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810 NE 100 St (5)Date � 30 Job Address SfO /J& [ c%J (. Tax Folio ` k39 Q' L'3 1)0 0 Legal Description /Q 41/ S//0K-PS Historically Designated: Yes No Ci/e/ c t c/aS //lel 1eabh//JNiaster Per # 4`� �5 '/9(7.2) Owner/Lessee / Tenant Owner's Address 4 & (J Contracting Co. 4. ,ar) e K Address 0002d S/ zS �f Qualifier :J Dha r77 SS# / hone 04' WM4c '� State # 5 909 m 2-' Municipal # Competency # Ins. Co. Architect/Engineer Bonding Company Mortgagor Permit Type (circle one): BUILDING ELECTRICAL WORK DESCRIPTION Square Ft. Esti WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENT PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMM Application is hereby made to obtain a pernut to do work and installation as indicate, will be performed to meet the standards of all laws regulating construction in this jut PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK. OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate an■ construtie{1 and zoning. Furthermore, I authorize the above -named contractor to owner and/or ondo President i /Ar No . as to Owner and/or Condo Presi My Conunission Expir - y N, DEBORAH HENRY MY COMMISSION # CC 967734 i toF pea EXPIRES: Sep 13, 2004 1-800-3-NOTARY FL Notary Service & Bonding, Inc. FEES: PERMIT RADON C.C.F. APPROVED: Zoning Mechanical Plumbing PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Building ate r D O Address Ad Si Phone MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request 23-02 Time 44'a ?e Z Type Insp'n Permit No. P2 O' 2- s(g� Name /761 Address ./O 4': /&7 Si Company 4 kfiti Phone # 5',7 -s)e *G For Inspector: 9 O Approved Correction ❑ Re- Insp'n Fee ❑ CQNSTRUCTION PERMIT FOR: (No New System [ fJ Repair �s APPLICANT: PROPERTY ApDRESS: LOT: C t ( BLOCK: PROPERTY ID #: / 9 SYSTEM DESIG AND,SPS F . ?L( •d': T [1 ]. GALLONS / GP A [ ] GALLONS / GPD - N.[ ] GALLONS GREASE R. [ ] GALLONS DOSING 0 T H E R SP APPROVED BY: DATE ISSUED: 0 1 1 STATE OF FLORIDA DEPARTMENT OF HEALTH ONSITE SEWAGE TREATMENT CONSTRUCTION PERMIT I' d CATIONS / D [' O! ] ' SQUARE FEET PRIMARY R [ ] SQUARE. FEET A TYPE SYSTEM: [y'] STANARD I CONFIGURATION:. [1.1.A TRENCH N F LOCATION OF BENCHMARK: p I ELEVATION OF PROPOSED SYSTEM SITE [I* ] [INCHES E BOTTOM OF DRAINFIELD TO BE ( .. -u [INeS /FT] FILL REQUIRED: [44 )6 ] INCH EXCAVATION REQUIRED: Ti a SAL SYSTEM Existing System ['y Holding Tank Abandonment [ /�.J' Temporary r&-,),) .3 '/D /.1 /00 t /4: 4 , SUBDIVISION: / -1 1 [SECTION, TOWNSHIP, RANGE, PARCEL NUMBER] z of; ®® 43 [OR TAX ID NUMBER] SYSTEM MUST BE CONSTRUCTED IN ACCORDANCE WITH SPECIFICATIONS AND STANDARDS OF SECTION 381.0065, F.S., AND CHAPTER 64E -6, F.A.C. DEPARTMENT APPROVAL OF SYSTEM DOES NOT GUARANTEE SAFTISFACTORY 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. ISSUANCE OF THIS PERMIT DOES NOT EXEMPT THE APPLICANT FROM COMPLIANCE WITH OTHER FEDERAL, STATE, OR LOCAL PERMITTING REQUIRED FOR DEVELOPMENT OF THIS PROPERTY. /AEROBIC UNIT CAPACITY MULTI- CHAMBERED /IN- SERIES [fY] CAPACITY MULTI- CHAMBERED /IN- SERIES [! ] INTERCEPTOR CAPACITY [MAXIMUM CAPACITY SINGLE TANK: 1250 GALLONS] TANK CAPACITY [ ]GALLONS @ [ ] DOSES PER 24 HRS # PUMPS [ ] DRAINFIELD SYSTEM SYSTEM �) [ FILLED /[ "7 MOUND Iy�] BED [^4 [ABOVE/ [ABOVE c" E 0 DH 4016, 12/99 (Page 1) RECi r"a t161i13- MayP_Be' Use t r �G`�7 r� =^ 1 �� a 1 �� pt, 1 : Health Department ELEVATION D(t OC9 ib't�t UU'a'm�' Ev truJ u �l:a uv�pt Pty Aib1cant pt. 3: Installer /Contractor pt. 4: Building Department TITLE: 1 r 11 EXPIRATION DATE: PERMIT NO. 00/2.- .t 0 DATE PAID: 8- e_15, FEE PAID: 7 S , O RECEIPT #:b o/ .0 8 o o O � /3 _ <-7 -`q 98 ? 7 [ Innovative (� f «= s� u tin • INCHES. BENCHMARK/REFERENCE POINT BENCHMARK /REFERENCE POINT CHD INSTALL OF LOA1VW GO_ RH, SAND UNUIC bu; I vwf VI- UI 41 ; :i D INVERT ELEVATION 1-'1 BOTTOM OF DRAINFIELD ELEVATION 1 .-- � CQNSTRUCTION PERMIT FOR: (No New System [ fJ Repair �s APPLICANT: PROPERTY ApDRESS: LOT: C t ( BLOCK: PROPERTY ID #: / 9 SYSTEM DESIG AND,SPS F . ?L( •d': T [1 ]. GALLONS / GP A [ ] GALLONS / GPD - N.[ ] GALLONS GREASE R. [ ] GALLONS DOSING 0 T H E R SP APPROVED BY: DATE ISSUED: 0 1 1 STATE OF FLORIDA DEPARTMENT OF HEALTH ONSITE SEWAGE TREATMENT CONSTRUCTION PERMIT I' d CATIONS / D [' O! ] ' SQUARE FEET PRIMARY R [ ] SQUARE. FEET A TYPE SYSTEM: [y'] STANARD I CONFIGURATION:. [1.1.A TRENCH N F LOCATION OF BENCHMARK: p I ELEVATION OF PROPOSED SYSTEM SITE [I* ] [INCHES E BOTTOM OF DRAINFIELD TO BE ( .. -u [INeS /FT] FILL REQUIRED: [44 )6 ] INCH EXCAVATION REQUIRED: Ti a SAL SYSTEM Existing System ['y Holding Tank Abandonment [ /�.J' Temporary r&-,),) .3 '/D /.1 /00 t /4: 4 , SUBDIVISION: / -1 1 [SECTION, TOWNSHIP, RANGE, PARCEL NUMBER] z of; ®® 43 [OR TAX ID NUMBER] SYSTEM MUST BE CONSTRUCTED IN ACCORDANCE WITH SPECIFICATIONS AND STANDARDS OF SECTION 381.0065, F.S., AND CHAPTER 64E -6, F.A.C. DEPARTMENT APPROVAL OF SYSTEM DOES NOT GUARANTEE SAFTISFACTORY 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. ISSUANCE OF THIS PERMIT DOES NOT EXEMPT THE APPLICANT FROM COMPLIANCE WITH OTHER FEDERAL, STATE, OR LOCAL PERMITTING REQUIRED FOR DEVELOPMENT OF THIS PROPERTY. /AEROBIC UNIT CAPACITY MULTI- CHAMBERED /IN- SERIES [fY] CAPACITY MULTI- CHAMBERED /IN- SERIES [! ] INTERCEPTOR CAPACITY [MAXIMUM CAPACITY SINGLE TANK: 1250 GALLONS] TANK CAPACITY [ ]GALLONS @ [ ] DOSES PER 24 HRS # PUMPS [ ] DRAINFIELD SYSTEM SYSTEM �) [ FILLED /[ "7 MOUND Iy�] BED [^4 [ABOVE/ [ABOVE c" E 0 DH 4016, 12/99 (Page 1) RECi r"a t161i13- MayP_Be' Use t r �G`�7 r� =^ 1 �� a 1 �� pt, 1 : Health Department ELEVATION D(t OC9 ib't�t UU'a'm�' Ev truJ u �l:a uv�pt Pty Aib1cant pt. 3: Installer /Contractor pt. 4: Building Department TITLE: 1 r 11 EXPIRATION DATE: PERMIT NO. 00/2.- .t 0 DATE PAID: 8- e_15, FEE PAID: 7 S , O RECEIPT #:b o/ .0 8 o o O � /3 _ <-7 -`q 98 ? 7 [ Innovative (� f «= s� u tin • INCHES. BENCHMARK/REFERENCE POINT BENCHMARK /REFERENCE POINT CHD INSTRUCTIONS: PERMIT NUMBER: CONSTRUCTION PERMIT FOR: SYSTEM DESIGN AND SPECIFICATIONS: Permit tracking number assigned by CPHU. 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 ID #: 27 character id number for property. (CHD may require property appraiser ID # or section/township /range/parcel number) TANK: Minimum specifications from Chapter 64E-6, FAC. DRAINFIELD: Minimum specifications from Chapter 64E4 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 Health Department (CHD) personnel reviewing and approving permit. DATE ISSUED: Date permit is issued by CHD 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. Site Plan submitted by: Plan Approved STATE OF FLORIDA DEPARTMENT OF HEALTH APPLICATION FOR ONSITE SEWAGE DISPOSAL SYSTEM CONSTRUCTION PERMIT Permit Application Number ( ?4 DH 4015, 10/96 (Replaces HRS-H Form 4015 which may be used) (Stock Number: 5744-002-4015-6) PART II SITEPLAN Scale: Each block represents 10 feet and 1 inch = 40 feet. _ ‘-(.‘ ?r s! J -4 It t, (7: 70 t e :II* it ( 1 . Not Apgrogad Date , 1 J A ), . - l.,t;t. '.:`", ea. A.; CWHeaIt By / 71 ..., i ' ..........0 De9artment h D ()" ‘ -- t ALL CHANGES MUST BE APPROVED BY THE COUNTY HEALTH DEPARTMENT Page 2 of 4 • _ MI . II I III MINN IIIIIIII II FA 11 III I M OM= III iii RION Mir NM r Mill 1111111 NNW : II Mall" 1111AMENINKE • _ NM 111111U1111111 11111111121‘ - MN ‘, i III • NEI '( III III 1111111111_ • II - - •WI= I 11111111111 111111111 I 1111 ; ti ll , ; IBM MIMI HEM ; . R 1111111TIM i III 11111 •IIUUUUU It III MI IIII MI =II i III NM= la -- -- - =Mill MINI II IIIII III , N-4-- sio--E1111111111111111 11 111111111= - 111111 - MI III int.s. • ,, ,,N\ .1---..- 4 - ,-_° rv,--% (-7-;__ 1_/ 1\1 . .., - , . -,I.J.,,!, Site Plan submitted by: Plan Approved STATE OF FLORIDA DEPARTMENT OF HEALTH APPLICATION FOR ONSITE SEWAGE DISPOSAL SYSTEM CONSTRUCTION PERMIT Permit Application Number ( ?4 DH 4015, 10/96 (Replaces HRS-H Form 4015 which may be used) (Stock Number: 5744-002-4015-6) PART II SITEPLAN Scale: Each block represents 10 feet and 1 inch = 40 feet. _ ‘-(.‘ ?r s! J -4 It t, (7: 70 t e :II* it ( 1 . Not Apgrogad Date , 1 J A ), . - l.,t;t. '.:`", ea. A.; CWHeaIt By / 71 ..., i ' ..........0 De9artment h D ()" ‘ -- t ALL CHANGES MUST BE APPROVED BY THE COUNTY HEALTH DEPARTMENT Page 2 of 4 - -' CLoorTS BATH TOSS SHOWER[ LA TORIES TORIES SLOP SINKS LAUNDRY Tuns URINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT'N• TOTAL /ItTI/R[S CONTR. LIST CHICK SEPTIC TANK SEWER CONK. DRAIN FIELD BOAKAO[ PIT G TRAP SOLAR NEATER DEEP WELL S . B SW INFO POOL CONTR. LIST �- CHECK Permit No MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein described. This application b 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. J / a Owners Name and Address y� _____1.:Lory Registered Architect and /or Engineer / � £ ployini F1 ,umb 'ss ?limo P-. -L© L_-. w...1�_(C) i�v..::, x � N . t 1 . . �r . ! ' C��T LocaBl and 'Lega pHon Lot •� l� B d Subdivision R/1 streeR..._ /P.0 ¶• .- and Number where work L to be performed —No No FY0 /u_. Street... -1_0O ` /State work to be performed and purpose of building (By Floors)_ .. 1y.. New Building. -_ -- _ — _.._..........._.. Remodeling__—_ - - -- Addition.. - - -_ ...__ Repairs No. of Stories ........ Size Septic Tank_. _Type of Tank____ Feet of Drain Tile. Disc- Feet of Tank or Drain Field from Well .. -_ - - -- -- ._ - - - -_ Nature of Water Supply: City —WeIL Size of Soakage Pit Amount of Permit $ --j-�e STATE OF FLORIDA, f COUNTY OF DADE. (Sigs►ed Capedty Gals..._..._...__ My Commisaioo Expires Notary Public, State of Florida Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and have com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to he 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 arr required by the Act. The undersigned agrees to employ only such sub-contractors, on work to be performed under this permit, lui are licensed by Miami Shores Village. (Signed) Muter 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 be 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 snob r►ltspeottota ie aaade•nsosswry by hnpaper notice for Inspection. or faulty materials and /or workmanship. Penn No... :I;'p11r:It ion k hereby rcby mode for the approval of the detailed statement of the plans and specifications herewith subr.to:...1 for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Mi.: • •t Shores Village, Florida. a..d all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulatic-s. of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and spec fications must be kept at .3uilding during progress of w am ')wner s Name and Address... \._ ._ . -_ __Zen________.. r 10 -- Street_. Ai/t . .egistsred Architect and /or Engineer :mploying Plumber's Name ... f1�^!.. _s.(�21 -a ttC t- NO..— _.._,._,,,.-/ �. .. `l ......,- street..... ... ,�. . - - -- • .� Location and Legal Description Lot- Block Subdivision__ ... Street and Number where work is to be performed —No 0 Street Jt State work to be performed and purpose of building (By Floors) ---- - -. f &. . —..- . 1 tt - . 3. 0 atA t �! New Building Remodeling_ — ._ Addition Repairs (/ . No of Stones Size Septic Tank_-...—. ..__- .....- .------- .--- .— _ - -• -- ..Type of Tank Capacity A Ala. Feet of Drain Tile. _ - - -_.__ —Dist. Feet of Tank or Drain Field from Well. Nature of Water Supply: City — Well.._-- •- .----- ....__..._— .--- .-- _ - -... -Size of Soakage Pit n o P ermit Amount $ STATE OF FLORIDA, } ss. COUNTY OF DADE. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT (Signed) _ (Sign s Plumbing Inspector The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an e ndloym' of Lobo under the Florida Workmen's Compensation Act, being Section 5988, Compiled General Laws of Florida Permanent rum lenient, and ha. eon.. v.lied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors emp • 1 y him in : •: ‘$.11-k c• b� performed under this permit; and will post or cause to be posted' for inspection on the site of • work suc pml notice r, no icer i a* required by the Act. The undersigned agrees to employ only such sub - contractors, on • k to be pe 'o ? Ifs , :r.rit as . licensed by Miami Shores Village. My Conunission Expires Notary Public, State of Florida Before me, the undersigned authority, a notary publlc, duly authorized to administer oaths and take acknowledgments, per;orri ; • ppraret, 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 acts therein by him stated are true. NOTE: A re inspection fee of $1.00 will be made when such re-inspection L made•necessary by improper notice for Inspection, ter mull) materials and /or workmanship. CLO[[T[ BATH TUB[ 6NOW [RS LAVA• TORIES SIN" SINKS LAUNDRY TU•• URINALS CATCH BASIN FLOOR I DRINKING DRAIN FOUNT I T07. RI[TI. RCS CONTR. LI 'T 1 CHECK SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SWIM •0 POOL I — CONTR. LIST I CHICK . -- ,�.• I mo- Penn No... :I;'p11r:It ion k hereby rcby mode for the approval of the detailed statement of the plans and specifications herewith subr.to:...1 for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Mi.: • •t Shores Village, Florida. a..d all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulatic-s. of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and spec fications must be kept at .3uilding during progress of w am ')wner s Name and Address... \._ ._ . -_ __Zen________.. r 10 -- Street_. Ai/t . .egistsred Architect and /or Engineer :mploying Plumber's Name ... f1�^!.. _s.(�21 -a ttC t- NO..— _.._,._,,,.-/ �. .. `l ......,- street..... ... ,�. . - - -- • .� Location and Legal Description Lot- Block Subdivision__ ... Street and Number where work is to be performed —No 0 Street Jt State work to be performed and purpose of building (By Floors) ---- - -. f &. . —..- . 1 tt - . 3. 0 atA t �! New Building Remodeling_ — ._ Addition Repairs (/ . No of Stones Size Septic Tank_-...—. ..__- .....- .------- .--- .— _ - -• -- ..Type of Tank Capacity A Ala. Feet of Drain Tile. _ - - -_.__ —Dist. Feet of Tank or Drain Field from Well. Nature of Water Supply: City — Well.._-- •- .----- ....__..._— .--- .-- _ - -... -Size of Soakage Pit n o P ermit Amount $ STATE OF FLORIDA, } ss. COUNTY OF DADE. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT (Signed) _ (Sign s Plumbing Inspector The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an e ndloym' of Lobo under the Florida Workmen's Compensation Act, being Section 5988, Compiled General Laws of Florida Permanent rum lenient, and ha. eon.. v.lied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors emp • 1 y him in : •: ‘$.11-k c• b� performed under this permit; and will post or cause to be posted' for inspection on the site of • work suc pml notice r, no icer i a* required by the Act. The undersigned agrees to employ only such sub - contractors, on • k to be pe 'o ? Ifs , :r.rit as . licensed by Miami Shores Village. My Conunission Expires Notary Public, State of Florida Before me, the undersigned authority, a notary publlc, duly authorized to administer oaths and take acknowledgments, per;orri ; • ppraret, 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 acts therein by him stated are true. NOTE: A re inspection fee of $1.00 will be made when such re-inspection L made•necessary by improper notice for Inspection, ter mull) materials and /or workmanship. ;UILDING :LECTRICAL ' LUMBING i0OF1NG )caner of : uilding architect '• ontractor r Builder egal iescription ddress of uilding Lot MIAMI SHORES VILLAGE. FLORIDA ❑ DATF ! PERMIT N? 8407 Bl. Work to be performed under this Permit Signed• Contractor's Subdi- vision Sq. Ft Value of Project $ License No ,Amt. of Permit $ CONTRACTOR a BUILDER BY AUTHORITY 195 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 erefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans, rawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any me 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 ranted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations ertaining 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 one by his agents, servants or employees. 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 - rtaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. accepting this permit I assume responsibility for all work done by either, myself, my agent, `servant or employee. BUILDING ELECTRICAL PLUMBING ROOFING Owner of Building Architect Contractor or Builder Legal Description Address of Building Lot MIAMI SHORES VILLAGE, PERMIT N9 8360 CONT1 ACTOR OR BUILDER Bi. Subdi- vision FLORIDA DATR 7 Contractor's License No Work to be performed under this Permit Sq. Ft Value of Project $ Amt. of Permit $ 4 ` BY AUTHORITY 7 195 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 anif regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted fo 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. 17 ‘.. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMEN APPLICATION FOR PLUMBING Permit No .. Date 1.7 Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the builg or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. {� c Owner's Name and Address �./ ; ' " ' _` 46.- _ - No._frZ ,k ' P -- --- --- - - --- Street_ ✓ a � �?'.. Registered Architect and /or Engineer ..... ________.............. _________ __ Employing Plumber's Name ________ __ _ ^_______ No Location and Legal Description Lot_________._________________ Blor1r Street and Number where work is to be performed —No 1 ++ State work to be performed and purpose of building (By Floors) _.��1.1! 6 9' '- y c i ; New Building _ ___ Remodeling_ ______.____._.________ Addition.._____ Repairs No. of Stories Street _. .......... --• -- ..... __________ Street . .44 i /e Size Septic Tank _ Type of Tank Capacity Gals Feet of Drain Tile _Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: City — Well.______ _ _ ___._Size of Soakage Pit Amount of Permit $ o STATE OF FLORIDA, } COUNTY OF DADE. My Commission Expires ( Signed) 2 ao ��'tt- (Signed) G f Plumbing Inspector. Notary Public, State of Florida 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 5988, Compiled General Laws of Florida Pennanent Supplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such sub- contractors, on work to be perform - . 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 TUBE SHOWERS LAVA- TORIES SINKB SLOP SINKS LAUNDRY Tuee U RINALS 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 SW IM'G POOL CONTR. LIST - -- CHECK ‘.. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMEN APPLICATION FOR PLUMBING Permit No .. Date 1.7 Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the builg or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. {� c Owner's Name and Address �./ ; ' " ' _` 46.- _ - No._frZ ,k ' P -- --- --- - - --- Street_ ✓ a � �?'.. Registered Architect and /or Engineer ..... ________.............. _________ __ Employing Plumber's Name ________ __ _ ^_______ No Location and Legal Description Lot_________._________________ Blor1r Street and Number where work is to be performed —No 1 ++ State work to be performed and purpose of building (By Floors) _.��1.1! 6 9' '- y c i ; New Building _ ___ Remodeling_ ______.____._.________ Addition.._____ Repairs No. of Stories Street _. .......... --• -- ..... __________ Street . .44 i /e Size Septic Tank _ Type of Tank Capacity Gals Feet of Drain Tile _Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: City — Well.______ _ _ ___._Size of Soakage Pit Amount of Permit $ o STATE OF FLORIDA, } COUNTY OF DADE. My Commission Expires ( Signed) 2 ao ��'tt- (Signed) G f Plumbing Inspector. Notary Public, State of Florida 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 5988, Compiled General Laws of Florida Pennanent Supplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such sub- contractors, on work to be perform - . 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. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING r• MIT Permit No. c T . l _ Date -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. Owner's Name and Address Registered Architect and /or Engineer Employing Plumber's Name Location and Legal Description Lot --- .--- _----- .- w____-- -- ._._.___ ___ _ Block My Commission Expires No._ Street and Number where work is to be performed —No .12 d str State work to be performed and purpose of building (Bysfleers)_•.12.�-- New Building .____.- Remodeling _.____ 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 — Well.______________.______________ — Size of Soakage Pit Amount of Permit $ Capacity Gals - ( S i g n e d ) No._ _--- •- ------ ---_ -- Street Repairs No. of Stories . . ...................... Street_____ i t/g 2 -re' Vfr. 4"._e- / » Plumbing Inspector. /e' S ? Notary Public, State of Florida The undersigned applicant for this building permit does hereby certify that he understands and accepts his ligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5968, Compiled General Laws of Florida P .rmanent Supplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such sub- contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. Master 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 S SLOP SINKS LAUNDRY TUBS U RINALS CATCH BASIN FLOOR DRAIN DRINKING DRINK 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 POOL CONTR. LIST _ CHECK MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING r• MIT Permit No. c T . l _ Date -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. Owner's Name and Address Registered Architect and /or Engineer Employing Plumber's Name Location and Legal Description Lot --- .--- _----- .- w____-- -- ._._.___ ___ _ Block My Commission Expires No._ Street and Number where work is to be performed —No .12 d str State work to be performed and purpose of building (Bysfleers)_•.12.�-- New Building .____.- Remodeling _.____ 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 — Well.______________.______________ — Size of Soakage Pit Amount of Permit $ Capacity Gals - ( S i g n e d ) No._ _--- •- ------ ---_ -- Street Repairs No. of Stories . . ...................... Street_____ i t/g 2 -re' Vfr. 4"._e- / » Plumbing Inspector. /e' S ? Notary Public, State of Florida The undersigned applicant for this building permit does hereby certify that he understands and accepts his ligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5968, Compiled General Laws of Florida P .rmanent Supplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such sub- contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. Master 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. ( )x"2 A LtJ IL Permit No - v Owner's Name and Address Registered Architect and /or En eer Employing Plumber's Name.___ Amount of Permit $ My Commission Expires MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING ' ibMIT Application is hereby made for the approval of the detailed statement of the plans and specifications herewith sibmitted f6r 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. No.__— Location and Legal Description Lot ._._____ ..... _________ -_ Block_ Subdivision.- Street and Number where work is to be performed—Not/ _ it _ Street.. 14 - a. -_hy ? � ...... No._. (Signed) _ 2 , -ss- Size Septic Tank Type of Tank____ !-\'` ? ? 7 Feet of Drain Tile._ -•- __Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: City—Well. ________ ______Size of Soakage Pit Date // 5° Street State work to be performed and purpose of building (By Floors)___._._ New Building Remodeling______ ___ Addition Repairs No. of Stories Capacity Gals Notary Public, State of Florida Master Plumber. P ; 1: : 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 Pennanent Supplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub- contractors employed by him in the work to be performed under this permit; and will post or cause to be posted' for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such sub- contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. STATE OF FLORIDA, COUNTY OF DADE. j 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 TUSS SHOWERS LAVA. TORIES S INKS SLOP SINKS LAUNDRY TUBS U RINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT' 1.46 TOTAL FIXTURES CONTR. LIST CHECK SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WILL SPRKLR. SYSTEM SW IM'O POOL CONTR. LIST _ CHECK f _ Permit No - v Owner's Name and Address Registered Architect and /or En eer Employing Plumber's Name.___ Amount of Permit $ My Commission Expires MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING ' ibMIT Application is hereby made for the approval of the detailed statement of the plans and specifications herewith sibmitted f6r 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. No.__— Location and Legal Description Lot ._._____ ..... _________ -_ Block_ Subdivision.- Street and Number where work is to be performed—Not/ _ it _ Street.. 14 - a. -_hy ? � ...... No._. (Signed) _ 2 , -ss- Size Septic Tank Type of Tank____ !-\'` ? ? 7 Feet of Drain Tile._ -•- __Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: City—Well. ________ ______Size of Soakage Pit Date // 5° Street State work to be performed and purpose of building (By Floors)___._._ New Building Remodeling______ ___ Addition Repairs No. of Stories Capacity Gals Notary Public, State of Florida Master Plumber. P ; 1: : 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 Pennanent Supplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub- contractors employed by him in the work to be performed under this permit; and will post or cause to be posted' for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such sub- contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. STATE OF FLORIDA, COUNTY OF DADE. j 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.