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865 NE 97 St (6)- -^ GLOM= ATH TUBS SHOWERS LAVA. TORIES SINKS S NKS L TUBS kitty NH � . G FO NT N6 t 14 wm TOTAL FIXTURES CONTR. LIST CHECK SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SWIM•G POOL Comm LIST CHECK a MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Date-_ - z 8 - Application is Hereby mace 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__PA L iL No. Registered Architect and /or Engineer_ — Employing Plumber's Name d.-d-C_CO..g1 1e3.—__ 63 Y 0 - No._._ (1 eti .._ Stree 41�� Pe Location and Legal Description Lot.--_...__- ... __I4 _ _ .___.__ Block 7 -g Subdivision ' ` a Street and Number where work is t� be performed —No r" cr A/ e 9 Y S treet_ State work to be performed and purpose of building (By Floors) __ New Building ___ Remodeling- _---- - - - -__ _ —._ Addition Street. Repairs No. of Stories D Size Septic Tank_ Feet of Drain Tile _Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: City —Well (Signed)_.-- LIM 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 5986, 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 require d by the Act. The undersigned agrees to employ only such sub - contractors, on wor be performed der this ,ermit, are Homed by Miami Shores Village. Amount of Permit $ 2 t. Type of Tank —___ Capacity Gals Size of Soakage Pit ( Signed STATE OF FLORIDA, 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 81.00 will be made when such re- inspection is made . necessary by improper notice for inspection, or faulty materials and /or workmanship. Master ' lumber. PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date — 7 Job Address e q65 . • 97 i r Tax Folio Legal Description Historically Designated: Yes No Owner/Lessee / Tenant LI / L Y' l q 7 Owner's Address 5 , 6,5-- A,/ • 77 sT Contractin Co. /9/ ///V / - � � (1 41 k a) "C-- Qualifier — T?*rl. � 3 / _ State # O ) Municipal # Architect/Engineer Bonding Company Mortgagor Address Permit Type (circle one): BUILDING ELECTRICAL PLUMBIN ECHANICAL ROOFING PAVING FENCE SIGN L 1 Art. !mac- ' W WORK DESCRIPTION Square Ft. Estimated Cost (val WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY RESULT IN YOUR PAYING TWICE FOR LMPROVEMENTS 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 ab named contractor to do the work stated. Signature of owner and/or Condo Q /. ent FEES: PERMIT ate Notary as to Owner and/or Condo President Date My Commission Expires: OFFICIAL NOTARY SEAL ODALIS THOMAS ARY PUBLIC STATE OF FLORIDA COMMISSION NO. CC771993 MY COMMISSION EXP. AUG. 31;2002 • RADON Address (Zotoci,, C.C.F. 1 ' .3 NOTARY Master Permit # 9 V,2 s6 Phone 3&S 7,5 7-" (5'WeP SS# c 3 7 / "D 0°7 Competency # Ins. Co. Address Address r-- ignature of Contractor or Owner- Builde' Notary as to Contractor or Owner- Builder My Commission Expires: OFFICIAL NOTARY SEAL ODALIS THOMAS NOTARY PUBLIC STATE OF FLORIDA COMMISSION NO. CC771993 MY COMMISSION EXP. AUG. 31,2002 BOND z — / 7 17 Date Ct,e. cL — / 7 -� g Date TOTAL DUE 6 APPROVED: Zoning Building Electrical Mechanical Plumbing Engineering �.--- CLOSETS TATS TUBS SHOWERS LAVA. TORIES SINKS SLOP SINKS LAUNDRY TUBE URINAL CATCH B BASIN IN FLOOR DRAIN DRINK! NO FO FOUNT' N6 TOTAL FIXTURE$ CONTR. LIAT CHECK SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SW IM'G POOL CONTR. LIST CHECK MIAMI SHORES VILLAGE Pestnit No. Date ill !_L 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. . a.....ceed 69 Owner's Name and Address Registered Architect and /or En ineer__ Employing Plumber's Name._ Location and Legal Description Lot_- __.._-__ Sir.e Septic Tank.. - -Z -- -_ -• -- Feet of Drain Tile :5 Nature of Water Supply: City —Well. Amount of Permit $ t PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT No. Street and Number where work is to be performed —No -Z. Street State work to be performe8 and purpose of building (By Floors) __ ___ New Building — .._.___ Remodeling ._ __.___ Addition Repairs No. of Stories. of Tank eet of Tank or Drain Field from Well __Size of Soakage Pit (Signed)_ Capacity Gals Street Street__ Subdivision l ( 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 bus 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) - - -/ T/6, — Master Plumber. STATE OF FLORIDA, } 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 necessary by improper notice for inspection, or faulty materials and /or worlananship.