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269 NE 100 St (3)r._ Date Legal Description j� Own r�/Lessee / Tenant p Da r ban Owner's Address Q '7 / 60 St Contracting Co. , I ('ti-- Qualifier 1 n;5 , , kIL,. State # C_Rt ('1S { %*0 Architect/Engineer Bonding Company Mortgagor Address Permit Type (circle one): BUILDING ELECTRICA WORK DESCRIPTION A /g_ 64.7 e / cL 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. O 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 L.A6(11. Notary as to Own o ondo President My Cor tt n p rfe G tr S mu ►owltY PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Job Address avg &l G • j Tax Folio //—' 3.9 % Q� 4 1-69b Historically Designated: Yes No C EXPIRES MAY 19, 2000 ° ra ? !� COMMISSION # CC 555898 f OF - 9'}TLANTIC BOND NG CO., INC. FEES: PERMIT 35 RADON AP" ROVED: Municipal # Competency # Address Address ndo President Date 4( Date Building Plumb' ,. �►� ► Master Pennit # 9 r / p 6 2._ Phone" / `� / — D r 9 c4 Address 8Z ) SS# hone 306- 75 / Ins. Co. LUMBING ECHANICAL ROOFING PAVING FENCE/SIGN 20 C.C.F. 1.. NOTARY Electrical / / 0V o 0 Signature of Conttor or Owner- Builder rer- Builder Date My Commission ExpireWi'4 E. Millie Oratz- SmulowItz � COMMISSION # CC 555898 ,� Q tr EXPIRES MAY 19, 2000 OF Rl ATLANTIC BONDING CO., INC. 3 oc? TOTAL DUE 3 3 G• 20 BOND -2/3 Date Engineering CONSTRUCTION PERMIT FOR: New System , Existing System ] Y [ ��' g stem Y [ y ) Repair [ J Abandonment APPLICANT: PROPERTY STREET ADDRESS: LOT: BLOCK: T A N •K ] ] ] L D FILL REQUIRED: STATE OF FLORIDA DEPARTMENT OF HEALTH ONSITE SEWAGE DISPOSAL SYSTEM CONSTRUCTION PERMIT Authority: Chapter 381, FS & SPECIFICATIONS BY: APPROVED BY: DATE ISSUED: SYSTEM DESIGN AND SPECIFICATIONS 0 T a. 'places HRS -H Form 4016 [page 1) which may be used) ' -001. 1016 -0) TITLE: 6. Chapter 10D- 6,.FAC [ 'V] olding Tank (�' ) Temporary /Experimental [ d)'Other(Specify) AGENT: ///2. //L1 ,SUBDIVISION: PROPERTY ID A�: . p / TOWNSHIP /RANGE /PARCEL NUMBER] :tOR'TAX ID NUMBER) SYSTEM MUST BE CONSTRUCTED IN ACCORDANCE WITH SPECIFICATIONS AND STANDARDS OF CHAPTER 10D -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 TANK /AEROBIC UNIT CAPACITY MULTI- CHAMBERED /IN SERIES:[ ) [GALLONS / GPDJ CAPACITY MULTI- CHAMBERED /IN SERIES:[ ] GALLONS GREASE INTERCEPTOR. CAPACITY [MAXIMUM CAPACITY SINGLE TANK: 1250 GALLONS] GALLONS PER DOSE DOSING TANK CAPACITY DOSE-RATE [ ] PER 24 HRS NO. OF PUMPS: [ ] D [ ] SQUARE FEET PRIMARY DRAINFIELD SYSTEM R [ ] SQUARE FEET SYSTEM A TYPE SYSTEM: [ ] STANDARD [ ] FILLED [ ] MOUND I CONFIGURATION: [ ] TRENCH [ °"] BED ( ] N F LOCATION OF BENCHMARK: I ELEVATION OF PROPOSED SYSTEM SITE (`l/ '/J [INCHES /FT) [ABOVE /BELOW] BENCHMARK /REFERENCE E BOTTOM OF DRAINFIELD TO BE [ e.<? ] [INCHES/FT) [ABOVE /BELOW1 BENCHMARK' /REFERENCE INCHES EXCAVATION REQUIRED: [`�,' 1 INCHES TITLE: PERMIT # DATE PAID -7 FEE PAID $ _��' "mac^ RECEIPT ,f` [ EXPIRATION DATE: POINT POINT CHID Page 1 of 2 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 /pai,;el number.) SYSTEM DESIGN AND SPECIFICATIONS: TANK: Minimum specifications from Chapter I0D -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. 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. APPLICANT: LOT: 20 PROPERTY ID #: /1- 3 - - 0/3 -'/6 y � BLOCK: TO BE COMPLETED BY ENGINEER, HEALTH UNIT EMPLOYEE, OR OTHER QUALIFIED PERSON. ENGINEER'S MUST PROV IDE REGISTRATION NUMBER AND SIGN AND SEAL EACH PAGE OF SUBMITTAL. COMPLETE ALL ITEMS. BENCHMARK /REFERENCE POINT LOCATION: THE MINIMUM SETBACK WHICH SURFACE WATER: /00 FT WELLS: PUBLIC: FT BUILDING FOUNDATIONS: - SOIL PROFILE INFORMATION SITE 1 SITE EVALUATED BY: STATE OF FLORIDA DEPARTMENT OF HEALTH ONSITE SEWAGE DISPOSAL SYSTEM SITE EVALUATION AND SYSTEM SPECIFICATIONS I� C� Jj SUBDIVISION: Munsell # /Color Texture y - Depth to 2 6/'n<a/ 5414 4 ...;)' to —� to USDA SOIL SERIES: to to to to to OBSERVED WATER TABLE: c [ABOVE / ESTIMATED WET SEASON WATER TABLE ELEVATION: HIGH WATER TABLE VEGETATION: [ ] YES [\/] NO DH 4015, 10/96 (Replaces HRS -H Form 4015 [Page 3] which may be used vl �y (Stock Number: 5744 - 003 - 4015 -1)' '� AGENT: 4000j /10,„ $I,r)r2 S c? es. B [Section /Township /Range /Parcel No. or Tax ID Number] PROPERTY SIZE CONFORMS TO SITE PLAN: [ ] YES NO NET USABLE AREA AVAILABLE: ACRES TOTAL ESTIMATED SEWAGE FLOW: . 3 -- 6 GALLONS PER DAY [RESIDENCES -TABLE 1•/ OTHER -TABLE 2) AUTHORIZED SEWAGE FLOW: To 0 GALLONS PER DAY [1500 GPD /ACRE OR 2500 GPD /ACRE] UNOBSTRUCTED AREA AVAILABLE: 5 O SQFT UNOBSTRUCTED AREA REQUIRED: 7 O eD SQFT ELEVATION OF PROPOSED SYSTEM SITE IS ' /FT] [ABOVE /BELOW] BENCHMARK /REFERENCE POINT ' SITE SUBJECT TO FREQUENT FLOODING: [ ] YES [4 NO 10 YEAR FLOODING? [ -] YES b<rNO 10 YEAR FLOOD ELEVATION FOR SITE: FT MSL /NGVD SITE ELEVATION: r- 7,75 FT MSL /NGVD CAN BE MAINTAINED FROM THE PROPOSED SYSTEM TO THE FOLLOWING FEATURES: DITCHES /SWALES: /2 ,0 FT NORMALLY WET? [ ] YES 14 LIMITED USE: ,--( 4>- FT PRIVATE -r-- FT NON- POTABLE: FT FT PROPERTY LINES: ,gLo FT POTABLE'WATER LINES: / LL_,FT 0,n SOIL TEXTURE /LOADING RATE FOR SYSTEM SIZING: DRAINFIELD CONFIGURATION: [ ] TRENCH [X] BED [ REMARKS /ADDITIONAL CRITERIA: %% a , 7 5 — �f S ee` - SOIL PROFILE INFORMATION SITE 2 PERMIT ,O` ? Munsell # /Color Texture Depth to to USDA SOIL SERIES: to to to to to to to BELOW] EXISTING GRADE. TYPE: [PERCHED / APPARENT] INCHES [ ABOVE / BELOW ] EXISTING GRADE. MOTTLING: [ ] YES [ ] NO DEPTH: _1? INCHES DEPTH OF EXCAVATION: 30 INCHES ] OTHER (SPECIFY) DATE: c F10 VC� • / ' Page 3 cf 3 1 2 3 4 APPLICATION FOR: [ ] New System Repair AGENT: MAILING ADDRESS: STATE OF FLORIDA DEPARTMENT OF HEALTH ONSITE SEWAGE DISPOSAL SYSTEM APPLICATION FOR CONSTRUCTION PERMIT Authority: Chapter 381, FS & Chapter 10D -6, FAC BUILDING INFORMATION APPLICANT: DI A l v ddd> ✓) PROPERTY STREET ADDRESS: DIRECTIONS TO PROPERTY: APPLICANT'S SIGNATURE: Existing System [ ] Holding Tank [ ] Temporary /Experimental ] Abandonment [ ] Other(Specify) / 5G ? j l -t /)- % �32 TO BE COMPLETED BY APPLICANT OR APPLICANT'S AUTHORIZED AGENT. ATTACH BUILDING PLAN AND TO -SCALE SITE PLAN SHOWING PERTINENT FEATURES REQUIRED BY CHAPTER 10D -6) FLORIDA ADMINISTRATIVE CODE. PROPERTY INFORMATION [IF LOT IS NOT IN A RECORDED SUBDIVISION, ATTACH LEGAL DESCRIPTION OR DEED] I Cj7� LOT: BLOCK: SUBDIVISION: DATE OF r, j 31 1/Xrn i a�iOa��S cer° SUBDIVISION: PROPERTY ID #: In _ ...0/3 [Section /Township /Range /Parcel No.] ZONING: PROPERTY SIZE: X., ACRES [Sqft /43560] PROPERTY WATER SUPPLY: [ ] PRIVATE r PUBLIC //'/E / 5/ 57 o �� 1 4 '�= / d /'%d t / 5 7 /d h%U /2= r Unit Type of No. of No Establishment Bedrooms DH 4015, 10/96 (Replaces HRS -H Form 4015 [Page 11 which may be used) (Stock Number: 5744- 001- 4015 -1) [c] RESIDENTIAL [ ] COMMERCIAL 3 (35 o _5 Building Area Sqft (.2-R0 S L f C() 3 PERMIT # DATE PAID FEE PAID $ RECEIPT # DATE: e„ `^ TELEPHONE: `,5y 7:2_ # Persons Business Activity Served For Commercial Only [ ] Garbage Grinders /Disposals [ ] Spas /Hot Tubs [ ] Floor /Equipment Drains [ ] Ultra -low Volume Flush Toilets [ ] Other (Specify) Pagp 1 of 3 INSTRUCTIONS: 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, city, state and zip code mailing address for applicant or agent. LOT, BLOCK, SUBDIVISION: PROPERTY SIZE: Lot, block, and subdivision for lot (recorded or unrecorded subdivision). If lot is not in a recorded subdivision, a copy of the lot legal description or deed must be attached. DATE OF SUBDIVISION: Official date of subdivision recorded in county plat books (month /day /year) or date lot originally recorded. Dividing an approved lot into two or more parcels for the purpose of conveying ownership shall be considered a subdivision of the lot. PROPERTY ID#: 27 character number for property. (Health Department may require property appraiser ID# or section /township /range /parcel number.) Net usable area of property in acres (square footage divided by 43,560 square feet) 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. Contiguous unpaved and noncompacted road rights -of -way and easements with no subsurface obstructions may be included in calculating lot area. WATER SUPPLY: Check private or public. PROPERTY ADDRESS: Street address for property. For lots without an assigned street address, indicate street or road and locale in county. DIRECTIONS: Provide detailed instructions to lot or attach an area map showing lot location. BUILDING INFORMATION: Check residential or commercial. TYPE ESTABLISHMENT: List type of establishment from Table II, Chapter 1OD-6, FAC. Examples: single family, single wide mobile home, restaurant, doctor's office. NO. BEDROOMS: Count all rooms designed primarily for sleeping and those areas expected to routinely provide sleeping accommodations for occupants. BUILDING AREA: Total square footage of enclosed habitable area of dwelling unit, excluding garage, carport, exterior storage shed, or open or fully screened patios or decks. Based on outside measurements for each story of structure. k PERSONS: Number of persons residing, using, or working in establishment. For residential establishment, 2 persons per bedroom are assumed. BUSINESS ACTIVITY: For commercial applications only. List number of employees, shifts, and hours of operation, or other information required by Table II, Chapter IOD -6, FAC. FIXTURES: Mark each listed fixture with number installed or "NA" if not applicable. SIGNATURE: Signature of applicant or agent. Date application on day submitted to Health Department with appropriate fees and attachments. ATTACHMENTS: A site plan drawn to scale, showing boundaries with dimensions, locations of residences or buildings, swimming pools, recorded easements, onsite sewage disposal system components and location, slope of property, any existing or proposed wells, drainage features, filled areas, obstructed areas, and surface water. Location of wells, onsite sewage disposal systems, surface waters, and other pertinent facilities or features on adjacent property, if the features are with 75 feet of the applicant lot. Location of any public well within 200 feet of lot. For residences, a floor plan (residences) showing number of bedrooms and building area of each unit. For nonresidential establishments, a floor plan showing the square footage of the establishment, all plumbing drains and fixture types, and other features necessary to determine composition and quantity of wastewater. Scale: Each block represents 5 feet and 1 inch = 50 feet. I 11 11 !1 11 ii 1 i - ii 11 i +l _1 1- 111 id( _1 -1 j.1 - i J - I Ci 1 - � i Y I nl lnl - ; II u I I I-1 _ 1 _( I C1 I II! 1 1 1 1 1 i" 1 1 -1 I I - II 1 I lL 1 1 _ . 1 I Notes: I I _ _____11 11 I_j1 _LL1_ I 1 1 1 1 I I ' - 1 -- E �- I I!1 1111! I IIII11 J I I -1 I 1 - -I I I I dill Illliiii I!'! 1 I __ ___I_ I_ I. 1 _I1 p_ 11 _l_1 III 11 _ 1_I_ II_' I I I I L_ I I 1 1 I_I 1_1_1 1_I - I 11 1 1 1 1 I II !11 1 1 I I 1 1 - 1 17 ! 1 1 1 I I 1 " 1 f 1 1. III ) _I _ I I _ I I I I _I LI ' 1 1 I I I 1 1 1 I 1 I 1 I I _ - ; ' LI I I I it LI I I I I - 1 I L[I 11 _I __ 1O i I I 1 1 1 1 I _ I i t 1 1_ 1_ I I_ I I _1 1 ' - I III L1 I I _ _1_ 1_1 1 1 !- 1 1 1_1_1 1 _I Ii i i_i_i i_i i_i_ _i i 1 1 1 1 I i 1 : I ( I I_ _ _ I I 1- _ _ _ _ _ 1 ' 1 L_I_I _i 1_.I_ I ____ -I iI l l - [ 1= I I I 1I1 II 1 1 1 1 I I I I I i I I l I _ 1_I - ILI _1_ 1 I_I ' 1 11 ,_ C I I I I I Tip{ I� _ [ 1 11_1 - - I ! - tl hI j _ I I _ II I I _ I_I 1 I I_ I 1_ I _ I_I_ _ __I 1 I_ hI_',_L_ I 1 '. l - I_I_I_I_I_l - -1 _ ^I _ -( 1_, _LEI_I_._I U _1. . I_L1 '_ �J_ I_1 _1 _ ,. 1 II_ _i_I_I I I 1 1_I_ _I_I I_I_,._I i I - - I_I_I_I_1 I I_I I 1_I -1 - 1 I II! ' I' I1 I 1 I - I _I_I_ I I ) II I1 1I! I III 1_� 1f I. 1 _I _ I - IJ _ ( _ _ _ II I ( I I ' � ! I I II I � ' Site Plan submitted by: Plan Approved By DH 4015. 10/96 (Replaces HRS-H Form 4015 which may be used) (Stock Nur ber: 5744- 002 - 4015.6) STATE OF FLORIDA • DEPARTMENT OF HEALTH APPLICATION FOR ONSITE SEWAGE DISPOSAL SYSTEM CONSTRUCTION PEW? z� Permit Application Number ®' PART II - SITE PLAN 111illl, igna ure Not Approved I I I' 1 11 11, J1 1 I I 1 i 1 1_L _ 1 1 ! l _ I I- I l 1 1 _ 1 1 11 I - 1 _ 1 Z _ I - 1 I - __ I _ I _ I _ I' I ' I - - -- ' 1 -- Illllli IIIIII ! __1_1 I_ I I 1 1 1 1 y l I _ - 1 I 1 1 1 I II 11I I 1 1 1 1 I1 1 1 11 1 1 . 11' 11 1111 1!I li'1 ALL CHANGES MUST BE APPROVED BY THE COUNTY HEALTH DEPARTMENT -( 8r III III I �: 1 . -I ! I 1 I I I! j 111 I I 1 1 1 I II I - El ! _ I 1 I- - 11]11 1 1 1 1 - CC I - Cl Ii II ( _ i_ I_ I_I_� 1=1-1- - I I.1 I I� I II IIIIIli II1 111111 IIIIIIII -i. 11! l 1 II I 1 1 1 1 1 1 - I - I -4 _ I - J. 1 _I I I- 1__ -1_1 -I_1 I_I- ' - -I_I- ! i 11 _i__ I_i I ! _I_1 I I_ -I- I I I_i_ 11 11111 1 I I _ I _ I LI_I_I I l _I_1 I I I i 1 1 I I 1 1 1 I I I _ _ _ _1_1_17-1 i 1 1 1_1 -- 1_1_1 f 1_I_I 11 _ I. 1 1 I 1 1 _ 1 _1 I I_I I , I_ 1 1 1 1 - I i_II I I _I 1 1 _ i_I_I_I I I I_ 11 1 1_I I I_ I I� (. _I L I_I I __ 1 !! I_I L 11 I - 1 I I I I I I :11 1 _1 - _i _ �1 -� 1 I 1 1 I I • 1 r i 1 1, 1 I I 1 t � 1 I 1 1 • 1 ( I I 1 III I I I I 1 1 - 1 _ I — ' _ _ 1 - - i - I _ I _ ; - 1 1 I - _ 1 1 I I III III!ILI� !11.11..1 1 1(11 :1 £ bd' ) eZ 05016) Title Date Z -G County Health Department Page 2 of 3 Pena': No. 0 MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Application is hereby madq for the approval of the detailed statement of the plans and specifications herewith submitted for the building or, other stractire 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 F• Parboux No 269 N. E. T00 Street Registered Architect and /or Engineer ---_----___--_-_------__ Employing Plumber's Name O'Neal Septic Tank Co.. No. 4145 N _ Street 22nd Ave. Location and Legal Description Lot __— _______ —_ ____._ _ _____ Block_ Subdivision Street and Number where work is to be performed —No. 269 N.. E. iOOth. $t.. Street State work to be performed and purpose of building (By Floors )__- _ -_ —dra_ € e-lf}-- -reley New Building _ Remodeling Addition ______._.______________. Repairs No. of Stories. Size Septic Tank- - -- Pi __ &N I ?, Tank_ Capacity Gals Feet of Drain Tile______ 2.5' bitlak_drailDist. Feet of Tank or Drain Field from Well Nature of Water Supply: City — Well.___----------- _______ .... of Soakage Pit Amount of Permit $ . ---- ----- — -- (Signed) _- Plum ing pector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his •lig: ions as an employer of labor under the Florida Workmen's Compensation Act, being Section 5988, Compiled General Laws of Florida P In • t Supplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub- contracto •loyed 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 : uch public notice or notices as . are required by the Act. The undersigned agrees to employ only such sub- contractors, on to be performed under this permit, as are licensed by Miami Shores Village. My Commission Expires (Signed) Nov.. 26 1962: Date Notary Public, State of Florida Master Plumber. STATE OF FLORIDA, t COUNTY OF DADE. j Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. NOTE: A re- inspection fee of $1.00 will be made when such re-inspection is made•necessary by improper notice for inspection, or faulty materials and /or workmanship. CLO$ET8 BATH TUBS SHOWERS LAVA. TORIES SINKS SLOP SINKS LAUNDRY TUBS URINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT'NB TOTAL FIXTURES CONTR. LIST CHECK SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SWIM'G POOL ELI; R. 25 t lock Relay _ CHECK Pena': No. 0 MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Application is hereby madq for the approval of the detailed statement of the plans and specifications herewith submitted for the building or, other stractire 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 F• Parboux No 269 N. E. T00 Street Registered Architect and /or Engineer ---_----___--_-_------__ Employing Plumber's Name O'Neal Septic Tank Co.. No. 4145 N _ Street 22nd Ave. Location and Legal Description Lot __— _______ —_ ____._ _ _____ Block_ Subdivision Street and Number where work is to be performed —No. 269 N.. E. iOOth. $t.. Street State work to be performed and purpose of building (By Floors )__- _ -_ —dra_ € e-lf}-- -reley New Building _ Remodeling Addition ______._.______________. Repairs No. of Stories. Size Septic Tank- - -- Pi __ &N I ?, Tank_ Capacity Gals Feet of Drain Tile______ 2.5' bitlak_drailDist. Feet of Tank or Drain Field from Well Nature of Water Supply: City — Well.___----------- _______ .... of Soakage Pit Amount of Permit $ . ---- ----- — -- (Signed) _- Plum ing pector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his •lig: ions as an employer of labor under the Florida Workmen's Compensation Act, being Section 5988, Compiled General Laws of Florida P In • t Supplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub- contracto •loyed 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 : uch public notice or notices as . are required by the Act. The undersigned agrees to employ only such sub- contractors, on to be performed under this permit, as are licensed by Miami Shores Village. My Commission Expires (Signed) Nov.. 26 1962: Date Notary Public, State of Florida Master Plumber. STATE OF FLORIDA, t COUNTY OF DADE. j Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. NOTE: A re- inspection fee of $1.00 will be made when such re-inspection is made•necessary by improper notice for inspection, or faulty materials and /or workmanship. Permit No Date � -d 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 E n Meer__ Employing Plumber's Name MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT No._ Location and Legal Description Street and Number where work is to be performed —No State work to be performed and purpose of building (By Floors)_ New B Remodeling_ Addition Repairs �— Nature of Water Supp Amount of Permit $ re Well (Signed) '' 2 Street./ _ ?:_ !_.. C/ No._____ ___L — Street _ 1 _ o" Subdivision Street__ / ©O Size Septic Tank — Type of Tanl' Capacity Gals. Feet of Drain Tile — _.__Dist. Feet of Tank or Drain Field from Well __Size of Soakage Pit The undersigned applicant for this building permit does hereby certify that he understands and acre • obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5986, Compiled General Laws of Flo ermanent 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. No. of Stories. My Commission Expires Notary Public, State of Florida umbing Inspector. Master Plumber. STATE OF FLORIDA, } as. COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. NOTE: A re- inspection fee of $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 TU85 SHOWERS LAVA- TORIES SINKS SLOP SINKS LAUNDRY TUBE URINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT'NS TOTAL FIXTURES CONTR. LIST CHICK - SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SWIM'G POOL CONTR. LIST CHICK Permit No Date � -d 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 E n Meer__ Employing Plumber's Name MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT No._ Location and Legal Description Street and Number where work is to be performed —No State work to be performed and purpose of building (By Floors)_ New B Remodeling_ Addition Repairs �— Nature of Water Supp Amount of Permit $ re Well (Signed) '' 2 Street./ _ ?:_ !_.. C/ No._____ ___L — Street _ 1 _ o" Subdivision Street__ / ©O Size Septic Tank — Type of Tanl' Capacity Gals. Feet of Drain Tile — _.__Dist. Feet of Tank or Drain Field from Well __Size of Soakage Pit The undersigned applicant for this building permit does hereby certify that he understands and acre • obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5986, Compiled General Laws of Flo ermanent 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. No. of Stories. My Commission Expires Notary Public, State of Florida umbing Inspector. Master Plumber. STATE OF FLORIDA, } as. COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. NOTE: A re- inspection fee of $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.__. r2J D 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 _____4119.4.42 ' I State work to be performed and purpose of building (By Floors) _ __ _. - -.. New Building ___- Remodeling _— _ .._ _— Addition Size Septic Tank._______ Feet of Drain Tile_—... Nature of Water Supply: City —Well. Amount of Permit $____------- .._.. ___________ My Commission Expires MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Size of Soakage Pit (Signed) _ (Signed)... Date____ le) 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 Ct ..... Street_ Street_ Subdivision Street Repairs No. of Stories Type of Tank Capacity Gals — __ __Dist. Feet of Tank or Drain Field from Well Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accept is obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida ennanent Supplement, and bus 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 are licensed by Miami Shores Village. Master Plumber. STATE OF FLORIDA, COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. 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 worlmtanahip. CLOUTS TUBE TUBS SHOWER! LAVA. Toms SINKS SINK{ SLOP LAUNDRY TUBS URINAL{ CATCH BASIN FLOOR DRAIN DRINKING FOUNT' N5 TOTAL FIXTURES CONTR. LIST CHECK SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SW IM'G POOL CONTR. LIST CHECK Permit No.__. r2J D 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 _____4119.4.42 ' I State work to be performed and purpose of building (By Floors) _ __ _. - -.. New Building ___- Remodeling _— _ .._ _— Addition Size Septic Tank._______ Feet of Drain Tile_—... Nature of Water Supply: City —Well. Amount of Permit $____------- .._.. ___________ My Commission Expires MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Size of Soakage Pit (Signed) _ (Signed)... Date____ le) 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 Ct ..... Street_ Street_ Subdivision Street Repairs No. of Stories Type of Tank Capacity Gals — __ __Dist. Feet of Tank or Drain Field from Well Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accept is obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida ennanent Supplement, and bus 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 are licensed by Miami Shores Village. Master Plumber. STATE OF FLORIDA, COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. 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 worlmtanahip. BUILDING ELECTRICAL PLUMBING Owner of Building. Architect Contractor r ws or Builder Legal Lot 'Description CONTRACTOR OR BUILDER MIAMI SHORES VILLAGE, FLORIDA DATE t` _. '�, .,.. 194-3 Contractor's License No. ilk. t • PERMIT N? 4783 Work to be performed under this Permit �►" ° = y,..� BL E Address of p• ems- `�' Value of / '( Amt. of R ,' g Building • t Project / Permit � " This permit is ranted to the contractor or 6uiider named above to construct the building or to install equipment or device described in the appli- cation herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any . plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes respon- sibility for work done by his agents, servants or employees. . Subdi- vision Signed • By INSPECTOR In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations 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 allrk don by • e m self a y agent, servant or employ ' ;. . ' r 4. 'Ns " A . 1 pA 1 .tip 3 BY AUTHORITY BUILDING ELECTRICAL PLUMBING Owner of Building Architect Contractor or Builder Legal Lot Bl. .t: • Description f �,b... Value of Address of % ! - _ +t. Project Permit Building 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 chan ed without authorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above assumti t e responsibility for a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on. the plans or dr wi s or in the statements or specifications and that he assumes responsibility for work done by his agents, servants or employees. , r Signed• i- By INSPECTOR In consideration of the issuance to me of this permit I agree to perform the w ork covered hereunder in compliance 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 acjeptin. this permiC I adsu*e resp for all work done by either myself, my agent, servant or employee. f / 1• f CONTRA OR OR BUILS `R 4r. MIAMI SHORES VILLAGE, FLORIDA e DATE 1944 Contractor's License No. PERMIT N9 2910 Work to be performed under this Permit . '`°'" to 4„ Subdi- vision Amt. of / .. P i t BY AUTHORITY JOB: -71/1 BUILDING BUILDING ELECTRICAL PLUMB ING • ADD: WORK DONE BY: REQUESTED The Following is ready for inspection:. Inspector's Report: - : WILL BE READY o BUILDING ELECTRICAL PLUMBING Contractor A or Builder Legal Description Lot MIAMI SHORES VILLAGE, FLORIDA DATE PERMIT N° 4783 Work to be performed under this Permi Owner of Building t Architect Bl. Subdi- vision Contractor's License No t � .4194A cfm‘kA.A--s.:-) Address of ' Value of C� A ,c Amt. of '� t (. ;) Building "y I 0 t ('•m `j . i „�.+""� This permit is ranted to the contractor or builder named above to construct the building or to install the uipment or device described in the appli- cation herefor in strict compliance with all ordinances pertaining thereto and w th the understanding that the work will be performed in compliance with any plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes respon- sibility for work done by his agents, servants or employees. • Signed. INSPECTOR By 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 p ns, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. r p In acce rig this permit 1 ssun e fponsi for a .oti k done by r myself, y agent, servant or employee. 0 CONTRA OR BUIL BY AUTHORITY Registered Architect and /or ginger Employing Plumber's Name___ No Street__ Location and Legal Description Lot Street and Number where work is to be performed —No Street State work to be performed and purpose of building (By Floors) New Building Remodeling Addition Repairs No. of Stories Permit No 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 . ti Owner's Name and Address 7 '___ Street "<Y as Nature of Water Supply: City —Well. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Block Size Septic Tank Type of Tank Capacity Gals._ Feet of Drain Tile -L. Dist. Feet of Tank or Drain Field from Well Size of Soakage Pit Amount of Permit $ ( Signed) CT A ' Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub- contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such sub - contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. (Signed)_ °_, Y I'' STATE OF FLORIDA, 1 j ss. COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared My Commission Expires Notary Public, State of Florida Subdivision Master Plumber. to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty materials and /or workmanship. CLOSETS BATH TUBS SHOWERS LAVA- TORIES SINKS SLOP SINKS LAUNDRY TUBS URINALS CATCH BASIN FLOOR DRAIN DRINKING 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'G POOL. CONTR. LIST CHECK Registered Architect and /or ginger Employing Plumber's Name___ No Street__ Location and Legal Description Lot Street and Number where work is to be performed —No Street State work to be performed and purpose of building (By Floors) New Building Remodeling Addition Repairs No. of Stories Permit No 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 . ti Owner's Name and Address 7 '___ Street "<Y as Nature of Water Supply: City —Well. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Block Size Septic Tank Type of Tank Capacity Gals._ Feet of Drain Tile -L. Dist. Feet of Tank or Drain Field from Well Size of Soakage Pit Amount of Permit $ ( Signed) CT A ' Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub- contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such sub - contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. (Signed)_ °_, Y I'' STATE OF FLORIDA, 1 j ss. COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared My Commission Expires Notary Public, State of Florida Subdivision Master Plumber. to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty materials and /or workmanship.