SEPTIC TANKMIAMI SHORES VILLAGE
BU!LDiNG DEPARTMENT
305- 795 -2204
Building Inspection Req
Date __ Of) Time
Type Insp'n _t T /Y1 k.
Permit No. P L C� _ 2.52
Approved
Correction
Re- Insp'n Fee
Name ( U a , 0 1 /22
t
Address 1 097 LiE 9967
/
Company WeeT /aid ,-/03 4L
Phone # SOS 557 - 9 ' 03 ,/
/
For Inspector: PL 120, Nam & / ate -'.
Type lnsp'n
Permit No.
MIAMI SHORES VILLA
BUILDING DEPARTM
305- 795 -2204
Building Inspection Request
Date iC q `3'°0 7
Company
Phone #
Inspection Date
Approved
Correction
Re- Insp'n Fee
c' aeL k
/pL J oD3 -
y r
Name C� 1,
Address ) of 9 /V e 9/5i"
IECE ,ED
OCT 1 7 2003 j
Permit No.
Master Permit No. P1
Permit Type (circle): Building Electrical Plumbin Mechanical Roofing
Owner's Name (Fee Simple Titleholder) o
Owner's Address
City
Tenant/Lessee Name Phone #
BUILDING
PERMIT APPLICATION
FBC 2001
Job Address (where the work is being done) /� f �-! e q9 S�
City Miami Shores Village
Is Building Historically Designated YES NO
SSl ��
Contractor's Company Name C' S 7G7/g/--- 0 S t 4-(1;1.4 Phone # 3ZSS 63
Contractor's Address l<2//() S; Z'° q /
City �7i / , State_GL Zip 3 3 /7 5
Qualifier O<o .54
Architect/Engineer's Name (if applicable) Phone #
$ Value of Work For this Permit
,�fCI i' fb
Total Fee Now Due $
(Continued on opposite side)
State
43$ , 59
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
5,9
* * * * * * * * * * * * * * * * * * * * * * * * * * ** Fees * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
Phone #
Zip
County Miami -Dade Zip
Square Footage Of Work:
Type of Work: ❑Addition ❑Alteration ['New ❑ Repair/Replace ❑ Demolition
Describe Work:
/•im �1
Q. t. 3sget . ` 2
Submittal Fee $ 50 . CX) — Permit Fee $ 1 } S •(0 • CCF $ ZO
Notary $ 5 .00. Training/Education Fee $ 1 20. • Technology Fee S 2 '. 431
Scanning $ Radon $ Bond $ 30 to .
Code Enforcement $ Structural Plan Review. $
Bonding Company's Name (if applicable)
Bonding Company's Address
City State Zip
Signature
Owner or Agent
The foregoing instrument was acknowledged before me this
day of , 20 _, by
who is personally known to me or who has produced
APPLICATION APPROVED BY:
Chc 10/14/03
Signature
As identification and who did take an oath.
NOTARY PUBLIC: NOTARY P
Sign: Sign:
Print: Print:
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.
ontractor
The foregoing instrument was acknowledged before me this(
day of ON- , 20 by \ (.xfl tel: \ � S
who is personally known to me or Wo has produced n (L LLL
It rI ■
identification and who did take an oath.
My Commission Expires: . 'Q; xPlres:
My Commission Expirr ' 1 3, 2007
02 Mod Thru
(Certificate of Competency Holder)
State Certificate or Registration No. Certificate of Competency No.
***************************************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
Plans Examiner
Engineer
Zoning
TEM
4Th TUB
UNIT
FEE
ITEM
SWITCH OUTLETS
UNIT
FEE
ITEM
SPACE HEATERS
UNIT
FEE
IDET
LIGHT OUTLETS
CENTRAL HEATING
ISHWASHER
RECEPTACLES
A/C (WHO)
ISPOSAL
SERVICE TEMPORARY
A/C (CENTRAL)
SINKING FOUNTAIN
SERVICE SIZE IN AMPS
DUCT WORK
LOOK DRAIN
SERVICE REPAIR/METER CHANGE
REFRIGERATION
REASE TRAP
APPLIANCE OUTLETS
PROCESS AND PRESS PIPING
NTERCEPTCA
RANGE TOP
UNDERGROUND TANKS
AVATORY
OVEN
ABOVE GROUND TANKS
AUNDRY TRAY
WATER HEATER
U.F. PRESSURE VESSELS
LOTHES WASHER
MOTORS 0- 1 HP
STEAM BOILERS
HOWER
MOTORS OVER 1- 3 HP
HOT WATER BOILERS
INK, POT /3 COMP.
MOTORS OVER 3- 5 FP
MECHANICAL VENTILATION
INK, RESIDENCE
MOTORS OVER 5- 8 HP
TRANSPORTING ASSEMBLIES
INK, SLOP
MOTORS OVER 8- 10 HP
ELEVATORS/ESCALATORS
EMPORARY WATER CLOSET
MOTORS OVER 10- 25 HP
FIRE SPRINKLER SYSTEMS
RINAL
MOTORS OVER 25-100 HP
COOLING TOWERS
LATER CLOSET
MOTORS OVER 100 HP
VIOLATION
NDIRECT WASTES
-
A/C WINDOW
REINSPECTION
'ATER SLPPLY T0:
AIR CONDITIONERS
A/C UNIT
STRIP HEATER
FIRE SPRINKLER
GENERATORS TRANSFORMERS
•
HEATER -NEW INST.
GENERATORS TRANSFORMERS
I
HEATER - REPLACE
GENERATORS TRANSFORMERS
LAWN SPRINKLER -WELL
SPECIAL PURPOSE
SWIMMING POOL
OUTLETS COWERCIAL
r
WATER SERVICE
SIGN TUBES
EWER CONNECTIONS
SIGN TRANSFORMERS
TILITY- SEWER
SIGN TIME CLOCK
TILITY -WATER
FIXTURES
EPTIC TANK
f
ANTENNA
ELAY
,
TELEVISION OUTLETS
RAINFIELD, 4' TILE/RES.
VIOLATION
UMP S ABANDON SEPTIC TANK
REINSPECTION
OAKAGE PIT CU.
ATCH BASIN
IISCHARGE WELL
_
DOMESTIC WELL
REA DRAIN
AOF INLET 1
OLAR WATER HEATER
IRE STANDPIPE
COL PIPING
AWN SPRINKLER SYSTEM
AS RANGE
ETER SET (GAS)
AS PIPING
ADDENDUM TO BUILDING PERMIT APPLICATION
AN APPLICATION•FOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. IF A MASTER PERMIT HAS B.
OBTAINED, THE'OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.)
PLUMBING
ELECTRICAL
MECHANICAL
NOTICE OF COMMENCEMENT
A RECORDED COPY MUST BE POSTED ON THE JOB SfE AT TIME OF FIRST INSPECTION
ERMfT NO.
2. Description of improvement:
Notary Public
Print Notary's Name
My commission expires:
TAX FOUO NO
TATE OF FLORIDA:
. OUNTY OF MIAMI- DADE::
HE UNDERSIGNED hereby gives notice that improvements will be made to certain real
roperty, and In accordance with Chapter 713. Florida Statutes. the following Information
s provided in this Notice of Commencement
1. Legal description of property and street/address:
Interest in property
Name and address of fee simple titleholder.
7
9. Expiration date of this Notice of Commencement: (theexphati
different date Is specified)
Signature of Owner
Print Owners Name Prepared bye.
s �v \ h P L
f
•
Sworn to and subs - f • before me this 2 day y of OCT . 201Z
MM, ._.a. unm1 I flan
111111111111111111111111111111111111
CFhi 200380812640
OR Bk 21779 Ps 4273; (1PS)
RECORDED 10/30/2003 12 :15:21
HARVEY RUVINr CLERK OF COURT
MIAMI -DADE COUNTY, FLORIDA
LAST PAGE
4. Contractor's name and address:
5. Surety: (Payment bond required by owner from contractor, if any)
Name and address:
Amount of bond S
a. Lender's name and address:
7. Persons within the state of Florida designated by Owner upon whom notices or other documents may be served as
provided by Section 713.1S(1)(a)7.. Florida Statutes;
Nertie and address: r • -
' rovided
8.in addition to himself, Owners designates the following person(s) to receive a copy of the Uenors Notice as p
in Section 713.13(1)(b), Florida Statutes.
Name end address:
date is 1 year from the date of recording unless a
4
Miami Shores Village
10050 NE 2nd Avenue
Plumbing Permit
Phone: 305 - 795 -2204 Permit Number: PL2003 -290
Printed: 10 /22/2003 Page 1 of 1
Applicant: CHRISTINE O'NEIL
Owner: O'NEIL CHRISTINE
JOB ADDRESS: 1099 NE 99 ST
Contractor WESTLAND SEPTIC TANK CORP. Contractor's Address: 12110 SW 41 DRIVE
Local Phone: 305 - 551 -9303
Parcel # 1132050180040 Legal Description: REV PL MIAMI SHORES SEC 8
Fees: Description Amount
FEE2003 -6324 Building Fee $175.00
FEE2003 -6325 CCF $3.00
FEE2003 -6326 Notary Fee $5.00
FEE2003 -6328 Training and Education Fee $1.20
FEE2003 -6329 Technology Fee $4.37
FEE2003 -6330 Builders Bond $300.00
Total Fees: $488.57
Permit Status: APPROVED Permit Expiration: 4/19/2004 Construction Value: $5,000.00
Work: INSTALATION OF A SEPTIC TANK
Signed: (INSPECTOR)
Total Fees: $488.57
Total Receipts: $0.00
PB 43 -69 LOT 15 BLK 178 LOT
CL 5
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:
7 4'1
Permit No
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. 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
Edward Swan N 1099 N.E. st St
Registered Architect and/or Engineer
Ej,,p)oyineirjoe;1 North Dade Septic Tank Na, ._ 800 NW "L ......_ .. .._ .
5 , 9 , 2
No r.
Locaten andVegal Desaiption Lot_ .......1- Block i_Ye Subdivision._*4)Si..e._
Street and Number where work is to be performed-No 1099 N.E. 99th St. Street
State work to be performed and purpose of building (By Floon) _ _ _
New Building Remodeling__. Addition _ .__ Repairs XXX No. of Stories
Size Septic Tank— Type of Tank__
Feet o f D Tile 2 0 0 S. Feet of Tank or Drain Field from Well____
Nature of Water Supply: City-Well. Size of Soakage Pit
Amount of Permit
71 00
My Commission Expires
( Signed )_
(Signed)
Plumbing In vector.
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 Worlanen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and Itov com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub-contractors employed by him in the woe.- 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 arr
required by the Act. The undersigned agrees to employ only such sub-contractors, on to be under thh permit, as are
licensed by Miami Shores Village.
1.2
STATE OF 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 be is the ._
of the above described construction, that he has carefully read the foregoing application, and that he did sign the mune, and that all facts
therein by him stated are true.
Notary Public, State of Florida
ister Plumber. ..
NOTE: A re-trupection fee of OM will be owls when mob rolsrproaos mods soosaory by Improper soda for Inspection, er faulty
material, artd/ar warlosoarhip.
CLOCKS
BATH
T1./•S
SNOWER•
LAVA.
TORIES
•IPE.
S L 0 P
SIN KS
L AU u N e l D o n
T
URINALS
II A•IPI N
FLOOR
DRAIN
DRINKING
FOUNT'NS
TOTAL
PIETURES
Comm.
LIST
Cmccic
—
SEPTIC
TANK
SEINER
CONN.
DRAIN
FIELD
SOAKAGS
PIT
G
TRAP
SOLAR
HEATER
MEP
WELL
B
SYSTEM
SWIWO
P001.
I
CONT.
Lin
CHECK
.-.—,
7 4'1
Permit No
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. 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
Edward Swan N 1099 N.E. st St
Registered Architect and/or Engineer
Ej,,p)oyineirjoe;1 North Dade Septic Tank Na, ._ 800 NW "L ......_ .. .._ .
5 , 9 , 2
No r.
Locaten andVegal Desaiption Lot_ .......1- Block i_Ye Subdivision._*4)Si..e._
Street and Number where work is to be performed-No 1099 N.E. 99th St. Street
State work to be performed and purpose of building (By Floon) _ _ _
New Building Remodeling__. Addition _ .__ Repairs XXX No. of Stories
Size Septic Tank— Type of Tank__
Feet o f D Tile 2 0 0 S. Feet of Tank or Drain Field from Well____
Nature of Water Supply: City-Well. Size of Soakage Pit
Amount of Permit
71 00
My Commission Expires
( Signed )_
(Signed)
Plumbing In vector.
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 Worlanen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and Itov com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub-contractors employed by him in the woe.- 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 arr
required by the Act. The undersigned agrees to employ only such sub-contractors, on to be under thh permit, as are
licensed by Miami Shores Village.
1.2
STATE OF 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 be is the ._
of the above described construction, that he has carefully read the foregoing application, and that he did sign the mune, and that all facts
therein by him stated are true.
Notary Public, State of Florida
ister Plumber. ..
NOTE: A re-trupection fee of OM will be owls when mob rolsrproaos mods soosaory by Improper soda for Inspection, er faulty
material, artd/ar warlosoarhip.