304 NE 99 St (2)MIAMI SHORES VILLAGE
BUILDING`DEPAR
305- 795 -2204
Building Inspection Request
Date 3 I ') D
Type Insp'n .bh I (TQ ,Q 11 G
Permit No. el 20b3 - 261
Name
3() NIL Gast
&2j
, r 1cjep ^ p �
Address
Company
Phone #
Inspection Date 3
Approved
Correction
Re-Insp'n Fee
MIAMI SHORES VILLAGE
g BUILDING DEPARTM
305- 795 -2204
Building Inspection Reque
D
Type Insp'n
Permit No.
Name
Company
Phone #
Address 3 O r
Inspection Date
Approved
Correction
Re- Insp'n Fee
\ C. 9.7 -4,
Date
Type Insp'n
Correction
Re- Insp'n Fee
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
Buildin: Inspection Request
4
Permit No.
Name g 119414 71-8 14-eJ
Address 3o 4) e" j ,J,F
Company
Phone # (J•) 9 99
Inspection Date ! / / .°)*
❑
Miami Shores Village
1
RECE V
OCT 0 6 2003
BUILDING
PERMIT APPLICATION
FBC 2001
Permit Type (circle): Building Electrical
Owner's Name (Fee Simple Titleholder) TA,. fa A (9t' S- Phone # 3 7 4 7 -1 7 50
Owner' Address 3 0'4 Ale ' R 5 T
City i 7/ A Sii—t l /:i Ft Zip
Tenant/Lessee Name Phone #
Job Address (where the work is being done) 3 0 'f
City Miami Shores Village
Is Building Historically Designated YES
Contractor's Company Name l___ rr / '
Contractor's Address 2- /6 5' S m 5 i
City 9.4-44 /4 ed.-4 State
Qualifier /-f G n / 4 / // 4ga e
$ Value of Work For this Permidi
Number of: Bays Stories
Type of Work: ['Addition IgiAlteration
Describe Work: Rot-41 + Sz
c_ Z(2 ?)
Building Department
County
NO
Miami -Dade Zip
•
Minus Plans Check Fee $ " 6h Total Fee Now Due $
Permit No. cy`t
Master Permit No. 61
lumbing Mechanical Roofing
Phone # '.3 05 - - 7 1`( -7 •�
Zip 3 30O'-{
Square Footage Of Work: 0
* * * * * * * * * * * * * * * * * * * * * * * * * * ** F ees * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
County Escrow Fee $ 1, 0 Permit Fee $ .60 0 v Notary $ 7 v 0
Education/Training Fee $ L i 0 Tech $ 3. g Scanning $
Code Enforcement $ Bond $ Struct. $
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
Families Bedrooms Baths e*i- e_
['New ❑ Repair/Replace ❑ Demolition
l T( to c_ / /At
Architect/Engineer's Name (if applicable) - Phone #
Architect/Engineer's Address
City State Zip
Radon $ ,
(Continued on opposite side)
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
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 certif ed 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.
Signature
Owner or Agent
The foregoing instrument was acknowledged before me this
day of ,20
who is personally known to me or who has produced
As identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
Signature IC ) ezi
Contr ctor p
The foregoing instrument was acknowledged before me this2._I
day of Tt • , 20 , by t1" IC 1- -610es
'
who is personall known to me or who has produced
II as identification and who did take an oath.
, Mabel Vargas
comm on #D P 1984
J / I 1 / �
• o , L' I. 13,21.7
NOTARY P
Sign
Print:
My Commission Expires: My Commission Expires:
(Certificate of Competency Holder)
State Certificate or Registration No. Certificate of Competency No.
•* * * * * * * * * * * * * * * * * * * * * * * * * * * *,* ** **
APPLICATION APPROVED B
chc7nio3
Plans Examiner
Engineer
Zoning
'EM
; TH TU3
UNIT
./
FEE
ITEM
SWITCH OUTLETS
UNIT
FEE
ITEM
SPACE HEATERS
UNIT
FEE
LIGHT OUTLETS •
CENTRAL HEATING
.DET
'SHWASHER
RECEPTACLES
A/C (WINO)
SPOS{L
SERVICE TEMPORARY
A/C (CENTRAL)
LINKING FOUNTAIN
SERVICE SIZE IN AMPS
DUCT WORK
DRAIN
SERVICE REPAIR/MIETER CHANGE
REFRIGERATION
_OOR
TEASE TRAP
APPLIANCE OUTLETS
PROCESS AND PRESS PIPING
4TERCEPTOR
RANGE TOP
UNDERGROUND TANKS
WVATCRY
)
OVEN
ABOVE (MOUND TANKS
AJNDRY TRAY
WATER HEATER
U.F. PRESSURE VESSELS
_OTHES WASHER
MOTORS 0- 1 HP
STEAM BOILERS
,'OWER
MOTORS OVER 1- 3 HP
HOT WATER BOILERS
INK, POT /3 COMP.
MOTORS OVER 3- 5 HP
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
ATER CLOSET
/
MOTORS OVER 100 hP
VIOLATION
.DIRECT-WASTES
A/C WINDOW
REINSPECTION
ATER SUPPLY TO:
AIR CONDITIONERS
-
A/C UNIT
STRIP HEATER
FIRE SPRINKLER
GENERATORS TRANSFORMERS
•
HEATER -NEW INST.
GENERATORS TRANSFORMERS
HEATER - REPLACE
GENERATORS TRANSFORMERS
LAWN SPRINKLER -WELL
SPECIAL PURPOSE
SWIMMING POOL
OUTLETS COMfiERCIAL
WATER SERVICE
SIGN TUBES
EWER CONNECTIONS
SIGN TRANSFORMERS
TILITY- SEWER
SIGN TIME CLOCK
TILITY -WATER
FIXTLRES
EPTIC TANK
ANTENNA
ELAY
TELEVISION OUTLETS
RAINFIELD, 4' TILE/RES.
VIOLATION
'UR & ABANDON SEPTIC TANK
REINSPECTION
WAGE PIT CU. FT.
•
:ATCH BASIN
)ISCHARGE WELL
,OMESTIC WELL
iREA DRAIN
100F INLET t
OLAR WATER HEATER I .
'IRE STANDPIPE
'OOL PIPING
•
.AWN SPRINKLER SYSTEM
1AS RANGE
ETER SET (GAS)
1AS PIPING
APPLICATION FOR'BLTILDING 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
ADDENDUM TO BUILDING PERMIT APPLICATION
ELECTRICAL
MECHANICAL
BP #23700
.a=s
Permit No c1R-3 7 6
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 Richard Grande N 304 N.E. 99 St. st
Registered Architect and/or Engineer
Emp n N Doug] asOrr P1 umbi n Inc. N Flag) er i 33166
Location and Legal Description Lot. Mork Subdivision
Street and Number where work is to be performed—No 304 N.E. 99 Street Street.
State work to be performed and purpose of building (By Fi 1 ation
New Building. Rernodeling_X.. Addition. Repairs No. of Stades... .....
Size Septic Tank__
Feet of Drain Tile
Nature of Water Supply: City—Well.
STATE OF FLORIDA,
u.
COUNTY OF DADE.
aQ-
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Type of Tank__
_Dist Feet of Tank or Drain Field from .... _ .....
Size of Soakage Pit
'1
(si ktEAVCL
Plumbing Inspec tor.
(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 hive 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 te of the work such public notice or notices as are
required by the Act. The undersigned agrees to employ only such sub-contractors, k to be p11med under this permit, KO are
licensed by Miami Shores Village.
Capacity
Master Plumber.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
Douglas Orr
to me well known, and who, being by me first duly sworn, upon oath deposes and says that be is the plum bi ng contractor
of the above Alooribed construction, that he has carefully read the foregoing applicstion. and that he did sign the same, and that all facts
t b iekkilfeSTATE OF FLORIDA AT LARcg
Y C OMMISSION EXPIRE MAR 7 1984
BOND ptj
444 EitikEVERWK I I tR$
My CoMmission
Notary Public, State of Florida
NOTE: A re-inspection fee of $1.00 will ba made when ancis miarpootiva le sonde nsoissary by improper nosier for lespection, or faulty
materials and/or workmanship.
CLOUTS
BATH
Tull,.
SHOWERS
LAVA-
TORIES
SIMKO
SLOP
SINKS
LAUNDRY
Tuns
UniNALII
CATCH
BASIN
FLOOR
DRAIN
DRINK i NO
FOUNT' NO
TOTAL
FIXTURE,
Cos.
LIIIIT
2
1
2
.5".
CHECK
—
-..
....
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
G
TRAP
SOLO. PI
HEATER
Davi
WELL
5 .
SYSTEM
SWIN'O
POOL
CONTR.
EXiSt.
LI WT
C NICK
BP #23700
.a=s
Permit No c1R-3 7 6
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 Richard Grande N 304 N.E. 99 St. st
Registered Architect and/or Engineer
Emp n N Doug] asOrr P1 umbi n Inc. N Flag) er i 33166
Location and Legal Description Lot. Mork Subdivision
Street and Number where work is to be performed—No 304 N.E. 99 Street Street.
State work to be performed and purpose of building (By Fi 1 ation
New Building. Rernodeling_X.. Addition. Repairs No. of Stades... .....
Size Septic Tank__
Feet of Drain Tile
Nature of Water Supply: City—Well.
STATE OF FLORIDA,
u.
COUNTY OF DADE.
aQ-
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Type of Tank__
_Dist Feet of Tank or Drain Field from .... _ .....
Size of Soakage Pit
'1
(si ktEAVCL
Plumbing Inspec tor.
(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 hive 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 te of the work such public notice or notices as are
required by the Act. The undersigned agrees to employ only such sub-contractors, k to be p11med under this permit, KO are
licensed by Miami Shores Village.
Capacity
Master Plumber.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
Douglas Orr
to me well known, and who, being by me first duly sworn, upon oath deposes and says that be is the plum bi ng contractor
of the above Alooribed construction, that he has carefully read the foregoing applicstion. and that he did sign the same, and that all facts
t b iekkilfeSTATE OF FLORIDA AT LARcg
Y C OMMISSION EXPIRE MAR 7 1984
BOND ptj
444 EitikEVERWK I I tR$
My CoMmission
Notary Public, State of Florida
NOTE: A re-inspection fee of $1.00 will ba made when ancis miarpootiva le sonde nsoissary by improper nosier for lespection, or faulty
materials and/or workmanship.
BUILDING ❑ MIAMI SHORES VILLAGE, FLORIDA e
Da 19 4f
ELECTRICAL ❑
PLUMBING ❑ PERMIT N9 9020 Contractor's teL. z ►
RO ?ING ❑ License No.
LJ . Work to be performed under this Permit
Owner of
Building a t ��. r
Architect
Contractor ! 1 C -
or Builder s El. .t , -/ C �}� r� , i ,-
Legal Lat i 1
Description 11 B1
I ( Address '7 r
Building < /[�
, : Cr-- / .- ,( Ir
4 j am . r . rr
CON AC/OR or BUILDER
BY
L
Subdi-
vision
Sq Ft
Value of 11 Amount of
Project $ 11 Permit $
This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the applica-
tion herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any
plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked
at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this
permit is granted is the understanding that the contractor or builder name bove assumes the responsibility for a thorough knowledge of the ordinances and
regulations pertaining to the work covered hereby whether shown pn the fans or drawings or in the statements or specifications and that he assumes respon-
sibility for work done by his agents, servants �r emplq'ees.
C j
Signed { a -?r �[ " +- tee- (I ECTOR) BY
In consideration of the issuance to me of this permit I a r to perform the work covered hereunder in compliance with all ordinances and regulations
pertaining thereto and in strict conformity with the plans, dra 4n s, statements or specifications submitted to the proper authorities of Miami Shores Village.
In accepting this permit I assume responsibility for all work qne by either, myself, my agent, servant or employee.
•
AUTHORITY
.. MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
C ) f Permit No ___ . Z G� f JJ' Z - C.,' - -. -- Date 6
Application i hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build ng or other
structure herein described. This application is made in comphance 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 th Building Div slon
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. --L ��_ _OUH _ No. : 3 o �- /1J -- __ - - q 9 Street /n /_!gym /. ' • o ' e _4"
Registered Architect and /or Engineer _ . ________ __- -_______—�.______
Employing Plumber's Name. D v "y Spvi a _ _ No.l ll ° n ,- t - /1,1,9%. # - -
Location and Legal Description Lot _ _ _ Block_ _ Subdivision. _ `
Street and Number where work is to be performed —No 3 oX '' ' 99 - Street /!q!°!_..S`i e:e_F,s
State work to be performed and purpose of building (By Floors)._ _ -
New Building ___ -- _ - • -- - -- - -- Remodeling____ ___ _. _ _ _ Addition._._ . _. ____ __ _ Repairs_
Size Septic Tank -_ _ -- Type of Tank _- ---_- - -- _ •- _
Feet of Drain Tile. - .. ___ _- _ _- _ __ _ - _._ _Dist Feet of Tank or Drain Field from Well.
Nature of Water Supply. City —Well.
Amount of Permit $
STATE OF FLORIDA, 1
COUNTY OF DADE.
__ _ Si a of Soakage Pit
- (Signed)-
Capacity Gals.
._. No. of Stories . .
Pl..mb ng In :pecto -
The undersigned applicant for this building permit does hereby certify that he understands and accepts his oblig , • s as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, owl 1.1.4 tom••
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by hin in the woak 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 no ices as are
required by the Act. The undersigned agrees to employ only such sub contractors, on work to be perfo. ed under this per nit, as are
licensed by Miami Shores Village.
( Signed )
Master Plumber.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgn ents, personall 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 apphcation, and that he did sign the same, and that all •acts
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•neoessary by improper notice for inspection, or faulty
materials and /or workmanship.
CLOSETS
BATH
TUBE
SHOWERS
LAVA-
TORIES
INK
SINKS
SLOP
SINKS
LAUNDRY
TUBS
U
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOU 'T'NS
TOTAL
F %TURES
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
,
! /
.. MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
C ) f Permit No ___ . Z G� f JJ' Z - C.,' - -. -- Date 6
Application i hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build ng or other
structure herein described. This application is made in comphance 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 th Building Div slon
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. --L ��_ _OUH _ No. : 3 o �- /1J -- __ - - q 9 Street /n /_!gym /. ' • o ' e _4"
Registered Architect and /or Engineer _ . ________ __- -_______—�.______
Employing Plumber's Name. D v "y Spvi a _ _ No.l ll ° n ,- t - /1,1,9%. # - -
Location and Legal Description Lot _ _ _ Block_ _ Subdivision. _ `
Street and Number where work is to be performed —No 3 oX '' ' 99 - Street /!q!°!_..S`i e:e_F,s
State work to be performed and purpose of building (By Floors)._ _ -
New Building ___ -- _ - • -- - -- - -- Remodeling____ ___ _. _ _ _ Addition._._ . _. ____ __ _ Repairs_
Size Septic Tank -_ _ -- Type of Tank _- ---_- - -- _ •- _
Feet of Drain Tile. - .. ___ _- _ _- _ __ _ - _._ _Dist Feet of Tank or Drain Field from Well.
Nature of Water Supply. City —Well.
Amount of Permit $
STATE OF FLORIDA, 1
COUNTY OF DADE.
__ _ Si a of Soakage Pit
- (Signed)-
Capacity Gals.
._. No. of Stories . .
Pl..mb ng In :pecto -
The undersigned applicant for this building permit does hereby certify that he understands and accepts his oblig , • s as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, owl 1.1.4 tom••
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by hin in the woak 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 no ices as are
required by the Act. The undersigned agrees to employ only such sub contractors, on work to be perfo. ed under this per nit, as are
licensed by Miami Shores Village.
( Signed )
Master Plumber.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgn ents, personall 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 apphcation, and that he did sign the same, and that all •acts
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•neoessary by improper notice for inspection, or faulty
materials and /or workmanship.
BUILDING
ELECTRICAL
PLUMBING
Owner of
Building
14�
MIAMI SHORES VILLAGE, FLORIDA
PERMIT N9 3431
Work to be performed under this Permit
WARNING: This Construction may be in violation of
Wm Production Hoard 611e1 at limile(iurrs Order 41
Architect
Contractor
or Builder
Subdi-
vision
Legal Lot Bl.
Description
Address of Value of
Building / , ' Project
DATE
You are cautiond to consult your War Pioduc.vi
Board uffice berore swung ure woiK autnoriztii In
this permit.
Amt. of
Permit
/ 194
Contractor's
License No
This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the
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 ork 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 f
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 woyk done by either myself, my agent, servant or employee.
v or
i
CONTRACTOR OR BUILDER BY M AUTHORITY
Permit No
Application is hereby made for the approval of the detailed statement of the plans and specifications h ith submitted for the building or other
structure herein described. This application is made in compliance and conformity with the Building j'•inance of Miami Shores Village, Florida,
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all` • es and regulations of the Building Division
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of ap oved plans and specifications must be kept at
building during progress of work.
Owner's Name and Address A
,),:k1 __��'� 21/Q•lzf � =L - ,� . Street-2i , " g
Registered Architect and /or Engine
Employing Plumber's Name —.L _ . No._:..? z _ 6 street___K[` • _./L 4 •
Location and Legal Description Lot_____— _______ _________________________Block 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 No. of Stories____
Size Septic Tan ___.. .__ _ _, Lr!`'! '_ — Type of "Tanit____•
Feet of Drain Tile_________________W___ ___ —__ Dist. Feet of Tank or Drain Field from Well__
Nature of Water Supply: City —Well.
Amount of Permit S_
The undersigned applicant for this building permit does hereby certify that he untands and accepts his obligations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled Gene 1 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,
COUNTY OF DADE. ss.
MIAMI SHORES VILLAGE
APPLICATION FOR PLUMBING PE
i
My Commission Expires
PLUMBING INSPECTION DEPARTMENT
Size of Soakage Pit
_(Signed)
(Signed)
_Capacity Gals.________________,_
Notary Public. State of Florida
Plumbing Inspector.
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 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 DEEP
HEATER WELL
SPRKLR.
SYSTEM
SWIM'G
POOL
CONTR.
LIST
CHECK
A
Permit No
Application is hereby made for the approval of the detailed statement of the plans and specifications h ith submitted for the building or other
structure herein described. This application is made in compliance and conformity with the Building j'•inance of Miami Shores Village, Florida,
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all` • es and regulations of the Building Division
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of ap oved plans and specifications must be kept at
building during progress of work.
Owner's Name and Address A
,),:k1 __��'� 21/Q•lzf � =L - ,� . Street-2i , " g
Registered Architect and /or Engine
Employing Plumber's Name —.L _ . No._:..? z _ 6 street___K[` • _./L 4 •
Location and Legal Description Lot_____— _______ _________________________Block 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 No. of Stories____
Size Septic Tan ___.. .__ _ _, Lr!`'! '_ — Type of "Tanit____•
Feet of Drain Tile_________________W___ ___ —__ Dist. Feet of Tank or Drain Field from Well__
Nature of Water Supply: City —Well.
Amount of Permit S_
The undersigned applicant for this building permit does hereby certify that he untands and accepts his obligations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled Gene 1 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,
COUNTY OF DADE. ss.
MIAMI SHORES VILLAGE
APPLICATION FOR PLUMBING PE
i
My Commission Expires
PLUMBING INSPECTION DEPARTMENT
Size of Soakage Pit
_(Signed)
(Signed)
_Capacity Gals.________________,_
Notary Public. State of Florida
Plumbing Inspector.
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 inspection, or faulty
materials and /or workmanship.
Permit No
Application is hereby made for the approval of the detailed statement of the plans and specifications h
structure herein described. This application is made in compliance and conformity with the Building
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all es
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of apjroved
building during progress of work. 4 .4„, Owner's Name and Address 9___ 1 G No 0 9
Registered Architect and /or Engine
Employing Plumber's Name .�
Location and Legal Description Lot______
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
Feet of Drain Tile
Amount of Permit $_
1
APPLICATION FOR PLUMBING PEI4MII
STATE OF FLORIDA,
COUNTY OF DADE.
MIAMI SHORES VI LLAG E
PLUMBING INSPECTION DEPARTMENT /
Size Septic TandwiC1e�____LR�'_� 'Type Capacity Gals. ______
Nature of Water Supply: City —Well. Size of Soakage Pit
The undersigned applicant for this building permit does hereby ce
under the Florida Workmen's Compensation Act, being Section 5966,
plied with the provisions thereof, and will require similar compliance
performed under this permit; and will post or cause to be posted for
required by the Act. The under signed agrees to employ only such
licensed by Miami Shores Village.
My Commission Expires
Dist. Feet of Tank or Drain Field from Well
-- --- -
r �
(Signed)
Plumbing Inspector.
rtify that he uncre,rscands and accepts his obligations as an employer of labor
Compiled Genetta Laws of Florida Permanent Supplement, and has coin-
from all contractors or sub - contractors employed by him in the work to be
inspection on the site of the work such public notice or notices as are
under this permit, as are
No._ Z 6 Street_rCl___ ! '
__Block
sub - contractors, on work to be performed
(Signed)
ith submitted for the building or other
finance of Miami Shores Village, Florida,
and regulations of the Building Division
plans and specifications must be kept at
"
Street__1J__: _iEarx�
-- -- Subdivision ._ —_________----- ._- _'__w.,
Street
Repairs No. of Stories____
Notary Public, State of Florida
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 wbo,- 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
Tues
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
Application is hereby made for the approval of the detailed statement of the plans and specifications h
structure herein described. This application is made in compliance and conformity with the Building
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all es
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of apjroved
building during progress of work. 4 .4„, Owner's Name and Address 9___ 1 G No 0 9
Registered Architect and /or Engine
Employing Plumber's Name .�
Location and Legal Description Lot______
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
Feet of Drain Tile
Amount of Permit $_
1
APPLICATION FOR PLUMBING PEI4MII
STATE OF FLORIDA,
COUNTY OF DADE.
MIAMI SHORES VI LLAG E
PLUMBING INSPECTION DEPARTMENT /
Size Septic TandwiC1e�____LR�'_� 'Type Capacity Gals. ______
Nature of Water Supply: City —Well. Size of Soakage Pit
The undersigned applicant for this building permit does hereby ce
under the Florida Workmen's Compensation Act, being Section 5966,
plied with the provisions thereof, and will require similar compliance
performed under this permit; and will post or cause to be posted for
required by the Act. The under signed agrees to employ only such
licensed by Miami Shores Village.
My Commission Expires
Dist. Feet of Tank or Drain Field from Well
-- --- -
r �
(Signed)
Plumbing Inspector.
rtify that he uncre,rscands and accepts his obligations as an employer of labor
Compiled Genetta Laws of Florida Permanent Supplement, and has coin-
from all contractors or sub - contractors employed by him in the work to be
inspection on the site of the work such public notice or notices as are
under this permit, as are
No._ Z 6 Street_rCl___ ! '
__Block
sub - contractors, on work to be performed
(Signed)
ith submitted for the building or other
finance of Miami Shores Village, Florida,
and regulations of the Building Division
plans and specifications must be kept at
"
Street__1J__: _iEarx�
-- -- Subdivision ._ —_________----- ._- _'__w.,
Street
Repairs No. of Stories____
Notary Public, State of Florida
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 wbo,- 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.