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70 NE 100 St (5)MIAMI SHORES VILLAGEE BUILDING DEPARTMENT 305- 795 -2204 Buil.ing Inspection Reques Date f �.. 5e 1C Type Insp'n nGI /Cfld ) Permit No. P/ Name LJ /f 1 00 31 Approved Correction Re- Insp'n Fee Address Company cop f7) Phone # Inspection Date Miami Shores Village 10050 NE 2nd Avenue Phone: 305- 795 -2204 Permit Number: PL2004 -357 Printed: 12/17/2004 Applicant: PATRICIA Owner: DAVIE JOB ADDRESS: 70 Parcel # 1132060131200 NE 100 Contractor W P SEPTIC TANK CO INC Local Phone: 305 - 620 -6320 Signed: (INSPECTOR) Plumbing Permit DAVIE PATRICIA ST Contractor's Address: 17235 NW 12 CT Permit Status: APPROVED Permit Expiration: 6/15/2005 Construction Value: $1,500.00 Work: INSTALL A 300 SQFT ON EXISTING SEPTIC TANK Page 1 of 1 Legal Description: MIAMI SHORES SEC 1 AMD PB 10 -70 LOT 4 & E1/2 OF 5 & W35FT OF LOT 3 Fees: Description Amount FEE2004 -12711 Building Fee $175.00 FEE2004 -12712 CCF $1.20 FEE2004 -12713 Training and Education Fee $0.40 FEE2004 -12714 Scanning Fee $3.00 FEE2004 -12715 Technology Fee $4.37 FEE2004 -12716 Builders Bond $300.00 Total Fees: $483.97 Total Fees: $483.97 Total Receipts: $483.97 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 responisibility for all work done by either myself, my agent, servants or employes. Signed: (Contractor or Builder) BY: Miami Shores Village 10050 NE 2nd Avenue Phone: 305- 795 -2204 Permit Number: PL2004 -357 Printed: 12 /17/2004 Applicant: PATRICIA Owner: DAVIE JOB ADDRESS: 70 NE 100 Contractor W P SEPTIC TANK CO INC Local Phone: 305 - 620 -6320 Parcel # 1132060131200 Signed: (INSPECTOR) Plumbing Permit DAVIE PATRICIA ST Contractor's Address: 17235 NW 12 CT Page 1 of 1 Legal Description: MIAMI SHORES SEC 1 AMD PB 10 -70 LOT 4 & E1/2 OF 5 & W35FT OF LOT 3 Fees: Description Amount FEE2004 -12711 Building Fee $175.00 FEE2004 -12712 CCF $1.20 FEE2004 -12713 Training and Education Fee $0.40 FEE2004 -12714 Scanning Fee $3.00 FEE2004 -12715 Technology Fee $4.37 FEE2004 -12716 Builders Bond $300.00 Total Fees: $483.97 Total Fees: $483.97 Total Receipts: $483.97 Permit Status: APPROVED Permit Expiration: 6/15/2005 Construction Value: $1,500.00 Work: INSTALL A 300 SQFT ON EXISTING SEPTIC TANK 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 responisibility for all work done by either myself, my agent, servants or employes. Signed: (Contractor or Builder) BY: BUILDING PERMIT APPLICATI FBC 2001 Permit Type (circle): Building Owner's Name (Fee Simple Titleholder) Owner's Address City / ;Om Tenant/Lessee Name Job Address (where the work is being done) • City / / t OA Miami Shores Village Is Building Historically Designated YES NO Contractor's Company Name i- Contractor's Address /7Z 3 ' /VGA/ City H � Q M ► State r/ Qualifier Wia `6C e le>� State Certificate or Registration No. Certificate of Competency No. Architec $ Value Type of Work: Describe Work: Submittal Fee $ Notary $ Code Enforcement $ Total Fee Now Due $ 11ee arit( a rri lltf: S,SS Air _. bQ t a ri94ala3ra% ) ❑Addition 1�► Sitli (Continued on opposite side) / 7n tiF loo •5-- cAorCS State /" r/ /te 10050 ..,.2nd Avenue, Miami Shores, Florida 33138 Permit Fee $ Training/Education Fee $ 4 3.ar . ). Miami Shores Village Building Department i DEC 1 !V4 Os aft Electrical U// �lumbin Mechanical P et IYi`c_ck a ,/e ! offs County Miami de Zip 3 3/30 * * * * * * * * * * * * * * * * * * * * * * * ** F ees * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Scanning $ ' . Radon $ W . ua Ar/A Structural Plan Review. $ 05) 756.8972 Permit No. PI J3,S3- Master Permit No. My - y to..7-/` Zip Phone # Phone # 33/3 Roofing Phone # ? ©S - 62c) O SZD Zip 73 /556 one` r). 13 8 l'Li�l �, . IJ wi�"iiuf Squad a ' 'OP Wtirk: 300 S F7 (7 x %S�;r1 Q .s r� ZT.e? ll . ❑ Alteration ❑New E .-' epair/Replace ❑ Demolition CCF $ I ID- • CO /CC Technology Fee $ 4- 3 3 Zoning Bond $ 500 �� Bonding Company's Name (if applicable) Bonding Company's Address City Mortgage Lender's Name (if applicable) . Mortgage Lender's Address City State Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all work' will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC 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. "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT 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." Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will no be approved and a reinspection fee will be charged. Signature The foregoing in day of 1 who is personally NOTARY PUBLIC: Sign: 1 Print:iL My Commission E Owner or Agent ment was acknowledged before me this **** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** APPLICATION APPROVED BY: Chc 05/13/03 State Z p Signature .. -% ,/, 0"G'��l,G_J�' Contractor The foregoing ins ment was acknowledged before me this day of ..��, f a C ukINEY k. a�,LrK fEARON Y who is personally ` 1 ; , riiiki,: :Ylte44(14 an oath. WILL : -..... ..,4 i 1 1*. t k. ar a A .!!4...r.al 7A,.!„ imutimil � , W My Commission .� . t - *......................... * . NOTARY PUBLIC: Sign: Print: ***************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** v// ' 0 y * * * * * * * * * * * * * * * * * * ** Plans Examiner Engineer Zoning LOT: 3 CONSTRUCTION PERMIT FOR: [ ]New System [ ]Existing System [ X ]Repair [ ]Abandonment APPLICANT: Davie, Patricia STATE OF FLORIDA DEPARTMENT OF HEALTH QNSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM CONSTRUCTION PERMIT SYSTEM DESIGN AND SPECIFICATIONS [ PROPERTY STREET ADDRESS: 70 NE 100 St Miami FL 33138 BLOCK: 9 SUBDIVISION: Miami Shores D [ 300 ]SQUARE FEET PRIMARY DRAINFIELD SYSTEM R [ 0 ]SQUARE FEET SYSTEM A , C.TYPE SYSTEM: [ N ]STANDARD [ N ]FILLED I CONFIGURATION: [ N ]TRENCH [ N ]BED ] Temporary [ NA ] AGENT: WALLACE P, Ponder Wallace [ ] Innovative Other [Section /Township /Range /Parcel No.] PROPERTY ID #: 11- 3206 - 013 -1200 [OR TAX ID NUMBER] SYSTEM MUST BE CONSTRUCTED IN ACCORDANCE WITH SPECIFICATIONS AND STANDARDS OF CHAPTER 64E -6,FAC DEPARTMENT APPROVAL OF SYSTEM DOES NOT GUARANTEE SATISFACTORY PERFORMANCE FOR ANY SPECIFIC TIME PERIOD. 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. ISSUANCE OF THIS PERMIT DOES NOT EXEMPT THE APPLICANT FROM COMPLIANCE WITH OTHER FEDERAL, STATE OR LOCAL PERMITTING REQUIRED FOR PROPERTY DEVELOPMENT. T [ 900 ]Gallons SEPTIC TANK A [ 0 ]Gallons N [ 0 ]GALLONS GREASE INTERCEPTOR CAPACITY K [ 0 ]GALLONS DOSING TANK CAPACITY [ 0 ]GALLONS @ [0 F TLOCATION TO BENCHMARK: Top of Bottom Floor, 12.80' NGVD. I 1. ELEVATION OF PROPOSED SYSTEM SITE [ 1.8 ] [ FEET ] [ BELOW BENCHMARK /REFERENCE POINT E ,,BOTTOM OF DRAINFIELD TO BE [ 4.5 ] [ FEET ] [ BELOW BENCHMARK /REFERENCE POINT L D FILL REQUIRED: [ 0.0 ]INCHES EXCAVATION REQUIRED: [ 32.0 ] INCHES OTHER REMARKS: This permit is not for additions. *Existing 900 gl. septic tank to remain. *Install 300 sq. ft. of drainfield. *Invert elevation of drainfield to be no less than 8.83' NGVD. *Bottom of drainfield elevation to be no less than 8.83' NGVD. SPECIFICATIONS BY: Icaza, Carlos APPROVED BY: Icaza, Carlos DATE ISSUED: 12/10/04 TITLE: DH 4016, 03/97 (Obsoletes previous editions which may not be used) (Stock Number: 5744- 001 - 4016 -0) fostds_cons_4016 -1) CENTRAX #: 13 -SG -23173 DATE PAID: FEE PAID : $ RECEIPT . OSTDSNBR : 04 -4123- -R MULTI - CHAMBERED /IN SERIES: [Y ] MULTI - CHAMBERED /IN SERIES: [Y ] ]DOSES PER 24 HRS # PUMPS[ 0 ] [ N ]MOUND [ N ] [ N ] Y , PER - °`YIj 8S NOT ADDITION(S) P: h. THE SEPTIC TAU SHALL BE PUMPED AND A SOLID DEFLECTION DEVICE INSTALLED ON THE OUTLET TEE TITLE: Engineer I Dade EXPIRATION DATE: 3/10/05 CHD Page 1 of 2 Scale: Each block repo s feet and 1 inch = 5 ii Notes: Site Plan submitted b . Plan Approved By STATE OF FLORIDA DEPARTMENT OF HEALTH APPLICATION FOR ONSITE SEWAGE DISPOSAL SYSTEM CONSTRUCTION PER Permit Application Number OH 4015, 10/96 (Replaces HRS-H Form 4015 which may be used) PART II - SITE PLAN �r „uynature Not Approved rrbP- f tv o EQA coo p CNN TO . 4 - Z s ALL CHANGES MUST BE APPROVED BY THE COUNTY HEALTH DEPARTMENT -�1 1n� Title Da a /L - County Health Department _t.. BUILDING ELECTRICAL PLUMBING ROOFING Owner of Building MIAMI SHORES VIILLAGE, FLORIDA PERMIT N9 6508 Architect } 5 x Contractor I or Builder ' m e .l r 1:,.. 'S.. 1. Legal Lot ! Description II Bl CONTRACTOR OR BUILDER ves?" DATE. 19 Contractor's License No. f Work to be performed under this Permit Subdi- vision Address of r r . r Building `- t ' L ' , Value of Amount of > Project $ II 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 applica- tion herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes respon- sibility for work done by his agents, servants or employees. is <' Signed �,, ` ade, n 41 . , 4' ` '`,_*tINSPECTOR In consideration of the issuance to me of this permit I agree to perform the work covered hereur in complian with all ordinances atgdegulatfons pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper au b t rities of Miami Shores Village. In ao cepting this permit I assume responsibility for ell work done by either, myself, my agent, servant or employee. BY AUTHORITY ABBOT '�' MIAMI SHORES VILLAGE, FLA. JOB 7 ADDRESS 7 D INSPECTION ( C. TIME READY N9 7142 REMARKS : INSPECTOR DATE - MIAMI SHORES VILLAGE . PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT C.r�j b Permit No Date..._ vy; e ._ 3 )9‘� 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 Registered Architect and /or Engineer --- - - - --- -- Employing Plumber's Namei f_AlY1_� _ _ -e to Location and Legal Description Lot Street and Number where work is to be performed —No State work to be performed and purpose of building (By Floors)-- - - -___ e J f?y atev i �� -P 3C ' ,�. oL New Building __ Remodeling —___ ____ Addition Repairs a/ No. of Stories Size Septic Tank_ Feet of Drain Tile Nature of Water Supply: City — Well.____.______._..__._____ - ______________Size of Soakage Pit Amount of Permit $ The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations under the Florida Workmen's Compensation Act, being Section 5988, Compiled General Laws of Florida Pennanent/S plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors em performed under this permit; and will post or cause to be posted' for inspection on the . the work s required by the Act. The undersigned agrees to employ only such sub- contractors, .n wor to be licensed by Miami Shores Village. STATE OF FLORIDA, } COUNTY OF DADE. 0 Type of Tank L_._Y_ No._-- ___._______ -_ -- Street..._ .. - - --- .� 7. 6 Street- Al.E Block Subdivision Street -- _ - -. N FioO ZsT _Dist. Feet of Tank or Drain Field from Well (Signed) _ (Si My Commission Expires Notary Public, State of Florida Capacity Gals 7�s Plumbing Inspector. s an employer of labor plement, and has con- y him in the work to be notice or notices as are under this permit. as are 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. CLOSITB BATH TUBS OWERS SHOWERS LAVA- TORIES SINKS SLOP SINKS LAUNDRY TUBS 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 - MIAMI SHORES VILLAGE . PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT C.r�j b Permit No Date..._ vy; e ._ 3 )9‘� 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 Registered Architect and /or Engineer --- - - - --- -- Employing Plumber's Namei f_AlY1_� _ _ -e to Location and Legal Description Lot Street and Number where work is to be performed —No State work to be performed and purpose of building (By Floors)-- - - -___ e J f?y atev i �� -P 3C ' ,�. oL New Building __ Remodeling —___ ____ Addition Repairs a/ No. of Stories Size Septic Tank_ Feet of Drain Tile Nature of Water Supply: City — Well.____.______._..__._____ - ______________Size of Soakage Pit Amount of Permit $ The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations under the Florida Workmen's Compensation Act, being Section 5988, Compiled General Laws of Florida Pennanent/S plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors em performed under this permit; and will post or cause to be posted' for inspection on the . the work s required by the Act. The undersigned agrees to employ only such sub- contractors, .n wor to be licensed by Miami Shores Village. STATE OF FLORIDA, } COUNTY OF DADE. 0 Type of Tank L_._Y_ No._-- ___._______ -_ -- Street..._ .. - - --- .� 7. 6 Street- Al.E Block Subdivision Street -- _ - -. N FioO ZsT _Dist. Feet of Tank or Drain Field from Well (Signed) _ (Si My Commission Expires Notary Public, State of Florida Capacity Gals 7�s Plumbing Inspector. s an employer of labor plement, and has con- y him in the work to be notice or notices as are under this permit. as are Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me, well known, and who, being by me first duly sworn, upon oath deposes and says that he is the of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. NOTE: A re-inspection fee of $1.00 will be made when such re- inspection is made•necessary by improper notice for inspection, or faulty materials and /or workmanship. BUILDING ❑ ELECTRICAL ❑ PERMIT N? 8011 PLUMBING ROOFING ❑ ❑ Work to be performed under this Permit Owner of Building Architect Contractor or Builder Legal Description Address of Building Lot CONTRACTOR OR MIAMI SHORES VILLAGE, FLORIDA ER Bl. Subdi- vision DATP ,,w 195 Contractor's License No. 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 fora 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 • gy 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 Miaiii,Shores Village. In accepting this permit I assume responsibility for all work done by either, myself, my agent; sersant or employee. At- , LEN BY AUTHORITY 17 Permit No._ .C1 r / 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 bet at building during progress of work. Owner's Name and Address. _ jefY71 ;IfYILIelc) No. 1 7 0 Street_ "1 t "A/) STATE OF FLORIDA, i COUNTY OF DADE. Registered Architect and Engirt �r Employing Plumber's game •' ' MIAMI SHORES VILLAG PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING °' ►• TIT - -.._ " . W Street. Location and Legal Description n Sub /division ✓. ' t1 Street G 6 A Street and Number where work is to be performed —No State work to be performed and purpose of building (By Floors) New Building _._ Remodeling___ __-_.._ Addition.________._______... Repairs No. of Stories Size Septic Tank ...... ----- _-- .------ _ - -_ -- cl Feet of Drain Tile Nature of Water Supply: City — Well. Amount of Permit $ Type of Tank__ Capacity Gals. Dist. Feet of Tank or Drain Field from Well ..Size of Soakage Pit (Signed)_ ( Signed)._ Date .• My Commission Expires Notary Public, State of Florida Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts is obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and bus com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted' for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such sub- contractors, on work o be performed under this permit, as are licensed by Miami Shores Village. Master Plumber. 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 rues URINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT' NB TOTAL FIXTURES CONTR. LIST CHECK SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SW IM'O POOL CONTR. LIST ` - -- CHECK Permit No._ .C1 r / 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 bet at building during progress of work. Owner's Name and Address. _ jefY71 ;IfYILIelc) No. 1 7 0 Street_ "1 t "A/) STATE OF FLORIDA, i COUNTY OF DADE. Registered Architect and Engirt �r Employing Plumber's game •' ' MIAMI SHORES VILLAG PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING °' ►• TIT - -.._ " . W Street. Location and Legal Description n Sub /division ✓. ' t1 Street G 6 A Street and Number where work is to be performed —No State work to be performed and purpose of building (By Floors) New Building _._ Remodeling___ __-_.._ Addition.________._______... Repairs No. of Stories Size Septic Tank ...... ----- _-- .------ _ - -_ -- cl Feet of Drain Tile Nature of Water Supply: City — Well. Amount of Permit $ Type of Tank__ Capacity Gals. Dist. Feet of Tank or Drain Field from Well ..Size of Soakage Pit (Signed)_ ( Signed)._ Date .• My Commission Expires Notary Public, State of Florida Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts is obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and bus com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted' for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such sub- contractors, on work o be performed under this permit, as are licensed by Miami Shores Village. Master Plumber. 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. PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT .,- Permit No. "' Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the buildin structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Vill and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Buil of Miami Shores Village shall be complied with and building during progress of fork. whether herein specified or not. A copy of approved dee' d Owner's Name and Address No Registered Architect and /or Engineer New Building 40 Amount of Permit $_ 1r ss. My Commission Expires MIAMI SHORES VILLAGE Employing Plumber's Name _s _f_ 1 " `':191 No Location and Legal Description Lot___: -__'''' _ ....,__ � Block_ _ _ _a i lk Street and Number where work is to be performed— No. ___ State work to be per formed and purpose of building (By Floors) Remodeling Addition Repairs No. of Stories a fb Size Septic Tank____ '' __ ___ Type of Tank .__! ' c • Capacity Gals Feet of Drain Tile_____ /__ • -_ -___ Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: City -4 ✓ell. .Size of Soakage Pit (Signed) -`�- $ Y -- – -r. - -- (Signed • {- y Date__ plans Street4 Notary Public. State of Florida specifications must r t r ' � 1 Street Subdivision __�_�_ ,r. y Street --- -t' : . r Plumbing Inspector. The undersigned applicant for this building permit does hereby certify thaiefie understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub-contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The under signed agrees to employ only such sub-contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. , Master Plumber. or other e, Florida, ng Division be kept at 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'O POOL CONTR. LIST CHECK PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT .,- Permit No. "' Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the buildin structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Vill and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Buil of Miami Shores Village shall be complied with and building during progress of fork. whether herein specified or not. A copy of approved dee' d Owner's Name and Address No Registered Architect and /or Engineer New Building 40 Amount of Permit $_ 1r ss. My Commission Expires MIAMI SHORES VILLAGE Employing Plumber's Name _s _f_ 1 " `':191 No Location and Legal Description Lot___: -__'''' _ ....,__ � Block_ _ _ _a i lk Street and Number where work is to be performed— No. ___ State work to be per formed and purpose of building (By Floors) Remodeling Addition Repairs No. of Stories a fb Size Septic Tank____ '' __ ___ Type of Tank .__! ' c • Capacity Gals Feet of Drain Tile_____ /__ • -_ -___ Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: City -4 ✓ell. .Size of Soakage Pit (Signed) -`�- $ Y -- – -r. - -- (Signed • {- y Date__ plans Street4 Notary Public. State of Florida specifications must r t r ' � 1 Street Subdivision __�_�_ ,r. y Street --- -t' : . r Plumbing Inspector. The undersigned applicant for this building permit does hereby certify thaiefie understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub-contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The under signed agrees to employ only such sub-contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. , Master Plumber. or other e, Florida, ng Division be kept at 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. • • • JOB: BUILDING ELECTRICAL PLUMBING The following is ready for Inspection: -- Inspector.'s Report : i•7 D fill : IP . • WOF.K DONE BY: . :REQUESTED . • • • m • WILL BE READY BUILDING ELECTRICAL PLUMBING Owner of Building Architect Contractor or Builder Legal ' Description Lot CONTRACTOR OA BUILDER MIAMI SHORES VILLAGE, FLORIDA DATE 1 7 194_ E R M I T O Contractor's / N. • 5 085 License No Work to be performed under this Permit Bl. Subdi- vision Address of y } d ; f oft.. Value of Amt. ...." Building 1 ' i , °"" V ' ,. i V- 4 .! Project Permit This permit is granted to the contra tor or builder named above to construct the building or to install the equipment or devic escribed in the appli- cation herefor in strict compliance with all ordinances pertaining thereto and w th the understanding that the work wil 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 assn& es the responsibility for a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or dr,�,wings or the statements or specifications and that he assumes respon- sibility for work done by his agents, servants or employees. Fes. < Signed•.. / , ' ' , ' ' 1 IN gCTOR I In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and re pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami ShoyEs Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servant or employee. B BY AUTHORITY BUILDING - ELECTRICAL PLUMBING Work to be performed under this Permit Owner of w . Building Architect Contractor or Builder Legal Lot Description Address of Building 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 /47. Signed• By INSPECTOR In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regula- tions pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this pertpit I assu e respons ility4or all work done by either myself, my agent, servant or employee. 1 pp .1 F." it '' �� • /CONTRACTOR OR BUILDER BY MIAMI SHORES VILLAGE, FLORIDA PERMIT N9 2683 BI. Subdi- vision Value of Project DATE Contractor's License No. Amt. of Permit AUTHORITY 1 94/ BUILDING ELECTRICAL PLUMBING Owner of Building ,;MIAMI SHORES VILLAGE, FLORIDA DATE PERMIT N? 5085 Work to be performed under /P. ' : ,. 1 Architect Contractor or Builder Legal ' Lot Description Address of I Building This perf sit is granted to the contractor or build named above to construct the building or to install the equipment or aevic described in the appli- cation herefor in strict compliance with all ordinances pertaining thereto and w th 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 a es the rsponsibility for a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or wings or the statements or specifications and that he,assumes respon- sibility for work done by his agents, servants or employees. Lam. by his B y TAi ! this P e r m i Subdi- vision Value of Project Contractor's License No. Amt. of<*... Permi 194_ .r. In consideration of the issuance to me of this permit I agree to perform the work covered'hereunder in compliance with. 11,��PPrdinances an r u1ations` pertaining thereto and in strict conformity with the plans, drawings, statements or specificatid submitted to the proper authorities of Miami Sh 'Village: In accepting this permit I assume responsibility for a work done by either myself, my agent, servant or employee. h CON TRAl_aun OR Bli D AUTHORITY