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321 NE 100 St (16)PERMIT APPLICATION FOR MIAMI SHORES VILLAGE 10050 N.E. 2nd Avenue • Miami Shores, Florida 33138.305- 795 -2204 Date C/i V/0 L Job Address 3 2 kC / ( A ) Tax Folio Legal Description �M p ) Historically Designated: Yes No Owner /Lessee/Tenet I" l \ . 1 L �� Master Permit # 2 (7 (- Z ' 4w% 131 j Owner's Address I Phone Contracting Co. — 1 - 1 - )1L017 P l— I., / Address q Z. if Sw / 0 1C-7 Qualifier t S l4" I U C 2 . j cc /) SS# Phone S r (._ L( 7 3 f State # r2 Fa ()4 30 3 Municipal # WORK DESCRIPTION: 110 I r i d ia1 1 — 1 -- u6 2 Signature of owner and/or Condo President Date Notary as to Owner and/or Condo President My Commission Expires Date /)�j FEES: PERMIT / ,8 RADON C.C. Competency # / 5 11_3 / ` 4u NOTARY Ins. Co. IF THERE IS NO PERMIT PACKAGE ACCESSIBLE ON THE JOB SITE FOR INSPECTORS TO VERIFY, THERE WILL BE NO INSPECTION. RE- INSPECTION FEE IS $50.00 AND MUST BE PAID IN ADVANCE BEFORE CALLING FOR ANOTHER INSPECTION. Permit Type (circle one): BUILDING ELECTRICAL ( PLUMBING ) MECHANICAL ROOFING I To (Li- 7 Square Ft. Estimated Cost (value) 2 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 ANY 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 all disciplines. OWNERS AFFIDAVIT: 1 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. BOND APPROVED: TOTAL DUE Zoning Building Electrical Mechanical Plumbing Structural Engineer Miami Shores Village 10050 NE 2nd Avenue Phone: 305- 795 -2204 Permit Number: PL2002 -309 Printed: 11/14/2002 Applicant: JAMES Owner: KNUTT JOB ADDRESS: 321 NE 100 Contractor TOLEDO PLUMBING COMPANY Local Phone: Parcel # 1132060135350 )000 X0,00 Total Fees: $8O Total Receipts: $0.00 Permit Status: APPROVED Permit Expiration: 5/13/2003 Work: ADDITION 1 SHOWER, 1 TUB 2 LAV 1 W/H 1 TOILET If there is no permit package accessible on the job -site for inspectors to verify, there will be no inspections. Re- inspection fee is $50.00, which must be paid in advance before calling for another inspection. �}. 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 O 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 ondition 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 regulati .ns 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 •r employees. Signe Prfr:uance i/� (INSPECTOR) BY: Oo In co ' 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 pia , 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: Plumbing Permit KNUTT JAMES ST Contractor's Address: 4211 SW 107 CT Construction Value: $2,000.00 Page 1 of 1 Legal Description: MIAMI SHORES SEC 1 AMD PB 10 -70 LOTS 15 & 16 BLK 39 LOT SIZE REC C01 112102 1501 MC401 002912 CASH $120.00 (Contractor or Builder) BY: CONTRACTOR Name A( f )4,( v tnr ��1 Name O o 1 ` Tit Home Telephone License No. , (5e. OS ll J Business Telephone Address \ %Ao r�ic, m i F l N Fax Telephone nya5 (Jq 12_ J / � Fax ( hi< �+� ss V jJ I Qualifier Name R \ exp.() id C 1 b i' PROPERTY OWNER Name A( f )4,( v tnr ��1 Address 321 8 s E. ICU 5-- Home Telephone , J ^ . 3 39 Business Telephone License No 1 10 1 4 Fax ENGINEER Name E i` s i tpzs . r4 (s,1r.+ License No. (4 2. y S 7 v Address 262 f Qo04t.p5 nub IM1AC'I -st p(-. 33133 Telephone - 7 b S p/� . c3 4 J ? Fax 3 px • C (t 7,5" ARCHITECT New Construction Name M A C diii, 03 cut_ 1 Alteration Exterior License No 1 10 1 4 Repair Address 3? 3 m c 5 LA° 1Nt141 -x..r SIM t F 3 31 b Telephone 3 o J - 7. r i • 13 i Relocation of Structure ! € Fax 1 u • 7 ST. 1 “C Foundation Only TYPE OF MANAGEMENT (✓ ) New Construction Enclosure Alteration Exterior Repair Alteration Interior Demolish Relocation of Structure Shell Only Foundation Only Add'I Attachment Other Add'l Detachment Other INSTRUCTIONS - The following steps must be taken to obtain a permit from the Miami Shores Village: Step I. Complete the attached permit application which must be signed by the property owner and qualifier. Both signatures must be notarized. Please print or type to allow for a more accurate processing of your application. If roofing work will be done, a roofing application must be submit- ted along with this permit application. Step 2. Submit the completed application with all necessary documents to the Building, Planning and Zoning Department for processing. During the processing of your application, you may be asked to submit additional information. APPLICATION Job Address: , IAt U 40 Address Apt. City !!11 State Folio Number Description of Worki V' [ 5 ( U r • 1 Lot 1 S • t ` Block ?j Subdivision y'1 S *1 PB 10 � PG ` ` Current Use of Property V 4 t tr av µY Proposed Use of Property `� Tenant Information t'Y'\ i4 PERMIT TYPE (✓ ) Building Electrical Mechanical Plumbing LPGX Roofing Fence Other PERMIT CHANGE (✓ ) Chg. Contractor Renewal Revision Extension Supplement Reinspection PERMIT APPLICATION Master Permit No. 8P 2 - 2 3 Subsidiary Permit No. Flood Zone Base Floor Elev. 3313e. Zoning Linear Feet Square Feet Units Floors Value of Work (11. S Bldg Value Tax Assessed/Appraised Value SECTION BY DATE Zoning Electrical 4�6 Mechanical Plumbing f' N r`L Fire Public Works Structural Building Official Page 4 OFFICE USE ONLY CIIECKLIST O OWNER - BUILDER FORM (Attach) ❑ FIRE DEPARTMENT APPROVAL (Commercial / multi - family) ❑ CONCURRENCY (New Construction) ❑ OTHER (Specify & Attach) $3.00 per page (Scanning Fee) Miami Shores Village Bond Metropolitan Dade County (C.C.F.) $ Inspector State Educational Fund $ State DCA (Radon) $ Code Enforcement Fine Zoning Review Notary REVIEWED AND PREPARED BY: ❑ PROOF OF OWNERSHIP (Attach) O }IRS / DERM APPROVAL (Septic / Sewer) ❑ IMPACT FEE (New Construction) ❑ OTHER (Specify & Attach) PERNII'I' FEES $ (Xq..ftt. = x/1000 (¢.005 /sq.ft.) (¢.01 /sq.ft.) PERMIT APPLICATION ❑ CONDO ASSOCIATION APPROVAL (Attach) ❑ BPR APPROVAL (Restaurants) ❑ CONTRACTOR REGISTRATION (On File) TOTAL $ ISSUING OFFICIAL DATE: CONDITION OF APPROVAL Revised July 2001 10050 N.E. 2ND AVE., MIAMI SHORES, FL • (305) 795 -2207 • FAX (305) 756 -8972 • http : / /www.miamishoresvillage.com CONTRACTOR BY Name GQN‘, e DATE License No. ( - 1, r5 c O 7 I O Zoning Address s iq `i) UJ (oC-F N- 1'a'1ianlI 1=1 . Telephone ,3i05)�75. al t JJ `1 Fax / oicq C V ? C J / , Qualifier Name p. \ e /�U to cool SECTION BY License No. 44 2 4 S y DATE Telephone 3 tS S offs- r3 - -2171 f) z Zoning 1e) -- Repair Home Telephone _ .52 3 U Electrical / e / Address 3 / � 3 Ai Ce 9 Z O I't -.t s►/e s F. �,l'cv s Mechanical Plumbing °' //..--;', ; .. Fire Add'l Detachment Other Public Works Structural Building Official ENGINEER t. Name r%„ s 1 t 0.14 ..x/ ca. License No. 44 2 4 S y Address 2S Z ( 0ou4 -p5 nua►o 11'11 A "it pL- 33I33 Telephone 3 tS S offs- r3 - -2171 f) z C Fax 3 Ji' • q c �1jTJ PROPERTY OWNER New Construction Name % 1 ( � tr\ V �i+ ►`l Name MAVI.V.. G4 r`b p'3 (, . Address 321 I-E 1e) -- Repair Home Telephone _ .52 3 U I 9 Business Telephone Address 3 / � 3 Ai Ce 9 Z O I't -.t s►/e s F. 3 Fax 8 Telephone 3 0 - 7/1 .1t3 i ARCHITECT New Construction Enclosure Name MAVI.V.. G4 r`b p'3 (, . Alteration Exterior Repair License No. p ii 0 1 4 Alteration Interior Demolish Address 3 / � 3 Ai Ce 9 Z O I't -.t s►/e s F. 3 313 8 Telephone 3 0 - 7/1 .1t3 i Foundation Only Add'I Attachment , // Fax 3 u , 7 � g.44. Other Add'l Detachment TYPE OF MANAGEMENT (✓ ) New Construction Enclosure Alteration Exterior Repair Alteration Interior Demolish Relocation of Structure Shell Only Foundation Only Add'I Attachment Other Add'l Detachment Other Page 4 OFFICE USE ONLY CHECKLIST ❑ OWNER - BUILDER FORM (Attach) ❑ FIRE DEPARTMENT APPROVAL (Commercial / multi - family) ❑ CONCURRENCY (New Construction) ❑ OTHER (Specify & Attach) $3.00 per page (Scanning Fee) Miami Shores Village Bond Metropolitan Dade County (C.C.F.) $ Inspector State Educational Fund $ State DCA (Radon) $ Code Enforcement Fine Zoning Review Notary REVIEWED AND PREPARED BY: ❑ PROOF OF OWNERSHIP (Attach) ❑ HRS / DERM APPROVAL (Septic / Sewer) ❑ IMPACT FEE (New Construction) ❑ OTHER (Specify & Attach) PERMIT FEES (sq.ft. ) x/1000 (¢.005 /sq.ft.) (¢.01 /sq.ft.) PERMIT APPLICATION ❑ CONDO ASSOCIATION APPROVAL (Attach) ❑ BPR APPROVAL (Restaurants) ❑ CONTRACTOR REGISTRATION (On File) TOTAL $ ISSUING OFFICIAL DATE: CONDITION OF APPROVAL Revised July 2001 10050 N.E. 2ND AVE., MIAMI SHORES, FL • (305) 795 -2207 • FAX (305) 756 -8972 • http : / /www.miamishoresvillage.com INSTRUCTIONS - The following steps must be taken to obtain a permit from the Miami Shores Village: Step 1. Step 2. Submit the completed application with all necessary documents to the Building, Planning and Zoning Department for processing. During the processing of your application, you may be asked to submit additional information. APPLICATION Job Address: :J/,..I RE_ 100 s Address Apt. City !!11 State Zip Folio Number Description of Work "f V� [ 5 U r . `'_ Lot G � Zoning Linear Feet Current Use of Property v 4 t/� Ir 9a 1 ti) Square Feet Units Floors Subdivision Complete the attached permit application which must be signed by the property owner and qualifier. Both signatures must be notarized. Please print or type to allow for a more accurate processing of your application. If roofing work will be done, a roofing application must be submit- ted along with this permit application. 15 - t (. S*-1 Block ?j PB 10 PG Zb Proposed Use of Property Value of Work Tenant Information �n.IA + PERMIT TYPE (✓ ) Building Electrical Mechanical Plumbing LPGX Roofing Fence Other PERMIT CHANGE (✓ ) Chg. Contractor Renewal Revision Extension Supplement Reinspection Master Permit No. - EP 2C):32._-- C373 Subsidiary Permit No. �IQ 1 ry)os. 33a 3 q0 LL S Tax Assessed/Appraised Value PERMIT APPLICATION Bldg Value Flood Zone Base Floor Elev. ELECTRICAL - rvi.E Minimum Fee ()Ty. TV"PI: Dryer QTV. TYPE Outlet, Appliance QTV. TV I'i: Service Repair Q V. A/C Central 1 -3 Ton Dryer Vents, Number of Fan Ventilation, Cost Outlet, Wall Ductwork, Cost of Service, Temporary Periodic Inspections A/C Central 4 -7 Ton Fire Sprinkler System Fire Pump Outlet, Switch Fireplaces, Number of Signs A/C Central 8 -15 Ton Fixture - Fluorescent Oven Space Heater (kw) A/C Central 16-20 Ton Fixture Light Parking Lot Lights Spas/Hot Tubs A/C Central 20+ Ton Flood Lights Plugmold/Strip Subfeeds, No. of Amps A/C Window FPL - Load Central Posts Swim Pool, Commercial Air Conditioners Garbage Disposal Range/Range Top Swim Pool, Residential Chiller Generators, etc. Receptacles Switchboards Clear Violations Heat Recovery Refrigerator, Comm. (p/PH) Temp Serv., Construction Compactor Low -volt, Burglar Refrigerator, Domestic Temp for Test - 30 days Deep Freezer Low -volt, Fire Renew - Temp Service Water Closet Demolition Low -volt, Intercom/I'eleph. Repair Circuits Water Heater Dishwasher Low -volt, Television Service, Number of Amps Water Heater New MECHANICAL TYPE QTY. Minimum Fee TYPE QTV. Condensate Drain TYPE Generator QTV. TVPI: QT1". Refrigeration, Tons A/C Central, Tons Cooling Tower Heating Strips, each Vent Hood, Cost A/C Wall/Win. Tons Dryer Vents, Number of Paint Booth Ventilation, Cost Air Handler, Tons Ductwork, Cost of Piping, Flammable Liquid Periodic Inspections Barbecue Fire Sprinkler System Process/Pressure Piping Bath Fan - Vented, # Fireplaces, Number of Pressure Vessel PLUMBING TYPE A/C Condensate QTY. TYPE Drains, Roof QTV. TYPE Miscellaneous Fixture QTV. TYPE Soakage Pit QTV. Bath Tub Drinking Fountain Miscellaneous Repairs Solar Water Heater Bidet Filter Replace Pool Piping Sprinlder Repair Cap - Fixture Fountain Pump and Abandon Sprinkler System Cap - Water Gas - Appliance Pump, Domestic Supply, AC Well Cap - Sewer Gas - Natural Pump, Fire Stand Temporary Toilet Catch Basin Gas - Propane Pump, Re- circulate Temporary Water Closet Clothes Washer Gas Piping Pump, Replace - Pool Urinal Dental Chair Grease Trap Pump, Sprinkler Utility - Sewer Discharge Well Ice Maker Pump, Sump Utility - Water Dishwasher Indirect Wastes Relay Repair Vacuum Pump Disposal Interceptor Roof Inlet Water Closet Domestic Well Laundry Tray Septic Connection Water Heater Drainfield, 4" Tile/Res. Lavatory Septic Tank Water Heater New Drains, Area Meter Set (Gas) Sewer Connection Water Re -pipe Drains, Floor Minimum Fee Shower Water Service Drains, French Miscellaneous Equipment Sink Well, Supply Page 2 IMPORTANT NOTICES DO NOT BEGIN ANY WORK WITHOUT HAVING RECEIVED YOUR VALIDATED PERMIT AND PERMIT CARD. Applying for a permit does not grant the right to begin construction. HOURS OF CONSTRUCTION are limited to: Monday through Friday from 7:30 a.m. to 6 :00 p.m., and Saturday from 8:00 a.m. to 5:00 p.m. No inspections will be conducted on weekends or holidays. 2. All construction of demolition areas MUST BE MAINTAINED IN A CLEAN, NEAT AND SANITARY CONDITION free from construction debris. 3. STREETS AND NEIGHBORING PROPERTIES SHALL BE KEPT FREE FROM DIRT AND DEBRIS. 4. SWALES MUST BE PROTECTED FROM BEING DAMAGED BY EQUIPMENT OR VEHICLES, AND MAY NOT BE USED FOR STORAGE. A bond is required for work in or near the street/sidewalk. 5. CONSTRUCTION TRAILERS ARE PROHIBITED ON SINGLE FAMILY RESIDENTIAL CONSTRUCTION SITES. Other construction may have a trailer which requires a separate permit. 6. PORTABLE TOILETS for a construction site require a separate permit. 7. DO NOT DISCHARGE WATER INTO THE RIGHT OF WAY OR STORM DRAINS without approval from the Building, Planning and Zoning Department. 8. EQUIPMENT AND MATERIALS SHALL BE STORED at least 10 feet from the edge of pavement. 9. Department of Health and Rehabilitative Services (HRS) approval is required for applications involving septic tanks. Department of Environmental Resources Management (DERM) and/or Miami -Dade Water and Sewer Department (MDWASD) approval is required for applications involving sewers. AFFIDAVIT - Please read carefully. Application is hereby made to obtain a permit to do work and installation as indicated. I, the OWNER of the property, 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, POOL, EXTERIOR DOOR, MECHANICAL, WINDOW, FENCE, DRIVEWAY, ROOFING and SIGNS and there may be additional permits required from other governmental agencies. I, the OWNER of the property, have disclosed all information related to any work at the property performed in the prior twelve months to the Building Official. Further, I am fully aware that if the cumulative cost of work to my home or business under this and any other permit equals or exceeds fifty percent (50 %) of the fair market value of the structure, the entire structure must meet the present federal flood criteria for finished floor elevation. I am also fully aware that if the total cost of work to my home or business under this and any other permit exceeds fifty percent (50 %) of the replacement cost of the structure, then the entire structure must conform to the current code requirements of the Building Code. WARNING TO OWNER: Your failure to record a NOTICE OF COMMENCEMENT may result in you paying twice for improvements to your property. If you are spending more than $2,500 or intend to obtain financing, you may wish to consult with your attorney or lender before recording your Notice of Commencement. The Notice of Commencement must be recorded at: 22 N.W. 1st Street, 1" Floor, (305) 679 -1078. Once recorded, the Notice of Commencement must be POSTED AT THE JOB SITE in accordance with Section 713 -35 of Florida Statutes. Review the brochure at Village Hall on Construction Lien Law and Choosing a Contractor. STATE OF FLORIDA, COUNTY OF MIAMI -DADE Signature of Owner Print Name Sworn to and subscribed before me this day of Signature of Notary Public - State of Florida SEAL: STATE QF Sign altdr of5on r / Qualifier / 72 PERMIT APPLICATION SEAL: OUNTY OF MIAMI -DADE Print Name Sworn to and subscribed befs me this - 62 day of (' © 6 2 Iglesias III Nancy g D1 17024 ::: --t� Com misstooblnay 1 2006 , fires � � azu re of No . lic - State o F6� -4' Atlantic Bonding Co.,lnc• 'Inu%%` Personally known OR, Produced Identification Personally known // Produced Identification Type of Identification Produced: Type of Identification Produced: Page 3 PERMIT APPLICATION INSTRUCTIONS: Please indicate the type of work being performed and quantity(ies) in the space provided below. RECEIVED AND REVIEWED BY: DATE: Date /�-�G' 6 Z Legal Description Owner /Lessee/Tenet ▪ . .•. • .•. .. .. • . . .. .. • PFRNIITAP..PLZCATI ©N FOR MIAMI SHORES VILLAGE • • • ... • • • 10050•1 •dd Avenge %Miami Shores, Florida 33138.305- 795 -2204 Job Address f /1i�. ✓e O•Z! • • • • • .• • • • • • • • • • • • • • • • • • • Krt/ u 7T •. . . • .. •.• •. • . . . • . • •• • Owner's Address 3 D- / " • � ; 4;0:; /, 6 ; Tax Folio Historically Designated: Yes No Master Permit # Q p o D d �= / 3) 3 Phone r .. • • • • • ••• •• p Contracting Co. W , TT3 z Le /C. tic- Address / 71' t 3 U F _ Qualifier C!J + C'OV - - LE . SS# State # IF THERE IS NO PERMIT PACKAGE ACCESSIBLE ON THE JOB SITE FOR INSPECTORS TO VERIFY, THERE WILL BE NO INSPECTION. RE- INSPECTION FEE IS $50.00 AND MUST BE PAID IN ADVANCE BEFORE CALLING FOR ANOTHER INSPECTION. Permit Type (circle one): BUILDING r 1&j f 4 Signature of owner and/or Condo President Notary as to Owner and/or Condo President My Commission Expires Municipal # G /4L Phone.3AS) SW :3 3 7 aL Competency #GL /64 O /7 Ins. Co. L PLUMBING MECHANICAL ROOFING WORK DESCRIPTION: ' ° 1 rr /O N N w E t��t /G� Ce Square Ft. Estimated Cost (value) 9000 D v 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 ANY 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). 1 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 all disciplines. OWNERS AFFIDAVIT: 1 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. /2 --16-6 Date Sigyffture of Contractor or Owner Builder Date Date Notary as to Contractor or Owner Builder My Commission Expires Date FEES: PERMIT PO RADON C.0 APPROVED: TOTAL DUE Zoning Building Electrica Mechanical Plumbing Structural Engineer NOTARY BOND The Sunshine State LICENSE NOISES G524420 -38 -224 -0 JUAN GONZAL.EZ 470W 88PL. HIAL EAH, R. 83012.1228 MOH SEX HOT. REST. MORSE. 06 -24-38 M 607 A MUSS EIO'IRES oUPUMTE 0622-00 06-24-08 00-0640 SAFE ORNER Operation d a motor vehicle constitutes consent to any sobriety test oegt*ed by law. • ` n Printed: 12 /27/2002 Applicant: JAMES KNUTT Owner: KNUTT JAMES Local Phone: 305 - 824 -3722 Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Permit Number: EL2002 -424 JOB ADDRESS: 321 NE 100 ST Contractor WATTS ELECTRIC INC Parcel # 1132060135350 Signe 0 0 This Permit is granted to the contractor or builder named . • ordinances pertaining thereto and with the understanding th and approved by the proper municipal authorities. This Pern authorization. A further condition upon which this permit is g ordinances and regulations pertaining to the work covered he by his agents, servants or employees. In consideration of the issuance to me of this permit, I agree with the plans, drawings, statements or specifications submitt myself, my agent, servants or employes. n Electrical Permit Contractor's Address: 470 W 38 PL Page 1 of 1 Legal Description: MIAMI SHORES SEC 1 AMD PB 10 -70 LOTS 15 & 16 BLK 39 LOT SIZE Permit Status: Approved Permit Expiration: 6/25/2003 Construction Value: $9,000.00 Work: NEW SERVICE AND CENTRAL A/C FOR ADDITION 0 ao Se ED 09916e11-59 • 5 Doll 2, `I ZZS_ 0 Total Fees: •k00 Total Receipts: $0.00 If there is no permit package accessible on the job -site for inspectors to verify, there will be no inspections. Re- inspection fee is $50.00, which must be paid in advance before calling for another inspection. E 0E0 ..:1213E11 09 . 5B1 00 zlo£[ V003014' {601YIH . • 13301S H.1.61 .1.0306 061 >INVB NV300 ■ ttOCC '14V31VIH 2Lc W,9 'Fld 30Vld H18C'M OLV 'd803 VOU101d Hinos AO 311113313 SLI M r Miami Shores Village 10050 NE 2nd Avenue Phone: 305-795 -2204 Permit Number: ME2003 -6 Printed: 1/21 /2003 Applicant: JAMES KNUTT Owner: KNUTT JAMES JOB ADDRESS: 321 NE 100 ST Contractor BLUE SUPPLY CORP Local Phone: Parcel # 1132060135350 Permit /- tatus: Approved Permit Expiration: 7/20/2003 Construction Value: $3,000.00 Work' 2 1/2 TON INSTALL WITH DUCTWORK Signed: . ( . /. z 0 1 Mechanical Permit Contractor's Address: 4238 SW 75 AVE (INSPECTOR) BY: Page 1 of 1 Legal Description: MIAMI SHORES SEC 1 AMD PB 10 -70 LOTS 15 & 16 BLK 39 LOT SIZE Total Fees: $000 7r Total Receipts: $0.00 If there is no permit package accessible on the job -site for inspectors to verify, there will be no inspections. Re- inspection fee is $50.00, which must be paid in advance before calling for another inspection. 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. 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. RE C01 012203 1641 /TCU01 004196 CHARGE $75.00 (Contractor or Builder) BY: MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Dat Time Type Insp'n Permit No Name Address Compan Phone # 3 os For Inspector( D I a t t . [0 7 Approved Correction Re- Insp'n Fee ❑ alp Type Insp'n Permit No. MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 ® Bui dng Inspection Request DateO 2 Time r w� 1 � ) • C � ' i-1_t I' L, D i O Name n Address 3"\ I D a - • t` A , :�. .ius' For Inspectorg Approved Correction Re- Insp'n Fee Compan Phone # 3 OS i 1J r: L JLA r i Type Insp'n Permit No. MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date?( / 1 / h 1 Time Name Address • 1 0 \ ( , )0(LA Compan i • Phone # 3 ° 1 -C . °� 9 \ \J ^ ev g For Inspector?! / l ` ° 1P Approved Correction ❑ Re- Insp'n Fee ❑ cs-\ D Type Insp' Permit Name Approved Correction Re- Insp'n Fee MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Address [ / 0 hi* Company l k (A A 2e A P 4 ' Phone # 3 Of 9 'c '7 SS For Inspector C 13 / ° 4 71/ MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 B ilding Inspection Request Date Time Type Insp'n 0s t .4 = Permit No. p L — a Ln C f ) o Approved Correction Re- Insp'n Fee Name Address Company Phone # For Inspector:$ l ) ( 0 3 ?-S r - � 7 MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Da ( , Time Type Insp'n Permit No Name Address Compan Phone # Q / For Inspector:" ft i1 Approved Correction ❑ Re- Insp'n Fee ❑ Date Time Type Insp'n Permit No. Name Address Company Correction Re- Insp'n Fee MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Phone # 3®s- a , For Inspecto l / Approved Name & Date jc‘)g Miami Shores Village Plumbing Permit 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Permit Number: PL2002 -206 (N( Printed: 8/12/2002 Applicant: JAMES KNUTT (Ni Owner: KNUTT JAMES JOB ADDRESS: 321 NE 100 ST Contractor A ARON SUPER ROOTER Local Phone: 305 - 944 - 8886 Parcel # 1132060135350 Fees: Description Amount FEE2002 -4451 Building Fee $80.00 FEE2002 -4452 Buildier's Bond $300.00 FEE2002 -4453 CCF $1.20 Total Fees: $381.20 Total Fees: $381.20 Total Receipts: $0.00 Permit Status: Approved Permit Expiration: 2/8 /2003 Construction Value: $2,000.00 Work: NEW CONTRUCTION OF DRAINFILED AND SEPTIC TANK If there is no permit package accessible on the job -site for inspectors to verify, there will be no inspections. Re- inspection fee is $50.00, which must be paid in advance before calling for another inspection. 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 furthe 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 regula ons 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 ervant or employees. Contractor's Address: 6022 SW 35 CT Page 1 of 1 Legal Description: MIAMI SHORES SEC 1 AMD PB 10 -70 LOTS 15 & 16 BLK 39 LOT SIZE Sign 1 . , i l (INSPECTOR) BY: In consid he 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 pla �• 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: CONTRACTOR Name � � C ny- ���7 /� 4L )'R 2 1/ t ' supue pooma i p-c License No. , 0 4 /9Q( — O � .�1� �JIIJ` ! Address 69oac} SiA) - ..„ L m uncc.rr ,c(-• 3 Telephone 3/4/, g-g 7 Faxq 9 &27— gg33 Qualifier Name 7 h fl y /Y / , PROP Y OVxR New Construction Name 1 fit to , / , �(` Address 1 Repair Home Telephone Alteration Interior Business Telephone Relocation of Structure Fax Shell Only TYPE OF MANAGEMENT (✓ ) New Construction ✓ Enclosure . Alteration Exterior 1 Repair Alteration Interior Demolish Relocation of Structure Shell Only Foundation Only Add'I Attachment Other Add'1 Detachment Other Step 1. Job Address: PERMIT APPLICATION Master Permit No. Subsidiary Permit No. - 2 ' ..,2 Oo " c2d ce INSTRUCTIONS - The following steps must he taken to obtain a permit from the Miami Shores Village: Complete the attached permit application which must be signed by the property owner and qualifier. Both signatures must be notarized. Please print or type to allow for a more accurate processing of your application. If roofing work will be done, a roofing application must be submit- ted along with this permit application. Step 2. Submit the completed application with all necessary documents to the Building, Planning and Zoning Department for processing. During the processing of your application, you may be asked to submit additional information. A PPLI CATION 3 nQ (00 S. • (Yliarlii Shores Ft • 3 i32 Address Apt. City State Zip o 1 1- 2010 - 013. 5350 Lscription of Work Oe L C (--"< -r - L)C (_ t.- ki 0.4 3 pct .n -C Id cL - 4 se„ n e --t CCil L PG Zoning Linear Feet Squa 200 Units Floors .Slue of Work Bldg Bldg Value Tax Assessed/Appraised Value Flood Zone Base Floor Elev. Folio Number Lot 15 Block Subdivisionf l t arsi l _9- PB Current Use of Property Proposed Use of Property Tenant Information PERMIT TYPE (✓ ) Building Electrical Mechanical Plumbing LPGX Roofing Fence Other PERMIT CHANGE (✓ ) Chg. Contractor Renewal Revision Extension Supplement Reinspection ARCHITECT Name License No. Address Telephone Fax ENGINEER Name License No. Address Telephone Fax Page 2 I\IPOR'I'AN'I' NOTI('ES DO NOT BEGIN ANY WORK WITHOUT HAVING RECEIVED YOUR VALIDATED PERMIT AND PERMIT CARD. Applying for a permit does not grant the right to begin construction. HOURS OF CONSTRUCTION are limited to: Monday through Friday from 7:30 a.m. to 6:00 p.m., and Saturday from 8:00 a.m. to 5:00 p.m. No inspections will be conducted on weekends or holidays. 2. All construction of demolition areas MUST BE MAINTAINED IN A CLEAN, NEAT AND SANITARY CONDITION free from construction debris. 3. STREETS AND NEIGHBORING PROPERTIES SHALL BE KEPT FREE FROM DIRT AND DEBRIS. 4. SWALES MUST BE PROTECTED FROM BEING DAMAGED BY EQUIPMENT OR VEHICLES, AND MAY NOT BE USED FOR STORAGE. A bond is required for work in or near the street/sidewalk. 5. CONSTRUCTION TRAILERS ARE PROHIBITED ON SINGLE FAMILY RESIDENTIAL CONSTRUCTION SITES. Other construction may have a trailer which requires a separate permit. 6. PORTABLE TOILETS for a construction site require a separate permit. 7. DO NOT DISCHARGE WATER INTO THE RIGHT OF WAY OR STORM DRAINS without approval from the Building, Planning and Zoning Department. 8. EQUIPMENT AND MATERIALS SHALL BE STORED at least 10 feet from the edge of pavement. 9. Department of Health and Rehabilitative Services (HRS) approval is required for applications involving septic tanks. Department of Environmental Resources Management (DERM) and/or Miami -Dade Water and Sewer Department (MDWASD) approval is required for applications involving sewers. AFFII)\'IT - Please read carefully. Application is hereby made to obtain a permit to do work and installation as indicated. I, the OWNER of the property, 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, POOL, EXTERIOR DOOR, MECHANICAL, WINDOW, FENCE, DRIVEWAY, ROOFING and SIGNS and there may be additional permits required from other governmental agencies. I, the OWNER of the property, have disclosed all information related to any work at the property performed in the prior twelve months to the Building Official. Further, I am fully aware that if the cumulative cost of work to my home or business under this and any other permit equals or exceeds fifty percent (50 %) of the fair market value of the structure, the entire structure must meet the present federal flood criteria for finished floor elevation. I am also fully aware that if the total cost of work to my home or business under this and any other permit exceeds fifty percent (50 %) of the replacement cost of the structure, then the entire structure must conform to the current code requirements of the Building Code. WARNING TO OWNER: Your failure to record a NOTICE OF COMMENCEMENT may result in you paying twice for improvements to your property. If you are spending more than $2,500 or intend to obtain financing, you may wish to consult with your attorney or lender before recording your Notice of Commencement. The Notice of Commencement must be recorded at: 22 N.W. 1st Street, 1" Floor, (305) 679 -1078. Once recorded, the Notice of Commencement must be POSTED AT THE JOB SITE in accordance with Section 713 -35 of Florida Statutes. Review the brochure at Village Hall on Construction Lien Law and Choosing a Contractor. S TE OF FLO • IDA, COUNTY OF MIAMI -DADE Signature of Owner Print Name Sworn to and subscribed before me this day of Signature of Notary Public - State of Florida SEAL: OR, Produced Identification Personally known PERMIT APPLICATION STATE OF P.ORIDA, COUNTY OF MIAMI -DADE Signature of Co ctor / Qualifier c3 TT Print Name S rn to d subscribed before me this 1 day ofq • OR, Produced Identification Personally known ,� �i Type of Identification Produced: Type of Identification Produced: t��i N • C - -7 • ELECTRICAL TYp Minimum Fee Q .1.1 T'I'P Dryer ("Ty. .I.V.1'1{ Outlet, Appliance `1.1.1. .1.1.1'1: Service Repair `I.I.v A/C Central 1 -3 Ton Fan Dryer Vents, Number of Outlet, Wall Ventilation, Cost Service, Temporary Air Handler, Tons A/C Central 4 -7 Ton Piping, Flammable Liquid Fire Pump Outlet, Switch Fire Sprinkler System Signs A/C Central 8 -15 Ton Bath Fan - Vented, # Fixture - Fluorescent Pressure Vessel Oven Space Heater (kw) A/C Central 16-20 Ton Fixture Light Parking Lot Lights Spas/Hot Tubs A/C Central 20+ Ton Flood Lights Plugmold/Strip Subfeeds, No. of Amps A/C Window FPL - Load Central Posts Swim Pool, Commercial Air Conditioners Garbage Disposal Range/Range Top Swim Pool, Residential Chiller Generators, etc. Receptacles Switchboards Clear Violations Heat Recovery Refrigerator, Comm. (p/PH) Temp Serv., Construction Compactor Low -volt, Burglar Refrigerator, Domestic Temp for Test - 30 days Deep Freezer Low -volt, Fire Renew - Temp Service Water Closet Demolition Low -volt, Intercom/Teleph. Repair Circuits Water Heater Dishwasher ( Low -volt, Television Service, Number of Amps r Water Heater New I\IECHANICAL TV'1'1. Minimum Fee QTY. TYPE. Condensate Drain QTY. TYI'F. Generator (TTY. TYPE: Refrigeration, Tons (1'1'1'. A/C Central, Tons Cooling Tower Heating Strips, each Vent Hood, Cost A/C Wall/Win. Tons Dryer Vents, Number of Paint Booth Ventilation, Cost Solar Water Heater Air Handler, Tons Ductwork, Cost of Piping, Flammable Liquid Periodic Inspections Barbecue Fire Sprinkler System Process/Pressure Piping Cap - Fixture Bath Fan - Vented, # Fireplaces, Number of Pressure Vessel Pump and Abandon PLUMBING "1'1'1'1: A/C Condensate QTY. TYPE: Drains, Roof (TTY. TYI'1: Miscellaneous Fixture QTY. TV1'1: Soakage Pit QTY. Bath Tub Drinking Fountain Miscellaneous Repairs Solar Water Heater Bidet Filter Replace Pool Piping Sprinkler Repair Cap - Fixture Fountain Pump and Abandon Sprinkler System Cap - Water Gas - Appliance Pump, Domestic Supply, AC Well Cap - Sewer Gas - Natural Pump, Fire Stand Temporary Toilet Catch Basin Gas - Propane Pump, Re- circulate Temporary Water Closet Clothes Washer Gas Piping Pump, Replace - Pool Urinal Dental Chair Grease Trap Pump, Sprinkler Utility - Sewer Discharge Well Ice Maker Pump, Sump Utility - Water Dishwasher Indirect Wastes Relay Repair Vacuum Pump Disposal Interceptor Roof Inlet Water Closet Domestic Well Laundry Tray Septic Connection Water Heater Drainfield, 4" Tile/Res. ( Lavatory Septic Tank r Water Heater New Drains, Area Meter Set (Gas) Sewer Connection Water Re -pipe Drains, Floor Minimum Fee Shower Water Service Drains, French Miscellaneous Equipment Sink Well, Supply Page 3 PERMIT APPLICATION INSTRUCTIONS: Please indicate the type of work being performed and quantity(ies) in the space provided below. RECEIVED AND REVIEWED BY: DATE: Page 4 OFFICE USE ONLY CHECKLIST U OWNER - BUILDER FORM (Attach) LI FIRE DEPARTMENT APPROVAL (Commercial / multi- family) U CONCURRENCY (New Construction) LI OTHER (Specify & Attach) $3.00 per page (Scanning Fee) Miami Shores Village Bond Metropolitan Dade County (C.C.F.) Inspector State Educational Fund $ State DCA (Radon) $ Code Enforcement Fine Zoning Review Notary ❑ PROOF OF OWNERSHIP (Attach) ❑ HRS / DERM APPROVAL (Septic / Sewer) LI IMPACT FEE (New Construction) LI OTHER (Specify & Attach) PERM IT FEES $ SECTION Zoning Electrical Mechanical Plumbin Fire Public Works Structural Building Official BY DATE ( x .60 x/1000 ) (¢.005 /sq.ft.) (¢.01 /sq.ft.) PERMIT APPLICATION LI CONDO ASSOCIATION APPROVAL (Attach) ❑ BPR APPROVAL (Restaurants) LI CONTRACTOR REGISTRATION (On File) TOTAL $ ISSt'ING OFFICI REVIEWED AND PREPARED BY: DATE: CONDITION OFAPPRO\'AL Revised July 2001 10050 N.E. 2ND AVE., MIAMI SHORES, FL • (305) 795 -2207 • FAX (305) 756 -8972 • http : / /www.miamishoresvillage.com CONTRACTOR New Construction Name 3 . .1 ‘,A_ Name /. }' om0,-a S.apv.P-- cr. Address License No. ( ' 9 Q �O — 0 t Repair Home Telephone Address 40 'a. SW 3S C T . Mlle 0{ t PL . Business Telephone Telephone _ 571- fc Fax ' 9e 7 _' 33 Qualifier Name T Foundation Only PRO ERTY OWNER �t t't • New Construction Name 3 . .1 ‘,A_ l 6 V cr. Address Repair Home Telephone Alteration Interior Business Telephone Relocation of Structure Fax Shell Only TYPE OF MANAGEMENT (✓ ) New Construction Enclosure Alteration Exterior Repair Alteration Interior Demolish Relocation of Structure Shell Only Foundation Only Add'1 Attachment Other Add'I Detachment Other INSTRUCTIONS - The following steps must be taken to obtain a permit from the Miami Shores Village: Step 1. Complete the attached permit application which must be signed by the property owner and qualifier. Both signatures must be notarized. Please print or type to allow for a more accurate processing of your application. If roofing work will be done, a roofing application must be submit- ted along with this permit application. Step 2. Submit the completed application with all necessary documents to the Building, Planning and Zoning Department for processing. During the processing of your application, you may be asked to submit additional information. A PPLI CATI ON Job Address: oC I %j C 1 a0 c.7 Address PERMIT TYPE (✓ ) Building Electrical Mechanical Plumbing LPGX Roofing Fence Other Apt. Folio Number Description of Work Lot Block Subdivision PB PG Current Use of Property Square Feet Units Floors Proposed Use of Property ( slue of Work 4 a t c2cO . °- Bldg Value Tenant Information Tax Assessed/Appraised Value Flood Zone Base Floor Elev. PERMIT CHANGE (✓ ) Chg. Contractor Renewal Revision Extension Supplement Reinspection ARCHITECT Name License No. Address Telephone Fax Zoning Linear Feet City PERMIT APPLICATION Master Permit No. Subsidiary Permit No. PI ' 0 ' c› 7 State Zip i'6 pr/WJ e)(l57 ENGINEER Name License No. Address Telephone Fax Page 2 IJIPOR'I'vNT NOTICIS DO NOT BEGIN ANY WORK WITHOUT HAVING RECEIVED YOUR VALIDATED PERMIT AND PERMIT CARD. Applying for a permit does not grant the right to begin construction. HOURS OF CONSTRUCTION are limited to: Monday through Friday from 7:30 a.m. to 6:00 p.m., and Saturday from 8:00 a.m. to 5:00 p.m. No inspections will be conducted on weekends or holidays. 2. All construction of demolition areas MUST BE MAINTAINED IN A CLEAN, NEAT AND SANITARY CONDITION free from construction debris. 3. STREETS AND NEIGHBORING PROPERTIES SHALL BE KEPT FREE FROM DIRT AND DEBRIS. 4. SWALES MUST BE PROTECTED FROM BEING DAMAGED BY EQUIPMENT OR VEHICLES, AND MAY NOT BE USED FOR STORAGE. A bond is required for work in or near the street/sidewalk. 5. CONSTRUCTION TRAILERS ARE PROHIBITED ON SINGLE FAMILY RESIDENTIAL CONSTRUCTION SITES. Other construction may have a trailer which requires a separate permit. 6. PORTABLE TOILETS for a construction site require a separate permit. 7. DO NOT DISCHARGE WATER INTO THE RIGHT OF WAY OR STORM DRAINS without approval from the Building, Planning and Zoning Department. 8. EQUIPMENT AND MATERIALS SHALL BE STORED at least 10 feet from the edge of pavement. 9. Department of Health and Rehabilitative Services (HRS) approval is required for applications involving septic tanks. Department of Environmental Resources Management (DERM) and/or Miami -Dade Water and Sewer Department (MDWASD) approval is required for applications involving sewers. A HA °A1'I'I' - Please read carefully. Application is hereby made to obtain a permit to do work and installation as indicated. I, the OWNER of the property, 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, POOL, EXTERIOR DOOR, MECHANICAL, WINDOW, FENCE, DRIVEWAY, ROOFING and SIGNS and there may be additional permits required from other governmental agencies. I, the OWNER of the property, have disclosed all information related to any work at the property performed in the prior twelve months to the Building Official. Further, I am fully aware that if the cumulative cost of work to my home or business under this and any other permit equals or exceeds fifty percent (50 %) of the fair market value of the structure, the entire structure must meet the present federal flood criteria for finished floor elevation. I am also fully aware that if the total cost of work to my home or business under this and any other permit exceeds fifty percent (50 %) of the replacement cost of the structure, then the entire structure must conform to the current code requirements of the Building Code. WARNING TO OWNER: Your failure to record a NOTICE OF COMMENCEMENT may result in you paying twice for improvements to your property. If you are spending more than $2,500 or intend to obtain financing, you may wish to consult with your attorney or lender before recording your Notice of Commencement. The Notice of Commencement must be recorded at: 22 N.W. 1st Street, 1" Floor, (305) 679 -1078. Once recorded, the Notice of Commencement must be POSTED AT THE JOB SITE in accordance with Section 713 -35 of Florida Statutes. Review the brochure at Village Hall on Construction Lien Law and Choosing a Contractor. STATE OF FLORIDA, COUNTY OF MIAMI -DADE STATE OF FLORIDA, COUNTY OF MIAMI -DADE Signature of Owner ' Signature of Contractor /Qualifier Print Name Sworn to and subscribed before me this day of Signature of Notary Public - State of Florida SEAL: Print Name Sworn to and subscribed before me this day of Signature of Notary Public - State of Florida SEAL: PERMIT APPLICATION Personally known OR, Produced Identification Personally known OR, Produced Identification Type of Identification Produced: Type of Identification Produced: Miami Shores Village 10050 NE 2nd Avenue Phone: 305- 795 -2204 Permit Number: PL2002 -207 Printed: 8/12/2002 Applicant: JAMES KNUTT Owner: KNUTT JAMES JOB ADDRESS: 321 NE 100 ST Contractor A ARON SUPER ROOTER Local Phone: 305 - 944 - 8886 Parcel # 1132060135350 Fees: Description Amount FEE2002 - 4463 Building Fee $90.00 Total Fees: $90.00 Total Fees: $90.00 Total Receipts: $0.00 Permit Status: Approved Permit Expiration: 2/8 /2003 Work: NEW SEPTIC TANK /ABANDON EXISTING Plumbing Permit Contractor's Address: 6022 SW 35 CT Construction Value: $2,000.00 Page 1 of 1 Legal Description: MIAMI SHORES SEC 1 AMD PB 10 -70 LOTS 15 & 16 BLK 39 LOT SIZE If there is no permit package accessible on the job -site for inspectors to verify, there will be no inspections. Re- inspection fee is $50.00, which must be paid in advance before calling for another inspection. 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 conditio 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 pert fining 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, serv. is • empl. ees. Signed: 01 /4 (INSPECTOR) BY: • ��� In consideration o he s nce 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, drawin• . 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: ELECTRICAL ' rvi , I.; Minimum Fee Q.I.}. T) 1 Dryer QTy. . Outlet, Appliance Q . I . V . I . v . I , i.: Service Repair QTy. A/C Central 1 -3 Ton Fan Outlet, Wall Service, Temporary A/C Central 4 -7 Ton Fire Pump Outlet, Switch Signs A/C Central 8 -15 Ton Fixture - Fluorescent Oven Space Heater (kw) A/C Central 16-20 Ton Fixture Light Parking Lot Lights Spas/Hot Tubs A/C Central 20+ Ton Flood Lights Plugmold/Strip Subfeeds, No. of Amps A/C Window FPL - Load Central Posts Swim Pool, Commercial Air Conditioners Garbage Disposal Range/Range Top Swim Pool, Residential Chiller Generators, etc. Receptacles Switchboards Clear Violations Heat Recovery Refrigerator, Comm. (p/PH) Temp Serv., Construction Compactor Low -volt, Burglar Refrigerator, Domestic Temp for Test - 30 days Deep Freezer Low -volt, Fire Renew - Temp Service Water Closet Demolition Low -volt, Intercom/Teleph. Repair Circuits Water Heater Dishwasher Low -volt, Television Service, Number of Amps Water Heater New MECHANICAL TYPE: Minimum Fee QTY. i I'I. Condensate Drain QTY. "I'Ypli Generator Q'I'Y. 'INK Refrigeration, Tons Q'I'Y. A/C Central, Tons Cooling Tower Heating Strips, each Vent Hood, Cost A/C Wall/Win. Tons Dryer Vents, Number of Paint Booth Ventilation, Cost Air Handler, Tons Ductwork, Cost of Piping, Flammable Liquid Periodic Inspections Barbecue Fire Sprinkler System Process/Pressure Piping Supply, AC Well Bath Fan - Vented, # Fireplaces, Number of Pressure Vessel Temporary Toilet PLUr1131NG TYPE: A/C Condensate Q'I'Y. 'I'YPP, Drains, Roof Q'I'Y. T1'pE, Miscellaneous Fixture QTY. 'rvPI: Soakage Pit QTY. Bath Tub Drinking Fountain Miscellaneous Repairs Solar Water Heater Bidet Filter Replace Pool Piping Sprinlder Repair Cap - Fixture Fountain Pump and Abandon Sprinlder System Cap - Water Gas - Appliance Pump, Domestic Supply, AC Well Cap - Sewer Gas - Natural Pump, Fire Stand Temporary Toilet Catch Basin Gas - Propane Pump, Re- circulate Temporary Water Closet Clothes Washer Gas Piping Pump, Replace - Pool Urinal Dental Chair Grease Trap Pump, Sprinkler Utility - Sewer Discharge Well Ice Maker Pump, Sump Utility - Water Dishwasher Indirect Wastes Relay Repair Vacuum Pump Disposal Interceptor Roof Inlet Water Closet Domestic Well Laundry Tray Septic Connection Water Heater Drainfield, 4" Tile/Res. Lavatory Septic Tank Water Heater New Drains, Area Meter Set (Gas) Sewer Connection Water Re -pipe Drains, Floor Minimum Fee Shower Water Service Drains, French Miscellaneous Equipment Sink Well, Supply Page 3 PERMIT APPLICATION INSTRUCTIONS: Please indicate the type of work being performed and quantity(ies) in the space provided below. RECEIVED AND REVIEWED BY: DATE: Page 4 OFFICE USE ONLY C11iX'K1.1ST Li OWNER - BUILDER FORM (Attach) ❑ FIRE DEPARTMENT APPROVAL (Commercial / multi - family) O CONCURRENCY (New Construction) ❑ OTHER (Specify & Attach) $3.00 per page (Scanning Fee) Miami Shores Village Bond Metropolitan Dade County (C.C.F.) $ Inspector State Educational Fund $ State DCA (Radon) $ Code Enforcement Fine Zoning Review Notary ❑ PROOF OF OWNERSHIP (Attach) ❑ HRS / DERM APPROVAL (Septic / Sewer) ❑ IMPACT FEE (New Construction) ❑ OTHER (Specify & Attach) $ 9 g $ SECTION Zoning Electrical Mechanical Plumbin Fire Public Works Structural Building Official BY DATE ( x ¢ . x/1000 (¢.005 /sq.ft.) (¢.01 /sq.ft.) PERMIT APPLICATION ❑ CONDO ASSOCIATION APPROVAL (Attach) ❑ BPR APPROVAL (Restaurants) ❑ CONTRACTOR REGISTRATION (On File) PER111'1' FEES TOTAL $ s W9 ISSUING OFFI('I,1L REVIEWED AND PREPARED BY: DATE: CONDITION OFAPPRONAL Revised July 2001 10050 N.E. 2ND AVE., MIAMI SHORES, FL • (305) 795 -2207 • FAX (305) 756 -8972 • http : / /www.miamishoresvillage.com - -� GLOa[TS BATH Tuna SNOW[Ra LAVA. TORIES SINK[ SLOP SINKS LAUNDRY Tue. URINAL/ CATCH BASIN FLOOR DRAIN DRINK NO FOUNT' NS TOTAL FIXTURES CONTK. LIST CHECK SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT G TRAP SOLAR M[AT[R DEEP WaLL a . SYSTEM SWIM•G POOL CONTK. LIST CHECK I �— Permit No Application is hereby made for the approval of the detailed statement of the plans and specifications herewith subml structure herein described. This application is made in compliance and conformity with the Building a ce of Miami Shores and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village 11 rules and regulations of the Building Di of Miami Shores Village shall be complied wit! whether herein specified or not. A copy approved plans and speciftcatbru must be kept at building during progress of work. C Owner V s Name and Address V /L ill F 9 / No. 2 / Street..' V _ L f f " LS / Registered Architect�i d /or En /v� t " • l e e/t �eP 71 C - N ic £>giployina s ame fat g� 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)__ MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT .. Na 13104 2/ New Building..__._ - - .--- •........._.. Remodeling_____.- ._. —__ Addition..._ -__. -_ Repairs plied with the provisions thereof, and will require similar compliance from all contractors or sub-contra performed under this permit; and will post or cause to be posted' for inspection on the site of the required by the Act. The undersigned agrees to employ only such sub -oontr . work lioensed by Miami Shores Village. (Si Subdivision ..._ Z• i iAItt/ Size Septic Tank_ _Type of Tank - -_. ---- _- .-- --- ... _...-_- .-- Capaclty Cals..._. Feet of Drain Tile Dist Feet of Tank or Drain Field from Wen .. __.__. _----- .- -.__ -- Nature of Water Supply: City -Well. _size of Soakage Pit. : (Signed) IT )-- ------ - - - W' By No. of Stories.... 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 Isar com- employed by him in the work to be ch public notice or notices as err under this permit, as are Muter Plumber. STATE OF FLORIDA, 1 µ 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 dgo the same, and that all facts therein by hire stated are true. My Commission Expires Notary Public, State of Florida NOTE: A re - inspection fee of $1.00 will be roads wham asai rwiupactlon r niade by improper nodes for impaction, at faulty materials and /or workmanship. Permit Size Septic Tank Feet of Drain Tile Nature of Water Supply: City —Well Amount of Permit $ . 0 ° MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or 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. No. 3 'Z' F - __ Street_ 74..1. /49.e= Owner's Name and Address Registered Architect and /or Engineer ----- Employing Plumber's Name__flr No. ____ 0 / Street: f 2 2 . 614 Location and Legal Description Lot_____ ........ Subdivision Street and Number where work is to be performed —No— Street_ State work to be performed and purpose of building (By Floors) _ N B Remodeling Addition._ -_ Repairs No. of Stories - Type of Tank_ Capacity Gals __Dist. Feet of Tank or Drain Field from Well - _-- _-- ___ - -- �_ -- - Size of Soakage Pit (Signed) _ _ -� ' Date. 7-/7- 76 Plumbing Irfspector. 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. Master Plumber. STATE OF FLORIDA, 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. My Commission Expires Notary Public, State of Florida NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made•necessary by improper notice for inspection, or faulty materials and /or workmanship. CLOSETS BATH TUBS SHOWERS LAVA- TORIES SINKS SLOP SINKS LAUNDRY TUBS 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 co.. LIST a� 201 CHECK Permit Size Septic Tank Feet of Drain Tile Nature of Water Supply: City —Well Amount of Permit $ . 0 ° MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or 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. No. 3 'Z' F - __ Street_ 74..1. /49.e= Owner's Name and Address Registered Architect and /or Engineer ----- Employing Plumber's Name__flr No. ____ 0 / Street: f 2 2 . 614 Location and Legal Description Lot_____ ........ Subdivision Street and Number where work is to be performed —No— Street_ State work to be performed and purpose of building (By Floors) _ N B Remodeling Addition._ -_ Repairs No. of Stories - Type of Tank_ Capacity Gals __Dist. Feet of Tank or Drain Field from Well - _-- _-- ___ - -- �_ -- - Size of Soakage Pit (Signed) _ _ -� ' Date. 7-/7- 76 Plumbing Irfspector. 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. Master Plumber. STATE OF FLORIDA, 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. My Commission Expires Notary Public, State of Florida NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made•necessary by improper notice for inspection, or faulty materials and /or workmanship. MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build- ing or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of the work. Owner's Name and Address___ 4T � •li Street Registered Architect and /or Engineer Name and address of licensed contractor_,, _ - — Y Location and legal description of lot to be built on: Lot Block Sub v' si� /7 �� Street and Number where work is to be done 4 4 / _ State work tq be done and purpose of buil i g (by floors c and for no other purpose. New Building Remodeling Addition Repairs No. of Stories To be constructed of Kind of foundation Estimated Total cost of improvements $ Amount of Permit $__ Zone cubage required plan Cubage Distance to next nearest building _Size of Building Lot Maximum live load to be borne by each floor _____________________�______.__ I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may be sent to The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Supplement, and has complied 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 su}cont ct �s, on work to be performed under this - permit, as are licensed by Miami Shores Village. )( r 1 Remarks ( Signed) STATE OF FLORIDA, COUNTY OF DADE. ss. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap- peared - 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. Permit No Disapproved (Signed) - 1 . 1 Date Covering Read, Sworn to and Subscribed before me. Notary Public, State of Florida Building Inspector / f My Commission Expires PLANNI C BOARD DATE Chairman Member Member Member Member ___________ Member Council Approved_ Date Disapproved Date NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has been obtained from the Planning Board. A re- inspection fee of $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and /or workmanship. 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. . P O u • rc,(J .1' 14%E Owner's Name and Addressith,l_ -_.. Registered Architect and /or ineer �___�__ - Employing Plumber's Name_ _. r * `' ^ L -_ Streele#' C ' 1 Location and Legal Description Lot________________ ____ Block_ �+, Subdivision A g 'IL A ' • Street Stele work to be performed and purpose of building (By Floors)____ §.� -t - ^ i? _ - S� New Building _._.-- • -• -. -• .__ -_ -- Remodeling __- -_- Addition._ Street and Number where work is to be performed —No Size Septic Tank Feet of Drain Tile.c2+5- ' Nature of Water Supply: ity— Well._______.______ ___ ... __..____.... _-____--Size of Soakage Pit Amount of Permit $ !lumbing 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 5986, 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, 1 s are licensed by Miami Shores Village. STATE OF FLORIDA, } COUNTY OF DADE. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Type of Tank Capacity Gals. t. Feet of Tank or Drain Field from Well — (Signed)___ ( Signed) __ Repairs ' Street___ -1__,9 — Date No. of Stories.. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the____ _.. of the above described construction, that he has. carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. My Commission Expires Notary Public, State of Florida aster 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 -r s SHOWERS LAVA- TORIES SINKS SLOP SINKS LAUNDRY Tulsa URINALS CATCH BASIN FLOOR DRAIN DRINKING FOU NT • NB TOTAL FIXTURES CONTR. LIST CHECK 1 CEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SWIM'S POOL CONTR. LIST CHECK 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. . P O u • rc,(J .1' 14%E Owner's Name and Addressith,l_ -_.. Registered Architect and /or ineer �___�__ - Employing Plumber's Name_ _. r * `' ^ L -_ Streele#' C ' 1 Location and Legal Description Lot________________ ____ Block_ �+, Subdivision A g 'IL A ' • Street Stele work to be performed and purpose of building (By Floors)____ §.� -t - ^ i? _ - S� New Building _._.-- • -• -. -• .__ -_ -- Remodeling __- -_- Addition._ Street and Number where work is to be performed —No Size Septic Tank Feet of Drain Tile.c2+5- ' Nature of Water Supply: ity— Well._______.______ ___ ... __..____.... _-____--Size of Soakage Pit Amount of Permit $ !lumbing 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 5986, 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, 1 s are licensed by Miami Shores Village. STATE OF FLORIDA, } COUNTY OF DADE. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Type of Tank Capacity Gals. t. Feet of Tank or Drain Field from Well — (Signed)___ ( Signed) __ Repairs ' Street___ -1__,9 — Date No. of Stories.. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the____ _.. of the above described construction, that he has. carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. My Commission Expires Notary Public, State of Florida aster 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. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Date.. -off /f/ �7 s -' 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. j� Ch / ,, / Owner's Name and Address 1 0 - - - - - No. _3 1_ - -. - -- /v� o / f _-- -__ _.___.��-__ _ --__ Street Re Architect and /or Engineer _____ ___—.___________ ._._______. Employing Plumber's Name y/<- .5/ 7/I/a 17..E _ / 5! Street_ Location and and Legal Description Lot___.__ _ _ _ Block_. Subdivision Street and Number where work is to be performed -No - o2 / Street N l O S T State work to be performed and purpose of building (By Floors)__ _ New Building Remodeling.___ .___ Addition._._ Repairs No. of Stories. - Permit 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 $ /21 0 STATE OF FLORIDA, t te. COUNTY OF DADE. (Signed)_ Capacity Gals 24 My Commission Expires Notary Public, State of Florida 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 notic as are required by the Act. The undersigned agrees to employ only such sub - contractors, on work to be performed u der this peryfit, as are licensed by Miami Shores Village. (Signed f Mister Plumber. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty materials and /or workmanship. CLOSETS TUBS BATH TUB6 SHOWERS LAVA. TORIES S SLOP SINKS LAUNDRY TUBE URINALS CATCH BASIN FLOOR DRAIN DRINKI NO FOUNT'NG 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 PERMIT Date.. -off /f/ �7 s -' 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. j� Ch / ,, / Owner's Name and Address 1 0 - - - - - No. _3 1_ - -. - -- /v� o / f _-- -__ _.___.��-__ _ --__ Street Re Architect and /or Engineer _____ ___—.___________ ._._______. Employing Plumber's Name y/<- .5/ 7/I/a 17..E _ / 5! Street_ Location and and Legal Description Lot___.__ _ _ _ Block_. Subdivision Street and Number where work is to be performed -No - o2 / Street N l O S T State work to be performed and purpose of building (By Floors)__ _ New Building Remodeling.___ .___ Addition._._ Repairs No. of Stories. - Permit 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 $ /21 0 STATE OF FLORIDA, t te. COUNTY OF DADE. (Signed)_ Capacity Gals 24 My Commission Expires Notary Public, State of Florida 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 notic as are required by the Act. The undersigned agrees to employ only such sub - contractors, on work to be performed u der this peryfit, as are licensed by Miami Shores Village. (Signed f Mister Plumber. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty materials and /or workmanship. UILDING LECTRICAL LUMBING . PERMIT N° 5491 CONTRACTOR OR BUILDER MIAMI SHORES VILLAGE, FLORIDA Work to be performed under this Permit )caner of wilding - �,.e[�•► • rchitect :ontractor r Builder '�+- ' .egal Lot Bl• �f )escription I ' .ddress of / �r • :wilding 3Q /ii r This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the appli- ation herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any lans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked t any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further con n .upon: hich this .ermit is granted is the understanding that the contractor or builder named above asses thpffespon$bility for a thorough knowledge 4, Std' a ces and 3gulations pertaining to the work covered hereby whether shown on the plans or drifeings or In thers ate is or specifications and tilt - assn espon- ibility for work done by his agents, servants or employees. Signed• By .CTO In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances all regulations •ertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. n accepting this permit I assume responsibility for all work done by either myself, my agent, servant or employee. Subdi- vision Value of Project BY DATE Contractor's License No. - 7 Amt. of Permit 194 7 / 3A/4 AUTHORITY ti f BUILDING ELECTRICAL PLUMBING Owner of ( Building Architect Contractor or Builder Legal Description d MIAMI SHORES VILLAGE, FLORIDA 7 1 'PERMIT N° 5491 Work tube performed under this Permit < 4� DATE - 194• Contractor's / 5 J/6 License No 't f l A Bl. 3 9,. Address of " .c;? .'� �� i Building +' iR e7" J 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 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 ww;;ttl1lout authorization. A further ne�tt ,upon which this permit is granted is the understanding that the contractor or builder named above Gies the respgfisibility for a thorough knowle fof li o dinances' and regulations pertaining to the work covered hereby whether shown on the plans or wings r' in statements or specifications mid i af he' Ines respon- sibility for work done by his agents, servants or employees. 'fit ' *, „ °f ^ • , i 1 Signed.,,,. t ; :„•.. <9 -y *� -F; By -, ` ..... tISPECTOR In conside of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with full ordinan' es ail 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, servant or employee. t CONTRACTOR OR BUILDER Subdi- vision Value of Project BY Amt. `04 Permit AUTHORITY