933 NE 99 StMIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
Bujlding Inspection Request
Date
Type Insp'n rr1 (��
Permit No. 11 b �, I cq -1
Name e
Address -I _ NE, 9 -( s
Company 1./ F 6Z-A-P
Phone #
Inspection Date
Approved
Correction
Re- Insp'n Fee
151
MIAM SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
Building Inspection Request
Date 1 112.8 105
Type Insp' n�t
Permit No.
Pl--C; — 1
Name
Address aZ n 9q �T
Company .15 4..
Phone # (3°S) C — -9 - 7 J
Inspection Date ' ' 1 Zc CS
Approved
Correction
Re- Insp'n Fee ❑
Company
Phone #
3qo,
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
B ilding Inspection Request
Date
Insp'n pi 1 1�1 C'cpu_Ar
Permit No. Pi Z 1
Name .
Address c 1\
99 31
P
Inspection Date
Approved
Correction
Re- Insp'n Fee
Miami Shores Village
10050 NE 2nd Avenue
Phone: 305 - 795 -2204 Permit Number: PL2005 -1
Printed: 2/17/2005
Applicant: DARYL
Owner: DARYL
JOB ADDRESS: 933 NE 99 ST
Contractor D & D PLUMBING CORP
Local Phone: 305 - 379 -0516
Parcel # 1132060340250
Signed: (INSPECTOR)
Plumbing Permit
Contractor's Address: 3145 SW 19 ST
Page 1 of 1
Legal Description: 5 -6 53 40 MIAMI SHORES SEC 8 PB 14 -33 E9FT LOT 16 ALL LOT 17 & W16FT LOT
Fees: Description Amount
FEE2005 -2230 Building Fee $160.00
FEE2005 -2232 CCF $1.80
FEE2005 -2233 Training and Education Fee $0.60
FEE2005 -2234 Technology Fee $4.00
Total Fees: $166.40
Total Fees: $166.40
Total Receipts: $0.00
Permit Status: APPROVED Permit Expiration: 7/2/2005 Construction Value: $2,400.00
Work: PLUMBING FOR NEW ADDITION - MASTER PERMIT BP2004 -1299
FEB `0`.LP
1 s 1005
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 accepting this permit I assume responisibility for all work
done by either myself, my agent, servants or employes.
Signed: (Contractor or Builder) BY:
BUILDING
PERMIT APPLICATION
FBC 2001
Permit Type (circle): Building Electrical ` rlumbin Mechanical Roofing
Owner's Name (Fee Simple Titleholder) / t fr(w j IL( . ' I/O Phone # („; - >f 6 6: `' r `7
Owner's Address ( 13 3 k . ' j ci 6 S722. C°• %
City pine 1 ! .sAY-e e7 State / Zip 33 / ge
Tenant/Lessee Name /0/A3
Job Address (where the work is being done) cl3 3 / 'di.E . c / ? - i t i .14Z-r -c rr d' r�
City Miami Shores Village County Miami -Dade Zip 3 S /3
Is Building Historically Designated YES
Contractor's Company Name ---
Contractor's Address
City 4/.4 /
Qualifier " V - 74 ) i 2
7
State Certificate or Registration Nc�, ( / / 7 Certificate of Competency No.
Architect/Engineer's Name (if applicable4 -.x.:50 L_i j 4 ,. /N< <e r re? stet. Phone #
$ Value of Work For this Permit 2/1 t . C)C.3
Type of Work: ,,Addition
Describe Work: NJ CLL.) t ll k -& (314- ti."2C) 14 -
Submittal Fee $ Permit Fee $ �6 0 CCF $ CO /CC
Notary $ Training/Education Fee $ V : + L Technology Fee $
Scanning $
Code Enforcement $ Structural Plan Review. $
Total Fee Now Due $
(Continued on opposite side)
Miami Shores Village
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
NO X
(-6C, Ce
State /2 .
Building Department
* * * * * * * * * * * * * * * * * * * * * * * * * * ** F * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
Radon $
a, 61
Zoning Bond $
� r
Permit No. 13 i.cct l l
Master Permit No.
Phone # C ire; ` . 6 /
Phone #
Zip S�1`� -�
3 ° -2yy- eta 7 ?
Square Footage Of Work: /0
❑ Alteration ENew ❑ Repair/Replace ❑ Demolition
Bonding Company's Name (if applicable)
Bonding Company's Address 1 6�
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 certified copy of the recorded notice of c ice nt m t be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is iss •d In th . su h posted notice, the
inspection will not be approved and a r tion fee will be charged. -'-'
Signatr j ��/��`
Owner or Agent /
The foregoing instrument was acknowledged before me this
day of , 20 _ , by
who is personally known to me or who has produced who
As identification and who did take an oath.
APPLICATION APPROVED BY:
Chc 05/13/03
ntractor
The foregoing instrument was acknowledged before me this L%
day of A i 49J ,2o65 , by i f�l/t`i ij-1 - Z
or who has produced
as identification and who did take an oath.
NOTARY PUBLIC: NOTARY
P\ !p � Sign:in. , . • c P ; er ▪ Pu c My Commission Expires: y C2 O. iLs:
***************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** • .. ' ad * * * * * * * * * * * * * * * * * * * * * * * * * * * **
t C
, , STAZ; �N
** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** � * * *, ** * * * * * * * * * * * * * * * * * * * * **** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
Plans Examiner
Engineer
Zoning
a P 9c 12 4 1 Miami Shores Village
Building Department
BUILDING
PERMIT APPLICATION
FBC 2001
Permit Type (circle): Building Electrical
Owner's Name (Fee Simple Titleholder) M2 .* Mar
Owner's Address 9' 3 3 C ctcf 1. 4
Notary $
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
I�c , G*/lo
S .
Permit No.
Master Permit No.
7 L e 9OP5 —1
Mechanical Roofing
Phone # 305 75 - 6,7 / 7
City 611 r t SNotc State F/. Zip 3 3/ 3k
Tenant/Lessee Name` Phone # N /h
i+
Job Address (where th
City Miami Sli
Is Building Historically Designated
Contractor's Company Name
Contractor's Address ,(I'/ S'a�
City State t- Zip e / P3
Qualifier « /dam ,$ 4 _( _s-
State Certificate or Registration No. C ®S643. 3 Certificate of Competency No.
Architect/Engineer's Name (if applicable)CoN$uL4... % Pei__-(v 4 1 Ei Jiw. f Phone # VS
—
$ Value of Work For this Permit
Type of Work: ❑Actitio
Describe Work:
Scanning $
Code Enforcement $
Total Fee Now Due $
(Continued on opposite side)
County Miami -Dade'
YES NO �\
e s /�!/itt/fK9 f J Phone # —`- 44/7
Training/Education Fee $
❑New
Square Foo
Structural Plan Review. $
❑ Repair/Replace
* * * * * * * * * * * * * * * * * * * * * * * * * * ** F ees * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
Submittal Fee $ 5 Permit Fee $ CCF $
Technology Fee $
Radon $ Zoning Bond $
CO /CC
1/4
❑ Demolition
3Q5 =S'.i -- Oyio
Bonding Company's Naine (if applicable) •
Bonding Company's Address
City
State Zip
1
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 certified 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 w • be chr rged.
Signature
Sign // j
Owner or Agent / Contractor
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before nee this t i,
day of , 20 _ , by , day of e. c p , 20 A, by ( k� ‘t -a\ .`.:Aief, ,
who is personally known to me or who has produced who is personally known to me or who has produced C y ti \ . ".._ w ‘,
As identification and who did take an oath. � ,v
NOTARY PUBLIC:
NOTARY PUBLIC:
Sign:
Print:
My Commission Expires:
as identification and Ito did take an oath.
Yovalla Ruz
Sign: �= ti"_ Commission #DD246t
• � . �-�— ' Bxptres: on Sep Thru
03, 2C
Print: �;`�;ae;l� Bd
tlanuc Building Co.,
My Commission Expires: -- k .' o
***************************************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
APPLICATION APPROVED BY:
Chc 05/13/03
Plans Examiner
Engineer
Zoning
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 ._... ."e'
Registered Architect and /or Engineer
Name and address of licensed contractor. (-/ 6) AU .EGes72 c '-r,e'YS'— /3.) o,Lw p 9
Permit No
Disapproved
(Signed)
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
SS.
State work to be done and purpose of building (by floors)
Date
����
o/ or �✓ / '7, Ss No
Location and legal description of lot to be built on:
Lot_ lock / Subdivision '4' S
EgoT7iiAZ�J'7 bob -?ort � 9 _ '
Street and Number where work is to be do 93 n/c
ne `�'
C33
Street'✓ c'5"
V/0 /
and for no other purpose.
New Building Remodeling Addition Repairs No. of Stories
To be constructed of Kind of foundation Roof g ring
Estimated Total cost of improvements $ Amount 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 submit all the plans and specifications for said building. All notices with reference to the building and its construction may
be sent to
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 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)
PLANNING BOARD DATE
Chairman Member
Member Member
Member Member
Council Approved Date Disapproved
Notary Public, State of Florida
STATE OF FLORIDA,
COUNTY OF DADE.
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 stated are u
Date 7 (A_I__ Read, Sworn to and Subscribed before me.
Date
Building Inspector — My Commission Expires
Date
NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval
the Planning Board.
A re- inspection fee of 51.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty
materials and /or workmanship.
has been obtained from
New Building ___ Remodeling.
Amount of Permit $._
STATE OF FLORIDA, }
C')UNTY OF DADE.
My Commission Expires
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMEi "'
APPLICATION FOR PLUMBING
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. �y
Owner's Name and Address _____ No.__ / ` _ Street
Registered Architect and /or Engineer .... ___.— _._- _...... _- e�
Employing Plumber's Name " �'� T No..71 /___ -! Street. -7r S-7-
Location and Legal Description Lot_____ ........ ____ Block_
Street and Number where work is to be performed- No. _______
State work to be performed and purpose of building (By Floors)_
Addi tion.
Size Septic Tank �� - Type of Tank Capacity Gals
Feet of Drain Tile. ' 215-
/"
Nature of Water Supply: City -Well.
_Dist. Feet of Tank or Drain Field from Well
Size of Soakage Pit
(Signed)_
Street
Repairs No. of Stories.
Date
Subdivision
Notary Public, State of Florida
Plumbing Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts is obligations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida ' ennanent 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) --
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
TUBE
SHOWERS
LAVA-
TORIES
SINKS
SLOP
SINKS
LAUNDRY
Toes
I NAS
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT' NS
TOTA
FIXTURES
CONTR.
LIST
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SW IM•G
POOL
Comm
LIST
CHECK
New Building ___ Remodeling.
Amount of Permit $._
STATE OF FLORIDA, }
C')UNTY OF DADE.
My Commission Expires
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMEi "'
APPLICATION FOR PLUMBING
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. �y
Owner's Name and Address _____ No.__ / ` _ Street
Registered Architect and /or Engineer .... ___.— _._- _...... _- e�
Employing Plumber's Name " �'� T No..71 /___ -! Street. -7r S-7-
Location and Legal Description Lot_____ ........ ____ Block_
Street and Number where work is to be performed- No. _______
State work to be performed and purpose of building (By Floors)_
Addi tion.
Size Septic Tank �� - Type of Tank Capacity Gals
Feet of Drain Tile. ' 215-
/"
Nature of Water Supply: City -Well.
_Dist. Feet of Tank or Drain Field from Well
Size of Soakage Pit
(Signed)_
Street
Repairs No. of Stories.
Date
Subdivision
Notary Public, State of Florida
Plumbing Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts is obligations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida ' ennanent 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) --
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.
;
- 7 -
_3 -
MIAMI SHORES VILLAGE. FLORIDA
BUILDING ❑ r„
ELECTRICAL ❑ DATE f K 195 `'�
PLUMBING E PERMIT N? 7644 Contractors
License No .2 I
ROOFING ❑
❑ Work to be performed under this Permit
Owner of
Building
Architect
Contractor
or Builder
Legal
Description
A .; , , ,.�
f�.
Lot
Address of
Building
•
CONTR) CTOR OR BUILDER
Bl.
`f .F
rd
Subdi-
vision
Sq. Ft
Value of
Project $
Amt. of
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 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 state,nents or specifications and that he assumes responsibility for work
done by his agents, servants or employees.
a.,�
Signed • BY
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 regulations
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.
BY AUTHORITY
BUILDING
ELECTRICAL
PLUMBING
Contractor r �f
or Builder :
LLgal
Building
This p
cation heref
LL-41
2
C.Z.
MIAMI SHORES VILLAGE, FLORIDA
PERMIT N? 6349
1
Owner of
Building
Architect
Work to be performed under t
v � � �� �• '" "f f
Bl.
Permit
Subdi-
vision
Lot
lam`` cription
Ad Tress of r ,
it is granted to the contractor orb lder named above to construct the building or to install the equipment or device described in the appli-
in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any
Value of
Project
DATE V h j,
Contractor's i
Lieense No
Amt. dP
Permit
194
•
plans, draw gs, 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.sta$ements or specifications and that he assumes respon-
sibility for work done by his agents, servants or employees. . �, . .f ,.,
Si ed • :. R t r By '"
, 'INSPECTOR y
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 authdirhies of MiantS re V' lage,
In accepting is permit J. Ispurn responsibility for a work done by either myself, my agent, servant or employee.
/
C NTRAeTOR OR BUILDER /r BY
AUTHORITY
Permit No
Amount of Permit
STATE OF FLORIDA, 1
COUNTY OF DADE.
MIAMI SHORES VILLAGE
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. L�
Owner's Name and Address C• j- F/ A ��m) 77)
Registered Architect and /or Engineer
Employing Plumber's Name / GV i Kfi // �'' rie; P C � /� C_ No / -3 Street I 79
`t'. 7
Location and Legal Description Lot' I ` F /4 ' *17114 of 8' Block _______/7 1 -' Subdivision .t-`Z'
93.3 A,�
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
Size Septic Tank 6 C C Type of Tank 1 !t-k C 1t 5 r Capacity Gals.
Feet of Drain Tile / 0 0 Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City -15
ss.
yarn.
PLUMBING INSPECTION DEPARTMENT'
APPLICATION FOR PLUMBING PERMIT
y 3.3
No Street ._L!____ r1._;__7_
Repairs _. .
Size of Soakage Pit
(Signed)
Date ____
Street
No. of Stories _
My Commission Expires Notary Public, State of Florida
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. G •
frj ( Signed) _
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 fo regoing 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
O t � 'f
TOTAL
FIXTURES
CONTR.
LIST
/
/
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
�� (
AILCAR '
HEATER
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Permit No
Amount of Permit
STATE OF FLORIDA, 1
COUNTY OF DADE.
MIAMI SHORES VILLAGE
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. L�
Owner's Name and Address C• j- F/ A ��m) 77)
Registered Architect and /or Engineer
Employing Plumber's Name / GV i Kfi // �'' rie; P C � /� C_ No / -3 Street I 79
`t'. 7
Location and Legal Description Lot' I ` F /4 ' *17114 of 8' Block _______/7 1 -' Subdivision .t-`Z'
93.3 A,�
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
Size Septic Tank 6 C C Type of Tank 1 !t-k C 1t 5 r Capacity Gals.
Feet of Drain Tile / 0 0 Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City -15
ss.
yarn.
PLUMBING INSPECTION DEPARTMENT'
APPLICATION FOR PLUMBING PERMIT
y 3.3
No Street ._L!____ r1._;__7_
Repairs _. .
Size of Soakage Pit
(Signed)
Date ____
Street
No. of Stories _
My Commission Expires Notary Public, State of Florida
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. G •
frj ( Signed) _
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 fo regoing 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.