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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 DEEP WELL SPRKLR. SYSTEM SW IM'G POOL /4..r f CONTR. LIST tt CHECK 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.