866 NE 99 St (2)No
My
S gnat
Dat
APPROVED:
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date 3/, 1 7 W ,.Job Address . Al/t.... C ! 9 S T Tax Folio / I • 52446 Aoki:- 2:42
Legal Description alt- /S (�O 1 ,- S iLCosG/ic. Z
A,./ 1 .S14avi - 15/11-c77
� ty ��ii2es› Lessee / Tenant 5 %/,fit. S! N�� 4 D Le a f ,/ D*ON Biter Permit # S�S/I�(c.
Phone 3c) 5") 7s-$ - Ini s
/5,.-z, _S.■ 4.4 'l. <
Owner's Address JkM'Jie-e I4-3
Contracting Co.44A7,4.0 4o ,s017,447;1-4; % ;cif; caap,
Qualifier Jt Gi. (/(o )Q�
SS4 # / </
State # #OJ /6 (d Municipal # Competency # Ins.Co.
Architect /Engineer 1 .• gµ Address_J.sk' f3iScott/o.K.
Bonding Company /Vl/- Address
Mortgagor e!9 poN fu E_Y Address
Permit Type(circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING PENCE SIGN
WORK DESCRIPTION /:44�,AGel., A... 0114., Q
Square Ft. Estimated Cost(value)
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
be done in compliance wit all applicable la •:ul
authorize the ab e7tyamed contr work
1».
0100
re o owner and /o
IS GH
6Tit/✓1
Condo President
S
s..
e of C.nt ac or or Owner- Builder
tii26/Sy
'sion Expires:
FEES: PERMIT
RADON
d
!Try as ro Own : - and or Condo President
Commi
t il NANCY ANN BOLLEA
+; +=
MY .COMMISSION EXPIRES
** * * May 2*, 1994 *
,G W^ s EnN ^PCB !i:: ';:NARY PUBLIC UNDERWRITERS
Zoning
Mechanical
s
r
Buildin
Plumbin
Address
Phone _ oT SS < 3 /
information is accurate and that all work will
It ng construction and zoning. Furthermore, I
s ated.
Notary as to a T>A�+E>li l►d
My Commissio 1 ., fi SCOTT W DAVIS
* COMMISSION NUMBER
• ' 1117 . Q' CC255237
�l m O
� MY COMMISSION EXP.
* * * ** cta * ,JAN* 26 1997 **
*
C.C.P.
Fire Other
NOTARY TOTAL DUE
Electrical
engineering
CONSTRUCTION PERMIT FOR:
[, New System
[ ] Repair
PROPERTY STREET ADDRESS: it/
APPLICANT:
LOT: /J :. BLOCK:
PROPERTY ID #: /J /f
T
A
N
K
[ 1
[ ]
D
1"-1/41 ] SQUARE
R [ ] SQUARE FEET
A TYPE SYSTEM: ['`] STANDARD
I CONFIGURATION: [ ] TRENCH
N
F LOCATION OF BENCHMARK: /f *.
I ELEVATION OF PROPOSED SYSTEM
E BOTTOM OF DRAINFIE.LD TO BE [
L
D FILL REQUIRED:
O `t' G
T //v 1,
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
[ ] Existing System [ ] Holding Tank
[ ] Abandonment [ ] Other(Specify)
7 2
t
SUBDIVISION: /e3 i _'
FEET PRIMARY DRAINFIELD SYSTEM
SYSTEM
[ ] FILLED
[ +-r`BED
/li
SITE [ f.i1. 4
` «... ]
µ
( ] INCHES EXCAVATION REQUIRED: [3 3] INCHES
s .
TITLE:
TITLE:
HRS -H Form 4016, Mar 92 (Obsoletes previous editions which may not be used)
(Stock Number: 5744 - 001-4016-0)
[
[
INSTALLER /CONTRACTOR
PERMIT #
DATE PAID
FEE PAID $
RECEIPT #
Temporary /Experimental
[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
e-4
[ ] [GALLONS / GPD] SEPTIC TANK /AEROBIC UNIT CAPACITY MULTI- CHAMBERED /IN SERIES:[ ]
( ] [GALLONS / GPD] CAPACITY MULTI- CHAMBERED /IN SERIES:[ ]
GALLONS GREASE INTERCEPTOR CAPACITY [MAXIMUM CAPACITY SINGLE TANK: 1250 GALLONS]
GALLONS PER DOSE DOSING TANK CAPACITY DOSE RATE [ ] PER 24 HRS NO. OF PUMPS: [ ]
] MOUND [ ]
]
IN CHE /FT] [ABOV LOW BENCHMARK/ EFERENCE _POINT/
4NCHE /FT] [ABOVE/,$ELOW1 BENCHMARK /REFERETICE POIfi
c
EXPIRATION DATE:`
; CPHU
/N r
Page 1 of 2
L
7£:IV!CC::.
3 ....... E:: h..
131::31/16.1.//:: . ?cs.Se tia... it c[ y t; _.: c.. c: r; ns cy
m'u: c ._� t7 i i s ( c; J n c. ^.d n;rovinl* rmit.
by
• i' t7... ;ra: :nstalIc.... .. ear _ _e" : y c.!;: ? so'.* va!d 90 duyu f.om L ?e date
Legal Description _� -5.5'r T
■larusa 4111111MINO. Ser-ArioN AI GA 3
Lessee / Tenant "3 'AiAblaeFr_ g Q r AIVA 'DA-Vito; Master Permit # 5l5 "So
Owner's Address
Contracting Go g_1 3 e` er Address 77 L'Ie*, »'/ f&-Vic /01)
Qualifier s
e212. SS#Z 3
State #C.4c0 CfMunicipa1 # Competency # Ins .Go / 1i� _g 41,5y
11lvVA-
Address Pri'/ f3 i Sc l"Vid
Architect /Engineer ,'/J Nt'- d -iirt_
Bonding Company &Of Address �^
Mortgagor Eo PN=NNINALLIMDle Address
Permit Type(circle one). WILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION IS /( ?t 5 ` /447 l na.t L,,V 91447 4 S/ P17 c. S`8 Si/WI
-,r-
Square Ft.
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 wit all applicable laws r :- ating construction and zoning. Furthermore, I
authorize the above-named cont�aetor7o d' - wor stated.
Si at :e o o er and /o Condo President
Date' ' S
No
My
NANCY ANN BOLLEA
w COMMISSItI EXPIRES *
,.. ..- May 21, 1994
°+,,; (,t'i,' - j .,• :.`; RY PUBIC UNDERWRITERS L /
FEES: PERMIT ;' 6 RADON
*
APPROVED:
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Job Address c5grea. ,J 11 'ST. Tax Folio lI - 37=6 - ,j1 - Z4jo
SR a dA f* Phone -- 7 5 2s 9 3
Owner and /or Condo President
on Expires:
* * *
C.C.F. ICJ
Fire
Zoning Buildin
Mechanical
Plumbing
Estimated Cost(value)
Signatur
Date:
Notary as
My Commission
of ontractor or
t.5,
34 /xcJv
•: --
o Contractor or Owner -Builder
OfFICI :.L N•JI A.,
NO AF'i 1:%./111:C.
* * * COi‘ZgaS:C1.14). * **
*
T�(COie:i!r 5I0i+1 EXP. MAR. l �
d NOTARY TOTAL DUE
Other 4�
Electrical
Engineering
17 January 1994
Structural Plans Examiner
Miami Shores Village
Project:
Addition to Residence
866 N.E. 99th Street
Disposition: Not approved
g ;O:&= A, 1. Roof framing plan does not clearly indicate field
conditions, nor method of anchoring new members to
existing structure, per 2906.10
,x -- Zh2-. Soffit vent size not specified, per 2913.3(d) .
3. Minimum size for "isolated" footing is 24" square,
.41„7 per 2404.3(a).
4. What provisions have been made to take care of
� eccentricity in side and back footings, per
11097 > ' 2404.3 (b )
5. How is roof uplift resisted at the new rear patio ?'
P rovide calculations, per 2309.4(c) .
e.4-a rye 4'W s
Clarification required for the following items:
1-47-7 6. New tie beam elevation in relation to existing.
/2 d 4 " 7. Specify new tie beam size. s=� eta. S /S"
.5;$70 :?../�. Detail beam /column connections where applicable. 5 ,
/1 9. Detail new /existing tie beam connection.
// 10. Detail new /existing footing connection.
// 11. Suggest use of vapor barrier under new floor slab.
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reV /eWe a' d �-� �d aceep/aLle
(� P /4"5 i CaleulaIIons)
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as 14d1eal
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NOTICE OF COMMENCEMENT
PERMIT NO.
STATE OF FLORIDA:
COUNTY OF DADE:
TAX FOLIO NO. `1 3 .7.0fo L 4 Ziic70 C'
94-R 1' 1994 MAR 14
THE UNDERSIGNED hereby gives notice that improvements will be made to certain real property, and in accordance with
Chapter 713, Florida Statutes, the following informationtis provided in this Notice of Commencement.
1. Legal description of property and street address:
4. Contractor's name and address:
5 4 5 /
2. Descri tion of improvement: /1dc
3. Owner(s) name and address: / l /, Joie I. 7Th 0 cs‘ __Leyriiefi g L
4 !.."7/1e -
Interest in property: C>t h.et--3
Name and address of fee simple titleholder: �,�„i,�/_✓ �, �L�l1_>1�.� -�,
—Air/.1 11 ;.
g#A P.
5. Surety:(Payment bond required by owner from contractor, if any) �p D��
Name and address: "VA-- 0r :, ORIt)p� C 0� � a°�ti °+ �� y c9
Arm
d C 0091 C°
Amount of bond $ -- Stls a &� rYp�p %c °n "u
. olI%C 01
6. Lender's name and address:
7. Persons within the State of Florida designated by Owner upon whom notfs or
by Section 713.13(1)(a)7., Florida Statutes,
Name and address: . e�
8. In addition to himself, Owner designates the following person(s) to receive a copy of the Lienor's Notice as provided in
Section 713.13(1)(b), Florida Statutes.
Name and address: Nc�
9. Expiration date of this Notice of Commencement: (the expir 'on date is 1 year fro
efferent date is specified)
Print Owners Name Wile/ER >-/N96 L
Sworn to and subscribed before me this . " " "" of/
ignature of Owner
Print Notary's Name
My Commission Expires:
, :T, type, or Stax:p Cumnnssioned Name of Nctcr P�
y Public)
Personalty Knovvm Cl OR Produced Identification
Tvno of I n 1) '092.: d
the date of recording unless a
Prepared by: ,
Address: 7> N Cc _� c_ /� /✓c
'-0i ,7 AS. /J/) y c... /`
33/Y
16 :09
E
R
SPECIFICATIONS BY:
APPROVED BY:
DATE ISSUED: •?
a✓
STATE OF FLORIDA
DEPARTMENT OF HEALTH AND REHABILITATIVE SERVICES
ONSITE SEWAGE DISPOSAL SYSTEM
CONSTRUCTION PERMIT
c- / 4
TITLE:
HRS -H Form 4016, Mar 92 (Obsoletes previous editions which may not be used)
(Stock Number: 5744 - 001 - 4016-0)
FT] [ABOVE
/FT] [ABOVE/
TITLE:
BUILDING DEPARTMENT
f
[
-
PERMIT #
DATE PAID
FEE PAID $
RECEIPT #
Authority: Chapter 381, FS & Chapter 1OD -6, FAC
4
CONSTRUCTION PERMIT FOR:
[AiNew, System [ ] Existing System [ ] Holding Tank [ ] Temporary /Experimental
[ ] Repair [ ] Abandonment [ ] Other(Specify)
APPLICANT: ....),0„4 V I e_ I ' - � � " , ,, 3 °� c' f> 6 < 5 f.
PROPERTY STREET ADDRESS: f�/ ) q y - "' s
LOT: /L 4 %" BLOCK: L - SUBDIVISION: i�1�J s -4, ,<, 5;„„
PROPERTY ID #: / p . [SECTION /TOWNSHIP /RANGE /PARCEL NUMBER]
[OR TAX ID NUMBER]
SYSTEM MUST BE CONSTRUCTED IN ACCORDANCE WITH SPECIFICATIONS AND STANDARDS OF CHAPTER 1OD -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 [ 1 ] [GALLONS / GPD] SEPTIC TANK /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 [." C SQUARE FEET PRIMARY DRAINFIELD SYSTEM
R [ ] SQUARE FEET SYSTEM
A TYPE SYSTEM: [l STANDARD [ ] FILLED [ ] MOUND
I CONFIGURATION: [ ] TRENCH [ J ED [ ]
F LOCATION OF BENCHMARK: // . 2 / F F .
I ELEVATION OF PROPOSED SYSTEM SITE [ (7j• 1
E BOTTOM OF DRAINFIELD TO BE [ 14Z, - e0 . 2_ ]
L 1
D FILL REQUIRED: [ ] INCHES EXCAVATION REQUIRED: [ a 0] INCHES
� i
O 1 12. C-- 0 67 , 5 - -e.-4--e-0&- P� t te
T J / P' i' I/ R• / '
ii
/
]
ENCHMARK /FERENCE POINT
ENCHMARK /kEfEREI CE POW
cf
1
` a � j 1 CPHU
EXPIRATION DATE:
Page 1 of 2
INSTRUCTIONS:
.LIMIT NUMBER: P:.rmit tracking number assigned by CPHU.
APPLICATION FOR: Check type of permit, if 'Other" specify type in blank.
APPLICANT: PLICAN G': Property owner's full name.
'":'t.1.lE" IION: Telephone number for applicant or agent.
Ati'EN"T': Property owner's legally authorized representative.
MAILING AD::BC SS: P.O. box or street mailing address for applicant or agent.
LOT, BLOCK, SUBDIVISION or
PROPERTY IDI: 27 character id number for property. (CPHU may require prcperty appraiser ID # or section/township /range /parcel number)
SYSTEM DESIGN AND
SPECIFICATIONS:
'TANK: Minimum specifications from Chapter 10D -6, FAC.
DRAINFIELC: Minimum specifications from Chapter IOD -6, FAC.
OTHER: Other specifications, such as operating permit requirements, low - volume flush toilets, variance provisos.
SPECIFICATIONS BY: Name of individual providing specifications. if designed by a registered engineer must be sealed.
APPROVED :3Y: County Public Health Unit (CPHU) personnel reviewing and approving permit.
DATE ISSUED: Date permit is issued by CPHU.
LXPIRATION DATE: One year from date issued if the system has not been installed. Permits for system repairs become void 90 days from the date
issued.
APPLICATION FOR:
(Y1 New tystem
[ ] Repair
APPLICANT:
AGENT:
MAILING ADDRESS:
LOT:
1
2
3
4
TO BE COMPLETED BY APPLICANT OR APPLICANT'S AUTHORIZED AGENT. ATTACH BUILDING PLAN AND TO -SCALE
SITE PLAN SHOWING PERTINENT FEATURES REQUIRED BY CHAPTER 10D -6, FLORIDA ADMINISTRATIVE CODE.
PROPERTY INFORMATION [IF LOT IS NOT IN A RECORDED SUBDIVISION, ATTACH LEGAL DESCRIPTION OR DEED]
PROPERTY ID #:
PROPERTY SIZE:
PROPERTY STREET ADDRESS:
DIRECTIONS TO PROPERTY:
` • C
BUILDING INFORMATION
Unit Type of
No Establishment
BLOCK:
L•
STATE OF FLORIDA
DEPARTMENT OF HEALTH AND REHABILITATIVE SERVICES
ONSITE SEWAGE DISPOSAL SYSTEM
APPLICATION FOR CONSTRUCTION PERMIT
Authority: Chapter 381, FS & Chapter 10D -6, FAC
ACRES [Sgft /43560] PROPERTY WATER SUPPLY: [ ] PRIVATE [,} PUBLIC
APPLICANT'S SIGNATURE:
] Existing System
] Abandonment
f] Garbage Grinders /Disposals
[ /] Ultra -low Volume Flush Toilets
Bedrooms Area Soft Served
[ /] Spas /Hot Tubs
[ ] Other (Specify)
HRS-H Form 4015, Mar 92 (Obsoletes previous editions which may not be used)
(Stock Number: 5744 - 001 - 4015 -1)
PERMIT # r1 ',/A/
DATE PAID #4/
FEE PAID $ / 5' , GO
RECEIPT #
] Holding Tank [ ] Temporary /Experimental
] Other(Specify)
TELEPHONE:
SEPTIC TANK COQ RAC ;O3o , : �c
SUBDIVISION: ` f,-7/ DATE OF
U E7 '�l4b fyM6 7
SUBDIVISION:
[Section /Township /Range /Parcel No.] ZONING:
DATE:
_ 1 '
No. of Building # Persons Business Activity
4 ) n 6 r r F� -� F= .- d � =K ��t:st� Y!f /vf
s
RESIDENTIAL [ ] COMMERCIAL
For Commercial Only
] Floor /Equipment Drains
Page 1 of 3
'4; ?or.m.il, if nell,or°
;?:, EN•L'irto.
ournbor for oppli.CCRI 07 t■501.11.
:ejay Cle11107i7-..c'es
y, ct c I? scrlo ceema cor c.pp!isca". or r.gern.
co::::.y °•_:•col...1 :
....t Or 2.n4
• .
.*o. (resort:of; o nz: n axoTsice. c.oT r.; 7c..^..
or door: mut?
2"; . • . • ••-
• ' • 77'1 :!"...
e '.*
r t.‘: 1 '
•••.:. • o4.
I c 41:: • • •.; • •.:
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• ' • , C=1: .
•
• .,
4:••4:44•;.41
".'•r• • :• ^40 •:4141:.•• , • . •.
V t\tktz.
BUILDING ❑
PLUMBING ❑ PERMIT
ROOFING ❑ /►
Owner of
Building
Architect
Contractor
or Builder
Legal
Description
Lot
CONTRACTOR OR BUILDER
MIAMI SHORES VILLAGE, FLORIDA
B1
N9 6622
Work to be performed under this Permit
DATE 19
Contractor's
License No.
a
Subdi-
vision
Address of Value of 1 Amount of t _ _:_
Building , "_ Project $ ( 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 named above assumes the responsibility for a thorough knowledge of the ordinances and
regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes respon-
sibility for work done by his agents, servants or employees.
Signed. _ r ,INSPECTOR
In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance witlrs all ordinancesin d iteiilations
pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In ao
cepting this permit I assume responsibility for edl work done by either, myself, my agent, servant or employee.
BY AUTHORITY
AeeOT
SEPTIC SEWER DRAIN SOAKAGE GREASE SOLAR DEEP SPRKLR. SWIM'G
TANK CONN. FIELD PIT TRAP HEATER WELL SYSTEM POOL
CONTR.
LIST V V
CHECK
Iv ■
Permit No , 6 3 2
Date.
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida,
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at
building during progress of work.
Owner's Name and Address ll 1/,//407-
Registered Architect and /or Engineer _ ___�____
Employing Plumber's Name . Q4W ,UI'JF .5. A°7 1
Street__!a-. i.e / /Sege*
Location and Legal Description Lot Block__ Subdivision- - -_ -_- — - - --
Street and Number where work is to be performed —No 53 (..c. ) E , C itreet . -t
State work to be performed and purpose of building (By Floors)
New Building _- _-- Remodeling -- _------- -___ -- Addition Repairs.
Size Septic Tank 7_!/__1 _ Type of Tank
,,aa Capacity Gals.
Feet of Drain Tile________ 3.2'L_r _____Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City— Well ._____ _ __Size of Soakage Pit
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
- - - -.f �s
No._ v444 - - -._ Street_ -._ _9.9 - --
No. of Stories.
-- (Signed) - — — � S? �u• - -U
Plum in b spector.
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 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 tlie 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.
Amount of Permit $
STATE OF FLORIDA, }
COUNTY OF DADE.
My Commission Expires
(Signed).
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
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 B
BATH S
SHOWERS L
LAVA- S
SINKS S
SLOP L
LAUNDRY C
URINALS B
CATCH F
FLOOR D
DRINKING
IXTUR
FIxTURE6
Cowrie.
LIST
CHECK _
__
Permit No , 6 3 2
Date.
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida,
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at
building during progress of work.
Owner's Name and Address ll 1/,//407-
Registered Architect and /or Engineer _ ___�____
Employing Plumber's Name . Q4W ,UI'JF .5. A°7 1
Street__!a-. i.e / /Sege*
Location and Legal Description Lot Block__ Subdivision- - -_ -_- — - - --
Street and Number where work is to be performed —No 53 (..c. ) E , C itreet . -t
State work to be performed and purpose of building (By Floors)
New Building _- _-- Remodeling -- _------- -___ -- Addition Repairs.
Size Septic Tank 7_!/__1 _ Type of Tank
,,aa Capacity Gals.
Feet of Drain Tile________ 3.2'L_r _____Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City— Well ._____ _ __Size of Soakage Pit
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
- - - -.f �s
No._ v444 - - -._ Street_ -._ _9.9 - --
No. of Stories.
-- (Signed) - — — � S? �u• - -U
Plum in b spector.
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 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 tlie 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.
Amount of Permit $
STATE OF FLORIDA, }
COUNTY OF DADE.
My Commission Expires
(Signed).
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
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.