2001 Plumbing permitDate l Job Address f 7 77c /6 0 4Tax Folio
Legal Description
(/(}Alet
L g
a.a4-05
Qualifier f V ( D L- .
State # C iC 62
Owner/Lessee / Tenant
Owner's Address �[
Contracting Co.
Architect/Engineer
Bonding Company
Mortgagor
Permit Type (circle one): BUILD G ELECTRICAL
WORK DESCRIPTION
Square Ft. Estimated Cost (value) 52 O --
--
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.
OWNERS 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.
V ..J✓l� -sZ 3,
2491 p 1
d/or C/ndo President T /
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Si
ture of owner
/
•
�'. CC786697
- 4 MY COMMISSION EXPIRES
OF FAO NOV. 15,2002
. A M BECK
OOMMSSION NUMBER
Notary as ; • Owner
My Commission Expir
FEES: PERMIT
APPROVED:
Zoning
Mechanical
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
RADON
Phone 25 3 7
1 5 - 6 7 3 ' /
.56 /CJ 6
5 t - i SS# - 567ZPhone345 "7 / 0
Historically Designated: Yes No
Address
Master Permit # g 6
Municipal # J� _C 22-0? 7Competency # C1156 61 3 1 Ins. Co.
Address
Address
Address
ECHANICAL ROOFING PAVING FENCE SIGN
)
4
•
gnatur of . ontractor or Owner-
uilde;
Date
c /
4
I`' t1 w•s-
No . as to Contr a tor or • pp
4R`! PUB . StA , OF FLORIDA
COMMISSION NO. CC714103
MY COMMISSION EXP. MAR. 1,2002
My Commission E
C.C.F. D NOTARY S., () BOND
Building
Plumbing
Electrical
Structural Engineer
TOTAL DUE
3 —o
Date
ADDENDUM TO BUILDING PERMIT APPLICATION
(AN APPLICATION FOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM.
OBTAINED, THE OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON
PLUMBING
ELECTRICAL
IF A MASTER PERMIT HAS B.
SUBSEQUENT APPLICATIONS.)
MECHANICAL
ITEM
',ATH TUB
UNIT
FEE
ITEM
SWITCH OUTLETS
UNIT
FEE
ITEM .
SPACE HEATERS
UNIT
FEE'
IIDET
LIGHT OUTLETS
CENTRAL HEATING
IISHWASHER
RECEPTACLES
A/C (WIND)
'ISPOSAL
SERVICE TEMPORARY
A/C (CENTRAL)
RINKING FOUNTAIN
SERVICE SIZE IN AMPS
DUCT WORK
LOOR DRAIN
SERVICE REPAIR/METER CHANGE
REFRIGERATION
REASE TRAP ,
APPLIANCE OUTLETS
PROCESS AND PRESS PIPING
NTERCEPTOR
RANGE TOP
UNDERGROUND TANKS
AVATORY
OVEN
ABOVE GROUND TANKS
AUNDRY TRAY
WATER HEATER
U.F. PRESSURE VESSELS
LOTHES WASHER
MOTORS 0- 1 FP
STEAM BOILERS
HOWER
MOTORS OVER 1- 3 FP
HOT WATER BOILERS
INK, POT /3 COMP.
MOTORS OVER 3- 5 HP
MECHANICAL VENTILATION
INK, RESIDENCE
✓
MOTORS OVER 5- 8 FP
TRANSPORTING ASSEM6LIES
INK, SLOP
MJTCRS OVER 8- 10 HP
ELEVATORS/ESCALATORS
EMPORARY WATER CLOSET
MOTC% S OVER 10- 25 HP
FIRE SPRINKLER SYSTEMS
1INAL
MOTORS OVER 25-100 HP
COOLING TOWERS
;TER CLOSET
MOTORS OVER 100 HP
VIOLATION
DIRECT WASTES
A/C WINDOW
REINSPECTION
;TER SUPPLY TO:
AIR CONDITIONERS
•
A/C UNIT
FIRE
STRIP HEATER
SPRINKLER
GENERATORS TRANSFORMERS
•
HEATER -NEW INST.
GENERATORS TRANSFORMERS
.
HEATER - REPLACE
GENERATORS TRANSFORMERS
LAWN SPRINKLER -WELL
SPECIAL PURPOSE
SWIMMING POOL
OUTLETS COMt,ERCIAL
WATER SERVICE
SIGN TUBES
WER CONNECTIONS
SIGN TRANSFORMERS
ILITY -SEWER •
SIGN TIME CLOCK
ILITY -WATER
'TIC
FIXTURES
TANK
ANTENNA
.AY
TELEVISION OUTLETS
kINFIELD, 4' TILE/RES.
VIOLATION
F & ABANDON SEPTIC TANK
REINSPECTION -
.
'RAGE PIT CU. FT.
'CH
BASIN
CHARGE WELL
GESTIC WELL •
A DRAIN
.
F INLET
AR
WATER HEATER
E STANDPIPE
L PIPING
N
SPRINKLER SYSTEM
'
RANGE
-
:R SET (GAS)
•
PIPING
ADDENDUM TO BUILDING PERMIT APPLICATION
(AN APPLICATION FOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM.
OBTAINED, THE OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON
PLUMBING
ELECTRICAL
IF A MASTER PERMIT HAS B.
SUBSEQUENT APPLICATIONS.)
MECHANICAL
/L
Permitlio .
Amount of Permit
STATE OF FLORIDA,
sa.
COUNTY OF DADE.
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 F)orida, all ordinances of Miami Shores Village and all rules and regulations of the Building
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 E
Employing Plumber's Nano 11,7STV1.1.9
Location and Legal Description Lot
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Size Septic Tank_ ...Type of Tank__
Feet of Drain Tile
Nature of Water Supply
e a No._ / Street./
mvsysttts NO0•2aigFulL4s StireteLeaser2
Subdivision
Street and Number where work is to be performed-No Street
State work to be perf e8 se of building (By Floors)__
New Building_ Remodeling_________ Addition _ Repairs.
(Signed)-
(Signed)
No. of Stories.
Capacity Gab._____ _____
___ l of Tank or Drain Field from
et
Size of Soakage Pit
. . ....
umbing Inspectoi.
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 Workmen's Compensation Act, being Section 5988, Compiled General Laws of Florida Permanent Supplement, and)las 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 notic or notices as are
required by tlie Act. The undersigned agrees to employ only such sub-contractors, on wo4 iformed unde4Jth permit, as 'are
licensed by Miami Shores Village.
Master Plumber.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take adcnowledgments, personally appeared
to me well Imown, mid 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 fee of *1.00 will be made when such se-humans is wader necessary by improper notice for inspection, or faulty
materials and/or workmanship.
CLosiTs
BATH
TUBS
SNOWERS
LAVA.
To
SINKS
SLOP
SINKS
LAUNDRY
Tuss
..
uRINALIS
CATCH
BASIN
FLOOR
DRAIN
_.__
DRINKING
FOUNTIY5
W '
% ( / .c
TOTAL
. Prirrunas
Cows.
LIST
,...
.....
. 2—
1
- L
•
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
Fume
e
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEE P
WELL
SPRKLR.
SYSTEM
SWIM*0
POOL
Ty
y c ......
CONTR.
LIST
CHECK
/L
Permitlio .
Amount of Permit
STATE OF FLORIDA,
sa.
COUNTY OF DADE.
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 F)orida, all ordinances of Miami Shores Village and all rules and regulations of the Building
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 E
Employing Plumber's Nano 11,7STV1.1.9
Location and Legal Description Lot
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Size Septic Tank_ ...Type of Tank__
Feet of Drain Tile
Nature of Water Supply
e a No._ / Street./
mvsysttts NO0•2aigFulL4s StireteLeaser2
Subdivision
Street and Number where work is to be performed-No Street
State work to be perf e8 se of building (By Floors)__
New Building_ Remodeling_________ Addition _ Repairs.
(Signed)-
(Signed)
No. of Stories.
Capacity Gab._____ _____
___ l of Tank or Drain Field from
et
Size of Soakage Pit
. . ....
umbing Inspectoi.
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 Workmen's Compensation Act, being Section 5988, Compiled General Laws of Florida Permanent Supplement, and)las 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 notic or notices as are
required by tlie Act. The undersigned agrees to employ only such sub-contractors, on wo4 iformed unde4Jth permit, as 'are
licensed by Miami Shores Village.
Master Plumber.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take adcnowledgments, personally appeared
to me well Imown, mid 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 fee of *1.00 will be made when such se-humans is wader necessary by improper notice for inspection, or faulty
materials and/or workmanship.
Permit No.__]
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 X ___
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Block
May 30, 1972
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.
MERCE LAND COR ° . 4721 N.W. 4th Terrace
Owner's Name and Address _________— No._ Street.
Registered Architect and /or Engineer _____
-__-�_ - _-- __ —� --
Employing Plumber's Name SUN GOLD INDUSTRIES, INC. P.0 BOX 726 LUDLAM STATION 3315
___ -_ -- No._ � treat_ 5
187 Street N.E. 100th Street
Remodeling _-------- _-- _-- __ -_ -_ Addition__ -_ Repairs No. of Stories.... ______
Size Septic T aDk- ____� -2 �a __ �nType of T C G
Feet of Drain Tile_________________? 5 t _______—_ __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.
4
(Signed)
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-
plier 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 tlie 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)
apacity s.
Plumbing Inspector.
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
Master Plumber.
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made' necessary by improper notice for inspr' "'t-nn, or faulty
materials and /or workmanship.
CLOSETS
BATH
TUBS
SHOWERS
LAVA-
TORIES
INKS
SINKS
SLOP
SINKS
LAUNDRY
Tups
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
SWIM'G
POOL
COPT!.
NT LIST
CHICK
- - —
CI 00 11 s PRECAST 900 gallons
Permit No.__]
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 X ___
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Block
May 30, 1972
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.
MERCE LAND COR ° . 4721 N.W. 4th Terrace
Owner's Name and Address _________— No._ Street.
Registered Architect and /or Engineer _____
-__-�_ - _-- __ —� --
Employing Plumber's Name SUN GOLD INDUSTRIES, INC. P.0 BOX 726 LUDLAM STATION 3315
___ -_ -- No._ � treat_ 5
187 Street N.E. 100th Street
Remodeling _-------- _-- _-- __ -_ -_ Addition__ -_ Repairs No. of Stories.... ______
Size Septic T aDk- ____� -2 �a __ �nType of T C G
Feet of Drain Tile_________________? 5 t _______—_ __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.
4
(Signed)
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-
plier 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 tlie 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)
apacity s.
Plumbing Inspector.
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
Master Plumber.
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made' necessary by improper notice for inspr' "'t-nn, or faulty
materials and /or workmanship.