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278 NE 101 St (3)/ ° 9 3 C /`/ ' 6 �U / S' Tax Folio I/ 3°�Q(O !� 7� J� 9 Date Job Address Legal Description 044: n 4 4 c5 / f Owner / Lessee / Tenant /vaSda ,4 p OS Z L Master Permit # Owner's Address 02 N /4/ $ / Phone 7 3 -7- Srd Contracting Co. E(M.) a /?O6 11 Address /� Qualifier LOWS 7 j iq ss# / Phone (76 - /o d U State # OW Municipal # d7/ "? /Competency # 93 Ins.Co. tw(.4F Architect /Engineer Address Bonding Company Address Mortgagor Address Permit Type(circle one): BUILDING ELECTRICAL UMBIN MECHANICAL ROOFING PAVING FENCE SIGN WORK e) ORK DESCRIPTION ti -IN -!(� , g Square Ft. PERMIT APPLICATION FOR MIAMI SHORES VILLAGE 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 cer ify that all the foregoing informati•n is accurate and that all work will be done in comp ' -nce all applicable laws regulating c• std, ion and zoning. Furthermore, I authorize th- ='ov < I d contractor to do the work stat V4 Signatu Date: ** * d /or Condo President Notary - to an: '8413 My Commission Ex eE dx3 wwo3 V113Snw V1311Vd Zoning Buildin Mechanical Plumbin Estimated Cost(value) /00 o (, Signature of Contractor or Owner- Builder Date: Q .1 1ltrt as to Contractor or Owner- Builder My Commission ExWON •sub aawaS A8 Papuoe 96 £ tq ww03 4w * * * * * * * * * * 113Snw'r1311Vd ** FEES: PERMIT 0t 463vP RADON C.C.F. w 5t) NOTARY TOTAL DUE LD APPROVED: Fire Other Electrical 1 1 5 Engineering LOT: CONSTRUCTION PERMIT FOR: New System [ ] Existing System [ ] Holding Tank [ ] Temporary /Experimental ] Repair [ ] Abandonment [ ] Other(Specify) AGENT: L 0 4 ) ROD APPLICANT: PROPERTY ID #: PROPERTY STREET ADDRESS: STATE OF FLORIDA DEPARTMENT OF HEALTH AND REHABILITATIVE SERVICES ONSITE SEWAGE DISPOSAL SYSTEM CONSTRUCTION PERMIT Authority: Chapter 381, FS & Chapter 10D -6, FAC 54.4 A 6 BLOCK: 2 eci NE /0/ sf- SUBDIVISION: 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 T [lv ] [GALLONS / GPD] 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 [ s'y l ] GALLONS PER DOSE DOSING TANK CAPACITY DOSE RATE [ ] PER 24 HRS NO. OF PUMPS: [ ] D [ 60] SQUARE FEET PRIMARY DRAINFIELD SYSTEM R [ ] SQUARE FEET SYSTEM A TYPE SYSTEM: [ ] STANDARD [ ] FILLED [ ] MOUND [ ] I CONFIGURATION: [ ] TRENCH [X] BED [ [ 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: [ ] INCHES T fr 41/ , iZ d c 0 1/ / 11- 0-.__.. H E R SPECIFICATIONS BY: TITLE: APPROVED BY: DATE ISSUED:/4 HRS -H Form 4016, Mar 92 (ObsoLetes previous editions which may not be used) (Stock Number: 5744-001- 4016 - 0) B ©O(L ©ON© ©EpQf gL 7 LIV PERMIT # DATE PAID FEE PAID $ RECEIPT # [SECTION /TOWNSHIP /RANGE /PARCEL NUMBER] [OR TAX ID NUMBER] -2 7 TITLE: - 4e CPHU EXPIRATION DATE: Page 1 of 2 INSTRUCTIONS: PERMIT NUMBER: Permit tracking number assigned by CPHU. APPLICATION FOR: Check type of permit, if "Other" specify type in blank. APPLICANT: Property owner's full name. TELEPHONE: Telephone number for applicant or agent. AGENT: Property owner's legally authorized representative. MAILING ADDRESS: P.O. box or street mailing address for applicant or agent. LOT, BLOCK, SUBDIVISION or PROPERTY 11311: 27 character id number for property. (CPHU may require property appraiser ID (/ or section/township /range /parcel number) SYSTEM DESIGN AND SPECIFICATIONS: TANK: Minimum specifications from Chapter 1OD-6, FAC. DRAINFIELD: Minimum specifications from Chapter 10D-6, FAC. OTHER: Other specifications, such as operating permit requirements, low - volume flush toilets, variance provisos. SPECIFICATIONS BY: Name of individual providing specifications. If designed by a registered engineer must be sealed. APPROVED BY: County Public Health Unit (CPHU) personnel reviewing and approving permit. DATE ISSUED: Date permit is issued by CPHU. EXPIRATION DATE: One year from date issued if the system has not been installed. Permits for system repairs become void 90 days from the date issued. APPLICATION FOR: [ ] New System [ ] Existing System [ ] Holding Tank [ ] Temporary /Experimental [X✓] Repair [ ] Abandonment [ ] Other(Specify) APPLICANT: JV ij Il V?) AGENT: & oil/ 6 ?d G :.6) MAILING ADDRESS: D '33 WIA D a S r 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. <: PROPERTY INFORMATION [IF LOT IS NOT IN A RECORDED SUBDIVISION, ATTACH LEGAL DESCRIPTION OR DEED] LOT: PROPERTY ID #: PROPERTY SIZE: BLOCK: PROPERTY STREET ADDRESS: 7h2 /q7 /o/ (' r Imo„! / r/ d ; / 3 F' DIRECTIONS TO PROPERTY: BUILDING INFORMATION Unit Type of No. of No Establishment Bedrooms 1 2 3 4 l�tl6 -dam icy l r7)0 [ ] Garbage Grinders /Disposals 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 SUBDIVISION: DATE OF SUBDIVISION: [Section /Township /Range /Parcel No.] ZONING: ACRES [Sqft/43560] PROPERTY WATER SUPPLY: [ ] PRIVATE ( R' RESIDENTIAL [ ] COMMERCIAL Building # Persons Business Activity Area Sqft Served [ ] Spas /Hot Tubs PERMIT # DATE PAID FEE PAID RECEIPT # 9 A9 ) TELEPHONE: / 575-0 9 For Commercial Only DATE: /a - �3 [ ] Floor /Equipment Drains [ ] Ultra -low Volume Flush To'lets [ ] Other (Specify) HRS -H Form 4015, Mar 92 (Obsoletes previous editions which may not be used) Page 1 of 3 (Stock Number: 5744- 001 - 4015-1) Cc : type of permit, if °Other° specify typo blan.lc. 1. owner's fur! Eltn Ie. 7dephone number fo: applicant or agent. ienty :owner's initboz repavae:nttive. ?.O. boo or street, city, L arid zip code ng aciciaece ▪ applicant oa- agent. eft and nubr"ivrior. To:: lot (reco...-cler" 71' =60"2;( f.nlet:ivon.). 7:flea iC not in n recorded subdivision, a copy of tan let :CE n o:: must be attached. :::::_i: CT cid dote of rub-"ive cc"; bo.1 C7 0:: date lot 0:tinnily :.-econded. DivEing co 7.o^.. Into two or mon:: pds for the po..-porn z" rboll be considered c. aubdsion of the tot. :: : E2e7.7_17 . 0'2) 0 Cr reCii07rre:01.7./$`''..7.1f)/rr:.7::je/9Ce: No. :37.DIICC?„7.S: :7:1JS:51\r.F.SS :7"\l. flernr! feet) exclusive of nil paved cmas and wily Or cod:naive normal:y marshes, 0:: sud 'loclies o ::::07uous unpaved /1 noncom, ▪ 71glIta-of-way and easements witie no subsurface obsV:Lictions inny be included io criculcting lot area. 1,"./ATal. Check private or public. address for prie?erty. or lots withou: u.n assigned c rers, indicate street or road and /male in county. 13=7:DNS: ?rovide detailed instructions to lot or attach on area map showing lot location. Check residential or commercial. :As: type of cseablishment fl 'fable Z, Chaptc: 10D-6, IF1C. Exampies: zingto family, single wide mobile home., ::ectourarit, doctor's office. Count nil rooms design;(5 primarily for sleeping :1 those C.1::.3 eXpeeed to :routinely provide sleeping accommodations for occupants. I cr footage of nnclosed habitable ono: cf dwelling n.nit, excluding gamge, carport, exterior storage shed, on open c:: aL. ,:lcand on outside :::ems fon eine:: atory of structure. NLire'n.,::: of ':.;nn mnidinL, ing, c. wofi.tin.; -^ 'For establi 2 perconc per bedroom are assumed. :701' 1:11 r.pplicctionn only. T: and i:OUre of operation, Or oilier irtfOritE:10n required by 77able Chapte:: TiAC. Mar% ccc:h. listed foiti.re wife number instolled or 'NA" !f00 applicable. of a:J:3 co i Date application one day ▪ 7.24Z to fee ^.7..?:n7.',J with ap?ropaiate fees and attachments. A wing bolo:dor-inn dimn , "ienntionie of residences on buildings, swimming pools, .Tecorded ors onsite cevir■Je n"isposi:1 Elyfre77. coo' :"ints nod lonnlion, slope of property, any existing Or proposed xlrells, ea fnnt:. .'"Ilers. creas, obEt:nc:nr.1 arena, cn r. viCten. 7..cnntion of vin;7, onsitn CeWC.Se disposal systems, surface wate arc: When facilltieL fnztures 00 adjcce.:; .l'entums 00e "..'et of the applicant !et. Location of any public %loll within 200 fecl of let. 10C 0 :CC. C.. :cidences) r.r.172ber building area or MX:7. unit. For 1'ton:residential ostab"isl a floor p showing the silvan:: f:ezta.ge Cr :', ".. plumbing drains artsl firtum types, and offer features nece:za.ry to cleti;.. composition 000 '. cp.iantity cviotctoo. 1 Irl it , _f r' l ▪ i 0 1 �i 1 I I 1_1_1 _1 ,. � 1 ,' !J_ _1-1_ 1 U_ 1_�_ _l _1_ 1 - J 1 111 1 ( I 1I _ ! !_L I �. 1_1_1 n I I III 1, 1 1 I J I 1 J I J J 1 1 - 1 I f, i I 1 !I L1. 11 ' 1 _1_1 1 1 1 _t_1 I 1 I 1I1 11 I rl ❑ LI - I1II1( 1 (I1 1 11 ' I 1_1 - - I 1 1 - _1 1 1 1 I I, 1 I ! 1 � 1 I 1 1 1 I l l 11 1 `E.11 1 I 1 L i (1 1 1 _i I n 1 I I 1.1.1111111 II I 1 • 1 1 I 1 1 1 1 _ 1 -I - L , I ( - I I I_ l_ ' 1 1 1 tit uL�L IJJ_ (1 I I __ %1 H I _ I i 1 STATE OF FLORIDA • DEPARTMENT OF HEALTH AND REHABILITATIVE SERVICES APPLICATION FOR ONSITE SEWAGE DISPOSAL SYSTEM CONSTRUCTION PERMIT Permit Application Number 9 9 S 0 PART 1I - SITE PLAN 1 1 11 ' 1 I 1. 1_1_ 1., i „-;) r 1 r �_ 1 1 i 1 I rQ� 1' ' -- .I 11_ _n� _1 III �, 11- 1.-.H » o 1! I ( r I J 1 1 --- 1 11_? ' _(- .i -�i`� � 1�1 I I'T I I �! ■ r! 1 _ - 1 I .1 1 - _ I - i � - .. I I 1 l I ._ , 1__ ( 1 J C_ I.[ I _! 1 I I I J .- $ L H HH H+ - F - + t +H+ 1 1 n Ul, _`. J I 1ti i I r4BR n I nit 1_ 1 ri -[ I - 1 - JJ !J _ �l_1 ( t 1 Il _ - In - 1' ( Il(T1 I f I ;( - 1 I I I - I ` J ' L, I r ti I I �- -I U 1 ! I_ _ 1 1 1 1 1. L 1 f 1 (!_ I I 1 J f l i ! 1 J I n L _!J w! II1 � � I� I j ' t - - _ ■ J u - I ! 1j I1 J i (_1 r-A-- {�' `��1T1 - " 1_' ' �i I C_ 1 `� !�"1 _ I I I 1 h I _. h _ I �11-172-1-' � € I I - + I ! 1 1 1_I l_I 1- 1 1 1 I n J ! J _ ; _ - '_ 1 L 1_ -1 , 1 1 1 1_1_1_1 J_ J JJ_ _ t 1 I _ I I T I 1 I I I 1 1 I� ' • . u 1 1 ■ L( ■ , 1 ! , , 6 - , -' I un ( T�I 1_1 _( 1 ( (11 I f I_ 1 t LI I 1 ( 1 _ 1 t 1 1 1 _ I , _ I 1 1 , 1 _ I ' I . y l' J I f (J I _ 1 f I LI 1 I1 (- J I) I 1 _ 1 t i_I ± _I_t _, fl 1 1 -I 1 I t I 1 11_ I_ 1 1 i_ _ _I_ w J_ u II .I • /. • ! - 1 hi 1 11 -�lJ 1 `_ ll 4 I_ ! 1 1 s 1 IN ■ I I( a 1_I a a I 1 If I i,/■O 1 1=i I I 1 J 1 I 1 1 1 - R - - 1 ma •� iii $ / • 1 • I , J _�1��_ 1 * // I / ' ' • H _ I _ _ - III© "1 .... 0% ■1 1 ■/■ • 11 •J /■ J • / ��%�11� t // ■ I •■ • F■ ■1 # ■' ■ � � j ■ - 1J •//1� 1■1 • � •Al • 111 _ ,_ awA il// �■ _ _ i ■ •r ■r // mI�tlIII■ minsomUau � a ■ Rr suT l��/��t u‘mt■ i rm �ii s moir+ `ri>tir .* MAMA AAA. . /m■ OA _■ * mai •'r l'iiw a& ■�I.a�R�IOROMAA.... AEA Amm -, 1 111,•••• •• OW RUIWOO •••••• •4 MON WOW AMMO ■. ■ ■ ■ ■R/■ • •■■■■ II,�rCAIAwJlww,il�tiri�� _ __. J al AI 1 1 1 1 1 . 1 . Notes - 360 (- 1-:),(11/ Site Plan Submitted by Plan Approved Not Approved SIGNATURE J ' [ I 1 I i . I 1 1 „ill-- 1 1 f 1[ 1 � - 1 - I I 1 1_ 1 ( )C_) 1 1 1 r 1 1 I a =` n 1 f l 1 ' I t t -f 11 -I i 1 i it HRS- H,Form 4015, Feb 85 (Obsoietes previous editions which may not be used) (Stock Number. 5744-002-4015-6) ddi aye" By 7 li lt II 1 0 ?_r LC 1 1 1 ' 1 0�� 1 N-1 J 1 I 1 - I 1 i _ I L I , 1± I , ! I 1 I I 1 , J I I I _I !�� 1_ 1 _ 11 1 1 1 ' I_L(_, 1_1J 1 I_ I _1 I 1 L JI l . 1 1 1 1 1{ I !_ J_ J_ I_' 1 1 1 -1 f1 ! I I' 1 t 1 1 TIT- f 1 I 1 I l l - _ 1 1 1 1 L i 11! ' 1 '- J ` I 11 ,, I 11 1 1 11 . ▪ ( - I ! ! 1 . I f J_i 1 1 1 l 1 1 II 1 1 � - n I I I I i -1 I J I- I 1 1 1 ! i I I 1 r ' 11 11 I I1 1 1' I 1 1 1 I 1 I _I 1J IJ_' r- I I i1I 17,11 1 1 ; I 1 1 I I ! _ 1 1 1 n 1 1 1 1 -1 I_ - , 1 1 1 1 _1J I 1, n I 1 1 J t 1 ( - 1 (j I I 1 _I 1 1 I 1 !_; �.' I I I 1 J 1 1 I 11 t1 1 1 1� - 7D 1 J - - I ^1 I I _I [l I_1 I ;7 1_ _{ 1 1 e 1+ II i ' ' I( 1-1 1 11 I I0L_I - I 1( I I I I I f I_I J 0 [I I IL 1_ �I ' i J I t . I-1 1 1 -1 1_ L _IJ I, I IJ 1 _ 1 11 'JJ r �-- } LL I q r' l Vi I l - - ' r h - 0-1-0 o 1 II A ALL CHANGES MUST BE APPROVED BY TYIE COUNTY PUBLIC HEALTH UNIT TITLE Date /0' C ' ; County Public Unit Page 2 of 3 BUILDING ❑ ELECTRICAL ❑ PLUMBING Architect Contractor or Builder Legal Description Address of Building Lot ROOFING ❑ MIAMI SHORES VILLAGE. FLORIDA PERMIT N9 9969 Owner of Building Bl. Subdi- vision Sq. Ft Value of Project $ Signed: E By . . INSPECTOR DATE � 195 t► �. Contractor's License No f ~` Work to be performed under this Permit 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. 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. CONTRACTOR OR BUILDER BY AUTHORITY Pen- at No Owner's Name and Address Registered Architect and /or En . eer Employing Plumber's Name__ �f . .._ Location and Legal Description Lot_ 1l._._..... ____:______.______ .Street and Number where work is to be performed —No 7 2 State work to be performed and purpose of building (By Floors)__-___ New Building __ -- Remodeling- _--- ____ -- Addition_ Size Septic Tank Feet of Drain Tile_ _ nn r ________ Feet of Tank or Drain Field from Well Nature of Water Suppl . City —Well ______Size of Soakage Pit Amount of Permit $_ G . • My Commission Expires MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT No. (Signed)- ( Signed). • � — /5 6o Date Application is hereby Luade 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 mus be kept at building during progress of work. /� / 7�� �/ No._C1� ?I-AL _ .. Street_ /e /� C1 7Pilo Street_ Subdivision Street Repairs No. of Stories Type of Tank_ Capacity Gals Notary Public, State of Florida Master Plumber. Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obli ions as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Penman t Supplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors em ' oyed 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, work to be erformed under this permit, as are licensed by Miami Shores Village. STATE OF FLORIDA, } COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and . says that he is the of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts • therein by him stated are true. NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made •necessary by improper notice for inspection, or faulty materials and /or worlmtanship. CLOSETS BATH TUBS SHOWERS LAVA- TORIES NKS SINKS SLOP SINKS LAUNDRY TUBS U URINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT'NS TOTAL FIXTURES CONTR. LIST CHICK SEPTIC TANK SEWER CONN. DRAIN. FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SWIM•G POOL CONTR. LIST ` - _- CHECK Pen- at No Owner's Name and Address Registered Architect and /or En . eer Employing Plumber's Name__ �f . .._ Location and Legal Description Lot_ 1l._._..... ____:______.______ .Street and Number where work is to be performed —No 7 2 State work to be performed and purpose of building (By Floors)__-___ New Building __ -- Remodeling- _--- ____ -- Addition_ Size Septic Tank Feet of Drain Tile_ _ nn r ________ Feet of Tank or Drain Field from Well Nature of Water Suppl . City —Well ______Size of Soakage Pit Amount of Permit $_ G . • My Commission Expires MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT No. (Signed)- ( Signed). • � — /5 6o Date Application is hereby Luade 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 mus be kept at building during progress of work. /� / 7�� �/ No._C1� ?I-AL _ .. Street_ /e /� C1 7Pilo Street_ Subdivision Street Repairs No. of Stories Type of Tank_ Capacity Gals Notary Public, State of Florida Master Plumber. Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obli ions as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Penman t Supplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors em ' oyed 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, work to be erformed under this permit, as are licensed by Miami Shores Village. STATE OF FLORIDA, } COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and . says that he is the of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts • therein by him stated are true. NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made •necessary by improper notice for inspection, or faulty materials and /or worlmtanship. BUILDING ELECTRICAL PLUMBING ROOFING Owner of Building ❑ PERMIT N° 4284 Architect Contractor or Builder Legal Lot Description Address of Building CONTRACTOR OR BUILDER MIAMI SHORES VILLAGE. FLORIDA t BI DATF 195 Contractor's License No. / t* Work to be performed under this Permit Subdi- vision Value of Project $ Amount of Permit $ This permit is granted to the contractor or builder named above to construc 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 knoyledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings cr in the statements or specifications and that he assumes responsibility for work 3one by his agents, servants or employees. Signed. : BY INSPECTOR In consideration of the issuance to me of this permit I cigree to perform the work covered hereu der in compliance with all ordinances and regulations Jertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted/to the proper authorities of Miami Shores Village. In ac- epting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. BY AUTHORITY ems, 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 building during progress of work. Registered Architect and /or Engineer ___, Employing Plumber's Name __ _ _ ___ l N o. t 7 O J Street 3 ��!.�C� -,-� 71 _LA) p / C4=-41,.. Location and Legal Description Lot_ —_- � � Block ,rte __ - f Subdivision_ ---- _QyLAu � Street and Number where work is to be performed— No._ __ ___7__ Er - 2 4 Street 1 D / sue' • State work to be performed and purpose of building (By Floors) New Building Remodeling Addition Repairs No. of Stories.. Owner's Name and Address (mod Amount of Permit $_ MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT 197 (Signed) Date No (Signed) Street "/L7 / �_ Q Size Septic Tank Type of Tank. <__" Capacity Gals Feet of Drain Tile 7 Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: City —Well. Size of Soakage Pit. i Plu ing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent ement, 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 this permit, as are licensed by Miami Shores Village. Master Plumber. STATE OF FLORIDA, ss. COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. My Commission Expires Notary Public. State of Florida NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty materials and /or workmanship. CLOSETS BATH TUBS SHOWERS LAVA- TORIES SINKS SLOP SINKS LAUNDRY TUBS URINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT'NS TOTAL FIXTURES CONTR. LIST CHECK SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SWIM'G POOL CONTR. LIST !v/ CHECK 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 building during progress of work. Registered Architect and /or Engineer ___, Employing Plumber's Name __ _ _ ___ l N o. t 7 O J Street 3 ��!.�C� -,-� 71 _LA) p / C4=-41,.. Location and Legal Description Lot_ —_- � � Block ,rte __ - f Subdivision_ ---- _QyLAu � Street and Number where work is to be performed— No._ __ ___7__ Er - 2 4 Street 1 D / sue' • State work to be performed and purpose of building (By Floors) New Building Remodeling Addition Repairs No. of Stories.. Owner's Name and Address (mod Amount of Permit $_ MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT 197 (Signed) Date No (Signed) Street "/L7 / �_ Q Size Septic Tank Type of Tank. <__" Capacity Gals Feet of Drain Tile 7 Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: City —Well. Size of Soakage Pit. i Plu ing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent ement, 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 this permit, as are licensed by Miami Shores Village. Master Plumber. STATE OF FLORIDA, ss. 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. Permit No.__ Registered Architect and /or Engineer ( c__._______ —_ Employing Plumber's Name _ (1f i L__��_^-}�� a . r -yt_•.,.�t! f'` C No t j.. ,r Location and Legal Description Lot____._2___:_"___ ' 't. Z" Block Street and Number where work is to be performed —No f+ J e / 1 Size Septic Tank Feet of Drain Tile 4 Amount of Permit $- ss. Type of Tank _ (Signed) s MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Date Nature of Water Supply: City —Well Size of Soakage Pit My Commission Expires Notary Public. State of Florida / V.; Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. Owner's Name and Address t. t e '' �' " t' No Street Street__ ..ELY -?-+ -L ) �^%., Subdivision_ —1_ 1 !_ tom. "' --4 F Street l "_ / -' r, State work to be performed and purpose of building (By Floors) New Building Remodeling Addition Repairs No. of Stories Capacity Gals Dist. Feet of Tank or Drain Field from Well 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 S,up�"lement, 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 this permit, as are licensed by Miami Shores Village. �' / / ; ''" r 4 t - r (Signed) s-- —,,—...,:_o__—...,.____,___ Plumber. STATE OF FLORIDA, COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the . of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty materials and /or 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 . i ✓ CHECK I j Permit No.__ Registered Architect and /or Engineer ( c__._______ —_ Employing Plumber's Name _ (1f i L__��_^-}�� a . r -yt_•.,.�t! f'` C No t j.. ,r Location and Legal Description Lot____._2___:_"___ ' 't. Z" Block Street and Number where work is to be performed —No f+ J e / 1 Size Septic Tank Feet of Drain Tile 4 Amount of Permit $- ss. Type of Tank _ (Signed) s MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Date Nature of Water Supply: City —Well Size of Soakage Pit My Commission Expires Notary Public. State of Florida / V.; Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. Owner's Name and Address t. t e '' �' " t' No Street Street__ ..ELY -?-+ -L ) �^%., Subdivision_ —1_ 1 !_ tom. "' --4 F Street l "_ / -' r, State work to be performed and purpose of building (By Floors) New Building Remodeling Addition Repairs No. of Stories Capacity Gals Dist. Feet of Tank or Drain Field from Well 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 S,up�"lement, 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 this permit, as are licensed by Miami Shores Village. �' / / ; ''" r 4 t - r (Signed) s-- —,,—...,:_o__—...,.____,___ Plumber. STATE OF FLORIDA, COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the . of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty materials and /or workmanship.