PLUMBINGPermit No. _l __._L__�
Application is hereby made for the approval of the detailed statement of the plans and Specifications herewith sub lifted 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 Divisior
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 wor
Owner's Name and Address - -_ ° ...... ____ -- ----- ___ _. No.__.__.__. - -_ -- -- ------ - - - -_- _ -- Street
Registered Architect and /or Engineer - -- - -- - ---- -- ___ --
Employing Plumber's Name - -_ -- . �1^�O'__ __------ _ -.�_ - -_ No. Y S S 6___ __ Street -_- -C,
Location and Legal Description Let _-- _-- ._._-_.-.. ------ ......... ______
New wilding
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
_ -____ Subdivision
Street and Number where work is to be performed -No. —__ __ ____ __ __ q . Street_ _ _VV 4— fi t
State work to be performed and purpose of building (By Floors) _
Remodeling Addition.
Size Septic Tank - -__lt `- - - r '"` Type of Tank_ _
Feet of Drain Tile __..f Al2. j _+ _ ______ _ ...... Feet of Tank or Drain Field from Well_ ..... _ - -•- ..............
Nature of Water Supply: City- Well 1i----- -_ - - -- - - - - - -- - - -- - - -- Size of Soakage Pit ._ ....
Amount of Permit $- // - - — — - - - - —_ ( Signed)
Plumbing Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and acc'pt`s his obligations as all employer of labor
under the Florida Workmen s Compensation Act, being Section 5988, Compiled General Laws of Florida Pennanent Supplement, and Man -
plied with the provisions thereof, and will require similar compliance from all contractors or subcontractors 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 art
licensed by Miami Shores Village.
Repairs
Date •Z 6 1 y s�
Capacity Gals
My Commission Expires Notary Public, State of Florida
No. of Stories .._ /. . .. ....... ..
Master Plumber.
STATE OF FLORIDA, u,
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeare
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 tat.
therein by him stated are true.
NO E: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or LW
materi and /or workmanship.
CLOSETS
BATH
TUBS ue.
SHOWER.
LAVA-
TORIl6
SINKS
SLOP
SINKS
LAUNDRY
Tuff
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT'NS
6 441 . 5 ‘ 6 441 . 5 ‘
0/003
TOTAL
f1ET
CONTR.
LIST
/
/
3
CHECK
S-1-3
-
- -
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SfiIRR
HEATER
DEEP
WILL
SPRKLR.
SYSTEM
SWIM - G
POOL
CONTR.
LIST
/
/
/
CHECK
J p V
/0 O
S O
Permit No. _l __._L__�
Application is hereby made for the approval of the detailed statement of the plans and Specifications herewith sub lifted 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 Divisior
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 wor
Owner's Name and Address - -_ ° ...... ____ -- ----- ___ _. No.__.__.__. - -_ -- -- ------ - - - -_- _ -- Street
Registered Architect and /or Engineer - -- - -- - ---- -- ___ --
Employing Plumber's Name - -_ -- . �1^�O'__ __------ _ -.�_ - -_ No. Y S S 6___ __ Street -_- -C,
Location and Legal Description Let _-- _-- ._._-_.-.. ------ ......... ______
New wilding
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
_ -____ Subdivision
Street and Number where work is to be performed -No. —__ __ ____ __ __ q . Street_ _ _VV 4— fi t
State work to be performed and purpose of building (By Floors) _
Remodeling Addition.
Size Septic Tank - -__lt `- - - r '"` Type of Tank_ _
Feet of Drain Tile __..f Al2. j _+ _ ______ _ ...... Feet of Tank or Drain Field from Well_ ..... _ - -•- ..............
Nature of Water Supply: City- Well 1i----- -_ - - -- - - - - - -- - - -- - - -- Size of Soakage Pit ._ ....
Amount of Permit $- // - - — — - - - - —_ ( Signed)
Plumbing Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and acc'pt`s his obligations as all employer of labor
under the Florida Workmen s Compensation Act, being Section 5988, Compiled General Laws of Florida Pennanent Supplement, and Man -
plied with the provisions thereof, and will require similar compliance from all contractors or subcontractors 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 art
licensed by Miami Shores Village.
Repairs
Date •Z 6 1 y s�
Capacity Gals
My Commission Expires Notary Public, State of Florida
No. of Stories .._ /. . .. ....... ..
Master Plumber.
STATE OF FLORIDA, u,
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeare
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 tat.
therein by him stated are true.
NO E: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or LW
materi and /or workmanship.
Job Address
t
PERMIT APPLICATION FOR MUNICIPALITIES OF DADE COUNTY
Qualifier LOU tf /U 1
State #
Legal Description 'eJee
/ Lessee / Tenant l /NCis Trio fY)
Owner's Address 7'1S IV. e , 2 j■ / phone 7 c7-616
Contracting Co. 4T[0M0 £do /aZ
Architect /Engineer A/' / Address
Bonding Company Address
,Mortgagor Address
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL PAVING FENCF SIGN
WORK DESCRIPTION
t YL4 I N Fa A) i
Square Ft . -SOO Goa
q Estimated Cost � O ` -
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. I certify
that all work will be performed to meet the standards of all laws regulating construction in this
jurisdiction. I understand that separate permits are required for ELECTRICAL, PLUMBING, SIGNS,
POOLS, ROOFING, and MECHANICAL work.
OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work
will be done in compliance with all applicable laws regulating construction and zoning.
Furthermore, I author the above -named contractor to .• the work stated.
e
Signatute of Owner and /or C,pndo President
( Date ,
Notary/ as co Owner and /or President
My Commission Expires: ,� �TATr mOA.
* * * r T�., �._
� ,, , * A*. 2.0, 1993*
EhMUL[ ' .0 il, ∎14h, 1'4.131-1C; UN'I:RWRITER
PERMIT FEE: APPROVED: Fire
3 o.
(OWNER TO RETAIN COPY)
Tax Folio'? .O ' /
Master Permit #
Address 05 /L v(/. /2 sr 32r /hiI9111 i
SS# phone 5-76--ado ✓ � /��
Competency# - - Lt ? Co. OI1/ ; C. tT '
Signa'ure of Contr ctor or Owner - Builder
Da
Not ry as to Contra
My 'Commission Expires:
.),1
Other
r Owner-BuSlder
Zoning Building
Mechanical � � Plumbing F ring
Electrical
ECONO-000FEO
WE DO DRA /NF /ELDS
SEPTIC TANK CLEANING
PAT HOSLER
Manager
•Authority: Chapter 301, F.S. & Chapter 10D -6, F.A.C.
Application Is For:
New System: Repair: Existing System: Experimental System
Tank Abandonment: olding Tank: Other (Specify):
NOTE: PERMITS EXPIRE ONE YEAR FROM THE DATE OF ISSUANCE AND ARE NOT RENEWABLE. REPAIR PERMITS AND HOLDING TANK PERMITS
EXPIRE 90 DAYS FROM DATE OF ISSUANCE. APPROVAL OF A SYSTEM DOES NOT GUARANTEE SATISFACTORY PERFORMANCE
SPECIFIC PERIOD OF TIME.
TO BE COMPLETED BY APPLICANT: GENERAL INFORMATION
Owner: L / /1i0 s / >2C mY)
Owner's Mailing Address: t?' Y5 /v 74
Owner's Agent: ELc /tJ) , LC' ilk,
Telephone:(W) ?( -woo (H)
Agent's Mailing Address: 3-3 N tA,/ / ) 7 City: `i/ //9i7t / State: Zlpt' i
Property Street Address:
Exact Directions to Property:
Lot //
Section:
Property size:
Is Sanitary Sewer Available: Yes No� If No, approximate tho dlstanco to the sewer Tine closest to your property;
Is Public Water Available: Yes ,� No If No, approximate the distance to the water Ilne closest to your property: !?r
Typo of 1ablithiRont
Commerci Rostdontlal c ono)
ono)
Plumbing Fixtures:
BUILDING PLANS MUST
CHAPTER 10D -6, F.A.C.
Block #
l T ` ownship:
Y
DIMENSIONS, BUILDING LOCATIO
'
Applicant's Signature: r i
STATE OF FLORIDA
DEPARTMENT OF HEALTH AND REHABILITATIVE SERVICES
APPLICATION FOR ONSITE SEWAGE DISPOSAL SYSTEM
CONSTRUCTION PERMIT
?y.5 ti E yr s
Telephone: (Work) /V (Home) 95 74 f i
Unit: Date Subdivided:
r City: i mn / Tito/US State:
Subdivision:
Rango: Parcel Number: Zoning Designation: ;. .' ,,
Squarr� -F o /l ;res" Wator Supply: Private: Public: V Limited Usk ''' '�
i
BUILDING INFORMATION
# Of Units Building Aron (Square Foot) 0 01 Porsons M Of Soots
& Num +or of Bedrooms
Building Permit #:
Application /Permit Number , z —/. - /7
Date Application Received / / �'
Fee Amount Paid
(Temporary): Receipt #
Date Paid /
Date:
Yti
.1�
_; l ; I ill,al I,
7;.
Flours of O eral on 4
I;
I 's;
Zi
Garbage Grinders /Disposals: Spas /Hot Tubs: FIQor /Equipment Drains:
'1V! I
Ultra -low volurpo Flush Toilets: Other:
BE ATTACHED S OWING OFFICES, BEDROOMS, TOTAL BUILDING AREA, AND ANY PERTINENT FEATURES REQUIRED p
IN ADOITIO A DETAILED SITE PLAN AND /OR SURVEY, DRAWN TO SCALE,MUST BE ATTACHED SHOWING 1 t 1OPE tTY
ND PERTINENT FEATURES REQUIRED TO BE SUBMITTED PER CHAPTER 10D- 8.048, F.A.C.
"'
• STATE OF FLORIDA
• � ry� DEPARTMENT OF HEALTH AND REHABILITATIVE SERVICES
• ��r:�/ ONSITE SEWAGE DISPOSAL SYSTEM CONSTRUCTION AND INSTALLATION PERMIT
Permit Application Number gel
Notes: 36O l
Site Plan submitted by:
PART II • SITE PLAN
Scale: Each block represents 5 feet and 1 inch = 50 feet.
Otp tic ��✓�
LuoiVL Jac/1(k- t o /9i s
dor 7b q
TITLE
SIGNATURE
Plan Approved
B County Public U
ALL CHANGES MUST BE APPROVED BY THE COUNTY PUBLIC HEALTH UNIT
HRS -H FORM 4015 -A January 1992 (Obsolotos All Previous Editions) FOR OPTIONAL USE AS AN ATTACHMENT TO HRS -H FORM 4015
Not Approved Dale
APPLICATION FOR PLUMBING PERMIT
Permit No ___ i Date - (.2 - G
Appl cation i 1 ereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build ng or other
structure herein described This application is made in compliance and conformity with the Building Ordmance 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 th Building Di ' sion
of Miami Shores Village shall be comphed 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. t .._
Registered Architect and; or Engineer ..
Employing Plumber's Name
Location and Legal Description Lot____ -- --_ _ �+— — _ _ Block
7 __
�
Street and Number where work is to be performed —No `r
" t
State work to be performed and purpose of building (By Floors).
New Building - __ —_ . - - -- _ -- _ -- Remodeling - -_ ___ __ - . _ Addition__--
Size Septic Tank__ _ _. __ __ _ — Feet of Drain Tile. '# a _ _ __ - -- _Dist. Feet of Tank or Drain Field from Well..
Nature of Water Supply. City—Well. __ __ __ _ _ _ - __ - Si . of Soakage Pit
Amount of Permit $ _ y" 0
STATE OF FLORIDA,
COUNTY OF DADE. J
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
No. 9V 5 E el Street
No.. a /,t 3 S treet .
(Shed)-
Subdivision.
Repairs_ ✓- . _ _ ___ No. of Stories -
The undersigned applicant for this building permit does hereby certify that he understands and .;cc is hi ga•ions as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Pei anent Supplement, ^nE1 I a om
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by hin 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 no ices as are
required by the Act. The undersigned agrees to employ only such sub contractors, on work to be perfo. ed under this per nit, as are
licensed by Miami Shores Village.
Capacity Ga " +s.
Ph.mb rig In.pecto.
Master Plumber
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgn ents, personall 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 foregomg apphcation, and that he did sign the same, and that all acts
therein by him stated are true.
My Commission Expires 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
BATH
TUBE
SHOWERS
LAVA-
TORIES
S INKS
SLOP
SINKS
LAUNDRY
Tim;
URINALS
U RINALS
CATC,I
FLOOR
DRAIN
DRINKING
FOU• r NS
TOTAL
F XTURES
CONTR.
LIST
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WE -L
SPRKLR.
SYSTEM
SWIM•G
POOL
CONTR.
LIST
CHECK
APPLICATION FOR PLUMBING PERMIT
Permit No ___ i Date - (.2 - G
Appl cation i 1 ereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build ng or other
structure herein described This application is made in compliance and conformity with the Building Ordmance 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 th Building Di ' sion
of Miami Shores Village shall be comphed 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. t .._
Registered Architect and; or Engineer ..
Employing Plumber's Name
Location and Legal Description Lot____ -- --_ _ �+— — _ _ Block
7 __
�
Street and Number where work is to be performed —No `r
" t
State work to be performed and purpose of building (By Floors).
New Building - __ —_ . - - -- _ -- _ -- Remodeling - -_ ___ __ - . _ Addition__--
Size Septic Tank__ _ _. __ __ _ — Feet of Drain Tile. '# a _ _ __ - -- _Dist. Feet of Tank or Drain Field from Well..
Nature of Water Supply. City—Well. __ __ __ _ _ _ - __ - Si . of Soakage Pit
Amount of Permit $ _ y" 0
STATE OF FLORIDA,
COUNTY OF DADE. J
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
No. 9V 5 E el Street
No.. a /,t 3 S treet .
(Shed)-
Subdivision.
Repairs_ ✓- . _ _ ___ No. of Stories -
The undersigned applicant for this building permit does hereby certify that he understands and .;cc is hi ga•ions as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Pei anent Supplement, ^nE1 I a om
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by hin 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 no ices as are
required by the Act. The undersigned agrees to employ only such sub contractors, on work to be perfo. ed under this per nit, as are
licensed by Miami Shores Village.
Capacity Ga " +s.
Ph.mb rig In.pecto.
Master Plumber
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgn ents, personall 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 foregomg apphcation, and that he did sign the same, and that all acts
therein by him stated are true.
My Commission Expires 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.