69 NE 99 St (10)Date
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE J.
Job Address ? /1/, £ - 571 Tax Folio
Legal Description ! 5 Historically Designated: Yes No
Owner/Lessee / Tenant 7; Master Permit # 39070
Owner's Address
Contracting Co.
Address
Phone - 7r 7— S
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION � � J e � ��y�
Qualifier SS #, -hone
State # Municipal # Competency # s. Co.
Architect/Engineer Address
Bonding Company Address
Mortgagor Address
Square Ft. Estimated Cost (value) c i ,-Q9
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.
/y 7't
Date
Signature of owner and/or Co o President Date Signature of Contractor or Owner- Builder
Notary as to Owner and/or Condo President Date
My Commission Expires:
FEES: PERMIT
APPROVED:
Zoning
Mechanical
RADON C.C.F. NOTARY
Notary as to Contractor or Owner- Builder
My eomrmti si
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Building q4. J v Electrical
Plumbing Engineering
THE CITY OF MIAMI SHORES
APPLICATION FOR GAS INSTALLATION
PERMIT NO:
ADDRESS: 7200 N. W. 7 Ave.
TYPE INSTALLATION: 100 lbs.
FEE:... - 1,.00
DATE: November 19, 1957
ADDRESS WF INSTALLATION: 69 N. E. 99 St.
OWNER: Mrs. Piooford
GAS CONTRACTORS NSME: Public Gas Company
Permit No 6340
e-d
Amount of Permit $
STATE OF FLORIDA,
sa
COUNTY OF DADE.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING Nr .MIT
( Signed) _
( Signed).
Date / cr7
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 2 _ _S_q _ D w_._.___.___ No.___ Street
Registered Architect and /or Engineer —
Employing Plumber's Name ?‘ a c i _S. CT/ft t S__ C O No.. .7
Location and Legal Description Lot.__ _____ ......... _.__________.____ _____ ___._ Block_ . Subdivision
Street and Number where work is to be performed —No 6 9' �" �� 9 S4eet.
Street__• ( AL 7
State work to be performed and purpose of building (By Floors)____: / ___________ —
—
New Building _ Remodeling____ ______ Addition._______.__._____._.. Repairs No. of Stories
Size Septic Tank Type of Tank
Feet of Drain Tile_ _________ __________________________Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City — Well._.._____ ____._Size of Soakage Pit
Capacity Gals.
Plumbing Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his gations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Pennanent Supplement, and bus com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be
performed under this permit; and will post or cause to be posted' for inspection on the site of the work such public notice or notices as are
required by the Act. The undersigned agrees to employ only such sub- contractors, on work to be performed 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
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
SINKS
SLOP
SINKS
LAUNDRY
TueS
U RINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT' NS
TOTAL
FI %TURFS
CONTR.
LIST
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FI ELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEV
WELL
SPRKLR.
SYSTEM
SW IM'O
POOL
CONTR.
LIST
CHECK
Permit No 6340
e-d
Amount of Permit $
STATE OF FLORIDA,
sa
COUNTY OF DADE.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING Nr .MIT
( Signed) _
( Signed).
Date / cr7
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 2 _ _S_q _ D w_._.___.___ No.___ Street
Registered Architect and /or Engineer —
Employing Plumber's Name ?‘ a c i _S. CT/ft t S__ C O No.. .7
Location and Legal Description Lot.__ _____ ......... _.__________.____ _____ ___._ Block_ . Subdivision
Street and Number where work is to be performed —No 6 9' �" �� 9 S4eet.
Street__• ( AL 7
State work to be performed and purpose of building (By Floors)____: / ___________ —
—
New Building _ Remodeling____ ______ Addition._______.__._____._.. Repairs No. of Stories
Size Septic Tank Type of Tank
Feet of Drain Tile_ _________ __________________________Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City — Well._.._____ ____._Size of Soakage Pit
Capacity Gals.
Plumbing Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his gations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Pennanent Supplement, and bus com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be
performed under this permit; and will post or cause to be posted' for inspection on the site of the work such public notice or notices as are
required by the Act. The undersigned agrees to employ only such sub- contractors, on work to be performed 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
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.
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The following is ready for inspection:-
Inspector's Report:-
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