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PLUMBINGLegal Description Owner/Lessee / Tenant c( 1 G 6 T ti.[s Master Permit # Owner's Address Contracting Co. C ha f a i S_ \'i t C S V Address ? 0 1111Q1,0 1! 33,2 Y3 Qualifier Cla eGyS S C—A/t. V►A_A� SS# 3es— /`06.c -g state # Q5— 1/6 7 Municipal # Competency # 060 Ins. Co. Architect/Engineer Address Bonding Company Address Mortgagor Address Permit Type (circle one): BUILDING ELECTRIC PLU BING ECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION ( /66 AIL 00. t,^.Tttkct QU 144 Q 00A lCl.. A-t Square Ft. 4 106 !'r Estimated Cost (value) i -261616 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. PERMIT APPLICATION FOR MIAMI SHORES VILLAGE 9 Job Address 3 9 14 E 9 (s Tax Folio Signature of owner and/or Condo Presidennt Datez /9, No(a y as to Owner and/orCondo President /Date My Commission Expir ► � L ND7ARY lEAL oaawasoi WOOER O tG Al1Ac!U A COSTA A �: ;. CC620279 Yr Co___ oat APPROVED: Zoning Building Mechanical Plumbing Historically Designated: Yes No Signature o Phone or or Owner- Builder FEES: PERMIT 3S ' RADON C.C.F. l NOTARY S Electrical tary as to Contractor or Owner - Builder My Commission Expires: 54 Date BOND 1 TOTAL DUE � 41 I D Engineering CONSTRUCTION PERMIT FOR: [J New System [,.j Existing System [ /Holding Tank [ ` Temporary /Experimental [A Repair [/1 Abandonment [/ Other(Specify) J A APPLICANT: r f ya AGENT: C c ( i 47 PROPERTY STREET ADDIfE8S: 0 ,' Ai c f 1U /4 LOT: PROPERTY% ID #: 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. SYSTEM DESIGN AND SPECIFIQTIONSk ° T [ fj /,) GALLONS /' GPD] PTIC TANK ROBIC UNIT CAPACITY MULTI- CHAMBERED /IN SERIES:[ ] A [ ] [bALLONS - - / GPD] s_ ___ ---- CAPACITY MULTI- CHAMBERED /IN SERIES:[ ] N [ ] GALLONS GREASE INTERCEPTOR CAPACITY [MAXIMUM CAPACITY SINGLE TANK: 1250 GALLONS] K ( ] GALLONS PER DOSE DOSING TANK CAPACITY DOSE RATE [ ] PER 24 HRS NO. OF PUMPS: [ ] D [ !)] SQUARE FEET PRIMARY DRAINFIELD SYSTEM R [ ] SQUARE FEET SYSTEM A TYPE SYSTEM: [ ] STANDARD [ ] FILLED [ ] TRENCH I CONFIGURATION: N F LOCATION OF BENCHMARK: I ELEVATION OF PROPOSED SYSTEM SITE [ E BOTTOM OF DRAINFIELD TO BE [ L D FILL REQUIRED: [ ] INCHES 0 T H E R ,4 SPECIFICATIONS BY: APPROVED BY: DATE ISSUED: STATE OF FLORIDA DEPARTMENT OF HEALTH AND REHABILITATIVE SERVICES ONSITE SEWAGE DISPOSAL SYSTEM CONSTRUCTION PERMIT Authority: Chapter 381, FS & Chapter 10D -6, FAC BLOCK: /J /,gyp SUBDIVISION: .e• 1' S " u.s ‘ ,3 Mwi; ,, s�r,. HRS -H Form 4016, Mar 92 (Obsoletes previous editions which may not be used) (Stock Number: 5744- 001 - 4016 - 0) PERMIT # DATE PAID FEE PAID RECEIPT # r $ ,7) .,tea ✓ }. [SECTIOAf /TOWNSHIP /RANGE /PARCEL NUMBER] [OR TAX ID NUMBER] [ ] MOUND [ ] [ ] ] ,( •' T] ABOVE,ELOW« BENCHMARK/ EFERENCE POINT ] [INCHES /FT] -ABOVE %BELOW] BENCHMARK /REFERENCE POINT EXCAVATION REQUIRED: 0 /3 ] INCHES STALL OF L AMY CODE SA D UNDER BorroM OF DRATNFTP3 ` 0 A'.IVERT F.!.E VA la " ••! w"IftOrVi OF 11 T TITLE: APPLICANT TITLE: CPHU EXPIRATION DATE: �� • Page 1 of 2 4; :' Tc: U2 ?:. J Tny I:. 7." r-12.i..1730? :TY C7 (:.:,;;;77 f:)r:f; CE; ;3111: :• .; '.1C71 7 ." fro 5 AC. 1!2:'1 FAc. 2IL !;;;C■y" Purl- !29, V1 31CC •:" :evilly 2L15 Unit f',"?.:-": f) nnsi r?p:ovins issuai !■,'! h7;, VC g0 . 7,-; i' -•— :7%; Permit No gt7 MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMEi `: APPLICATION FOR PLUMBING Application is hereby made for the approval of the detailed statement of the plans and specifications herewi l 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. 9 A / Q Owners Name and Address .._____.- ________________ �� - No. '3 gJ Street_ A t y ?(5 Location and Legal Description Lot. _______.___-- __- _._---._-__-__ Street and Number where work is to be performed- No.______ Dat L it 3 Registered Architect and /or Engineer --- _ .---- - _---- -- , - .-- --- _ - - __ _ Employing Plumber's Namen!) L1L1h �_. � _ ______�T� � � "__ Street..__ ----- �°!,�r - -• -� Block ___ Subdivision _..__.,___._ 2' G Stieet 1LLE 29 S F State work to be performed and purpose of building (By Floors) ____ / ddition._.___._ Repairs a/ No. of Stories. New Building . •__ -_ -- Remodeling_ —_ _ -- A Size Septic Tank _ Type of Tank Capacity Gals Feet of Drain Tile _____Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: City -Well —_— --- - - - - -- -ice Amount of Permit $ / ( Signed ) _ 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 w' ch public notice or notices as are required by the Act. The undersigned agrees to employ only such sub - contracto inn work t. s . erformed under this pe nit, as are licensed by Miami Shores Village. STATE OF FLORIDA, u. COUNTY OF DADE. Size of Soakage Pit Before me, the undersigned authority, a notary public, duly authorized to a ( Signed ster oaths and take acknowledgments, personally appeared to me wcil 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 Plumbing Inspector. Master Plumber. NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made•necessary by improper notice for inspection, or faulty materials and /or workmanship. CLOSETS BATH TU85 SHOWERS LAVA. TORIE8 NKS SINKS SLOP SINKS LAUNDRY Tugs URINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT' NS TOTAL FI %TURES CONTR. LIST CHICK SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SW IM•G POOL CONTR. LIST CHECK Permit No gt7 MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMEi `: APPLICATION FOR PLUMBING Application is hereby made for the approval of the detailed statement of the plans and specifications herewi l 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. 9 A / Q Owners Name and Address .._____.- ________________ �� - No. '3 gJ Street_ A t y ?(5 Location and Legal Description Lot. _______.___-- __- _._---._-__-__ Street and Number where work is to be performed- No.______ Dat L it 3 Registered Architect and /or Engineer --- _ .---- - _---- -- , - .-- --- _ - - __ _ Employing Plumber's Namen!) L1L1h �_. � _ ______�T� � � "__ Street..__ ----- �°!,�r - -• -� Block ___ Subdivision _..__.,___._ 2' G Stieet 1LLE 29 S F State work to be performed and purpose of building (By Floors) ____ / ddition._.___._ Repairs a/ No. of Stories. New Building . •__ -_ -- Remodeling_ —_ _ -- A Size Septic Tank _ Type of Tank Capacity Gals Feet of Drain Tile _____Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: City -Well —_— --- - - - - -- -ice Amount of Permit $ / ( Signed ) _ 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 w' ch public notice or notices as are required by the Act. The undersigned agrees to employ only such sub - contracto inn work t. s . erformed under this pe nit, as are licensed by Miami Shores Village. STATE OF FLORIDA, u. COUNTY OF DADE. Size of Soakage Pit Before me, the undersigned authority, a notary public, duly authorized to a ( Signed ster oaths and take acknowledgments, personally appeared to me wcil 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 Plumbing Inspector. Master Plumber. NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made•necessary by improper notice for inspection, or faulty materials and /or workmanship. BUILDING ELECTRICAL PLUMBING Architect Contractor or Builder MIAMI SHORES VILLAGE, FLORIDA DATE PERMIT N? 3816 A Work to be performed under this Permit Owner of Building Legal Lot Bl. Description Address of Building 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 application 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 responsibility for work done by his agents, servants or employees. Signed• By INSPECTOR In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regula- tions 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. Subdi- vision Value of Project 194_ Contractor's License No .A'ti,.p;(; Th!s Co,Istr;lciion may be in violation of Vtiar ;'iOfii rjn �;,:tr l Gc: er , Limitatags Q` 1 1 r r 41 i vp :i(t ' ei!ui,i;i d i0 Vial PIoda.,.ion Et►a,d office before the wor aut; oriz �i in th(S permit. Amt. of Permit CONTRACTOR OR BUILD* BY AUTHORITY BUILDING ELECTRICAL PLUMBING ROOFING Owner of Building i Architect Contractor or Builder s Legal Lot Description Bl Address of -- - Building ' 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 application 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 responsibility for work done by his agents, servants or employees. In consideration of the iss ce to me pertaining thereto and in strict formity with cepting this permit I assume spo sibiliy for CONTRACTOR OR BUILD MIAMI SHORES VILLAGE. FLORIDA o PERMIT 1■19 2862 Work to be performed under this Permit 1 . Signed- INSPECTOR DATF Contractor's License No. 195 Subdi- vision Value of Project $ .',..' BY Amount of Permit $ of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In ac- all work done by either, myself, my agent, servant or employee. BY AUTHORITY ems. MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building , Inspection Request Date )2-1 I') 1 <eS Type Insp'ncc Permit No. ` T 345 Name e—Cne-A n Address & xD , Company Phone # Inspection Date Approved Correction Re- Insp'n Fee ' MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date o %� Type Insp'n Permit No. Name o v'2 '3� ri Address (1 e/ � - Company Phone # (0)) Inspection Date Approved Correction Re- Insp'n Fee Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Printed: 12 /13/2004 Applicant: ROBERTO Owner: RODRIGUEZ JOB ADDRESS: 269 Parcel # 1132060134570 NE 99 Contractor CONSUMER GAS PLUMBING CORP. Local Phone: 305 - 608 - 5400 Plumbing Permit Permit Number: PL2004 -343 RODRIGUEZ ROBERTO ST Contractor's Address: 4510 SW 154 PLACE Page 1 of 1 Legal Description: MIAMI - SHORES SEC 1 AMD PB 10 -70 LOT 20 & 21 BLK 33 LOT SIZE 100.000 Fees: FEE2004 -12489 FEE2004 -12490 FEE2004 -12491 FEE2004 -12492 FEE2004 -12493 FEE2004 -12494 Description Building Fee CCF Training and Education Fee Technology Fee Scanning Fee Submittal Fee Total Fees: Amount $140.00 $0.60 $0.20 $3.50 $3.00 ($50.00) $97.30 Total Fees: $97.30 Total Receipts: $0.00 Permit Status: APPROVED Permit Expiration: 6/1/2005 Construction Value: $350.00 Work: LP LINE AND TANK SET ® EC 14 PAID Signed: (INSPECTOR) 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: 10050 N.E.2nd Avenue, Miami5hore& -F ririda 33138 Tel: (30 ;�(g ' 6.8972 BUILDING DEC 0 3 ," Permit No. Pt_ a00tk -3V3 ,3 PERMIT APPLICATION a -Master Permit No. FBC 2001 $ Value of Work For this Permit Type of Work: DAddition Describe Work: Total Fee Now Due $ (Continued on opposite side) Miami Shores Village Building Department 1. 3 Sp. 00 teration Permit Type (circle): Building Electrical Plumbing Mechanical Roofing Owner's Name (Fee Simple Titleholder) �B Ot2i b k&R-IC l) CZ Phone # 3 05- .. 5 - 3 O 1 Owner's A Address 77.--(41 N E 61,ci ' i • City A 5 ss fLC 2 State rt— • Tenant/Lessee Name Phone # ❑New Zip Job Address (where the work is being done) a (Dq f\) G s Rl 5V City Miami Shores Villa= County Miami -Dade Zip Is Building Historically Designated YES NO ' Company Name CO Y‘ S vvn G R. G s Phone # S 0 B . a 0 - �- S Contractors p y Contractor's Address D f S4 7Li' e t City J� W�‘ te FL- . Zip � 'K Qualifier G `^ �—� ° C �`� Sta `L . Architect/Engineer's Name (if applicable) Phone # L \' e -.E- `C r ❑ Repair/Replace ❑ Demolition Square Footage Of Work: * * * * * * * * * * * * * * * * * * * * * * * * * * ** Fees * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** ` e7'" Submittal Fee $ Permit Fee $ �11 CCF $ Notary $ Training/Education Fee $ ' t )o Technology Fee $ Scanning $ Radon $ Bond $ Code Enforcement $ Structural Plan Review. $ /0 (i3 Bonding Company's Name (if applicable) Bonding Company's Address City State Zip 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 conunenced 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 CONDMONERS, 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 whos • • • is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site fo the first insp n whic(r occurs seven (I) days after the building permit is issued. In the absence of such posted notice, the inspection will not be ' pproved and a r infection fee will be charged. Signature er or Agent The foregoing instrument was a day of , 20 _, by who is personally known to me or• ,l p As ide NOT Sign: Print: C My Commission Expires: - f 7 - ******** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** APPLICATION APPROVED BY: Chc 10/14/03 owledged b thi produced did take an oath. `\ * * **, * * * ** Signature or The foregoing instrument was a -• ./ before me this day of , 20 _ , by G o Vi o Q.- 0 0 , who is personally known to me or who as identificatiotr' _ . f NOTARY PUB Sign: (Certificaompetency Holder) State Certificate or Registration No. ( 7 3 6 0 A ,, 4 ; . a 4j� N My Commission Expires: `kt '1' #`4) ` **************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** `2 ti * C ff J � \ Print: C Q•11c 5 Certificate of Competency No. *********************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** roduced 'd take an oath. C7 Plans Examiner Engineer Zoning Scale: 1" = 20' This Survey Map is not valid without the signature and original raised seal of a Florida Registered Land Surveyor and Mapper. B oundary Li y Li rNr y Fa 3/4" IP z b x 491._ 0.30' OljT LOT 1 19 ) BLOCK 33 I L'P TAnIe. 40 6ALLDA 1 2 ro &66' 5PAce Tr. 0.50 CL Fa 314" IP 1 0 0 851 15. ALLEY 11.61' z 0 LOT 20 BLOCK 33 STORY AMILY RESIDF_NCE S 269 34.65. 9.55' (1) 011111111111 0 .. Num .....11.1.1 0 0 ..............14 • is ow le. me vox 4 BRICK • Em me 8.4 su4 4 me I= 0 C. ATM j• -- v tO I um a 4 enolomm....11, .•.........• 4 ,milimmm..• - ,0.14.1=4.......4 9.00' • milni ni v e r 4 111!■" (4 16.40' Omsmommaiommkil I ',. OM ormrom B•lird , 01••••=1101••••14 e j 01111MBIMBI•11•MB•• AIMMIIIIIIMIIMIIIIIMIII. 11111111r ow im us ____=4 emi4 ..........4 • 11M10 ■ 100.00(P) 100.16(M) io• ASPHALT PAVEMENT LOT 21 X BLOCK 33 x x x--I i 100.06(M) 100.00' (P) 23' PARKWAY 42.4 '4> ( 2V ASPHALT PAVEMENT Page 2 of 2 Survey Number. 2088 (See Reverse) Fa 3/4" IP L;3' OUT —1 LOT BLOCK 33 x 1 1W °UT D. O5. IN 103217 (P) Fa 103.24' (M) 3/4•/p 1/ B.C. NAME: ROBERTO RODRIGUEZ ADDRESS: 269 NE 99ST MIAMI SHORES Phone 1: 305 751 -3017 Phone 2: CLIENT INFORMATION: Folio: Total Gas Load :60 000 BTUH Total Developed Length : 25' CONSUMER GAS PLUMBING CORP. 4510 SW 154PL MIAMI FL 33185 305 608 -5400 TABLE 402 (26) COMPANY INFORMATION: COOK TOP 60 000 BTUH SOV 3/4" 25' INTEGRAL 1/2" PIPE REGULATOR ACROSS ESPACE PRESSURE 11" WC 1 40 GALLONS LP TANK A/G LYING DOWN . 10' AWAY `I U FROM ANY SOURCE IGNITION Permit No. Amount of Permit $ MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT 53 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 Judge Goo. E. Holt No. Registered Architect and /or Engineer Employing Plumber's Name G. C • _ MCC+ 1 N3_ Street. N. Baishor• Dr! Location and Legal Description Lot___y___ Street and Number where work is to be performed —No _ 269_11..___E..- - 9.9t—,at Street NiAIDj_£h0r81.,_11s . State work to be performed and purpose of building (By Floors) New Remodeling Addition Repairs No. of Stories Size Septic Tank______ Type of Tank Feet of Drain Ti1e________________________ Dist. Feet of Tank or Drain Field from Well__ Nature of Water Supply: City— Well. .Size of Soakage Pit. ° v (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 ander 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 the work such public notice o otices as are required by the Act. The under signed agrees to employ only such sub - contractors, o be performed under th . rmit, as are licensed by Miami Shores Village. My Commission Expires (Signed Date______ -- Capacity Gals._________ Master Plumber. STATE OF FLORIDA, COUNTY OF DADE. ss. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally Notary Public. State of Florida appeared me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty materials and /or workmanship. CLOSETS BATH "rues SHOWERS LAVA- TORIES SINKS SLOP SINKS LAUNDRY Tuns URINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT'NS TOTAL FIXTURES CONTR. L ST 1 1 1 CHECK SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SWIM'G POOL CONTR. LIST CHECK Permit No. Amount of Permit $ MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT 53 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 Judge Goo. E. Holt No. Registered Architect and /or Engineer Employing Plumber's Name G. C • _ MCC+ 1 N3_ Street. N. Baishor• Dr! Location and Legal Description Lot___y___ Street and Number where work is to be performed —No _ 269_11..___E..- - 9.9t—,at Street NiAIDj_£h0r81.,_11s . State work to be performed and purpose of building (By Floors) New Remodeling Addition Repairs No. of Stories Size Septic Tank______ Type of Tank Feet of Drain Ti1e________________________ Dist. Feet of Tank or Drain Field from Well__ Nature of Water Supply: City— Well. .Size of Soakage Pit. ° v (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 ander 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 the work such public notice o otices as are required by the Act. The under signed agrees to employ only such sub - contractors, o be performed under th . rmit, as are licensed by Miami Shores Village. My Commission Expires (Signed Date______ -- Capacity Gals._________ Master Plumber. STATE OF FLORIDA, COUNTY OF DADE. ss. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally Notary Public. State of Florida appeared me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty materials and /or workmanship. BUILDING ELECTRICAL PLUMBING Owner d Building Architect Contractor or Builder • � Legal Lot Bl. Description I _ ! •� MIAMI SHORES VILLAGE, FLORIDA PERMIT N° 2534 Work to be performed under this Permit Address of Building 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 application 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 thg plans or drawings or in the statements or specifications and that he assumes responsibility for work done by his agents, servants or employees. , E '1 / Signed-, By / INSPECTOR In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regula- tions 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 tie by eitr myself, tj agent, servant or employee. "4 ) CONTRACTOR OR BUILDER 1 °r...� ! BY AUTHORITY Subdi- vision Value of Project DATE 194 Contractor's /- License No. Amt. of Permit Permit No.__ ___9e6 _ 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 cp¢tplied with, whether herein specified or not. A copy of approved plans and specifications m kept at building during progress of work Owner's Name and Address Registered Architect and /or Engineer __ Employing Plumber's Name " No Location and Legal Description Lot_ Block_ •✓ Street and Number where work is to be performed— No u____ Street State work to be performed and purpose of building (By Floors) New Building Remodeling Addition Repairs Amount of Permit $_ PLUMBING INSPECTION EPARTMENT APPLICATION FOR PLUMBING PERMIT Date) SS. My Commission Expires MIAMI SHORES VILLAGE No e5?,0 (Signed) f Street__ Street Subdivision Notary Public, State of Florida Size Septic Tank -- Type of Tank Capacity Gals. Feet of Drain Tile_ Feet of Tank or Drain Fiel. from Nature of Water Supply: City —Well No. of Stories Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The under signed agrees to employ only such sub - contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. Master Plumber. STATE OF FLORIDA, COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the. of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. 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 SWIM•G POOL CONTR. LIST CHECK Permit No.__ ___9e6 _ 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 cp¢tplied with, whether herein specified or not. A copy of approved plans and specifications m kept at building during progress of work Owner's Name and Address Registered Architect and /or Engineer __ Employing Plumber's Name " No Location and Legal Description Lot_ Block_ •✓ Street and Number where work is to be performed— No u____ Street State work to be performed and purpose of building (By Floors) New Building Remodeling Addition Repairs Amount of Permit $_ PLUMBING INSPECTION EPARTMENT APPLICATION FOR PLUMBING PERMIT Date) SS. My Commission Expires MIAMI SHORES VILLAGE No e5?,0 (Signed) f Street__ Street Subdivision Notary Public, State of Florida Size Septic Tank -- Type of Tank Capacity Gals. Feet of Drain Tile_ Feet of Tank or Drain Fiel. from Nature of Water Supply: City —Well No. of Stories Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The under signed agrees to employ only such sub - contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. Master Plumber. STATE OF FLORIDA, COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the. of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. 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. Owner's Name and Address _ `4 • Registered Architect and /or Engineer __ Employing Plumber's Name Location and Legal Description Lot Size Septic Tank Type of Tank Amount of Permit $ MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT s� APPLICATION FOR PLUMBING PERMIT Permit No. ___ 2 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 c building during progress of work. plied with, whether herein specified or not. A copy // 6' ' i t r� __ __ ,:= No. Street L 1_'__B1ock_ (Signed) Feet of Drain Tile__ _ __ tst. Feet of Tank or Drain Field from L Nature of Water Supply: City —Well 4_ , � Size / -of Soak ge' Pit \ Y Subdivision Street and Number where work is to be performed —No Street State work to be performed and purpose of building (By Floors) New Building — Remodeling Addition Repairs (Signed) of approved plans and specifications must be kept at Street__ {. My Commission Expires Notary Public, State of Florida No. of Stories Capacity Gals Master Plumber. Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit: and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The under signed 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, I ss. COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. 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 H EATER DEEP WELL SPRKLR. SYSTEM SWIM•G POOL CONTR. LIST CHECK Owner's Name and Address _ `4 • Registered Architect and /or Engineer __ Employing Plumber's Name Location and Legal Description Lot Size Septic Tank Type of Tank Amount of Permit $ MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT s� APPLICATION FOR PLUMBING PERMIT Permit No. ___ 2 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 c building during progress of work. plied with, whether herein specified or not. A copy // 6' ' i t r� __ __ ,:= No. Street L 1_'__B1ock_ (Signed) Feet of Drain Tile__ _ __ tst. Feet of Tank or Drain Field from L Nature of Water Supply: City —Well 4_ , � Size / -of Soak ge' Pit \ Y Subdivision Street and Number where work is to be performed —No Street State work to be performed and purpose of building (By Floors) New Building — Remodeling Addition Repairs (Signed) of approved plans and specifications must be kept at Street__ {. My Commission Expires Notary Public, State of Florida No. of Stories Capacity Gals Master Plumber. Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit: and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The under signed 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, I ss. COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. 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. JOB: BUILDING ELECTRICAL : PLUMBING • • Inspector's Report: ......yo•■••■•••■•••■••••■••■••■•■■■■•••■ AD: • WORK : DONE BY: • • : REQUESTED The following is ready for Inspection: • 2f— 4./ • • • • „ 49 74— e / 4 : WILL BE READY o ( (7 JOB: BUILDING • Inspector's Report: ELECTRICAL AD: `�.6 PLUMBING •. WORK DONE BY: • •REQUESTED : WILL BE READY • • d /i r /6 • • / e • • • • • • • • • • • r • • • • • • The following is ready for Inspection: • • • BUILDING ELECTRICAL PLUMBING Legal Lot Description v Address of ' f Building Work to be performed under this Permit Owner of Building j Architect Contractor or Builder 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 application 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 plan! dr, drawings or in the statementgror.apecifications and that he assumes responsibility for work done by his agents, servants or employees. A -- ,,,,,.- Signed.a. x .. r,,. In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regula- tions 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 1 assume responsibility , �ior all work done by either myself, my agent, servant or employee. / V , 4 , CONTRA OR BUILDER MIAMI SHORES VILLAGE, FLORIDA PERMIT N° 1544 B BI Subdi- vision Value of Project DATE 194_ Contractor's License No. Amt. of Permit ay INSPECTOR BY AUTHORITY