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920 NE 100 St (6)BUILDING PERMIT APPLICATION FBC 2001 Miami Shores Village Building Department Permit Type (circle): Building Electrica Y Plum Mechanical Roofing Owner's Name (Fee Simple Titleholder) /1i /C 1 1/4E4- , / T LJAa Phone # Owner's Address 9/0 /lf /13Z) 7,-f ..37 City /'Ll /WO / Ofit-VIS State FL.072 /DA Zip 3-3/31 Tenant/Lessee Name Phone # Job Address (where the work is being done) Az- c'71EET City Miami Shores Village County Miami -Dade Zip 33/31 Is Building Historically Designated YES NO Contractor's Company Name / (( CitJ✓ /72OJf1CM)%HL A6g Phone # -7 F6 4099 Contractor's Address QQl /Oil /1 //U 51_11 540 b # City m // TYI / State FL d9 /PA Zip 33/ Qualifier Jo 'E 5 -p[."10 Architect/Engineer's Name (if applicable) . Phone # Architect/Engineer's Address City $ Value of Work For this Permit State f . 'AM Zip Number of: Bays Stories Families Bedrooms Baths Type of Work: ['Addition ['Alteration DNew ['j ❑ Demolition Describe Work: / 7M(J DOA- Code Enforcement $ * * * * * * * * * * * * * * * * * * * * * * * * * * ** F ees * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** County Escrow Fee $ o (p (D Permit Fee $ i ) 5 - O U Notary $ FEB 1 8 PAID Education/Training Fee $ , 2-0 Tech $ q • 3r7 . Scanning $ Radon $ Bond $ Struct. $ Minus Plans Check Fee $ Total Fee Now Due $ 1 50 i 3 ' 2004 Square Footage Of Work: /U• /4 • L — 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Permit No. 1 l a y — 00 Master Permit No. 10 y — Sit (Continued on opposite side) Bonding Company's Name (if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State Zip 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 not be approved and a reinspection fee will be charged. NOTARY PUBLIC: NOTARY P Sign: Sign: Print: Print: APPLICATION APPROVED BY: Chc7r7 /03 Owner or Agent Contractor The foregoing instrument was acknowledged before me this The foregoin_ instrument was acknowledged before me this /DTI -• day of , 20 _, by , day of � c41k 20 o� b Jb 'BO/ -,' fOO who is personally known to me or who has produced ho is personally known to n1e.6r who has produced As identification and who did take an oath. as identification and who did take an oath. Ills bill __.. i �►: aY My Commission Ex fires: Y P My Commission Expires. (Certificate of Competency Holder) State Certificate or Registration No. 1 Certificate of Competency No. ****************************** * * ** * * ** ********************•************* * *s * * * * * * *s * * * * * * * * * * * * * * *s * * ** Plans Examiner Engineer Zoning Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Permit Number: PL2004 -60 Printed: 2/25/2004 Applicant: KATHLEEN ROTUNDO Owner: ROTUNDO KATHLEEN JOB ADDRESS: 920 NE 100 ST Contractor MIAMI DADE ENVIROMENTAL Contractor's Address: 9591 FOUNTAINE BLUE BLVD #208 Local Phone: 786 -251 -4099 Parcel # 1132060340210 Signed: (INSPECTOR) Plumbing Permit Page 1 of 1 Legal Description: MIAMI SHORES SEC 8 PB 14 -33 LOTS 8 & 9 BLK 170 LOT SIZE 100.000 X Fees: Description Amount FEE2004 -1955 Building Fee $175.00 FEE2004 -1956 CCF $0.60 FEE2004 -1957 Training and Education Fee $0.20 FEE2004 -1958 Technology Fee $4.37 Total Fees: $180.17 Total Fees: $180.17 Total Receipts: $180.17 Permit Status: APPROVED Permit Expiration: 8/16/2004 Construction Value: $100.00 Work: ABANDON 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: Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Permit Number: PL2004 -60 Printed: 2/25/2004 Applicant: KATHLEEN ROTUNDO Owner: ROTUNDO KATHLEEN JOB ADDRESS: 920 NE 100 ST Contractor MIAMI DADE ENVIROMENTAL Contractor's Address: 9591 FOUNTAINE BLUE BLVD #208 Local Phone: 786 251 - 4099 Parcel # 1132060340210 Permit Status: APPROVED Permit Expiration: 8/16/2004 Construction Value: $100.00 Work: ABANDON TANK l- Fees: Description Amount FEE2004 -1955 Building Fee $175.00 FEE2004 -1956 CCF $0.60 FEE2004 -1957 Training and Education Fee $0.20 FEE2004 -1958 Technology Fee $4.37 Total Fees: $180.17 Total Fees: $180.17 Total Receipts: $180.17 Signed: (INSPECTOR) Plumbing Permit Page 1 of 1 Legal Description: MIAMI SHORES SEC 8 PB 14 -33 LOTS 8 & 9 BLK 170 LOT SIZE 100.000 X 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 APPLICATION FBC 2001 Permit Type (circle): Building Electrical Miami Shores Village Is Building Historically Designated YES NO Architect/Engineer's Name (if applicable) P1 /A— S Value of Work For this Permit 5 440t) Total Fee Now Due $ 415 q • I / 461 (Continued on opposite side) Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Job Address (where the work is being done) Q 20 J E . !OCJST Master Permit No. FEB� S 8014 Mechanical Roofing Owner's Name (Fee Simple Titleholder) H1 r � . A t_l. NoTom Q Phone # Owner's Address q ` �.0 p1J . I oo c r M f S lSo (tee City 11 1 ta3K1 S t4Oli0 5 State / /1 Zip S3 1 S& Tenant/Lessee Name Phone # City Miami Shores Village County Miami -Dade Zip 3 424 RBI- Phone # N /4— Square Footage Of Work: * * * * * * * * * * * * * * * * * * * * * * * * * * ** F ees * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** FEB 1 PAID Submittal Fee $ Permit Fee $ n5-00 CCF $ 1 -6'.1.--) Notary $ /% Training/Education Fee $ . (00 Technology Fee $ u . 3 7 Scanning $ - 00 Radon $ Bond $ vU - 00 Code Enforcement $ Structural Plan Review. $ 1 L Permit No. P 1 acoq - Contractor's Company Name M l A at • C lV U ( R QIJ ta Phone <786 1 ,s/-40 q'q' Contractor's Address 9 pC Foo (v'T r.) P Qtai B( V O g Ire City M (1A.1t( State P1 14- Zip 3 3/7 Qualifier ,,OS' e_ 1 1 -5 • 10.16 200 Sa FT Type of Work: ❑AAddition ['Alteration ['New Ri Repair/Replace ❑ Demolition Describe Work: : / 4 N 1N ADD S6il a r - (n).A\u I (d(. Bonding Company's Name (if applicable) iv! /4, Bonding Company's Address City State Zip Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State Zip 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 not • • • • •. �•• d a rei ctio ' e will be charged. Age -wird-TA. 4,„,, Signature Contractor The f', regoing instrument was acknowledged before me this %rT/ The fore: • ing instrument was acknowledged before me this APR/ Uq, day of F 20 b4 , by /n1 / Cl-t<1CL % URaD , day of tIARY , 20 tom, by J 0'5 3pZ."J0.5 , w rs ersonally k me o nown to who has produced w o ispersonally known to me or who has produced As identification and who did take an oath. as identification and who did take an oath. My Commission Expires: LESTER E. Gig' ': • MV COMPISSIW' i May 20 k/ / NOTARY PUB Sign: Print: 1-C — E CROCKETT ON#DD014762 20,200= Budaet Notery r My Commission Expires: ' " ! cb S ***************************************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** State Certificate or Registration No. Chc 10/14/03 (Certificate of Competency Holder) Certificate of Competency No. * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** * * * * * * ** * * * * * * * * * * * * * * * * * * * * * * * * ** ******** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** APPLICATION APPROVED BY: ) / f .1 3 t iPlans Examiner Engineer Zoning Scale: Each block represents 5 feet and 1 inch = 50 feet. 11,1, li 1 17-] LLT:E111 rpm 1 - 1 _ r t , -t, t7 3 t-t 1 rJ i ■ is ,a F. • i , 1 a , _ —■ � .. _ - irr ei i ,- 4 1 1 { , Y /a , ; ` - ~ -,. , , • , • ■'�' •I ;, „ t i f - 4 anito — -1- A 7 ■■■ •■■■■■ WWII i k, -- _ 1- -� ( t L_ 1 ' ■ �' . .... -* _.�.. _l ( IN roj, IS WIN 111 ■�: 1111111111111N1 I i ■ i f t p -- j 1 , �� ). � t ... -_ • 1 .._ 1-1—'-1111 .e i i I- { 1 - - ( i .. i. i i r . ; f i -) ,. ■■■■■ ■i 1I i � ., f i i + flII [1 t11TtLtt —� — ■ — . ■ i t �1 f r -i — ` - ■■■■ ■ ■ ■■■■ ■ - ■N � - ` ' i j ■ i ' EL r il 1 1 ',..-.'..... ' -1 , ---i-+-- •-■ , ---4--i-- -.-- ','--.4.--i-j . T Hi [ --- 1 I r4=9 - nia llllllll ga■■■ � �� • LH NM .■ ■■ ■ � ii■■■ i n. 111 O� MUM • ■ ■�11■■ 1,1111•1111 ■■■■ 1 ■■ ■■ 1111111111111 v ■■■ • as ■ ■ a ■■ A �._ �- - t � 1 I t t ' r + �- 1 ; _ i I t i j 1 1 f y , s "�� } MI 1 i t( f 1' i 1 I i i i f-+ !' ' I ■■ i 0 r ! -: i-� 11 i■ ■■I ■ ■ a ■ ■■■ __..... NNW ■■■ ■■ us rt ■ T �..._ ....... f 1 J � � � n r t � msu n■■■ T , , , � f r ■� 1 i r ■■a�i ■ ■w ■■re 1 , • _L._c.. f � �_ I ' t ' �■■■■■■■■a r . 1 I 1 + , ■II■■■o■■ 4, t r- i r -- ; t 1 l i r Site Plan submitted b Plan Approved r. By . STATE OF FLORIDA FIECEOVED DEPARTMENT OF HEALTH 1 11,6r51I�f���U11I11�� F�OR 1? NSITE SEWAGE DISPOSAL SYS ONS Number � Permit Application be pp CC�� ) PART II - SITE PLAN- Notes: Mi01 s kiEM ko e-u te, _ Ci2n 1 100ST- MAP SNol e P/A- csys - -- 9l DS i DUe11 nOurcLi En_oreo UJ(l( 1, R Pore DH 4015. 10196 (Replaces HRSH Form 4015 which may be used) (Stock Number: 5744.002. 40154) Signature Not Approved ALL CHANGES MUST BE APPROVED BY THE COUNTY HEALTH DEPARTMENT Title Date 47109' - County Health Department Page 2 of 3 CONSTRUCTION PERMIT FOR: [ ]New System [ [ X ]Repair APPLICANT: Rotundo, LOT: 8 T [ A [ N [ K [ D [ R [ A I N F I E L D • STATE OF DEPARTME ONSITE SE CONSTRUCT SYSTEM DESIGN AND SPECIFICATIONS FILL REQUIRED: [ 0.0 ]INCHES SPECIFICATIONS BY:Icaza, Carlos APPROVED BY: Icaza, Carlos DATE ISSUED: 2/17/04 RECEIVED LORIDA 4 A, 2094 AGE TREATMENT AND 'ISPOSAL SYSTEM ON..RERM•I T This Permit is not for Addition (s) ]Existing System [ ]Holding Tank ]Abandonment [ ]Temporary Michael & Kathleen AGENT: SA0021077, PROPERTY STREET ADDRESS: 920 NE 100 St Miami Shores FL 33138 BLOCK: 170 SUBDIVISION: Miami Shores [Section /Township /Range /Parcel No.] PROPERTY ID #: 11- 3206 - 034 -0210 [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. 900 ]Gallons SEPTIC TANK 0 ]Gallons 0 ]GALLONS GREASE INTERCEPTOR CAPACITY 0 ]GALLONS DOSING TANK CAPACITY [ 0 ]GALLONS 200 ]SQUARE FEET PRIMARY DRAINFIELD SYSTEM 0 ]SQUARE FEET SYSTEM TYPE SYSTEM: [V ]STANDARD [ N ]FILLED N ]TRENCH [)C� ]BED LOCATION TO BENCHMARK: Top of Bottom F1 or , 14.00' NGVD. ELEVATION OF PROPOSED SYSTEM SITE [ 2.2 ] [ FEET ] BOTTOM OF DRAINFIELD TO BE [ 3.9 ] [ FEET ] OTHER REMARKS: This permit is not for additions. *Replace existing broken septic tank by a new 900 gl. outlet filter. *Install 200 sq.ft. of drainfield. *Invert elevation to be no less than 10.63' NGVD. *Bottom elevation to be no less than 10.13' NGVD. TITLE: DH 4016, 03/97 (Obsoletes previous editions which may not be used) (Stock Number: 5744- 001 - 4016 -0) [ostds cons 4016 -1) [ ] Innovative Other [ NA ] Bolanos Jose EXCAVATION REQUIRED: [ 20.0 ] INCHES CENTRAX #: 13 -SG -19642 DATE PAID: FEE PAID : RECEIPT . OSTDSNBR : 04 -0612- -R MULTI- CHAMBERED /IN SERIES: [Y ] MULTI - CHAMBERED /IN SERIES: [Y ] [0 ]DOSES PER 24 HRS # PUMPS[ 0 ] [ N ]MOUND [ N ] [ N ] [ BELOW] BENCHMARK /REFERENCE POINT BELOW] BENCHMARK /REFERENCE POINT C -1 septic tank with its approved NEM ?' INSTALLED LI ED d=•? IF. SEPTIC TANK SHALL BE klULTi-CHAMERED AND EQUIPPED APPROVED OUTLET FILTER TITLE: Engineer I Dade CHD EXPIRATION DATE: 5/17/04 Page 1 of 2 Miami Shores Village 10050 NE 2nd Avenue Printed: 2/25/2004 Applicant: KATHLEEN ROTUNDO Owner: ROTUNDO KATHLEEN JOB ADDRESS: 920 NE 100 ST Parcel # 1132060340210 Signed: Plumbing Permit Phone: 305- 795 -2204 Permit Number: PL2004 -59 Page 1 of 1 Contractor MIAMI DADE ENVIROMENTAL Contractor's Address: 9591 FOUNTAINE BLUE BLVD #208 Local Phone: 786 -251 -4099 Legal Description: MIAMI SHORES SEC 8 PB 14 - 33 LOTS 8 & 9 BLK 170 LOT SIZE 100.000 X Fees: Description Amount FEE2004 -1949 Building Fee $175.00 FEE2004 -1950 CCF $1.80 FEE2004 -1951 Training and Education Fee $0.60 FEE2004 -1952 Technology Fee $4.37 FEE2004 -1953 Scanning Fee $3.00 FEE2004 -1954 Builders Bond $300.00 Total Fees: $484.77 Total Fees: $484.77 Total Receipts: $484.77 Permit Status: APPROVED Permit Expiration: 8/16/2004 Construction Value: $2,400.00 Work: REPLACE SEPTIC TANK AND 200 SQFT OF DRAINFIELD (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 accepting this permit I assume responisibility for all work done by either myself, my agent, servants or employes. Signed: (Contractor or Builder) BY: AA , ATM yI $ •••••••:". ;AZ AREA 1117X3 [2] sQvit DISTRIBUTION BOIL NUMBER OF DRAINLINES [ DEAINLINN SEPARATION : [ DRAINLINE otOOS riziita or coiiii 1 1 1 1 1 1101 (11) [12 ) [13) . E141 I (16) [17) [18] [19] (20] (21) FILL / [23) • ELEVATION Bag - - SYSTEM f DoSitni PUMPS AGGREGATE SIBE'l* 0 [ AGGREGATE SEUESSIUE ' [22] ExcAVATzoitiv- 7 6(o ( 0 q C ST . • PAID: 7-0(4 T NO. 01 06i) 'r; PAID: Z f7r) ) fl DisosAv AND PIW1. • gRA? MATER - 1 titbit* , : FT I . _ [ 3.30t FT 1 (4 4111144AT10.4041*r, , FT 011 POTABLE ATER * PT 133) FT t I 101 PROPERTY Limn FT I 0 FILLED / MOUND"SYSTEM -- ` 1 1 FILL .**Oiii100 J , FILL mvRE • [ ) [24] . . .„ . .guipopoprz •••••••- : I (25) AREA 9414A0ID rpliw,flomm PUMPED a Li ; c1 t y (i I I [26) catigue a FILLED =41. linithitOiON ' ..... • :1. ..fl 4016, 10/97-(Pr4ifinisAiditions E61604e-biaE)---. - Installer / Contractor 'Owsr*ELD. cow,* •-.) •I17I 1 0$j ELOPES 1 [39) ADDITIONAL untioa0tOit :iitiOnOttoopkb, AREA t 4 8TORWTgR 'RUNOFF 101 4040 :,•-, • r ' •• • j : Lot adittsioorr • 1 (41 iiti#0# UEA . 053 LOAT X0 c�NFORMS virtu - Bits - kit; 1 1 -1 FINAL gTE • ',ir;Wei Arl CONSTRUCatiltp gasAppRovnori - - . 4 - . . , FINAL SYSTEM -WPROFED ISAPPROVEDI - - . (47] C0ETRAUTOR xD 1 I IBM CED DUNA - 40 L. Pogo 2 of 3 APPLICANT: AGENT: y ", STATE OF FLORIDA DEPA tTMENT of EEALTE ONBITE SEIM= TREATMENT CONSTRUCTION INSPECTION PROPERTY ADDRESS, , () f )/, L _ , /eU LOTS 7 • BLOCKS 7() SUBDIVISIONS �??L`a... -� .0 y �... PROP ID #s 1 .� 3 -2.<-) `C) r `/ CHECKED [X] ITEMS ARE NOT INCOMPLIANCI WITH STATUTE OR RULE AND j MUST EE TAB INSTALLATION [01) TANK SIZE [1] Jc 1 c- [2) [02) TANK 1o1TERIAL [03) OUTLET DEVICE (04) MULTI - CHAMBERED (`.Y)/ N ] (OS) OUTLET PI1jTE2 - h 1.. (06) IEOEND ("5 - [07] "WATERT [08) LEVEL [09) DEPTH TO LID / DRAINFIELD INSTALLATION ( A3131 1 ( SCUM [11] DISTRIBUTION NOZ HEADER [12) NUMBER OF DRAINI.INES 3 (13) DRAIMU.INE SEPARATION •3 ' [14) DRAINLINE SLOPE (15) DEPTH Or COVER 4 [16] ELEVATION [AB0VE BM [ 17) SYSTEM LOCATION - a-� -- [ 18] DOSING PUMPS . (19) AGGREGATE SIZE . ; ' 00, r'? -• (10) AGGREGATE EXCESSIVE FINES (21) AGGREGATE . DEPTH /4 FILL / EXCAVATION MATERIAL [22) FILL AMOUNT (33] FILL MIXTURE [24) EXCAVATION DEPTH [ZS] AREA REPLACED [26] REPLACEMENT MATERIAL CONSTRUCTION FINAL SYS „.APPROVED DE 4016, 10/97 (Previous Editions May Be Used) AND DIPOBAL 8Y8TEM AND FINAL APPROVAL / DISAPPROVED] f ISAPPROVED] s tI -' ' PERMIT NO. DATI PAID: FEE PAID: RECEIPT #s STORMNATER RUNOFF n 0 /2 / 7 -G'V r-1 S•:7") V /,i17c /.I CORRECTED. SETBACKS [27] SURFACE MATER (28] DITCHES (29) PRIVATE WELLS [30] PUBLIC MSLLS (311 :IRRIGATION WELLS N / [32] POTa8L3 MATER LINES d [33) EVILDI1if r0UNDATION • . 5" • [34] PROPERTY LINES [ OTENR I FT FT FT FT FT FT FT FT rILLED /MOUND SYSTEM (36] DRAINFIELD COVER (37] SMOULDERS • 1 [38] SLOPES t. [39] STABILIZATION ADDITIONAL INFORMATION [40] UNOBSTRUCTED AREA (41) (42] ALARMS [43] MAINTENANCE AGREEMENT [44) BUU.DINO AREA (45) LOCATION CONFORMS MITE [46) FINAL SITE GRADING (47) CONTRACTOR [48] OTHER SITE PLAN - AMIAMEMINKENT (49 ) TANK PUMPED �-'� v/ c/ (50] TANK CRUSESD ai FILLED 0 EXPLANATION OF VIOLATIONS / REMARKS: : "; t ] [ t / C8D DATES-. _ 2-0 '0 ' 7)) • D . C. imp DATE- ' ' Pagsl;,_2 of +3 APPLICATION FOR PLUMBING PERMIT Permit No IP / Date... �_. l _ .. / ___ ..._ .- _. - -' 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 whether herein specified or not. A copy of approved pI ns 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. Street and Numbgr where work is to be performed —No 9 State work to be performed and purpose of building (By New Building .. - - -._ _ ---- ........... -__ Remodeling —__ _. -._ __ Addition. Size Septic Tank_. -. Feet of Drain Tile Nature of Water Supply: City—We1L -Type of Tank Dist. Feet of Tank or Drain Field from Well. _ _ __ ___ -- _ -- - -• - -_ __ Size of Soakage Pit. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT CE ( Signed) . (Si No. __H20 Street-'vr2Lt'.Ls'. �.. Block Subdivision A Street . ...A 4_/ O Repain No. of Stories. Capacity Cals..._..__.__. 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 Pennanent Supplement, and hes 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' foe inspection on the site of the work �suc . blic notice or notices as are required by the Act. The undersigned agrees to employ only such Bub - contractors, on to be psi► A under this permit, as are licensed by Miami Shores Village. Plumber. STATE OF FLORIDA, µ COUNTY OF DADE. j Before me, the undersigned authority, a notary public, duly authorised to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath dep oses and says that be is the __--- '-- _.- _..-- • -_ - -. - - -•- _ - -- _ of the above described construction, that be has carefully read the forsgaing application, and that be did sign the same, and that all facts therein by him stated are true. My Commission Expires Notary Public, State of Florida NOTE: A re inspection fee of $1.00 will be made when nob twbospeotdon is mode•neosseery by improper notice for inspection, or faulty materials and /ar workmanship. CLOUTS BATH T eMOW[A• LAVA• Toas[O SINKS SLOP SINK! LAUNDRY TUD• URINALS CATCH SAO IN FLOOR DRAIN ORINKIN. FOUNT'N. TOTAL FI CONTR. LIST CHICK SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAO[ PIT GREASE TRAP SOLAR H EATER Da6P WILL SPRKLR. °TOTEM SWIM'O POOL • Cowne. LIST •—� CHECK APPLICATION FOR PLUMBING PERMIT Permit No IP / Date... �_. l _ .. / ___ ..._ .- _. - -' 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 whether herein specified or not. A copy of approved pI ns 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. Street and Numbgr where work is to be performed —No 9 State work to be performed and purpose of building (By New Building .. - - -._ _ ---- ........... -__ Remodeling —__ _. -._ __ Addition. Size Septic Tank_. -. Feet of Drain Tile Nature of Water Supply: City—We1L -Type of Tank Dist. Feet of Tank or Drain Field from Well. _ _ __ ___ -- _ -- - -• - -_ __ Size of Soakage Pit. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT CE ( Signed) . (Si No. __H20 Street-'vr2Lt'.Ls'. �.. Block Subdivision A Street . ...A 4_/ O Repain No. of Stories. Capacity Cals..._..__.__. 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 Pennanent Supplement, and hes 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' foe inspection on the site of the work �suc . blic notice or notices as are required by the Act. The undersigned agrees to employ only such Bub - contractors, on to be psi► A under this permit, as are licensed by Miami Shores Village. Plumber. STATE OF FLORIDA, µ COUNTY OF DADE. j Before me, the undersigned authority, a notary public, duly authorised to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath dep oses and says that be is the __--- '-- _.- _..-- • -_ - -. - - -•- _ - -- _ of the above described construction, that be has carefully read the forsgaing application, and that be did sign the same, and that all facts therein by him stated are true. My Commission Expires Notary Public, State of Florida NOTE: A re inspection fee of $1.00 will be made when nob twbospeotdon is mode•neosseery by improper notice for inspection, or faulty materials and /ar workmanship. u& Permit - - - - - - Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the bidding 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 � ' , I c Registered Architect and /or Engineer____ _ __--_ Employing Plumber's Name_ /klififl4.121eele .5_ C`<!' _ 'V Ir No. -� Street_ Size Septic Tank Feet of Drain Tile._ Nature of Water Supply: City —Well. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT (Signed)- ( Signed) __ Ci No.____...... Q ___.__ _ Street Location and Legal Description Lot_.__.._______ _ .____ Block_ Street and Number where work is to be performed —No.__ A 9 z-0 treet State work to be performed and purpose of building (By Floors)_______.___.�4C&L Type of Tank _Dist: Feet of Task or‘Drain Field from Well __Size of Soakage Pit The undersigned applicant for this building permit does hereby certify that he understands and accepts h under the Florida Workmen's Compensation Act, being Section 5988, Compiled General Laws of Florida P plied with the provisions thereof, and will require similar compliance from all contractors or sub - contracto performed under this permit; and will post or cause to be posted' for inspection on the si required by the Act. The undersigned agrees to employ only such sub - contractors, o licensed by Miami Shores Village. the work su to be pe Date /94C/ 6 / A/47 i oos l Subdivision ----- .,---------- .._.---- -•__ -- ch r f My Commission Expires Notary Public, State of Florida T Oa 4S' t` - " New Building Remodeling__:__.__..._ ______ Addition Repairs No. of Stories Capacity Gals Plumbing Inspector. bligations as an employer of labor inanent Supplement, and has coin- employ -: y 'm in the work to be or notices as are this permit, as are mber. STATE OF FLORIDA, I COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oa s 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_ 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. CLOBrTS BATH TU BE SHOWERS LAVA- TORIES SINKS SLOP SINKS LAUNDRY TUBE URINALS CATCH BASIN FLOOR DRAIN DRINK! NG FOUNT' NS TOTAL FI %TORES CONTR. LIST CHECK .Z..� SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR H EATER DEEP WELL SPRKLR. SYSTEM SW IM'G POOL CoNTR. LIST CHECK u& Permit - - - - - - Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the bidding 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 � ' , I c Registered Architect and /or Engineer____ _ __--_ Employing Plumber's Name_ /klififl4.121eele .5_ C`<!' _ 'V Ir No. -� Street_ Size Septic Tank Feet of Drain Tile._ Nature of Water Supply: City —Well. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT (Signed)- ( Signed) __ Ci No.____...... Q ___.__ _ Street Location and Legal Description Lot_.__.._______ _ .____ Block_ Street and Number where work is to be performed —No.__ A 9 z-0 treet State work to be performed and purpose of building (By Floors)_______.___.�4C&L Type of Tank _Dist: Feet of Task or‘Drain Field from Well __Size of Soakage Pit The undersigned applicant for this building permit does hereby certify that he understands and accepts h under the Florida Workmen's Compensation Act, being Section 5988, Compiled General Laws of Florida P plied with the provisions thereof, and will require similar compliance from all contractors or sub - contracto performed under this permit; and will post or cause to be posted' for inspection on the si required by the Act. The undersigned agrees to employ only such sub - contractors, o licensed by Miami Shores Village. the work su to be pe Date /94C/ 6 / A/47 i oos l Subdivision ----- .,---------- .._.---- -•__ -- ch r f My Commission Expires Notary Public, State of Florida T Oa 4S' t` - " New Building Remodeling__:__.__..._ ______ Addition Repairs No. of Stories Capacity Gals Plumbing Inspector. bligations as an employer of labor inanent Supplement, and has coin- employ -: y 'm in the work to be or notices as are this permit, as are mber. STATE OF FLORIDA, I COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oa s 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_ 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.