PLUMBING PERMITPERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date Job Address 2-Z E f 1) I p,1 Tax Folio
Legal Description Historically Designated: Yes No 7(
Owner/Lessee / Tenant V P.j/lti /1.) Master Permit # (Z2 24c ( / ( 7 / 30 T 6
Owner's Address / 2- 2- ( �� / 10 1 - Phone
% Z/ 3r e ��
P Contracting Co. 02-eNtt Address
Qualifiers 1 SS# Phone P4 2--
state ti C Fe o S' c‘) 7) S Municipal # Competency # Ins. Co.
Address
Address
Architect/Engineer
Bonding Company
Mortgagor Address
Permit Type (circle one): BUILDING ELECTRICA - " ' LUMBING _ ECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIP'T'ION ,4,/Y✓,.f .K J TUA �� A'
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 comp c all applicable
laws regulating construction and zoning. Furthermore, I authorize the above -nam a - ,ntractor to do .,e work st
Signature of owner and/or Condo President Date
Notary as to Owner and/or Condo President Date
My Commission Expires:
APPROVED:
Zoning Building
Mechanical Plumbing
1
lI
e
e of Contrac r
1v
41;7 ,7 1 es: COMMISSION NO. CC 4 41 1at3 � A
M YCOMM13SIONEXP. MARL 1
ac
S P.
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Signa
aryastoCo t
y Commission Exp
Electrical
Engineering
°
or Owner- : uilde / Date
// - d
Date
FEES: PERMIT, RADON C.C.F. t 0 NOTARY BOND
TOTAL DUE
CLosrrs
BATH
Tue.
SHOWER.
LAVA•
To
ISINK•
SLOP
SINKS
LAUNOY
Tugs
R
UINALS
CATCH
w
...ACM
FLOOR
R 4
DRA
OINKING
FOUNT•19
FIXTt RIES
Corm!.
LI T
CHECK
......■
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
Somckoa
PIT
G
TRAP
SOLAR
H
DEEP
WELL
,--
SPRKLR.
SYSTEM
SWIM'CI
POOL
--
.-.•■••—•
I
--
I
......
—
CONTR.
LIST
I
CHICK
.
01-01-782-055-00-20-0
D-81-392- 01-01-420-618-01-20-0
Size Septic Tank.....—
Feet of Drain Tile
Nature of Water Supply: .... of Soakage Pit
-• •
STATE OF FLORIDA,
u.
COUNTY OF DADE.
a- C2
ii7Ct,-41e /5-7
MIAMI SHORES SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT NRSe leffif70 4 33 )—
(Signed) .
Perini, Nu... C; Date__ / Ai'cr A 7j
Applic.,tioli is hereby made for the approval of the detailed statement of the plans and specifications herewith subrit!. _1 for the building or other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miz. Shores Village, Florida.
,md all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulatic- , of the Building Division
ot Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and spot fications must be kept at
)uilding during progress of work.
ex's Name and Address snyciez
.egist.tred Architect and/or Engineer
:.rnploying Plumber's Name ...People.S--Gas—Systent No. Street. LZ5St.
Location and Legal Description Lot_ Block Subdivision...._..._._
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 Repairs No of Stories
No 1225NA_ Ell_ Street 101
Street
• • ..... •
_Type of Tank Capacity Ads.
__Dist. Feet of Tank or Drain Field from Well
cas,Nter, 4 2.,50 Provided_ Cutlet.jor Pool. Heater
Amount of Permit $ (SigOed) ■1.1.0,
Plumbing Inspector
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an endloyet of lahot
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent f up lement, and has oori..
hid svith the provisions thereof, and will require similar compliance from all contractors or sub-contractors employed 1 y him in : • X , rir v
performed under this permit; and will post or cause to be posted' for inspection on the site of the work such publ: notice 3■ no leer •43
requ!red by the Act. The undersigned agrees to employ only such sub-contractors, on work to be performed this (41 .
licensed by Miami Shores Village.
Mast ./1 Plumber.
Before me, the undersigned authority, a notary public. duly authorized to administer oaths and take acknowledgments, pericr.4. .ppearer..
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 be did sign the sone, and hut all acts
therein by him stateLlTitERWWSLIC STATE OF FLORIDA AT LARGE
MY CO...\MISSIUN E.,PlaES iL8 23 1985
cL-14:A41. .
My ComnussiOn tapirs*
0 15
Notary Public, State of Florida
NOTE: A re-inspection fee of $1.00 will be made when such re-inspection la mede•neoemary by improper notice for inrpoy..eon, or fruity
materials and/or workmanthip.
A. Li t r3
. 4 E `LT
0 0 0
BUILDING
ELECTRICAL
PLUMBING
ROOFING
Owner of
Building
Architect
Contractor
or Builder
MIAMI SHORES VILLAGE, FLORIDA
U DATE
PERMIT N? 13175
11
❑ Work to be performed under this Permit
C Is. % =
Legal /212-51
Lot 7 e ( 5 ' I) Bl. Subdi- �- ,.
Description / �' vision f'
Building J
Address of / /� j / ,/ Value of
Project II Amt. of
�✓
$ Permit $
This permit is granted to the contractor or builder named
herefor in strict compliance with all o finances pertaining thereto and with the un
drawings, statements or specifications th may have been submitted to and app .ve
time if the work is not done in compliant with such ordinances or if the plans a c
granted is the understanding that the co ractor or builder named above assume
pertaining to the work covered hereby w ether shy �„�o�lans or drawing
done by his agents, servants or employe
CONTRACTOR
In consideration of the issuance to me of this pe
pertaining thereto and in strict conformity with thy'plans, r
In accepting this permit I assutge resp�gsibility �/E all work done
c 4 ii ,�. -;, tjir
'0 v..)
1 195_
Contractor's
License No
/ #
above to tract 144011. dersta
d
Signed •
I agree to perf
a state
the building or to install the equipment or device described in the application
that the work will be performed in compliance with any plans,
oper municipal authorities. This Permit may be revoked at any
ut authorization. A further condition upon which this permit is
lity for a thorough knowledge of the ordinances and regulations
ements or specifications and that he assumes responsibility for work
BY
4 414 0 „ ,0
INSPECTOR
the work covered hereunder in compliance with' all ordinances nd regulations
or specifications submitted to the prop authorities of Miami bores Village.
° - 1f, m agent, servant or employee.
, j
Permit No. l__t! 6
Owner's Name and Address _ Pet, t `
Registered Architect and /or Engineer
i -
Size Septic Tank
Feet of Drain Tile e ll.
Nature of Water Supply: City —Well.
Amount of Permit $
My Commission Expires
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 othel
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Divisior
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept al
building during progress of work.
� , l
Employing Plumber's Name. • P . /'',-e '( �' . ' i s `� '� No.___4 '' /' " Street
Location and Legal Description Lot Block__ Subdivision
Street and Number where work is to be performed— No.___, s _9i _ ? /r__ . �_.__ Street ' '
�� . -
State work to be performed and purpose of building (By Floors)
New Building_ __.l ' Remodeling Addition__ _ Repairs No. of Stories
•
Type of Tank
_Dist. Feet of Tank or Drain Field from We1L
Size of Soakage Pit
(Signed)
No. 12 ./d • Street
Date
Capacity Gals.__.
I. y i!
The undersigned applicant for this building permit does hereby certify that he underst,' • ' anfl accepts his obligations an employer �f labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General s of Florida Permanent Supplement, and has corn-
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 art
licensed by Miami Shores Village.
(Signed).
STATE OF FLORIDA,
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeare
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the
of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all fat.
therein by him stated are true.
Notary Public, State of Florida
P1i}mliing Inspeyfor.
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 faul
materials and /or workmanship.
eP ' llu� cam-- Cc J?
CLOSETS
BATH
TUBS
SHOWERS
LAVA-
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TUe9
URINALS
CATCH
BASI
FLOOR
DRAIN
DRINKING
FOUNT'NS
TOTAL
FIXTURE:
--
CONTR.
LIST
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SWIM'G
POOL
_
CONTR.
LIeT
CHECK
i
Permit No. l__t! 6
Owner's Name and Address _ Pet, t `
Registered Architect and /or Engineer
i -
Size Septic Tank
Feet of Drain Tile e ll.
Nature of Water Supply: City —Well.
Amount of Permit $
My Commission Expires
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 othel
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Divisior
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept al
building during progress of work.
� , l
Employing Plumber's Name. • P . /'',-e '( �' . ' i s `� '� No.___4 '' /' " Street
Location and Legal Description Lot Block__ Subdivision
Street and Number where work is to be performed— No.___, s _9i _ ? /r__ . �_.__ Street ' '
�� . -
State work to be performed and purpose of building (By Floors)
New Building_ __.l ' Remodeling Addition__ _ Repairs No. of Stories
•
Type of Tank
_Dist. Feet of Tank or Drain Field from We1L
Size of Soakage Pit
(Signed)
No. 12 ./d • Street
Date
Capacity Gals.__.
I. y i!
The undersigned applicant for this building permit does hereby certify that he underst,' • ' anfl accepts his obligations an employer �f labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General s of Florida Permanent Supplement, and has corn-
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 art
licensed by Miami Shores Village.
(Signed).
STATE OF FLORIDA,
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeare
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the
of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all fat.
therein by him stated are true.
Notary Public, State of Florida
P1i}mliing Inspeyfor.
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 faul
materials and /or workmanship.
eP ' llu� cam-- Cc J?
Amount of Permit $
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT -1 2 ,
/ e / 7 � ��
Permit No Date
C.)
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the bui ng o ther
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores lage, F rida
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Bi 1 • ion
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications u e kept at
building during progress of work.
Owner's Name and Address ; ial e i No. Street
Registered Architect and /or Engineer " "'l : day d E'I
.l % a.1- ) - .r
Employing Plumber's Name •'• , " . -ri121 7 No. - - -
Location and Legal Description Lot 7 T' • 4 r t • 8 Block 1 r
Street and Number where work is to be performed —No ? ` Street -° • I. • L l r: t t •
State work to be performed and purpose of building (By Floors) , ' , i1 i i ` no F.
-v
New Building - Remodeling Addition Repairs No. of Stories
Size Septic Tank Type of Tank Capacity Gals
Feet of Drain Tile
Nature of Water Supply: City — Well.__
Street ' ' i O t •
Subdivision
1
eet f 6 k or Drain Field from Well __ __
Size of oakag 'it
(Signed
The undersigned applicant for this building permit . • _. hereby certify that he un I erstands and accepts his obligations as an employer of lab
under the Florida Workmen's Compensation Act, being Section ° . - ompiled G • •ral Laws of Florida Permanent Supplement, and has co n
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 1 work be pe or. J. ndej. this •ennit, as are
licensed by Miami Shores Village.
STATE OF FLORIDA,
ss.
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.
Plumbing spector.
CLOSETS
BATH
TUBS
SHOWERS
LAVA -
TORIES
SINKS
SLOP
SINKS
LAUNDRY URINALS
TUBS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT'NS
TOTAL
FIXTURES
CONTR.
LIST
4
7
1
4
CHECK
� �
IScp
1 Lr` f.*
l
'' I S
c-i.
-
--
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SWIM'G
POOL.
L' , f ,,.
}1 � 1.{(•x
1
�'�'1
.' ;.'i�
:. to al
CONTR.
LIST
I
CHECK
/f��
i '/'
(`^�• _
SO
V
''1S
\ °b
\
Amount of Permit $
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT -1 2 ,
/ e / 7 � ��
Permit No Date
C.)
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the bui ng o ther
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores lage, F rida
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Bi 1 • ion
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications u e kept at
building during progress of work.
Owner's Name and Address ; ial e i No. Street
Registered Architect and /or Engineer " "'l : day d E'I
.l % a.1- ) - .r
Employing Plumber's Name •'• , " . -ri121 7 No. - - -
Location and Legal Description Lot 7 T' • 4 r t • 8 Block 1 r
Street and Number where work is to be performed —No ? ` Street -° • I. • L l r: t t •
State work to be performed and purpose of building (By Floors) , ' , i1 i i ` no F.
-v
New Building - Remodeling Addition Repairs No. of Stories
Size Septic Tank Type of Tank Capacity Gals
Feet of Drain Tile
Nature of Water Supply: City — Well.__
Street ' ' i O t •
Subdivision
1
eet f 6 k or Drain Field from Well __ __
Size of oakag 'it
(Signed
The undersigned applicant for this building permit . • _. hereby certify that he un I erstands and accepts his obligations as an employer of lab
under the Florida Workmen's Compensation Act, being Section ° . - ompiled G • •ral Laws of Florida Permanent Supplement, and has co n
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 1 work be pe or. J. ndej. this •ennit, as are
licensed by Miami Shores Village.
STATE OF FLORIDA,
ss.
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.
Plumbing spector.
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