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229 NE 101 St (4)MIAMI SHORES VILLAGE BUILDING DEPART 305- 795 -2204 Building Inspection Reque Dahlk) Time Type Insp'n !_.. Permit No. Name D \ el o (M Como : ny I. A I , Address Phone # For Inspector: r I Approved Correction Re- Insp'n Fee BUILDING PERMIT APPLICATION FBC 2001 Permit Type (circle): Building Owner's Name (Fee Simple Titleholder) Owner's �� City / — Cks- State Job Address (where the work is being done) City Miami Shores Village Is Building Historically Designated YES NO Architect/Engineer's Name (if applicable) Architect/Engineer's Address City State $ Value of Work For this Per Number of: Bays Stories Type of Work: ❑Addition Describe Work: 1� Miami Shores Village Building Department Electrical Plumbing fqt I 5.4.4 Zip • County Miami -Dade Contractor's Company Name /114. ' eS Contractor's Addre s /19 77 M ` .._ S to `' l Zip 1 City / /� Sate Qualifier ePLwr-n/ G� Families ['Alteration [New LC /R P t— r Phone # i J 5) Fax: (305) Permit No 20034 Master Permit No. Mechanical Roofing i s Phone # Tenant/Lessee Name Phone # q Zip .. Phone # Zip Square Footage Of Work: Bedrooms ❑ Repair/Replace 7 n/c /v/A Baths * * * * * * * * * * * * * * * * * * * * * * * * * ** *Fee Calculation -Misc Permits * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** ❑ Demolition Avenue 33138 795.2204 756.8972 County Escrow Fee $ J . a,� Permit Fee $ Notary $ 1-. O Education/Training Fee $ Tech $ Scanning $ Radon $ Code Enforcement $ Bond $ 0 e Struct. $ Minus Plans Check Fee $ Fee Totals $ 374 0 I ic�l ac_ ov 7 (fvm1 a 1 (Continued on opposite side) Bonding Company's Name (if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State Zip Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature Signature _� Owner or Agent Contractor The foregoing instrument was acknowledged before me this The . regoing instrument was acknowledged before me thjis_ day of , 20 , by day o` _ , . who is personally known to me or who has produced who is personally As identification and who did take an oath. APPLICATION APPROVED BY: Chc6/18/03 200j_, byak p 1 cC ( 16 1 ) own to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: NOTARY P i : ' C: Sign: Si:: . A . i d , . i AA 1 i l � ■ . : , ,,., Print: t• my Commission DD150n411 °t' ' My Commission Expires: My Commission E • r itVires:'p Tres November 15, 2008 (Certificate of Competency Holder) State Certificate or Registration No. Certificate of Competency No. ***************************************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Plans Examiner . Zoning orvimpornrfrot IIWEI3d 0NI!l3AO0 3ALL031O1:Id H1IM JNIOlIf18 d0 30Vd NO aaVD NO C131V3ICINI SV DNIN3VB 01 N3lSV1 Ii3N31SVd H1IM dVld N33f1OSIA ao DISPLAY THIS CARD ON F 3aVIN 38 11IM NOI13 dSNI ON HO Sa0H13W ONIMO11OJ 31-11d0 3NO AS 801' 3H1 101NOHI 3H1 NO 133AV1dSla 38 1Sf1IAI aHIVO 1IWa3d SIH1 30031 3ALL031OIid ..8 MIAMI SHORES BUILDING P NOIiV1113N3d I ..9I NWI ..Z L 08 ONINOV9 ..81. x 'NINA f'13 ` I ,.' T PERMIT # pi 2fD!y" • DATE OWNER F E r-. ADDRESS 22 NE lol Sim CONTRACTOR lAr /� I� Q PERMIT TYPE 02121C/Ce � �e "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." MECHANICAL INSPECTION TYPE NSPECIOR DATE Una& NO Pipe C ; Slab condensate Columns / Poured Cells Slab Je n -Aire Rough Duct Tie Beam Rough Pipe 44 Exhaust Fan Rough Hood Rough 2nd Floor Slab Pool Heat Pump Fire Dampers 2nd Floor Columns Fireplace Vent Vacuum Pipe Rough Vacuum Pipe Final Roof Sheating Equipment Anchor ,) Suppression Test Wall Sheathing Tuct Detector U Ventilation Pressure Test Truss, Roof Fire Sprinkler Final FINAL Truss, Floor STRUCTURAL INSPECTION TYPE INSPECTOR DATE Footing Top Out Columns / Poured Cells 2nd Floor Rough 3rd Floor Rough Tie Beam Condensate Rake Beam Suppression Test 2nd Floor Slab Septic Sewer 2nd Floor Columns ,. 2nd Floor Tie Beam Gas Rough Roof Sheating Gas Final ,) ? - Wall Sheathing Well U Floor Sheeting Pressure Test Truss, Roof Fire Sprinkler Final Pool Maindrain Truss, Floor Pool Piping Store Front FINAL Buck Lath Window Installation Door Installation Tin Cap Mop in Progress Tile in Progress m . PLUMBING INSPECTION TYPE INSPECTOR DATE Ground Rough Top Out 2nd Floor Rough 3rd Floor Rough Condensate Drainfield Suppression Test Septic Sewer Water Service L P Tank Gas Rough Gas Final Irrigation Int: Ext: Well 0 Interceptor Pressure Test Fire Sprinkler Final Pool Maindrain Pool Piping FINAL NO INSPECTION WILL BE MADE UNLESS PERMIT CARD IS DISPLAYED AND APPROVED PLANS ARE READILY AVAILABLE STRUCTURAL INSPECTION TYPE Shingle in Progress Framing Insulation Drywall Sidewalk Driveway Form / Rock Storm Shutter Anchors Storm Shutter Final Patio / Deck Final Fence Final Pool Steel Pool / Patio Deck Screen Encl Final Pool Final Roof Final INSPECTOR DATE FINAL INSPECTION RECORD WORK MUST BE COMPLETED PRIOR TO REQUESTING INSPECTIONS 24 HOUR NOTICE FOR ALL INSPECTIONS 0 li ti 0 Q ELECTRICAL INSPECTION TYPE Temporary Pole Footer Grounding Slab Service Rough B. Alarm Prewire T.V. Prewire Intercom Prewire Phone Prewire B. Alarm Final T.V. Final Intercom Final Phone Final 30 Day Temp Power Pool Grounding Pool Slab NSPEC OR DATE FINAL FOR INSPECTIONS CALL 305 - 795 -2204 INSPECTION REQUESTS ARE ACCEPTED DURING THE HOURS OF 8:30 AM TO 3:30 PM FOR INSPECTIONS THE FOLLOWING BUSINESS DAY. CERTIFICATE OF OCCUPANCY MUST BE SECURED BEFORE THIS BUILDING CAN BE USED FOR ANY PURPOSE DO NOT REMOVE THIS CARD BEFORE COMPLETION OFFICE PHONE NUMBER: 305 - 795 -2204 pia 4-2 h • 0' ERMIT APPLICATION FOR MIAMI SHORES VILLAGE 6 Job A d d r e s s ) 6 /a i S Tax Folio y) 3 a d 013 s o -10 R S -0 / I A- -} g I Historically Designated: Yes No Date Legal 1. ption Owner/Lessee / Tenant Contracting Co. A, C. JG`PTII f faiJ 1/.4_ Address / �j� 7ti r✓� 2 Q`'^ Owner's Address Qualifier / '(14- SS# Phone 5= Cs /' 7 ' State # Municipal # . Competency # Ins. Co. Address Address Architect/Engineer Bonding Company Mortgagor Address Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION Square Ft. p FEES: PE APPROVED: Zoning Mechanical �• �/l(pi✓ �� Master Permit # 01 - 3/T 0 Zoz /k.. /DI , - er and/or Condo President Date Notary as to My Commission Expires: STEPHEN E COCI 4C State of1turiclo -My Comm. Exp: X1441' it: CC Owner and/or Condo President / 133/0/ ate C.C.F. Phone Estimated Cost (value /I sv 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 constructio and zoning. Furthermore, I authorize the above -named contractor to do the work stated. Si e of Contract as ----- 5/ 7X G./ e er- Builder Date •. V • 1 er- Builder •! ontract∎ or 0 My Commission Expires Electrical 1P Ry p 0,, OFFICIAL NOTARY SEAL e, ANGELA N9 BECKER I T 0 COMMISSION NUMSER _ Q CC786697 7 t Q om . 10 COMPASSION EXPIRES OF PN.O NOV. 1 £,2002 NOTARY S DT) BOND 3 D '. ate TOTAL DUE /6.4 V Structural Engineer APPLICANT: Fee, James STATE OF FLORIDA DEPARTMENT OF HEALTH ONSITE SEWAGE TREATMENT CONSTRUCTION PERMIT AND DISPOSAL SYSTEM 2ONSTRUCTION PERMIT FOR: ( ]New System [ ]Existing System. [' ]Holding Tank ( X ]Repair [ ]Abandonment [ ]Temporary ? ROPERTY STREET ADDRESS: 229 NE 101 St Miami FL 33138 ,OT: 15 BLOCK: 35 ?ROPERTY ID #: 11- 3206 - 013 -4790 SYSTEM MUST BE CONSTRUCTED IN ACCORDANCE WITH SPECIFICATIONS AND STANDARDS OF CHAPTER 64E -6,FAC )EPARTMENT APPROVAL OF SYSTEM DOES NOT GUARANTEE SATISFACTORY PERFORMANCE FOR ANY SPECIFIC TIME ?ERIOD. ANY CHANGE IN MATERIAL FACTS WHICH SERVED AS A BASIS FOR ISSUANCE OF THIS PERMIT, tEQUIRE THE APPLICANT TO MODIFY THE PERMIT APPLICATION. SUCH MODIFICATIONS MAY RESULT IN THIS ?ERMIT BEING MADE NULL AND VOID. ISSUANCE OF THIS PERMIT DOES NOT EXEMPT THE APPLICANT FROM :OMPLIANCE WITH OTHER FEDERAL, STATE OR LOCAL PERMITTING REQUIRED FOR PROPERTY DEVELOPMENT. ;YSTEM DESIGN AND SPECIFICATIONS ' [ 900 ]Gallons SEPTIC TANK MULTI - CHAMBERED /IN SERIES: [Y ] [ 0 ]Gallons MULTI - CHAMBERED /IN SERIES: [Y ] 1 [ 0 ]GALLONS GREASE INTERCEPTOR CAPACITY [ 0 ]GALLONS DOSING TANK CAPACITY [ 0 ]GALLONS @ [0 ]DOSES PER 24 HRS # PUMPS[ 0 ] [ 300 ]SQUARE FEET PRIMARY DRAINFIELD SYSTEM [ 0 ]SQUARE FEET TYPE SYSTEM: [ N ]STANDARD CONFIGURATION: [ N ]TRENCH SYSTEM [ N ]FILLED [ N ]BED LOCATION TO BENCHMARK: Finished Floor of E /R, 11.9' NGVD ELEVATION OF PROPOSED SYSTEM SITE [ 2.2 ] [ FEET ] BOTTOM OF DRAINFIELD TO BE [ 4.0 ] [ FEET ] FILL REQUIRED: [ 0.0 ]INCHES EXCAVATION REQUIRED: [ )THER REMARKS: This permit is not for addition (s) Install 300 sq.ft. of d /f. Invert elevation to be no less than 8.45' NGVD. Bottom elevation to be no less than 7.95' NGVD. The s/t shall be pumped & a solid deflection device ; PECIFICATIONS BY: ;PPROVED BY: Icaza, Carlos LATE ISSUED: 4/25/01 TITLE: AGENT: SR0931119, COCKING MSTEPHEN SUBDIVISION: Miami Shores Sec N 1 [Section /Township /Range /Parcel No.] [OR TAX ID NUMBER] TITLE: Engineer I CENTRAX #: 13 -SG -08725 DATE PAID: FEE PAID : $ RECEIPT . OSTDSNBR : 01 -1315- -R ] Innovative Other ] [ eela�. ] BENCHMARK /REFERENCE POINT [ p ,„... ]BENCHMARK /REFERENCE POINT [ N ]MOUND [ N ] [ N ] 21.0 ] INCHES installed on the outlet of the tee. IjNSTA I_ I t:iv, 1l:.N '7 -9S P-4u Dade CHD THE SE!• ° TAM F•! ". r_" TTAi1 se '43/01 :t r It )• f'rli _ • -" T'-- 41WITIRrn"Trio 1111111:13d fr ONIU3AOO 3ALL331OHd H.IM ONI011fS AO 3OVd NO aHV3 NO a31V3IaNI SY DNINDVB 01 N31SVI M3N31SVd HIIM dVld N33fOSIA aO 30031 3ALLO31OHd „@ X ., l , NOLLV1i13N3d 1 1 "In NIW 3aVIN 38 11IM NOI103dSNI ON HO Sa0H13W ONIMO11OJ 31-11.d0 3NO A8 80(' 3H1 JO 1NO1:1h 3H1 NO a3AV1dSla 38 iS(1W aHIVO 1I1N1:13d SIHI '09 ONIIOV9 •.BI. X „ Ll 'NIW PERMIT # pI 2teXDfr iqS DISPLAY THIS CARD ON F MIAMI SHORES BUILDING P OWNER ADDRESS 2z 9 CONTRACTOR IA 1 5 PERMIT TYPE Lit DATE ic "WARNING TO OWNER:YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." STRUCTURAL INSPECTION TYPE FISPECTOR DATE DATE Footing Slab condensate Slab Jeln -Aire �. Columns / Poured Cells Rough Duct Rough Pipe v Tie Beam Exhaust Fan Rough Hood Rough Rake Beam Pool Heat Pump Fire Dampers 2nd Floor Slab Fireplace Vent Vacuum Pipe Rough 2nd Floor Columns Vacuum Pipe Final I Equipment Anchor 2nd Floor Tie Beam Suppression Test Tuct Detector Roof Sheating ' ,) 11 Wall Sheathing Fire Sprinkler Final (' FINAL Floor Sheeting Pool Piping J Truss, Roof FINAL Truss, Floor Store Front Buck Lath Window Installation Door Installation Tin Cap Mop in Progress Tile in Progress a MECHANICAL INSPECTION TYPE NSPBCIOR DATE UnIdF NC Pipe Slab condensate Slab Jeln -Aire Rough Duct Rough Pipe v Exhaust Fan Rough Hood Rough Pool Heat Pump Fire Dampers Fireplace Vent Vacuum Pipe Rough Vacuum Pipe Final Equipment Anchor Suppression Test Tuct Detector Ventilation Pressure Test Fire Sprinkler Final FINAL PLUMBING INSPECTION TYPE &SPECTOR DATE Ground Rough Top Out 2nd Floor Rough 3rd Floor Rough Condensate Drainfield Suppression Test Septic Sewer Water Service L P Tank Gas Rough Gas Final Irrigation 1nt: Ext: Well Interceptor Pressure Test Fire Sprinkler Final Pool Maindrain Pool Piping FINAL NO INSPECTION WILL BE MADE UNLESS PERMIT CARD IS DISPLAYED AND APPROVED PLANS ARE READILY AVAILABLE STRUCTURAL INSPECTION TYPE Shingle in Progress Framing Insulation Drywall Sidewalk Driveway Form / Rock Storm Shutter Anchors Storm Shutter Final Patio / Deck Final Fence Final Pool Steel Pool / Patio Deck Screen Encl Final Pool Final Roof Final INSPECTOR DATE INSPECTION RECORD WORK MUST BE COMPLETED PRIOR TO REQUESTING INSPECTIONS 24 HOUR NOTICE FOR ALL INSPECTIONS 0 • r' ELECTRICAL INSPECTION TYPE Temporary Pole Footer Grounding Slab Service Rough B. Alarm Prewire T.V. Prewire Intercom Prewire Phone Prewire B. Alarm Final T.V. Final Intercom Final Phone Final 30 Day Temp Power Pool Grounding Pool Slab INSPECTOR DATE FINAL FOR NSPECTIONS CALL 305 - 795 -2204 INSPECTION REQUESTS ARE ACCEPTED DURING THE HOURS OF 8:30 AM TO 3:30 PM FOR INSPECTIONS THE FOLLOWING BUSINESS DAY. CERTIFICATE OF OCCUPANCY MUST BE SECURED BEFORE THIS BUILDING CAN BE USED FOR ANY PURPOSE DO NOT REMOVE THIS CARD BEFORE COMPLETION OFFICE PHONE NUMBER: 305 - 795 -2204 Pe ct ^2 6.0 MIAMI H �f PERMIT APPLICATION FOR MIAM SHORES VILLAGE S O Date Legal 1 Job Address / E • lots tirTax Folio 1 1 3 a 6 ©I 3 '- 7 D ' On �p ^� D ption S 4 7 1 A _p a Historically Designated: Yes No Owner/Lessee / Tenant /'14. ✓u , Q-Q__� Master Permit # Owner's Address �2..2 9 V C - /6 / f�/ -�-4 Phone Contracting Co. C S -J 6, 1 D(1J Qualifier .0 L 6 . & (,./t- "` . / 7 State # Municipal # Architect/Engineer Bonding Company Mortgagor Address Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION v 7464-- Square Ft. 4 0-3 70/ ' Notary as to Owner and/or Condo President Date My Commission Expires: FEES: PE er and/or Condo President i\2o)o) k STEPHEN E COCK Stets of1'r'tds -My Comm. Exp: Oti Vs10 i H: CC � APPROVED: Zoning Building Mechanical Plumbing C.C.F. 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 constructio and zoning. Furthermore, I authorize the above -named contractor to do the work stated. Address My Commission Expires ss# Phone - 5' CS/ Competency # Ins. Co. Address Address Estimated Cost (valut /I dv NOTARY S . C7 7) BOND 3 0 V .1 ‘ . `• TOTAL DUE ,�j r%, V Electrical D/ / 3/S /2 • / 9y' 31- ,✓t 2 a- ' �y Po OFFICIAL NOTARY SEAL 1P d ANGELA PA 8ECKER O )1 2,( 1( ! / C' COMWSSON NUMBER A i L Q CC786697 7 t � Q ,: MY COMMISSION EXPIRES CF fL NOV. 15,2002 Structural Engineer CONSTRUCTION PERMIT FOR: [ ]New System [ ]Existing System [ X ]Repair [ ]Abandonment APPLICANT: Fee, James ?ROPERTY STREET ADDRESS: 229 NE 101 St Miami FL 33138 [ 300 ]SQUARE FEET PRIMARY DRAINFIELD SYSTEM [ 0 ]SQUARE FEET SYSTEM TYPE SYSTEM: [ N ]STANDARD [ N ]FILLED CONFIGURATION: [ N ]TRENCH [ N ]BED I ; PECIFICATIONS BY: A PPROVED BY: Icaza, Carlos SATE ISSUED: 4/25/01 STATE OF FLORIDA DEPARTMENT OF HEALTH ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM CONSTRUCTION PERMIT 1HoidingTank ]Temporary TITLE: AGENT: SR0931119, COCKING MSTEPHEN SOT: 15 BLOCK: 35 SUBDIVISION: Miami Shores Sec N 1 [Section /Township /Range /Parcel No.] ?ROPERTY ID #: 11- 3206 - 013 -4790 [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 ?ERIOD. ANY CHANGE IN MATERIAL FACTS WHICH SERVED AS A BASIS FOR ISSUANCE OF THIS PERMIT, 2EQUIRE THE APPLICANT TO MODIFY THE PERMIT APPLICATION. SUCH MODIFICATIONS MAY RESULT IN THIS ?ERMIT BEING MADE NULL AND VOID. ISSUANCE OF THIS PERMIT DOES NOT EXEMPT THE APPLICANT FROM :OMPLIANCE WITH OTHER FEDERAL, STATE OR LOCAL PERMITTING REQUIRED FOR PROPERTY DEVELOPMENT. SYSTEM DESIGN AND SPECIFICATIONS ' [ 900 ]Gallons SEPTIC TANK MULTI - CHAMBERED /IN SERIES: [Y ] [ 0 ]Gallons MULTI - CHAMBERED /IN SERIES: [Y ] 1 [ 0 ]GALLONS GREASE INTERCEPTOR CAPACITY C [ 0 ]GALLONS DOSING TANK CAPACITY [ 0 ]GALLONS @ [0 ]DOSES PER 24 HRS # PUMPS[ 0 ] LOCATION TO BENCHMARK: Finished Floor of E /R, 11.9' NGVD ELEVATION OF PROPOSED SYSTEM SITE [ 2.2 ] [ FEET ] [ 1Z1 /REFERENCE POINT BOTTOM OF DRAINFIELD TO BE [ 4.0 ] [ FEET ] [ p0 /REFERENCE POINT FILL REQUIRED:[ 0.0 ]INCHES EXCAVATION REQUIRED: [ 21.0 ] INCHES CENTRAX #: 13 -SG -08725 DATE PAID: FEE PAID : $ RECEIPT . OSTDSNBR : 01 -1315- -R ] Innovative Other ] [ N ]MOUND [ N [ N ] )THER REMARKS: This permit is not for addition (s) Install 300 sq.ft. of d /f. Invert elevation to be no less than 8.45' NGVD. Bottom elevation to be no less than 7.95' NGVD. The s/t shall be pumped & a solid deflection device installed on the outlet of the tee. TITLE: Engineer I INSTALL l.7sf COPIPS7 SAND ... aJ EL ' Ivr c J _ '7 - s N6 Dade CHD ���`�a TANK .•19 9 � ., r e.'a q Si) ,11/o1 ;C ; w.,bs� �'rc,t�:I. Bs 3 /o1 w� a•r: r•....__..r l∎r!.1r∎ ••• a• r .. •-11 S' t': T.11 Tr, f 'ir•ti tiT.....�t .i�I�I. uiww�(u lr'u.iw ■" a Si.7�•�■ `i i�ijif..l..iuu... *Worn o. /•Ko•.RRf ■ .ur m.w WWWENOR OWWW: �//f■ ■R■RR I• f' / /■UR/ ■■'!' ■a K/f.■R/ � ■R■ • ■••K•■ ■KR■.■■.. A • ■m ■ , •K.■ ■...•II: •.f ■. f.•.■f ■�1.. K• f ■ ■. ■ .■rr■X■.■ . ••www •www■R wwwwww1. 11 ;..!! ��■�f ■fit MO !R> / /■O R�MOMR . ■' f� a ■/R■M . 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STATE OF FLORIDA DEPARTMENT OF HEALTH AND REHABILITATIVE SERVICES APPLICATION FOR ONSITE SEWAGE DISPOSAL SYSTEM CONSTRUCTION PERMIT t j Permit Application Number f ` .)/ PART II - SITE PLAN „CV._ Site Plan Submitted by: Plan Approved By HRS -H Form 4015, Feb 85 (Obsoletes previous editions which may not be used) (Stock Number: 5744- 002 - 4015 -6) Not Approved p ALL CHANGES MUST BE APPROVED BY THE COUNTY PUBLIC HEALTH UNIT County Public Unit Page 2 of 3 Permit No. ___ New Building 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 comphance 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 tho. 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. _../4/402___ 7Ct Registered Architect and /or Engineer -.. Employing Plumber's Name Amount of Permit $_ STATE OF FLORIDA, } COUNTY OF DADE. Remodeling Size Septic Tank__ _ -_ - Feet of Drain Tile___-__.__ Nature of Water Supply: City—Well. _ _ _____ MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Date ,?/ - - -•-- __ . No.-- -- --- ------ Street- • - -- - -- - . (Signed). o._ Street Location and Legal Description Lott__ _ Block__ Subdivision_ Street and Number where work is to be performed —No _��— a� 49 Street State work to be performed and purpose of building (By Floors) _ _ _ _ _ _ Addition____ _ _ ___ .... Repairs. No. of Stories _ - Type of Tank _______ _ _ .___ °__Dist. Feet of Tank or Drain Field from Well. _ . Size of Soakage Pit Plumbing In:'pector 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 no'ices as are required by the Act. The undersigned agrees to employ only such sub- contractors, on work to be perfo;wed under this per nit, as are licensed by Miami Shores Village. (Signed)_. - -_ -L' ._.Capacity Gals. My Commission Expires Notary Public, State of Florida M t& IP umber. ' Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personall 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 • acts 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 TUBS SHOWERS LAVA TORIES SINKS SLOP SINKS LAUNDRY TUBE URINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT'N6 TOTAL F'XTURE6 comm. LIST CHECK SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SWIM'G POOL Corms. LIST CHECK Permit No. ___ New Building 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 comphance 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 tho. 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. _../4/402___ 7Ct Registered Architect and /or Engineer -.. Employing Plumber's Name Amount of Permit $_ STATE OF FLORIDA, } COUNTY OF DADE. Remodeling Size Septic Tank__ _ -_ - Feet of Drain Tile___-__.__ Nature of Water Supply: City—Well. _ _ _____ MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Date ,?/ - - -•-- __ . No.-- -- --- ------ Street- • - -- - -- - . (Signed). o._ Street Location and Legal Description Lott__ _ Block__ Subdivision_ Street and Number where work is to be performed —No _��— a� 49 Street State work to be performed and purpose of building (By Floors) _ _ _ _ _ _ Addition____ _ _ ___ .... Repairs. No. of Stories _ - Type of Tank _______ _ _ .___ °__Dist. Feet of Tank or Drain Field from Well. _ . Size of Soakage Pit Plumbing In:'pector 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 no'ices as are required by the Act. The undersigned agrees to employ only such sub- contractors, on work to be perfo;wed under this per nit, as are licensed by Miami Shores Village. (Signed)_. - -_ -L' ._.Capacity Gals. My Commission Expires Notary Public, State of Florida M t& IP umber. ' Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personall 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 • acts 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. BUILDING ❑ MIAMI SHORES VILLAGE, FLORIDA ELECTRICAL E1 PLUMBING al PERMIT N? 10035 Contractor's ROOFING ❑ License No. ❑ Work to be performed under this Permit Owner of Building Architect Contractor or Builder Legal Lot Description II BI Address of Building CONTRACTOR or BUILDER Dates 19 s Subdi- vision Sq. Ft. Value of 11 Amount of Project $ II 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• • "i y (INSPECTOR) BY - In consideration of the issuance to me of this permit' I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plants, 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 BUILDING ❑ MIAMI SHORES VILLAGE, FLORIDA If Date ELECTRICAL ❑ PLUMBING PERMIT N? 10079 ROOFING ❑ 0 Owner of l# Building { E . t ., a,.Y Architect Contractor ; .. or Builder ` ... .� ,. < 4 ■ ; .;' 4 Legal Lot 11 Description 11 Bl. Address of Building e , I f`°' t c- Signed• CONTRACTOR or BUILDER Work to be performed under this Permit Contractor's , l / License No 4.)r ♦a+ a 194 Subdi- vision Sq Ft. ,�/ x,. ® " Value of Amount of �• .." ` Project $ I Permit $ BY AUTHORITY 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 whethe shown on the plans qr drawings or in the statements or specifications and that he assumes respon- sibility for work done by his agents, s v�ts o //r; employee. 1 4^^ \1 -' '(INSPECTOR) BY In consideration of the issuance to me of this permit I agre to I perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawin atements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work do either, myself, ,my agent, servant or employee. MIAMI SHORES VILLAGE, FLORIDA L —" ❑ DATE ' ( f 1 195- ❑ PERMIT N° 15 910 Contractor's .: License No. ❑ Work to be performed under this Permit BUILDING ELECTRICAL PLUMBING ROOFING Owner of Building Architect Contractor or Builder CONTRACTOR OR BUILDER Description Legal Lot ll 1 i1. vision Subdi- .._ Address of '"° I.( Value of o r n Amt. of Building Project $ Permit $ ` This permit is ranted to t e contractor bui a a bove 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 wil b perf 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. f Signed: ( `� rte _. ', � . B k t '. -) \ ,. 1 INSPECTOR } In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances ar regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami S ores Village. In accepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. BY AUTHORITY 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 mplied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. Owners Name and Address Registered Architect and /or Engineer —M Employing Plumber's Name __ _ i_ J _____ No. Location and Legal Description Lot Street and Number where work is to be performed —No State work to be performed and purpose of building (By Floors) ____--_ New Building _. Remodeling_____ — _._._ Addition. _._.___.__. Size Septic Tank L� Feet of Drain Nature of Water Supply: City —Well Amount of Permit $ STATE OF FLORIDA, I COUNTY OF DADE. ss. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Block _Type of Tank t. Feet of Tank or Drain Field from Well Size of Soakage Pit (Signed)_ Date Cok) No. _ G.. l _ 3 I J - — Street.__..._ Street__ Repairs No. of Stories Capacity Gals The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer s labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and h' s com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the w.rk 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. My Commission Expires Notary Public, State of Florida P1 . g nspec .r. 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•ne.esssry by improper notice for inspection, or faulty materials and /or workmanship. CLOSETS BATH TUBS SHOWERS LAVA- TORIES INK SINKS SLOP SINKS LAUNDRY TUBS U 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 SW IM'G POOL Corm. 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 mplied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. Owners Name and Address Registered Architect and /or Engineer —M Employing Plumber's Name __ _ i_ J _____ No. Location and Legal Description Lot Street and Number where work is to be performed —No State work to be performed and purpose of building (By Floors) ____--_ New Building _. Remodeling_____ — _._._ Addition. _._.___.__. Size Septic Tank L� Feet of Drain Nature of Water Supply: City —Well Amount of Permit $ STATE OF FLORIDA, I COUNTY OF DADE. ss. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Block _Type of Tank t. Feet of Tank or Drain Field from Well Size of Soakage Pit (Signed)_ Date Cok) No. _ G.. l _ 3 I J - — Street.__..._ Street__ Repairs No. of Stories Capacity Gals The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer s labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and h' s com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the w.rk 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. My Commission Expires Notary Public, State of Florida P1 . g nspec .r. 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•ne.esssry by improper notice for inspection, or faulty materials and /or workmanship. BUILDING ELECTRICAL PLUMBING Owner of Building Architect Contractor or Builder Legal Lot Description MIAMI SHORES VILLAGE, FLORIDA DAT k' 194 ERMIT N° 7569 Work to be performed under this Permit )22 Bl. Subdi- vision RACTOWOR BUILDER BY 44. By INSPECTOR L o 1tractor's icense No. Address of Value of Building_ ��' ,/ Project This permit is grax'fted 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 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. s Signed. Amt. of Permit In consideration of the issuance to me of this permit I agree to perform the w6rk covered hereunder in compliance with all ordin pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of In acc tthi peimi I assume responsibility for a work done by either myself, my agent, servant or employee. AUTHORITY d and regulations i Stole Rage. Permit No.7- 7 Employing Illotathes Name__ 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 e 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 h 1 k bf ° No 7 1 Street �` r' Registered Architect and /or Engineer /� <f / No , - C ; r I Street f✓. " " o Location and Legal Description Lot Block Subdivision Street and Number where work is to be performed —No 2. 7 -a M L. Street cy / 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 Feet of Drain Tile Dist. Feet of Tank or Drain Field from Well 1 (L9 /lids Size of Soakage Pit Nature of Water Supply: ity —Well ( Signed) Date 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, o work to be performed, under this permit, as are licensed by Miami Shores Village. / / t ' (Signed)... 1 {� My Commission Expires Notary Public, State of Florida 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.7- 7 Employing Illotathes Name__ 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 e 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 h 1 k bf ° No 7 1 Street �` r' Registered Architect and /or Engineer /� <f / No , - C ; r I Street f✓. " " o Location and Legal Description Lot Block Subdivision Street and Number where work is to be performed —No 2. 7 -a M L. Street cy / 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 Feet of Drain Tile Dist. Feet of Tank or Drain Field from Well 1 (L9 /lids Size of Soakage Pit Nature of Water Supply: ity —Well ( Signed) Date 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, o work to be performed, under this permit, as are licensed by Miami Shores Village. / / t ' (Signed)... 1 {� My Commission Expires Notary Public, State of Florida 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 $1.00 will be made when such re inspection is made necessary by improper notice for inspection, or faulty materials and /or workmanship. OWNE$ <w LOT BLOCK SUBD1V ION , i 1 -- , :rif., e AN6 i 6 'it Issued to PLUMBING PERMIT / -4) to lkta11 CKe following described plumbing, in accordance with the laws, statutes and regu- lations of Miami Shores Village, Florida and the State of Florida, governing plumbing and drainage work done in Miami Shores Village, Florida. For a /story Agi building at 2. ' , / /4/ I Fixtures Fixtures $ Sewer $ •ic Tank / $ ! °„� Total $ aiami efhores F L O B ID A Village Plumbing Inspector Received Payment by N9 1088 t Permit No .___y____ ` Date New Building Remodeling ° Size Septic Tank Type of Tank Feet of Drain Tile Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: C y Well Size of Soakage Pit Amount of Permit $ STATE OF FLORIDA, COUNTY OF DADE. ss. My Commission Expires (.. 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____ l L Registered Architect and /or Engin Employing Plontherts Name Y__ - ti t_! / G__ sed + No3 /7 5 Street__ ' Location and Legal Description Lot Block Subdivision Street and Number where work is to be performed —No 1__2 Street 2/1"' 1 e / e State work to be performed and purpose of building (By Floors) No. 1 e C Street Lr `/ l Addition Repairs No. of Stories Plumbing Inspector. The undersignedpplicant for this building rmit does hereby certify that he understands and accepts his obligations as an employer of,tabor under the Florida W rkmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and ha/ 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. 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 FOU NT' NS TOTAL FIXTURES CONTR. LIST CHECK SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL • SPRKLR. SYSTEM STEM � ' SW IM'G POOL CONTR. LIST ` M +++ CHECK t Permit No .___y____ ` Date New Building Remodeling ° Size Septic Tank Type of Tank Feet of Drain Tile Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: C y Well Size of Soakage Pit Amount of Permit $ STATE OF FLORIDA, COUNTY OF DADE. ss. My Commission Expires (.. 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____ l L Registered Architect and /or Engin Employing Plontherts Name Y__ - ti t_! / G__ sed + No3 /7 5 Street__ ' Location and Legal Description Lot Block Subdivision Street and Number where work is to be performed —No 1__2 Street 2/1"' 1 e / e State work to be performed and purpose of building (By Floors) No. 1 e C Street Lr `/ l Addition Repairs No. of Stories Plumbing Inspector. The undersignedpplicant for this building rmit does hereby certify that he understands and accepts his obligations as an employer of,tabor under the Florida W rkmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and ha/ 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. 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.