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429 NE 99 St (2)- Date pi '241 Job Address 42 q 14E. q q STREET Tax Folio Legal Description Historically Designated: Yes No Owner/Lessee / Tenant 1 0 LLA 1J D Master Permit # ao 7 7 �o Owner's Address i` N "1"1 STREET Phone 1 — 0 (3 4- Contracting Co. 1.1-01 p- NORTH DA D SEPTIC. Address 8 N w t 11 1 Qualifier DE N N `S N EV ( L LE SS# Phone — IS IF 3 3 1 State # 075 36 - 8 . Municipal # Architect/Engineer Bonding Company Mortgagor Address Permit Type (circle one): BUILDING ELECTRICAL WORK DESCRIP'T'ION 1t't 5p5 D Ft EL.D Square Ft. `t-7() 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 an t at all ork will be done in compliance with all applicable laws regulating construction and zoning. Furthermore, I authorize the above -nam contract•. to do the k stated. 7 1) 24 Signature of owner and/or Condo Pr sident Da s to Own ission FEES: PERMIT PERMIT APPLICATION FOR MIAMI SHORES VILLAGE or Co es: , fit do President Date wAsimvio tttttttttttttttttttKtttstt cwo, pPV D e , B Teresa J. Felder Notary Public, State of Florida f ` `•' i` ! � Q Commission No. CC 4U0 7 OF ae My Commission Expires 07/16/99 ; 1.800.3•NOrARY • Fla Notary a. Mo g B Z O g !!! f e l t 11 !! t o ee et k r e a t e e t eel cY ra ve t ll Y l f 11 ! c RADON C.C.F. 1 . APPROVED: Zoning Building Mechanical Plumbin C o m p e t e n c y # ' 2 84-2 Ins. Co. 17 E S/ V I F Address Address Estimated Cost (value) 1900 Si MECHANICAL ROOFING PAVING FENCE SIGN al- 11320G0tio -oo Con : ' or or O to Contrac ssion E NOTARY Electrical er- Builder Date Builder 44 94 Date tt ttW,tttKlttttKtWASt ttt Mie. ij u RV PG Tere;.a J. Felder • , } ��:. Q Notary Public, State of F:orids i -?oF F'• ° MY Commiscion No. mmissian Expires 07 /16/99 .; r- 8 OO- 3•NOrAity_ m_ TOTAL DUE 33 G clp Engineering • STATE OF FLORIDA PERMIT # ' p.,,2_87 DEPARTMENT OF HEALTH AND REHABILITATIVE SERVICES DATE PAID 12/ ONSITE SEWAGE DISPOSAL SYSTEM FEE PAID $ °" CONSTRUCTION PERMIT RECEIPT # Authority: Chapter 381, FS & Chapter 10D -6, FAC CON TRUCTION PERMIT�F� R: 1 ] New System [/! ] xisting System [ olding Tank [Temporary /Experimental [y] Repair [A bandonment [her(Specify) APPLICANT: E .. 9 T\ e �(_ _. a�ry r �? 7 ® / AGENT: PROPERTY STREET ADDRESS: (42_57 4I)& ?57 LOT: AM-- BLOCK: .A SUBDIVISION: �J PROPERTY ID #: j 2-0.O / 7 0 , o J, [SECTION /TOWNSHIP /RANGE /PARCEL NUMBER] [OR TAX ID•NUMBER] 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 SPECIFICATIONS T [7C. ] / GPD<EPTIC T5IK/AEROBIC UNIT CAPACITY MULTI-CHAMBERED/IN SERIES:[ ] A [ ] [GALLONS / GPD] 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 [ 4%°e0 ] UARE '1' PRIMARY DRAINFIELD SYSTEM R [ ] SQUARE FEET SYSTEM A TYPE SYSTEM: [ ] STANDARD [ ] FILLED [ ] MOUND [ ] ) I CONFIGURATION: [ ] TRENCH [ g.TIED [ ] N F LOCATION OF BENCHMARK: 17,7 'AOY I ELEVATION OF PROPOSED SYSTEM SITE [ C .) J INCHES /FT] [ABOVEy E BOTTOM OF DRAINFIELD TO BE [ �a FT] [ABOVE L .�! D \EILL 1 R 1 EQUI � R �tttt ED: [ �rnrn11�� 1� ] t \ C � H y ES A��c1� EXCAVATION REQUIRED: [3 INCHES i 2 t, ILOA1�d ]! OE Ci��'1lli BE n1 �iVay UNDER BOTTOM TOM OF DRK:NOFItEL1D T SUIS1V IT B EN(Ir iiWIA Z BEFORE J N PPC B'YCT.J TIHIJS PERM TT IS NOT FOR AiDifwT<'m E [WERT ELIEVA F'AOR! R BOTTOM Of DRA1NFREC D ?4.PVATEIM Jam' SPECIFICATIONS BY: a APPROVED BY: 7'>.' TITLE:' � Q� r‘ DATE ISSUED. • ` - ma A-0 , ,- • �� i EXPIRATION DATE: /�� � y. ' -� ' ^ _ L C C a± fig 1! E781 uf�� G� ku� , llG 3 8B��i d 'E IrAE PEC C n^ C ACC :� HRS -H Form 4016, Mar 92 (Obsoletes previous editions which may not be use d )P v", �� , `E '3L11 a 1: (Stock Number: 5744 - 001 - 4016 -0) page 1 of 2 TITLE: QPPLa ©QC34 G E (FI1 FERENCE P. BENCHMARKAREFERENCE POINT CPHU • 2 WST: 1! :D: SICN AND c'. ;'.�,, aim..,,_ assign "ny e :...:, .;'1.: U' pE'n'::, if vL:l.._ C7C '. a7,' -yps in L...:A. ..'C1Cphone number fo7 c p11cr: 07 agai?i. .. -op; riy owner's legally Lu rc a:JC; sepresentativu. ?.C. : or street mri'inf, tt -.; ,:: s for applicant or rE, o: 7.7 ^ : :. t:r id number for _)_:up,:r.y. (C ?I-1 may :. :cuir. '7 =a_ . :: ; _rJ .ir : ` 3 0 a: c ction/tovinship /rune /)axel number) _._inh -nu r. specifcations fro::: °"hepter IOD-6, L -'A.C. D_cA :it`?;: ELD, h7.ini:,rurn specifications from Chapter IOD -6, ] *AC. Other so, :cifrcations, such as operating permit requirements, loci-volume flush toilets, variance provisos. S? :wc CA d IONS 3'': Name of individual providing specifications. :fdesigned by a s:e:cd engineer must be sealed. ?. y• Cuun =ublic Health Unit (C.? °_-1U) personnel :.viewing Lad cco:oving permit. A... _cOFJ3iD 3 , - DA": :ISSUED: Date permit is issued by C::' :t U. . XL RATION DATE: One year from date issued if the system has not been installed. ?erm is for system repairs become void 90 days from the date issued. ` —, CLOSETS BATH - ruse use LAYA• Topics SINKS SLOP SINKS LAUNDRY Tuna U RINAL{ CATCH BASIN FLOOR DRAIN DRINK' NO FOUNT' NI TOTAL FIXTURES CONr . LIST CHECK — SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT G TRAP SOLAR MUTER DEEP WELL aPRKLR. SYSTEM eW IM'0 POOL �— CONTR. LIST CHECK Permit No. .. 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 Amount of Permit MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Registered Architect and/ ngineer�— --� Employing Plum `i vU►geP/, {clot /r Nit /8/A n ' - AN No 42 street . F 9 9 7 (Si 1■1■11...•• etrieLi••• OIMTIREA014:::C2. • Size Septic Tank_ _Type of Tank__ Feet of Drain Tile Dist- Feet of Tank or Drain Field from Well Nature of Water Supply: City—WeIL Si_ • ' Soakage Pit it /2.- Capacity Gals (Signed ) �s.(.! V'`1. Location and Legal Description Lot. Mork Subdivisio —__ —_ Street and Number where work is to be performed —No T C i Str e . J.- ? State work to be performed and purpose of building (By a. Safi_ / New Building..__.._ — _.-- .-- ........_.. Remodeling__. ___.__ Addition.. __ _..__ Repair... -L/ . 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 5988, Compiled General Laws of Florida Permanent Supplement, and ilu•c com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractor - • ployed by him in the work to be performed under this permit; and will post or cause to be posted' far inspection on the to • the wor public notice or notices as are required by the Act. The undersigned agrees to employ only such sub - contractors, on k to • -- und.. this permit, as are licensed by Miami Shores Village. Master Plumber. STATE OF FLORIDA, I u. COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and says that be is the. - . -- - -- of the above described construction, that he has csrofully read the foregoing application, and that be 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 swab twaupaodos V made osmium by hemmer notice for hapection. or faulty material and /or workmanship. MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build- ing or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village. Florida. and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of the work. Owner's Name and Address 6, Registered Architect and /or Engineer Name and address of licensed contractor Location and legal description of lot to be bui t on: Lot Block Subdivision Street and Number where work is to be done /. -a State work to be done and purpose of building (by floors) • STATE OF FLORIDA, COUNTY OF DADE. ss. Disapproved Date (Signed) Date..._ 4 . /#. `��.19..._.. a Ilia \ r New Building Remodeling. 1 Addition Repairs No. of Stories J To be constructed of Kind of foundation / Roof Coverin _ g�� Estimated Total cost of improvements $ %� g - t r .�•-� 0 1 : i 4mount of Permit $ Zone cubage required .Plan Cubage Distance to next nearest building Size of Building Lot Maximum live load to be borne by each floor I hereby s m th ns a spe ifications for said building. All notices wi reference to the building and its construction may be sent to C� t l - - © j 7 3 , �%G' P / a ,�'`-"' g teom The u ersigned a plicant for this building pennit 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, Pennanent Supplement, and has complied 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 subcontractors, on work to be performed under this permit, as are licensed by Miami Shores Village. Remarks (Signed)� and for no other purpose. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap- peared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the. of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him sta are true. Permit No C--3c Date Read, Sworn to and Subscribed before me. Notary Public, State of Florida Building Inspector My Commission Expires PLANNING BOARD DATE Chainnan Member Member Member Member Member Council Approved Date Disapproved Date NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has been obtained from the Planning Board. A re-inspection fee of $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and /or workmanship. Permit No % Amount of Permit $_ STATE OF FLORIDA, I ss. COUNTY OF DADE. 6e ( Signed)__ MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT (Signed ) 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. O w n e r ' s Name and Address ......... __ -- 8 W ! ------ -_ -_ -. I2 9__d . No._. - - -- 9. 9 --_ Sr Street Registered Architect and /or Engineer..... ------- __ — _ - -,, Employing -Plmnb Name 40.5.1 as • No. -_ ' -- w' Street f 6..6 7 s � ' Location and Legal Description Lot_ Street and Number where work is to be performed —No Vag N' C ' Steed/ State work to be performed and purpose of building (By Floors) New Building_____ . Remodeling-------- .__________ Addition Blocti Subdivision ...--- ,------ ..__._._--- _ -_ - -- Repairs No. of Stories . . ........ ....... .... Size Septic Tank Type of Tank Feet of Drain Tile 38 fr. 84 Dis t. Feet of Tank or Drain Field from Well. ............ __________ Nature of Water Supply: City — Well._______ .--- _ .... of Soakage Pit Capacity Gals The undersigned applicant for this building permit does hereby certify that he understands and accepts his o.'g: ions as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Peri . rent 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 under this permit, as are licensed by Miami Shores Village. 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. My Commission Expires Notary Public, State of Florida Plumbing Inspector. NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made•necessary by improper notice for insp ''ten, or faulty materials and /or workmanship. CLOSETS BATH TUBS SHOWERS LAVA- TORIES SINKS SLOP SINKS LAUNDRY TUBS URINALS NALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT' NS TOTAL FIXTURES CONTR. LIST CHICK SEPTIC TANK SEWER CONN. DRAIN FIELD i0 Q .`� SOAKAGE PIT GREASE TRAP SOLAR H EATER DEEP WELL SPRKLR. SYSTEM SW IN '0 POOL CONTR. ST I S L CHECK ` -- Permit No % Amount of Permit $_ STATE OF FLORIDA, I ss. COUNTY OF DADE. 6e ( Signed)__ MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT (Signed ) 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. O w n e r ' s Name and Address ......... __ -- 8 W ! ------ -_ -_ -. I2 9__d . No._. - - -- 9. 9 --_ Sr Street Registered Architect and /or Engineer..... ------- __ — _ - -,, Employing -Plmnb Name 40.5.1 as • No. -_ ' -- w' Street f 6..6 7 s � ' Location and Legal Description Lot_ Street and Number where work is to be performed —No Vag N' C ' Steed/ State work to be performed and purpose of building (By Floors) New Building_____ . Remodeling-------- .__________ Addition Blocti Subdivision ...--- ,------ ..__._._--- _ -_ - -- Repairs No. of Stories . . ........ ....... .... Size Septic Tank Type of Tank Feet of Drain Tile 38 fr. 84 Dis t. Feet of Tank or Drain Field from Well. ............ __________ Nature of Water Supply: City — Well._______ .--- _ .... of Soakage Pit Capacity Gals The undersigned applicant for this building permit does hereby certify that he understands and accepts his o.'g: ions as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Peri . rent 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 under this permit, as are licensed by Miami Shores Village. 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. My Commission Expires Notary Public, State of Florida Plumbing Inspector. NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made•necessary by improper notice for insp ''ten, or faulty materials and /or workmanship. 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 building during progress of work. Permit No Size Septic Tank Feet of Drain Tile Amount of Permit $ MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING €^ w.MiT j %r ! .� J Owner's Name and Address Registered Architect and/ Employing Plumber's .0 Location and Legal Des Street and Number where work is to be performed —No State work to be performed and purpose of building (By Floors) New Building _ Remodeling_ _ - My Commission Expires No. 4 Addition_ Block (Signed). Date Street__H6� Street__-���C= i '- / i Street. Repairs No. of Stories..- Type of Tank__ Capacity Gals. Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: City — Well.___ '7 _, _ -_Size of Soakage Pit (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 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, . Amy ork be performed under this permit, as are licensed by Miami Shores Village. STATE OF FLORIDA, 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. 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 INK SINKS SLOP SINKS LAUNDRY Tues U RINALS 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 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 building during progress of work. Permit No Size Septic Tank Feet of Drain Tile Amount of Permit $ MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING €^ w.MiT j %r ! .� J Owner's Name and Address Registered Architect and/ Employing Plumber's .0 Location and Legal Des Street and Number where work is to be performed —No State work to be performed and purpose of building (By Floors) New Building _ Remodeling_ _ - My Commission Expires No. 4 Addition_ Block (Signed). Date Street__H6� Street__-���C= i '- / i Street. Repairs No. of Stories..- Type of Tank__ Capacity Gals. Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: City — Well.___ '7 _, _ -_Size of Soakage Pit (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 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, . Amy ork be performed under this permit, as are licensed by Miami Shores Village. STATE OF FLORIDA, 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. 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 ROOF? Owner of Building (4 Architect Contractor �.-,d�'� I /`� or Builder G 11 , 4. - -1 f' , '- °`,L.,,* --• Legal Lot d Description Address of Building '" ❑ PERMIT N° 6268 0 CONTRACTOR OR BUILDER- MIAMI SHORES VILLAGE. FLORIDA Bl. Work to be performed under this Permit Value of Project $ - DATE A Contractor's License No. Amount of Permit $ 1/ a te. } BY AUTHORITY 195— Subdi- vision 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, cifications and that he assumes responsibility for work done by his agents, servants or employees. Signed BY S ECTOR 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 ac- cepting this permit I assume responsibility for all work done by either, myselfr my agent, servant or employee. 'o �...�� CLOSETS BUTS TUBS SHOWERS LAVA- TORIES SINKS SLOP SINKS LAUNDRY Tuee U RINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT'N$ TOTAL FIXTURES LIST —.— CHECK SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SWIM'O POOL CL 18T LIST CHECK C Permit No. Date : .1.✓ Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or (Abel structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Divisior of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept al building during progress of work. Owner's Name and Address. Ul/ - �'- -- " No. Street Registered Architect and /or Engineer- ------- ........ --- .__..... .... _________ Employing Plumber's Name. Nature of Water Supply: City —Well. l Amount of Permit $ -! MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT _ _ .._._..._ No.. ___ -_ Block_ ._.. Street and Number where work is to be performed —No. ' 2 State work to be performed and purpose of building (By Floors ) Location and Legal Description Lot. - Remodeling Addition____ Repairs _- ........ _.. _..__.. No. of Stories New Building .- -- - - -- g -- - - -- - eP Size Septic Tank Type of Tank Feet of Drain Tile Dist. Feet of Tank or Drain Field from Well __Size of Soakage Pit 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 undersigned agrees to employ only such sub - contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. (Signed) _ _---- __ -_._ Street...-- __.__. _--- --- - --- -- - -- --- Subdivision Street Capacity Cals. c (Si & STATE OF FLORIDA, ss, COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeare to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all iat' therein by him stated are true. My Commission Expires Notary Public, State of Florida NOTE: A re spection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or h ul materials and/ workmanship.