46 NE 101 St (4)NEW DRIANFIELD
t #65'
d,
MAR 0 2 nu
Passed
Inspector Comments
Failed
Correction
Needed
Re- Inspection
Fee
($75)
No Additional Inspections can be scheduled
re- inspection fee is paid.
until
nspection N u m ber: INSP -416
!ermit Number: PL2005 -126
Inspection Date: 03/01/2007
Inspector: Levrack, James
Owner: None, None
Job Address: 46 101 ST t4
Project: <NONE>
Miami Shores Village, FL
Contractor: STATEWIDE SEPTIC CONNECTIONS
Building Department Comments
Wednesday, February 28, 2007
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Block:
Permit Type: Imported Permit
Inspection Type: Final
Work Classification: <NONE>
Phone Number
Parcel Number 1132060131360
Lot:
Phone: 305 -661 -6633
Page 1 of 2
BUILDING
PERMIT APPLICATION -
FBC 2001
Permit Type (circle): Building
Owner's Name (Fee Simple Titleholder)
Owner's Address MCO °E 1 t
City AS (•xchoe State
'I'enant/Lessee Name
Job Address (where the work is being done)
City Miami Shores Village
Is Building Historically Designated YES
Contractor's Address 35/0 S• ' Rd i if 14
City re r G rnext
Qualifier 1 erf Sa lo rI o r,
State Certificate or Registration No.
Architect /Engineer's Nanie (if applicable)
$ Value of Work For this Permit IS € 90-
Type of Work: EAddition
Describe Work:
Submittal Fee $
Notary $ 5.cX)
Scanning $ 5 co
Radon $
Code Enforcement $
Total Fee Now Due $
(Continued on opposite side)
Training /Education Fee $
Miami Shores Village
Building Department
10050 N.E.2n91 Auenue Florida 33138
Tel: 305) 1D95,220 4 `63) 756.8972
Permit Fee $
Electrical
State
S 024 O1 L
N
Structural
AK' 2 Cti 9"
W,
County Miami -Dade
NO e/
aster Permit No.
Mechanical
P
Phone #
zip 33j38
Phone #
1 44, Ne lol STgeeT
ElAlteration ENew
cJ� vt) $F LO
(,-MC
Permit No. 9 l v : 12G.
Zip 3 &I 38
Contractor's Company Name S T A T E r► i .Dg S E pT'C Con► r.CT hone # ( 3o.0 66 I— 6 6 33
Z 5 302
Certificate of Competency No.
Phone #
Square Footage Of Work: ZOO
Repair /Replace
Roofing
❑ Demolition
* ** * * * *,r * * * * * * * * * * * * **1 2 * f **** * * * * ** * * * * * * * * * * * * * * * * * * * **
1 5 • CCF $ I , 20 CO /CC
4o Technology Fee $ � _ 37-
Zoning Bond $ .?"'00 • 00
Plan Review. $
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 l " Zip
Application is hereby made to obtain a permit to do the work and installations as indicated. 1 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: 1 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.
■
Signature (,�p
Signature
Contractor
The foregoing instrument was acknowledged before me this ICI The foregoing instrument was acknowledged before me this 20
day of Q . 20 by ta day of ''/l'l , 20 by SQ 1 V
who is personally known to me or who has produced 0. L; C who is personally kno n to me or who has produced si
dentification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
no 05/13/03
Owner or Agent
As identification and who did take an oath.
MY C:' MN':ISSION # DD250437
.1'
My Commis�'or� Fes:
OF N. EXPIRES: e ptember 16, 2007
* * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
APPLICATION APPROVED BY:
NOTARY PUBLI
i Sign:
FA 1.46161e140 Print:
My Co mission Expire i RondedThr'L
; 1►lanf is Bonding Co , In
* * * * * * * * ** *144 11e4 •* 4 * * ** *r *14,'v,i * * * * * * * * * * * * * *.. ********************* * * * *,r * * * * * * * * * * * * * * * * * * * * * * * **
************************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
Plans Examiner
Engineer
Zoning
Miami Shores Village
10050 NE 2nd Avenue
Phone: 305 - 795 -2204
Printed: 4/27/2005
Applicant: KAREN
Owner: PUMA
JOB ADDRESS: 46 NE 101 ST
Parcel # 1132060131360
Signed: (INSPECTOR)
Plumbing Permit
Permit Number: PL2005 -126
PUMA
KAREN
Page 1 of 1
Contractor STATEWIDE SEPTIC CONNECTIONS Contractor's Address: 3590 SOUTH STATE ROAD 7, SUITE 26
Local Phone: 305 - 661 -6633
Legal Description: 1 53 41 6 53 42 MIAMI SHORES SEC 1 AMD PB 10 -70 LOT 7 & E1/2 OF LOT 8 BLK
Fees: Description Amount
FEE2005 -5250 Building Fee $175.00
FEE2005 -5251 CCF $1.20
FEE2005 -5252 Notary Fee $5.00
FEE2005 -5253 Training and Education Fee $0.40
FEE2005 -5254 Technology Fee $4.37
FEE2005 -5255 Scanning Fee $3.00
FEE2005 -5256 Builders Bond $300.00
Total Fees: $488.97
Total Fees: $488.97
Total Receipts: $488.97
Permit Status: APPROVED Permit Expiration: 10/17/2005 Construction Value: $1,800.00
Work: NEW DRIANFIELD
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:
STATE OF FLORIDA
DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM
CONSTRUCTION PERMIT lin:
:ONSTRUCTION PERMIT FOR:
[ ]New System [ ]Existing System [
[ X ]Repair [ ]Abandonment
kPPLICANT: Puma, Lawrence 6 Karen
AGENT: 8A0021074, Solomon Teresa
? ROPERTY STREET ADDRESS: 46 NE 101 St Miami Shores FL 33138
LOT: 7 BLOCK: 10
PROPERTY ID #: 11- 3206 - 013 -1360
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 QHICH 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 Oft LOCAL PERMITTING REQUIRED FOR PROPERTY DEVELOPMENT.
SYSTEM DESIGN AND SPECIFICATIONS
T
A
N
D
R
A
I
N
F
I
E
L
D
SUBDIVISI)N: Miami Shores See N 1
[Section /Township /Range /Parcel No.]
[OR TAX ID NUMBER]
900 ]Gallons SEPTIC TANK
O ]Gallons
O ]GALLONS GREASE INTERCEPTOR CAPACITY
O ]GALLONS DOSING TANK CAPACITY [ 0 ]GALLONS
[ 200 ]SQUARE FEET PRIMARY DRAINFIELD SYSTEM
[ 0 ]SQUARE FEET SYSTEM
TYPE SYSTEM: [ ]STANDARD [ N ]FILLED
CONFIGURATION: [ N ]TRENCH [ •.. ' ] BED
LOCATION TO BENCHMARK: FFE: 12.6 Ft NGVD
ELEVATION OF PROPOSED SYSTEM SITE [ 2.0 ] [ FEET
BOTTOM OF DRAINFIELD TO BE [ 4.5 ] [ FEET
FILL REQUIRED:[ 0.0 ]INCHES EXCAVATION REQUIRED: [
OTHER REMARKS:
1. Install 900 sf of drainfield in bed configuration.
2. Existing 900 gal. septic tank has to remain.
3. Existing 900 gal. septic tank to be inspected for an appropriate pump -out and a solid
vertical deflector installed on the outlet device.
4. Invert elevation of drainfield to be no less than 8.60' NGVD.
5. Bottom of drainfield elevation to be no less than 8.10' NGVD.
THIS PERMIT I8 NOT FOR ADDITION(®).
SPECIFICATIONS BY: Andre, Pa ul
APPROVED BY: Andre, Paul
DATE ISSUED: 4/20/05
TITLE:
DH 4016, 03/97 (Obsoletes previous editions which may not be used)
(Stock Number: 5744- 001 - 4016 -0) [oetde cons_4046 -11
ZO 'd
Z800£96b96
CENTRAX #: 13- SG-24762
DATE PAID:
FEE PAID : $
RECEIPT
] [
l [
n�
TITLE: Professional Engin
OSTDSNBR : 05 -1349- -R
]Holding Tank [ ] Innovative Other
]Temporary [ NA ]
MULTI - CHAMBERED /IN SERIES: [Y ]
MULTI- CHAMBERED /IN SERIES: (Y ]
0 [ 0 ]DOSES PER 24 HRS # PUMPS( 0 ]
[ N ]MOUND ( N ]
[ N
BELOW]BENCHMARK /REFERENCE POINT
BELOW 1 BENCHMARK/REFERENCE POINT
30.0 ] INCHES
Dade
EXPIRATION DATE: 7/19/05
CHD
Page 1 of 2
SNOI1O3NNOO OI,LddS Wd z0;£0 5002- 8Z -Hdd
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
B lding l Inspection Request , �
5
Date
I
Type Insp' n T C , 0 5eP4CC
Permit No. P I O - 1 `4 O
Name
Porn ci .
Address 4(0 NE 101 5
Company c e u t c, Leo
Phone #
Inspection Date
Approved
Correction
Re- Insp'n Fee
17IO1h10
APPLICANT:
AGENT:
PROPERTY ADDRESS:
LOT: n BLOCK:
1
1
1
1
]
1
1
1
1
STATE OF FLORIDA
DEPARTMENT OF HEALTH
.ONBITE SEWAGE TREATM D 'DIPOS L SYSTEM
CONSTRUCTION INSPECTION AND FINAL
T
.��- rt ,te r.•=
- >.' >•::,: ... mama
CHECKED [X] ITEMS ARE NOT IN
a xssmas _� ITS STATUTE OR RULE AND MUST BE COMdECTEb .
xsa:�sxmsa>Qa>�
COMPLIANCE WITS
o���a = = ==sass == sue g gTgA css
[ 27 l SURFACE WATER
SIZE
[01] TANK [1122 [Z ] d . • ,
TANK INSTALLATION
[28] DITCHE8
[02) TANK MATERIAL 14SE -A 6'(fi, S'!. c. [ ] PRIVATE WELLS [03] OUTLET DEVICE Ok da -1 [ , r
[04] MULTI - CHAMBERED (
[05] OUTLET FILTER �.
[06] LEGEND
[07] WATERTIGHT
[08] LEVEL
[09] DEPTH TO LID
] [11] DISTRIBUTION BO
NUMBER OF DRAINLINSS
DRAINLINE SEPARATION
DRAINLINE SLOPE
DEPTH OF COVER [ABOVE/BELOW]
ELEVATION [ABU /
SYSTEM LOCATION
DOSING PUMPS
AGGREGATE SIZE j f)Of
AGGREGATE EXCESSIVE FINES
AGGREGATE DEPTH
FILL / EXCAVATION MATERIAL
[ ] [ 22] FILL AMOUNT l: ::
[ 1 [23] FILL TEXTURE
[ ] [24] EXCAVATION DEPTH
[ 1 [251 AREA REPLACED
EXPLANATION OF VIOLATIONS /
[ 1
[ 1
[ 1
[ 1
BM
rn
1
]
1
1
1
1
1
[29]
[30)
[31]
[32]
[33]
[34]
[35]
�r1
'DISAPPROVED]
CONSTRUCTION PPRY9V8R/
. ; � DISAPPROVED]
FINAL SYSTEM - VAPACATf}/ /
DH 4016, 10/97 (Previous Editions May Be Used)
r'r MMTP r:Tf R
PERI[IT NO.
DATE PAID:
Fat PAID:
RECEIPT 0t
PT t: Applicant
PT 2: lnstaIler/Contractor
PT 3: Building Department
PT 4: Health Department
FT
PUBLIC WELLS F , $
IRRIGATION WELLS FT
POTABLE WATER LINES !__�-____
BUILDING FOUNDATION ___:;__.__ FT FT
PROPERTY LINES 1[5
O FT '
THER
FILLED / mum
[ 3 ] DRAZNFIELD COYPR
'[.371 BBOULU$RS -..
[38] SLOPES
[39] STABILIZATION
ADDITIONAL INFORMATION
[40] UNOBSTRUCTED AREA
[41] STORMWATER RUNOFF
[42] ALARMS AGREEMENT
[43) MAINTENANCE
[44] BUILDING AREA
[45) LOCATION CONFORMS WITH SITE PLAN
46] FINAL-SITE GUmR¢ ff r'
[47] CONTRACTOR -"'� t '
[48] OTHER •
AB ANDOmmiNT
/
FT
FT
FT
DATES ' 0 t' -N
DATE: t/ 1 -0 i
P 2 of 3
Amount of Permit $
Size Septic Tank._
_ --
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 Ls 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 wo
Owner's Name and Address ,.l
Registered Architect and /or
Employing Plato,' _ -
Location and Legal Descrip . n Lot.
Street and Number where work is to be performed —No
State work to be performed and purpose of building (By Floors)_____
STATE OF FLORIDA, 1
COUNTY OF DADE.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
.Type of Tank -
(Signed)
No.
Dis
Feet of Drain Tile_ t. Feet of Tank or Drain Field from Well.
Nature of Water Supply: City—Well. Size of Soakage Pit
(Signed) .. (.I2 •
Subdivlaton. —.__ �
!G� Street. -.
New Building.__ -- __ _._ _.. Remodeling__ - - - - ._ Addition.- .___._ : Repairs No. of Stories.
Capacity Gals
Street . /' _ E / 0 /
lumbing Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligati a as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Pennanen - upplement, 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 Rerformed 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. an - d that - a t a s
therein by him stated are true. at all ll facts
My Commission Expires Notary Public, State of Florida
materials
NOTE: Axrelrozkmctio fee of $1.00 will be made when such re inspection L made'neoessary by improper notice for inspection, or faulty
CLOSETS
BATH
TUBE
SHOWERS
LAVA.
TORIES
SINK6
SLOP
SINK/
LAUNDRY
TUBE
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT'NB
TOTAL
FIXTURES
CONTR.
LIST
CHECK
---
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SWING
POOL
CONTR.
LIST
CHECK
Amount of Permit $
Size Septic Tank._
_ --
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 Ls 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 wo
Owner's Name and Address ,.l
Registered Architect and /or
Employing Plato,' _ -
Location and Legal Descrip . n Lot.
Street and Number where work is to be performed —No
State work to be performed and purpose of building (By Floors)_____
STATE OF FLORIDA, 1
COUNTY OF DADE.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
.Type of Tank -
(Signed)
No.
Dis
Feet of Drain Tile_ t. Feet of Tank or Drain Field from Well.
Nature of Water Supply: City—Well. Size of Soakage Pit
(Signed) .. (.I2 •
Subdivlaton. —.__ �
!G� Street. -.
New Building.__ -- __ _._ _.. Remodeling__ - - - - ._ Addition.- .___._ : Repairs No. of Stories.
Capacity Gals
Street . /' _ E / 0 /
lumbing Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligati a as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Pennanen - upplement, 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 Rerformed 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. an - d that - a t a s
therein by him stated are true. at all ll facts
My Commission Expires Notary Public, State of Florida
materials
NOTE: Axrelrozkmctio fee of $1.00 will be made when such re inspection L made'neoessary by improper notice for inspection, or faulty
New Building -- Remodeling
Size Septic 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 $_
STATE OF FLORIDA, I
COUNTY OF DADE.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
- - -- - - - - -- -Type of Tank - - - - -- - -- -
-sue -- - --- - - - - -- ---- -__._- - - - -- .
(Signed)_
( Signed -_..
Date /
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 th? 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 _ - No. 1 ('‘_ Street
Registered Architect and /or Engineer __. _ . -_— — �.
Employing Plumber's Name
Location and Legal Description Lot__---_..__ ___________ Block_._ Subdivision.
Street and Number where work is to be performed —No Street _ . _.. _ -- -- - -- -•- -- - - _.._.
State work to be performed and purpose of building (By Floors)_. _ . N c E _ _ 7 S 7E�z
No. Street.___ _ _
Addition-___ - _.__- ___ -.___ Repairs_ __... _ . _ ___ No. of Stories -
Capacity Gals.
Plumbing In.pecto.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his gations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be
performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or no'ices as are
required by the Act. The undersigned agrees to employ only such sub- contractors, on work to be perfo::cted under this per nit, as are
licensed by Miami Shores Village.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personall 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 .acts
therein by him stated are true.
My Commission Expires Notary Public, State of Florida
Master Plumber. -
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
OW
SHOWERS
LAVA.
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TUBS
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT'NS
TOTAL
FIXTURES
Comm.
LIST
_ T-
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SWIM'O
POOL
CONTR.
/
t LIST
1../
--
CHECK
-
-
p
7..;--
7 a.
-
-
_ .
New Building -- Remodeling
Size Septic 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 $_
STATE OF FLORIDA, I
COUNTY OF DADE.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
- - -- - - - - -- -Type of Tank - - - - -- - -- -
-sue -- - --- - - - - -- ---- -__._- - - - -- .
(Signed)_
( Signed -_..
Date /
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 th? 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 _ - No. 1 ('‘_ Street
Registered Architect and /or Engineer __. _ . -_— — �.
Employing Plumber's Name
Location and Legal Description Lot__---_..__ ___________ Block_._ Subdivision.
Street and Number where work is to be performed —No Street _ . _.. _ -- -- - -- -•- -- - - _.._.
State work to be performed and purpose of building (By Floors)_. _ . N c E _ _ 7 S 7E�z
No. Street.___ _ _
Addition-___ - _.__- ___ -.___ Repairs_ __... _ . _ ___ No. of Stories -
Capacity Gals.
Plumbing In.pecto.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his gations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has com-
plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be
performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or no'ices as are
required by the Act. The undersigned agrees to employ only such sub- contractors, on work to be perfo::cted under this per nit, as are
licensed by Miami Shores Village.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personall 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 .acts
therein by him stated are true.
My Commission Expires Notary Public, State of Florida
Master Plumber. -
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made• necessary by improper notice for inspection, or faulty
materials and /or workmanship.
BUILDING p MIAMI SHORES VILLAGE, FLORIDA
ELECTRICAL ❑ Date 3
PLUMBING ii PERMIT N? 10494 Contractor's
0
ROOFING ❑ License No
Owner of
Building
Lc .
Architect
Contractor
or Builder (,) W i4 r tL
Legal Lot
Description Bl
Address of 1.
Building
This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the applica-
tion herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any
plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked
at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further cor' Lion upon which this
permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge -••.nces and
regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and t
sibility for work done by his agents, servants or employhes.
Signed t ' / L &$L(INSPECTOR) BY
In consideration of the issuance to me of this permit I ak ee to perform the work covered hereunder in compliance with all of
pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of
In accepting this permit I assume responsibility for all work °dine by either, myself, my agent, servant or employee.
',% . els
CONTRACTOR or 'BUILDER BY AUT
❑ Work to be performed under this Permit
,
'7 c
Subdi-
vision
Sq. Ft.
Value of
Project
0
Gam
I Amount of
II Permit $
Y
BUILDING
ELECTRICAL
PLUMB!
MIAMI SHORES VILLAGE, FLORIDA —
DATE �- / c 194
ERMIT N° 6178
k to be performed under this Permi
Owner of
Building
Architect
Contractors`
or Build(r
Legal Lot
Description
Address of
- Building
This perm' is gran ed to the contractor or builder named above to \ onstruct the building or to install the equipment or d•vice described in the appli-
cation 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 responsib' ity for a`thorough knowledge of "ordinances and
regulations pertaining to the work covered hereby whether shown on the plans or drawing or °st•tement or specif ations and tha " e.ass respon-
sibility for work done by his agents, servants or employees.
Signed.
Subdi-
vision
Contractor's
License No.
By
/6' CY
INSP CT
In consideration of the issuance to me of this permit I agree to perform the work covered hereund in comp . ante with Ardinances and,regglatlions
i rtaining thereto and in strict conformity with the plans, drawings, statements or specifications submi ed to the proper author tics of Miami ShoFes Wige.
Incep this permit I assume res onsibility for all work done by either myself, my agent-servant or employee.
f ! ( s j t
�tl i� f J- i . .; � L' J
CONrI CTOR R``R ILE•E12"::." L ! i .
r° anE /
AUTHORITY
Permit No •
MIAMI SHORES- VILLAGE.
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
ACME SEPTIC TANK CO.
P. O. BOX 1000
HIALEAH. FLORIDA
Z , ,? e '
Date � •
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 1.:1__C -h"r / 0 No r O Street / 0 / 4
Registered Architect and /or Engineer
Employing Plumber's Name No Street
Location and Legal Description Lot Block �I Subdivision
Street and Number where work is to be performed —No � ° n ' £ ' Street /
State work to be performed and purpose of building (By Floors
New Building Remodeling Addition Repairs No. of Stories
t Type of Tank. Capacity Gals
J Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City —Well Size of Soakage Pit
Size Septic Tank
Feet of Drain Tile
STATE OF FLORIDA, 1
COUNTY OF DADE.
ss.
Amount of Permit $ (Signed)
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 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.
(Signed)
7 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.
My Commission Expires Notary Public, State of Florida
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty
materials and /or workmanship.
CLOSETS
BATH
TUBS
SHOWERS
LAVA-
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TUBS
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT'NS
TOTAL
FIXTURES
CONTR.
LIST
•
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
H EATER
DEEP
WELL
SPRKLR.
SYSTEM
SWIM'G
POOL
CONTR.
LIST
CHECK
Permit No •
MIAMI SHORES- VILLAGE.
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
ACME SEPTIC TANK CO.
P. O. BOX 1000
HIALEAH. FLORIDA
Z , ,? e '
Date � •
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 1.:1__C -h"r / 0 No r O Street / 0 / 4
Registered Architect and /or Engineer
Employing Plumber's Name No Street
Location and Legal Description Lot Block �I Subdivision
Street and Number where work is to be performed —No � ° n ' £ ' Street /
State work to be performed and purpose of building (By Floors
New Building Remodeling Addition Repairs No. of Stories
t Type of Tank. Capacity Gals
J Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City —Well Size of Soakage Pit
Size Septic Tank
Feet of Drain Tile
STATE OF FLORIDA, 1
COUNTY OF DADE.
ss.
Amount of Permit $ (Signed)
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 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.
(Signed)
7 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.
My Commission Expires Notary Public, State of Florida
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty
materials and /or workmanship.