Loading...
1180 NE 100 St (2)PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date ` g , ob Address //,04 / Legal Description Historically Designated: Yes No Owner/ Tenant _ 4.1 ' ` C(/ v t/ aster Permit # / Z c '� i Owner's Address / 00 S ���N�W 1 Po e-5 7 �y f C S i Contracting Co. /i5 /�l / /L��: Address • l) O i Qualifier /2t, / p 9Ad(/S SS# Phone �. State e.e S Competency # Ins. Co. Architect/Engineer Address B Company Address Mortgagor Address Permit Type (circle one): BUILDING ELECTRICA . PLUMBING i CHANICAL ROOFING PAVING FENCE SIGN (i- Signa WORK DESCRIPTION (-e h I as to Owner y Commission Expire res Municipal # FEES: PERMIT 4 ( 6 RADON `-8 Signa wire7c 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 as to Contra My Commission C.C.F. f r/® NOTARY APPROVED: Zoning Building Mechanical Plumbing' J/( ,. f Engineering Electrical BOND TOTAL DUE `/ ,�/ 4 '�'� Permit No. of 7 (,�S 6 Date -._20 ��.- _ _ _ Application is hereby made for the approval of the detailed statement of the plans and specifications herewith su mitred 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 Dopy of approved plans and specifications must be kept at building during progress of work. , Owners Name and Address jzt e v w / rZ Registered Architect and /or En eer �a og 2t)I n/ £ login 1'1 boa' ; o l ..., Na, � 1. . Staid —.6. !P .. r/ Locatldd anct ptidn Lot Bloom ` Subdi 7 i- /.Co-�.,/ Street and Number where work L to be performed -No / /G! /v L ' Street - l.DU -t _ ibs iiNt 7o li w re 4f /Tc�t a A . 1 " 4 k' e'y s- /t /so _.1•c�ra/ State work to be performed and purpose of building (By Floor)_ -_ F 1 1 7b�`�` - 1S% i gtr Pi re/ stl4 rcr� New Building..__.._ ___- •--- ........ -_.- Remodeling _ __ -_ �__ Addition.- _- __ - -•__ Repair No. of Stories..... Amount of Permit $ Axe Septic Tank -__ Feet of Drain Tile Nature of Water Supply: City-We1L 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 5988, Compiled General Laws of Florida Permanent Supplement, and !laic 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-con . on work to be performed under this permit, as are licensed by Miami Shores Village. (Slimed) ' , i'�� ► STATE OF FLORIDA, 1 COUNTY OF DADE. Before me, the undersi publi to me well known, and who, be of the above described con therein by him stated suer Al TA ^ Y pursue. Fl:0131151c: ray commISSiON r:XPli ApniL 20. 1990: pnNDIIn 4NRU NOTARY PUULIC UNGURWRIT5RO My Commission Expires MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT -Type of Tank.____ _Dist. Feet of Tank or Drain Field from Well Size of Soakage Pik upm read the Foregoing NOTE: A re- inspection fee of $1.00 will be made when amok miaspeoltotr materials toad /err workmanship. No / /IV N street_ - ,0 0 — Capacity Gals. , y authorized to administer oaths and take acknowledgments, personally appeared gn the same, and that all facts State of Florida Master Plumber. notion for inspection, or faulty CLOSET S BATH TUa/ SHOWERS LAVA. TORIES SINKS SLOP PINKS LAUNDR Twos URINALS CATCH OASIN FLOOR DRAIN DRINKING FOU NT'NS TOTAL •IIITURES CONT1. LIST CHECK — SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT G TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SWIM'G POOL 1ST NECK Permit No. of 7 (,�S 6 Date -._20 ��.- _ _ _ Application is hereby made for the approval of the detailed statement of the plans and specifications herewith su mitred 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 Dopy of approved plans and specifications must be kept at building during progress of work. , Owners Name and Address jzt e v w / rZ Registered Architect and /or En eer �a og 2t)I n/ £ login 1'1 boa' ; o l ..., Na, � 1. . Staid —.6. !P .. r/ Locatldd anct ptidn Lot Bloom ` Subdi 7 i- /.Co-�.,/ Street and Number where work L to be performed -No / /G! /v L ' Street - l.DU -t _ ibs iiNt 7o li w re 4f /Tc�t a A . 1 " 4 k' e'y s- /t /so _.1•c�ra/ State work to be performed and purpose of building (By Floor)_ -_ F 1 1 7b�`�` - 1S% i gtr Pi re/ stl4 rcr� New Building..__.._ ___- •--- ........ -_.- Remodeling _ __ -_ �__ Addition.- _- __ - -•__ Repair No. of Stories..... Amount of Permit $ Axe Septic Tank -__ Feet of Drain Tile Nature of Water Supply: City-We1L 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 5988, Compiled General Laws of Florida Permanent Supplement, and !laic 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-con . on work to be performed under this permit, as are licensed by Miami Shores Village. (Slimed) ' , i'�� ► STATE OF FLORIDA, 1 COUNTY OF DADE. Before me, the undersi publi to me well known, and who, be of the above described con therein by him stated suer Al TA ^ Y pursue. Fl:0131151c: ray commISSiON r:XPli ApniL 20. 1990: pnNDIIn 4NRU NOTARY PUULIC UNGURWRIT5RO My Commission Expires MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT -Type of Tank.____ _Dist. Feet of Tank or Drain Field from Well Size of Soakage Pik upm read the Foregoing NOTE: A re- inspection fee of $1.00 will be made when amok miaspeoltotr materials toad /err workmanship. No / /IV N street_ - ,0 0 — Capacity Gals. , y authorized to administer oaths and take acknowledgments, personally appeared gn the same, and that all facts State of Florida Master Plumber. notion for inspection, or faulty BUILDING ELECTRICAL PLUMBING ROOFING Owner of Building ` 0 MIAMI SHORES VILLAGE, FLORIDA DATE PERMIT Architect Contractor or Builder Legal Lot Description II Bl Address of ' «. • Building N9 4211 Contractor's License No. 19 Work to be performed under this Permit Subdi- vision Value of Project $ 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': Signed. (, � • • .p ', ' . INSPECTOR • In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliancse vvkith all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper a lhorlties of Miami Shores Village. In as cepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. j CONTRACTOR OR BUILDER BY AUTHORITY ABBOT Amount of Permit $ Permit No 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 Address Registered Architect and /or Engineer .... _____ Employing Plumber's M • "� --1P y -� ll _ e IJo. --- --- -1.0- Street-. - /41 D/ X i -f Emplo Name__ _Mid �� � � c Location and Legal Description Lot______�_____.�__._ _ _ Block- Subdivision Street Ni 1 D 0 - -4 Street and Number where work is to be performed —No —12 CL State work to be performed and purpose of building (By Floors)_______LL_P__f 11.0.16i_F'1 r a r1 New Building Remodeling.____----- _-- ____ -_ Addition -------- •- _ -__ -- _ -•_ -- Repairs ,t! Size Septic Tank Feet of Drain Tile _Dist. Feet of Tank or Drain Field from Well __Size of Soakage Pit Nature of Water Supply: City—Well. oQ Amount of Permit $ 2 Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obliga .ns as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Per►nane I upplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors empl d 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 .'..lic 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 pert , as ar licensed by Miami Shores Village. STATE OF FLORIDA, i COUNTY OF DADE. My Commission Expires MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT No._ Type of Tank -_ Capacity Gals. (Sled) --- C "' �- Date A 3 la---- - - - - -- Street/Yr ( 0O S '�: No. of Stories 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. 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 rues U CATCH BASIN FLOOR DRAIN DRINKING FOUNT'NS TOTAL FIXTURES CONTR. LIST x 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 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 Address Registered Architect and /or Engineer .... _____ Employing Plumber's M • "� --1P y -� ll _ e IJo. --- --- -1.0- Street-. - /41 D/ X i -f Emplo Name__ _Mid �� � � c Location and Legal Description Lot______�_____.�__._ _ _ Block- Subdivision Street Ni 1 D 0 - -4 Street and Number where work is to be performed —No —12 CL State work to be performed and purpose of building (By Floors)_______LL_P__f 11.0.16i_F'1 r a r1 New Building Remodeling.____----- _-- ____ -_ Addition -------- •- _ -__ -- _ -•_ -- Repairs ,t! Size Septic Tank Feet of Drain Tile _Dist. Feet of Tank or Drain Field from Well __Size of Soakage Pit Nature of Water Supply: City—Well. oQ Amount of Permit $ 2 Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obliga .ns as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Per►nane I upplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors empl d 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 .'..lic 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 pert , as ar licensed by Miami Shores Village. STATE OF FLORIDA, i COUNTY OF DADE. My Commission Expires MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT No._ Type of Tank -_ Capacity Gals. (Sled) --- C "' �- Date A 3 la---- - - - - -- Street/Yr ( 0O S '�: No. of Stories 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. 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 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 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 Registered Architect and /or Engineer Name and address of licensed contractor Location and legal description of lot to be built on: Lot Block Subd' Iay'sion Street and Number where work is to be done State work to be done and purpose of buildi (by -44 and for no other purpose. New Building Remodeling Addition Repairs ✓ No. of Stories 1 To be constructed of Kind of ndation Roof Covering Estimated Total cost of improvements $ a ,% Amount of Permit $ S O 0 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 L. s of Florida, Permanent Suppklement and has complied with the provisions thereof, and will require similar compliance from all contracto . sub- contractors employe d by him in the work to be performed under this permit; and will post or cause to be posted f. ' spection on t e of the work suc pblic notice or notices as are required by the Act. The undersigned agrees to employ • j such tr. .rs, �` •3 t. be performed under this permit, as are licensed by Miami Shores Village. Remarks (Signe STATE OF FLORIDA, COUNTY OF DADE. ss. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgment , .ersonally ap- peared 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. Permit No l Z ( 0 Disapproved a Date CAM— M— Date Date \\ SO \ 4 c) ,19`0 \ \. _.Q Street- ._. \ ca_..o to me well known, Read, Sworn to and Subscribed before me. Notary Public, State of Florida Building Inspector My Commission Expires PLA►�t'NG 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. Permit No ._r/ New Building Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building oI 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 S e of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be co • with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. STATE OF FLORIDA, I COUNTY OF DADE. Owner's Name and Address Registered Architect and /or Engineer Employing Plumber's Name Size Septic Tank Feet of Drain Tile - -- Nature of Water Supply: ity —Well -- - /6t MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING No. Street-- Location and Legal Description Lot.______— ______— _____ —_. _ 1 _ Block __ _ _ . Subdivision - Street and Number where work is to be performed —No / F0 Street State work to be performed and purpose of building (By Floors) _ ____ Remodeling__.__ ___ Addition______._. — Repairs No of Stories Type of Tank_- Capacity Gals ...Dist. Feet of Tank or Drain Field from Well ....Size of Soal�ge Pit Amount of Permit $ _- _----- ..__ -- _ — (Signed) _ 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 5968, 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. (Signed) No. _.7 / _JO— Date My Commission Expires Notary Public, State of Florida Street._r�� /E a _..J �! . --- --- -.._ -- - fi r- ��- •- •-- - -- - 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 SI NKS SLOP SINKS LAUNDRY TUBS URINALS I NAS CATCH BASIN FLOOR DRAIN DRINK NG FOUNT' NS TOTAL FIXTURES CONTR. LIST CHECK — SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SW IM'GI POOL CONTR. LIST CHECK Permit No ._r/ New Building Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building oI 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 S e of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be co • with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. STATE OF FLORIDA, I COUNTY OF DADE. Owner's Name and Address Registered Architect and /or Engineer Employing Plumber's Name Size Septic Tank Feet of Drain Tile - -- Nature of Water Supply: ity —Well -- - /6t MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING No. Street-- Location and Legal Description Lot.______— ______— _____ —_. _ 1 _ Block __ _ _ . Subdivision - Street and Number where work is to be performed —No / F0 Street State work to be performed and purpose of building (By Floors) _ ____ Remodeling__.__ ___ Addition______._. — Repairs No of Stories Type of Tank_- Capacity Gals ...Dist. Feet of Tank or Drain Field from Well ....Size of Soal�ge Pit Amount of Permit $ _- _----- ..__ -- _ — (Signed) _ 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 5968, 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. (Signed) No. _.7 / _JO— Date My Commission Expires Notary Public, State of Florida Street._r�� /E a _..J �! . --- --- -.._ -- - fi r- ��- •- •-- - -- - 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. Permit No../ 3 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 conforrnity 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 wor Owner's Name and Address No 1.3 �t Registered Architect and /or Eng eer Employing Plumber's Name Location and Legal Description Lot Street and Number where work is to be performed —No r !I State work to be performed and purpose of building (By Floors) Remodeling Addition Repairs T ew Buildin Size Septic Tank Amount of Permit $ ss. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT 4t. No. Block ( Signed) _ 4 ( "i 1 ( Date___ Street] h- ` y Street__ (14' 141:4 � Subdivision`_: j Street_ji ✓� A Type of Tank Capacity Gals Feet of Drain Tile _____ I-- Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: City —Well Size of Soakage Pit (Signed)___ m� nspector. The undersigned applicant for this building permit does hereby certify that 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. 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. My Commission Expires Notary Public, State of Florida No. of Stories IC A Master Plumber. 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 COTR. LINST 1 ,7., _ 1 - 1 1� U / 7 �.► -I-- -- ;d . U -- CHECK 7J . SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE( TRAP E ER DEEP WELL SPRKLR. SYSTEM SW IM'G POOL CONTR. LIST /./� CHECK / 4 / - / 4 0 ..1) / 1 Permit No../ 3 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 conforrnity 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 wor Owner's Name and Address No 1.3 �t Registered Architect and /or Eng eer Employing Plumber's Name Location and Legal Description Lot Street and Number where work is to be performed —No r !I State work to be performed and purpose of building (By Floors) Remodeling Addition Repairs T ew Buildin Size Septic Tank Amount of Permit $ ss. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT 4t. No. Block ( Signed) _ 4 ( "i 1 ( Date___ Street] h- ` y Street__ (14' 141:4 � Subdivision`_: j Street_ji ✓� A Type of Tank Capacity Gals Feet of Drain Tile _____ I-- Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: City —Well Size of Soakage Pit (Signed)___ m� nspector. The undersigned applicant for this building permit does hereby certify that 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. 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. My Commission Expires Notary Public, State of Florida No. of Stories IC A Master Plumber. 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_4 BUILDING ELECTRICAL PLUMBING Owner of Building Architect Contractor or Builder Legal Description. Address of Building Lot l MIAMI SHORES VILLAGE, FLORIDA I DATE / " / 195 re' 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 io:the sta erhents r pecifications d that he assumes o re gisibility for work done by his agents, servants or employees. , : 1 CONTRACTOR OR BUILI� PERMIT N° 10373 Work to be performed under this Permit Bl. Subdi- vision Value of Project $ BY Contractor's License No yr Amt. of 1 4," Permit $ Signed d 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 pertain ing thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In eptiryg this pg(ti }t I assume responsib)lity for all work done bq either, myself, my agent, servant or employee. AUTHORITY