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1155 NE 100 StPermit No. r,./). 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 mus be kegt,4 building during the progress of work. Owner's Name and Address /J /l) acs.$ //S .3 AL , /OD it No. /4 Street /0 0 Registered Architect and/or Engineer ,/ Employ g Pl ber's rNam /9/1 d U A)v At. S C P // & Sit IP(� No .�� G - J `7�/ 8 St / 9(2 3 4)406 ' f f�cfi �/.3/ �y Slit' . 3 0� Location and Legal Description Lot �� Blocckk_/ 7 Subdivision Q4 Street and Number where work is to be performed — No. // .57. ®. J Street State work to be performed and purpose of building (By Floors) New Building Remodeling Addition 4 /1 gX Size Septic Tank Feet of Drain Tile c0 Nature of Water Supply: City - Well e /r( Amount of Permit $ °" QO MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Type of Tank OoNc Dist. Feet of Tank or Drain Field from Well Date /be.7f Repairs No. of Stories Capacity Gals. 75(9 Size of Soakage Pit (Signed) tta / ,ii I 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 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 sub - contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. (Signed) C `C ` %- 132 7 ^ Master Plumber. STATE OF FLORIDA, COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. NOTE: A re- inspection fee of $25.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty materials and/or workmanship. ss. My Commission Expires Notary Public, State of Florida CLOSETS BATH TUBS SHOWERS LAVA- TORIES SINKS SLOP SINKS LAUNDRY TUBS URINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNTAINS TOTAL FIXTURES CONTR. LIST CHECK SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SWIM'G. POOL CONTR. LIST CHECK Permit No. r,./). Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications mus be kegt,4 building during the progress of work. Owner's Name and Address /J /l) acs.$ //S .3 AL , /OD it No. /4 Street /0 0 Registered Architect and/or Engineer ,/ Employ g Pl ber's rNam /9/1 d U A)v At. S C P // & Sit IP(� No .�� G - J `7�/ 8 St / 9(2 3 4)406 ' f f�cfi �/.3/ �y Slit' . 3 0� Location and Legal Description Lot �� Blocckk_/ 7 Subdivision Q4 Street and Number where work is to be performed — No. // .57. ®. J Street State work to be performed and purpose of building (By Floors) New Building Remodeling Addition 4 /1 gX Size Septic Tank Feet of Drain Tile c0 Nature of Water Supply: City - Well e /r( Amount of Permit $ °" QO MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Type of Tank OoNc Dist. Feet of Tank or Drain Field from Well Date /be.7f Repairs No. of Stories Capacity Gals. 75(9 Size of Soakage Pit (Signed) tta / ,ii I 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 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 sub - contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. (Signed) C `C ` %- 132 7 ^ Master Plumber. STATE OF FLORIDA, COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. NOTE: A re- inspection fee of $25.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty materials and/or workmanship. ss. My Commission Expires Notary Public, State of Florida Date of Application HRS-H Form 4015, Feb 85 (Obsoletes previous editions which may not be used) (Stock Number. 5744- 001 - 4015.1) STATE OF FLORIDA DEPARTMENT OF HEALTH AND REHABILITATIVE SERVICES APPLICATION FOR ONSITE SEWAGE DISPOSAL SYSTEM CONSTRUCTION PERMIT Type of Establishment Authority: Chapter 381, FS Chapter 10D -6, FAC PART I - APPLICATION Name of Owner '� ��'� f1'S.S Telephone Number TOTAL FLOW = Permit Application Number e / 7 /. Mailing Address of Owner A4 /00 S 7% c,/,e. s s 6 - Pr,e s Owner's Agent Builder Agent's Mailing Address /-3 3 �!,(i, ( ,, 7 /9- /° Telephone No G -/ 4/ Property Street Address / ' /00 Lot No. Block No Subdivision Date Subdivided NOTE: IF NOT IN A SUBDIVISION ATTACH A METES AND BO r) ,R TJ t This Application is for: New System Repair v /> Existing System • Sewage Flow Sewage Flow (Gallons per day) ' Based On Type of No. Bedrooms Heated or Cooled Area No. Dwelling • Sewage Flow Residential (each dwelling unit) (each dwelling unit) Units (Gallons per day) ft ft2 Exact Directions to Property ° 2 4 414 5 �� 4 ra� _�`' . AUDIT CONTROL NO. Applicant's Signature Page 1 of 3 Permit No._Q___, _9_ Application is hereby made for the approval of the detailed statement of the plans and specifications' herewith submitted for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. Owner's Name and AddressC- __ R 2 ran i -- _ Registered Architect and /or g nee r Employing Plumber's Name Y a� Location and Legal Description Lot__ Street and Number where work is to be performed—No-it-IS State work to be performed and purpose of building (By Floors) New Building 4 Remodeling Addition Repairs No. of Stories Size Septic Tank O e Feet of Drain Tile Nature of Water Supply: City —Well Amount of Permit $__ STATE OF FLORIDA, 1 ss. COUNTY OF DADE. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT ✓ 11 1 6 ..s... 44 " No Street Type of Tank Capacity Gals Dist. Feet of Tank or Drain Field from Well Size of Soakage Pit (Signed) No Street 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 w k to be perfori -d under t11i• permit, as are licensed by Miami Shores Village. Street (Signed)__ -_i Date f 0 — z-4/ v°9 Subdivision 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 FOU NT' NS TOTAL FIXTURES CONTR. LIST CHECK SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SW IM'G POOL CONTR. LIST 4r CHECK Permit No._Q___, _9_ Application is hereby made for the approval of the detailed statement of the plans and specifications' herewith submitted for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. Owner's Name and AddressC- __ R 2 ran i -- _ Registered Architect and /or g nee r Employing Plumber's Name Y a� Location and Legal Description Lot__ Street and Number where work is to be performed—No-it-IS State work to be performed and purpose of building (By Floors) New Building 4 Remodeling Addition Repairs No. of Stories Size Septic Tank O e Feet of Drain Tile Nature of Water Supply: City —Well Amount of Permit $__ STATE OF FLORIDA, 1 ss. COUNTY OF DADE. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT ✓ 11 1 6 ..s... 44 " No Street Type of Tank Capacity Gals Dist. Feet of Tank or Drain Field from Well Size of Soakage Pit (Signed) No Street 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 w k to be perfori -d under t11i• permit, as are licensed by Miami Shores Village. Street (Signed)__ -_i Date f 0 — z-4/ v°9 Subdivision 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.