PLUMBINGPERMIT APPLICATION FOR. MUNICIPALITIES OF DADE COUNTY
(OWNER TO RETAIN COPY)
Date 8 -1 -94 Job Address 104 N.E. 100 St. Tax Folio
Legal Description
Owner / Lessee / Tenant Rick Pitchman
Master Permit # 33861
Owner's Address 104 N.E. 100 St. Phone 756 -8154
Contracting Co. B & D Plumbing & Heating, Inc. Address 10228 NW 50 St., Sunrise, FL.
Qualifier David J. Kopp SS# 150 - 42 -2129 Phone 305 - 572 -7506 C--'
State # Municipal # Competency #CFCO22550 Ins.Co.'•
Architect /Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type(circle one): BUILDING ELECTRICAL PLUMBIN MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION Room Addition — (a)
LaAs
(-- _.. -1=1:4 is / -loci t' k
Square Ft. Estimated Cost(value) $2,500.00
WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AN)' YOUR FAILURE TO DO
SO MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTEND
TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR
NOTICE OF COMMENCEMENT).
Application is hereby made to obtain a permit to do work and installation as indicated above, and
on the attached addendum (if applicable). I certify that all work will be performed to meet the
standards of all laws regulating construction in this jurisdiction. I understand that separate
permits are required for ELECTRICAL, PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK.
OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will
be done in compliance with all applicable laws regulating cpnstrlt on and zoning. Fur rmore, I
authorize the above -named contractor to do the work stat(d. � 7
Signature of owner and /or Condo President
Date:
Signature of
Date:
or Owner- Builder
Notary as to Owner and /or Condo President Notary,,,,,,• .•ntracto or I -r- Builder
My Commission Expires: My Co =�.• �av FSCN1A
A Y omm3clion cc33
$384
4 - E Expirsa Jan. 22, 1 og
Bonded by ANS
** * * * * * * * * * * e4404td IOO.852.58R8
FEES: PERMIT 5 RADON C.C.F. NOTARY TOTAL DUE
*
*
**
APPROVED: Fire Other
Zoning Buildin
Mechanical PlumbingAt/' 'n ing
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date L \t-\ C\- Job Address\°4\ Tax Folio
Legal Description
Owner / Lessee / Tenant - -- (--- &__ O \ \ \ O N \f Master Permit #
Owner's Address ���� ,, `` ,r
Co .'u`-N� SQ l)A - \ Co
r SS# - - Phone
** *
FEES: PERMIT
APPROVED:
\r$-- ( , \�Q ST \k\ ��11 5 - L , \- q Phone c-� S�
Address �3Z �3 1 V`� `� 11�C N. I O n1
Contracting
Qualifier
# Municipal # Competency # Ins.Co.
Architect /Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type(circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION ?a-C`C\ -- "1 \ �—�CJ\
Square Ft. Estimated Cost(value)
WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO
SO MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTEND
TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR
NOTICE OF COMMENCEMENT).
Application is hereby made to obtain a permit to do work and installation as indicated above, and
on the attached addendum (if applicable). I certify that all work will be performed to meet the
standards of all laws regulating construction in this jurisdiction. I understand that separate
permits are required for ELECTRICAL, PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK.
OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will
be done in compliance with all applicable laws regulating construction and zoning. Furthermore, I
authorize the above -named contractor to do the work stated.
Signature of owner and /or Condo President
Date:
Notary as to Owner and /or Condo President
My Commission Expires:
Signature of Cont actor or Owner- Builder
Date:
Zoning Building
Notary as to- Contractor or Owner- Builder
My Commission Expires:
* * * * * * * * * * * **
RADON C.C.F. NOTARY TOTAL DUE
Fire Other
E ctrical
).)
Mechanical Plumbing' / �� neering
Date 6 -30 -92 Job Address 104 N.E. 100th St. Tax Folio! / / / _' at/76 3
Legal Description Lots 13 & 14, Block 16, Amended Plat of Miami Shores Section No. 1
Owner / Lessee / Tenant Rick Pitchman
Owner's Address 104 N.E. 100th St. . Phone 794 -0971
Contracting Co. B & D Plumbing & Heating, Inc. Address 10228 N.W. 50th St.
Qualifier SS# - - Phone 572 -7506
State # CFCO22550 Municipal # Competency # Ins.Co.
Architect /Engineer Address
Bonding Company Address
Mortgagor
Permit Type(circle one): BUILDING ELECTRICAL \ PLUMING MICHANICAL ROOFING PAVING PENCE SIGN
WORK DESCRIPTION
PERMIT APPLICATION FOR MUNICIPALITIES OF DADE COUNTY
(OWNER TO RETAIN COPY)
Zoning
Mechanical
Signature of owner and /or Condo President Signature of Co
Date: Date: 7� /�f z
Building
Address
��� ►GP r o MO 7e
Square Ft. Estimated Cost(valu4) ' 9 )
WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO
SO MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTEND
TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR
NOTICE OF COMMENCEMENT).
Application is hereby made to obtain a permit to do work and installation as indicated above, and
on the attached addendum (if applicable). I certify that all., work will be performed to meet the
standards of all laws regulating construction in this jurisdiction. I understand that separate
permits are required for ELECTRICAL, PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK.
OWNER'S AFFIDAVIT: I certify that all the foregoing informati• is ac at all wor will
be done in compliance with all applicable laws regulating •nstructi• _�.•�'1 Furt 'd!re, I
authorize the above -named contractor to do the work sta
9 ra p na mme of ;V orar; F'ubh¢
1.no y � ni
Notary as to Owner and /or Condo President i •tar /as to Cgg
My Commission Expires: y Commission Expires: roduse
❑ DID rake an oath, or
-- DID NOT take an oath'.
* * * * * *
** * * * * * * * *
FEES: PERMIT 10-a RADON C.C.F. 1 J � • NOTARY J�' - 4 0 TOTAL DUE .3-5
APPROVED: Fire Other
Master Permit #5
*
**
Electrical
Engineering
,i i :145
r ii/e 1 ""4 1'
,
Owner's Name and Address ' P 4I1 _c
Registered Architect and /or Engineer.
State k to be d e and urpose of building (by floors)
STATE OF FLORIDA,
COUNTY OF DADE.
Chairman
Member
Member
Council Approved.
ss.
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
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 ,hall be complied with, whether herein specified or not. A copy of approved
plans and specifications must be kepi at building during progress of the work.
ic_L.
Name and address of licensed contractor. 1� �- L �� (� i$1.v � /L //0
Location and legal description of lot to be built on: I P
Lot_. Block.._ ___._ Subdivision _ �,
Street and Number where work is to be done .. 1. 4 Ai c' /0 __o " �::_Y_
Date
,19
S
No - �_.. S get Ai fJ' /Do 9
and for no other purpose.
New Building Remodeling__. ff. Addition Repairs. _ .__ . - _. No. of Stories
To be constructed of Kind of ndation.. oo Covering______.
Estimated ntal cost of improvements $___.___ _ 0 Amount c- Permit $._._...____sm��
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 provkions thereof, and will require similar comoliance from all contractors or sub - contractors employed by him
in the work to be performed under this permit; and will post or cause to he posted for inspe oon the site of the work such public notice
or notices as are required by the Act. The undersigned agrees to employ only such subcon , . s, on work to be performed under this
permit, as are licensed by Miami Shores Village.
Remarks__ (Signed)
Notary Public, State of Florida
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowl ents, 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 th • abov: described , Instruction, that he has carefully read tl}e foregoing application, and that he did sign the same, and that all facts
therein by him stated are true. /
Permit No e= _._6 ..��1 � S_ Read, Sworn to and Subscribed before me.
Disapproved Date
(Signed)
Buildin Inspector My Com:nission Expires_
PLANNING BOARD DATE
Member
Member .
Member
.Date Disapproved Date
NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has been obtained from •
the Planning Board.
A re- inspection fee of $1.00 will be charged when such re- inspection is male necessary by improper notice for inspection or faulty
materials and /or workmanship.
APPLICATION FOR BUILDING PERMIT
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. T7 f( _ Date. !rte ,19SJ
No. 0__ Street_ I , /
Remark 1
STATE OF FLORIDA, s
COUNTY OF DADE.
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
'ate
(Signed)._
Registered Architect and /or Engineer
Name and address of licensed contractor
Location and legal description of lot to be built on:
Lot Block Subdivision
Street and Number where work is to be done (L1 C / d_ , 5 T
State work to be dfln� and purpose of building (by floors) 1 !L-see a; G3 „ '„ ` T v / �G�.LR.0
�! /' � �
and for no other purpose.
New Building Remodeling Addition Repairs No. of Stories
To be constructed of Kind of foundation Roof Covering
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 su tractors, n F)c to be performed under this
permit, pare licensed by Miami Shores 'llage. c�
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 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 e. _
Permit No r Date `� Read, Sworn to and Subscribed before me.
Disapproved
( Signed)
Notary Public, State of Florida
ui ding Inspector My Commission Expires
PLANNING BOARD DATE
Chairman Member
Member Member
Member Member
Council Approved Date Disapproved Date
NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has been obtained from
the Planning Board.
A re- inspection fee of $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty
materials and /or workmanship.
it
MIAMI SHORES VILLAGE, FLORIDA
❑ DATE ' °"'" • -195
❑ PERMIT N? 14856
❑ Work to be performed under this Permit
BUILDING
ELECTRICAL
PLUMBING
ROOFING
Owner of
Building -�
Architect
Contractor
or Builder
Legal Lot II B1.
Description.
Address of
Building
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 he responsibility for a thorough knowledge of the ordinances and regulations
pertaining to the work covered hereby whether shown on the plans or drawings dr in the statements or specifications and that he assumes responsibility for work
done by his agents, servants or employees. .
Signed • '.c -__ . 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.
CONTRA(9FOR OR BUILDER
J
Subdi-
vision
Value of
Project $
BY
Contractor's
License No
Amt. of
Permit
$
AUTHORITY
BUILDING ❑ DATE - 195
ELECTRICAL ❑ PERMIT N? 14240
PLUMBING ❑ 'r
ROOFING ❑ Work to be performed under this Permit
Owner of
Building
Architect
Contractor
or Builder
Legal Lot II BI.
Description.
Address of
Building
4
CONTRACTOR OR BUIL ' ER
MIAMI SHORES VILLAGE, FLORIDA
Subdi-
vision
Value of
Project $
Contractor's
License No,
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 drawin s or in the statements or specifications and that he assumes responsibility for work
done by his agents, servants or employees.
Signed• BY E`."
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
Permit No -f
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.
Feet of Drain Tile
Nature of Water Supply:
Amount of Permit $
ss.
Well
a... -
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
- -
(Signed)
No l D
Owner's Name and Addr
Registered Architect and /or Engineer
Employing Plumber's Name
No
/ o
Date 42 — w1 a -
Street
C / 0-6 - 7,11/
Street L- 5
Location and Legal Description Lot V Block Subdivision
Street and Number where work is to be performed —No /a e. tab Street / a a —
State work to be performed and purpose of building (By Floors)
New Building Remodeling Addition Repairs No. of Stories
Size Septic Tank Type of T Capacity Gals
ist. Feet of Tank or Drain Field from Well
„ '3______ 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. -
Master Plumber.
STATE OF FLORIDA, 1
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.
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
TUBS
SHOWERS
LAVA-
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TUBS
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT' NS
TOTAL
FIXTURES
CONTR.
LIST
/�
%
/ � � /
L
/�
/
CHECK
/ '/ .
1S Z
/SD
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SW IM'G
POOL
CONTR.
LIST
J�-
v
CHECK
CZ D
Permit No -f
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.
Feet of Drain Tile
Nature of Water Supply:
Amount of Permit $
ss.
Well
a... -
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
- -
(Signed)
No l D
Owner's Name and Addr
Registered Architect and /or Engineer
Employing Plumber's Name
No
/ o
Date 42 — w1 a -
Street
C / 0-6 - 7,11/
Street L- 5
Location and Legal Description Lot V Block Subdivision
Street and Number where work is to be performed —No /a e. tab Street / a a —
State work to be performed and purpose of building (By Floors)
New Building Remodeling Addition Repairs No. of Stories
Size Septic Tank Type of T Capacity Gals
ist. Feet of Tank or Drain Field from Well
„ '3______ 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. -
Master Plumber.
STATE OF FLORIDA, 1
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.
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.
4
V
December 29, 1952
Owner — Mrs. J. B. Baile
Address — 61 N. E. 96th Street
To replace terra cotta sewer into septic tank
..,
MIAMI SHORES VILLAGE
Plumbing Inspection Department
STATE OF FLORIDA, 1
COUNTY OF DADE.
ss.
Amount of Permit $ /
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Signed)
( Signed)
/ 14 /
Permit No Date
6 -- - y--9
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith sub fitted 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 ith, whether herein specified or not. A copy of approved plans and specifications must be kept at
building during progress of work.
/9 7 i0z) No Street
Owner's Name and Address
Registered Architect and/or Engineer
Employing Plumber's Name eriiiigkcit 14 No Street
Location and Legal Description Lot Block Subdivision
Street and Number where work is to be performed—No / _a 57
State work to be performed and purpose of building (By Floors) —
New Building Remodeling Addition Repairs ' No. of Stories
Size Septic Tank Type of Tank Capacity Gals
Feet of Drain Tile Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City —Well Size of Soakage Pit
g I spect
Plumbi
The undersigned app cant for this building permit does hereby certi y-that he understan i s and accepts his obligations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled'General La • s 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.
My Commission Expires Notary Public, State of Florida
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
TUBS
SHOWERS
LAVA -
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TUBS
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT' NS
SAL.
c•O�('�
1
• ,
,
TOTAL
FIXTURES
CONTR.
LIST
/
/
/
CHECK
�ryy
/'`5
'/� /.
/ 5
h,
/ 5-
50
/ ..
S
75+
n
/5
/ / DEEP
t�
/ 2
/i' 6
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
WELL
SPRKLR.
SYSTEM
SW IM'G
POOL
CONTR.
LIST
CHECK
/
STATE OF FLORIDA, 1
COUNTY OF DADE.
ss.
Amount of Permit $ /
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Signed)
( Signed)
/ 14 /
Permit No Date
6 -- - y--9
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith sub fitted 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 ith, whether herein specified or not. A copy of approved plans and specifications must be kept at
building during progress of work.
/9 7 i0z) No Street
Owner's Name and Address
Registered Architect and/or Engineer
Employing Plumber's Name eriiiigkcit 14 No Street
Location and Legal Description Lot Block Subdivision
Street and Number where work is to be performed—No / _a 57
State work to be performed and purpose of building (By Floors) —
New Building Remodeling Addition Repairs ' No. of Stories
Size Septic Tank Type of Tank Capacity Gals
Feet of Drain Tile Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City —Well Size of Soakage Pit
g I spect
Plumbi
The undersigned app cant for this building permit does hereby certi y-that he understan i s and accepts his obligations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled'General La • s 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.
My Commission Expires Notary Public, State of Florida
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.
Size Septic Tank � (")
Feet of Drain Tile 1 b
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Permit No ; .2 9
Application is hereby made for the approval of the detailed statement of the plans and specifications herewit "ubmitted 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.
.�O t- X- 3 \681_ No b Street -- -�__-� C
Owner's Name and Address
Registered Architect and /or ineer _ ..
c� Street and Number where work is to be performed—No Street
State work to be performed and purpose of building (By Floors)
Location and Legal Description Lot Block Subdivision
New Building Remodeling Addition
Type of Tank X_ __0.2
Date
Repairs No. of Stories
Capacity Gals t.0 Q Q
Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City —Well. Size of Soakage Pit
Amount of Permit $__ " d ( S
Plumbing Inspector.
The undersigned applicant for this building permit does hereby certify that he derstands and accepts his obli ns 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.
STATE OF FLORIDA,
ss.
COUNTY OF DADE.
(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.
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
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
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SW IAt'G
POOL
CONTR.
LIST
CHECK
Size Septic Tank � (")
Feet of Drain Tile 1 b
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Permit No ; .2 9
Application is hereby made for the approval of the detailed statement of the plans and specifications herewit "ubmitted 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.
.�O t- X- 3 \681_ No b Street -- -�__-� C
Owner's Name and Address
Registered Architect and /or ineer _ ..
c� Street and Number where work is to be performed—No Street
State work to be performed and purpose of building (By Floors)
Location and Legal Description Lot Block Subdivision
New Building Remodeling Addition
Type of Tank X_ __0.2
Date
Repairs No. of Stories
Capacity Gals t.0 Q Q
Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City —Well. Size of Soakage Pit
Amount of Permit $__ " d ( S
Plumbing Inspector.
The undersigned applicant for this building permit does hereby certify that he derstands and accepts his obli ns 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.
STATE OF FLORIDA,
ss.
COUNTY OF DADE.
(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.
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.
BUILDING
ELECTRICAL
PLUABING
•
PERMIT N° 7795
Work to be performed under this Permit
Owner of(
Building
Architect
Contractor y '
or Build P �� �- -
•
MIAMI SHORES VILLAGE, FLORIDA
DATE
Contractor's
License No
Subdi-
vision
.Legal Lot
Description
Address of
Building
This permit i s 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 drawings or in the statements or specifications and that he assumes respon-
sibility for work done by his agents, servants or employees.
Value of
Project
BY
Amt. o
Permit
Signed. By
SPECTOR
AUTHORITY
199
In consideration of the issuance to me of this tri' ermit I agree to perform work covered hereunder in compliance or nances d la h
P P P
pertaining ,thereto and in strict pnformity with the plans, drawings, statements or specifications submitted to the proper a�t s f Miami Shores Villa
de.
I pting th ,.perm t I assumpresponsibility fy r a work done by either myself, my agent, servant or employee.
Date 1" Job Address \0 :T 4• Tax Folio Ti 32-P6 132-1 0 3
NL o l'G
_ Q. TbOJK�I • ]U
Legal Description L r / 1 �d t . f b /i4 i(Lvt / ��p/Z t7-J 4l�t,Md'ii'b.09
Lessee / Tena_n �\ &. \ 0\ • Master Permit #
Owner's Address
Contracting Co. r\
Qualifier
APPROVED:
PERMIT APPLICATION FOR MUNICIPALITIES OF DADE COUNTY
(OWNER TO RETAIN COPY)
State # Municipal # Competency #
WORK DESCRIPTION
owner and /or Condo President
Notary' as toiOWUer- and /or Condo President
My Commission Expires:
•
Zoning
Address
Phone
Ins.Co.
1Nt.n (0%
Architect /Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type(circle one): BUILDING ELECTRICAL r LUMBING CHANICAL ROOFING PAVING PENCE SIGI
cm _
Square Ft. Estimated Cost(value)
WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DC
SO MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTENI
TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUF
NOTICE OF COMMENCEMENT).
Application is hereby made to obtain a permit to do work and installation as indicated above, an
on the attached addendum (if applicable). I certify that all work will be performed to meet th
standards of all laws regulating construction in this jurisdiction. I understand that separat,
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 wil.:
be done in compliance wits = . applicable laws regulating constr ctio% x' zoning. Furthermore,
authorize the : ontractor to do the work stated.
vJ'
Signatute of Cont ctor or Owner- Builder
Date:
Notary as to Contr
My Commiss;.en E pi %s:
SONDRA JONES
My Comm. UO. 1-1416
** * * * * * * * * * * Bonde*By S4.1. cot , **
CC17324$ 4
FEES: PERMIT RADON C.C.F. NOTARY TOTAL DUE
Fire Other
Building Electrical
Mechanical Plumbing, Engineering
0 A
PERMIT APPLICATION FOR MUNICIPALITIES OF DADE COUNTY
(OWNER TO RETAIN COPY)
Job Address C \ • \ Tax Folio // voii /3 2/7
Legal Description /39 / 9 / /c���J / tImp
Lessee / Tenant \QX----S) \ f)Mcxj \
Owner's Address 1�JL \C—)0 ` \ E V
Contracting Co. l� �-�- Address
Qualifier_
S'gnatu owner and /or 0114o President
G . 2 WA'
Notary as to,Owner and /or Ogg President
My Commission E,:pires: 2ip° I90
APPROVED:
Phone
Municipal # Competency # OIAJII3\t Ins.Co
Master Permit .A1S/9
Phone ( kS �
Architect /Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type(circle one): BUILDING ELECTRICAL MECHANICAL ROOFING PAVING FENCE SIGt
eared
WORK DESCRIPTION t - %j+
Square Ft. Estimated Cost(value -
WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DC
SO MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTENI
TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUF
NOTICE OF COMMENCEMENT).
Application is hereby made to obtain a permit to do work and installation as indicated above, an
on the attached addendum (if applicable). I certify that all work will be performed to meet th
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
be done in compliance wit 11 applicable laws regulating const
authorize ti- =•o sa(ontractor to do the work stated.
Mechanical
SignatVr of Con at 0 • ourun)wauer iak4Etblic
Date: 3�9/ PC ISO ally known DOR Produc' d LD
Type and number of 1.D p_;oduced:
lull VdJI, 0!
y as to Con q ngr }gREpuilder
y Commission Ex ires:
•
** * * * , n * * * * * * * * * * * * **
PEES: PERMIT 5 v i w RADON C.C.P. e BO NOTARY SlDD TOTAL DUE L. 57, 0
.; Fire Other
Zoning Building Electrical
ngineering
4'06/23/92 16!28 '$305 594 3749
Y
Type of
Establishment=
Commercial identia
j (circle one)
�L ' / 0 L7uc ,r
Applicant'S Signature:
SUN GOLD I ND 002
S'T'ATE OF FLORIDA-DEPARTMENT OF HEALTH AND REHABILITATIVE SERVICES
APPLICATION FOR ONSITE SEWAGE DISPOSAL, SYSTEM - CONSTRUCTION PERMIT
Building Permit #:
Authority: Chapter 381, F.S.
& Chapter 10D -6, F.A.C. Application /Permit N umber: 2 9 6.
/ 1' 1 0r -11 no
Application Is For: New System [V] Repair [ ) Date Application Received:
Existing System ( ] Experimental. System [ 0
(Temporary) ( ] Tank Abandonment ( 1 Amount Paid:$
Holding Tank ( ] Other (Specify):
Receipt # :_1
NOTE: PERMITS EXPIRE ONE YEAR FROM 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 FoR A SPECIFIC PERIOD OF TIME.
• TO BE COMPL' BY PLTCANT: l C
Owner: f\ 1 c- F( 7G/J ei A /✓ Telephone: (Work) �3 /l 0 - ( Home ) -" 2/srq
Owner's Mailing Address: /9 (� •E 10 - city / /D/I.G1
� � Q �. y:�• Stater MI) Zip: _
Owner's Agent: _) L) `` U Telephone (W) / L- ��Oa (H)
Agent's Mailing Address: 14-70 N. 0'% J F City: 44 /4/0 / State:[1 / ZLp:Ti
l
Property Street Address: r OV /V,l ,l-, /00
Exact Directions to Property: _
Lot # Block # Subdivision Unit Date Subdivided
Section: Township: Range: Parcel #: Zoning Designation:_
Property Size: Square Feet /Acres;
Water Supply: Private [ 1 Public (/ Limited, -Use (
Is Sanitary Sewer Available: Yes ( ) No [f No, approximate the distance to the sewer
.line closest to your property:
Public Water !Available: Yes ( ] No [ ) If No, approximate- the distance to the wat
line closest to your property:
BUILDING INFORMATION
If of Units Building 1t of Persons # of Seats Hours of
Area (sq ft) Operation
& # of Bedrooms !.mac (Z, op.C.
Sru AM
Plumbing Fixtures: Garbage Grinders /Disposals Spas /Hot Tubs _ Floor /Equip. Drains
Ultra -low Volume Flush Toilets Other
BUILDING PLANS MUST BE ATTACHED SHOWING OFFICES, BEDROOMS, TOTAL BUILDING AREA, AND ANY
PERTINENT FEATURES REQUIRED BY CHAPTER l0D - 6, F.A.C. IN ADDITION, A DETAILED SITE PLAN AND /OR
SURVEY, DRAWN TO SCALE, MUST BE ATTACHED SHOWING PROPERTY DIMENSIONS, BUILDING LOCATIONS,
AND PERTINENT FEATURES REQUIRED TO BE SUBMITTED PER CHAPTER 10D-6.046 F.A.C.
'06/23/92 16 : 28 /2305 594 3749 SUN GOLD I ND 0 003
•
STATE OF FLonIDA
OEPA~TiRFNT OF 11FALT11 Atkin nr.14A4;t1ITAT1VE gtFIVICES
PIKrtMlt F'On CON!Tr%UCT1ON OF API ONAiTE 6FWAOf3 Oi*P08AL SYSTEM
q2- /96c
Authority: Chapter 301, F.S. & Chaplet 10D-0, F.A.C. AprMcmtlon /Perrnh Number
Petmtl is felt: '
New System: t Ilo lr: Existing Syt1em: t"xperlmentai System (omporvey):
Tank Abnndontrent: _ bolding Tank: 01 t�ITACMy):
GENERAL INror ' ../ o
Ownnr : R G (g,� V c N M t . Vt/ Te1epltone: (Woth) , (Home)
Properly Strout Addrete: • N : 700 r4 3.
Lot A: (flock #: 6 kdIv1 ni: J Unit
Secllon: Torwniln: Songs:
TO OF. COMrt ETFD (;Y tNODUIEER OR COMM PUR1_ICTIE/i1,T14 tit41T itMPM.OYEES ONLY. 1<rY'A'TtAl 1910 8E COP19111UCIPIT !N ACCOrt
SrF.CIrICAtiotts AUD STANOAtlDS SET FORTrf 114 CNAPTtktt i004, PAC. maims tXPmE OM! YEA/1 PACO *MC DATE or iS9tUANCE
nENrwnet.r-. nirAin rroulrtg AND itoLbrriO TANK rtnurre Eitt+Ift1 ne RAYS MOM DATtt! Of P1*UANCf APPROVAL OP A SYSTEM t
GUARANTEE SATISFACTORY PEI1rORMANCtt TOR ANY ammo tr'ENPOQ Of TMtt,
SYSTEM Dr91oN AND SPECIPICATi0N8
Design Snwn!)e Plow Irgrn labia 11 at> orD Mom nAetrlct)ve Sol Texture Wood Pot Syatem Sizing: C;
Loading (fain:, / _T' Gatlone /Sgtmre Foot /Day Stondord: P11ed: Mound: ___ 0;
Dispo;ai system configuration: Trench: god: Other(doecttbe):
Minimum Absorption t+re11 required: — iguana feet
Bottom or dralnrll3ld absorption ores must be 'mhos abovo/be4ow (chcle one) benchmark /axed point
Is Fill required? Yee No 11 Yes, Whot itihe Mkilrnt,m 1.40011 DA Fill Rdqulr€d:
Excnvalinn ttaciulred: Yes No Minimum Depth of Excavation: _ rt. Arett icAvel mmauxuxasum
U►1Ohslructed men Enquired: Square rant Unot ructied ;too ova/able:
,� _�
S nntIc tank tlquid ceppchy :_ p - Cc , gatttx» Mk►Mxrm DraIn eld Are4 pegt$red: _ - c
Laundry lank liquid cnr►ncPt patIor►a Min mum Drolnlield Area negt ►4red: `
Grey water hank liquid cepec psNons.,......Mhilmum Drolnf ld Area Pterptired:
Aerobic trentment unli treatment cepecrty:.. OM Drein11eld Area Reguirsd:
Gre:150 Interceptor cttrloclty: gellong s enk: CAgeetty/voium* per Dose (ctrcl® one ):
toir.lIng Tank CnpACMy (mast be .uttmcier t to handle W west* general .; writ a seven deny pet
Additional construction ctltetta: "4 . -r6,43 a► ,c�.� �'1
,/,441:
Relo
Design by:
11 designed by n P.C., provkde registration number:
TO OE coMrt.ttto BY IIFALTTI Witt:
Incorrrleto:
blsepprovod: Data: /
Approved: ` Dy: E LU P Z�
9 2--
bnln Iinund: I l
11ns -tl rnmm 40t, Jen toot (0beoleto4 Atl 1NovbuI EdMorw)
D it* of Eftpb0101t
019epprovsd: Doe; / / Rlson:
Arprtcnttan nocetvod: / / _ 11trvtrood try: PO:
z-3
1111e:
PJNce your sell upon the epproptlat9 plans Grp
> y
9/ J�Q- l ! mu onto:
/mount of r.. r.ld. O
...06/23/92
Ji
•
REMARKS:
16!27
V305 594 3749
SUN GOLD INDUSTRIES, INC.
— Engineering Contractors —
8470 N.W. 68th STREET • MIAMI, FLORIDA 33166 • PHONE 592-7500
SUN GOLD IND
OUR FAX NUMBER: 594 -3749
FACSIMILE TRANSMISSION TICKET
CO
FAX NUMBER _
ti
NUMBF,.R OF STIFETS INCLUDING COVER EHFET_ _ ,....-
if ( /k
DAT 4 TRANSMITTAL: TIME:j. AM PM •(-3
T O f 1 Dc A T T N : _ "' j I t ��
FROM : ())j • : .L 1 NAME:
TvPF OF DOCUMENTS TRANSMITTED:
TF YOU SHOULD HAVE PROBLEMS RE(;EIVING ANY PAGES PLEASE CALL 592 - 7540
Fttll Septic Tank Service - Pipe Lines - Drainage Systems - Sewer Systems - Excavating
MAILING ADDRESS!
P.O. BOX 557267
MIAMI, FLORIDA 3;55
Permit No S-77
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 spe or not. A copy of approved plans and specifications must be kept at
building during progress of work.
Owner's Name and Address / '. 2
Registered Architect and /or Engineer
Size Septic Tank____________ _______Type of Tank--_
Feet of Drain Tile __Dist. Feet of Tank or Drain Field from Well-- -_.__. _ _. ___.--- _ — .----- -_ - -�
Nature of Water Supply: City—Well. Size of Soakage Pit
Amount of Permit $
STATE OF FLORIDA,
COUNTY OF DADE. J
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
(Sign
No. ' / 1 F Street..._AI 100 S/
k -
�iPlQ I; ?�lutia `� ng__l1n (nn,i_ s d,5 ?,c _ M 1.»:= _. Sheet..!` ., S
Location and Legal Description Lot. glair Subdivision
Street and Number where work is to be performed —No la 4- A./ r
State work to be performed and purpose of building (By Floors)__-_ —____L g_-._E.5J__. tO till t e j - 3 / r
New Building._...._ - _.. Remodeling — ..__._.. Addition..._..._ Repairs.._.
No. of Stories.
CI <.
Capacity Cale..-- ..__.__.____._-.__..
tor.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his oblig .ns as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5988, Compiled General Laws of Florida Pennan t 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 rformed under this permit, as are
licensed by Miami Shores Village.
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 — - that all facts
therein by hire stated are true. y m8O application, and that he did sign the same, and that aA facts
My Commission Expires Notary Public, State of Florida
materials
NOTE: A r e- i in nsp� pee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty
CLoscre
BATH
TUBE
SHOWBRB
LAVA-
TORIES
SINKS
SLOP
SINK[
LAUNDRY
TUes
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT•NB
TOTAL
FI %TUR[f
CONTR.
LIST
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SwIM'O
POOL
Coterie.
LIST
CHECK
Permit No S-77
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 spe or not. A copy of approved plans and specifications must be kept at
building during progress of work.
Owner's Name and Address / '. 2
Registered Architect and /or Engineer
Size Septic Tank____________ _______Type of Tank--_
Feet of Drain Tile __Dist. Feet of Tank or Drain Field from Well-- -_.__. _ _. ___.--- _ — .----- -_ - -�
Nature of Water Supply: City—Well. Size of Soakage Pit
Amount of Permit $
STATE OF FLORIDA,
COUNTY OF DADE. J
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
(Sign
No. ' / 1 F Street..._AI 100 S/
k -
�iPlQ I; ?�lutia `� ng__l1n (nn,i_ s d,5 ?,c _ M 1.»:= _. Sheet..!` ., S
Location and Legal Description Lot. glair Subdivision
Street and Number where work is to be performed —No la 4- A./ r
State work to be performed and purpose of building (By Floors)__-_ —____L g_-._E.5J__. tO till t e j - 3 / r
New Building._...._ - _.. Remodeling — ..__._.. Addition..._..._ Repairs.._.
No. of Stories.
CI <.
Capacity Cale..-- ..__.__.____._-.__..
tor.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his oblig .ns as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5988, Compiled General Laws of Florida Pennan t 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 rformed under this permit, as are
licensed by Miami Shores Village.
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 — - that all facts
therein by hire stated are true. y m8O application, and that he did sign the same, and that aA facts
My Commission Expires Notary Public, State of Florida
materials
NOTE: A r e- i in nsp� pee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty
MIAMI SHORES VILLAGE, FLA.
JOB
ADDRESS fb
INSPECTION
TIME READY
REMARKS•
INSPECTOR
DATE
MIAMI SHORES VILLAGE, FLA.
JOB. JO
ADDRESS • JO CL / ®eD
INSPECTION e>l i �
TIME READY t - /0 — 9�
N? 6125
REMARKS:
INSPECTOR
DATE \
Permit No 41--
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
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.
Vac e 104 Stmt. N E 100th Street
Owner's Name and Address N o .
Registered Architect and/or. Engineer_
Employing Plumber's Name ABC SEFT I.C_TARIc__URKXE No- 3121 StreetiSthStXt
Location and Legal Description Lot Block
Street and Number where work is to be performed—No 104 Street N.E. 100th Street
State work to be performed and purpose of building (By Floors )_
New Building _..._____ Remodeling_ Addition Repairs No. of Stories
Size Septic ______ Type of Tank_ Capacity Gals
REtht 1
Feet of Drain 25 .Dist. Feet of Tank or Drain Field from Well
Nature of Water Suplilyi Size of Soakage Pit
Amount of Permit $___: (Signed)_
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligatio as an employer of labor
under the Florida Workniees Compensation Act, being Section 5968, Compiled General Laws of Florida Perm e' upplement, and has com-
plied with the provisicaiS -thereof, and will require similar compliance from all contractors or sub-contractors emp oyed 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 . Slimes
STATE OF FLORIDA,
COUNTY OF DADE:. -
Before me, the undereign 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 trim.
,Moraniisaion Ezpires
( Signed )___
Date October 5 1 __ 1964
Subdivision
lumbing Inspector.
Notary Public, State of Florida -----
NOTE: A re-inspectioii 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
rues
614
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
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SWIWG
POOL
---
CONTR.
LIST
CHECK
Permit No 41--
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
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.
Vac e 104 Stmt. N E 100th Street
Owner's Name and Address N o .
Registered Architect and/or. Engineer_
Employing Plumber's Name ABC SEFT I.C_TARIc__URKXE No- 3121 StreetiSthStXt
Location and Legal Description Lot Block
Street and Number where work is to be performed—No 104 Street N.E. 100th Street
State work to be performed and purpose of building (By Floors )_
New Building _..._____ Remodeling_ Addition Repairs No. of Stories
Size Septic ______ Type of Tank_ Capacity Gals
REtht 1
Feet of Drain 25 .Dist. Feet of Tank or Drain Field from Well
Nature of Water Suplilyi Size of Soakage Pit
Amount of Permit $___: (Signed)_
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligatio as an employer of labor
under the Florida Workniees Compensation Act, being Section 5968, Compiled General Laws of Florida Perm e' upplement, and has com-
plied with the provisicaiS -thereof, and will require similar compliance from all contractors or sub-contractors emp oyed 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 . Slimes
STATE OF FLORIDA,
COUNTY OF DADE:. -
Before me, the undereign 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 trim.
,Moraniisaion Ezpires
( Signed )___
Date October 5 1 __ 1964
Subdivision
lumbing Inspector.
Notary Public, State of Florida -----
NOTE: A re-inspectioii 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
ROOFING
MIAMI SHORES VILLAGE, FLORIDA
PERMIT
Owner of
Building
Architect
Contractor
or Builder
Legal Lot
Description II Bl
Address of Value of 1 Amount of
Building Project $ 1 Permit $
This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the applica-
tion herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any
plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked
at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this
permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and
regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes respon-
sibility for work done by his agents, servants or employees. f
•
N9 5766
DATE r. 19
Contractor's
License No.
Work to be performed under this Permit
Subdi-
vision
Signed ,{ ,1± - -INSPECTOR
In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in complianc '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 ac
cepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee.
CONTRACTOR OR BUILDER BY AUTHORITY •ceor
ermit No 7
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING °' ! 1,,,MIf°
New Building _._ Remodeling__.__ _____ Addition.
Nature of Water Supply: City —Well
Amount of Permit $
- 4 -ems.._
STATE OF FLORIDA, }
COUNTY OF DADE.
No.__1_D
( Signed) _
(Signed).
Date
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida,
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at
building during progress of work.
Owners Name and Address v d ____
Registered Architect and /or Engineer _.___.__. —____ , /
Employing Plumber's Name_ _V t L K l /2. S L �°� P ICJ. JA_.e 3_ L Street..l:�6 •
Location and Legal Description Lot_ Subdivision
Street and Number where work is to be performed— No.___ lZ _ _L_ C / 0 !Civet
State work to be performed and purpose of building (By Floors) __ Z.0 Jt E L y
Repairs No. of Stories
Street N
My Commission Expires Notary Public, State of Florida •
o
Master Plumber.
Size Septic Tank _ Type of Tank__ Capacity Gals.
Feet of Drain Tile _Dist. Feet of Tank or Drain Field from Well
__Size of Soakage Pit
Plumbing Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts hri • . 'gations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida ,Pe nanent Supplement, and has com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub- contrac 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.
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
TUBE
URINALS
A
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT' NS
TOTAL
FIXTURES
CONTR.
LIST
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP SPRKLR.
WELL SYSTEM
SW IM'O
POOL.
CONTR.
LIST
- -
-
2" S. Q. 0
- -_
CHECK
2
6/ ~ Da g,
ermit No 7
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING °' ! 1,,,MIf°
New Building _._ Remodeling__.__ _____ Addition.
Nature of Water Supply: City —Well
Amount of Permit $
- 4 -ems.._
STATE OF FLORIDA, }
COUNTY OF DADE.
No.__1_D
( Signed) _
(Signed).
Date
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida,
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at
building during progress of work.
Owners Name and Address v d ____
Registered Architect and /or Engineer _.___.__. —____ , /
Employing Plumber's Name_ _V t L K l /2. S L �°� P ICJ. JA_.e 3_ L Street..l:�6 •
Location and Legal Description Lot_ Subdivision
Street and Number where work is to be performed— No.___ lZ _ _L_ C / 0 !Civet
State work to be performed and purpose of building (By Floors) __ Z.0 Jt E L y
Repairs No. of Stories
Street N
My Commission Expires Notary Public, State of Florida •
o
Master Plumber.
Size Septic Tank _ Type of Tank__ Capacity Gals.
Feet of Drain Tile _Dist. Feet of Tank or Drain Field from Well
__Size of Soakage Pit
Plumbing Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts hri • . 'gations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida ,Pe nanent Supplement, and has com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub- contrac 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.
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
ROOFING
Contractor
or Builder L
Legal
Description
Address of
Building
Lot
CONTRACTOR OR BUILDER
MIAMI SHORES VILLAGE. FLORIDA
❑
fl PERMIT N9 7668
❑ Work to be performed under this Permit
Owner of
Building
Architect
Bl.
Subdi-
vision
DATE
Sq. Ft
Value of
Project $
Contractor's
License No =
Amt. of
Permit $
195%'
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 statements or specifications and that he assumes responsibility for work
done by his agents, servants or employees.
Signed • r 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
n
BUILDING
ELECTRICAL •
PLUMBING
Owner of`
Building
Architect
Contractor 1
or Builder r ,1
Work to bg.,performed under this Permi
MIAMI SHORES VILLAGE, 7R9 A ••
DATECaA- 4-6 –21 194
Contractor's
PERMIT N? 7829
Signed.
Subdi-
vision
c
BY
INSPECTOR
License No.
Legal Lot « Bl.
Description
Address of Value of Amt. o j 0
Building g Q/ 41,2 A: � ' Project Permit
This permit is grante 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 with the understanding that the work will be performed in compliance with any
plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked
at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this
permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and
regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes respon-
sibility for work done by his agents, servants or employees.
' By
In consideration of the issuance to me of this permit I agree to perform tlie; ork covered hereunder in compliance with all..yrdinan
pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authontt s of M
In accepting this permit I assume responsibility for all work done by either myself, my agent, servant or employee.
..7 .�.r!
CONTRACT O OR BUILDER
AUTHORITY
in g�l ns
Sh orts - �illige : 'S
Permit No..____ . ' ir - Date
Application is hereby ade for approval of the detailed statement of the plans and specifications herewith submitted for the building or (Abel
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 4 . not. A copy of approved plans and specifications must be kept al
building during progress of work.
Owner's Name and Address.____..__ -. ___ aS"-cA-a'' _- ..- _--- _- .`1Va�' Street
Registered Architect and /or Engineer
Employing Plumber's Name
Location and Legal Description Lot-.- _--- ................. _- . ....
_ -_
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, Type of Tank_
Feet of Drain Tile Dist. Feet of Tank or Drain Field from We1L
Nature of Water Supply: City —Well .-- Size of Soakage Pit
bing Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and ac 's obligations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Pennanent 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 an
licensed by Miami Shores Village. '
(Signed).' - - --
STATE OF FLORIDA, ss.
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appears
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 lac
therein by him stated are true.
My Commission Expires
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Street_
Block .. - Street Subdivision
Repairs__ __ _ -_ _. No. of Stories
Capacity Gals _
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 Ltd
materials and /or workmanship. ,
CLOSETS
BATH
TUBS
SHOWERS
LAVA-
TORIES
SIN
SLOP
SINKS
LAUNDRY
TUBS
URINALS
CATCH
BASIN
FLOOR
DRAIN
DR Nit, NG
FOU NT' Ns
TOTAL
F1XTURHI
CONTR.
LIST
CHECK
-
__
'
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DRIP
WELL
SPRKLR.
SYSTEM
SWIM•G
POOL
CONTR.
LIST
CRICK
Permit No..____ . ' ir - Date
Application is hereby ade for approval of the detailed statement of the plans and specifications herewith submitted for the building or (Abel
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 4 . not. A copy of approved plans and specifications must be kept al
building during progress of work.
Owner's Name and Address.____..__ -. ___ aS"-cA-a'' _- ..- _--- _- .`1Va�' Street
Registered Architect and /or Engineer
Employing Plumber's Name
Location and Legal Description Lot-.- _--- ................. _- . ....
_ -_
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, Type of Tank_
Feet of Drain Tile Dist. Feet of Tank or Drain Field from We1L
Nature of Water Supply: City —Well .-- Size of Soakage Pit
bing Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and ac 's obligations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Pennanent 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 an
licensed by Miami Shores Village. '
(Signed).' - - --
STATE OF FLORIDA, ss.
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appears
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 lac
therein by him stated are true.
My Commission Expires
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Street_
Block .. - Street Subdivision
Repairs__ __ _ -_ _. No. of Stories
Capacity Gals _
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 Ltd
materials and /or workmanship. ,