Loading...
157 NE 101 St (6)Date Legal Description (...04 ZZ t Z- € C) - AASVvice g See O Job Address 151 Ne O ( (/ 33 Tax Folio 1 1' 3LO6- 013 19S ) Owner/Lessee / Tenant CCU r \es - - Vov Owner's Address ( i Contracting Co. &C. G ConG nS \ c T-C ca J - So I 0 r*,o r` State # /g Municipal # Competency # Ins. Co. N 4 a 'll ac. S Architect/Engineer NA Address Bonding Company N-er Address Qualifier Mortgagor N Address Permit Type (circle one): BUILDING ELECTRICAL IVIIMiG MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION 11 (A 0 R -s\i14 G2P Square Ft. - J`. Estimated Cost (value) It 1 WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.) Application is hereby made to obtain a permit to do work and installation as indicated above, and on the attached addendum (if applicable). I certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits are required for ELECTRICAL PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK. OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Furthermore, I authorize the above -named contractor to do the work stated. TERESA J. S • LO ON M Y COMMISSIOpI .XPIRES: 7 t Fla. Notary Oond(rg CO. • INC s ,"T144i4 No r d/or a �an ors• i• gn n Notary s to • ommissio FEES: PERMIT APPROVED: Zoning Mechanical es: PERMIT APPLICATION FOR MIAMI SHORES VILLAGE RADON C.C.F. Historically Designated: Yes No Address Po bo x 3863 Ft. 3 SS# Phone (3 G6( 66 33 Notary as o Contractor or i't+r er -Bu Date CLADYS J V LIAR NOTARY PUBLIC STATE OF FLORIDA COMMISSION NO. CC714103 MY COMMISSION EXP. MAR. 1 2002 My Commission Expires: NOTARY Master Permit # Phone ( g.q 13 f C ,j3 act Electrical Structural Engineer c BOND TOTAL DUE 4 P , 711 Date o f STATE OF FLORIDA DEPARTMENT OF HEALTH ' APPLICATION FOR ONSITE SEWAGE DISPOSAL SYSTEM CONSTRUCTION PERMIT Permit Application Number DH 4015, 10/96 (Replaces HRS -H Form 4015 which may be used) (Stock Number: 5744 - 0024015 -6) PART II - SITEPLAN Scale: Each block represents 10.feet and 1 inch = 40 feet. • OLD ,%\t i OV A- FLot.0i 1 6 . Site Plan submitted by: Plan Approved By ..� County Health Department Not Approved AL CHANGES MUST BE APPROVED BY THE COUNTY HEALTH DEPARTMENT corTt'rzAc Date 400 / Page 2 of 4 Ma M • 111111111=1111 III ■• MIMI ■ ?fie' ■ Imtiit l♦ IIIIIII ■ ammunome. mmumil mmia 111 111111111111111, u■■ m im ,� - ; 1 _ • r. l■ ■ I■®IR`' III • m r E 1111 i • �' ••u m••� `•i •�i`i•uiuu It Ill iWT . II I 1 lawatme " il IP _ Mm�i•1 II - NEE ;. 1111111111111 III II III IIIIIIII , . . . & - — i'i N r 1 n t S . I ° "A STATE OF FLORIDA DEPARTMENT OF HEALTH ' APPLICATION FOR ONSITE SEWAGE DISPOSAL SYSTEM CONSTRUCTION PERMIT Permit Application Number DH 4015, 10/96 (Replaces HRS -H Form 4015 which may be used) (Stock Number: 5744 - 0024015 -6) PART II - SITEPLAN Scale: Each block represents 10.feet and 1 inch = 40 feet. • OLD ,%\t i OV A- FLot.0i 1 6 . Site Plan submitted by: Plan Approved By ..� County Health Department Not Approved AL CHANGES MUST BE APPROVED BY THE COUNTY HEALTH DEPARTMENT corTt'rzAc Date 400 / Page 2 of 4 CONSTRUCTION PERMIT FOR: [ ]New System [ X ]Repair APPLICANT: Fox, Jr., Charles AGENT: SEPTIC CO, Solomon Teresa PROPERTY STREET ADDRESS: 157 NE 101 St Miami Shores FL 33138 LOT: 22 [Section /Township /Range /Parcel No.] PROPERTY ID #: 11- 3206 - 013 -1951 [OR'TAX ID NUMBER] SYSTEM MUST BE CONSTRUCTED IN ACCORDANCE WITH SPECIFICATIONS AND STANDARDS OF CHAPTER 64E -6,FAC DEPARTMENT APPROVAL OF SYSTEM DOES NOT GUARANTEE SATISFACTORY PERFORMANCE FOR ANY SPECIFIC TIME PERIOD. 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. ISSUANCE OF THIS PERMIT DOES NOT EXEMPT THE APPLICANT FROM COMPLIANCE WITH OTHER FEDERAL, STATE OR LOCAL PERMITTING REQUIRED FOR PROPERTY DEVELOPMENT. SYSTEM DESIGN AND SPECIFI �xi5Ttitl9 SEPTIC WANK T [ A [ N [ K [ 900 ]Gallons O ]Gallons O ]GALLONS GREASE INTERCEPTOR CAPACITY O ]GALLONS DOSING TANK CAPACITY [ 0 D [ 300 ]SQUARE FEET PRIMARY R [ 0 ]SQUARE FEET A TYPE SYSTEM: [ ]STANDARD I CONFIGURATION: [ )TRENCH N F LOCATION TO BENCHMARK: 12.80'NGVD I ELEVATION OF PROPOSED SYSTEM SITE E BOTTOM OF DRAINFIELD TO BE L D FILL REQUIRED: [ 0.0 ]INCHES OTHER REMARKS: [ BLOCK: 14 SUBDIVISION: Miami Shores Sec N 1 SPECIFICATIONS BY: Arrieta, Rolando Eng.I APPROVED BY: Arrieta, Rolando DATE ISSUED: 4/12/01 ]Existing System [ ]Abandonment STATE OF FLORIDA DEPARTMENT OF HEALTH ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM CONSTRUCTION PERMIT )Holding Tank ]Temporary DRAINFIELD SYSTEM SYSTEM [ N ]FILLED [ I ]BED FF E/R [ 2.3 [ 4.3 Existing 900 gls s /t. Install 300 sq. ft. d /f. This permit is not for addition(s) Invert elev. of d/f no less than 9.00'NGVD. Botton of d/f elev. no less than 8.50'NGVD. The s/t shall be pumped and a solid deflector EXCAVATION REQUIRED: 1 ‘)' ] [ 1 [ FEET FEET TITLE: TITLE: DH 4016, 03/97 (Obsoletes previous editions which may not be used) (Stock Number: 5744- 001 - 4016 -0) [ ostds — cons - 4016 -11 [ 24.0 ] INCHES Engineer I CENTRAX #: 13 -SG -08560 DATE PAID: FEE PAID : $ RECEIPT . OSTDSNBR : 01 -1150- -R ] Innovative Other MULTI- CHAMBERED /IN SERIES: MULTI - CHAMBERED /IN SERIES: ]GALLONS @ [0 ]DOSES PER 24 HRS # PUMPS[ 0 ] [ N ]MOUND [ N ] [ N ] [ BELOW] BENCHMARK /REFERENCE POINT [ BELOW] BENCHMARK /REFERENCE POINT 'MIS M04 03 EMS FR A OTIEMS) • (� I�ppppfn1 0 V(CV�iT 1p EL 4�ATIM3 )' 5 r�. I� �[1� � 1 i1 �1'T �WDi'�� �''bY.U �tlYN7 e•S� V`W installed on e0 C d tl /MO � �� M pV LEAST 2.0 FEET WIDER S 1I MTV: j" o _ THE Dade CHD EXPIRATION DATE: 7/11/01 Page 1 of 2 Permit ?40.-4 7 If 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 Dopy of approved plans and specifications must be kept at building during progress of work. Owner's Name and Address le N/ Registered Architect and /or En eer Y.�celpy�na>i AI•' tion Lo bescit4 •�... L, q� down g pt. • .2 `if' cam./ /s-7 Street and Number where work is to be performed —No State work to be performed and purpose of building (By Floors)__.---_ New Building_._... _ _. _- •---- ........_ -- Remodeling— _.__.._ -_____ Addition t� NIA i n� 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 mist_ Feet of Tank tie Drain Field from Well. .._.__.___ Size of Soakage Pit. (Signed) No. /s l _ street _AZ. _ Date _ — — itret..424.4S4 E1T4- Subdivwon, . Repairs No. of Stories. . ....... _Type of Tani L1 d A/ ... _____Capacity Gals.._- ..._.-.__ _______ Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he erstands and a6Fepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled s oral Laws of Florida Permanent Supplement, and !lux com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the worn 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 ormed unddthls permit, as are # 44 ,.- licensed by Miami Shores Village. / r Street.—_________ ................ _..... -. STATE OF FLORIDA, } ts. 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 depose. and says that he is the ._ -. -- -- _...... -- - - .. - -�• of the above described construction, that be has carefully read the foregoing application, and that be did sign the same, and that all facts therein by him stated are true. Notary Public, State of Florida Master Plumber. NOTE: A re- inspection fee of $1.00 will be made when once milipaotfoa Is made aeossmry by Improper notice for Inspection, or faulty materials and /or workonanshnp• C 1 . 01 / 178 TS BATH . Tulle S HOWER. LAVA. TORIES SINKS SLOP SINKS LAUNDRY TUBS URINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT'NS TOTAL FIMTNRES GOWN. LIST - CHECK SEPTIC TANK SEWER CONK. DRAIN SOAKAGE FIELD PIT G TRAP SOLAR HEATER DEEP WELL SPRKLR. 5 SW 114•0 Pool CONTR. LIST CHECK 36 032 _ r r Permit ?40.-4 7 If 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 Dopy of approved plans and specifications must be kept at building during progress of work. Owner's Name and Address le N/ Registered Architect and /or En eer Y.�celpy�na>i AI•' tion Lo bescit4 •�... L, q� down g pt. • .2 `if' cam./ /s-7 Street and Number where work is to be performed —No State work to be performed and purpose of building (By Floors)__.---_ New Building_._... _ _. _- •---- ........_ -- Remodeling— _.__.._ -_____ Addition t� NIA i n� 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 mist_ Feet of Tank tie Drain Field from Well. .._.__.___ Size of Soakage Pit. (Signed) No. /s l _ street _AZ. _ Date _ — — itret..424.4S4 E1T4- Subdivwon, . Repairs No. of Stories. . ....... _Type of Tani L1 d A/ ... _____Capacity Gals.._- ..._.-.__ _______ Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he erstands and a6Fepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled s oral Laws of Florida Permanent Supplement, and !lux com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the worn 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 ormed unddthls permit, as are # 44 ,.- licensed by Miami Shores Village. / r Street.—_________ ................ _..... -. STATE OF FLORIDA, } ts. 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 depose. and says that he is the ._ -. -- -- _...... -- - - .. - -�• of the above described construction, that be has carefully read the foregoing application, and that be did sign the same, and that all facts therein by him stated are true. Notary Public, State of Florida Master Plumber. NOTE: A re- inspection fee of $1.00 will be made when once milipaotfoa Is made aeossmry by Improper notice for Inspection, or faulty materials and /or workonanshnp• STATE OF FLORIDA DEPARTMENT OF HEALTH AND REHABILITATIVE SERVICES ONSITE SEWAGE DISPOSAL SYSTEM CONSTRUCTION AND INSTALLATION PERMIT Applicant F x- P Number tr.‘_: /0t 3 PART II - SYSTEM INSTALLATION INSPECTION AND FINAL INST APPROVAL- Installer 6.44- J 7 Z,3W Tank Manufacturer Date sr is ft Approved by: Average depth to drainpipe invert from finished grade: F/rile aoe ,41-r 1 // C.6 - r 0,7 pr ' ac/ G. o r✓ .Q • Inspected by v — s uc l i PART III - FI I6STALLATION APPROVAL • HRS —H Form 4016, Feb 85 (Obsoletes previous editions which may not be used) (Stock Number. 5744- 002. 4016.0) Proper tank legend: Yes la/A No Tank material 0. e--'`R. f Tank level: Yes No Tanks watertight: Yes 1 No Tank size• gallons gallons N/A- gallons Proper tank outlet device: Yes No No Manhole or marker to grade: Yes A No Drainfield Trench Absorption Bed Length Width Length Width Lengthr2 4 / feetx lle0--'feet =3/ Z.ft feet feet , _ feet feet Length �eet x_ feet = ft feet feet feet Proper No. drainlines: Yes Z No feet feet feet feet Proper pipe separation: Yes 0/ No V Total = ft Total = ft Distribution box level: Yes No el/g / Systems located as permitted: Yes ✓ No Systems including plumbing stub -outs installed at proper elevation: Yes No f/# inches Maximum depth 0 Inches Average depth of drainfield gravel inches Minimum depth of gravel /Z- inches Proper gravel size: Yes f/ No Gravel is suitable quality: Yes ✓ No Backfill or fill material as required: (Quality) ✓ No (Quantity) Yes No Other findings AN APPROVED , TAL • TION DOES NOT GUARANTEE PERFORMANCE Date .2 d ‘t COUNTY PUBLIC HEALTH UNIT Note: Completed copies of this for will be provided to the applicant, installer and the building department. Page 2 of 2 BUILDING 0 MIAMI SHORES VILLAGE, FLORIDA DATE V "" I 19 4 ELECTRICAL PLUMBING 0 PERMIT N9 7089 coor . i Lice ntract No. � $41 ROOFING . Owner of Building Architect Contractor or Builder Legal Description Address of Building Lot Work to be performed under this Permi Subdi- B1 vision f,•� r �}+� Value of I Amount of 0 d' �. , f Project $ I Permit $ ,,,�, This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the applica- tion 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. Signed _ �'+�► n+� INSPECTOR In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance .. th all ordinances sad regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In ao cepting this permit I assume responsibility for ell work done by either, myself, my agent, servant or employee. • CONTRACTOR OR BUILDER BY AUTHORITY MIAMI SHORES VILLAGE, FLORIDA BUILDING ❑ CTRICA PLUMBING L V PERMIT ROOFING ❑ 0 Owner ofo'"" f Building . a 44 Architect Contractor or Builder Legal Description Lot Bl N° 7078 Address of , 9 F . Value of Amount of r; Bui 't 0., � t : ; 1 4... . 0 Protect $ Permit $ 000,'„„....... This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device descr ed in the applica- tion 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. In consideration of the issuance to me pertaining thereto and in strict conformity with cepting this permit I assume responsibility for Signed. :+ r - " !w ' r, _ y s. r -«, tc' INSPECTOR of this permit I agree to perform the work covered hereunder in compliance with all ordinances aliens the plans, drawings, statements or specifications submitted to the proper authorities of P Ilami Shores Village. In ac all work done by either, myself, my a seDrant or employee. vi 4 6 ' � y *' , sue' C- -'. CONTRACTOR R BUILDER BY Work to be performed under this Permit 3�r+ J Subdi- vision 1' 'Y DATE Contractor's License No AUTHORITY ABDO �- ' Permit No t. 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 ____:__14_1_ No. Registered Architect and /or Engineer' f Employing Plumber's Name L_ Location and Legal Description 1 Street and Number where work is to be performed —No ` 771 D , State work to be performed and purpose of building (By Fl oors)__ ..... - ...... - ..... ----------...... — New. Building Remodeling —____ __ ____ Addition__ Size Septic Tank_ __ Feet of Drain Tile.___ Nature of Water Supply: City —Well Amount of Permit $ a 943 STATE OF FLORIDA, } COUNTY OF DADE. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT f Tank___ Capacity Gals Tank or Drain Field from Well . _Size of Soakage Pit ( Signed) _ ( Signed). Date l2 Repairs No. of Stories. Street Street 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 die Act. The undersigned agrees to employ only such sub- contractors, on work to be per . ed under this permit, as are licensed by Miami Shores Village. My Commission Expires Notary Public, State of Florida Plumb Inspect Master 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 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 SWIM'G POOL. CONTR. LIST -- CHECK Permit No t. 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 ____:__14_1_ No. Registered Architect and /or Engineer' f Employing Plumber's Name L_ Location and Legal Description 1 Street and Number where work is to be performed —No ` 771 D , State work to be performed and purpose of building (By Fl oors)__ ..... - ...... - ..... ----------...... — New. Building Remodeling —____ __ ____ Addition__ Size Septic Tank_ __ Feet of Drain Tile.___ Nature of Water Supply: City —Well Amount of Permit $ a 943 STATE OF FLORIDA, } COUNTY OF DADE. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT f Tank___ Capacity Gals Tank or Drain Field from Well . _Size of Soakage Pit ( Signed) _ ( Signed). Date l2 Repairs No. of Stories. Street Street 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 die Act. The undersigned agrees to employ only such sub- contractors, on work to be per . ed under this permit, as are licensed by Miami Shores Village. My Commission Expires Notary Public, State of Florida Plumb Inspect Master 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. Permit 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. Owner's Name and Address_______ ___ J Norman _ _ No.-- _ -- - street 101 St ____-- .________--- .-- ___ -__. 157 N E _ _ _ Registered Architect and /or Engineer -- — ----- _ —__ -- -- - Ave __ .. Employing Plumber's Name 0 G LLOYD SEPTIC TANK SERVICE No.._ -1 W. Ql-22__AIeeet__ _ 696- u2016_ Location and Legal Description Lot Block ___ Subdivision_..___ ___._._._________._— __._____.._ Street 101 St Street and Number where work is to be performed —No 157 N E State work to be performed and purpose of building (By Floors) _ New. Building __ -- _ -- Remodeling _ _--- - - - -__ _ _ Addition Repairs Size Septic Tank Type of Tank_ Feet of Drain Tile_ 32 FT Remy _Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: City— Well..__-____ _ _ __— ._.______ ___Size of Soakage Pit d Amount of Permit $ © r.� Capacity Gals. (Signed) Pldmbing 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 Hemmed by Miami Shores Village. (Signed) Date My Commission Expires Notary Public, State of Florida No. of Stories. 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. 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 worlananship. CLOSETS BATH TUBE SHOWERS LAVA- TORIES SINKS SLOP SINKS LAUNDRY TUBE URINALS CATCH BASIN , FLOOR DRAIN DRINKING FOUNT' NE 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 °S r ~ ^- CHICK __ Permit 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. Owner's Name and Address_______ ___ J Norman _ _ No.-- _ -- - street 101 St ____-- .________--- .-- ___ -__. 157 N E _ _ _ Registered Architect and /or Engineer -- — ----- _ —__ -- -- - Ave __ .. Employing Plumber's Name 0 G LLOYD SEPTIC TANK SERVICE No.._ -1 W. Ql-22__AIeeet__ _ 696- u2016_ Location and Legal Description Lot Block ___ Subdivision_..___ ___._._._________._— __._____.._ Street 101 St Street and Number where work is to be performed —No 157 N E State work to be performed and purpose of building (By Floors) _ New. Building __ -- _ -- Remodeling _ _--- - - - -__ _ _ Addition Repairs Size Septic Tank Type of Tank_ Feet of Drain Tile_ 32 FT Remy _Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: City— Well..__-____ _ _ __— ._.______ ___Size of Soakage Pit d Amount of Permit $ © r.� Capacity Gals. (Signed) Pldmbing 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 Hemmed by Miami Shores Village. (Signed) Date My Commission Expires Notary Public, State of Florida No. of Stories. 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. 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 worlananship. BUILDING ELECTRICAL PLUMBING ROOFING Owner of Building Legal Description Address of Building Lot PERMIT IN? 12696 11 11 Architect Contractor or Builder Work to be performed under this Permit This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the application herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes responsibility for work done by his agents, servants or employees. CONTRACTOR OR BUILDER. MIAMI SHORES VILLAGE, FLORIDA BI. Signed: Subdi- vision Value of Project $ DATE "" 195 Contractor's License No Amt. of Permit $ BY LOR In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. BY AUTHORITY / b?fC-* MIAMI Sit ORES VILLAGE, FLA. JOB ADDRESS /X AJ .� INSPECTION TIME READY J �. 0 � - j 7 i N? 6104 REMARKS: F oe b` 17- ` A. C f3 t INSPECTOR DATE Tj Permit No . _a_ - -- 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 Owner's Name and Address Registered Architect and /or Engineer Employing Plumber's Name , 'y x-1 r -• ' S j u- t r ss. MIAMI SHORES . VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT 1i '( No 7 - Amount of Permit $ (Signed) /67 Date Street '1 ' 0 0 f No. _I Street Block Subdivision 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 Size Septic Tank Type of Tank____ Capacity Gals i of Drain Tile / ( Dist. Feet of Tank or Drain Field from Well I Nature of Water Supply: City —Well _- Size of Soakage Pit Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to 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. Q ( Signed) ° t s — Mastet'l lumber. 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. 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 CHECK _— SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SW IM'G POOL CONTR. LIST / ` CHECK e Permit No . _a_ - -- 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 Owner's Name and Address Registered Architect and /or Engineer Employing Plumber's Name , 'y x-1 r -• ' S j u- t r ss. MIAMI SHORES . VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT 1i '( No 7 - Amount of Permit $ (Signed) /67 Date Street '1 ' 0 0 f No. _I Street Block Subdivision 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 Size Septic Tank Type of Tank____ Capacity Gals i of Drain Tile / ( Dist. Feet of Tank or Drain Field from Well I Nature of Water Supply: City —Well _- Size of Soakage Pit Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to 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. Q ( Signed) ° t s — Mastet'l lumber. 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. 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. n PERMIT IT? 12793 ❑ Work to be performed under this Permit BUILDING ELECTRICAL PLUMBING ROOFING Owner of Building Architect Contractor or Builder Legal Description Address of Building Lot CONTRACTOR OR BUILDER MIAMI SHORES VILLAGE, FLORIDA Bl. Subdi- vision Value of Project $ BY DATE 195 Contractor's License No Amt. of Permit $ 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 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. AUTHORITY 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 all work done by either, myself, my agent, servant or employee. Permit No. Feet of Drain Tile 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 ___._OV • No. Street Registered Architect and /or gineer ___f f ___________ " S-r Employing Plumber's Nam c____ _ _ ' — = _ j €� - i'? `4 No y i4i ' Y » 71 Street Location and Legal Description Lot 25 Block_ ../ �� Subdivision_ Street and Number where work is to be performed —No o Street State work to be performed and purpose of building (By Floors) New Building 'Y Remodeling Addition Repairs No. of Stories___ / Size Septic Tank ® 0 ea Amount of Permit $ 8 STATE OF FLORIDA, ss. COUNTY OF DADE. My Commission Expires MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT (Si Type of Tank. Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: City —Well. (Signed) Date Capacity Gals a Z - Q -- - - - - -- Size of Soakage Pit Plu bing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as a 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 under signed agrees to employ only such sub - contr tors, on work to be performed under this permit, as are licensed by Miami Shores Village. Notary Public. State of Florida iV Master 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 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 SWIM'G POOL CONTR. LIST CHECK !! Permit No. Feet of Drain Tile 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 ___._OV • No. Street Registered Architect and /or gineer ___f f ___________ " S-r Employing Plumber's Nam c____ _ _ ' — = _ j €� - i'? `4 No y i4i ' Y » 71 Street Location and Legal Description Lot 25 Block_ ../ �� Subdivision_ Street and Number where work is to be performed —No o Street State work to be performed and purpose of building (By Floors) New Building 'Y Remodeling Addition Repairs No. of Stories___ / Size Septic Tank ® 0 ea Amount of Permit $ 8 STATE OF FLORIDA, ss. COUNTY OF DADE. My Commission Expires MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT (Si Type of Tank. Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: City —Well. (Signed) Date Capacity Gals a Z - Q -- - - - - -- Size of Soakage Pit Plu bing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as a 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 under signed agrees to employ only such sub - contr tors, on work to be performed under this permit, as are licensed by Miami Shores Village. Notary Public. State of Florida iV Master 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. Permit No Owner's Name and Address Registered Architect and /or Employing Plumber's Nam Feet of Drain Tile Q_ ______________ ____ Nature of Water Supply: City —Well Amount of Permit $ STATE OF FLORIDA, } COUNTY OF DADE. ss. 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. ,x My Commission Expires Size Septic Tank 16 ©Q + itt Type of Tank _____ 4 '4 Date No. Street _ '_! :C. "AMA No ?L ) 7/ Street Of_ Location and Legal Description Lot Block__ / Subdivision_ • Capacity Gals.__ Street and Number where work is to be performed —No /4.7 A__h______/ L State work to be performed and purpose of building (By Floors) New Building V Remodeling Addition Repairs No. of Stories___ l Street--------------- ----------- -- - - -- — — — — — — _ Dist. Feet of Tank or Drain Field from Well V � Size of Soakage Pit. (Signed) (Si Pl bing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as a 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 under signed agrees to employ only such sub- contr. tors, on work to be performed under this permit, as are licensed by Miami Shores Village. J 4? "'". ■ l Master 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. 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 CHECK SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SWIM'G POOL CONTR. LIST CHECK yy Permit No Owner's Name and Address Registered Architect and /or Employing Plumber's Nam Feet of Drain Tile Q_ ______________ ____ Nature of Water Supply: City —Well Amount of Permit $ STATE OF FLORIDA, } COUNTY OF DADE. ss. 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. ,x My Commission Expires Size Septic Tank 16 ©Q + itt Type of Tank _____ 4 '4 Date No. Street _ '_! :C. "AMA No ?L ) 7/ Street Of_ Location and Legal Description Lot Block__ / Subdivision_ • Capacity Gals.__ Street and Number where work is to be performed —No /4.7 A__h______/ L State work to be performed and purpose of building (By Floors) New Building V Remodeling Addition Repairs No. of Stories___ l Street--------------- ----------- -- - - -- — — — — — — _ Dist. Feet of Tank or Drain Field from Well V � Size of Soakage Pit. (Signed) (Si Pl bing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as a 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 under signed agrees to employ only such sub- contr. tors, on work to be performed under this permit, as are licensed by Miami Shores Village. J 4? "'". ■ l Master 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. 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. BUILDING : ELECTRICAL: PLUMBING : Inspector's Report: - : WORK • DONE BY, • The following is ready for Inspection: : REQUESTED TA : WILL BE READY • • • BUILDING ELECTRICAL PLUMBING Owner of Building MIAMI SHORES VILLAGE, FLORIDA DATE / Contractor's License No. PERMIT N9 1167 Work to be performed under this Permit Architect Contractor p I or Builder ,.. r1- k jrl Legal Lot I Description Address of •�► 4 g. Building 1 � '' / - S.— .+' / i 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 plats or drawings or in the statements or specifications and that he assumes responsibility for work done by his agents, servants or employees. Signed. ll, ` .I . "` By INSPECT In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regula- tions 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 ask „d ne responsibility for all work done by either myself agent servant or employee. t 'ONTRACTOR OR BUILDER Bl. Subdi- vision Value of Project BY Amt. of Permit r t:.. AUTHORITY