1209 NE 98 St (5)Date
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
J o b A d d r e s s 7 / q i S / , / o R e s / 7 G 3 i'/ •7P Tax Folio // - 3
Le 7O i 5Wo,z es i3LK ,Z - L o7
Legal Description // ( w / 4 o? /2 E zo Fr mar',Historically Designated: Yes No
Owner / Tenant G e...,z /fie / /e/ E ,9 G /C / q /1 4 e y Master Permit #
Owner's Address /-2-o f N E .9 f !1 / ea , SG44 , 3 3 / 5i Phone 30 .S- 7 5 - cF/ o 2 /
Contracting Co. / e4 1.-p e/L e2- li rC P 2- Address 7D c2 S /1/ e/z. //vA/ p -
Qualifier , A 1ti C I'S e0 (_. d UU5 1,j 74-4 Ni SS# Phone `7 5 % - yv-oq.
State # Municipal # Competency # Ins. Co.
Architect/Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
N •
ib G4S
WORK DESCRIPTION 2>i e cT f. /N
o (Pe: 10 ise s cc)5) Fo2 sr 2A7 meirR
Square Ft. Estimated Cost (value) A 3.5 - 0 , CTO
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 zonin urthermore, I authorize the above -named contractor to do the work stated.
Notary as to 0 or Condo Preside nt Date
My CQrtimisiiiikE i esra'ARY suAL li
1 GLAD:; j V:LLAR q
Nli A':Y PUBLIC STATE OF FLORIDA !I
L COMMISSION NO. CC714103 i
AY COMMISSION EXP. MAR. 1,20P
FEES: PERMIT X j 0 RADON
APPROVED:
Zoning Building
Mechanical
Plumbing
A/2 e49N 7
A 5 Re Q
Signal of Contractor or Owner - Builder I to
C5 2 z� 2 5�0"S ^ y" � � y C _®
/I<lotary as to C 'ttr. • or Owner=Builder
My Co .� . a .t• OTARYSEAL
GdADYS J VILLAR
NOTARY PUBLIC STATE OF FLORIDA
COMMISSION NO. CC714103
MY COMMISSION EXP. MAR. 1,20112
C.C.F. g 6 NOTARY c c BOND
Electrical
Engineering
TOTAL DUE
Date
ITEM
BATH TUB
UNIT
FEE
ITEM
SNITCH OUTLETS
UNIT
FEE
ITEM
SPACE BEATERS
UNIT
FEE
BIDET
LIGHT OUTLETS
CENTRAL HEATING
DISHWASHER
RECEPTACLES
A/C (WIND)
DISPOSAL
SERVICE TEMPORARY
A/C (CENTRAL)
DRINKING FOUNTAIN
SERVICE SIZE IN AMPS
DUCT WORK
FLOOR DRAIN
SERVICE REPAIR/METER CHANGE
REFRIGERATION
GREASE TRAP
APPLIANCE OUTLETS
PROCESS AND PRESS PIPING
INTERCEPTOR
RANGE TOP
UM ERGROM TANKS
LAVATORY
OVEN
ABOVE GUM TANKS
LAUNDRY TRAY
WATER HEATER
U.F. PRESSURE VESSELS
CLOTHES WASHER
MOTORS 0- 1 HP
STEAM BOILERS
SHOWER
MOTC S OVER 1- 3 HP
HOT WATER 80ILERS
SINK. POT /3 COMP.
MOTORS OVER 3- 5 HP
MECHANICAL VENTILATION
SINK, RESIDENCE
MOTCRS OVER 5- 8 HP
TRANSPORTING ASSEMBLIES
SINK, SLOP
MOTORS OVER 8- 10 HP
ELEVATCRS/ESCALATORS
TEMPORARY WATER CLOSET
MOTCRS OVER 10- 25 HP
FIRE SPRINKLER SYSTEMS
URINAL
MOTORS OVER 25-100 HP
COOLING TOWERS
WATER CLOSET
MOTORS OVER 100 HP
VIOLATION
INDIRECT WASTES
A/C WINDOW
REINSPECTION
WATER SUPPLY TO:
_
AIR CONDITIONERS
•
A/C UNIT
STRIP HEATER
FIRE SPRINKLER
n 3 TORS TRANSFORMERS
HEATER -NEW INST.
GENERATORS TRANSFORMERS
HEATER - REPLACE
GENERATORS TRANSFORMERS
LAWN SPRINKLER -WELL
SFECIAL PURPOSE
SWIMMING POOL
-
'
OUTLETS COMMERCIAL
_
WATER SERVICE •
SIGN TUBES
_
SEWER CONNECTIONS
SIGN TRANSFORMERS
UTILITY -SEWER
SIGN TIME CLOCK
UTILITY -WATER
FIXTLRES
SEPTIC TANK
ANTENNA
RELAY
TELEVISION OUTLETS
GRAINFIELD, 4' TILE/RES.
VIOLATION
PUMP & ABANDON SEPTIC TANK
RE INSPECTION -
1
SOAKAGE PIT CU. FT.
CATCH BASIN
DISCHARGE WELL
_
DOMESTIC WELL
AREA GRAIN
ROOF INLET
SOLAR WATER HEATER
FIRE STANDPIPE
POOL PIPING
LAWN SPRINKLER SYSTEM
GAS RANGE
METER SET (GAS)
GAS PIPING
ADDENDUM TO BUILDING PERMIT APPLICATION 4507f
(AN APPLICATION FOR BUILDING PERMIT MTJST ACCOMPANY THIS ADDENDUM. IF A MASTER PERMIT HAS B.
OBTAINED, THE OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.)
PLUMBING
/2'e' I As Zfly f
ELECTRICAL
MECHANICAL
Size Septic Tank____
Feet of Drain Tile —__
:Leaaoa
b
Permit No 10c
Amount of Permit $ °
v
STATE OF FLORIDA,
COUNTY OF DADE.
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. CC�� AA ,, �,'�
Owner's Name and Address �: L d __�-- -_ - - -- _ - .--- _ -._.. No. /A_ _ — _ __� Street.. 7Q.'-.g ! .._ _ _ ......
Registered Architect and /or Engineer
Employing Plumber's Name__..el!_3_
Location and Legal Description Lot. Block a.,
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- -._ -. Repairs No. of Stories.. _.. -- -..... .
Type of Tank
_Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: of Soakage Pit
(Signed )
Plum • ing 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-
plier 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 die Act. The undersigned agrees to employ only such sub - contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village.
(Signed)
Nol tc
Date_ Q0/"t_' -V
Street...A/hi OG
Capacity Gals...
My Commission Expires Notary Public, State of Florida
street/ .a91
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the.__ ................ _ . .
of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for insp.'' ,n, or faulty
materials and /or workmanship.
CLOSETS
BATH
TUBS
SNOWER6
LAVA-
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TUBS
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT'NB
1 1./
[J�
d
111
TOTAL
FIXTTURE$
lap
CONTR.
LIST
CHICK
_
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
H EATER
DEEP
WELL
SPRKLR.
SYSTEM
SWIM'G
POOL
CONTR.
LIST
CHECK
-
Size Septic Tank____
Feet of Drain Tile —__
:Leaaoa
b
Permit No 10c
Amount of Permit $ °
v
STATE OF FLORIDA,
COUNTY OF DADE.
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. CC�� AA ,, �,'�
Owner's Name and Address �: L d __�-- -_ - - -- _ - .--- _ -._.. No. /A_ _ — _ __� Street.. 7Q.'-.g ! .._ _ _ ......
Registered Architect and /or Engineer
Employing Plumber's Name__..el!_3_
Location and Legal Description Lot. Block a.,
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- -._ -. Repairs No. of Stories.. _.. -- -..... .
Type of Tank
_Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: of Soakage Pit
(Signed )
Plum • ing 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-
plier 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 die Act. The undersigned agrees to employ only such sub - contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village.
(Signed)
Nol tc
Date_ Q0/"t_' -V
Street...A/hi OG
Capacity Gals...
My Commission Expires Notary Public, State of Florida
street/ .a91
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the.__ ................ _ . .
of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for insp.'' ,n, or faulty
materials and /or workmanship.
N70 -1469 787 -4 $4,00
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Permit No C 7
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida,
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at
building during progress of work.
Owner's Name and Address R.__ - readmaa
Registered Architect and /or Engineer____— ___— __ _________ - -_ -_ --
New Building _ Remodeling -- —_ -_ -- Addition
Street
Employing Plumber's Name PeopleS._.G.as_Sys _ . — — ___ No. _____5 4 Street_-_- 10
Location and Legal Description Lot B1ork
Street and Number where work is to be performed —No
State work to be performed and purpose of building (By Floors)
Street
Repairs No. of Stories...............
Size Septic Tank
STATE OF FLORIDA, 1
COUNTY OF DADE.
_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
1 Gas Oulet
Amount of Permit $ $4..11D Min (Signed)_
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 leas com-
plier 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 rmed under this permit, as are
licensed by Miami Shores Village.
( Signed).
My Commission Expires Notary Public, State of Florida
NE 98 Street ......
Master Plumber.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the _ ___ ____________ __ ________..................
of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for insp m, or faulty
materials and /or workmanship.
CLOSETS
BATH
TUBS
TUBS
SHOWERS
LAVA-
TORIES
SINKS
S
SLOP
SINKS
LAUNDRY
TUBS
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT'NS
TOTAL
FIXTURES
CONTR.
LIST
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SWIM'G
POOL
CONTR.
LIST
CHECK
N70 -1469 787 -4 $4,00
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Permit No C 7
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida,
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at
building during progress of work.
Owner's Name and Address R.__ - readmaa
Registered Architect and /or Engineer____— ___— __ _________ - -_ -_ --
New Building _ Remodeling -- —_ -_ -- Addition
Street
Employing Plumber's Name PeopleS._.G.as_Sys _ . — — ___ No. _____5 4 Street_-_- 10
Location and Legal Description Lot B1ork
Street and Number where work is to be performed —No
State work to be performed and purpose of building (By Floors)
Street
Repairs No. of Stories...............
Size Septic Tank
STATE OF FLORIDA, 1
COUNTY OF DADE.
_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
1 Gas Oulet
Amount of Permit $ $4..11D Min (Signed)_
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 leas com-
plier 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 rmed under this permit, as are
licensed by Miami Shores Village.
( Signed).
My Commission Expires Notary Public, State of Florida
NE 98 Street ......
Master Plumber.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the _ ___ ____________ __ ________..................
of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for insp m, or faulty
materials and /or workmanship.
Lo 2
Permit No (i
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
N 69 -1215 787 -4
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 Dr. R. Freedman 1209 NE 98 Street
No.
- - - -_ _ -- -- - - -- - — - — - - - - Street
Registered Architect and /or Engineer ________-_--_____-- —._ - _------------------- _•.------- ____ -_
Employing Plumber's Name Peoples Gas System �_____•______ No._ ____ 5 6 4 Street___. NE 125th Street
Location and Legal Description Lot_________.__._.__________ _—_._— Block_ Subdivision
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 Repairs No. of Stories . . .......
Size Septic Tank______
Feet of Drain Tile._ —Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City — Well. _-------------------- _ -__ -_
Amount of Permit $- _ ___ t f
_£J0
My Commission Expires
Type of Tank__ Capacity Gals
Size of Soakage Pit
(Signed)_ % %��/
Street
Date
Plumbing Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his ob ixflons as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Pennanent Supplement, and bus com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be
performed under this permit; and will post or cause to be posted' for inspection on the site of the work such public notice or notices as are
required by the Act. The undersigned agrees to employ only such sub- contractors, on work to be performed jinder this permit, as are
licensed by Miami Shores Village.
(Signed)___
STATE OF FLORIDA, 1
COUNTY OF DADE. j
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.
Notary Public, State of Florida
Master Plumber.
7
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
Twits
SH
LAVA-
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TOES
I NAS
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT'NS
Arc
1
Dryer
1
TOTAL
FIXTURES
2
CONTR.
LIST
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
FIT
GREASE
TRAP
SOLAR
H EATER
DEEP
WELL
SPRKLR.
SYSTEM
SWIM'G
POOL
CONTR.
LIFT
CHECK
Lo 2
Permit No (i
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
N 69 -1215 787 -4
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 Dr. R. Freedman 1209 NE 98 Street
No.
- - - -_ _ -- -- - - -- - — - — - - - - Street
Registered Architect and /or Engineer ________-_--_____-- —._ - _------------------- _•.------- ____ -_
Employing Plumber's Name Peoples Gas System �_____•______ No._ ____ 5 6 4 Street___. NE 125th Street
Location and Legal Description Lot_________.__._.__________ _—_._— Block_ Subdivision
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 Repairs No. of Stories . . .......
Size Septic Tank______
Feet of Drain Tile._ —Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City — Well. _-------------------- _ -__ -_
Amount of Permit $- _ ___ t f
_£J0
My Commission Expires
Type of Tank__ Capacity Gals
Size of Soakage Pit
(Signed)_ % %��/
Street
Date
Plumbing Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his ob ixflons as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Pennanent Supplement, and bus com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be
performed under this permit; and will post or cause to be posted' for inspection on the site of the work such public notice or notices as are
required by the Act. The undersigned agrees to employ only such sub- contractors, on work to be performed jinder this permit, as are
licensed by Miami Shores Village.
(Signed)___
STATE OF FLORIDA, 1
COUNTY OF DADE. j
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.
Notary Public, State of Florida
Master Plumber.
7
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.
APPLICATION FOR PLUMBING PERMIT
Permit No.
Application is hereby n de for the approval of the detailed statement of the plans and specifications herewith submit d 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 No Street
Registered Architect and /or Engin
Employing Plumber's Name. No Street
Location and Legal Description Lot ___1 >~ Block Subdivision_
Street and Number where work is to be performed —No �_ Street v
State work to be performed and purpose of building (By Floors)
New Building Remodeling Addition Repairs No. of Stories
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
Date
Amount of Permit $_
Type of Tank____ • Capacity Gals.__.__
Size Septic Tank
ii
Feet of Drain Tile 4 "12 Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City —Well — Size of Soakage Pit
— _ ( Signed) ( Ling !� Ling 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 performed under this permit, as are
licensed by Miami Shores Village.
(Signed)
Master Plumber.
STATE OF FLORIDA, f
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oath and take acknowledgments, personally appeared
ss.
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the
of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
My Commission Expires Notary Public, State of Florida
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty
materials and /or workmanship.
CLOSETS
BATH
TUBS
SHOWERS
LAVA-
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TUBS
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT' NS
TOTAL
FIXTURES
CONTR.
LIST
•
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SW IM'G
POOL
CONTR.
LIST
CHECK
APPLICATION FOR PLUMBING PERMIT
Permit No.
Application is hereby n de for the approval of the detailed statement of the plans and specifications herewith submit d 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 No Street
Registered Architect and /or Engin
Employing Plumber's Name. No Street
Location and Legal Description Lot ___1 >~ Block Subdivision_
Street and Number where work is to be performed —No �_ Street v
State work to be performed and purpose of building (By Floors)
New Building Remodeling Addition Repairs No. of Stories
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
Date
Amount of Permit $_
Type of Tank____ • Capacity Gals.__.__
Size Septic Tank
ii
Feet of Drain Tile 4 "12 Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City —Well — Size of Soakage Pit
— _ ( Signed) ( Ling !� Ling 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 performed under this permit, as are
licensed by Miami Shores Village.
(Signed)
Master Plumber.
STATE OF FLORIDA, f
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oath and take acknowledgments, personally appeared
ss.
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the
of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
My Commission Expires Notary Public, State of Florida
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty
materials and /or workmanship.
•
Permit No.____'_! 7 ce'
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Date
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other
structure herein described. This application is made-in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida,
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at
building during progress of work.
Owner's Name and Address No. Street
Registered Architect and /or Engineer
Employing Plumber's Name) ___C t" __ �___ -' No Street '
� . ' ,
Location and Legal Description Lot r) 4 y 1 ' Block 2 Subdivision__ . - __�.'____ /„_ _LL: `
Street and Number where work is to be performed —No 4- t- 1 Street '
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 Dram Tile Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City —Well — Size of Soakage Pit
Amount of Permit $_ -_ 6 . J
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 emplAyed by him in the work to be
performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are
required by the Act. The undersigned agrees to employ only such sub - contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village.
STATE OF FLORIDA,
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
ss.
(Signed) / •
(Signed)
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 sane, and that all facts
therein by him stated are true.
My Commission Expires Notary Public, State of Florida
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty
materials and /or workmanship.
Master Plumber.
CLOSETS
BATH
TUBS
SHOWERS
LAVA-
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TUBS
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT'NS
J 11) ..
L
/
`
TOTAL
FIXTURES
- --
CONTR.
LIST
3
r
�,.+'"
w-
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SWIM'G
POOL
CONTR.
ISr
LIST
CHECK
•
Permit No.____'_! 7 ce'
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Date
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other
structure herein described. This application is made-in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida,
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at
building during progress of work.
Owner's Name and Address No. Street
Registered Architect and /or Engineer
Employing Plumber's Name) ___C t" __ �___ -' No Street '
� . ' ,
Location and Legal Description Lot r) 4 y 1 ' Block 2 Subdivision__ . - __�.'____ /„_ _LL: `
Street and Number where work is to be performed —No 4- t- 1 Street '
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 Dram Tile Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City —Well — Size of Soakage Pit
Amount of Permit $_ -_ 6 . J
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 emplAyed by him in the work to be
performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are
required by the Act. The undersigned agrees to employ only such sub - contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village.
STATE OF FLORIDA,
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
ss.
(Signed) / •
(Signed)
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 sane, and that all facts
therein by him stated are true.
My Commission Expires Notary Public, State of Florida
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty
materials and /or workmanship.
Master Plumber.
BUILDING
ELECTRICAL
PLUMBING
Owner of
Building
Architect
Contractor
or Builder e' '
7
MIAMI SHORES VILLAGE,
PERMIT N? 8179
Work to be performed under this Permit
Legal Lot
f
Description
Bl.
Address of _ _ ;#4.77,t Value of Amt. of - / , .
Building .' t Project Permit
This permit is grated to the contractor o uilder named above to construct the building or to install the equipment or device described in the appli-
cation 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: f.t . F ., '.. .�0. zd B ,
INSPECTOR
In consideration of the issuance to me of this permit I agree to perform a ,}work covered hereunder in compliance with all ord
pertaining thereto and in strict conformity with the plans, drawings, stateme is of specifications submitted to the proper authdr es d'l IYIfa mi Shtt e. .
In accepting this permit I assume responsibility for a work done by either myself, my agent, slant or employee.
1
CONTRACTOR OR BUILDER
FLORIDA
DATE 4,
Contractojs
License No.
y.
AUTHORITY
1944_
s and re atiogn
BUILDING.
ELECTRICAL
PLUMBING
Owner of /"~
Building
Architect
Contractor
or Builder
Legal Ldt
Description
Address of x Value of Amt. of
Building ` 1� Project I Permit /e
This permit is gra ed to the contractor or builder named above to construct the building or to install the equipment or device described in the appli-
cation 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.
CONTRACTOR BUILDER
MIAMI SHORES VILLAGE, FLORIDA
PERMIT N? 8176 Contractor's
License No
(1/
Work to be performed under this Permit
el
7 4,0„,
Bl.
(7_,4(
Subdi-
vision
DATE
" w r..+
Signed. � �• °� By
INSPECTOR
BY
In consideration of the is to me of this permit I agree to perform /the work covered hereunder in compliance with aaL, rdin ces aryl rfieujejqns1=0
pertaining thereto and in strict confo 'ty with the plans, drawings, statements or specifications submitted to the proper authorfff of Miami Sikore5 a e.
In accepting t 's permit I� assume respo sibilityb I. all work done by either myself, my agent, servant or employee.
AUTHORITY