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PLUMBINGType Insp'n Permit No. Name MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Requ st Date //L//0 \ / Address 3 L Compan Phone 3 °S Inspection Date Approved Correction Re- Insp'n Fee C' 1 -PA' RECT,1VED ktilA BUILDING PERMIT APPLICATION FBC 2001 Owner's Address City /IfQ vin. .1 136 Job Address (where the work is being done) City Miami Shores Village Is Building Historically Designated YES � r City r Qyh / State WL2 Qualifier (la Pond e►� Architect/Engineer's Name (if applicable) $ Value of orl `For'fFi Pertli9t reolzrogI viv -i rr o t U Type of W 4 Describe *or /v % . ��'iV �. • oar 200 �'- ] • l r I Submittal Fee $ Notary $ Training/Education Fee $ Scanning $ Radon $ Code Enforcement $ Total Fee Now Due 8 (Continued on opposite side) Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 State F Permit Fee $ IT /V/A ID Structural Plan Review. $ Permit Type (circle): Building Electrical Owner's Name (Fee Simple Titleholder) (1 /12V\ ..�, 1 /\ oMaS NE lot S+ � t �' Contractor's Company Name In it Sept- 1 c_ ( Contractor's Address / 7 3 < /V (-✓ l? cf Permit No. Master Permit No. 0 Phone # Mechanical Zip 33/.3 fq� Roofing Tenant/Lessee Name Phone # /36 NE /0/ 5 �- Phone # 305 - lD 2o--8 33/6 9' Zip 3 3 / 6 / State Certificate or Registration No. Certificate of Competency No. Phone # i, /,,,,,,, In 1 • 4, ew 10004 a'" nuartntkl obholl ac u krk • • . 4 `>J` ! ;. ,: l e + .. ; l:~ , 4, /Ydrilakaginie AV * * * * * * * * * * * * * * * * * * * * * * * * * * ** F ees * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Zip 3 3 3 N /A emolition CCF $ t) CO /CC Technology Fee $ r 3 Zoning Bond $3t) , Bonding Company's Name (if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC 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. "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT 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." Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature ✓// Contractor The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this day of J 0 to , � ,/ , day of , 20 06 t, by Signature who is son. �3Ssl�;�;�, Produced who is NOTARY Sign: Print: My Commission E * * * * * * * * * * * * * * ** * * * * * * * * * * * * * * * * * * * * * * * * * * ** APPLICATION APPROVED B i �, �.� ` ` - 0 /` Plans Examiner po r- Engineer Zoning Chc 05/13/03 Owner or oath. NOTARY PUB Sign: Printti �"- My Commiss Zip oath. **** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** **** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** * * * * * * * * * * * * * * * * * * * * * * * * ** ITEM BATH TUB UNIT FEE ITEM SWITCH OUTLETS UNIT FEE ITEM SPACE HEATERS UNIT FEE BIDET LIGHT OUTLETS CENTRAL HEATING DISHWASHER RECEPTACLES A/C (WIND) DISPOSAL SERVICE TEMPORARY A/C (CENTRAL) DRINKING FOUNTAIN SERVICE SIZE IN AMPS DUCT WORK FLOOR DRAIN SERVICE REPAIR/METER CHANGE REFRIGERATION GREASE TRAP APPLIANCE OUTLETS PROCESS AND PRESS PIPING INTERCEPTOR RANGE TOP UNDERGROUND TANKS LAVATORY OVEN ABOVE GROUND TANKS LAUNDRY TRAY WATER HEATER U.F. PRESSURE VESSELS CLOTHES WASHER MOTORS 0- 1 HP STEAM BOILERS SHOWER MOTCRS OVER 1- 3 HP HOT WATER BOILERS SINK, POT /3 COMP. MOTCRS .OVER 3- 5 HP MECHANICAL VENTILATION SINK, RESIDENCE MOTORS OVER 5- 8 HP ., TRANSPORTING ASSEMBLIES SINK, SLOP MOTORS OVER 8- 10 HP ELEVATORS/ESCALATORS TEMPORARY WATER CLOSET MOTORS OVER 10- 25 HP FIRE SPRINKLER SYSTEMS URINAL MOTORS OVER 25-100 HP COOLING TOWERS WATER CLOSET MOTCRS OVER 100 FP VIOLATION INDIRECT WASTES- A/C WINDOW REINSPECTION WATER SUPPLY TO: AIR CONDITIONERS A/C UNIT STRIP HEATER FIRE SPRINKLER GENERATORS TRANSFORMERS HEATER -NEW INST. GENERATORS TRANSFORMERS HEATER - REPLACE GENERATORS 'TRANSFORMERS LAWN SPRINKLER -WELL SPECIAL PURPOSE SWIMMING POOL OUTLETS COMMERCIAL WATER SERVICE • SIGN TUBES SEWER CONNECTIONS SIGN TRANSFORMERS UTILITY -SEWER SIGN TIME CLOCK UTILITY -WATER FIXTURES SEPTIC TANK _ gD Q + ANTENNA RELAY TELEVISION OUTLETS DRAINFIELD, 4' TILE/RES./Mt) VIOLATION PUMP & ABANDON SEPTIC TANK REINSPECTION SOAKAGE PIT CU. FT. CATCH BASIN DISCHARGE WELL DOMESTIC WELL AREA DRAIN ROOF INLET SOLAR WATER HEATER FIRE STANDPIPE POOL PIPING LAWN SPRINKLER SYSTEM GAS RANGE METER SET (GAS) GAS PIPING (AN APPLICATION FOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. IF A MASTER PERMIT HAS B. OBTAINED, THE OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.) PLUMBING ADDENDUM TO BUILDING PERMIT APPLICATION ELECTRICAL MECHANICAL PROPERTY ID SYSTEM DESIGN AND SPECIFICATIONS N [ 900 1 [ 1 [ ] K [ • SPECIFICATIONS BY: APPROVED BY: DATE ISSUED: 7 - 3 013'2006 DH 4016, 10/96 (Replaces HRS -H Form 4016 (page 11 which may be used) (Stock Number: 5744-001-4016-0) • STATE OF FLORIDA DEPARTMENT OF HEALTH ONSITE SEWAGE DISPOSAL SYSTEM CONSTRUCTION PERMIT Authority: Chapter 381, FS & Chapter 10D-6, FAC CONSTRUCTION PERMIT OR: - J ] New _System [Pi Existing System [ ) Holding Tank [ ] Temporary /Experimental ' [ Repair [J ] Abandonment [8J] Other(Specify) APPLICANT: 4 , T AGENT: / G1144 S PROPERTY STREET ADDRESS: 1 t9 G , / Q , •s +. LOT: R BLOCK f SUBDIVISION: Cire PERMIT # - z:5 h y DATE PAID - g - O FEE PAID $ 1 0 RECEIPT # S ([ L 70 off 1 3 -2 I 'f 4 P o ce.tr !3 [SECTION /TOWNSHIP /RANGE /PARCEL NUMBER] [OR TAX ID NUMBER] SYSTEM MUST BE CONSTRUCTED IN ACCORDANCE WITH SPECIFICATIONS AND STANDARDS OF CHAPTER .1OD -6, FAC. REPAIR PERMITS AND HOLDING TANK PERMITS EXPIRE 90 DAYS FROM THE DATE OF ISSUE. ALL•OTHER PERMITS EXPIRE ONE YEAR' FROM' THE. DATE OF ISSUE. DEPARTMENT OF HEALTH APPROVAL OF SYSTEM DOES NOT GUARANTEE' SATISFACTORY PERFORMANCE FOR ANY SPECIFIC PERIOD OF TIME. ANY CHANGE IN MATERIAL' FACTS WHICH SERVED AS A BASIS FOR ISSUANCE OF THIS PERMIT REQUIRE THE APPLICANT TO MODIFY THE PERMIT APPLICATION. SUCH MODIFICATIONS MAY RESULT IN THIS PERMIT BEING MADE NULL AND VOID. [GALLONS / GPD] SEPTIC TANKLAEROBIC UNIT CAPACITY MULTI- CHAMBERED /IN SERIES:[] [GALLONS / GPD], CAPACITY MULTI- CHAMBERED /IN SERIES:[ ) GALLONS GREASE INTERCEPTOR CAPACITY [MAXIMUM CAPACITY SINGLE TANK: 1250 GALLONS] GALLONS PER DOSE DOSING TANK CAPACITY DOSE MATE [-] PER 24 HRS NO. OF PUMPS: [ ] [2:0 0] SQUARE FEET PRIMARY DRAINFIELD SYSTEM [ ,r. ] SQUARE FEET SYSTEM A TYPE SYSTEM: [ mo d] STANDARD [. A ] FILLED [ ] MOUND ( J I CONFIGURATION:' ] TRENCH [ 1] BED [ [ }- F LOCATION OF .BENCHMARK: / Z 4 ® N t V o .) • p� p Eigt I ELEVATION OF PROPOSED SYSTEM SITE [2 [INCHES /FT] [ABOVE /BELOW] BENCHMARK /REFERENCE E BOTTOM OF DRAINFIELD TO BE [ d 1 [INCHES /FT] [ABOVE /BELOW] BENCHMARK /REFERENCE POINT L D FILL.REQUIRED: [LM.] INCHES EXCAVATION REQUIRED: [ q ] INCHES ]? A la , Li • — r',A ra o tvt t P try : UNDER BOTTOM OF DRAINF SLID joo' 611 -1( 4.10 30 (e tell. INSTALL 1 Z t OF SLIGHTH LY T T'SriF) COT( TITLE: 1f THTS PRT�AfiTT� `4Tl1 Cnn . n .. -.. IPd� ?T TT' -�T� � U B OM OF DRA 1 . _ 7 P5.:. UIV fE:1 O '1..,.' r ' al .. C7, �-•+[ . y LEAST .S ,2 � 4 ✓1 r ! h lA . 1.'� . :• : fi b7A N E' !s �:cs ,: gyp.: �•�11 , vs v . 6M b�d! cF Y / / ,,; et 4 CHD POINT EXPIRATION DATE: lit al Uy INSTRUCTIONS: PERMIT NUMBER: Permit tracking number by County Health Department. APPLICATION FOR: Check type of permit; if "Other" specify type in blank. APPLICANT: Property owner's full name. TELEPHONE: Telephone number for applicant or agent. AGENT: Property owner's legally authorized representative. MAILING ADDRESS: P.O. box or street mailing address for applicant or agent. LOT, BLOCK, SUBDIVISION or PROPERTY ID #: 27 character ID number for property. (Health Department may require property appraiser ID# or section /township /range /parcel number.) SYSTEM DESIGN AND SPECIFICATIONS: TANK: Minimum specifications from Chapter 10D -6; FAC. DRAINFIELD: Minimum specifications from Chapter 10D -6, FAC. OTHER: . Other specifications, such as operating permit requirements, low- volume flush toilets, variance provisos. SPECIFICATIONS BY: Name of individual providing specifications. If designed by a registered engineer must be sealed. APPROVED BY: County Health Department personnel reviewing and approving permit. DATE ISSUED: Date permit is issued by County Health Department.' 4 ti EXPIRATION DATE: One year from date issued if the system has not been installed. Permits for system repairs become void 90 days from the . date issued. Notes: DH 4015, 10198 (Replaces HRS-H Form 4015 which may be used) (Stock Number: 5744 - 002. 4015.6) STATE OF FLORIDA ' DEPARTMENT OF HEALTH Scale:- - Each block represents 5 feet and 1 inch = 50 feet. Site Plan submitted by: APPLICATION FOR ONSITE SEWAGE DISPOSAL SYSTEM CONSTRUCTION PE Permit Application Number PART II - SITE PLAN ALL CHANGES MUST BE APPROVED BY THE COUNTY HEALTH DEPARTMENT if' . Conerete T. rah s SfAeS S/�, Signature C u� T tr 4 -- t-1 1 - t }�. T( lotAk QA44. ..fo,e1( aniv. AA w - loo al 5 /r ttAAA . Z00 Fr ( > 116 /Pk n as %) 0 01 Title Plan Approved Not Approved Date 2 °0 • By County Health Department 1 Page 2 of 3 LOT: /4) BLOCK: / PROPERTY SIZE CONFORMS TO SITE PLAN: TOTAL ESTIMATED SEWAGE FLOW: AUTHORIZED SEWAGE FLOW: 3 ZS° UNOBSTRUCTED AREA AVAILABLE: 260 BENCHMARK /REFERENCE POINT LOCATION: ELEVATION OF PROPOSED SYSTEM SITE IS 2,20 [INCHES THE MINIMUM SETBAC WHICH SURFACE WATER: FT WELLS: PUBLIC: FT BUILDING FOUNDATIONS: SOIL PROFILE INFORMATION SITE 1 STATE OF FLORIDA DEPARTMENT OF HEALTH ONSITE SEWAGE DISPOSAL SYSTEM SITE EVALUATION AND SYSTEM SPECIFICATIONS SITE EVALUATED BY: , DH 4015, 10196 (Replaces HRS -H Form 4015 ]Page 3] which may be used) (Stock Number: 5744- 003 - 4015 -1) SUBDIVISION: AGENT: M/o v1 ( Shin re ` .. t . Va /Ior e , P er:. PROPERTY ID 1: /' 3 ( _ Q/3 a ..]Section /Township /Range /Parcel No. or<Tax ID NBum r] TO BE COMPLETED BY ENGINEER, HEALTH UNIT EMPLOYEE, OR HER UALIFIED PERSON ENGINEER'S MUST PROVIDE REGISTRATION NUMBER AND SIGN AND SEA r EACH PAGE OF SUBMITTAL. COMPLETE ALL ITEMS. YES [ ] NO NET USABLE AREA AVAILABLE: ,(3 ACRES GALLONS PER DAY SIDE.;_ ABLE 1 riOTHER -TABLE 2] GALLONS PER DAY [1500 GPD /ACRE 0 500 'GPD -ACRE] SQFT UNOBSTRUCTED AREA REQUIRED: ,60. SQFT OBSERVED WATER TABLE: t'V 4. INCHES [ABOVE / EXISTING GRADE. TYPE: ESTIMATED WET SEASON WATER TABLE ELEVATIOI�,e' gz $' INCHES [ ABOVE / HIGH WATER TABLE VEGETATION: [ ] YES [ NO MOTTLING: [ ] YES [ REFERENCE POINT CAN BE MAINTAINED FROM THE PROPOSED SYSTEM TO THE FOLLOWING FEATURE DITCHES /SWALES: A01 FT / NORMALLY WET? [ ] YES [ NO LIMITED USE: IV A FT PRIVATE:. /VA FT NON- POTABLE: 140 FT S FT PROPERTY LINES] , f FT- POTABLE WATER LINES: Ale) FT SITE SUBJECT TO FREQUENT FLOODING: [ ] YES [ NO 10 YEAR FLOODING? [ ] YES [ NO 10 YEAR FLOOD ELEVATION FOR SITE: FT MSL /NGVD SITE ELEVATION: 0 FT MSL / SOIL PROFILE INFORMATION SITE 2 RCHED / ] EXISTI NO DEPTH: A'4 G GRADE. INCHES SOIL TEXTURE /LOADING RATE FOR SYSTEM SIZING : �Q DEPTH OF EXCAVATION: INCHES [ ] DRAINFIELD CONFIGURATION: TRENCH [• BED [ ] OTHER (SPECIFY) REMARKS /ADDITIONAL CRITERIA: / 4W0A-F sL ( DATE: £ e L1 Page 3 of 3 INSTRUCTIONS: SEWAGE FLOW: UNOBSTRUCTED AREA: MINIMUM SETBACKS: . PERMIT NUMBER: Permit tracking number by County Health Department. APPLICANT: Property owner's full name. I , AGENT: Property owner's legally authorized representative. LOT, BLOCK, SUBDIVISION: Lot, block, and subdivision for lot. PROPERTY ID NUMBER: 27 character number for property (property appraiser ID number or section /township /range /parcel number). PROPERTY SIZE: Check if property at site conforms to submitted site plan. Record net usable area available - lot area exclusive of all paved areas and prepared road beds within public rights -of -way or easements and exclusive of streams, lakes, normally wet drainage ditches, marshes, or other such bodies of water. Record the estimated sewage flow for the establishment from Table 1 (residence) or Table 2 (non - residential), Chapter 10D-6, FAC. Record the authorized sewage flow for the lot based on net usable area and water supply (1500 gallons per day per acre for private water supplies and 2500 gpd per acre for public water supplies). If authorized sewage flow does not equal or exceed the estimated sewage flow, the application must be denied. Record the square feet of unobstructed area available and the amount required. Unobstructed area must be at least 2 times as large as the drainfield absorption area and at least 75 percent of the unobstructed area must meet minimum setbacks in Chapter IOD -6, FAC. The unobstructed area must be contiguous to the drainfield. BENCHMARK INFORMATION: Record the location of the benchmark. If using a surveyor's benchmark record the actual elevation. Record the elevation of the proposed system site in relation (above or below) to the benchmark. Record minimum setbacks which can be meet to all listed features. Actual measurements must be recorded or "NA" for nonapplicable features. Features on site plan or within 75 feet of the applicant lot must be measured. The location of any public drinking well within 200 feet of the applicant's lot must also be verified. FLOOD INFORMATION: Record information on lot's subject to flooding. For lots subject to flooding record 10 year flood elevation for site and actual site elevation. SOIL PROFILE INFORMATION: Two soil profiles within the proposed absorption area to a minimum depth of fr feet or refusal are required. Soil identification will use USDA Soil Classification methodology (Munsell colors and USDA soil textures). Refusals must be clearly documented. Provide USDA soil series if available, record "UNK" if the series cannot be determined. WATER TABLE: Record the depth of the observed water table at the time of the evaluation. Mark "perched" or "apparent" as appropriate. Record the estimated wet season water table elevation based on site evaluation, USDA soil maps, and historical information. Indicate if there is high water table vegetation present. Indicate if mottling is present and depth. SOIL TEXTURE: Record soil texture or loading rate for, system sizing. DEPTH OF EXCAVATION: If applicable record depth of excavation required. Record "NA" if not applicable. DRAINFIELD CONFIGURATION: Check drainfield configuration required. If other, specify type. ADDITIONAL CRITERIA: Record any additional remarks pertinent to site or installation. Ex. dosing required. SITE EVALUATED BY: Signature of evaluator, title, and date of evaluation. Professional engineers must seal all documents submitted. ELEVATION WORKSHEET ELEVATION OF BENCHMARK / REFERENCE POINT IS: BENCHMARK SITE 1 SITE 2 SITE 3 [ + ] SHOT H.I. H.I. H.I. H.I. [ - ]SHOT [ - ]SHOT [ - ]SHOT Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Printed: 7/9/2004 Applicant: BRYON THOMAS Owner: THOMAS BRYON JOB ADDRESS: 136 NE 101 ST Contractor W P SEPTIC TANK CO INC Local Phone: 305 - 620 -6320 Parcel # 1132060132000 Plumbing Permit Permit Number: PL2004 -198 Contractor's Address: 17235 NW 12 CT Page 1 of 1 Legal Description: MIAMI SHORES SEC 1 AMD PB 10 -70 LOT 10 BLK 15 LOT SIZE 50.000 X Fees: Description Amount FEE2004 -6910 Building Fee $175.00 FEE2004 -6911 CCF $1.20 FEE2004 -6912 Training and Education Fee $0.40 FEE2004 -6913 Technology Fee $4.37 FEE2004 -6914 Builders Bond $300.00 Total Fees: $480.97 Total Fees: $480.97 Total Receipts: $480.97 Permit Status: Approved Permit Expiration: 1/5/2005 Construction Value: $1,600.00 Work: INSTALL A NEW 900 GALLON SEPTIC TANK ON A NEW 200 SQ. TANK DRAINFIELD Signed: (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 responisibility for all work done by either myself, my agent, servants or employes. Signed: (Contractor or Builder) BY: Issue Date: 9/21/2006 Owner's Name: BRYON THOMAS Permit Type: Plumbing - Residential Work Classification: Sprinkler System Job Address: 136 101 Street NE Miami Shores Village, FL Contractor(s) Phone AFFORDABLE IRRIGATION, INC 305 - 681 -6322 Primary Contractor Yes Additional Information Type of Work: SPRINKLERS Additional Info: Classification: Residential Type of Piping: Bond Return : 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, servants, or employes. I understand that separate permits are required for ELECTRICAL, PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL 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. Futhermore, I authorize the above -named contractor to do the work stated. Fees Due Amount CCF $1.80 Education Surcharge $0.60 Permit Fee - Additions /Alterations $160.00 Scanning Fee $3.00 Technology Fee $4.00 Total: $169.40 Invoice Number PL -9 -06 -26215 Total: Amt Due $169.40 SCUP 2 2 P000 CA Amt Paid Building Department File Copy icant Signature Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Fax: (305)756 -8972 Permit Expires: 03/20/2007 Parcel #: Block: Section: Permit Status: APPROVED Permit Number: PL -9 -06 -2373 Phone: 1132060132000 Lot: PB: Total Square Feet: Total Valuation: $ 2,400.00 Re • uired Ins • ections Underground Sprinkler Final 0 NOTICE: In addition to the requirements of this permit, there may be additional restrictions applicable to this property that may be found in the public records of this county. AND THERE MAY BE ADDITIONAL PERMITS REQUIRED FROM OTHER GOVERNMENTAL ENTITIES SUCH AS WATER MANAGEMENT DISTRICTS, STATE AGENCIES, OR FEDERAL AGENCIES. Inspection Date: 10/12/2006 Inspector: Grande, Claudio Owner: THOMAS, BRYON Job Address: 136 101 Street NE Project: <NONE> Miami Shores Village, FL Contractor: AFFORDABLE IRRIGATION, INC Building Department Comments Wednesday, October 11, 2006 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 OCT 13 2006 Block: Permit Type: Plumbing - Residential Inspection Type: Final Work Classification: Sprinkler System Phone Number Parcel Number 1132060132000 Lot: Phone: 305 - 681 -6322 Page 2 of 2 In . e • ctor omments I II Passed Failed Correction Needed Re- Inspection Fee ($75) No Additional Inspections can be scheduled until re- inspection fee is paid . Inspection Date: 10/12/2006 Inspector: Grande, Claudio Owner: THOMAS, BRYON Job Address: 136 101 Street NE Project: <NONE> Miami Shores Village, FL Contractor: AFFORDABLE IRRIGATION, INC Building Department Comments Wednesday, October 11, 2006 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 OCT 13 2006 Block: Permit Type: Plumbing - Residential Inspection Type: Final Work Classification: Sprinkler System Phone Number Parcel Number 1132060132000 Lot: Phone: 305 - 681 -6322 Page 2 of 2 Date Friday, September 22, 2006 09/22/2006 Check Receipt Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Fax: (305)756 -8972 Permit Number: PL -9 -06 -2373 Invoice Number: PL -9 -06 -26215 Applicant: BRYON THOMAS Company Name: Owner Address: 136 NE 101 ST MIAMI SHORES, FL 33138 Job Address: 136 101 Street NE Miami Shores Village, FL Payment Type Check Number 11286 Amount $169.40 Change $0.00 Total Payment: $169.40 Page 1 of 1 Oc�zA10�� y- 9e BUILDING PERMIT APPLICATI FBC 2004 Permit Type (circle): Building Owner's Name (Fee Simple Titleholder) ae /a /77 ,2, &S Phone # Owner's Address // / e- / ReS - `� /a City /V 27/ ,Ee5 State F� Zip 3/(38 3 a) Tenant/Lessee Name Phone # Type of Work: Describe Work: Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 F • (305) 756.8972 Electrical ' umbinE Mechanical Job Address (where the work is being done) /3 6 /t/6 `Q/ s f1e � 7 City Miami Shores Village County Miami -Dade Zip ,53/.3 - 02 3Q / FOLIO /PARCEL# 3.206 - 0/3- .2 00 0 Is Building Historically Designated YES NO Contractor's Company Name WfOida j.(2/ 2/a 74O w Phone # 305" ,69/ Contractor's Address X98 /1/6e) /3 9' ,c7 City /4,74- /)*ia / State P Qualifier Name /J///pr_ ,e0 A5 State Certificate or Registration No. -, Certificate of Competency No. Architect/Engineer's Name (if applicable) Value of Work For this Permit $ ❑Addition ❑Alteration /Q/./ //J "4,4 Bond $ Code Enforcement $ Structural Review. $ Square / Linear Footage Of Work: a _ t-1 view // // ❑ `` Repair/Replace inS 7'Q /% Tim,1 * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** ** ** F * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Submittal Fee $ Permit Fee $ / C.' CCF $ I' Q r CO /CC Notary $ Training/Education Fee $ 0 ��'�/t Technology Fee $ / Scanning $ 3"CO Radon $ DPBR $ Zoning $ Double Fee $ Permit No.P(CC, -7 13 Master Permit No. Zip Phone # Phone # Total Fee Now Due $ See Reverse side Roofing 505 - RV t 3aa OOO2 ❑ Demolition SP 2 2 PAID CI( Vt . Ilz& Bonding Company's Name (if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State Zip Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC 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. "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT 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." Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Owner or Agent The foregoing instrument was acknowledged before me this �6 The foregoing instrument was acknowledged before me this /67 day of S ,20 by , day of Sy, , 20 dc, by who is personally known to me or who has produced who is personally known to me or who has produced as identification and who did take an oath. tergargtnIrtiltrtliq take an oath. NOTARY PUBLI comn DD0238491 Expires Bonded Rw (eoo)432-42 Florid. Nobly Paw - rie Sign: Print: ji,p4Le0 ej", My Commission Expires: APPLICATION APPROVED BY: (Revised 02/08/06) NOTARY PUBLIC: • e Toledo SS # DD348926 ;_A-`,;G, 22, 2008 Atlantic BoncLngCo., Inc. Sign: Pri i y Commission Expires: ************ * * * * * * * * * * * * * * * * * * * * * * * * * * * ** * ** *** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** * * * * * * * * * * * * * * * * * * * * * * * * * ** 6 Plans Examiner Engineer Zoning • • ••• • • • ••• •••• • •••••• • • • • • • • • • • • • • • • • .... • • • • • .. • • • ••••••• ie„c e- •••• .. .. .. • • .. •• • • • .. • • • • .. MCIEEVEI SEP 1 9 2006 BY: P I gpf A/, /6:4/ Lc 6 e41 — @.. b 7o 57o Vt4i L #&4 C/- FAD I p /2,e Jen 7eA. ® _ o o e t14 /112 5 • • .. • • • .. • . . • . • • edo Commison DD348926 .. . Exp AUG. 22, 2008 of �oQ Bonded Thru q�nn Arlantk Bonding Co., Inc. 3 / Y S / 7 u 1 " e'v CC# 96P000219 Affordable Irrigation, Inc. 198 NW 139 Street Miami, FL 33168 Tel: (305) 6 -6322 PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date f' -) 7 Job Address' 13 to N 6, i O k+ 3 t Tax Folio Legal Description Historically Designated: Yes g O pNo Owner/Lessee / Tenant y BeNI 1 Ina m 5 Master Permit # D / 2 Owner's Address Phon Contracting Co.l L tt cl 5e� -81 ? 1 V ►n b1 n 6 Address Qualifier SS# Phoney 305 - R3 7 NO State # Municipal # Competency # Ins. Co. Architect/Engineer Address Bonding Company Mortgagor Address Address Permit Type (circle one): BUILDING ELECTRICA PL MBIl MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION n Square Ft. Estimated Cost (value) u $3o O 305 - /10 3 -ca 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 cons and zoning. Furthermore, I authorize the above -named contractor to do the work stated. Condo Pi<al i STATE A fF c — NOTARY ( PUBLIC O. CC714103 COMMISSION N � 1 p02 PAY COMM5SION EXP. MAI No . : s t. Owner an My •mmission Expires: FEES: PE APPROVED: Zoning Building Mechanical Plumbing 7-0/ n ,n 1 -9n, d 1 -1b -oo dZ ild / 5 914 /0 O � gnature of wentractor or Owner- Builder Date 0/ RADON Notary as to Contractor or Owner- Builder Date My Commission Expires: C.C.F. NOTARY C BOND TOTAL DUE Electrical Structural Engineer PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date (- at,- 4 Job Address 3 6 j if 6± _ Tax Folio Legal Description Historically Designated: Yes X No Owner/Lessee / Tenant B r Y nr, m bt5 Master Permit # i1 Owner's Address Phone 3 0E) - gtO, - a7 3a Contracting Co. 0 )AJ n'i" Address Qualifier SS# Phone 306 - i 54 -L 3--3i State # 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 fr r2. Ot t/ Gt 'o r y 51 r K - , P i r\ )� l r o O 7r � Square Ft. Estimated Cost (value) i} 0 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 Signature 'of Contractor or Owner - Builder Notary as to Owner and/or Condo President Date My Commission Expires: FEES: PERMIT RADON APPROVED: Zoning Building Mechanical Plumbing C.C.F. NOTARY otary as to Con or or Owner- Builder My Commission Exp :77—, 0. SEAL . - vpllSmS�ON N YBER g14', Q CC797277 9 O to COMMISSION EXPIRES or F�0 DEC. 17,2002 Electrical BOND TOTAL DUE 1 - a��oo Date Date / Structural Engineer ITEM BATH TIB UNIT • I ITEM SWITCH CUTLETS UNIT FEE ITEM SPACE HEATERS UNIT FEE 310ET LIGHT CUTLETS CENTRAL HEATING DISHWASHER RECEPTACLES A/C (WIND) 0IS?0SAL SERVICE TEMPORARY A/C (CENTRAL) DRINKING FOUNTAIN I. SERVICE SIZE IN AMPS f &ET WORT( FLCCR DRAIN SERVICE REPAIR/0ER CiAtGE REFRIGERATION GREASE TRAP APPLIANCE CUTLETS PRC SSS AND PRESS PIPING INTMCEPTCR RANGE TCP UNDERGROUND TANKS LAVATORY � OVEN ABOVE 6R0Utt1 TANKS LAUNDRY TRAY WATER HEATER U.F. PRESSZRE VESSELS CLOTHES WASHER ROTORS 0- 1 >P STEAM BOILERS SOWER /VCRS OVER 1- 3 FP NOT WATER BOILERS SINK. POT/3 COMP. MOTCRS OVER 3- 5 IP 6ECHANNICAL VENTILATION SINK. RESIDENCE MOTORS OVER 5- 8 if TRANSPORTING ASSEE$L I ES SINK. SLOP M3TCRS OVER 8- 10 HIP EL EVATORS/ESCALATORS • TEMPORARY WATER CLOSET MOTORS OVER 10- 2S NP FIRE SPRINKLER SYSTEIS URINAL NOTCRS OVER 25-100 NP COOLING TOWERS WATER CLOSET --1 Xc /MRS OVER 100 HP I VIOLATION INDIRECT WASTES A/C WINDOW REINUSPECTION WATER SUPPLY T0: AIR CONDITIOERS A/C UNIT STRIP HEATER FIRE SPRINKLER GENERATORS TRS • • HEATER -NEW INST. GENERATORS TILVSFORMERS { HEATER-REPLACE GENERATORS TRANSFORMERS LAWN SPRINKLER -NE1 - SPECIAL PURPOSE SWIWING POOL • OUTLETS COMEMAL WATER SERVICE . SIGN TUBES SEWS CONNECTIONS SIGN 1RANSF0R/ERS UTILITY -SEWER SIGN TIME CLCCC UTILITY -WATER _ FIXTURES SEPTIC TANK ANTENNA • - � RELAY TELEVISION CUTLETS ORAINFIELO, 4' TILE/RES. VIOLATION MR & ABANDON SEPTIC TANK _ REINSPECTION SOAKAGE PIT CU. FT. CATCH BASIN DISCHARGE WELL DOb€STIC. NELL AREA (RAIN ROOF IMIT SOLAR WATER HEATER �^ FIRE STANDPIPE POOL PIPING LAWN R I NQQER SYSTEM GAS RANGE METER SET (GAS) GALS PIPING (AN APPLICATION FOR 3UILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. IF A MASTER PERMIT HAS 3- OBTAINED, THE OWNER'S NOTARIZED SIGNATURE NEED NOT HE PRESENT ON SUBSEEQUa1T APPLICATIONS.) PLUMBING ELECTRICAL ADDENDUM TO BUILDING PERMIT APPLICATION MECHANICAL Permit No . %/ ' MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Date. Application is hereby made for the approval of the detailed statement of the plans and specifications herew(tl'i 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 id s Name and Address k >/P P No I , (_ _,4/ Street../g .. .. ___ .. Registered Architect and /or Engineer E Plumbc's e � ids .�Z2./ Il �� d Legal bescti p Lot. /Q Block _ Subdiv ion. , /V Street and Number where work is to be performed —No -c, /V Street.._ill_. "x— State work to be performed and purpose of building (By Floors) -.. j^- ¢4 —> t- ^- -• P41lJ.G ... -/i j7.� Remodeling..____ —. -- Add / ition...- -. .. _— Repairs. of Stories. ... ... ..... _.. .... . New Building ..--- .___- .-- •---- ......._. .. ......... . 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 $_.1t O0 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 I iK cOm- piied 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 err 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 ( Signed )_4 ll j&W- 01///'e k STATE OF FLORIDA, µ COUNTY OF DADE. 1 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 be has carefully read the foregoing application, and that be did slgn the same, and that all facts therein by him stated are true. Notary Publio„ State of Florida NOTE: A re- inspection fee of $1.00 will be mad. whets mob awispaotlasi la made usossury by Improper soda. for l or faulty materials and /ar workmanship. CL OSETS BATH Tuns aNOW[RS LAVA- TORIES 69 4 4 * K• BLOT SINKS LAUNDRY TUBS URINAL/ CATCH BASIN FLOOR DRAIN DRINKING FOUNT'NS TOTAL FIXTURES C 1.157 CHECK SEPTIC TANK SEWER CONN. DRAIN FIELo SOAKAGE PIT G TRAP SOLAR NEATER DEEP WILL S 8 M SWIN'O POOL Comm. LIST CHECK Permit No . %/ ' MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Date. Application is hereby made for the approval of the detailed statement of the plans and specifications herew(tl'i 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 id s Name and Address k >/P P No I , (_ _,4/ Street../g .. .. ___ .. Registered Architect and /or Engineer E Plumbc's e � ids .�Z2./ Il �� d Legal bescti p Lot. /Q Block _ Subdiv ion. , /V Street and Number where work is to be performed —No -c, /V Street.._ill_. "x— State work to be performed and purpose of building (By Floors) -.. j^- ¢4 —> t- ^- -• P41lJ.G ... -/i j7.� Remodeling..____ —. -- Add / ition...- -. .. _— Repairs. of Stories. ... ... ..... _.. .... . New Building ..--- .___- .-- •---- ......._. .. ......... . 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 $_.1t O0 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 I iK cOm- piied 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 err 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 ( Signed )_4 ll j&W- 01///'e k STATE OF FLORIDA, µ COUNTY OF DADE. 1 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 be has carefully read the foregoing application, and that be did slgn the same, and that all facts therein by him stated are true. Notary Publio„ State of Florida NOTE: A re- inspection fee of $1.00 will be mad. whets mob awispaotlasi la made usossury by Improper soda. for l or faulty materials and /ar workmanship. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING t"w.MIT j 1S Permit No Date_f /f � 4- c— ._ � 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- Y':___ 4 `,____ F#_a_ 4__',_ No.___/3� Location and Legal Description Lot__ ..... __Block Subdivision &Ted and Number where work is to be performed—No 40- 6. / tree Registered Architect and/or Engineer ..... . Employing Plumber's iff es No. .3./ P.;;;). Street State work to be performed and purpose of building (By Floors)____R.L - Zi a New Building Remodeling_____ Addition____ Repairs No. of Stories.. B-o Amount of Permit $ STATE OF FLORIDA, } COUNTY OF DADE. ( Signed)._ (Signed) Street___ C, /6/ _4 ye w._ /¢7j 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._.___ _._______ ___________ .......... of Soakage Pit Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts is 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. 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 inspection, or faulty materials and /or workmanship. CLOSETS BATH TUBE S 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 IM'O POOL CONTR. LIST _ - -. - .. ~ -.- CHECK MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING t"w.MIT j 1S Permit No Date_f /f � 4- c— ._ � 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- Y':___ 4 `,____ F#_a_ 4__',_ No.___/3� Location and Legal Description Lot__ ..... __Block Subdivision &Ted and Number where work is to be performed—No 40- 6. / tree Registered Architect and/or Engineer ..... . Employing Plumber's iff es No. .3./ P.;;;). Street State work to be performed and purpose of building (By Floors)____R.L - Zi a New Building Remodeling_____ Addition____ Repairs No. of Stories.. B-o Amount of Permit $ STATE OF FLORIDA, } COUNTY OF DADE. ( Signed)._ (Signed) Street___ C, /6/ _4 ye w._ /¢7j 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._.___ _._______ ___________ .......... of Soakage Pit Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts is 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. 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 inspection, or faulty materials and /or workmanship. MAYFLOWER SUPPLY CO., INC. 321 -355 N. E. 71st St. r 1 For Re insulation of Heater Hot Water. At 136.i. E. 101 St. For G.W. Parrott Miami 38, FIa. Tel. PL 4 -5433 DISTRIBUTORS OF MUELLER BRASS CO. STREAMLINE PRODUCTS FOR PLUMBING, HEATING AND INDUSTRIAL APPLICATIONS BUILDING ELECTRICAL PLUMBING ROOFING MIAMI SHORES VILLAGE, FLORIDA DATE //,' PERMIT N° 7075 Contractor License No. Work to be performed under this Permit Owner of Architect Contractor or Builder Cl"" .ti i • , if' . ei Legal Lot Description 1 B1 Address of Building d� CONTRACTOR OR BUILDER 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 knowledgq 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 1 ../ 4 • 1( Subdi- vision Value of Project INSPEC. 7 Amount of Permit $ BY AUTHORITY In consideration of the issuance to me of this permit I agree to perform the work covered hereu9aer in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submittedito 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. BUILDING ELECTRICAL PLUMBING y MIAMI SHORES VILLAGE, FLORIDA DATE/ -el 194 C. PERMIT N9 1314 Work to be performed under this Permit Owner of (Air Building ' - vrt Architect j Contractor or Builde Legal Lot Bl. Description /4. Subdi- vision Contractor's 0 2 . , License No. Building of / ldi g r / Value of Amt. of Y �' c Buildin / t Project 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 drawings or in the statements or specifications and that he assumes responsibility for work done by his agents, servants or employees: Signed• 46 .'".., ..- 11 9 el By INSPEC OR In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in cot pliance with all ordinances and regula- tions pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village In f � a a+ ccepting this permit I assume responsibility for all work done by either myself,, my agent, servant or employee. _„rte • j � + <_' i ^ r'.. • _LA", � ..— r Fes' « +� i/�.M�"1�r, , 10• i 1 _ q...01 , \ CONTRACTOR OR BUILDER t BY AUTHORITY s ■\ 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 Name Location and Legal Description Lot_ Nature of Water Supply: City —Well MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT MA __e_t-4 No. (!ate __. Street_ .2Jt. L ��.„-, / I / Street No. • Block ______i Amount of Permit $_ (Signed) Date_ Subdivision_ _- Street and Number where work is to be performed —No Street__ State work to be erformed and purpose of building (By Floors fa r -� S If ? P P P g( Y � )-- ' - - - - ' -� Y1d- 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 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 su public notic .'r notices as a re required by the Act. The under signed agrees to employ only such sub - contractors, f n work to' be pe ormed' under '. ; a r rmi�, as � e / licensed by Miami Shores Village. � ' �� 9 % � ' - � /' % 1) j / A —1. ---- isiiasts t. SS. My Commission Expires (Signed) STATE OF FLORIDA, COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally Notary Public, State of Florida 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 be 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 TOTAL FIXTURES CONTR. LIST CHECK i i , - - . SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SWIM'G POOL _.ONTR. LI ST 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 Name Location and Legal Description Lot_ Nature of Water Supply: City —Well MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT MA __e_t-4 No. (!ate __. Street_ .2Jt. L ��.„-, / I / Street No. • Block ______i Amount of Permit $_ (Signed) Date_ Subdivision_ _- Street and Number where work is to be performed —No Street__ State work to be erformed and purpose of building (By Floors fa r -� S If ? P P P g( Y � )-- ' - - - - ' -� Y1d- 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 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 su public notic .'r notices as a re required by the Act. The under signed agrees to employ only such sub - contractors, f n work to' be pe ormed' under '. ; a r rmi�, as � e / licensed by Miami Shores Village. � ' �� 9 % � ' - � /' % 1) j / A —1. ---- isiiasts t. SS. My Commission Expires (Signed) STATE OF FLORIDA, COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally Notary Public, State of Florida 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 be 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. . 5 ly STATE OF FLORIDA, 1 as. COUNTY OF DADE. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Amount of Permit $_ (Signed) My Commission Expires (Signed) • Street 44, 1F 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 ccYrtplied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. (1 No .{ �,,,,I ___. Street Subdivision_ c /7 do Notary Public. State of Florida Owner's Name and Address Registered Architect and /or Engineer _ Employing Plumber's Name No. Location and Legal Description Lot__ /• Block Street and Number where work is to be performed —No State work to be performed and purpose of building (By Floors) ___Q____ New Building Remodeling Addition ''� Repairs No. of Stories Street 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. 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 performed under this permit; and will post or cause to be posted for inspection on th . ite of the work su public notice r notices as required by the Act. The under signed agrees to employ only such sub - contractors, .n work t be pe rme under a t 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- ipspection is made necessary by improper notice for inspection, or faulty materials and /or workmanship. CLOSETS BATH TU BE 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 SWIM'G POOL • CONTR. LIST CHECK Permit No. . 5 ly STATE OF FLORIDA, 1 as. COUNTY OF DADE. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Amount of Permit $_ (Signed) My Commission Expires (Signed) • Street 44, 1F 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 ccYrtplied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. (1 No .{ �,,,,I ___. Street Subdivision_ c /7 do Notary Public. State of Florida Owner's Name and Address Registered Architect and /or Engineer _ Employing Plumber's Name No. Location and Legal Description Lot__ /• Block Street and Number where work is to be performed —No State work to be performed and purpose of building (By Floors) ___Q____ New Building Remodeling Addition ''� Repairs No. of Stories Street 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. 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 performed under this permit; and will post or cause to be posted for inspection on th . ite of the work su public notice r notices as required by the Act. The under signed agrees to employ only such sub - contractors, .n work t be pe rme under a t 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- ipspection is made necessary by improper notice for inspection, or faulty materials and /or workmanship. Employtng PlumbWs Name ROSE. p l i c ., -... .- P.O.Box 344 Hialeah 33011 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) . 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 Maude Murray N 1 6 N - F _ ,, .O, j„ St Registered Architect and /or Engineer My Commission Expires MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT (Signed) (Signed) Street. New Building ..__._-------- ........ -__ Remodeling __ Addition -. - - -- .- __ -.... Repairs No. of Stories. ......... Size Septic Tank_._ Type of Tank Feet of Drain Tile Dist. Feet of Tank or Drain Field frosn Well Nature of Water Supply: City —Well. Size of Soakage Pit. .Capadty The undersigned applicant for this building permit does hereby certify that he understands and accepts his obli ons as an employer of labor under the Florida Workmen's Compensation Act, being Section 5988, Compiled General Laws of Florida Perin 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 be performed under this permit, as are licensed by Miami Shores Village. Notary Public, State of Florida Plum . ing tor. Master Plumber. STATE OF FLORIDA, s. 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 dep oses 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 same, and that all facts therein by him stated are true. NOTE: A re- inspection fee of $1.00 will be made wits smolt miuspeodon V meth'naowaey by improper notice for inspection, or faulty materials and /ar walmsanship. CLosErs BATH Tue. 15""" LAVA TORIIa am" SLOP SINK• LAUNDRY Tua• URINALS CATCH BASIN FLOOR DRAIN DRINK NO FOUNT •NS TOTAL PI CONTR. LIST CHICK SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DUMP WELL SPRKLIII 8 SWIH'O POOL CONTR. LIST 1 25' -$4 . M. `-- CHECK Employtng PlumbWs Name ROSE. p l i c ., -... .- P.O.Box 344 Hialeah 33011 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) . 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 Maude Murray N 1 6 N - F _ ,, .O, j„ St Registered Architect and /or Engineer My Commission Expires MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT (Signed) (Signed) Street. New Building ..__._-------- ........ -__ Remodeling __ Addition -. - - -- .- __ -.... Repairs No. of Stories. ......... Size Septic Tank_._ Type of Tank Feet of Drain Tile Dist. Feet of Tank or Drain Field frosn Well Nature of Water Supply: City —Well. Size of Soakage Pit. .Capadty The undersigned applicant for this building permit does hereby certify that he understands and accepts his obli ons as an employer of labor under the Florida Workmen's Compensation Act, being Section 5988, Compiled General Laws of Florida Perin 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 be performed under this permit, as are licensed by Miami Shores Village. Notary Public, State of Florida Plum . ing tor. Master Plumber. STATE OF FLORIDA, s. 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 dep oses 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 same, and that all facts therein by him stated are true. NOTE: A re- inspection fee of $1.00 will be made wits smolt miuspeodon V meth'naowaey by improper notice for inspection, or faulty materials and /ar walmsanship.