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277 NE 101 St (14)Permit No....-.. 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 et building during progress of work. Owners Name and Address Registered Architect and /or Engin Employing Plumber's Name Location and Legal Description Lot Street and Number where work L to be performed -No State work to be performed and purpose of building (By Floors) New Building..__.. _ _ -- •---- ........_.. Remodeling____ ._..._. __ __ Addition. Bloom • Size Septic Tank_.. -Type of Tank --_ Feet of Drain Tile Dist. Feet of Tank or Drain Field from Well ..._- __.___ Nature of Water Supply: City -WeIL Size of Soakage lit 3no,a1 e �l :��J' `�"�'�• Amount of Permit $ 1115 * (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 Iw' 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 arc 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 (Signed) No 7 7 N Street—IL/ . . � _ � .. //� _ . Street. . _ ..._.._ Repairs No. of Stories. / 2 9 {1 i Muter Plumber. STATE OF FLORIDA, COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the ..___.._ .__..------ ....... _ _...._. of the above described construction, that he has carefully read the foregoing application, and that be 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 war minspeoticn 11a made by improper notice for inspection, or faulty materials and /or worlananshnp. CLOSITB BATH Tutus aHOWIR LAVA- TORILS al". SINKS LAUNDRY TUBS URINAL{ CATCH BASIN FLOOR DRAIN DRINKING FOUNT 'N• TOTAL •IMTURES CONTR. LIST CHICK SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAOI PIT G TRAP SOLAR HEATER DUMP WILL $PRKLR. SYSTEM SW IM'0 POOL CONTR. LIST CHECK Permit No....-.. 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 et building during progress of work. Owners Name and Address Registered Architect and /or Engin Employing Plumber's Name Location and Legal Description Lot Street and Number where work L to be performed -No State work to be performed and purpose of building (By Floors) New Building..__.. _ _ -- •---- ........_.. Remodeling____ ._..._. __ __ Addition. Bloom • Size Septic Tank_.. -Type of Tank --_ Feet of Drain Tile Dist. Feet of Tank or Drain Field from Well ..._- __.___ Nature of Water Supply: City -WeIL Size of Soakage lit 3no,a1 e �l :��J' `�"�'�• Amount of Permit $ 1115 * (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 Iw' 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 arc 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 (Signed) No 7 7 N Street—IL/ . . � _ � .. //� _ . Street. . _ ..._.._ Repairs No. of Stories. / 2 9 {1 i Muter Plumber. STATE OF FLORIDA, COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the ..___.._ .__..------ ....... _ _...._. of the above described construction, that he has carefully read the foregoing application, and that be 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 war minspeoticn 11a made by improper notice for inspection, or faulty materials and /or worlananshnp. STATE OF FLORIDA DEPARTMENT OF HEALTH AND REHABILITATIVE SERVICES ONSITE SEWAGE DISPOSAL SYSTEM CONSTRUCTION AND INSTALLATION PERMIT . Applicant _ Permit Number dir`-� /tjV>" ' f �U E /jeL S t P c a. 6 3 �V PART I - SYSTEM IN5TALLATION INSPECTION AND FINAL INSTALLATION APPROVAL- Installer Gf%4/ - 1./ 112f T- G v�1��� Proper tank legend: Yes No Tanks watertight: Yes Tank size: gallons gallons gallons Proper tank outlet device: Yes Length Width Length Width feet feet feet feet Length feet x feet= ft feet feet feet feet Proper No. drainlines: Yes ,...../ o feet feet feet feet Proper pipe separation: Yes No �,� Total = ft Total = ft Distribution box level: Yes No Systems located as permitted: Yes No Systems including plumbing stub -outs installed at proper elevation: Yes No �/ Average depth to drainpipe invert from finished grade• ,2 3" Cinches Maximum depth: ' Inches Average depth of drainfield gravel: �13 inches Minimum depth of gravel /Z_ inches Proper gravel size: Yes LINO Gravel is suitable quality: Yes `...----- No Backfill or fill material as required: (Quality) Yes (Quantity) Yes =-- Other findings: f •4. 4t Inspected by: N c. -Tp2 44 nA11 tc !/g4/ Date Hi /V78r Date I Approved by: Drainfield Trench AN APPROVED INSTALLATION DOES NO GUARANTEE PERFORMANCE Note: Completed copies of this form will be provided to the applicant, installer and the building department. HRS —H Form 4016, Feb 85 (Obsoletes previous editions which may not be used) (Stock Number. 5744 - 002.4016.0) Tank material (PVC.✓e fQ Tank level: Yes No 0 Tank Manufacturer PART III - Fl INSTALLATION APPROVAL Manhole or marker to grade: Yes No Absorption Bed Length a / 2 feet x� feet= 3t ft COUNTY PUBLIC HEALTH UNIT Page 2 of 2 i'erznit No .__. -__4. 3 Size Septic Tank_ Feet of Drain Tile. Nature of Water Supply: City—Well. Amount of Permit $ STATE OF FLORIDA, } as COUNTY OF DADE. • MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Registered Architect and /or Engineer_____ n �______— Employing Plumber's Name_1►^'ril3a_!_!� =`an �1�°�« )1- _____ No.. (Signed)... 176 44 T Date pfi t Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or, other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at . building during progress of work. C "� Owners Name and Address 4� A/N'l61_Z HAM_ No._ g_ 7. Street_ A 7 Street__' V 4--S-6" 5T Location and • Legal Description Lot_______________________ __.-_— Blo4 • Subdivision ex 7 7 F -_ 7 Street and Number where work is to be performed— No.___ _ _ _. Street t _ State work to be performed and purpose of building (By Floors)_— ____Z_�______ LO . CX 13.A 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 ng Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his oblig 1'ns as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Perna pt Supplement, and has coin- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contras - .� 6yed 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 .r s public notice or notices as • are required by the Act. The undersigned agrees to employ only such sub-contract • on work t• be erformed under this permit, as are licensed by Miami Shores Village. Master Plumber. Before me, the undersigned authority, a notary public, duly authorized to adminis er oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts • therein by him stated are true. My Commission Expires Notary Public, State of Florida NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made •necessary by improper notice for inspection, or faulty materials and /or workmanship. CLOSETS BATH TUBS SHOWERS LAVA. TORIES S INKS SLOP SINKS LAUNDRY TUBE 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 $WIM•G POOL CONTR. LIST CHECK i'erznit No .__. -__4. 3 Size Septic Tank_ Feet of Drain Tile. Nature of Water Supply: City—Well. Amount of Permit $ STATE OF FLORIDA, } as COUNTY OF DADE. • MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Registered Architect and /or Engineer_____ n �______— Employing Plumber's Name_1►^'ril3a_!_!� =`an �1�°�« )1- _____ No.. (Signed)... 176 44 T Date pfi t Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or, other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at . building during progress of work. C "� Owners Name and Address 4� A/N'l61_Z HAM_ No._ g_ 7. Street_ A 7 Street__' V 4--S-6" 5T Location and • Legal Description Lot_______________________ __.-_— Blo4 • Subdivision ex 7 7 F -_ 7 Street and Number where work is to be performed— No.___ _ _ _. Street t _ State work to be performed and purpose of building (By Floors)_— ____Z_�______ LO . CX 13.A 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 ng Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his oblig 1'ns as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Perna pt Supplement, and has coin- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contras - .� 6yed 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 .r s public notice or notices as • are required by the Act. The undersigned agrees to employ only such sub-contract • on work t• be erformed under this permit, as are licensed by Miami Shores Village. Master Plumber. Before me, the undersigned authority, a notary public, duly authorized to adminis er 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. Permit No. Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted fo the building or othe 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 Divisior 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 Registered Architect and /or Engineer Employing Plumber's Name 4/1 ___L---U e C q1 Location and Legal Description Lot__ Street and Number where work is to be performed —No Size Septic Tank Feet of Drain Tile Amount of Permit $ y?-RoLf Nature of Water Supply: City —Well f/ MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT No 11 No .. _ Block A 7 (Signed) 277 Street State work to be performed and purpose of building (By Floors) __ C4._ , i Y New Building Remodeling Addition__._ Repairs Date Street Subdivision 40 z 2 .74x' No. of Stories Type of Tank___ Capacity Gals _Dist. Feet of Tank or Drain Field from WeIL __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 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 wor to be •rformed un is emit, as are licensed by Miami Shores Village. STATE OF FLORIDA, 1 COUNTY OF DADE. j Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeare 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 f:u' 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 faul materials and /or workmanship. CLOSETS BATH TUBS SHOWERS LAVA- TORIES SINKS SLOP SINKS LAUNDRY TUBE URINALS CATCH BASIN FLOOR DRAIN DRINKING FOU NT'NS TOTAL FIXTURE! 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. Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted fo the building or othe 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 Divisior 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 Registered Architect and /or Engineer Employing Plumber's Name 4/1 ___L---U e C q1 Location and Legal Description Lot__ Street and Number where work is to be performed —No Size Septic Tank Feet of Drain Tile Amount of Permit $ y?-RoLf Nature of Water Supply: City —Well f/ MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT No 11 No .. _ Block A 7 (Signed) 277 Street State work to be performed and purpose of building (By Floors) __ C4._ , i Y New Building Remodeling Addition__._ Repairs Date Street Subdivision 40 z 2 .74x' No. of Stories Type of Tank___ Capacity Gals _Dist. Feet of Tank or Drain Field from WeIL __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 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 wor to be •rformed un is emit, as are licensed by Miami Shores Village. STATE OF FLORIDA, 1 COUNTY OF DADE. j Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeare 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 f:u' 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 faul materials and /or workmanship. BUILDING ELECTRICAL PLUMBING ROOFING Owner of Building Architect Contractor or Builder Legal Description Address of Building Lot PERMIT IT? 12804 I1 MIAMI SHORES VILLAGE, FLORIDA n Work to be performed under this Permit 1 Bl. 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 • Subdi- vision Value of Project $ DATE .195 Contractor's License No Amt. of Permit $ BY INSPECTOR In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either, myself,.iny agent, servant or employee. CONTRACTOR OR BUILDER By, AUTHORITY