PLUMBINGOwner/Lessee / Tenant
PERMIT APPLICATION POR SHORES VILLAGE
Date 5 6 Job Address � 9 7 S7 7 Tax Folio
/ c ` dcief i/ - CettM -P�(
Legal Description ! DT -.3 7 ,e5/ 7 7 Historically Designated: Yes No
Master Permit # 4g2.3
Owner's Address V* " 7-17 c- PO i)6 / 7 - 7 -e- 7
/ r--
Contracting Co. ��5 �/5 �6�,) l 4c/ Address
Qualifier J j ( c C�/ SS# 5-o 6 - C/ - �J Z ) - Phone?0 (
C` J 2 s 0 Competency eki iel�
State # PC O Municipal # pe cy # Ins. Co.
Pit f(.e71..A,
Address 39 6 "tut
Bonding Company Address
Mortgagor Address
PLUMBING ECHANICAL ROOFING PAVING FENCE SIGN
Architect/Engineer
Permit Type (circle o e): BUILDING FiLECTRICAL
WORK DESCRIPTION 7 5 /NJ`1> -1 l 'O e - 0 4)1E7
p 0 o � 6� 14 C/ )
Square Ft. Estimated Cost (value) 15/9 /6/ 000
WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO
RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTEND TO OBTAIN
CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCE
Application is hereby made to obtain a permit to do work and installation as indicated above, and on the attached addendum (
certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I un '
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 all •5-k gone in compliance
laws regulating construction and zoning. Furthermore, I authorize the above -nam : contrac .r to o e • k stated.
a
iLaA•A"
'� of •wn- 5*
JL
fi t:o e5- an . Cond p ent D • to
My omm ission ExETH State �` Florida
Notary Public,
My comm. exp. May 24, 2003
r oot q Comm. No. CC8197
Q,Piity
FEES: PERMIT Q ✓
RADON
APPROVED: 6/7/0Z) Zoning / Building
Mechanical Plumbing
Phone 3t:),1 75 `7.,5'
t73
/f 0 0 J / S s! / N'- 1 f /� 33/2-
actor or Owner - Builde
My Commissio Expires:
KENNET SHE
Notary Public, State of Florida
My comm. exp. May 24, 2003
Conan. No. CC:1172Z
C.C.F. to za NOTARY 0 — BOND 3o&
Electrical
Engineering
4 G/ 2 /°"
OSOMAY
ANCING,
NT.)
applicable). I
that separate
wrtl} all applicable
authorize
Z,O
TOTAL DUE
NOTICE OF COMMENCEMENT
o R ECORDED COPY MUST BE POSTED ON THE -JOB SITE AT TIME OF FIRST INSPECTION
• `. - .
PERMIT NO. TAX FOLIO NO.
r
STATE OF FLORIDA:
COUNTY OF DADE: 00R227908 20017 NAY 11 12 :34
THE UNDERSIGNED hereby gives notice that improvements will be made to certain real property, and in accordance with
Chapter 713, Florida Statutes, the following informations provided in this Notice of Commencement.
1. Legal description of property and street address: / 6 0 /� _�, 97 ,7 v6/frw g /A9,e.
2. Description of improvement: /Oat, he.4. c. n .... �7Z84J
3. Owner(s) name and address:
Interest in property:
Name and address of fee simple titleholder:
My Commission Expires.
e Sr
owner
Print Owners N
Sworn to and sub , crib =d bete; e this day of
11160 E 9e tasL I / M S IJLe1
OM-
4. Contractor's name and address: Mc / - 5 f o 0 /A
/ O lo6 1 <l 37 ,c) , rn ./ f ./-6
5. Surety:(Payment bond required by owner from contractor, if any)
Name and address: !�
Amount of bond $
6. Lender's name and address: ) fPQ
7. Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as provided
by Section 713.13(1)(a)7., Florida Statutes,
Name and address:
8. In addition to himself, Owner designates the following person(s) to receive a copy of the Lienor's Notice as provided in
Section 713.13(1)(b), Florida Statutes..
Name and address:
9. Expiration date of this Notice of Commencement: (the expira
different date is specified)
Notary Publi
Print Notary V e
to is 1 year from the date of recording unless a
vJ
Notary Public, State of Florida Address:
My comm. exp. May 24, 2003
STATE OF FLORIDA, COUNTY OF DADE
., otthe
I HEREBY CERTIFY that Ms 1s a true c ' y day of
0nglnal feed on this office o^ n r /r0 O f
Courts
HARVEY R D.C.
By
g?A.0
te m k E gr
Prepared by: 0 ) -P 334)z-
12101.52 7193
Apr 26 00 04:42p Sid Reese
N. E.
JL
cD
0
N.E.
By:
97 th
96
LOCATION MAP.
SCALE i "= loo'
SKETCH OF SURVEY
. ALBERT R. TOUSSAINT
;REGISTERED LAND SURVEYOR NO. 907
STATE OF F LORIDA
305 757 4301 p.3
S T.
0
ST-
SURVEY of Lots 3 and 4, Block 77of Miami Shores, Section No. 3,
according to the Plat thereof recorded in Plat Book 10 at Page
37 of the Public Records of Dade County,Florida, being situated
in the Village of Miami Shores,Florida,
Order No. 11659 Date: June 18,1997
F.B. 453 Page 2 Scale: As Shown
WE HEREBY CERTIFY: that this Survey complies with the Minimum
Technical Standards for Land Surveying in the State of Florida,
Chapter 472 of the Florida Statutes.
A. R. TOUSSAINT & ASSOCIATES,INC.
LAND SURVEYORS
620 N.E. 126th Street, North Miami,Florida 33161
10.23 Denotes Elevation, All Elevations shown hereon refer to
M =r4 nn,,1 _c l nnn
w
Apr 26 00 04:43p
&1
FD. I -P
3' C.BS.
WALL
FD. l.P.
as
(1
SKETCH OF SURVEY
1
H
2
0.
E / P - -•
Sid Reese
SCALE
ae
305 757 4301
11.76'
12.14
: CONC :.: SWI(. •
OVERHANG
COVERED PATIO.
97 ST.
ALLEY
E/
GRASS AREA
X - L
0/H WIRES.
0
0
FD. I.P.
0.1' CL,
7
act.
4
WO
FD. I.P.
p. 4
CONTRACTOR
f/
Name IdU b S q
License No.S n „/)1'
r(� `-'� �
Business Telephone
Address
[Ox kc, co5T, AI 114.g
33 tf 1
Telephone 558 5 g Fax Q 3
�
0 a70
lJ
Qualifier Name 13Q b Pqg)
PROPERTY OWNER
Name ‘ j) A Jury J T
G
Address
qGo lue q 7 Srr1119401
Home Telephone /j /
Business Telephone
Fax
TYPE OF MANAGEMENT (✓ )
New Construction
Enclosure
Alteration Exterior
Repair
Alteration Interior
Demolish
Relocation of Structure
Shell Only
Foundation Only
Add'I Attachment
Other
Add'l Detachment
Other
INSTRUCTIONS - The following steps must be taken to obtain a permit from the Miami Shores Village:
Step 1.
Complete the attached permit application which must be si ng ed by the property owner and qualifier. Both signatures must be notarized. Please
print or type to allow for a more accurate processing of your application. If roofing work will be done, a roofing application must be submit-
ted along with this permit application.
Step 2. Submit the completed application with all necessary documents to the Building, Planning and Zoning Department for processing. During the
processing of your application, you may be asked to submit additional information.
APPLICATION
41
Job Address:
Address
Folio Number/ 0 14/ J! b 0
Lot 3 Block 77
SubdivisionM 5h cea, 3PB PG
Current Use of Property
Proposed Use of Property
Tenant Information
PERMIT TYPE (✓ )
Building
Electrical
Mechanical
Plumbing
LPGX
Roofing
Fence
Other
Chg. Contractor
Renewal
Revision
Extension
Supplement
Reinspection
ARCHITECT
Name
License No.
Address
Telephone
Fax
Description of Work
Zoning Rez
Square Feet
Value of Work
Subsidiary Permit No.
Master Permit No.
►' , 'AAjcs - : 7 531
City State
4°0 r 7 ? - 1,i7 E)
Linear Feet
Units Floors /
Bldg Value
PERMIT APPLICATION
Zip
Tax Assessed/Appraised Value
Flood Zone Base Floor Elev.
PERMIT CHANGE (✓ )
ENGINEER
Name
License No.
Address
Telephone
Fax
Page 2
PERMIT APPLICATION
INIPORTANT NOTICES
1. DO NOT BEGIN ANY WORK WITHOUT HAVING RECEIVED YOUR VALIDATED PERMIT AND PERMIT CARD. Applying for a permit does not grant
the right to begin construction. HOURS OF CONSTRUCTION are limited to: Monday through Friday from 7:30 a.m. to 6:00 p.m., and Saturday from 8:00 a.m.
to 5:00 p.m. No inspections will be conducted on weekends or holidays.
2. All construction of demolition areas MUST BE MAINTAINED IN A CLEAN, NEAT AND SANITARY CONDITION free from construction debris.
3. STREETS AND NEIGHBORING PROPERTIES SHALL BE KEPT FREE FROM DIRT AND DEBRIS.
4. SWALES MUST BE PROTECTED FROM BEING DAMAGED BY EQUIPMENT OR VEHICLES, AND MAY NOT BE USED FOR STORAGE. A bond is
required for work in or near the street/sidewalk.
5. CONSTRUCTION TRAILERS ARE PROHIBITED ON SINGLE FAMILY RESIDENTIAL CONSTRUCTION SITES. Other construction may have a trailer
which requires a separate permit.
6. PORTABLE TOILETS for a construction site require a separate permit.
7. DO NOT DISCHARGE WATER INTO THE RIGHT OF WAY OR STORM DRAINS without approval from the Building, Planning and Zoning Department.
8. EQUIPMENT AND MATERIALS SHALL BE STORED at least 10 feet from the edge of pavement.
9. Department of Health and Rehabilitative Services (HRS) approval is required for applications involving septic tanks. Department of Environmental Resources
Management (DERM) and/or Miami -Dade Water and Sewer Department (MDWASD) approval is required for applications involving sewers.
AFFIDAVIT - Please read carefully.
Application is hereby made to obtain a permit to do work and installation as indicated. I, the OWNER of the property; certify that all
work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits
are required for ELECTRICAL, PLUMBING, POOL, EXTERIOR DOOR, MECHANICAL, WINDOW, FENCE, DRIVEWAY,
ROOFING and SIGNS and there may be additional permits required from other governmental agencies.
I, the OWNER of the property, have disclosed all information related to any work at the property performed in the prior twelve
months to the Building Official. Further, I am fully aware that if the cumulative cost of work to my home or business under this and
any other permit equals or exceeds fifty percent (50 %) of the fair market value of the structure, the entire structure must meet the
present federal flood criteria for finished floor elevation. I am also fully aware that if the total cost of work to my home or business
under this and any other permit exceeds fifty percent (50 %) of the replacement cost of the structure, then the entire structure must
conform to the current code requirements of the Building Code.
WARNING TO OWNER: Your failure to record a NOTICE OF COMMENCEMENT may result in you paying twice for
improvements to your property. If you are spending more than $2,500 or intend to obtain financing, you may wish to consult with
your attorney or lender before recording your Notice of Commencement. The Notice of Commencement must be recorded at:
22 N.W. 1st Street, 1' Floor, (305) 679 -1078. Once recorded, the Notice of Commencement must be POSTED AT THE JOB SITE in
accordance with Section 713 -35 of Florida Statutes. Review the brochure at Village Hall on Construction Lien Law and
Choosing a Contractor.
STATE-OF FLORIDA COUNTY OF MIAMI -DADE STATE OF FL • ' ' A, COU ►_ Y MIAMI -DADE
Signatur
` Pig1A- - C! .
Print Name Print Name
w • . and subscribed before me this / y day off Sworn to and subscribed before me this) t i day of O4p ,
•
411P 0
Ir
: gnature of :
SEAL:
S . to of orida
r Putt, Angela M Becker
f
- My Commission DD150048
4 vdi° Expires November 15, 2006
Personally known OR, Produced Identification
Type of Identification Produced:
SEAL:
?oh err r
mgnature o otary '. c = §icfl teR onda DD150048
Y ;` 9p '-:'•'.- 48Vember 15, 2008
Personally known / /OR, Produced Identification
Type of Identification Produced:
ELECTRICAL
TYPE
Minimum Fee
QTY.
TVPI?
Dryer
()Ty.
TY'PI'.
Outlet, Appliance
Q7'1'.
TYPE
Service Repair
QTY.
A/C Central 1 -3 Ton
Fan
Outlet, Wall
Service, Temporary
A/C Central 4 -7 Ton
Fire Pump
Outlet, Switch
Signs
A/C Central 8 -15 Ton
Fixture - Fluorescent
Oven
Space Heater (kw)
A/C Central 16-20 Ton
Fixture Light
Parking Lot Lights
Spas/Hot Tubs
A/C Central 20+ Ton
Flood Lights
Plugmold/Strip
Subfeeds, No. of Amps
A/C Window
FPL - Load Central
Posts
Swim Pool, Commercial
Air Conditioners
Garbage Disposal
Range/Range Top
Swim Pool, Residential
Chiller
Generators, etc.
Receptacles
Switchboards
Clear Violations
Heat Recovery
Refrigerator, Comm. (p/PH)
Temp Serv., Construction
Compactor
Low -volt, Burglar
Refrigerator, Domestic
Temp for Test - 30 days
Deep Freezer
Low -volt, Fire
Renew - Temp Service
Water Closet
Demolition
Low -volt, Intercom/Teleph.
Repair Circuits
Water Heater
Dishwasher
/
Low -volt, Television
Service, Number of Amps
Water Heater New
MECHANICAL
T\'PI:
Minimum Fee
QTY.
'T'YPE
Condensate Drain
()Ty.
i'1'PL
Generator
Q'I'y.
TYPE:
Refrigeration, Tons
QTY.
A/C Central, Tons
Cooling Tower
Heating Strips, each
Vent Hood, Cost
A/C Wall/Win. Tons
Dryer Vents, Number of
Paint Booth
Ventilation, Cost
Air Handler, Tons
Ductwork, Cost of
Piping, Flammable Liquid
Periodic Inspections
Barbecue
Fire Sprinkler System
Process/Pressure Piping
Supply, AC Well
Bath Fan - Vented, #
Fireplaces, Number of
Pressure Vessel
_
PLUMBING
1-)TG
A/C Condensate
QTY.
TYPE.
Drains, Roof
QTY.
TYPE
Miscellaneous Fixture
QTY.
'I'}'PE
Soakage Pit
QTY.
Bath Tub
Drinking Fountain
Miscellaneous Repairs
Solar Water Heater
Bidet
Filter Replace
Pool Piping
Sprinkler Repair
Cap - Fixture
Fountain
Pump and Abandon
Sprinlder System
Cap - Water
Gas - Appliance
Pump, Domestic
Supply, AC Well
Cap - Sewer
Gas - Natural
Pump, Fire Stand
Temporary Toilet
Catch Basin
Gas - Propane
Pump, Re- circulate
Temporary Water Closet
Clothes Washer
Gas Piping
Pump, Replace - Pool
Urinal
Dental Chair
Grease Trap
Pump, Sprinkler
Utility - Sewer
Discharge Well
Ice Maker
Pump, Sump
Utility - Water
Dishwasher
Indirect Wastes
Relay Repair
Vacuum Pump
Disposal
Interceptor
Roof Inlet
Water Closet
Domestic Well
Laundry Tray
Septic Connection
Water Heater
Drainfield, 4" Tile/Res.
/
Lavatory
Septic Tank
Water Heater New
Drains, Area
Meter Set (Gas)
Sewer Connection
Water Re -pipe
Drains, Floor
Minimum Fee
Shower
Water Service
Drains, French
Miscellaneous Equipment
Sink
Well, Supply
Page 3
1 / 4 1Pli `s
PERMIT APPLICATION
INSTRUCTIONS: Please indicate the type of work being performed and quantity(ies) in the space provided below.
RECEIVED AND REVIEWED BY: DATE:
SECTION
BY
DATE
Zoning
Electrical
Mechanical
Plumbing
I
D? ? V 613
`
Fire
t
Public Works
Structural
Building Official
Page 4
OFFICE USE ONLY
CHECKLIST
O OWNER - BUILDER FORM
(Attach)
❑ FIRE DEPARTMENT
APPROVAL (Commercial /
multi - family)
❑ CONCURRENCY
(New Construction)
❑ OTHER
(Specify & Attach)
❑ PROOF OF OWNERSHIP
(Attach)
❑ HRS / DERM APPROVAL
(Septic / Sewer)
❑ IMPACT FEE
(New Construction)
❑ OTHER
(Specify & Attach)
PERNIIT FEES
$3.00 per page (Scanning Fee)
Miami Shores Village
Bond
Metropolitan Dade County (C.C.F.)
Inspector State Educational Fund $
State DCA (Radon) $
Code Enforcement Fine
Zoning Review
Notary
$ 2 O,
300 1
$ l
$
, CO
( x . '1000
(¢.005 /sq.ft.)
(¢.01 /sq.ft.)
PERMIT APPLICATION
❑ CONDO ASSOCIATION APPROVAL
(Attach)
❑ BPR APPROVAL (Restaurants)
❑ CONTRACTOR REGISTRATION
(On File)
TOTAL . y0
ISSUING OFFICIAL
REVIEWED AND PREPARED BY: DATE:
CONDITION OF APPROVAL
Revised July 2001
10050 N.E. 2ND AVE., MIAMI SHORES, FL • (305) 795 -2207 • FAX (305) 756 -8972 • http : / /www.miamishoresvillage.com
C
J B AG::,.c
Fees:
FEE2003 -1098
FEE2003 -1099
FEE2003 -1100
FEE2003 -1101
P b r p l ermit Status:
TOME
' ORDER OF
FOR
960
„ Contractor
(Q Local Phone:
co,
Parcel # 1132060143160
1) r Vork: 400 SQUARE FEET nPitor' -
Po If tti,._ •
Nc 97
APPROVED Permit Expiration: 8 /1Q0" "^
RAIN, INC.
BOB'S SEPTIC & 305-55
20 4RTH MIAMI Ft. 33161 -4211
• /v1
•
c tibank
27610 vt,ft FL3 B OtEVARD
pV ENTUR A, •
,
000 5 51,811 ''• 26 8 6 0 -w
Legal Description:
Description
Building Fee
Buildier's Bond
CCF
Notary Fee
Total Fees:
(Contractor or Builder)
ST
Contractor's Address:
LD 270
i -1
MIAMI SHORES SEC 3 PB 10 -37 LOTS 3 & 4
opTE
Amount
$80.00
$300.00
$1.80
$5.00
$386.80
BY:
Total Fees: $386.80
Total Receipts: $0.00
Re- inspection
111 -- — • ///
BLK 77 LOT SIZE 100.000 X
cation herefor in strict compliance with all
fications that may have been submitted to
or if the plans are changed without
onsibility for a thorough knowledge of the
iat he assumes responsibility for work done
Dertaining thereto and in strict conformity
• . bnlsibility for all work done by either
CONSTRUCTICN PERMIT FOR:
[ ]New System ( ]Existing Sysren
X )Repair [ jAbandonment
LOT: 3 BLOCK: 77
PROPERTY ID ##: 11- 3206 -011 - 3160
SYSTEM DESIGN AND SPECIFICATIONS
T [
N [
• [
D
R
A.
I
N
02/14/2003 16:30 3055133472
OSTDS
STATE. OF FLORIDA
• DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND'DISPOSAL SYSTEM
CONSTRUCTION PERMIT
AFpLI AN'T: Re pe Sidn AGENT: SR0921116, PARILLA ROBERT
PROPERTY STREET ADDRESS: 960 NE 97 St Miami Shores FL 33135
SUBDIVISION: Miami Shores Sea 3
[Section /Townstip /Range /Parcel No.]
[OR TAX I0 NUMBER]
SYSTEM MUST BE CONSTRUCTED IN ACCORDANCE WITS SPECIFICATIONS AND STANDARDS OF CHAPTER 64E -6,FAC
DEPARTMENT APPROVAL OF SYSTEM DOES NOT GUARANTEE SATISFACTORY PERFORMANCE FOR ANY SPECIFIC TIME
PERIOD. ANY CHANGE IN MATERIAL FACTS WHICH SERVED AS A BASIS FOR ISSUANCE OF THIS PERMIT,
REQUIRE THE APPLICANT TO MODIFY THE PERMIT APPLICATION. SUCH MODIFICATIONS MAY RESULT IN THIS
PERMIT BEING MADE NULL AND VOID. ISSUANCE OF THIS PERMIT DOES NOT EXEMPT THE APPLICANT FROM
COMPLIANCE WIT11 OTHER FEDERAL, STATE OR LOCAL PERMITTING REQUIRED FOR PROPERTY DEVELOPMENT.
900 ] Gallons SEPTIC TANK
0 ]Gallons
0 ]GALLONS GREASE INTERC.EPTOF. CAPACITY
0 ]GALLONS DOSING TANK CAPACITY [ 0 ]GALLONS
[ 300 ]SQUARE FEET
( 0 ]SQUARE FEET
TYPE SYSTEM.: [
CONFIGURATION: [
PRIMARY DRAINFIELD
N ]STANDARD
N ]TRENCH
[ ]Belding Tank [ ] Innovative Other
( ]Temporary [ NA ]
SYSTEM
SYSTEM
( N ]FILLED
[ N ]BED
IOC ATION TO BENCHMARK : Fitziahed leor of Exi
0 1-7.141, REQUIRED: r 0.0 ]INCHES EXCAVATION P
OTHER REMARKS:
Existing 900 Gallons Septic Tank To Remain.
Install 300 Square feet draiEfield
Invert elevation of the drain£ield to be NIT 8.1
Bottom elevation of the d ainfield to be NLT 7.6'
THIS PERMIT IS NOT FOR .ADDITION.
CENTRAX #: 13-SG-15550 DATE PAID:
FEE PAID : $
RECEIPT
OSTOSNBR : 03-0466- -R
MU TI- CHAMBERED /IN SERIES: [X
MULTI - CHAMBERED /IN SERIES: 1Y
@ [ 0 ] DOSES PER 24 HRS # PUMPS( 0 1
[ N ]MOUND
[
N )
PAGE 01
in
,EQU!REO: [300.0 ] INCHES
NGVD
NGVD • IS NOT ADD ✓ '
'riITS PRAT L .RTION �b .✓� V (1
MINTEKT B YTTO�I[ Of L�
]
1
SPECIFICATIONS BY: Andr6, Paul , TITLE: V V
APPROVED BY: Andre Paul
TITLE; Profeasi Engirt Dade CHD
THE SEPTIC TAN . SHALL SE PUMPED AND 4 p TION DATE: 5115103
DATE ISSUED: 2/14/03 TpO DEVICE INSTALLED ON T
ve 4016, 03/9 <hbsol0tes previous editions which ray not be used)
4. r o 1 -. 7
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 Divisior
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at
building during progress of work.
Owner's Name and Address
Registered Architect and /or Engineer
Employing Plumber's Name
Location and Legal Description Lot_ - Block_ - _ __._- _--- - - - - -- ---- __ -_ -- Subdixision .....
___ - -___
Street and Number where work is to be performed -No.
State work to be performed and purpose of building (By Floors
New Building Remodeling
Size Septic Tank Type of Tank_
Feet of Drain Tile ____Dist. Feet of Tank or Drain Field from We
Nature of Water Supply: City -Well — Size of Soaka
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Amount of Permit $ AMEMIRISmon ( Signed)
The undersigned applicant for this building permit does hereby certify that he un , erstan s and accepts his obligations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled Generpl La s of Florida Permanent Supplement, and has com-
plied with the provisions thereof, and will require similar compliance from all contract rs o 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 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.
STATE OF FLORIDA, 1
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeare
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the
of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all fac
therein by him stated are true.
- -------------------------------------- - - - - --
My Commission Expires Notary Public, State of Florida
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faul
materials and /or workmanship.
No
No
/7J
Date _
7J -
Date__
/ J "d
Street___ ) 7 -•
Street____ of �l
(Signed) -- -!�
Capacity Gals.
Plumbing Inspector.
Master Plumber.
CLOSETS
BATH
TUBS
SHOWERS
LAVA-
TORIES
SINKS
SLOP
SINKS
LAUNDRY
Tune
U RINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT'NS
TOTAL
FIXTURE!
CONTR.
LIST
- --
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
EL !
1
SPRKLR.
SYSTEM
7-
SWIM'G
POOL
Caine.
LIST
CHECK
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 Divisior
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at
building during progress of work.
Owner's Name and Address
Registered Architect and /or Engineer
Employing Plumber's Name
Location and Legal Description Lot_ - Block_ - _ __._- _--- - - - - -- ---- __ -_ -- Subdixision .....
___ - -___
Street and Number where work is to be performed -No.
State work to be performed and purpose of building (By Floors
New Building Remodeling
Size Septic Tank Type of Tank_
Feet of Drain Tile ____Dist. Feet of Tank or Drain Field from We
Nature of Water Supply: City -Well — Size of Soaka
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Amount of Permit $ AMEMIRISmon ( Signed)
The undersigned applicant for this building permit does hereby certify that he un , erstan s and accepts his obligations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled Generpl La s of Florida Permanent Supplement, and has com-
plied with the provisions thereof, and will require similar compliance from all contract rs o 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 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.
STATE OF FLORIDA, 1
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeare
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the
of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all fac
therein by him stated are true.
- -------------------------------------- - - - - --
My Commission Expires Notary Public, State of Florida
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faul
materials and /or workmanship.
No
No
/7J
Date _
7J -
Date__
/ J "d
Street___ ) 7 -•
Street____ of �l
(Signed) -- -!�
Capacity Gals.
Plumbing Inspector.
Master Plumber.
BUILDING
ELECTRICAL
PLUMBING
Owner of
Building
Architect
Contractor
or Builder
Legal
Description
Address of
Building
In consideration of the issuance to
pertaining thereto and in strict conformity
In accepting this permit I assume responsib
CTOR 0 BUIL
MIAMI
SHORES VILLAGE, FLORIDA
❑ PERMIT N? 13053
on the plans or dt
Signed:
i r to install the equipment or device descrfb
that the work will be performed !s complf
oper municipal authorities. his wit ma
out authorization. A further condition u
ility for a rough knowledge of the or
ents o ications and th at,
e of this permit I agree to rform the work covered hereunder in com
ith the plans, drawings, s ments or specifications submitted to
fty for all work done b either, myself, my agent, servant or e yee.
in lication
ce wi th , s,
be revoked at
which t • • ermit is
ces ations
• • or work
ces and
Miami Shor
ROOFING ❑ Work to be performed under this Permit
t r". 4.1 11116
This permit granted to the contractor or buf er n ed •ove to con
herefor in strict c• pliance with all ordinances pe ing ere • and with
drawings, statements or specifications that may have been submitted to and
time if the work is not done in compliance with such ordinances or if the •la
granted is the understanding that the contractor or b
pertaining to the work covered hereby whether s
done by his agents, servants or employees.
BY
DAT
Contra o
License No,
ns
e.
BUILDING
ELECTRICAL
PLUMBING
ROOFING
Owner of
Building
Architect
Contractor
or Builder
Legal
Description
Address of
Buildin g
Lot
MIAMI
E] PERMI 1v° 11483
El Work to be performed under this Permit
n
, y
This permit, s ranted to the contractor or bur er named above to construct the building or to install the equipment or devises described in the application
herefor in strict asap liance with all ordinances perta fag thereto and with the understanding that the work will be performs In compliance with any plans,
drawings, statements or specifications that may have b en submitted to and approved by the proper municipal authorities. Thh Parade 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 u n which this permit is
granted is the understanding that the contractor or b !der named above assumes the responsibility for a thorough knowledge of *R aces and regulatio
pertaining to the work covered hereby whether shown on the plans or drawings or ' statements or speci ations and that' `bilicy or work
done by his agents, servants or employees.
Bl.
SHORES VILLAGE, FLORIDA
DATF.
Subdi-
vision
Value of
Project $
In consideration of the issuance to me of this jpermit I agree to perform the wor
pertaining thereto and in strict conformity with the a drawings, statements or specifications s
In accepting this permit I assume responsibility for . ; u otk done by either, myself, my agent,
BY
Contractor's
License No
II Amt. of
Mott
9
Signed: BY
IN
hereunder in compliance with tiff ordinances and regulations
fitted to the proper authorities of Miami Shores Village.
t or employee.
f
BUUIDING
ELECTRICAL
PLUMBING
ROOFING E
Owner of ,./
Building
'
Architect /
Contractor
or Builder
1)
CONTRACTOR OR BUILDER
MIAMI SHORES VILLAGE, FLORIDA
DATF
PERMIT INTt 11584
Contractor's
License No
Work to be performed under this Permit
4,,
4-
If gi +
Signed:
In consideration of the issuance to me of this permit I agree to perform the
pertaining thereto and in strict conformity with the plans, drawings, statements or sp
In accepting this permit I assume responsibility for all work done by either, myself,
Subdi-
vision
Legal Lot
Description.
Address of
Building
This permit is granted to the contractor or builtler named above to construct the building or to install the equitmtiit.or vM described in the application
herefor in strict compliance with all ordinances pertaining thereto and With the understanding that the work will be perford fit cempliance with any plans,
drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Peak 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 oandftut upon which this permit is
granted is the understanding that the contractor or builder named above assumes the respons lity for a thorough knowledge of AO ordinances and regulations
pertaining to the work covered hereby whether shown on the plans or drawings or in the sta ents or specifications and that im IIIIRIntes responsibility for work
done by his agents, servants or employees.
dr-1 Value of AmI.
Project $ 11 Amt. of
"
Permft $
r
;
BY
• .j • • •
. •
ered hereunder in complian
ations submitted to the proper
agent, servant or employee.
1954_
CLOSETS
BATH
TUBS
SHOWERS
LAVA -
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TUBS
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT'NS
TOTAL
FIXTURES
CONTR.
IST
LIST
/
/
+�
CHECK _J 1(
� , j
•-
7 � q
,, •
l % .
1-4
I�
P71
/ . 7,1
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT I
GREASE
TRAP
HEATER
J
/ � V
DEEP
WELL
SPRKLR.
SYSTEM
SWIM'G
POOL
-fit
4
CONTR.
LIST
/
CHECK
I 0 0
Permit No. _ // 2
Application is hereby made for the approvals 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 t ith, whether herein specified or not. A copy of approved plans and specifications must be kept at
building during progress of work.
Owner's Name and Address
Registered Architect and /or E
Employing Plumber's Name
Location and Legal Description Lot_
STATE OF FLORIDA, t
COUNTY OF DADE.
Ss.
APPLICATION FOR PLUMBING PERMIT
Amount of Permit $
My Commission Expires
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
(Signed)
(Signed)
I
Block
Date
Repairs
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
Subdivision_
Street 9 7
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
No. of Stories
Notary Public, State of Florida
! r
Master Plumber.
---- ______ _____ _________
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 underknea ajrees to employ only such sub - contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village. . , 0 ,l C
/
4 5- 0
6a
Before me, the undersigne 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. //V -
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 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 (L t ./z___
Registered Architect and /or di r r
Employing Plumber's Name JE!`�L- A - ► jt_ No _ sI .) _ Street__ _
Location and Legal Description Lot__ -_ 1't_ _______ . ______ Block ' - Subdivision _
Street and Number where work is to be performed —No _a __ iC____ _7 Street
Amount of Permit $
STATE OF FLORIDA,
COUNTY OF DADE.
ss.
materials and /or workmanship.
My Commission Expires
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
(Signed)
No
f
Date
Street
State work to be performed and purpose of building (By Floors) ' •
New Building_ ✓ Remodeling Addition _ Repairs No. of Stories 1
Size Septic Tank_____3—X --]/ Type of Tank
Feet of Drain Tile J_K- - Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: Well Size of Soakage Pit
Capacity Gals
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 pe onned under this permit, as are
licensed by Miami Shores Village.
c
�
( Signed )_L_ /_� ° a.
Master Plumber.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally 7
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
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 inspel
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 SOAKAGE
FIELD PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SW IM'G
POOL
CONTR.
LIST
CHECK
✓
/
•�
Permit No. //V -
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 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 (L t ./z___
Registered Architect and /or di r r
Employing Plumber's Name JE!`�L- A - ► jt_ No _ sI .) _ Street__ _
Location and Legal Description Lot__ -_ 1't_ _______ . ______ Block ' - Subdivision _
Street and Number where work is to be performed —No _a __ iC____ _7 Street
Amount of Permit $
STATE OF FLORIDA,
COUNTY OF DADE.
ss.
materials and /or workmanship.
My Commission Expires
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
(Signed)
No
f
Date
Street
State work to be performed and purpose of building (By Floors) ' •
New Building_ ✓ Remodeling Addition _ Repairs No. of Stories 1
Size Septic Tank_____3—X --]/ Type of Tank
Feet of Drain Tile J_K- - Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: Well Size of Soakage Pit
Capacity Gals
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 pe onned under this permit, as are
licensed by Miami Shores Village.
c
�
( Signed )_L_ /_� ° a.
Master Plumber.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally 7
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
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 inspel
Permit No. __II 7
Registered Architect and /or Engineer__
Employing Plumber's Name_ _/ C
Nature of Water Supply: City —Well
Amount of Permit $_
SS.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
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. Thus 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 n 5.' — ,/cJ'
Owner's Name and Address 4 ,� �4 /Y • N o 6 S treet___ / -, 9 r •
!?�1f1° Q 1ITZ No Street
Location and Legal Description Lot_ __ Block Subdivision __.....
Street and Number where work is to be performed —No SE1 _ Stzeet__
State work to be performed and purpose of building (By Floors
New Building Remodeling Addition
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
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 to be performed this permit, as e
licensed by Miami Shores Village.
(Signe
D at c. .l _ 1_.K a9 9 �O
Repairs No. of Stories
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.
My Commission Expires Notary Public, State of Florida
Plumbin nspector.
Master Plumber.
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
TU55
SHOWERS
LAVA•
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TUBS
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT'NS
RR
azup
/ !/
f2
/
TOTAL
FIXTURES
--
CONTR.
LIST
f
1 16
/
7
CHECK
/
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PITT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SWIM 'G
POOL
CONTR.
LIST
CHECK
P el
Permit No. __II 7
Registered Architect and /or Engineer__
Employing Plumber's Name_ _/ C
Nature of Water Supply: City —Well
Amount of Permit $_
SS.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
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. Thus 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 n 5.' — ,/cJ'
Owner's Name and Address 4 ,� �4 /Y • N o 6 S treet___ / -, 9 r •
!?�1f1° Q 1ITZ No Street
Location and Legal Description Lot_ __ Block Subdivision __.....
Street and Number where work is to be performed —No SE1 _ Stzeet__
State work to be performed and purpose of building (By Floors
New Building Remodeling Addition
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
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 to be performed this permit, as e
licensed by Miami Shores Village.
(Signe
D at c. .l _ 1_.K a9 9 �O
Repairs No. of Stories
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.
My Commission Expires Notary Public, State of Florida
Plumbin nspector.
Master Plumber.
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.
Date Time
�`fype Insp'nif
...or—Permit No.
Name
Address Q' / p 2 0
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
Building Inspection Request
Phone #
For Inspector: �7 � Name & Date
Approve � ❑
Correction ❑
Re- Insp'n Fee ❑