874 NE 99 St (8)Permit No
Vol I 1
Application 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 ia 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.
Amount of Permit $S
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
(Si
No
Owner's Name and Address
Registered Architect and /or Engineer
r
A1Ai1 P ,ONNPA_ PC K
/` 3 1rtn lo gin lltmbew o
and Legal &sal piton B °Z Subdl L
X74- �NF9�s.
Street and Number where work L to be performed —No _... .a,, .__ __._.... ..
State work to be performed and purpose of building (By Finns) __. c,'1`.,•.... kN I ti
New Building.._ -- _....... -.._.. Remodeling —_. - -- Addition. . Repairs
(Signed)_
Street.
Size Septic Tank__ Type of Tank.____
Feet of Drain Tile Dist Feet of Tank or Drain Field from Well
Nature of Water Supply: City —We1L 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 5968, Compiled General Laws of Florida Perinanent Supplement, and hav com-
piied with the provisions thereof, and will require similar compliance from all contractors or sub - contract • employed by him in the work to be
performed under this permit; and will post or cause to be posted for inspection on the site of the w• h public notice or notices as arr
required by the Act. The undersigned agrees to employ only such sub -contr on work to this permit, Ks are
licensed by Miami Shores Village.
No. of Stories
6
M Commission Expo Notary Public, State of Florida
NOTE: A re- inspection fee of $1.00 will be made wham mob rrispeedne to a aade'naoaarary by improper notice for Mapee
materials and /or workmanship.
Master Plumber.
STATE OF FLORIDA, 1
es.
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take aclmowledgments, 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 be did sign the same, and that all facts
therein by him stated are true.
CLOSETS
BATH
Tuse
SH
LAVA-
TORIES
SINKS
SLOP
am,.
LAUNORY
Tuve
U RINAL/
CATCH
BASIN
FLOOR
GRAIN
DRINKING
FOUNT'NS
TOTAL
FIXTURES
CONTu.
LIST
CHICK
_
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
G
TRAP
SOLAR
HEATER
DEEP
WILL
5
SYSTEM
SWIM'S
POOL
LIST
CHECK
Permit No
Vol I 1
Application 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 ia 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.
Amount of Permit $S
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
(Si
No
Owner's Name and Address
Registered Architect and /or Engineer
r
A1Ai1 P ,ONNPA_ PC K
/` 3 1rtn lo gin lltmbew o
and Legal &sal piton B °Z Subdl L
X74- �NF9�s.
Street and Number where work L to be performed —No _... .a,, .__ __._.... ..
State work to be performed and purpose of building (By Finns) __. c,'1`.,•.... kN I ti
New Building.._ -- _....... -.._.. Remodeling —_. - -- Addition. . Repairs
(Signed)_
Street.
Size Septic Tank__ Type of Tank.____
Feet of Drain Tile Dist Feet of Tank or Drain Field from Well
Nature of Water Supply: City —We1L 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 5968, Compiled General Laws of Florida Perinanent Supplement, and hav com-
piied with the provisions thereof, and will require similar compliance from all contractors or sub - contract • employed by him in the work to be
performed under this permit; and will post or cause to be posted for inspection on the site of the w• h public notice or notices as arr
required by the Act. The undersigned agrees to employ only such sub -contr on work to this permit, Ks are
licensed by Miami Shores Village.
No. of Stories
6
M Commission Expo Notary Public, State of Florida
NOTE: A re- inspection fee of $1.00 will be made wham mob rrispeedne to a aade'naoaarary by improper notice for Mapee
materials and /or workmanship.
Master Plumber.
STATE OF FLORIDA, 1
es.
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take aclmowledgments, 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 be did sign the same, and that all facts
therein by him stated are true.
STATE OF FLORIDA
DEPARTMENT OF HEALTH AND REHABILITATIVE SERVICES
ONSITE SEWAGE DISPOSAL SYSTEM CONSTRUCTION AND INSTALLATION PERMIT
Applicant 64 / S Kermit Numioer f -
toeteere-63 f 71f A y /, : v/ o 6 ����
PART II - SYSTEM INSTALLATION INSPECTION AND FINAL INSTALLATI APPROVAL-
Installer /Y7i A�
Propertank legend: Yes A No
Tankswatertight: Yes A- No
Proper tank outlet device: Yes ipt). No
Drainfield Trench
Length Width
feet feet
feet feet
feet f
Total = ft
Other findings:
Systems located as permitted: Yes J No
Inspected by Pa d 17
Date /
/674
Approved by:
Length
feet
feet
feet
PART I - FIN
AN APPROVED IN LLATI
Note: Completed copies of this form will be pro
HRS —H Form 4018, Feb 85 (Obsoletes previous editions which may not be used)
(Stock Number. 5744 -002- 4018.0)
Tank materiale-i+"e 4e Tank level: Yes fi- 1 No
gallons
Tank size
Tank Manufacturer l,1la
Systems including plumbing stub -outs installed at proper elevation:
Manhole or marker to grade: Yes ' /
Absorption Bed
Width Length co feet x / 4 feet = 3Zo'ft
feet Length feet x — feet= — ft2
feet Proper No. drainlines: Yes No
feet Proper pipe separation: Yes ✓ No
Total= ft
TALLATION APPROVAL
Distribution box level: Yes NoP/ '
Yes No _EJfi
Average depth to drainpipe invert from finished grade , 2° 2 inches Maximum depth: Inches
Average depth of drainfield gravel / e3 inches Minimum depth of gravel. / 2--inches
Proper gravel size: Yes l/ No
Backfill or fill material as required: (Quality) Yes ti No
Gravel is suitable quality: Yes d/ No
(Quantity) Yes No
DOES NOT GUARANTEE PERFORMANCE
ided. to the applicant, installer and the building department.
gallons %o J gallons
COUNTY PUBLIC HEALTH UNIT
Page 2 of 2
Ir
Company
Job
Address
REQUEST FOR INSPECTION
//,
PHON E
IA
Permit No. __ 1 7 k
Date 6 ��j't 'off
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.__ __ar_ _r_ e v
Registered Architect and /or Engineer
Nature of Water Supply: City —Well
Amount of Permit $
ss.
MIA:;.i SHOES VILLAGE
°LUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
No 6 7 « Street.__
�i�f' Street_ /
Employing Plumber's Name ._ / y,0_ I_/I___� 1XL" `+J '�,f _1__�_'Y
Location and Legal Description Lot V Block
Street and Number where work is to be performed—No ........ _______ .... _ ?_ Street
State work to be performed and purpose of building (By Floors) //_S?'__pt /
New Building Remodeling Addition____ / Repairs No. of Stories
I
_ Size Septic Tank L" Type of Tank___
Feet of Drain Tile l _0 - -Q Dist. Feet of Tank or Drain Field from Well
Capacity Gals
_ (Signed)
3 „!? e/400,,
Subdivision
.A,i %v f /e-
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)
My Commission Expires Notary Public, State of Florida
1'
faster Plumber.
STATE OF FLORIDA, t
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the
of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty
materials and /or workmanship.
CLOSETS
BATH
TUBS
SHOWERS
LAVA-
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TUBS
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT'NS
TOTAL
FIXTURES
CONTR.
LIST
CHECK
•
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
H EATER
DEEP
WELL
SPRKLR.
SYSTEM
SW IM'G
POOL
CONTR.
LIST
�1,
/oV .
-
CHECK
IA
Permit No. __ 1 7 k
Date 6 ��j't 'off
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.__ __ar_ _r_ e v
Registered Architect and /or Engineer
Nature of Water Supply: City —Well
Amount of Permit $
ss.
MIA:;.i SHOES VILLAGE
°LUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
No 6 7 « Street.__
�i�f' Street_ /
Employing Plumber's Name ._ / y,0_ I_/I___� 1XL" `+J '�,f _1__�_'Y
Location and Legal Description Lot V Block
Street and Number where work is to be performed—No ........ _______ .... _ ?_ Street
State work to be performed and purpose of building (By Floors) //_S?'__pt /
New Building Remodeling Addition____ / Repairs No. of Stories
I
_ Size Septic Tank L" Type of Tank___
Feet of Drain Tile l _0 - -Q Dist. Feet of Tank or Drain Field from Well
Capacity Gals
_ (Signed)
3 „!? e/400,,
Subdivision
.A,i %v f /e-
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)
My Commission Expires Notary Public, State of Florida
1'
faster Plumber.
STATE OF FLORIDA, t
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the
of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty
materials and /or workmanship.
BUILDING
ELECTRICAL
PLUMBING
Owner of
Building
Architect
� �,a�, (
or Builder ��'`
Contractor
MIAMI SHORES VILLAGE, FLORIDA
DATE y 2 J / 194
rj
PERMIT N° 8178
Work to be performed under this Permit );.. �*.
Legal Lot Bl.
Description
Building of ,..i. 7 4/ ) T r" '° /
h � ,r'� 4/ -.�': �� Value of
Project
Subdi-
vision
BY
Contractdr'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 appli-
cation herefor in strict compliance with all ordinances pertaining thereto and w th 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 drawin s or in the statements or specifications and that he assumes respon-
sibility for work done by his agents, servants or employees.
Si ed• ..# !` . By i
—
gn .
INSPECTOR
In consideration of the issuance to me of this permit I agree to perform tii"e work covered hereunder in compliance with all ordirian s and regulations
pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorittemof mi Shore3VMap _ . D
In accepting this permit I assuyh responsibility for all work done by either myself, my agent, servant or employee.
CONTRACTOR OR BUILDER
Amt. of
Permit
AUTHORITY
S::TV`
BUILDING
ELECTRICAL
PLUMBING
Lot }.4
8 7s/7r
.."'le t
CONTRACBUILDER
MIAMI SHORES VILLAGE, FLORIDA
DATE / 194
PERMIT N9 1084
Contractor's
Liyense No.
A f I t '�- .►�'��•
Work " l je performed under this Permit
Owner of ,, S
Building -- s� -f'"7-- 4-"I'
Architect
t r j
Contractor /; - �f
,
� J . °.. el e- ,�,r... ,C ti,.
> .!r
Subdi-
vision
fir7 0$ 4 C .
Legal
Description
Address of
Building
This permit is granted to the contractor or builder named above to construct the building or to install the equipments 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 responsibility for a thorough knowledge of
the ordinances and regulations pertaining to the work covered hereby whether shown' on the ans or draw or in the statemCMseyprJpecifications and
that he assumes responsibility for work done by his agents, servants or employees.
AI
INSPECTOR
In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in 6mpliance with all ordinances and regula-
¢ions pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores
Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servant or employee.
Amt.
r ,� 7 •
Permit
Signed
Value of
Project
/ ?) A ,,R�i puup {�[{,++, AUTHORITY