above, you must attach documentation
indicating compliance with the Specified Type or Protection Indicated in Section A of this form.
C. All Applicants: To receive the premium credit being applied for, please read and sign the
certification below.
I hereby certify and agree to the following: (1) The property listed above has been fitted with Windstorm
Protective Devices which protect all openings in accordance with the requirements stated in Section A of this
affidavit. (2) I agree to close and secure the devices in the event of a tropical storm or hurricane warning
(3) in the event that t cannot install or secure such devices myself, l have or will arrange for someone else to
assume that duty.
tatizens reserves the right to confirm all Informaatioon contained in this form via a survey cf the risk.
°Arty person who rwawinggr and wi h intent to ink defraud, or deceive any insurer files a statement of
claim or an application containing any false, incomplete, or miming information Is guilty of a felony of
the third degree."
CIT -26 (0712004) 2 02 pages
PERMIT #
OWNER St4#m,z TM
ADDRESS //G q7. s
CJ V
CONTRACTOR
PERMIT TYPE
DISPLAY THIS CARD ON FRONT OF JO
IAMI SHORES VILLAGE
•
ILDING PERMIT
1
DA1 `R a4 2l
• "WARNING TO OWNER: YOUR FAILURETO RECORD A NOTICE
OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR
IMPROVEMENTSTO YOUR PROPERTY. IF YOU INTEND TO OBTAIN
FINANCING, CONSULT WITH YOUR LENDER OR ATTORNEY
BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
CERTIFICATE OF OCCUPANCY MUST BE SECURED BEFORE THIS
BUILDING CAN BE USED FOR ANY PURPOSE
DO NOT REMOVE THIS CARD BEFORE COMPLETION
OFFICE PHONE NUMBER: 305 - 795 -2204
(�D�� 1G4 - 2 O18.
((ca-S) ` 531 .
MECHANICAL
INSPECTION TYPE
HA MM
DATE
Undgr NC Pipe
"1
,
Slab condensate
i Tie
Slab Jenn -Aire
/ ,,
Rough Duct
Rough Pipe
Exhaust Fan Rough
Hood Rough
Pool Heat Pump
ft/a \I
Fire Dampers
t
Fireplace Ven: ;
, ,A•
Vacuum Pipe Rough
\A4
Vacuum Pipe Final
Equipment Anchor
Suppression Test
Tuct Detector
Ventilation
Pressure Test
Ti n Cap
FINAL
( / l r
. 1
r
STRUCTURAL
INSPECTION TYPE
INS' - '•
DATE
Footing
"1
,
Columns / Poured Cells
i Tie
Beam
/ ,,
Rake Beam
2nd Floor Slab
2nd Floor Columns
2nd Floor Tie Beam
Roof Sheeting
ft/a \I
Wall Sheathing
t
Floor Sheeting
b - •
Truss, Roof
\A4
Truss, Floor
Store Front
Buck
Lath
Window Installation
Door lnstallaio .. x ,
Ti n Cap
Mop in Progress
( / l r
, ' \
. Tile in Progress
/
!'k
NO INSPECTION WILL BE MADE UNLESS PERMIT CARD IS DISPLAYED
AND APPROVED PLANS ARE READILY AVAILABLE
INSPECTION RECORD
:WORK MUST BE COMPLETED PRIOR TO REQUESTING INSPECTIONS ` ` •
24 HOUR NOTICE FOR ALL INSPECTIONS
4'1
STRUCTURAL
FINAL
%Am !/
FINAL
MIN
AgliAMB
one Prewire
Alarm Final
T.V. Final
Intercom Final
Phone Final
30 Day Temp Power
of Grounding
Pool Sla
eLi/
INSPECTION TYPE
Insulation
Sidewalk
Driveway Form / Rock
Storm Shutter Anchors
Storm Shutter Final
Patio / Deck Final
Fence Final
Pool Steel
Pool / Patio Deck
Screen Encl Final
Pool Final
Roof Final
INSPECTION TYPE
Ground Roug
Top
2nd Floor Rough
3rd Floor Rough
Condensate
Drainfield
Suppression Test
Septic
Sewer
Water Service
L P Tank
Gas Rough
Gas Final
Irrigation
Interceptor
Pressure
Fire Sp I1
Pool
Pool •'Di
Int:
Ext:
• INSPECTION TYPE ;-
Temporary Pole
Service
Rough
T.V. Prewire
Intercom Prewire
n
1 f% / A l 1 /1 /1 /% r /% IN /1 A
03/17/04 11:17 FAX 3054614956 PR NEWSWIRE LATAM
•
Bonding Company's Name (if applicable)
Bonding Company's Address
City State Zip
Mortgage Lender's Name (if•applicable)
Mortgage Lender's Address
City State Zip
Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has
commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating
construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS,
WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC
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.
"WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT 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."
Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspection which occurs seven (7) days after the , building permit is issued In the absence of such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
Signature
ire me
VA f'i. ;
ay o
NOT
Sign:
Print:
LIC:
Owner or Agent
Th foregoing instrument was
20 4 b _
who is personally known tie or who has produced f L.
owledged be
63 LS 6 � - �
S35! - 7 _ As identification and who did take an oath.
Angola M Becke
Signature
Contractor
The forego' . g ins • . ent was a
day of 20 tby . 86 7/ ®/ 8 r
owledged before me thi
r e /
who is personally known to me or who has produced
as ide . ' ratio t and whop s d take .t oath.
NOT
% :�� NOHNN
ISETTE GARRIDO mi
LI , L /
Print: S 9D ° , " i�%,�' ! t
s�
• �����qq�
My Commission Expires• �� 7 i
Off,
� My Commission DD16004 My Commission Expires:
(Certificate of Competency Holder)
State Certificate or Registration No. 1 0 S ° ? L C C, Certificate of Competency No.
Ej003
* ** ass***** s* 1► L*s*********s*********s****** ********* *******s***************** *** * *s * * * ** * * * * * ** *s **** * **s **
1
APPLICATION APPROVED BY: Plans Examiner
Engineer
Chc7!NO3
Zoning
Miami Shores Village
10050 NE 2nd Avenue
Phone: 305- 795 -2204 Permit Number: PL2004 -74
Printed: 3/5/2004
Applicant: SILVIA MARIA STANFORTH
Owner: STANFORTH SILVIA MARIA
JOB ADDRESS: 846 NE 97 ST
Contractor QUALIFIED PLUMBING CO, INC Contractor's Address: 1083 E 23RD STREET
Local Phone: 305 - 620 -0200
Parcel # 1132060142730
Fees: Description Amount
FEE2004 -2306 Building Fee $180.00
FEE2004 -2307 CCF $1.80
FEE2004 -2308 Training and Education Fee $0.60
FEE2004 -2309 Technology Fee $4.50
Total Fees: $186.90
Total Fees: 51lit90.
Total Receipts: 1 4.0
Permit Status: APPROVED Permit Expiration: 8/30/2004 Construction Value:
Work: BATHROOM ADDITION
Signed: (INSPECTOR)
Plumbing Permit
Page 1 of 1
Legal Description: MIAMI SHORES SEC 3 PB 10 -37 LOT 10 & W1/2 LOT 9 BLK 74 LOT SIZE 75.000
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 responisibility for all work
done by either myself, my agent, servants or employes.
Signed: (Contractor or Builder) BY:
$ Value of Work For this Permit
Miami Shores Village
Building Department
, '7&L# V 1
a o
Permit No.
BUILDING
PERMIT APPLICATION
FBC 2001
Permit Type (circle): ' Electrical
Owner's Name (Fee Simple Titleholder)
./ / 7�s.L„ , {hone # .Se v5 ? S"2 f
Owner's Address aP R1/6 /U F 9 7 5 44.. �e
City /4/4Z ,' $Lvrro State ,fr? Zip 5 t/.t cr
Phone #
Tenant/Lessee Name
Job Address (where the work is being done)
City Miami Shores Village County Miami -Dade Zip
Is Building Historically Designated YES NO n _ ,
h ,
Contractor's Company Name .t' r �J - ki - t U 0\ Phone #
Contractor's Address es /7 S t.:? „ Q .... • ;3 , �; �+ 2
Zip
State
City Va X1' > -,
Qualifier
Master Permit No. Zoe
echanical Roofing
* * * * * * * * * * * * * * * * * * * * * * * * * ** *Fees * * * ** * * * / *** **************
R `7� Notary $ __
County Escrow Fee $ L = 8 b Permit Fee $
Radon $
� Education/Training '� g Fee $ •6 L —
Tech $ -6 Scanning $
Code Enforcement $ Bond $ ))
Total Fee Now Due $ 1 b . q, 0
Minus Plans Check Fee $ -- ) . 0 r 4-' S a. 0 0 AMv‘ chlfikAi A
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
Architect/Engineer's Name (if applicable)
Phone #
Architect/Engineer's Address
City
State Zip
Square Footage Of Work: •
Number of: Bays
Stories Families Bedrooms Baths
❑Demolition
Type of Work: ['Addition
['Alteration ['New 0 Repair/Replace
Describe Work: 4-77/ t
Struct. $
ntinued on opposite side)
Bonding Company's Name (if applicable)
Bonding Company's Address
City
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
City
Zip
Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has
commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating
construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC
OWNER'S AFFIDAVIT: ce '
that do
and zoningregoing information is accurate and that all work will be done in compliance with all
applicable laws regulating certify .
I I rtify at all the f
"WARNING TO OWNER: YOUR FAfLURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR
PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE O
COMMENCEMENT." OF
Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose roe
P P rty is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted. notice
inspection will not be approved and a reinspection fee will be charged. ,the
Owner or Agent
The foregoing instrument was acknowledged before me this lD
day o s2� � 20 by.5 • who is personally known to me or who has produced_
As identification and who did take an oath.
VOTAR 'iJBLIC:
Ay Commission Expires:
* * * * * * * * * * * * * * * * * * * * * * * **
tate Certificate or Registration No.
PPLICATION APPROVED B
c717/03
State
Stat
►; :*= MY COMMISSION # DD 169154
EXPIRES: December 3, 2006
* RiF iP * * 419.PAA' iO4 10eg*
(Certificate of Competency Holder)
Certificate of Competency No.
i f ** i * * * *: * * * * * * * * * * * * * * * * **
; -/ 1 ,
Signature
Zip
Contrac .r
The foregoing instrument was acknowledged before me this 2
day of t:ac l} 20 Dc./ , by
ersonally known
NOTARY PUBLIC:
Sign:
Print:
My Commission Expires:
* * * * * * * ** * * * * * * * * * * * * * * * * * * **
LL
who i - e or who has produced
as identification and who did take an oath.
th.
************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
Plans Examiner
Engineer
_ Zoning
Permit No f Date C - - Y l a
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 __. __. ���>r! No Q - -- Street
Registered Architect and /or Engineer _
Employing Plumber's Nam _�!!! No Street
Location and Legal Description Lot__ 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
STATE OF FLORIDA,
COUNTY OF DADE.
ss.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Size Septic Tank „I 0.0 Type of Tank__ 4 Capacity Cals.____
Feet of Drain Tile. Ir Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City —Well. Size of Soakage Pit
Amount of Permit �` +.-�- $__ ( Signed)
Plumbing Inspector.
'' -Y
i
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligati crP'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.
My Commission Expires Notary Public, State of Florida
Master Plumber.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the
of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty
materials and /or workmanship.
CLOSETS
BATH
TUBS
SHOWERS
LAVA-
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TUBS
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT' NS
TOTAL
FIXTURES
CONTR.
LIST
CHECK
—
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
BEATER
DEEP
WELL
SPRKLR.
SYSTEM
SW IM'G
POOL
CONTR.
LIST
CHECK
Permit No f Date C - - Y l a
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 __. __. ���>r! No Q - -- Street
Registered Architect and /or Engineer _
Employing Plumber's Nam _�!!! No Street
Location and Legal Description Lot__ 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
STATE OF FLORIDA,
COUNTY OF DADE.
ss.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Size Septic Tank „I 0.0 Type of Tank__ 4 Capacity Cals.____
Feet of Drain Tile. Ir Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City —Well. Size of Soakage Pit
Amount of Permit �` +.-�- $__ ( Signed)
Plumbing Inspector.
'' -Y
i
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligati crP'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.
My Commission Expires Notary Public, State of Florida
Master Plumber.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the
of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty
materials and /or workmanship.
Permit No. '"/j
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.
Owner's Name and Address
Nature of Water Supply.: City'—Well
STATE OF FLORIDA, 1
ss.
COUNTY OF DADE.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
No. Street
Registered Architect and /or Engineer
Employing Plumber's Name_ 7 ._ __..___- ,______- No Street
Location and Legal Description Lot / !r✓ ,-- _ ,__ Block_ 7 '/
Street and Number where work is to be performed— No ... _____ - s U' - ,0
State work to be performed and purpose of building (By Floors)___..
New Building. Remodeling
Addition Repairs
Size Septic Tank Type of Tank Capacity Gals
Feet of Drain Tile Dist. Feet of Tank or Drain Field from Well
Size of Soakage Pit
Amount of Permit $ / t (Signed)`�i =�` - i
�' ;� Plumbing Inspector.
The undersigned applicant for this building permit does hereby certify that e Understands and accepts his o ations 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. -=. / /-2 - -/ , "
(5igned) % e f a " e — blasteYP1
Street
Subdivision
My Commission Expires Notary Public, State of Florida
No. of Stories
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the _ ___ _
of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty
materials and /or workmanship.
CLOSETS
BATH
TUBS
SHOWERS
LAVA-
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TUBS
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT'NS
TOTAL
FIXTURES
CONTR.
LIST
o
,.
A
/
.
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. '"/j
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.
Owner's Name and Address
Nature of Water Supply.: City'—Well
STATE OF FLORIDA, 1
ss.
COUNTY OF DADE.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
No. Street
Registered Architect and /or Engineer
Employing Plumber's Name_ 7 ._ __..___- ,______- No Street
Location and Legal Description Lot / !r✓ ,-- _ ,__ Block_ 7 '/
Street and Number where work is to be performed— No ... _____ - s U' - ,0
State work to be performed and purpose of building (By Floors)___..
New Building. Remodeling
Addition Repairs
Size Septic Tank Type of Tank Capacity Gals
Feet of Drain Tile Dist. Feet of Tank or Drain Field from Well
Size of Soakage Pit
Amount of Permit $ / t (Signed)`�i =�` - i
�' ;� Plumbing Inspector.
The undersigned applicant for this building permit does hereby certify that e Understands and accepts his o ations 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. -=. / /-2 - -/ , "
(5igned) % e f a " e — blasteYP1
Street
Subdivision
My Commission Expires Notary Public, State of Florida
No. of Stories
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the _ ___ _
of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty
materials and /or workmanship.
STATE OF FLORIDA, I as.
COUNTY OF DADE.
Size Septic Tank_-_--------------- - - - - --
Feet of Drain Tile____ -__
Nature of Water Supply: City — Well.__
CO
Amount of Permit $_
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Polzzatt No l��tL
+t Date
3
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted or the/ruilding or other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida,
and ail 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 J
4 _s ' ( 214 d./ No.--- -- - - —! Street_ 7 5 Registered Architect and /or Engineer Ai _ _ _ _ - -- - - - _----------------- -_ / ___ _ - - -_
Employing Plumber's Name ___Pl!i_1Ahl.J. —_ �e tr_ --' L t C _R - - - - -- -_l 7 6 Street- A4 ---15-- 6 !
Location and Legal Description Lot . - -- _ - - - -__ _ ._._..__ _ Block Subdivision_. .-- ._..--- -.__ --
Street and Number where work is to be performed —No Street.
State work to be performed and purpose of building (By Floors)._ Al DRtJ up1 r 19 o dr-
New Building Remodeling
Addition_______ Repairs • No. of Stories
Type of Tank
--Dist. Feet of Tank or Drain Field from Well
.Size of Soakage Pit
(Signed)
Capacity Gals
Plumbing Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his ob ' Lions as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Penn ` nt 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 the work suc r . u lc notice or notices as are
required by the Act. The undersigned agrees to employ only such sub- contractors, on . ' to be form under this permit, as are
licensed by Miami Shores Village. _
Before me, the undersigned authority, a notary public, duly authorized to administer o; s 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
lumber.
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.
CLO5Irr
BATH
TUBS
SHOWERS
LAVA.
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TUBS
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT•NS
TOTAL
FIXTURE6
_
CONTR.
LIST
CHECK
1.----_
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SWIM'G
POOL
Comm
LIST
CHECK
STATE OF FLORIDA, I as.
COUNTY OF DADE.
Size Septic Tank_-_--------------- - - - - --
Feet of Drain Tile____ -__
Nature of Water Supply: City — Well.__
CO
Amount of Permit $_
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Polzzatt No l��tL
+t Date
3
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted or the/ruilding or other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida,
and ail 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 J
4 _s ' ( 214 d./ No.--- -- - - —! Street_ 7 5 Registered Architect and /or Engineer Ai _ _ _ _ - -- - - - _----------------- -_ / ___ _ - - -_
Employing Plumber's Name ___Pl!i_1Ahl.J. —_ �e tr_ --' L t C _R - - - - -- -_l 7 6 Street- A4 ---15-- 6 !
Location and Legal Description Lot . - -- _ - - - -__ _ ._._..__ _ Block Subdivision_. .-- ._..--- -.__ --
Street and Number where work is to be performed —No Street.
State work to be performed and purpose of building (By Floors)._ Al DRtJ up1 r 19 o dr-
New Building Remodeling
Addition_______ Repairs • No. of Stories
Type of Tank
--Dist. Feet of Tank or Drain Field from Well
.Size of Soakage Pit
(Signed)
Capacity Gals
Plumbing Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his ob ' Lions as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Penn ` nt 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 the work suc r . u lc notice or notices as are
required by the Act. The undersigned agrees to employ only such sub- contractors, on . ' to be form under this permit, as are
licensed by Miami Shores Village. _
Before me, the undersigned authority, a notary public, duly authorized to administer o; s 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
lumber.
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty
materials and /or workmanship.
2-0
- — -- - -- — -- - ..... - - -6"'
Amount of P e r m i t s - - - - -- -
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Block
Capacity Gals
(Signed) _
(Signed)__ . :_ _. t
Date' --
Permit No
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida,
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at
building during progress of work. _
p Street w 7 7 .
. d�_..d _:! ----- - - ---- 6) - A L ' J
Owner's Name and Address __ -____ No. ? 4-
__
Registered Architect and /or Engineer - , (' ,r B
Employing Plumber's Name_iHl-L�l_►-__B!?r]�'�t - :1_� -t�T� �' No. - __-- .— � /� ._ Street - - - -_g _ ts
Location and Legal Description Lot__ - -_
Street and Number where work is to be performed— No.__________
State work to b e performed and purpose of building (By Floors)._ � l � 1 a = A - i� . l f //!�%= L I-
New Building __— Remodeling__ __ ____.___ Addition________._ Repairs No. of Stories.
Subdivision_____ -___ _.___ ________
Street dL/ L 2.7
Size Septic Tank__ ..... --- -- - — — Type of Tank.
C) i -
Feet of Drain Tile -_, M c -- .0 d-$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 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 wo . s ch public notice or notices as are
required by the Act. The undersigned agrees to employ only such sub-contract • , . • work to . - rformed under this permit, as are
licensed by Miami Shores Village.
Master Plumber.
STATE OF FLORIDA, 1 es.
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
to me well known, and who, being by me first duly sworn, upon oath deposes and . says that he is the — of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
My Commission Expires Notary Public, State of Florida
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made by improper notice for inspection, or faulty
materials and /or workmanship.
LAVA-
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TUBS
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT'N6
TOTAL
FIXTURES
CLOSETD
BATH
Tues
SHOWERS
—
--
CONTR.
LIST
CHECK
-
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SWIM'G
POOL.
__!_
CONTR.
LIST
CHECK
2-0
- — -- - -- — -- - ..... - - -6"'
Amount of P e r m i t s - - - - -- -
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Block
Capacity Gals
(Signed) _
(Signed)__ . :_ _. t
Date' --
Permit No
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida,
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at
building during progress of work. _
p Street w 7 7 .
. d�_..d _:! ----- - - ---- 6) - A L ' J
Owner's Name and Address __ -____ No. ? 4-
__
Registered Architect and /or Engineer - , (' ,r B
Employing Plumber's Name_iHl-L�l_►-__B!?r]�'�t - :1_� -t�T� �' No. - __-- .— � /� ._ Street - - - -_g _ ts
Location and Legal Description Lot__ - -_
Street and Number where work is to be performed— No.__________
State work to b e performed and purpose of building (By Floors)._ � l � 1 a = A - i� . l f //!�%= L I-
New Building __— Remodeling__ __ ____.___ Addition________._ Repairs No. of Stories.
Subdivision_____ -___ _.___ ________
Street dL/ L 2.7
Size Septic Tank__ ..... --- -- - — — Type of Tank.
C) i -
Feet of Drain Tile -_, M c -- .0 d-$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 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 wo . s ch public notice or notices as are
required by the Act. The undersigned agrees to employ only such sub-contract • , . • work to . - rformed under this permit, as are
licensed by Miami Shores Village.
Master Plumber.
STATE OF FLORIDA, 1 es.
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
to me well known, and who, being by me first duly sworn, upon oath deposes and . says that he is the — of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
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 by improper notice for inspection, or faulty
materials and /or workmanship.