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916 NE 96 St (9)Date Legal Description / Tenant 0 6 S O ttC Owner's Address { ifs' N ti 4 L Phone ,� / - � PERMIT APPLICATION FOR MIAMI SHORES VILLAGE C a Job Address et 1 Kos" o 9 & S :t / Tax Folio Contracting Co. i / Qualifier J �.•�s yr-,7•A State # Architect/Engineer Bonding Company Mortgagor Square Ft. i OWNER'S AFF laws regulating c My Commission Expires: FEES: PERMIT der • s Municipal # No .'ras to Own - "r an or Condo President Date APPROVED: Zoning Building Mechanical Plumbing " / Address Address Address (// -0/4-3Ozo) Historically Designated: Yes No _ . IMF v Master Permit # q7 7 J7 - 68 6 ss# c 1 sIt — (' t 3 r 1 Competency # - I 4=>t..) q., Sa cy � Permit Type (circle one): BUILDING ELECTRICA LUMBING ECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION s V e (xi `m c. E-) 411, g (co- 5 S U cE) Estimated Cost (value) 41 -e-e-- , " r c' WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTENT) 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 req • ed for ELECTRICAL, PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK. AVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable nstruction and zoning. Furthermore, I authorize the above -named contractor to do the work stated. (ROTARY PUBLIC - STATE OF FLORIDA LUIS MONTERO COMMISSION Y CC711335 EXPIRES 112712002 �? \ A i a fore of Contract r Owner-Builder Signature Builder Ins. Co. Notary as to Contractor or Owner - Builder My Commission Expires: * *My commission CCTZ/s9s Expires Mach 24, 2002 C.C.F. 0 NOTARY Electrical 2_e/ ft) Date c)58‘ ate :BOND TOTAL DUE • 6. p Engineering I. LOCATE AND PROTECT ALL UTILITIES IN AREA OF CONS7RUCZTON. SUNSHINE /I -500-41Z-4770 2. RESTORE ALL AREAS ro PRIOR CONDITIONS J. ALL CONSTRUCTION /O FOLLOW JURISDICTIONAL GOVERMENT AND PCS STANDARDS. NE_ 96 ST -1 d. #96 LOT 10 BLK 76 J 0_ W / \ (U PROP 2' PREFAB RISER S P/L XIST " SP PROP OPEN CUT WORK AREA T /T, T /F, E/M TIE PROPOSED 1/2' PL GAS PIPE 916 NE 96 ST MIAMI SHORES ,/O ; 1225 AFE• 010170000102 ATLAS: M -13 L01 10 BM* 76 SHEET 1 OF 1 SCALE NTS DRAWN BY: C. H. NESBITT DAM: 05 -27 -98 N/ / 1. LOCATE AND PROTECT ALL UTILITIES IN AREA OF CONSTRUC77ON. SUNSHINE /1- 800 -432 -4770 2. RESIORE ALL AREAS 70 PRIOR CONONfONS. J. ALL CONSTRUCTION IV FOLLOW IURISO /C77ONAL GOVERMENT AND PCS STANDARDS \ N NE 96 ST #96 LOT 10 BLK 76 X S " SP PROP 2' PREFAB RISER 0 � S P/L PROP OPEN CUT WORK AREA T /T, T /F, E/M P HOPLas aas J d W PROPOSED 1/2' PL GAS PIPE 916 NE 96 ST MIAMI SHORES Jo ; 1225 AFE.• 010170000102 ATLAS: M -13 LOT: 10 BLK: 76 SHEET. 1 OF SCALE: NTS DRAWN BY: C. H. NESBITT DATE: 05 -27 -98 Permit No. __Q _____ APPLICATION FOR PLUMBING PERMIT Owner's Name and Address Registered Architect and /or Engineer MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT 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 al building during progress of work. Employing Plumber's Name ' re\c• C...�2•"' _— !�l =" vo Street 1 Location and Legal Description Lot____________ ____________________ __ Block_____ ____ , , Subdivision Street and Number where work is to be performed —No _1_LLL'_____ .. State work to be performed and purpose of building (By Floors) New Building Remodeling Addition Repairs No. of Stories Size Septic Tank Type of Tank_ _ Capacity Gals.__ Feet of Drain Tile Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: 9.ty } Well . l • O. _O ____Size of Soakage Pit Amount of Permit $ ,____ __ (Signed) _ _I 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 not' s as are required by the Act. The undersigned agrees to employ only such sub- contractors, on work to be perp'rrfed under this p , as are licensed by Miami Shores Village. `~ - (Si Date -i - 3 No Street Street Plumbing Inspector. aster plumber. STATE OF FLORIDA, COUNTY OF DADE. j 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. CLOSETS BATH TUBS SHOWERS LAVA. TORIES SINKS SLOP SINKS LAUNORY TUBS URINALS CATCH BASIN FLOOR DRAIN DRINKING FOI NT'NS TOTAL FI %TUREI - CONTR. LIST 1 I _ CHECK I . '1 .-- -.;sue i -,) 7 _ SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP GL.Mt HEATER ' DEEP WELL SPRKLR. SYSTEM SW IM 'G POOL CONTR. LIST CHECK 1 1 1 D0 s _ J 0 Permit No. __Q _____ APPLICATION FOR PLUMBING PERMIT Owner's Name and Address Registered Architect and /or Engineer MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT 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 al building during progress of work. Employing Plumber's Name ' re\c• C...�2•"' _— !�l =" vo Street 1 Location and Legal Description Lot____________ ____________________ __ Block_____ ____ , , Subdivision Street and Number where work is to be performed —No _1_LLL'_____ .. State work to be performed and purpose of building (By Floors) New Building Remodeling Addition Repairs No. of Stories Size Septic Tank Type of Tank_ _ Capacity Gals.__ Feet of Drain Tile Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: 9.ty } Well . l • O. _O ____Size of Soakage Pit Amount of Permit $ ,____ __ (Signed) _ _I 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 not' s as are required by the Act. The undersigned agrees to employ only such sub- contractors, on work to be perp'rrfed under this p , as are licensed by Miami Shores Village. `~ - (Si Date -i - 3 No Street Street Plumbing Inspector. aster plumber. STATE OF FLORIDA, COUNTY OF DADE. j 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. McCORMICK- BOYETT Plumbing Contractors 9443 W. RAILROAD (RENUART MILL BLDG.) MIAMI SHORES, FLORIDA PHONE 7 -4793 MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build- ing 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 the work. Date , 19 - Owner's Name and Address • No.______.- - Street � .__- .! Registered Architect and /or Engineer Name and address of licensed contractor ,. . • • • Location and legal description of lot to be built on: Lot Block Subdivision Street and Number where work is to be done ., _.: ___- ±._-;_t_— State work to be done and purpose of building (by floors) _____________ Remarks (Signed) and for no other purpose. New Building Remodeling Addition Repairs No. of Stories To be constructed of Kind of foundation Roo f Covering Estimated Total cost of improvements $ Amount of Permit $ Zone cubage required _Plan Cubage Distance to next nearest building Size of Building Lot Maximum live load to be borne by each floor I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may be sent to 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 complied with the provisions thereof, and will require similar compliance from all contractors or sub-cor tractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspe Lion on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such subcon actors, on work to be performed under this permit, as are licensed by Miami Shores Village. r. „ ' r% f�" °°` cam STATE OF FLORIDA, COUNTY OF DADE. ss. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap- peared 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. Permit No Date Read, Sworn to and Subscribed before me. Disapproved Date (Signed) Notary Public, State of Florid, Building Inspector My Commission Expires PLANNING BOARD DATE Chairman Member Member Member Member Member Council Approved Date Disapproved Date NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has been obtained from the Planning Board. A re- inspection fee of $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and /or workmanship. BUILDING ELECTRICAL PLUMBING ROOFING Owner of Building 1 1 �{ `t�•t+ 3 Architect Contractor or Builder •.ia'^"A' Legal Lot II Bl. Description Address of �+ f - Building �� l Ni A �'t,r • `'� r CONTRACTOR OR BUILDER MIAMI SHORES VILLAGE, FLORIDA ❑ PERMIT it 13722 ❑ Work to be performed under this Permit This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the applieadoe herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be perfxmed in compliance wilfr p drawings, statements or epeafications that may have been submitted to and approved by the proper mead authorities. This Permit may be at time if the work is not done in compliance with such ordinances or if the plans are changed without autho . A further condition uppon width ttiit *graft granted is the understanding that the contractor or builder named above assumes the responsibility for a R knowledge of the ordinanws im tMi pertaining to the work covered hereby whether shown on the plans or drawings or in tile , statements' tE at he assumes reap ilk wail! done by his agents, servants or employees. Signed: s�. Subdi- vision Value of Project $ 5 o BY DATE 1. &"C 3' 105__ Contructcx's Liosn.e I p to Amt. of d Permit $ By See ,i0.,tth. 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 plane, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by tither, myself, my agent, servant or employee. AUTHORITY BUILDING ❑ ELECTRICAL. ❑ PERMIT IV? 13409 PLUMBING ROOFING Owner of Building ) r � Architect Contractor or Builder Legal Description Address of Building Lot MIAMI SHORES VILLAGE. FLORIDA E Work to be performed under this Pursuit 1 BL Signed. Subdi- vision Value of Project $ torero 11 Amt of Permit 9 This permit is granted to the contractor or builder named above to construct the building or to install the uipment or device described, in herefor in strict compliance with all ordinance pertaining thereto Mold` with the understanding that the work will be performed in compliance drawings, statements or specifications that have been submitted ' to'and approved by the proper municipal authorities. This Permit may time if the work is not done in compliance with such ordinances or ,it he plans are changed without authorisation. A further condition u pps� wbi t granted is the understanding that the contractor or builder above assumes the responsibility for a thorough knowledge of the ordiaaaop pertaining to the work covered hereby whether shown on the p aanstatements �s or drawings o the or specifications and teat he assumes woel done by his agents, servants or employees. AAtu BY 1 DEIBOCTOR In consideration of the issuance to me of this permit I agree to perfo work covered hereunder in compliance: with all ordlnanc sod pertaining thereto in strict conformity the ns, drawings, statements or specifications •miffed to proper nutborities of Miami Shona In a • • pting 't I assume respon f . , r ' work by CONTRACTOR OR BUILDER BY AUTHORITY BUILDING ELECTRICAL PLUMBING ROOFING Owner of Building Architect Contractor or Builder_ ❑ PERMIT IT? 13395 ❑ Work to be performed under this Pannit Bl. Legal Lot Description. Address of Building I tt., ( 1 MIAMI SHORES VILLAGE,: FLORIDA Signed- Subdi- vision Value of Project $ BY I .Amt. of Permit $ DATE 1 ' ''"' 195— Contractor's Limns* No. This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device desafbed in the application herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with sxq plat, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be rsvelned at se time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which wit 1 granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and diet he assumes responsibility woxlt done by his agents, servants or employees. DRIPECIOR In consideration of the issuance to me of this permit I agree to perform ,d►e work cowered hereunder in compliance with all ordinances and es pertaining thereto and in strict conformity with the plans, drawings, statemer specifications submitted to the proper zuthorities of Miami Shores In accepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. , 6 // BY AUTHORITY Architect Contractor or Builder Legal Description. Address of Building CONTRACTOR OR BUILDER MIAMI SHORES VILLAGE.. FLORIDA BUILDING ❑ ELECTRICAL ❑ PERMIT IT ' T? 13649 PLUMBING L ` . ROOFING ❑ Work to be performed under this Permit Owner of I) Building J Lot I BI. Subdi- vision Value of Project $ BY DATE Amt. of Permit / 1 Contractor's Ucs s No $ � *^.'., This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the OpdgAioa herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be perfcemed in compliance with pimk drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be 'Irdy time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition uu}pwocn whisk tbM pe It granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordmaaeea " i t1rsY pertaining to the work covered hereby whether shown on the plans or drawings jr in the statements or specifications and that he assumes respossbakr done by Inc agents, servants or employees. In consideration of the issuance to me of this permit I agree to perform a, e work covered hereunder in compliance with all ordinances and rspdadons pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either, myself my agent, servant or employee. BUILDING ❑ ELECTRICAL ❑ PLUMBING ❑ ROOT I NG ❑ /t.r. ❑ Owner of Building <.•4 + r '4: Architect CONTRACTOR OR BUILDER MIAMI SHORES VILLAGE, FLORIDA DATE r ' . # PERMIT Contractor or Builder t Legal Lot Description ir a G Work to be performed under this Permit B1 N 9 7854 Contractor's License No. c 1 1 P • Subdi- vision Address of ,. Value of J Amount of ; Building ;'�'`<° Project $ n II Permit $ This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the applica- tion herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes respon- sibility for work done by his agents, servants or employees. Signed. 6 #._.w. 9_42+ INSPECTOR In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in com¢1>Eance with all ordinances cad regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In ao cepting this permit I assume responsibility for ell work done by either, myself, my agent, servant or employee. BY AUTHORITY U1OT Date PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Job Address 9/ �� 7 6 A4 ' Tax Folio Legal Description Lessee / Tenant i(' �Dt P 4 f7 1/ /. S G /l 9/t:, ) /V/ 9/ s7, (W z 'S _5/.77 _5 kz' oe ''Address Phone 7 (3 C Y‘, t' /� f�? /- a -Jo (4),S n, '(de(f Qualifier L /¢ /Z &4'/ J/' //::w SS4� ��` - Phone ,e4 6 -/ /,/ ff State # Municipal # Competency IPCO , 90 Architect /Engineer Address Bonding Company Address Owner's Address Contracting Co. Mortgagor Address Permit Type(circle one): BUILDING ELECTRICAL PfMBIN MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION ,r/.2_5 , 2 00 St,' i- T, ,D OWNER'S A be done i authorize Signatu Date: APPROVED: r, 0 Notary a •' Owner and /or Condo President My Commni = ion Expires: NOTARY PUBLIC, STATE OF FLORIDA. M cor:r.1 ?ss;oN RXPIrz S: April 16, 1995. bO;.DED Tan NOTARY PUaLIC UNDERWRITER$. ** * * * * * FEES: PERMIT "6 RADON Zoning Mechanical 2 Master Permit # 3440 Square Ft. Estimated Cost(value) / f D WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFO1RE 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 .re required for ELECTRICAL, PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK. FIDAVIT: I certify that all the foregoing information is accurate and that all work will comp k nce with all applicable laws regulating construction and zoning. Furthermore, I he above -named contractor to do the work stated. of owner and /or Condo President Signature of Cont =ctor or Owner- Builder Date: Notar -= to Contractor r Owner- Builder My Commission Expires: NOTARY PUBLIC, STATE OF FLORIDA. MY COMMISSION EXPIRES: April 16, 1995 BONDED TkIRU NOTARY PUBLIC UNDERWRITERS. * * * * * * * * ** C.C.F. ' NOTARY TOTAL DUE 5/ 14r° Fire Other Buildin: Electrical Plumbin_,_ t ^p ngineering ^• ^C� KE APPLICANT: BLOCK: SUBDIVISION: LOT: PROPERTY ID #: STATE OF FLORIDA DEPARTMENT OF HEALTH AND REHABILITATIVE SERVICES ONSITE SEWAGE DISPOSAL SYSTEM SITE EVALUATION AND SYSTEM SPECIFICATIONS PROPERTY SIZE CONFORMS TO SITE PLAN: [/ TOTAL ESTIMATED SEWAGE FLOW: AUTHORIZED SEWAGE FLOW: j UNOBSTRUCTED AREA AVAILABLE: SITE SUBJECT TO FREQUENT FLOODING: 10 YEAR FLOOD ELEVATION FOR SITE: SOIL PROFILE INFORMATION SITE 1 Munsell #JColor ,� USDA SOIL SERIES: Textur Depth Otto c)/ to to to to to to to to SITE EVALUATED BY: r / i( _ �,�' -H Form 4015, Mar 92 (Obsoletes previous editions which may not be used) ck Number: 5744 - 003 - 4015 -1) AGENT: PERMIT # 1 4 • [Section /Township /Range /Parcel. No. or Tax ID Number] TO BE COMPLETED BY ENGINEER, HEALTH UNIT EMPLOYEE, OR OTHER QUALIFIED PERSON. ENGINEER'S MUST PROVIDE REGISTRATION NUMBER AND SIGN AND SEAL EACH PAGE OF SUBMITTAL. COMPLETE ALL ITEMS. YES [ ] NO NET USABLE AREA AVAILABLE: ACRES GALLONS PER DAY [RESIDENCES -TABLE 1 / , HER -TABLE 2) GALLONS PER DAY [1500 GPD /ACRE OR 2500 G /ACRE] SQFT UNOBSTRUCTED AREA REQUIRED: BENCHMARK /REFERENCE POINT LOCATION: 4/7 C'1 %;( ) 4/ C '/' ELEVATION OF PROPOSED SYSTEM SITE IS , '" [INCHES /FTf[ABOVE/ I;LOWJ BENCHMARK/REFERENCE POINT THE MINIMUM SETBAC WHICH CAN BE MAINTAINED FROM THE PROPOSED SYSTEM TO THE FOLLOWING FEATURES: SURFACE WATER: d'ri FT DITCHES /SWALES: ///„ FT NORMALLY WET? [ ] YES NO WELLS: PUBLIC: 4 /l7' FT LIMITED USE: L•�'rj FT ORIVATE: FT NON - POTABLE: FT BUILDING FOUNDATIONS: FT PROPERTY LINES: '=; FT POTABLE WATER LINES: / FT YES [A NO FT`M$L /NGVD SITE ELEVATION: . .- FT MSL /NGVD 10 YEAR FLOODING? [ ) YES [,4 NO SOIL PROFILE INFORMATION SITE 2 Munsell # /Color Texture USDA SOIL SERIES: ! D ? SQFT r,' Depth ' to f� to to to to to to to to OBSERVED WATER TABLE: 7 ') INCHES [ABOVE / BELOW,} EXISTING GRADE. TYPE: PERCHED / APPARENT ESTIMATED WET SEASON WATER TABLE ELEVATION: ( INCHES [ ABOVE / B LOW) EXISTING GRADE. HIGH WATER TABLE VEGETATION: [ ] YES ] NO MOTTLING: [ ] YES L>4 NO - DEPTH: __ -- INCHES SOIL TEXTURE /LOADING RATE FOR SYSTEM SIZING: i',J, ` -Z' DEPTH OF EXCAVATION: < , INCHES DRAINFIELD CONFIGURATION: [ ] TRENCH [ aj BED [ ] OTHER (SPECIFY) REMARKS /ADDITIONAL CRITERIA: DATE: /�` f� Page 3 of 3 INSTRUCTIONS: ipaTIM FE' 0: Perrnii tracking cumber cmigneel by CU. APPLECANT: Property owner's full narn:,•. AGENT: Property owna's icgally : mprectmtctive. :I-07, 3LOGX, SULDNISION: Lot, block, and subdivision for EM. I?:10PERTY :DC 27 character number for 2:rope:v. (property apprairtr 0 or mcticovirlabip/r.r..se/przco: rurr_bc :?410?:ERTY E: Meek if property lac ct rite conams to (.,-..Lbrnittee, c! cvriIc - c.23 all pLIveri CaT,113 :,nt; pr,;:r„:,:c; :oaf, i4eCti wiftirt pub2c o:: ezr,:i2.C.vo of 1.7./st dry.1:17.3c 77;C:: cytirnat:46.1.1.:T•jfi; L01.7i.1[S.; 4:21•::c •••••• ••": •!. •1]; : • ; :77' • rc.hir:11' 7' eny ?L•I••••. - •:;:-• • ').00 11 :-;:• L.I g 1 • :1„ :orcl tho tiouth of 1.:cir. •::t(ce. 4 • appfo wet 111!:.0' : cc //:\::ON; (•::::4•:.• " ( 87, ;7;1 , .n.,:tur„ ,:vr..!t• ••••0 / 11-`1.11. SHG? to APPLICATION FOR: [ ` - New System [ ] Repair APPLICANT: :/.✓ AGENT: .- „ f MAILING ADDRESS: LOT: PROPERTY ID #: PROPERTY SIZE: PROPERTY STREET ADDRESS: DIRECTIONS TO PROPERTY: BUILDING INFORMATION 1 2 3 4 STATE OF FLORIDA DEPARTMENT OF HEALTH AND REHABILITATIVE SERVICES ONSITE SEWAGE DISPOSAL SYSTEM APPLICATION FOR CONSTRUCTION PERMIT Authority: Chapter 381, FS & Chapter 10D -6, FAC BLOCK: r f5 TO BE COMPLETED BY APPLICANT OR APPLICANT'S AUTHORIZED AGENT. ATTACH BUILDING PLAN AND TO -SCALE SITE PLAN SHOWING PERTINENT FEATURES REQUIRED BY CHAPTER 10D -6, FLORIDA ADMINISTRATIVE CODE. PROPERTY INFORMATION [IF LOT IS NOT IN A RECORDED SUBDIVISION, ATTACH LEGAL DESCRIPTION OR DEED] • ! ACRES [Sgft /43560] PROPERTY WATER SUPPLY: [ ] ]PRIVATE [ 4 Unit Type of No. of No Establishment Bedrooms [ ] Garbage Grinders /Disposals [ ] Spas /Hot Tubs [ ] Floor /Equipment Drains [ ] Ultra -low Volume Flush Toilets APPLICANT'S SIGNATURE: [ `J Existing System [ -r Holding Tank [ [ d ]' [ A-Other(Specify) rr SUBDIVISION: 6 [ �� RESIDENTIAL DATE OF SUBDIVISION: [Section /Township /Range /Parcel Na.] ZONING: Building Area Soft [ ] COMMERCIAL PERMIT # DATE PAID FEE PAID $ RECEIPT 0 F Temporary /Experimental TELEPHONE: - r # Persons Business Activity Served For Commercial Only [ ] Other (Specify) / /` H Form 4015, Mar 92 (Obsoletes previous editions which may not be used) k Number: 5744 - 001-4015 -1) v DATE: ` Page 1 of 3 ACA17.CN I: 0.1 Check type of permit, if apecify :ype in blank. Property owner's full zme. 7:elepiionc number fo: applicant jccn o arjeni. ilImperty ownerl.; TV:1_7; `1.179 1\7:3: ?.C.7.)ox atme ' :"; c: 0:7 SJ:7.tlis. IV :7,73N: date a's' !!',' hce lU t into two or rrori. larcel-. for th:, , :enveyin.3 2rivate o . ). :lescription deed :nut:: attr.r.:71er7. chater 71?.", f.:,2".":11 L.7 CCr" .‘.`i T") • `off :c :,Tia;:727-of e.• .; c' 'c _ may b.: M.A.:eat' caleolatir lot P.,;D:af ESS: Sct address fcr propt:::y. For loti r.. assigned It ..:er • : Provide detailed inatiuctone '.ct lot o: attach an area map sl'ow lc: :0er:ion. 131J7,1`...`31lNG KNI Check residentil/ or commercial. N. 13F.D11001t1S: C'ount all room; designed primarily for sieepim; and 0::pected te :outire! p. occupants. r..1st type of ectrblichment from. Tr.ble FAC. 1-my, sirgle wiale doctor's office. A.12A ".fotal square fontage of enclotted 17r:bitch:a 17:c of dwellin3 unit, Ec:!::, c • screened patios or decks. !heed on outside ;;leasummtat‘ta for ace?: o 2:371SONS: Number of oemon.s residinz, ttsint:., or wo:king in ert:.blichmert. Pe: .2., 2 Ter I?iSi.Nr,riSS AC Ts?: assumed. For commercirl applicationa only. rn: of e-7,loyces, a C..2C7 H:0:1 y Table Z1, Chapter 10D-5, FAC. Mark each li:Ard fixtura with nurnhe: installed or "NA" if rot nopl.'mtbl';. Signature 07 applicant or agent. le application on clay SIA:3771.1':': Ch V.;:ip77zZc, fern : A site orr.wr 10 reale, rhowir-; 0003 witl" • 0:: :7i3, el:a.ement.!;, or ite r. jra f:rte ce:7'10,!1C ..'7773:27C:27,', any er,intir■ featu:ca, filled areas, o..)structctl. rurface '71 F.'217" 7.31 pertinent facilities ea feature:, zr rC0722 pror?et if ?.: : ': - -c o t2:::; cpplicczt :et. i. pub:ic well wiliir 2C1 fect of lot. IFor reridence:, r plan (rd ce ; ^ .:'02 ioor plan • r• featuras noces.:r.ry to r:o:= LI qu;':. STATE OF FLORIDA DEPARTMENT OF HEALTH AND REHABILITATIVE SERVICES APPLICATION FOR ONSITE SEWAGE DISPOSAL SYSTEM CONSTRUCTION PERMIT Permit Application Number / ' Scale: Each block represents 5 feet and 1 inch = 50 feet. Plan Approved ' I —.3 1 Site Plan submitted by orm 4015 Feb 85 (Obsoletes previous editions which may not be used) mber: 5744-002-4015-6) PART II - SITE PLAN /SIGNATURE iii c! Notes: ' __4' 2 - d a Not Approved TITLE ALL CHANGES MUST BE APPRdVED BY THE COUNTY PUBLIC:HEALTH UNIT Date (14 County Public Unit Page 2 of 3 0 T H E R CONSTRUCTION PERMIT FOR: {` ] New System [` ] Existing System [t' ] Repair W) , ] Abandonment APPLICANT: PROPERTY STREET ADDRESS: LOT: PROPERTY ID #: STATE OF FLORIDA DEPARTMENT OF HEALTH AND REHABILITATIVE SERVICES ONSITE SEWAGE DISPOSAL SYSTEM CONSTRUCTION PERMIT Authority: Chapter 381, FS & Chapter 10D -6, FAC BLOCK: SUBDIVISION: SYSTEM DESIGN AND SPECIFICATIONS D [ ] SQUARE FEET PRIMARY DRAINFIELD SYSTEM R [ ] SQUARE FEET SYSTEM A TYPE SYSTEM: [ ] STANDARD [ ] FILLED I CONFIGURATION: [ ] TRENCH ( ] BED N F LOCATION OF BENCHMARK: I ELEVATION OF PROPOSED SYSTEM SITE [ E BOTTOM OF DRAINFIELD TO BE [ L D FILL REQUIRED: [ ] INCHES SPECIFICATIONS BY: APPROVED BY: DATE ISSUED: - -H Form 4016, Mar 92 (Obsoletes previous editions which may not be used) -ck Number: 5744- 001 - 4016 -0) „] Holding Tank [ PERMIT # DATE PAID FEE PAID $ % 1+ RECEIPT # Temporary /Experimental 1 Other(Specify) AGENT: [SECTION /TOWNSHIP /RANGE /PARCEL NUMBER] [OR TAX ID NUMBER] y '.. ' q n � SYSTEM MUST BE CONSTRUCTED IN ACCORDANCE WITH SPECIFICATIONS AND STANDARDS OF CHAPTER 10D -6, FAC REPAIR PERMITS AND HOLDING TANK PERMITS EXPIRE 90 DAYS FROM THE DATE OF ISSUE. ALL OTHER PERMITS EXPIRE ONE YEAR FROM THE DATE OF ISSUE. HRS APPROVAL OF SYSTEM DOES NOT GUARANTEE SATISFACTORY PERFORMANCE FOR ANY SPECIFIC PERIOD OF TIME. ANY CHANGE IN MATERIAL FACTS WHICH SERVED AS A BASIS FOR ISSUANCE OF THIS PERMIT, REQUIRE THE APPLICANT TO MODIFY THE PERMIT APPLICATION. SUCH MODIFICATIONS MAY RESULT IN THIS PERMIT BEING MADE NULL AND VOID. ] [GALLONS / GPD] SEPTIC TANK /AEROBIC UNIT CAPACITY MULTI- CHAMBERED /IN SERIES:[ ] ] [GALLONS / GPD] CAPACITY MULTI- CHAMBERED /IN SERIES:[ ] ] GALLONS GREASE INTERCEPTOR CAPACITY [MAXIMUM CAPACITY SINGLE TANK: 1250 GALLONS] ] GALLONS PER DOSE DOSING TANK CAPACITY DOSE RATE [ ] PER 24 HRS NO. OF PUMPS: [ ] TITLE: [ ] MOUND [ ] [INCHES /FT] [ABOVE /BELOW] BENCHMARK /REFERENCE POINT ] [INCHES /FT] [ABOVE /BELOW] BENCHMARK /REFERENCE POINT EXCAVATION REQUIRED: [ ] INCHES EXPIRATION DATE: TITLE: CPHU Page 1 of 2 :?rop■:rty . ...Q1.0 . ■J ' 1101"!■: • autn(Hzcd :Tvc. !;o7: - • ' f.o:. o... . . . : ps:,:elli....ations. such E:. - Name of individial providing speeificatio'w. ..i by r. ssr: 3 .? County Public Fealth Unit 2eramnel •ATTE :SSUED: Date permit is issued by Cf D One year from Cate issued if the system been installed. fo: renr.i...i 11.7.0 Mile void Cl dr.r.; issued. 4 PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date 7" ,fi 7 7P Job Address 9/6 N4( 96 - r'4'l ' Tax Folio Legal Description ��' / % .z b,1 / Owner / Lessee / Tenant �' / / O f ;/0.to f Master Permit # g. Ve Y Owner's Address 9/ / 6 r7'ee / Phone Contracting Co. Al/i r /4/34At ✓ 2 Address A9/5 / 2/e!' 4 M/eve' Qualifier CGWu rd J G'h /Iev SS# .f:?or G.r.' .7O .T/ State # CA5aVi /9, Municipal # Competency # Ins.Co. X re t,'G i Architect /Engineer Address Bonding Company Address Mortgagor Address Permit Type(circle one): BUILDING ELECTRICAL LUMBIN MECHANICAL / ROOFING PAVING / FENCE SIGN WORK DESCRIPTION f y Gild de/' 1 _r`to1.✓e-✓r / L✓ - C'f e ✓ j / G( • Square Ft. Estimated Cost(value) / 4,Jw do WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT). Application is hereby made to obtain a permit to do work and installation as indicated above, and on the attached addendum (if applicable). I certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits are required for ELECTRICAL, PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK. OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Furthermore, I authorize the above -named contractor to do the work stated. . ** * FEES: PERMIT Signature of owner and /or Condo President Date: Notary as to Owner and /or Condo President My Commission Expires: APPROVED: * * Zoning * * * * * RADON C.C.F. Buildin Mechanical Plumbi Signature of Contactor or Owner- Builder Date: ' 7 2 7- 'et o oR , % Ines Montero * *My Commission CC882422 Expires September 22, 200 N. ary as to Contractor or Owner- Builder y Commission Expires: Fire Other NOTARY TOTAL DUE Electrical Engineering ITEN BAT}i its BIDET UNIT FEE 1TE1 SNITCH WILETS LIGHT OJTLETs IKNIT FEE ITEM SPACE HEATERS UNIT FEE CF tE A TING eistoAS R RECEPTACLES Alt (1110) o I SP0SAL SERVICE TtWORARY A/C (CENTRAL t ORDOCDG FOIMTAIN SERVICE SIZE IN AMPS OICT RORK fLOOR DRAIN SERVICE REPAIR/1ETER Ma REFRIGERATION GREASE TRAP APPLIANCE CUTLETS PIKES AND PRESS PIPING INTERCEPTOR RANGE TOP UN CER01OU IC TANKS LAVATORY OVEN AADVE GRIM MSS wart TRAY RATER HEATER U.F. PRESSUM VESSELS CLOVES RASHER 1aTORS 0 1 HP STEAM BOILERS SNORER 10TORS OVER 1- 3 HP TOT MAO BOILERS SINK. POT/3 cm. IOTORS OVER 3- S NP MEXIA IICAL VENTILATION SINX. RES1' 6 IOTOtS DYER S a HP TRANSPCSTING ASSUMES SINK. SLOP NOTDRS OVER 11- 10 HP ELEVATOtS/ESCALATM>IO; TEA M/RY RATER CLOSET 113TERS OVER 10- 25 HP F IRE SPIT IMO.ER MIDIS URINAL I TMS OVER 25 HP =MG 1DRERS RATER CLOSET TOT= OVER 100 1P VIOLATION 1,0 IRECT DUES A M RE Il6PECf 1011 MATER SUPPLY TO: O PCOM t A/C UNIT STRIP HEATER F IRE SPAIN LER OtTERATERS TRANSFORMERS HEATER-AN 116T. GENERATORS 1R011SFOORRS II ?SEATS-REPLACE GENERA= AS TRAHI PERIERS LAN SPRINCLER -RELL SIIIWRG POOL RATER SERVICE SPECIAL APPOSE WR.ETS COIREN:IAI SIGN TUBES 1111111 SEVER KHNECTURS SIGN TRANSFONERS UTILITY -SET SION TIME CLOCK UT iL HTI- HATTER F IXTLAES SEPTIC TAROK AHREHNA RELAY TELEVISION URLETS GRAINFIELD. A' TILE/RES. VIOLATION PU1P 1 ABANDON SEPTIC TAN( REINSPECTtON SOAKAGE PIT W FT. CATCH BASIN ' OISt71ARGE WELL =WIC WELL AREA DRAIN ROOF ULET SOLAR RATER HEATER FIRE STANDPIPE POOL PKPIAG _ LANK SPRINKLER SYSTEM GAS RAKE NETER SET GAS) GAS PIPUT. . 1 Jul -27 -98 02:37A MARLIN PLUMBING OF MIAMI 305 -652 -3135 P.02 ADDENDUM TO BUILDING PERMIT APPLICATION (AN APELICATION FOR BUILDING P='m IT MUST ACCOMPANY THIS ADDENDUM. IT A MASTER PERMIT HAS B, OBTAINED, THE OVNER•S NOTARIZED SIGNATU NUM NOt BE PRESENT ON SUBSEQUENT APPLICATIONS.) 9/6 e �� S " /? r %n PlOon PLUMBING ELECTRICAL MECHANICAL „,, c - Date f t? Job Address `7 li/ / (- C Legal Description Historically Designated: Yes No Owner/Lessee / Tenant db E L i S C1 Owner's Address Contracting Qualifier OWNER'S laws regula Si Notary as to 0 My Commissi PERMIT APPLICATION FOR MIAMI SHORES VILLAGE ,14("0%•,-// it 2 Architect/Engineer Bonding Company ter' Address Mortgagor i��” 1 � Permit Type (circle one): BUILDING ELECTRICA WORK DESCRIPTION of A er and/o6c0o President Date PUBLIC - STATE OF FLORIDA LUIS MONTERO COMMISSION N CC711335 !20 EXPIRES 1/2702 D THRU ASA 1 388- NOTARYI S101,-/' ndo President Date •n (:).„ Tax Folio Master Permit # - 3 3 ? V 51 ( ( S ktE s Phone 757, gc9 Address Address 6 _ Gzd /,ice SS# g 6 , State # 4 C4 Z/ «S 3 Municipal # f4 . Competency # $ J C. Ins. Co. /44.4,54/ 29 Address - 44 ECHANICAL ROOFING PAVING FENCE SIGN -feczo /< '10 (0IJ) c rC��� Square Ft. Estimated Cost (value) �. 00 WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.) Application is hereby made to obtain a permit to do work and installation as indicated above, and on the attached addendum (if applicable). I certify that al work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits are re ' ' ed for ELECTRICAL, PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK. IDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable nstruction and zoning. Furthermore, I authorize the above -named contractor to do the work stated. Signa - of Contractor or Owner- Builder Date otary as to Contractor or Owner- Builder • Date My Commission Expires FEES: PERMIT S (,' RADON ' C.C.F NOTARY BOND TOTAL DUE APPROVED: Zoning Building Electrical Mechanical Plumbing .j■) a \ Engineering ' 4?c , 9eta,t, 9.5"' M-Pa. DATE: SHEET : 1 OF I SCALE: NTS Drawn by: Cust Sign: E 1 9 l 1 O ( 4o TECO: PEOPLES GAS (ZAka-. THE PROPOSED SERVICE LINE: FORA TOTAL FOOTAGE OF I N S E W ENTERS THE ❑ ❑ ❑ ❑ P!L (ft) FROM THE MAIN THROUGH R Q °cog (t1) NS E W .. 6 ' os - ❑ 0 ❑ ❑ _ _ ❑ n ❑ ❑ ❑ 0 0 n ❑❑❑❑__❑rr ❑ ❑0❑ ❑ 0000 ❑. 0 0 0 0❑ n • ❑ ❑ ❑ ❑ _ _ 0 n 0 ❑ ❑ ❑ ❑ n 00 ❑❑_•_.0n 00 0001 ❑ ❑ ❑ 0 _ _ 0 n ❑ ❑ 0 ❑ ❑ n ❑❑❑❑__ ❑n ❑❑❑❑ ❑n 0 ❑0o__ ❑n 00❑❑0n MAIN size 11 JO: AFE: ATLAS: BLOCK: LOT: THE RISER IS TO EIE LOCATED: N S E W ON THE ❑❑[]❑ ❑❑❑❑ (ft) 4 EW 0 ❑ 0 ❑ ❑ ❑ ❑ ❑ ❑ 0 0 0 1 i type ❑ steel _ 0 plastic 400 O?rz7 P14 flj,vl ° W/e{// 6c) up 0`a Od side of ❑ n 0 1 side of ❑ n on ❑ n 1 RAN SIZE PERMIT RECTO