34 NE 101 St (6)PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Date . 0 ' L —, CJob Address . _ 3 Al t/ G 10/ 5/7,7 - ! t Tax Folio
Legal Description Historically Designated: Yes No
Owner/Lessee / Tenant d. / . A I , J)- 0. 4. c.� Master Permit # Zip 021c71—
Owner's Address 5 �j r,-_401-
O l S c ; ? 7o S l ) 7.S 2 6
/ � �., � a �f ,?/}'Phone ( 7 z-
Contracting Co. .i ////''. C S $ 7 `4 « Address
er .CrC P�G:� E • i %,c SS#
1 7
State # Municipal # Competency # Ins. Co.
Architect/Engineer Address
Bonding Company Address
Mortgagor Address
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIP'T'ION
otary as to Owner and/or Condo President Date
My Commission Expires:
rQ L 5 &77, `fc- f 7 /-4.
FEES: PERMIT 36 ✓ RADON
APPROVED:
Zoning
Mechanical Plumbing
Building
Square Ft. Estimated Cost (value)t /
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 - that all the foregoing information is accurate and that all work will be done in compliance with all applicable
laws regulatin • ctio � _ d zo ing. Furthermore, I authorize the above -named contractor to do the work stated.
Signature of Contractor or Owner- Builder
C.C.F. 1" NOTARY <"'',.
Notary as to Contractor or Owner- Builder /Dat 96 ,
My ConunissionExpires: /
TOTAL DUE 47/
a te
APPLICATION FOR:
[�1 New System
[• ] Repair
APPLICANT:
AGENT:
MAILING ADDRESS:
LOT: fJ BLOCK:
PROPERTY ID #:
PROPERTY SIZE:
PROPERTY STREET ADDRESS:
DIRECTIONS TO PROPERTY:
STATE OF FLORIDA
DEPARTMENT OF HEALTH AND REHABILITATIVE SERVICES
ONSITE SEWAGE DISPOSAL SYSTEM
APPLICATION FOR CONSTRUCTION PERMIT
Authority: Chapter 381, FS & Chapter 1OD -6, FAC
[AO] Existing System
[ Abandonment
WQ]
TO BE COMPLETED BY APPLICANT OR A>PLICANT'S AUTHORIZED AGENT. ATTACH BUILDING PLAN AND TO -SCALE
SITE PLAN SHOWING PERTINENT EEATURES REQUIRED BY CHAPTER 1OD -6, FLORIDA ADMINISTRATIVE CODE.
7
PROPERTY INFORMATION [IF LOT IS NOT IN A RECORDED SUBDIVISION, ATTACH LEGAL DESCRIPTION OR DEED]
SUBDIVISION:
ACRES [Sgft /- 43560]
BUILDING INFORMATION [RESIDENTIAL
Unit Type of No. of
No Establishment Bedrooms
1
2
3
4
• (2„,
[,'4] Garbage Grinders /Disposals
[14] Ultra -low Volume Flush Toilets
APPLICANT'S SIGNATURE:
3
Holding Tank
Other(Specify)
.407-
3 # / / /s4,_
[ Spas /Hot Tubs
HRS -H Form 4015, Mar 92 (Obsoletes previous editions which may not be used)
(Stock Number: 5744 - 001 - 4015 -1)
W� ]
PROPERTY WATER SUPPLY:
Building i Persons
Area Saft Served
PERMIT #
DATE PAID
FEE PAID $
RECEIPT #
Temporary /Experimental
TELEPHONE: 7�� —6 g
DATE OF
SUBDIVISION:
[Section /Township /Range /Parcel No.] ZONING:
] COMMERCIAL
Business Activity
For Commercial Only
DATE: 8I se/ !6,
1 4 1 1 L.
[ ] PRIVATE [(A PUBLIC
[4] Floor /Equipment Drains
[,✓ ] Other (Specify)
Page 1 of 3
Notes:
STATE OF FLORIDA
DEPARTMENT OF HEALTH AND REHABILITATIVE SERVICES
APPLICATION FOR ONSITE SEWAGE DISPOSAL SYSTEM CONSTRUCTION 1,
e■ / Permit Application Number ;/C rd
(e i;A: J.(
PART II - SITE PLAN
Scale: Each block represents 5 feet and 1 nch = 50 feet.
1 I 1 - 1.
, II IF F_ t !I 1 III - I 1 l ' -i g i ii i i• -- I I _1 1
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ii
Site Plan submitted by
Plan Approved -
ALL ANGES MUST BE APPROVED BY THE COUNTY PUBLIC HEALTH UNIT
HRS-H Form 4015, Feb 85 (Obsoletes previous editions which may not be used)
(Stock Number. 5744-002-4015-6)
SIGNATURE
Not Approved
1,1
11111
I
-
5?".142
Date :___
County Public Unit
Page 2 of 3
STATE OF FLORIDA
DEPARTMENT OF HEALTH AND REHABILITATIVE SERVICES
ONSITE SEWAGE DISPOSAL SYSTEM
SITE EVALUATION AND SYSTEM SPECIFICATIONS
/b6 Amlii4x,3
LOT: i i ' ' BLOCK: 6 SUBDIVISION:
PROPERTY #: ) [Section /Township /Range /Parcel No. or Tax ID Number]
( 7/ / en I f Y
PERMIT #
AGENT: / (_jr . L1,1- (12
TO BE COMPLETED BY ENGINEER, HEALTH UNIT EMPLOYEE, OR OTHER QUALIFIED PERSON. ENGINEER'S MUST
PROVIDE REGISTRATION NUMBER AND SIGN AND SEAL EACH PAGE OF SUBMITTAL. COMPLETE ALL ITEMS.
PROPERTY SIZE CONFORMS TO SITE PLAN: [ ] YES [ ] NO NET USABLE AREA AVAILABLE: •//840 ACRES
TOTAL ESTIMATED SEWAGE FLOW: GALLONS PER DAY [RESIDENCES -TABLE 1 / OTHER -TABLE 2)
AUTHORIZED SEWAGE FLOW: q4$ GALLONS PER DAY [1500 GPD /ACRE OR 2500 GPD /ACRE]
UNOBSTRUCTED AREA AVAILABLE: /,p1) SQFT UNOBSTRUCTED AREA REQUIRED: GOU SQFT
BENCHMARK /REFERENCE POINT LOCATION:
ELEVATION OF PROPOSED SYSTEM SITE IS 7'
SOIL PROFILE INFORMATION SITE 1
Munse4l # /Color Texture Depth
r� ( tdL
2 y
to
to
USDA SOIL SERIES:
to
to
to
to
to
OBSERVED WATER TABLE: CJQ A i,V`CtS [ABOVE /
ESTIMATED WET SEASON WATER TELEVATION:
HIGH WATER TABLE VEGETATION: [ ] YES [1NO
SOIL TEXTURE /LOADING RATE FOR SYSTEM SIZING:
DRAINFIELD CONFIGURATION: [ ] TRENCH [ ✓f BED
REMARKS /ADDITIONAL CRITERIA:
SITE EVALUATED BY:
HRS-H Form 4015, Mar 92 (Obsoletes previous editions which may not be used)
(Stock Number: 5744 - 003 - 4015 -1)
[INCHES/FT] [ABOVE /BELOW] BENCHMARK /REFERENCE POINT
THE MINIMUM SETBACK WHICH CAN BE MAINTAINED FROM THE PROPOSED SYSTEM TO THE FOLLOWING FEATURES:
SURFACE WATER: /ODIC FT DITCHES /SWALES: /48 FT NORMALLY WET? [ ] YES F ) NO
WELLS: PUBLIC: "Wig FT LIMITED USE: /✓,0 FT PRIVATE: A14 FT NON- POTABLE: '`' ° FT
BUILDING FOUNDATIONS: /0 FT PROPERTY LINES: Zs FT POTABLE WATER LINES: 3 FT
SITE SUBJECT TO FREQUENT FLOODING: [ ] YES (-(NO 10 YEAR FLOODING? [ ] YES [t ] NO
10 YEAR FLOOD ELEVATION FOR SITE: FT MSL /NGVD SITE ELEVATION: 1J " FT MSL /NGVD
SOIL PROFILE INFORMATION SITE 2
JET
Aar
Muns
Color Texture Depth
t, oa-y
C to
to
to
to
to
to
to
USDA SOIL SERIES:
EXISTING GRADE. TYPE: [PERCHED / APPARENT]
INCHES [ ABOVE / BELOW ] EXISTING GRADE.
MOTTLING: [ ] YES [ NO DEPTH: INCHES
[ ] OTHER (SPECIFY)
DEPTH OF EXCAVATION:- INCHES
DATE: t/S /Q(-,
Page 3 of 3
STATE OF FLORIDA
DEPARTMENT OF HEALTH AND REHABILITATIVE SERVICES
ONSITE SEWAGE DISPOSAL SYSTEM
CONSTRUCTION PERMIT
Authority: Chapter 381, FS & Chapter 10D -6, FAC
CONS,RUCTION PERMIT FO
[ tom New System [1 E isting System [ /(Holding Tank [11-Temporary/Experimental
[ TNA Repair Abandonment
APPLICANT:
PROPERTY STREET ADDRESS:
LOT: BLOCK:
PROPERTY ID #:
0
T
H
E
R
A/ A,
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 - L
,,, f.„, ,ri
T [ ] NS--/ GPLSEPTIC TAN AEROBIC UNIT CAPACITY MULTI- CHAMBERED /IN SERIES:[ ]
A [ ] [GALLONS / GPD] —°- - - CAPACITY MULTI- CHAMBERED /IN SERIES:[ ]
N [ ] GALLONS GREASE INTERCEPTOR CAPACITY [MAXIMUM CAPACITY SINGLE TANK: 1250 GALLONS]
K [ ] GALLONS PER DOSE DOSING TANK CAPACITY DOSE RATE [ ] PER 24 HRS NO. OF PUMPS: [ ]
D [ - QUARE FEET P IMARY DRAINFIELD SYSTEM
R [ ] SQ ARE FETT SYSTEM
A TYPE SYSTEM: [ ] STANDARD [ ] FILLED
I CONFIGURATION: [ ] TRENCH [ 0 ] BED
N
F LOCATION OF BENCHMARK: ,� . / .ni rX �uQ _
I ELEVATION OF PROPOSED SYSTEM SITE [ / 1-] CHEJ
NFT] [ABOVE f LOW) BENCHMARK /REFE RENCEOINT
E BOTTOM OF DRAINFIELD TO BE [ v_.� ]TINCHE T] [ABO 78E LOW]�BENCHMARK /REFERENCE
L
D FILL RE W.RED: [,... ] INCHES, . XCAVATION REQUIRED:
SPECIFICATIONS BY:
APPROVED BY:
DATE ISSUED: f7 s
‚- - - )e 5-4 G C./
AGENT:
3 (,/ vt: /
SUBDIVISION: ,,v/ 4
HRS-H Form 4016, Mar 92 (Obsoletes previous editions which may not be used)
(Stock Number: 5744 - 001 - 4016-0)
[ ,.ther(Specify)
C 9
[SECTION /TOWNSHIP /RANGE /PARCEL NUMBER]
[OR TAX ID NUMBER]
TITLE:
[
[
] MOUND [
]
PERMIT #
DATE PAID
FEE PAID
RECEIPT #
[ 3i ] INCHES
7Zq2
$ 6
]
TITLE: CPHU
EXPIRATION DATE:
Page 1 of 2
Permit r___—. Date 4 -
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 A/ 1445. °°4/4 4.0 AMIL. No 34 street._
R egistered Architect and/or reer V
'C • qg 3 0 Z reA.
Location and Levi Desctiol Lot. k/A-
Employing 'Plumber's Nolo CIAIWK / WA/
it'VEF-0?; 37/4
Street I L Number wor Z performed-No
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
State work to be performed and purpose of building (By Floors)_____
New Building__ - _ Addition__.
Size Septic Tank_ Type of Tank_.__
Feet of Drain Tile _Dist Feet of Tank or Drain Field from Well
Nature of Water Supply: City-W.lL Size of Soakage Pit.
co
Amount of Permit $
STATE OF FLORIDA, I u.
COUNTY OF DADE. 1
(signed)_L _1_,V,Ni-Rf)e-Ac 13Y
Plumbing fnspec
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5968, Compiled General Laws of Florida Permanent Supplement, and luiq 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 to be performed under this permit, as are
licensed by Miami Shores Village.
( Signed
ut7fty ,zno7 / yrr, dnI3 a raised to administer oaths and tak
Before me, the undersigned a
NOT • PUBLIC STATE OF FLORIpA
MISS ION EXPIRES FEB 14 1987
D. IHRU GENERAL INSURANCE UND.
--4
Bloch Subdivision -Zig.-&-s21-1/14.2-
54 A/C Jo/ Street_
Repairs No. of Stories ......
to me well known, and who, being by me first duly sworn, upon oath deposes and says that be is the
of the above described construction, that be has carefully read the foregoing application, and that he did sign the
therein by him stated are
Notary Public, State of Florida
Master Plumber.
ts, personally appeared
NOTE: A re fee of $1.00 will ba soda wino meth misapsotios sande.nscassory by lawyer Dodos for brepaction, or faulty
materials aod/ot workmanship.
CLosrfis
BATH
T
SHOWERS
LAVA.
TORILS
SINK*
SLOP
SINKS
LAUNDRY
Tuve
UNINALs
CATCH
•ABIN
FLOOR
DRAIN
DRINKING
FOUNT'S,
TOTAL
Its TuRES
CONTR.
LIST
--
CHICCK
..—
SEPTIC
TANK
SILVIS
CONN.
DRAIN
PHILO
SOAKAGE
PIT
G
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SWIM'O
POOL.
•
CONTR.
Lull'
CHICK
••■■
Permit r___—. Date 4 -
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 A/ 1445. °°4/4 4.0 AMIL. No 34 street._
R egistered Architect and/or reer V
'C • qg 3 0 Z reA.
Location and Levi Desctiol Lot. k/A-
Employing 'Plumber's Nolo CIAIWK / WA/
it'VEF-0?; 37/4
Street I L Number wor Z performed-No
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
State work to be performed and purpose of building (By Floors)_____
New Building__ - _ Addition__.
Size Septic Tank_ Type of Tank_.__
Feet of Drain Tile _Dist Feet of Tank or Drain Field from Well
Nature of Water Supply: City-W.lL Size of Soakage Pit.
co
Amount of Permit $
STATE OF FLORIDA, I u.
COUNTY OF DADE. 1
(signed)_L _1_,V,Ni-Rf)e-Ac 13Y
Plumbing fnspec
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5968, Compiled General Laws of Florida Permanent Supplement, and luiq 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 to be performed under this permit, as are
licensed by Miami Shores Village.
( Signed
ut7fty ,zno7 / yrr, dnI3 a raised to administer oaths and tak
Before me, the undersigned a
NOT • PUBLIC STATE OF FLORIpA
MISS ION EXPIRES FEB 14 1987
D. IHRU GENERAL INSURANCE UND.
--4
Bloch Subdivision -Zig.-&-s21-1/14.2-
54 A/C Jo/ Street_
Repairs No. of Stories ......
to me well known, and who, being by me first duly sworn, upon oath deposes and says that be is the
of the above described construction, that be has carefully read the foregoing application, and that he did sign the
therein by him stated are
Notary Public, State of Florida
Master Plumber.
ts, personally appeared
NOTE: A re fee of $1.00 will ba soda wino meth misapsotios sande.nscassory by lawyer Dodos for brepaction, or faulty
materials aod/ot workmanship.
or.ir ai... -- - - -• --
Size Septic Tank
Feet of Drain Tile_
Nature of Water Supply: City —Well.
Amount of Permit $
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
(Signed)--_ --- /7
( Signed
Date
Street
Application is hereby .aide 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.____ L. �__y Cl�'� .. No— Street
Registered Architect and /or Engineer
Employing Plumber's Name ' / glePe
Location and. Legal Description Lot- -• - - -- ' ._ _Block � ` � on
Street and Number where work is to be performed— No.____ Str
State work to be performed and purpose of building (By Floors)___
New Building _ _-___. Remodeling___ __--__ Addition_______._ Repairs No. of Stories .... ...... ....... ......
Capacity Gals
m Well
Size of Soakage Pit
My Commission Expires Notary Public, State of Florida
mbing Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations an employer of labor
under the Florida Workmen's Compensation Act, being Section 5986, 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 tlie 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.
Master Plumb
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
Toss
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT' NS
TOTAL
FIXTURE6
cowrie.
LIS
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SW IM'G
POOL
CONTR.
LIST
CHECK
or.ir ai... -- - - -• --
Size Septic Tank
Feet of Drain Tile_
Nature of Water Supply: City —Well.
Amount of Permit $
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
(Signed)--_ --- /7
( Signed
Date
Street
Application is hereby .aide 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.____ L. �__y Cl�'� .. No— Street
Registered Architect and /or Engineer
Employing Plumber's Name ' / glePe
Location and. Legal Description Lot- -• - - -- ' ._ _Block � ` � on
Street and Number where work is to be performed— No.____ Str
State work to be performed and purpose of building (By Floors)___
New Building _ _-___. Remodeling___ __--__ Addition_______._ Repairs No. of Stories .... ...... ....... ......
Capacity Gals
m Well
Size of Soakage Pit
My Commission Expires Notary Public, State of Florida
mbing Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations an employer of labor
under the Florida Workmen's Compensation Act, being Section 5986, 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 tlie 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.
Master Plumb
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.
MIAMI SHORES VILLAGE. FLORIDA
BUILDING ❑
ELECTRICAL ❑ PERMIT o
PLUMBING N. 9952
ROOFING ❑
Owner of
Building
Architect
Contractor
or Builder
Legal
Description
Address of
Building
Lot
a
Bl.
Work to be performed under this Permit
Subdi-
vision
SQ. Ft
Value of
Project $
DATE + 195
Contractor's
License No.
Amt. of
Permit $
This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the application
herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans,
drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any
time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is
granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations
pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes responsibility for work
done by his agents, servants or employees.
Signed • 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 regttlations
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,ermit I assume responsibility for all work done by either, myself, my agent,servant or employee. , ) r --7" ii i ' '"--
,. .," .
CONTRACTOR OR BUILDER BY AUTHORITY
17
BUILDING
ELECTRICAL
PLUMBING
Owner of
Building
MIAMI SHORES VILLAGE, FLORIDA
DATE 194L
Contractor's
License No
PERMIT N2 4314
Work to be performed under this Permit
Architect
Contractor
or Builder }=�
Legal Lot Bl. Subdi-
Description vision
Address of t - i ,-. , i" ,,r' '� Value of Amt. of
Building �' ` -' .� Project 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 ppli-
cation herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance w h any
plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be evoked
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 w ich this
permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordin ces and
regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that be assu espon-
sibility for work done by his agents, servants or employees. - .r
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 regulations
pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village.
In aagceptin 'this permit I assume responsibility for all work done by,either myself, my agent, servant or employee.
CONTRAC R OR BUILDER BY I AUTHORITY