487 NE 100 St (15)MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
Building Inspection Request
Date. /3 Time
Type lnsp'n f 44 /4 1 Permit No. r
Name
Address
Company
Phone #
7
Nn' /05t
'/4
3o f 6 fc / -`/5'/ /
For Inspector: 3 / 41_ Q 2_„, Name & Date
Approved ❑
Correction ❑
Re- Insp'n Fee ❑
O a 61.1e7 -AC- 3 t'V ie4,416 4411-441
/ Yo c
V e_,
— (33
® //t/T7e, s' &/4 15'
9A9
7/ G �i�$5'o� v ��•G
. : PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date / .e9 .11 D2 Job Address 7 Air /o sZ Tax Folio , / 3 —O (0 rO / 0 0 5
Legal Description 0;61A Historically Designated: Yes No
Owner/Lessee / Tenant Ida/ 7 " r b
Owner's Address 027 A/ /00 j 4 J2 )1 &� Phone P 7� 7
Contracting Co. ��
/ � ?s a / &),&6. . Address 7 o a d 14 P., 711 <.d»'id
Qualifier /l 8/11441 ,E`� - / Phone0 9 / '7'" �/
State # Municipal # Competency #.0 Ins. Co.
Architect/Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION 6 &7? .�G�/ � j t 24 4- � 0-e
Square Ft. Estimated Cost (value) 4°' OCR
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 complian . wi ap ' licable laws regulating
construction and zoning. Furthermore, I authorize the above -named contractor to do the work ted.
„di , I
Notary as to • Owner, d/or C do ' 'dent
My C m ssion . ara G.
ME iai :* MYCOMMISSION # CC 427 EXPIRES
April 11, 200
BONDED THRU TROY FAIN INSURANCE, INC
ad
FEES: PERMIT Q RADON
APPROVED:
Zoning Building
Mechanical Plumbing
C.C.F. o Le 6 NOTARY
Notary : to ' ontractor or
My ' ommissioxt Ores:
= MYCOM : '''N #CC728427 EXPIR
nnl
=••." :• ;Q Ap 11 11, 2002
p BONDED THRU TROY FAIN INSURANCE, INC
Electrical
Master Permit #? (/ � °170 - a
BOND
TOTAL DUE 2
Structural Engineer
Name:
Address:
Phone 1:
Phone 2:
Cathy Peel
487 NE 100 St.
Miami Shores, FL 33138
305 759 -5099
CLIENT INFORMATION:
Folio:
Total Gas Load:
Total Developed Length:
To Furthest Appliance:
Siegel Gas & Oil Corp.
7400 NW 30th Ave.
Miami, FI. 33147
(305) 691 -4411
• .
•
•
• .
• •• •;'
••• •. CCA ANY INFORMATION:
• • •
• •
• • • • •
• ••• • • •
•
• ••
• •
• •
• •
•••
••• •
••• •
• • •
• • • •
• • •
• • • •
• •
die I Gas & Oil Corp.
•74t TvW 30th Ave.
Miami, FI. 33147
(405)6,81 -4411
• • • •
• : enan Siegel Qualifier
• iCete LPG 000013
• 3
Existing 50ft u/g PE pipe
Existing 2nd Stage
Regulator
10 ft
Existing 120 gal A/G LP Gas
Tank
3/4" SCH 40 GALV.
Pipe strapped
to the wall
Existing 1st Stage
Regulator
C I ►'.4 Shut off valve
0
3ft
Sleeve thru floor
4—
18 ft pipe through crawl
space
O
O
• • • • •
'• •
••
•
• • •
•
• • ••• ••
•• •••
•
Existing system adding a LP
Gas residential range
All work will be constructed in
accordance with NFPA No. 54 &
NFPA No. 58
PERMIT APPLICATION FOR MUNICIPALITIES OF DADE COUNTY
(OWNER TO RETAIN COPY)
Date —7 /1 Job Address 4Si NE 100 S I Tax Folio // 0EC /7 a6
Legal Description o{ 3 * 4 7/1g j
Owner / Lessee / Tenant a.
Owner's Address Sx5
Contracting Co. I\ JL) 1 pwrfANNI Address a460 N LC) 67 <12T
Qualifier DXNN 1S rfi [-a(-J LAN - Phone - 761 ``2440
State 4? Municipal # Competency # CRUt'wns.Co. IJ l Jkt_..1 Iv
Architect /Engineer Address
Bonding Company Address
Mortgagor
Permit Type(circle one): BUILDING ELECTRICAL PLUMBIN MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION � j , ,�Q ,
>40 Lk,rat
, M'7?c 9 L L ) r6z&e7 C4U
Square Ft. Estimated Cost(value) /S
WARNING TO OWNEP: 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, anc
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:
be don i omplia.
author' e e a••ve .- to
/i .-
_. - , at r - o owner - d //
Da e:
` :O
II 11
;!li
/ f
contr
Si
Notary
My Co
** • * * * R A
APPROVED:
+` en and
��. piregy COMMISSION EXPIRES
•
•, F Fly AUGUST id. 1995
.
Zoning
Mechanical
I certify that all the foregoing information is accurate and that all work will
with al app able laws regulating construction andMzon .. Furthermore, I
to do the work stated.
ndo President
esident
Master Permit #12667
Phone i / -0300
Address
J
re of Contractor o
A=
Signet
Date: 4
Notary $s 1:rh� t>) act d �i W SBIt aotBuil • er
•
My Co r ` r � `. re COMMISSION EXPIRES
� � % : ; „. i ' AUGUST la. 1995
OF n: •
FEES: PERMIT j e `BP RADON C.C.F. M1 NOTARY TOTAL DUEJ / /Va
* *
Fire Other
Building c} Electrical
OY /)t / /ngineeringt
ITEM
BATH TUB
UNIT
FEE
ITEM
SWITCH OUTLETS
UNIT
FEE
ITEM
SPACE HEATERS
UNIT
FEE
BIDET
LIGHT OUTLETS
CENTRAL HEATING
DISHWASHER
RECEPTACLES
A/C (WIND)
DISPOSAL
SERVICE TEMPORARY
A/C (CENTRAL)
DRINKING FOUNTAIN
SERVICE SIZE IN AMPS
DUCT WORK
FLOOR DRAIN
SERVICE REPAIR/METER CHANGE
REFRIGERATION
GREASE TRAP
APPLIANCE OUTLETS
PROCESS AND PRESS PIPING
INTERCEPTOR
RANGE TOP
UNDERGROUND TANKS
LAVATORY
OVEN
ABOVE GROUND TANKS
LAUNDRY TRAY
WATER HEATER
U.F. PRESSURE VESSELS
CLOTHES WASHER
MOTORS 0- 1 HP
STEAM BOILERS
SHOWER
MOTORS OVER 1- 3 HP
HOT WATER BOILERS
SINK, POT /3 COMP.
MOTORS OVER 3- 5 HP
MECHANICAL VENTILATION
SINK, RESIDENCE
MOTORS OVER 5- 8 HP
TRANSPORTING ASSEMBLIES
SINK, SLOP
MOTORS OVER 8- 10 HP
ELEVATORS/ESCALATORS
TEMPORARY WATER CLOSET
MOTORS OVER 10- 25 HP
FIRE SPRINKLER SYSTEMS
URINAL
MOTORS OVER 25-100 HP
COOLING TOWERS
WATER CLOSET
MOTORS OVER 100 HP
VIOLATION
INDIRECT WASTES
A/C WINDOW
REINSPECTION
WATER SUPPLY TO:
AIR CONDITIONERS
A/C UNIT
STRIP HEATER
FIRE SPRINKLER
GENERATORS TRANSFORMERS
HEATER -NEW INST.
GENERATORS TRANSFORMERS
HEATER - REPLACE
GENERATORS TRANSFORMERS
LAWN SPRINKLER -WELL
SPECIAL PURPOSE
SWIMMING POOL
OUTLETS COMMERCIAL
WATER SERVICE
SIGN TUBES
SEWER CONNECTIONS
SIGN TRANSFORMERS
UTILITY -SEWER
SIGN TIME CLOCK
UTILITY -WATER
FIXTURES
SEPTIC TANK
ANTENNA
RELAY
TELEVISION OUTLETS
DRAINFIELD, 4" TILE/RES.
VIOLATION
PUMP 8 ABANDON SEPTIC TANK
REINSPECTION
SOAKAGE PIT CU. FT.
CATCH BASIN
DISCHARGE WELL
DOMESTIC WELL
P -fl - » i i k -
F
k
AREA DRAIN
ROOF INLET
SOLAR WATER HEATER
FIRE STANDPIPE
POOL PIPING
LAWN SPRINKLER SYSTEM
GAS RANGE
METER SET (GAS)
GAS PIPING
ADDENDUM TO BUILDING PERMIT APPLICATION
(AN APPLICATION FOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. IF A MASTER PERMIT HAS BEEN
OBTAINED, THE OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.)
PLUMBING
ELECTRICAL
MECHANICAL
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING K IT
Permit No.
Z —/3
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
LJ
Owner's Name and Address 24
Registered Architect and /or Engineer a _ — _.- --__ -- _�--- ---- - - - - -- -- -- _ __ _
Employing Plumber's Name ��!'•� _ ��!���` —_— No.
Location and Legal Description L -___ — — _ Block_
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.
Amount of Permit $ ----------- -_ - - -- (Signed)-
M Commission Expires
No. ____V r f __. ��Street___.
Date
Street__
Street_
Repairs No. of Stories.
Size Septic Tank - _____- Type of Tank Capacity Gals
Feet of Drain ........................ Feet of Tank or Drain Field from Well
Nature of Water Supply: City -Well ______Size of Soakage Pit
Plumbing Inspector.
Iif
The undersigned applicant for this building permit does hereby certify that he understands and accepts his ob 'rations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Penn : ent Supplement, and has com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors el .loyed 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 sue I public notice or notices as are
required by the Act. The undersigned agrees to employ only such sub- contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village. ^ � %
(Signed).
Master Plumber.
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.
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
INK6
SINKS
SLOP
SINKS
LAUNDRY
Tuns
U RINAL/
CATCH
BASIN
FLOOR
DRAIN
DRINK NO
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
P001.
CONTR.
LIST
,2)
CHECK
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING K IT
Permit No.
Z —/3
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
LJ
Owner's Name and Address 24
Registered Architect and /or Engineer a _ — _.- --__ -- _�--- ---- - - - - -- -- -- _ __ _
Employing Plumber's Name ��!'•� _ ��!���` —_— No.
Location and Legal Description L -___ — — _ Block_
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.
Amount of Permit $ ----------- -_ - - -- (Signed)-
M Commission Expires
No. ____V r f __. ��Street___.
Date
Street__
Street_
Repairs No. of Stories.
Size Septic Tank - _____- Type of Tank Capacity Gals
Feet of Drain ........................ Feet of Tank or Drain Field from Well
Nature of Water Supply: City -Well ______Size of Soakage Pit
Plumbing Inspector.
Iif
The undersigned applicant for this building permit does hereby certify that he understands and accepts his ob 'rations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Penn : ent Supplement, and has com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors el .loyed 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 sue I public notice or notices as are
required by the Act. The undersigned agrees to employ only such sub- contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village. ^ � %
(Signed).
Master Plumber.
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.
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 # 494
Permission is hereby granted / �'r�;; {l
to install the following described plumbing, in accordance with th9
law, statutes and regulations of Miami Shores Village, Florida and
the State of Florida, governing plumbing and drainage work done in
Miami Shores Village, Florida.
For a
Lot ..2-3 2— _ Block
Fixtures A� r� !
FIXTURES ROUGHED IN
FIXTURES SET
SEWER
SEPTIC TANK
TOTAL'
MIAMI SHORES VILLAGE
Plumbing - Permit
Miami Shores Village, Fla.
At No. / /fir 7 2',
Subdivision
As Shown on attached approved plans.
C.T
i '"
Payment Received 7'
By
Village Plumbing Inspector
/ijrjn4sPermit issued subject to approval of County Plumbing Inspector
•
Permit ; 5
Permission is hereby granted
G?1R isaa
to install the following described plumbing, in accordance with the
laws, statutes and regulations of Miami Shores Village, Florida and
the State of Florida, governing plumbing and drainage work done in
Miami Shore Vill�r e Florida.
For a eAt No. v fi 7/g • /d-
Lot !' 3.. Block rd Subdivision
Fixtures
As Shown on attached approved plans.
FIXTURES ROUGHED IN
FIXTURES SET
• SEWER
SEPTIC TANK
TOTW
Village lum ing Inspector
MIAMI SHORES VILLAGE
Plumbing
Miami Sho es Villag- Fla.
Payment Re
By
eived
7 This permit issued subject to approval of County Plumbing Inspector
Permit #— J.9 4
Permission is hereby granted
TOTAL
MIAMI SHORES VILLAGE
P lumb-ing - P e rmi t
Miami Shores Village, Fla.
to install the following described plumbing, in accordance with the
laws, statutes and regulations of Miami Shores Village, Florida and
the State of Florida, governing plumbing and drainage work done in
Miami Shores Village, Florida.
For a At No.
Lot Block Subdivision
Fixtures
As Shown on attached approved plans.
FIXTURES ROUGHED IN
FIXTURES SET
SEWER
SEPTIC TANK
Payment Received
Village Plumbing Inspector
This permit issued subject to approval of County Plumbing Inspector
Address of work
Size of Soakage Pit
E P A R .T M l T T. O F 'P U L I C S I R V I C L
Building has stores
Additional information
Ready for Inspection on: /0 / 0
DIVISION OF PLUMBING INSPECTION
CITY OF MI.QMI, FLORIDA
I herewith submit the following application for a permit covering installation of
a Septic Tank (\t Soakage Pit ( )
Relaying ;New '/ ® / feat of drain tile.
Installed by (d
f4 Address
No. of Plumbing Fixtures in building:
Laundry tubs Floor Drains
Purpose of same
193-0 ; At
Approved: Condomned:
, O - 19'
(new((,) old( -) story( 1) addition( ) ren:odoled( )
For A (dwelling) store( ) garage( ) apartment( ) hotel( )
(
(office( ) garage wash floor( ) waste water from a
office apartments hotel rooms '''bedrooms
✓ Owner or Agent /92 ` Address
Lot No. Block IV. / 0 Subdivision
i....-Nature of Water Supply: City ( ) Well( ) Feet distant from all wells
Type of tank installed 4 j (1 , _____ capacity in gallons 1.
/ P.M.
Remarks: , .tL1 '`?jf c c!I. ` fac,,,,k -i (i, ",y f ,„, ,,. t✓ „,, -n) [ II 0 '% ”' `e I
Permit Number: ^�
7I �� ��� (
`4 ' e � G ca,V i/ .
Permit # 5 1 1
Permission is hereby grantee
004>
to install the following described plumbing, in accordance with the
laws, statutes and regulations of Miami Shores Village, Florida and
the State of Florida, governing plumbing and drainage work done in
Miami Shore Vi :_e, Florida.
For a
SEWER
SEPTIC TANK
TOTAL' '
MIAMI SHORES VILLAGE
Plu•nbdng Permit
Miami h9res Villa g��Fla. 4-4041
t No. 4./r,1 #44d1-49.
W it4.‘ " 4144 0 1:41 4'
Lot A5 Block Subdivision
ler
Fixtures
As Shown on attached approved plans.
FIXTURES ROUGHED IN
FIXTURES SET
• •
Payme e'eived
1,
By 4,..
Village Pluming Inspector
This permit issued subject to of County Plumbing Inspector
CLOSETS
BATH
TUBS
SHOWERS
LAVA-
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TUBS
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNTAINS
-
TOTAL
FIXTURES
£
7�
/.
I S
/
/
✓ 3
For a
I herewith submit the following plan of plumbing for approval:
/ f N Work executed by
New C Old 1:C1 Story El Dwelling Store ❑ Garage ❑ Apartment ❑
Owner or Agent i ear
Employing Plumber
Builder or Contractor is
Lot No.
Address
Sewer Connections
��� �• 6 ( 0.0 , tea/
At center of St. ❑ At curb ❑
A charge of $1.00 will be made for correcting any inaccuracies in the foregoing information.
DO NOT WRITE IN SPACE BELOW. THIS IS FOR THE USE OF THE DIVISION OF PLUMBING INSPECTION ONLY.
Date .
ROUGH -IN INSPECTION
Ground Rough -In Rain Leader
A M B ��> '• P M.
Approved by -.°1( . / "
Condemned by
Plan No
REMARKS.
914 eS`i/9.
DIVISION OF PLUMBING INSPECTION
DEPARTMENT OF PUBLIC SERVICE
MIAMI, FLORIDA 1,--7-3
19
Block No. Subdivision
SEWER INSPECTION
,� (fie
// REMARKS
Address
Address
At property line ❑ Existing in alley ❑ Existing bldg. sewer ❑
To septic tank ❑ Existing bldg. drain ❑ To dry well ❑
Date—
A M P M.
Approved by
Condemned by
Sewer Permit No
Addition ❑ Remodeled ❑
Hotel ❑ Office Bldg. ❑
Date
FINAL INSPECTION
A M P M.
Approved by
Condemned by
REMARKS
THIS SPACE FOR ELEVATION SKETCH
In alterations to existing work show the old work in red ink and the new in black ink. Letter each stack to
correspond with the opening shown in floor plan or ground plan on opposite page.
A PERSPECTIVE SKETCI
PROVIDED THE WORK'CA
WILL BE SUFFICIENT
N BE CLEARLY SHOWN
THIS SPACE FOR PLAN SKETCH
Show location of stacks and horizontal drains inside building, lettering each opening to correspond with the
stock connections as shown on the elevation sketch on opposite page. Where ground work is concealed, draw
floor plan of building showing location of walls, partitions, columns, etc., and the location of all horizontal
soil and waste pipes, in reference to same.
cri
•
Sketch position of building and lot lines in square (which represents an entire city block), showing on whigl
street the building and lot faces; also show exact location of "Y" in street and position of lateral or septic,.
tank. Show sewer and any change in direction same may make. The purpose of this plan is to have an accurate
layout of all underground pipes for future references.
WEST
NORTH
A
EAST
Remarks:
NORTH
SOUTH