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270 NE 101 St (9)PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date ' \IS1 Job Address'Z t S - r. Tax Folio 11- 3/2_0(0 r O ( , 3 ' c.1 fkMt7 P$ to -lo Legal Description b3 3 'lAtr✓wAt Skknc' Historically Designated: Yes No / Tenant '(7f4-9tk.... )1■A' -e- Master Permit # LI-z3 3g Owner's Address X22 o koo Phone 'art„'[ 7 -15 33 'f}� -c Set, is Contracting Co. AGO 1.1 o Rte. P"-i SW'I:ilk-- Address CoCD tkt4 V._ 1 TW �t�le nth Qualifier 0,,r) �6 lQ1VlQ. PXYr SS# (A ' b1 Le l State # g9-05 Municipal # Competency ,0g70 ( 1 Ins. Co.\r�l,vt t9y�,LL Architect/Engineer Address Bonding Company Address Mortgagor Address Permit Type (circle one): BUILDING ELECTRICAL ,PIBIN9 MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION t- -\ 1 - & 4_1 z Square Ft.O Estimated Cost (value) t 5007 WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.) Application is hereby made to obtain a permit to do work and installation as indicated above, and on the attached addendum (if applicable). I certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits are required for ELECTRICAL, PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK. \\) OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Furthermore, I authorize the above -named contractor to do the work stated. or Condo President Date Signature of owne i Notary as to Owner and/or Condo i'resi. - Date My Commission Expires: r P ^ , W; �' '.:• My E FEES: PERMIT 36 • RADON Signature of Contractor or Owner - C ilder ate otary as to Contractor or Owner - Builder My Commission Expires: APPROVED: Zoning Building Electrical Mechanical Plumbing e5), Date 2.0 3o C.C.F. / , NOTARY r- BOND TOTAL DUE Y V( Engineering CONSTRUCTION PERMIT F R: ,/ [ ) New System [ Existing System [ ^']/Holding Tank [ dTemporary /Experimental [ Repair [Al Abandonment [II Other(Specify) APPLICANT: /1 "(E/ n e PROPERTY STREET ADDRESS: 2 N LOT: 3 , s Z BLOCK: 3 3 SUBDIVISION: PROPERTY ID #: // 3 Z U c d /3 , z SZ /TOWNSHIP /RANGE /PARCEL NUMBER] [OR TAX ID NUMBER] SYSTEM MUST BE CONSTRUCTED IN ACCORDANCE WITH SPECIFICATIONS AND STANDARDS OF CHAPTER 10D -6, FAC REPAIR PERMITS AND HOLDING TANK PERMITS EXPIRE 90 DAYS FROM THE DATE OF ISSUE. ALL OTHER PERMITS EXPIRE ONE YEAR FROM THE DATE OF ISSUE. 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 DESIG SP FICATIONS //' T 10 ] CGALLONS GPD SEPTIC T 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 [.3] SQUARE FEET PRIMARY DRAINFIELD SYSTEM R [ ] SQUARE FEET SYSTEM A TYPE SYSTEM: [ ] STANDARD [ J FILLED [ ] MOUND [ ] I CONFIGURATION: [ ] TRENCH [ Y BED [ [ N G (e2-6.,, /- F LOCATION OF BENCHMARK: f •F ! .5 C ,4 ) I ELEVATION OF PROPOSED SYSTEM SITE [ ] [INCHES /FT] [ABOVE /BELOW] BENC K /REFERENCE POINT E BOTTOM OF DRAINFIELD TO BE [ /' L � ] [INCHES F [ABOV ENCH R EFE RE NCE POIN Cr* D FILL REQUIRE T ,- .,�NCiE$ v , F REQUIRED: [ 361 INCHES ` � ALL 112 a t0AM r ! t I saYil L)1''.;z. sorro ' OF DRAINFIELD 0 T H E R APPROVED BY: SPECIFICATIONS BY: r 3 1'� F STATE OF FLORIDA t] L ,! I , � ,1 DEPARTMENT OF HEALTH AND REHABILITATI ONSITE SEWAGE DISPOSAL SYSTEM CONSTRUCTION PERMIT Authority: Chapter 381, FS & Chapter 1OD -6, FAC . .._"i.ii _ . C �•. ..�:.. i:JN( DATE ISSUED U c TITLE: HRS-H Form 4016, Mar 92 (Obsoletes previous editions which may not be used)'. (Stock Number: 5744 - 001-4016 -0) ` PERMIT # VE SERVICES DATE PAID FEE PAID $ RECEIPT # AGENT: � -1 �/ o • / A / S -*"O .t" c=r, 1' S; / TITLE: n PHU EXPIRATION DATE: D q, /g � C , r 5 e ca Page 1 of 2; %PPNCATION FOR: ( New System (G,f Repair \PPLICANT: WENT: tAILING ADDRESS: ROPERTY STREET ADDRESS: ..i IRECTIONS TO PROPERTY: 1 2 3 1 ?PLICANT'S SIGNATURE: DEPARTMENT OF HEALTH AND REHABILITATIVE SERVICES ONSITE SEWAGE DISPOSAL SYSTEM APPLICATION FOR CONSTRUCTION PERMIT Authority: Chapter 381, FS & Chapter 1OD -6, FAC STATE OF FLORIDA UILDING INFORMATION 1\4 RESIDENTIAL nit Type of No. of Building o Establishment Bedrooms Area Scfft V ] Garbage Grinders /Disposals ] Ultra -low Volum F s Toilets /9E S -N Form 4015, Mar 92 (Obsoletes previous editions which may not be used) :cock Number: 5744- 001 - 4015 -1) PERMIT 1 DATE PAID FEE PAID $ RECEIPT i Existing System [$ 1 Holding Tank ( 0 ] Temporary /Experimental Abandonment J Other(Specify) TELEPHONE: /„9/ - )40 70 BE COMPLETED BY APPLICANT OR APPLICANT'S AUTHORIZED AGENT. ATTACH BUILDING PLAN AND TO -SCALE :ITE PLAN'SHOWING PERTINENT FEATURES REQUIRED BY CHAPTER 1OD -6, FLORIDA ADMINISTRATIVE CODE. 'ROPERTY INFORMATION [IF LOT IS NOT IN A RECORDED SUBDIVISION, ATTACH LEGAL DESCRIPTION OR DEED] S' 3 OT: 1` BLOCK: 3 3 SUBDIVISION: � �� re See_ / DATE OF SUBDIVISION: ' ROPERTY ID 1: //3,,941 6 6 5 , [Section /Township /Range /Parcel No.] ZONING: ROPERTY SIZE: A I [Sgft /43560] PROPERTY WATER SUPPLY: (L4 PRIVATE [ a` O f E. loo S� . [] Spas /Hot Tubs a .o-upo [,)] COMMERCIAL 1 Persons Served Business Activity For Commercial Only DATE: 1 33/ Er M Floor /Equipment Drains [ ] Other (Specify) Page 1 of 3 ; �"°'[IIE 40 WE' CP �'.:i APPLICANT: USDA SOIL SERIES: STATE OF FLORIDA DEPARTMENT OF HEALTH AND REHABILITATIVE SERVICES ONSITE SEWAGE DISPOSAL SYSTEM SITE EVALUATION AND SYSTEM SPECIFICATIONS LOT: 3 1 j 1 BLOCK: 3 SUBDIVISION: If r e _ 5 _Yee / PROPERTY ID #: // .5_2 G 6 /,3 4.11 1t Sd [Section /Township /Range /Parcel No. or Tax ID Number] 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: [ ] YES 641NO NET USABLE AREA AVAILABLE: ACRES TOTAL ESTIMATED SEWAGE FLOW: ( 0 GALLONS PER DAY [RESIDENCES -TABLE 1 / OTHER -TABLE 2] AUTHORIZED SEWAGE FLOW: GALLONS PER DAY [1500 GPD /ACRE OR 2500 GPD /ACRE] UNOBSTRUCTED AREA AVAILABLE: ,,� SQFT UNOBSTRUCTED AREA REQUIRED: 600 SQFT BENCHMARK /REFERENCE POINT LOCATION: ELEVATION OF PROPOSED SYSTEM SITE IS THE MINIMUM SETBACK WHICH CAN BE MAINTAINED FROM THE PROPOSED SYSTEM TO THE FOLLOWING FEA SURFACE WATER: FT DITCHE S � \NORMALLY WET? [ ] YES NO A FT - WELLS: PUBLIC: FT LIMITED USE: U VY FT PRIVATE: IL FT NON - POTABLE: FT BUILDING FOUNDATIONS: Z.S FT PROPERTY LINES: S FT POTABLE WATER LINES: FT SITE SUBJECT TO FREQUENT FLOODING: ( ] YES [ NO 10 YEAR FLOODING? [ ] YES NO 10 YEAR FLOOD ELEVATION FOR SITE: FT MSL /NGVD SITE ELEVATION: - 7?-0 FT MS /NGVD SOIL PROFILE INFORMATION SITE 1 SOIL PROFILE INFORMATION SITE 2 MMunsell # /Color Tex ure Dept "'gat 1 to to to to to to to to to OBSERVED WATER TABLE :1) ,INCHES [ABOVE / BELOW] EXISTING GRADE. TYPE: [PERCHED / APPARENT] ESTIMATED WET SEASON WAT R TABLE ELEVATION: INCHES [ ABOVFr/ BELOW ] EXISTING GRADE. HIGH WATER TABLE VEGETATION: [ ] YES NO MOTTLING: [ ] YES � `` / , NO DEPTH: INCHES SOIL TEXTURE /LOADING RATE FOR SYSTEM SIZING: / I0 DEPTH OF EXCAVATION: v 0INCHES DRAINFIELD CONFIGURATION: [ ] TRENCH BED [ ] OTHER (SPECIFY) REMARKS /ADDITIONAL CRITERIA: AGENT: Tar 9. SITE EVALUATED B 1 �. :a ' HRS-H Form 4015, Mar 92 (Obsoletes previous editions which may no be used) (Stock Number: 5744- 003-4015 -1) PERMIT # /O' V U �✓ [INCHES /FT] [ABOVE /BELOW] BENCHMARK /REFERENCE POINT DATE: l 1 ( 4P 1 [ I Page 3 of 3 N Site Plan submitted b STATE OF FLORIDA DEPARTMENT OF HEALTH AND REHABILITATIVE SERVICES APPLICATION FOR ONSITE SEWAGE DISPOSAL SYSTEM CONSTRUCTION ERMIT v Permit Application Number L d 1 0 Plan Approved By HRS-H Form 4015, Feb 85 (Obsoletes previous editions which may not be used) (Stock Number. 5744. 002 - 4015.6) PART II - SITE PLAN Scale: Each block represents 5 feet and 1 inch = 50 feet. ■ ■_■ ■ ■_ ■�- ■■�■■■�■w� ■■�■■■�■�- ■ ■_ ■ ■ ■_■�- ••111•1 ■ _■ 111111 ■01 1111111; 11111111111111101 r ■_■ ■■■ .--- ■I otes: a LTcD r r I c S � , tcL SIGNATURE Not Approved / .42: a / /•1 ifi S'/ ->ci i3O/- /e D--60 S 1 TITLE 6 Date U " "7.g County Public Unit ALL CHANGES MUST BE APPROVED BY THE COUNTY PUBLIC HEALTH UNIT Page 2 of 3 - -' CLOSETS BATH TUBS SNOW tRa LAVA• TORIES SINKS - SLOP SINKS LAUNDRY TUBS URINAL/ CATCH BASIN FLOOR DRAIN DRINKING FOUNT' NS T O •A� FIE/WIMP CONTR. LIST CHECK _, — SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT G TRAP SO LAR HEATER DRIP WELL SPRKLR. a SMN POOL CONTR. LIST r� CHECK Permit No . f.- A 1131111 ! New Building.. -..._ _ _.._ _.. Remodeling —_ _.._..__ Addition Size Septic Tank_ -Type of Talc_ Feet of Drain Tile. _— __DIst. Feet of Tank or Drain Field from Well. . .--_-•_- - Nature of Water Supply: City —WeIL Size of Soakage Pit. Amount of Permit $ My Commission Expires MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT (Signed )- (Si Repair ,2o2-Y/ 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. V Ownei s Name and Address 6 C / ALS Registered Architect and /or Engineer C_ r £rat Lorin Pl bur's I ppry f t VIA Gee'LJ.o�OTIL Z.- 1 ■ J Z i . .N �. rte ) / l L o c a ° 2 and g a l o tot. ?- IL aloes - - � _ Su4divlslon . _ / /11.1 Street and Number where work is to be performed —No Z Street . n k.._../ #.. S _. State work to be performed and purpose of building (By Floors)__.-._ -- _ LA . .1-7 I 1. .:(.... ..... /`.7.'......... . No._2 7 Street hik /0/ '47‘V Notary Publio, State of Maids No. of Stories ............ Master Plumber. 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 5968, Compiled General Laws of Florida Permanent Supplement, and hay com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to he 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 licensed by Miami Shores Village. required by the Act. The undersigned agrees to em><ploy only such sub�aoatr wor�be performed under this permit, as are STATE OF FLORIDA, t si. 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 her 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 mob se`iaspeotiaa Y snade by improper notice for inspection, oe faulty materials and/or workmanship. Iv1AMI SHORES VILLAGE, FLA. No 2105 JOB ‘L' pi ) ADDRESS —2 1 - c) t INSPECTION TIME READY REMARKS: INSPECTOR DATE BUILDING LI ELECTRICAL ❑ PERMIT N. U PLUMBING 8062 ROOFING Architect Contractor or Builder Legal Description. Lot El Owner of Building Address of Building ❑ Work to be performed under this Permit CONTRACTOR OR BUILDER MIAMI SHORES VILLAGE. FLORIDA DATE . ` 195 Contractor's License No I° Bl. Subdi- vision Sq. Ft 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. Signed: INSPECTOR In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances 'and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. C, BY AUTHORITY 17 Permit No 6 v b Application is hereby made for the approval of the detailed statement of the plans and specifications herewith s mitted f 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 Street. /0 building during progress of work 7/ Registered Archit and /or_meer____— __— _______— Employing Plumber's N „fp i • ! - '° l �, No _— - -- � Street. Subdivision..- _..__. Street Location and Legal Description Street and Number where work is to be performed— No.__.____ State work to be performed and purpose of building (By Floors)._ New Building __ Remodeling__._ —.____ Addition Size Septic Tank Amount of Pennit $ Feet of Drain Tile Nature of Water Supply: City —Well Plumbing Inspe or. 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 Ias com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in th 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 otices 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 MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING ,° "V,CMlT Block Type of Tank Capacity Gals. _Dist. Feet of Tank or Drain Field from Well Size of Soakage Pit (Signed)_ Repairs No. of Stories Master Plumber. STATE OF FLORIDA, 1 gs. COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. Notary Public, State of F lorida 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 TUB6 SHOWERS LAVA. TORIES SINKS SLOP SINKS LAUNDRY Tints U RINALS URINALS CATCH 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'O POOL CONTR. LIST CHECK Permit No 6 v b Application is hereby made for the approval of the detailed statement of the plans and specifications herewith s mitted f 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 Street. /0 building during progress of work 7/ Registered Archit and /or_meer____— __— _______— Employing Plumber's N „fp i • ! - '° l �, No _— - -- � Street. Subdivision..- _..__. Street Location and Legal Description Street and Number where work is to be performed— No.__.____ State work to be performed and purpose of building (By Floors)._ New Building __ Remodeling__._ —.____ Addition Size Septic Tank Amount of Pennit $ Feet of Drain Tile Nature of Water Supply: City —Well Plumbing Inspe or. 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 Ias com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in th 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 otices 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 MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING ,° "V,CMlT Block Type of Tank Capacity Gals. _Dist. Feet of Tank or Drain Field from Well Size of Soakage Pit (Signed)_ Repairs No. of Stories Master Plumber. STATE OF FLORIDA, 1 gs. COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. Notary Public, State of F lorida 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. Location and Legal Description Lot. Street and Number where work is to be performed—No 270 NAR. State work to be performed and purpose of building (By Floors) New Building Remodeling Addition Nature of Water Supply: 'j'—Well e .-4.;00/ Sprinkler. system 4700.00 Amount of Permit 43- (Si MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT __Block-- Size of ,Soakage Street Date Application is hereby ma .rova of the d statement of the plans and specifications herewith submitted for the building or other stru •e.. This application is m in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida an isions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Divisior of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept al building during progress of work. Owner's Name and Address Mrs, L. Davis. No._ 270 N•Es 101 Street RegisteredMileit Engineer. • Drilling & Eauipment No._ 1429 NatYN. Employing OlaTuTaiZ Name 'tar at s treet _ 7th Ave., Subdivision 101 Street, Repairs No. of Stories Size Septic Tank Type of Tank__ Capacity Gals. (ea 1 Feet of Drain Tile Di st. Feet of Tank or Drahi Field from Well i lum m spector. The undersigned applicant for this building permit does hereby certi that he understan and accepts his obligations as alt employer of lab under the Florida Workmen's Compensation Act, being Section 5988, Comp ed Genera s of Florida Pennanent Supplement, and has cox 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 an licensed by Miami Shores Village. (Signed)__Egr t ing & Egualpment zusioxiebiztax STATE OF FLORIDA, I COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ztppeare 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 lac 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 foul materials and/or workmanship. CLOSETS BATH TUBS SHOWERS LAVA. TORIES SINK5 SLOP SINKS LAUNDRY T URINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT'NS TOTAL. FIXTURE, CONTR. LIST - CHECK SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SWIM'O POOL CONTR. LIST CHICK Location and Legal Description Lot. Street and Number where work is to be performed—No 270 NAR. State work to be performed and purpose of building (By Floors) New Building Remodeling Addition Nature of Water Supply: 'j'—Well e .-4.;00/ Sprinkler. system 4700.00 Amount of Permit 43- (Si MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT __Block-- Size of ,Soakage Street Date Application is hereby ma .rova of the d statement of the plans and specifications herewith submitted for the building or other stru •e.. This application is m in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida an isions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Divisior of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept al building during progress of work. Owner's Name and Address Mrs, L. Davis. No._ 270 N•Es 101 Street RegisteredMileit Engineer. • Drilling & Eauipment No._ 1429 NatYN. Employing OlaTuTaiZ Name 'tar at s treet _ 7th Ave., Subdivision 101 Street, Repairs No. of Stories Size Septic Tank Type of Tank__ Capacity Gals. (ea 1 Feet of Drain Tile Di st. Feet of Tank or Drahi Field from Well i lum m spector. The undersigned applicant for this building permit does hereby certi that he understan and accepts his obligations as alt employer of lab under the Florida Workmen's Compensation Act, being Section 5988, Comp ed Genera s of Florida Pennanent Supplement, and has cox 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 an licensed by Miami Shores Village. (Signed)__Egr t ing & Egualpment zusioxiebiztax STATE OF FLORIDA, I COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ztppeare 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 lac 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 foul materials and/or workmanship. MIAMI SHORES VILLAGE, FLORIDA„.. BUILDING ❑ ELECTRICAL ❑ PERMIT N° 14804 PLUMBING ROOFING ❑ Work to be performed under this Perini Owner of Building /I.?, .04 - 4v4fs Architect Contractor / 4:/.);7 - or Builder r � _e " I . C .- Legal Lot IP BL 1 Description Address of y Il tk ` ire., Building OR BUILDER Signed i Subdi- vision DATE I 195 j_ Contractor's • Lic = e No Value of Project $ Amt. of Permit This permit is gra ed �o the contractor or builder named above to co truct the building or to install the equipment or device desc' .ed in the a ation herefor in strict compli ce with all ordinances pertaining thereto and with he understanding that the work will be performed in co s lance with any plans, drawings, statements or-specifications that may have been submitted to and pproved x,she -,#zQ er 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 liged witho authorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above assume ' e�responsibilit for a thorough knowledge of the ordinances and re lations pertaining to the work covered hereby whether shown on the plans or drawing of in the statem is or specifications and that he assumes sponsibility or w•rk done by his agents, servants or employees. BY ECTOR In consideration of the issuance to me of this permit I agree to perfo the work covered hereunder in compliance ;. ' ordinances and rejulations pertaining thereto and in strict conformity with the plans, drawings, state or specifications submitted to the proper a thorities of Miami Shores Village. In accepting this permit I assume responsibility far 'all work�done'1 rt er, myself, my agent, servgnt or employee. AUTHORITY BUILDING ELECTRICAL PLUMBING Owner of Building MIAMI SHORES VILLAGE, FLORIDA PERMIT N° 3900 A, Work to be performed under this Permit DATE 194— Contractor's License No tkar Q {U �U !i9 i j 4! i You are cGutiorrd to Cots: ;r1t y. !!r ' ,liar Wit,'c'icn Hoard office befire sii'ritr,g the wc,ic ��itr�orz.0 Sri this permit. Architect Contractor f ' _ .t or Builder Legal Lot Bl. Description Address of •) Value of Amt. of Building ^; > s t - Project Permit .• `? i This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the application herefor in strict compliance with all ordinances perraining 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. "*"% et „,` Signed. By r r <...... 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 Emit I assume responsibility for all work done by either myself, my agent, servant or employee. A Subdi- vision CONTROR tat BUILDER BY AUTHORITY 4 MIAMI SHORES VILLAGE, FLA. .APPLICATION FOR SEPTIC TANK PERMIT • DIVISION OF PLUMBI NSPECTION Date: � 0 I herewith submit the following applicak on for a permit covering the installation of a Septic Tank Soakage Pit: Feet of drain tile: (NEW: Size of Soakage Pit: APPROVED BY: Installed by: Old: Relaying: For a (Store: Garage: Apt: Hotel: Office Bldg. (Res: p, Garage wash floor: Waste water from a: Building has: Stores; Offices; Apts; Hotel Rms; Bedrums k„) Owner or Agent : / ) 2 ((,7 /M � L Address: ' 7 // �^ : ,' Lot No . Block No.,1i4 SUBDIVISION "i , %- ° r.' ) 2.. Address of work: ` e.) d � J7 No. of Plumbing Fixtures: 4 Laundry Tubs: / Floor Drains: Nature of water supply: City: /7 Well: Feet Distant from all wells: Type of tank installed: gallons: I Story: Addition: Remodeled: Purpose of same: Additional information: I , �s' (/ / ,/ /' ce, , = -, . Lam 6 I 3 'Ready for Inspection: Date: 0- /-p, � l Remarks: PERMIT NO. /ij CONDEMNED BY: /44-4 1 e, 7-3 7, New: Address: Time: ,,? Tank capacity in