230 NE 101 St (4)Date 1/15/96
Legal Description Historically Designated: Yes No
Owner/Lessee / Tenant JAMES MORRIS Master Permit #
Owner's Address 230 NE 101 STREET, MIAMI SHORES 33138 Phone 758 -8592
Contracting Co. NORTH DADE SEPTIC TANK
Qualifier DENNIS NEVILLE
WORK DESCRIPTION INSTALL DRAINFIELD
Square Ft 300
I t ivA...4
Si fiture of owner and/or Condo President D . to
a
Not ?%'Owner and/or
My Commission Expires:
FEES: PERMIT
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Job Address 230 NE 101 STREET
do Pr ident Date
APPROVED:
Zoning
Mechanical Plumbing
Building
SS#
Tax Folio
Address 800 NW 111 STREET, MIAMI 33168
phone 754 -3375
State# 025836 -8 Municipal# Competency# 12842 ins C �RAVEI;ERS /ESIF
Architect/Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
Estimated Cost (value)$1000.00
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 OF 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 th • work will be done in compliance with all applicable
laws regulating construction and zoning. Furthermore, I authorize the above -named to do the w tated.
Signa ontractor or Owner- l; uilder Date
My
VAWM AVOW
4S'
oar vas Teresa J. Felder
1 ' Notary Public, Stale of Florida
•': if Commission No. CC 480807
v / Or F,.o My Commission Expires 07/16/99. ;
> I .800.3NOTARY - na. Notary Service & Bearding
36" . RADON C.C.F. .5 NOTARY
Ci
s to Contractor : •wne - Builder Date
ommission Expir
Electrical
SSSKSSSSSMMMM SSSSSSSSSSSSSSSRSSSSSSRSSSSSS
� ).a Teresa J. Felder
Notary Public, State of Florida •
Commission No. CC 480807
� "eor No' My Commission Expires 07/16/99
I-800.3IOTARY• Fla,Notary Service &BondiegCo
emeerweatereetweeteeeeeteeeeeeeeteetweeeee
TOTAL DUE 3 ‹•
Engineering
0
T
H
E
R
CONSTRUCTION PERMIT FOR:
[ N] New System [ N] Existing System [ N] Holding [ N] Temporary /Experimental
[ Y] Repair [ N] Abandonment [ N] Other(Specify)
APPLICANT: MORRIS
LOT: g) PC BLOCK: 04_ SUBDIVISION: VA
PROPERTY ID #:
SPECIFICATIONS BY:
APPROVED BY:
DATE ISSUED:,Q.
STATE OF FLORIDA PERMIT #
DEPARTMENT OF HEALTH AND REHABILITATIVE SERVICES DATE PAID
ONSITE SEWAGE DISPOSAL SYSTEM FEE PAID $
CONSTRUCTION PERMIT RECEIPT #
Authority: Chapter 381, FS & Chapter 10D- 6,
INSTALL 12 OF LOAMY COARSE SAND UNDER BOTTOM
OF DRAINFIELD SUBMIT BENCHMARK BEFORE INSPECTION.
THIS PERMIT IS NOT FOR ADDITION(S).
INVERT ELEVATION (MINIMUM):
BOTTOM OF DRAINFIELD ELEVATION (MINIMUM): )J'
COLDILDMLIT
AGENT: NORTH DADE SEPTIC
PROPERTY STREET ADDRESS: 230 NE 101 STREET, MIAMI SHORES 33138
[SECTION /TOWNSHIP /RANGE /PARCEL NUMBER]
[OR TAX ID NUMBER]
TITLE:
THE SEPTIC TANK SHALL BE PUMPED AND A
SOLID DEFLECTION DEVICE INSTALLED ON THE
OUTLET TEE,
HRS -H Form 4016, Mar 92 (Obsoletes previous editions which may not be used)
(Stock Number: 5744- 001 - 4016-0)
EXPIRATION DATE:
SYSTEM MUST BE CONSTRUCTED IN ACCORDANCE WITH SPECIFICATIONS AND STANDARDS OF CHAPTER 10D -6, FAC
REPAIR PERMITS AND HOLDING TANK PERMITS EXPIRE 90 DAYS FROM THE DATE OF ISSUE. ALL OTHER PERMITS
EXPIRE ONE YEAR FROM THE DATE OF ISSUE. HRS APPROVAL OF SYSTEM DOES NOT GUARANTEE SATISFACTORY
PERFORMANCE FOR ANY SPECIFIC PERIOD OF TIME. ANY CHANGE IN MATERIAL FACTS WHICH SERVED AS A
BASIS FOR ISSUANCE OF THIS PERMIT, REQUIRE THE APPLICANT TO MODIFY THE PERMIT APPLICATION. SUCH
MODIFICATIONS MAY RESULT IN THIS PERMIT BEING MADE NULL AND VOID.
SYSTEM DESIGN AND SPECIFICATIONS
EXISTING
T [ 990 ] [GALLONS / GKRI SEPTIC TANK /AEROBIC UNIT CAPACITY MULTI- CHAMBERED /IN SERIES:[ ]
A [ ] [GALLONS / GPD] CAPACITY MULTI- CHAMBERED /IN SERIES:[ ]
N [ ] GALLONS GREASE INTERCEPTOR CAPACITY [MAXIMUM CAPACITY SINGLE TANK: 1250 GALLONS]
K [ ] GALLONS PER DOSE DOSING TANK CAPACITY DOSE RATE [ ] PER 24 HRS NO. OF PUMPS: [ ]
D [ 300 ] SQUARE FEET PRAIMDRAINFIELD SYSTEM
R [ ] SQUARE FEET SYSTEM
A TYPE SYSTEM: [ X] STANDARD [ ] FILLED [ ] MOUND [ ]
I CONFIGURATION: [ ] TRENCH [ x] BED [ J
N
F LOCATION OF BENCHMARK:
I ELEVATION OF PROPOSED SYSTEM SITE [ ] [INCHES /FT] [ABOVE /BELOW] BENCHMARK /REFERENCE POINT
E BOTTOM OF DRAINFIELD TO BE [ ] [INCHES /FT] [ABOVE /BELOW] BENCHMARK /REFERENCE POINT
L
D FILL REQUIRED: [ ] INCHES EXCAVATION REQUIRED: [3Q] INCHES
CPHU
Page 1 of 2
El\l3 a :3l:=3NS:
1Y.1r"' NI1R!,3a'8: Permit treeltir.. number assignee, E:y
A221 C.A Ch•cs type of permit, if °Other' specify type in bars
A2:K.ICAN">; : 12roporty owner's full amen.
TI.4.E2iiaON;:.: Telephone zw.rnbCr for cy2licant or agent.
Drope?ty owner's legally cu�lozz73 rapeesentative.
A° FR.i ADD SS: P.O. 1 box or <irce2 mailine,• addra:;a for cpplicani or age:'.
1.07, 3LOCi£, SU3DIVli.SION o°
2302: 3e 1,' DO: 27 character id number for prope :y. (CPI IU may rrqui.:: ?ropetly rpv:ci: r ]D 0 or section /township /range /parcel number)
S T Zy 'ES.GN AND
Spy 7F..S=ECA" ONS:
IN'iri ur s? ;ci`cationa from Cher..ler E0D-6, IPAC.
1 E : ':: Minimum speeifiestiois from C r?:er 10D-6, IPAC.
,,:";' : Other spccificatio_'. , such es oor_ permit ecquirem.nts, low- voleTe f_usb toiie :a, vet provisos.
3 :7 C:!:=;CAe:ONS 3Y: Nam of individual providing speciucations. if designer. `:y a repisiesed engineer mutt he sealed.
AE':'.:i0V.3D 3Y: County Fublic Health Unit (CL' -i:J) personnel reviewing end approving peEnit.
DAT :F. !SSU .D: Date permit is issued by CPWJ.
^°C ' A'":CN DATE: One year &ore date issued if the ay. Lett! has no: been i • ^i.. ?enn: ::s 4:0 system repairs become void 90 days from the date
issued.
APPLICANT: MORRIS
LOT:
STATE OF FLORIDA
DEPARTMENT OF HEALTH AND REHABILITATIVE SERVICES
ONSITE SEWAGE DISPOSAL SYSTEM
SITE EVALUATION AND SYSTEM SPECIFICATIONS
BLOCK: SUBDIVISION:
PROPERTY ID #: 230 NE 101 STREET, 33138
TO BE COMPLETED BY ENGINEER, HEALTH UNIT EMPLOYEE, OR OTHER QUALIFIED PERSON. ENGINEER'S MUST
PROVIDE REGISTRATION NUMBER AND SIGN AND SEAL EACH PAGE OF SUBMITTAL. COMPLETE ALL ITEMS.
PROPERTY SIZE CONFORMS TO SITE PLAN: [']
TOTAL ESTIMATED SEWAGE FLOW: EF10
AUTHORIZED SEWAGE FLOW: fPy
UNOBSTRUCTED AREA AVAILABLE: (
BENCHMARK /REFERENCE POINT LOCATION:
ELEVATION OF PROPOSED SYSTEM SITE IS Qa_ 5 /FT] [ABO i 3t1r BENCHMARK /K C POINT
THE MINIMUM SETBACK WHICH CAN BE MAINTAINED FROM THE PROPOSED SYSTEM TO THE FOLLOWING FEATURES:
SURFACE WATER: 100+ FT DITCHES /SWALES: --- FT NORMALLY WET? [ ] YES (X] NO
WELLS: PUBLIC: 100 FT LIMITED USE: -- FT PRIVATE: — FT NON - POTABLE: — FT
BUILDING FOUNDATIONS: 5 FT PROPERTY LINES: 5 FT POTABLE WATER LINES: 15 FT
10 YEAR FLOODI G? [ ] YES x] NO
10 YEAR FLOOD ELEVATION FOR SITE: W.T. 3.5 FT MSL /NGVD SITE ELEVATION: 4.1115.q3 FT MSL /NGVD
SITE SUBJECT TO FREQUENT FLOODING: [ ] YES [X) NO
SOIL PROFILE INFORMATIONW'SITE 1
Munsell # /Color Texture
• BROWN SNADY
USDA SOIL SERIES: SANDY
0"
Depth
to 72"
to
to
to
to
to
to
to
to
OBSERVED WATER TABLE: INCHES [t / BELOW] EXISTING GRADE. TYPE: [ `it° 'dffI / APPARENT]
ESTIMATED WET SEASON WATER TABLE ELEVATION: 108 INCHES [b`{ / BELOW ] EXISTING GRADE.
HIGH WATER TABLE VEGETATION: ,[ ] YES [X] NO MOTTLING: [ ] YES [X] NO DEPTH: INCHES
SOIL TEXTURE /LOADING RATE FOR SYSTEM SIZING: 1.25 DEPTH OF EXCAVATION: 30 INCHES
DRAINFIELD CONFIGURATION: [ j TRENCH [Xx] BED [. ) OTHER (SPECIFY)
REMARKS /ADDITIONAL CR<YTERIA:
•
SITE EVALUATED BY:
HRS -H Form 4015, Mar 92 (Obsoletes previous edit
(Stock Number: 5744 - 003 - 4015 -1)
•
AGENT:
NORTH DADS.
PERMIT # ?° � 6 (6_3
SOIL PROFILE INFORMATION SITE 2
[Section /Township /Range /Parcel No. or Tax ID Number]
YES [ ] NO NET USABLE AREA AVAILABLE: a/ K2-- ACRES
GALLONS PER DAY [RESIDENCES -TABLE 1 / OTHER -TABLE 2]
GALLONS PER DAY [1500 GPD /ACRE OR 2500 GPD /ACRE]
SQFT UNOBSTRUCTED AREA REQUIRED: �n ®® SQFT
FF o9g
Munsell # /Color Texture
BROWN SANDY
USDA SOIL SERIES: SANDY
Depth
0" to 72"
to
to
to
to
to
to
to
to
i
)
DATE: 1/16/95
Page 3 of 3
,FORI.
New `Systtt [ N ]. Existing System [ N ] Holding Tank [ N ] Temporary /Experimental
Repair;' [ Nj Abandonment [ N] Other(Specify)
- (S
ApP.LTGAHT: .MORRIS TELEPHONE: 758 -8592
AGENT: NORTH DADE SEIC TANK
MAILING ADDRESS: 800 NW 111 STREET, MIAMI 33168
PROPERTY. ID #:
PROPERTY SIZE:•
DIRECTIONS TO PROPERTY:
Unit ;• Type. of •
No Establishment
Z2E2 SFR
APPLICANT'S SIGNATURE:
STATE OF FLORIDA
DEPARTMENT OF HEALTH AND REHABILITATIVE SERVICES
ONSITE SEWAGE DISPOSAL SYSTEM
APPLICATION FOR CONSTRUCTION PERMIT
Authority: Chapter 381, FS & Chapter 10D -6, FAC
PERMIT #
DATE PAID
FEE PAID
RECEIPT #
' ////6 7
/,/ /(, 7q4
$ '
754 -3375
TO BE COMPLETED BY APPLICANT OR APPLICANT'S AUTHORIZED AGENT. ATTACH BUILDING PLAN AND TO -SCALE
SITE PLAN SHOWING PERTINENT FEATURES REQUIRED BY CHAPTER 10D -6, FLORIDA ADMINISTRATIVE CODE.
a
'P.ROPERTY•INFORMATION [IF.LOT IS NOT IN A RECORDED. SUBDIVISION, ATTACH LEGAL OR DEED]
BLOCK:. SUBDIVISION:
PROPERTY STREET ADDRESS: 230 NE 101 STREET, 33138
BUILDING INFORMATION [X] RESIDENTIAL
No. of
Bedrooms
3 BEDROOMS
HRS -H Form 4015, Mar 92 (Obsoletes previous editions which may not be used)
(Stock Number: 5744- 001- 4015 -1)
[
Building # Persons
Area Saft Served
DATE: `OF•BEFeRE : 72
• SUBDIVIS'•ION.
{Section / Township /Range /Parcel•No..]JONING
ACRES [Sgft /43560]. PROPERTY WATER SUPPLY:
] COMMERCIAL
[. ] . PRIVATE (X ]• PUBLIC
Business Activity
For Commercial Only
[N ] Garbage'Grinders /Dispos s [N ] Spas /Hot Tubs [N ] Floor /Equipment Drains
[N] Ultra -low Volume Flu OT lets [N] Other (Specify)
DATE:1 /16/96
Page 1 of 3
STATE OF FLORIDA
DEPARTMENT OF HEALTH AND REHABILITATIVE SERVICES
- APPLICATION FOR ONSITE SEWAGE DISPOSAL SYSTEM CONSTRUCTION PERMIT T
Permit Application Number / 6 / • 0 /6
Scale: Each flock represents5 feet and 1 inch = 50 feet. Al eq
Co
S Y"I
r
c
' 4
4
T INK
•
f
r*�
D:
m
-9G
9, 7
7 d ,
LS)
t
Notes: JAMES MORRIS: 230 NE 101 STREET° 33138
OLD SYSTEMOVERFLOWING o •
Site Plan submitted by:
Plan Approved
HRS-H Form 4015, Feb 85 (Obsoletes previous editions which may not be used)
(Stock Number. 5744-002-4015-6)
PART II - SITE PLAN
SIGNATURE
Not Approved
By e'`//
ALL C G S MUST BE APPROVED BY THE COUNTY PUBLIC HEALTH UNIT
TITLE
?-6 Da te /
County Public Unit
Page 2 of 3
..--
CLOSETS
BATH
TUGS
SHOWERS
LAVA.
TORIES
SINK•
SLOP
SINKS
LAUNDRY
TWOS
URINALS
CATCH
SA•IN
FLOOR
DRAIN
DRINKING
FOUNTEI 'N
•r•
,IT,OTT....01.1„
CONTR.
LIT
--
CHECK
,....±.7...:
......=
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
G
TRAP
SOLAR
H
DEEP
WILL
SPRKLR.
SYSTEM
SWIM*0
POOL
—
,............ ,.
copfrot.
LIST
.....
I
CHICK
lenni; N.. b
.._ ..... Date
pplic;■1 ion is hereby made for the approval of the detailed statement of the plans and specifications herewith subtu!....1 for the building or other
.tructure herein described. This application is made in compliance and conformity with the Building Ordinance of Miz. uf Shores Village, Florida,
J., all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulatic of the Building Division
oi Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and spec;fic.ations must be kept at
Building during progress of work.
'.)wner's Name and Address
.egist ...red Architect and/or Engineer
1:mploying Plumber's Name ....A4tILD
de, 5 :c
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
Amount of Permit $
STATE OF FLORIDA, I
is.
COUNTY OF DADE.
My ConunissionExpires
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Block
(Signed)___
.23 it?6
Street QC M t/t. /051
No..
No.
— Street.
Street
Addition y Repairs No of Stones
Size Septic Tank__ . Type of Tank
Feet of Drain Tile. J- _Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City—Well. Size of Soakage Pit
Ca pacity ^ 415.
(Signed)-‘ ae %))
Plumbin3 Inspector
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an endloyei of laho)
under the Florida ‘Vorkinen's Compensation Act, being Section 5986, Compiled General Laws of Florida Permanent Cup i lement, and ltd. 0470-1..
.lied with the provisions thereof, and will require similar compliance from all contractors or sub-contractors employed 1 y him in " rk v
performed under this permit; and will post or cause to be posted for inspection on the site of the work such pnbl: notice T. no ice!' 43 a?
required by the Act. The undersigned agrees to employ only such sub-contractors, on worn to be performed - 1 , 4 this .> riii 1701 .
licensed by Miami Shores Village.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, persin444: 4noraren
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 be did sign the same, and tnat all acts
therein by him stated are true.
NOTE: A re-inspection fee of $1.00 will be made when such re-Inspection 1. made•neoessary by improper notice for inspeeten, ort,uIt y
materials and/or workmanship,
Notary Public, State of Florida
Matta Plumber.
J9/
Permit No
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida,
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at
buildin durin rogress of work.
:;0::;: e9.
Registered Architect and /or Engineer_______
Employing Plumber's Name_1_
Location and Legal Description Lot_ _P
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
No.______________.__ Street___
Street___
Subdivision
Street and Number where work is to be performed— No._:!` �?�C_lLr g _� Street
State work to be performed and purpose of building (By Floors) ______ ___________________
New Building __ Remodeling_____ ________ Addition ._______________________ Repairs No. of Stories
„7/L ,ems
Block_
_Type of Tank___
_Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City — Well.______ _____. .......... of Soakage Pit
Size Septic Tank s�
Feet of Drain Tile .d--� ---
O-d
Amount of Permit $ 3 (Signed)_
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 die Act. The undersigned agrees to employ only such sub - contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village.
(Signed).
Capacity Gals.
Date /.91 Z f
Master Plumber. I
STATE OF FLORIDA, I
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
Tues
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
J9/
Permit No
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida,
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division
of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at
buildin durin rogress of work.
:;0::;: e9.
Registered Architect and /or Engineer_______
Employing Plumber's Name_1_
Location and Legal Description Lot_ _P
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
No.______________.__ Street___
Street___
Subdivision
Street and Number where work is to be performed— No._:!` �?�C_lLr g _� Street
State work to be performed and purpose of building (By Floors) ______ ___________________
New Building __ Remodeling_____ ________ Addition ._______________________ Repairs No. of Stories
„7/L ,ems
Block_
_Type of Tank___
_Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City — Well.______ _____. .......... of Soakage Pit
Size Septic Tank s�
Feet of Drain Tile .d--� ---
O-d
Amount of Permit $ 3 (Signed)_
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 die Act. The undersigned agrees to employ only such sub - contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village.
(Signed).
Capacity Gals.
Date /.91 Z f
Master Plumber. I
STATE OF FLORIDA, I
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.
BUILDING ❑ MIAMI SHORES VILLAGE, FLORIDA
ELECTRICAL ❑
PLUMBING PERMIT 11T° 8725 Contractor's r . 3
ROOFING ❑ License No.
c`
❑ Work to be performed under this Permit
Owner of
Building
Architect
4.-
_1 .L
Contractor • l
or Builder h/io �'' -. :-Z-
Legal Lat
Description 11 BI
Address of s Q ® `;,
Building ,..e ....+ d /1" ° / tV .- V
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 emplo ees.
d
Signed '' xi if •• 4..i (INSPECTOR) BY
In consideration of the issuance to me of this permit agree to perform the work covered hereunder in compliance with all ordinances and regulations
pertaining thereto and in strict conformity with the plans, awings, statements or specifications submitted to the proper authorities of Miami Shores Village.
In accepting this permit I assume responsibility for all wo k done by either, myself, my agent, servant or employee.
CONTRACTOR or BUILDER
Date
•..� /� 190-I
Subdi-
vision
Sq Ft.
Value of Amount of
Project $ Permit $ ✓
BY AUTHORITY
Application is hereby made for the approval of the detailed statement of the plans and specifications he - submit or the building or other
structure herein described. This application is made in compliance and conformity with the Building Or ce of Mi Shores Village, Florida,
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rule nd regulates , s 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.
Permit No
Owner's Name and Address___
Registered Architect and /or En ineer ... - ___ __�_
Employing Plumber's NameZ44- Wes' /IWJ///L �.' No. - / .
Location and Legal Description Lot ___— ..— ______ __.__. —___ — _ Bloch
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______._.__..___ ______ Repairs No. of Stories
Size Septic Tank
Feet of Drain Tile
Nature of Water Supply:
Amount of Permit $
V
MIAMI SHORES VIL ,AGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING
Q
_Type of Tank__
�
ist. Feet of Tank or Drain Field from Well
Well , -- ....... of Soakage Pit
No. __ g`30 Street
(Signed)_
umbing Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as ah,employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Pennanent 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 u r this permit, as are
licensed by Miami Shores Village.
My Commission Expires
(Signed)- - - ' ,
edo/Ar
`
Stree ..
Subdivision.
Notary Public, State of Florida
-- - - - - -- -
Street 4 E 4 _Q_ -� __• .__ �[}
Capacity Gals
Master Plumber.
STATE OF FLORIDA,
U.
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments , personally appeared
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the
of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made • necessary by improper notice for inspection, or faulty
materials and /or workmanship.
CLOSETS
BATH
TUBS
SHOWERS
TORIES
Toms
SINKS
SLOP
SINKS
LAUNDRY
TUBS
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT•NB
TOTAL
FIXTURES
CONTR.
LIST
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SWIM'O
POOL
CONTR.
LIST
-•
CHECK
Application is hereby made for the approval of the detailed statement of the plans and specifications he - submit or the building or other
structure herein described. This application is made in compliance and conformity with the Building Or ce of Mi Shores Village, Florida,
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rule nd regulates , s 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.
Permit No
Owner's Name and Address___
Registered Architect and /or En ineer ... - ___ __�_
Employing Plumber's NameZ44- Wes' /IWJ///L �.' No. - / .
Location and Legal Description Lot ___— ..— ______ __.__. —___ — _ Bloch
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______._.__..___ ______ Repairs No. of Stories
Size Septic Tank
Feet of Drain Tile
Nature of Water Supply:
Amount of Permit $
V
MIAMI SHORES VIL ,AGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING
Q
_Type of Tank__
�
ist. Feet of Tank or Drain Field from Well
Well , -- ....... of Soakage Pit
No. __ g`30 Street
(Signed)_
umbing Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as ah,employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Pennanent 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 u r this permit, as are
licensed by Miami Shores Village.
My Commission Expires
(Signed)- - - ' ,
edo/Ar
`
Stree ..
Subdivision.
Notary Public, State of Florida
-- - - - - -- -
Street 4 E 4 _Q_ -� __• .__ �[}
Capacity Gals
Master Plumber.
STATE OF FLORIDA,
U.
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments , personally appeared
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the
of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made • necessary by improper notice for inspection, or faulty
materials and /or workmanship.
Company
PHONE.
Job
Aildress
REQUEST FOR INSPECTION
r
/ 6.
Inspection/6- j 72
Time Ready
Date Ready
. /c
A.M.
P.M.
BUILDING
ELECTRICAL
PLUMBING
ROOFING
Owner of
Building
Legal Lot
Description
Address of
Building
n
11
PERMIT IT? 11826
❑ Work to be performed under this Permit
Lefit..e.C 4
Architect
Contractor
or Builder ' . +
MIAMI SHORES VILLAGE, FLORIDA
Bl.
• 4.4 • f
Subdi-
vision
Value of
Project $
DATE
Signed• ' •• Sk.r` t 4 � 4L BY ti
INSPECTOR
E( 4 • •
Amt. of
Permit $
195
Contractor's
License No.
This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the application
herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans,
drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any
time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is
granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations
pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes responsibility for work
done by his agents, servants or employees.
In consideration of the issuance to me of this permit I ag to perform the work covered hereunder in compliance with all ol+l9inances and regulations
pertaining thereto and in strict conformity with the plans,s,�ydrr ' : s, stat is or specifications submitted to the proper authorities of Miami Shores Village.
In accepting this permit I assume responsibility for x 11,. . 7' . e by m self, my :e se nt • employee.
Aof
toe
CONTRACTOR OR BUILDER BY
Permit No //(C
Date_ v1
)
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith subn 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 No �f Street k
Registered Architect and /or Engingerf , 4
Employing Plumber's Name
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) 4 f'' )/
Size Septic Tank
Feet of Drain Tile
Nature of Water Supply: City —Well
Amount of Permit $ �
ss.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
e
. b N
licensed by Miami Shores Village. /
i
/
( Signed)_. `
Street
Block Subdivision
(Signed)
i
My Commission Expires Notary Public, State of Florida
i
t �R
New Building Remodeling Addition _ Repairs No. of Stories
Type of Tank Capacity Gals
Dist. Feet of Tank or Drain Field from Well
Size of Soakage Pit
Plumbing Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be
performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are
required by the Act. The undersigned agrees to employ only such sub - contractors, or( wotk to be ,3erformed under +this permit, as are
Master.lPlumber. "
STATE OF FLORIDA, 1
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the
of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty
materials and /or workmanship.
CLOSETS
BATH
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
r
CHECK
Permit No //(C
Date_ v1
)
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith subn 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 No �f Street k
Registered Architect and /or Engingerf , 4
Employing Plumber's Name
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) 4 f'' )/
Size Septic Tank
Feet of Drain Tile
Nature of Water Supply: City —Well
Amount of Permit $ �
ss.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
e
. b N
licensed by Miami Shores Village. /
i
/
( Signed)_. `
Street
Block Subdivision
(Signed)
i
My Commission Expires Notary Public, State of Florida
i
t �R
New Building Remodeling Addition _ Repairs No. of Stories
Type of Tank Capacity Gals
Dist. Feet of Tank or Drain Field from Well
Size of Soakage Pit
Plumbing Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be
performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are
required by the Act. The undersigned agrees to employ only such sub - contractors, or( wotk to be ,3erformed under +this permit, as are
Master.lPlumber. "
STATE OF FLORIDA, 1
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the
of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty
materials and /or workmanship.
BUILDING
ELECTRICAL
PLUMBING
Owner of
Building
Architect
Contractor
or Builder
Legal
Description
Address of
Building
Lot
MIAMI SHORES VILIGE, FLORIDA
DATE 194_
Contractor's
License No
PERMIT N9 1351
Work to be performed under this Permit
BI.
Subdi-
vision
Value of
Project
Amt. of
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. d -
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 regula-
tions pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores
Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servant or employee.
CONTRACTOR OR BUILDER BY AUTHORITY
JOB:
BUILDING
ELECTRICAL :
PLUMBING
d'otit,e6
{ '''A DD
•
•
•
The following is read: for Inspection: -
Inspect I s Report: -
: WORK
DONE BY:
: -R Q
INSPECT yN
• WAS MA • WILL BE READ
NOTE: REQUESTS FOR INSPECTIONS MUST BE MADE BY THE CONTRACTOR
PERFORMING THE WORK.
Permit No
of Permit $
ss.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
f /'�
Date_ ___,L ' �!
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 complie4wj, whether herein ,pecified or not. A copy of approved plans and specifications must be kept at
building during progress of work.
Owner's Name and Address
Registered Architect and /or Engineer ____
Employing Plumber's Name _l�..l /_- 1-
V4-Le.°"-/Bloc No.__� Street
Location and Legal Description Lot ? p
Street an d Number where work is to be performed —No.-.
State work to be performed and purpose of building (By Floors)
New Building Remodeling Addition Repairs
No Street
Size Septic Tank__ 1Y - Q- Type of Tank __ ____ __ ____ ___ _ Capacity Gals.___
Feet of Drain Tile 7 6
Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City .-Well. Size of Soakage Pit
of
(Signed)
(Signed
My Commission Expires - Notary Public, State of Florida
No. of Stories_'
ar<
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 under signed agrees to employ only such sub- contractors, on work to be performed under is permit, as are
licensed by Miami Shores Village.
aster Plumber.
STATE OF FLORIDA, k
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally
appeared
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the
of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty
materials and /or workmanship.
CLOSETS
BATH
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
of Permit $
ss.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
f /'�
Date_ ___,L ' �!
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 complie4wj, whether herein ,pecified or not. A copy of approved plans and specifications must be kept at
building during progress of work.
Owner's Name and Address
Registered Architect and /or Engineer ____
Employing Plumber's Name _l�..l /_- 1-
V4-Le.°"-/Bloc No.__� Street
Location and Legal Description Lot ? p
Street an d Number where work is to be performed —No.-.
State work to be performed and purpose of building (By Floors)
New Building Remodeling Addition Repairs
No Street
Size Septic Tank__ 1Y - Q- Type of Tank __ ____ __ ____ ___ _ Capacity Gals.___
Feet of Drain Tile 7 6
Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City .-Well. Size of Soakage Pit
of
(Signed)
(Signed
My Commission Expires - Notary Public, State of Florida
No. of Stories_'
ar<
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 under signed agrees to employ only such sub- contractors, on work to be performed under is permit, as are
licensed by Miami Shores Village.
aster Plumber.
STATE OF FLORIDA, k
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally
appeared
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the
of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty
materials and /or workmanship.