PLUMBING PERMITOWNERS
construct
Signa
PERMIT APPLLICATION FOR MIAMI SHORES VILLAGE
1 - i' ' tot Date Job Address 9I r
/'� 4 Tax Folio
Legal Description
Owner/Lessee / Tenant . ....
2.A+ --3 Si hA4 a Master Permit #
Owner's Address Leii isi6. ten S-f-" f Phone
Contracting Co. ,u1 C S J e opt- t) (°.,e,) Address 14q 3 Z ,./ a - Z 1.40 •
5=fed/ 6. �4/4
Qualifier
State # Municipal #
Architect/Engineer
Bonding Company
Mortgagor Address
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
/ de) 794,t—e..,
WORK DESCRIPTION
Square Ft. /( .
WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY RESULT IN YOUR
PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY OF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER
OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.)
Application is hereby made to obtain a permit to do work and installation as indicated above, and on the attached addendum (if applicable). I certify that all work
will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits are required for ELECTRICAL
PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK.
AVIT: I certify
oning. Furth
President
3
ate
c....- C. 3/Z 3ljf J'
Notary as to Owner and/or Condo President ! D a� f te
My Commissiongsvw'.:°�'ti:
STEPHEN E COCKING
State of Florida
My Comm. Exp: O 04101
Comm#: CC868180
APPROVED:
Zoning
Mechanical
C.C.F.
Historically Designated: Yes No
Phone 3 °C' 1 -721
Competency # Ins. Co.
Address
Address
kitILJ
Estimated Cost (value) / OT's
the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
auth e the above -named contractor to do the work stated.
Signature of C Date
Notary as • Contracto
My ssion Expir
NOTARY J BOND 3
TOTAL DUE
Electrical
Structural Engineer
CON�TRIICTION PERMIT FOR:
New System [ Existing System
Repair Abandonment
Li
APPLICANT•:
PROPERTY ADDRESS:
GALLONS DOSING TANK CAPACITY [
D [ /S I) ] SQUARE FEET PRIMARY DRAINFIELD SYSTEM
R [ ] SQUARE FEET
A TYPE SYSTEM: [ STANARD
I CONFIGURATION: ] TRENCH [1 BED
N A
F LOCATION OF BENCHMARK: er14'
I ELEVATION OF PROPOSED SYSTEM SITE [10 [
E BOTTOM OF DRAINFIELD TO BE
D FI L REQUIRED: [ 440'] INCHES
•
T ��
H 1 1111 � 1WMIT IWAW NIB/AIR .
SPECIFICATION
APPROVED BY:
DATE ISSUED: q 1 t
DH 4016, 12/99 (Page 1)
STATE OF FLORIDA
DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM
CONSTRUCTION PERMIT
[2 .8]
r
lding Tank
[ Temporary
1 GALLONS @ [
!—
A o a
ES/ [ABOVE/
S /FT] [ABOVE/
EXCAVATION REQUIRED: [ . j ] IN
TITLE:
EXPIRATION DATE:
(Previ.us Editions av II ed e •
"��'' V e. °,
� ? A r l a l� �fIFa19M°
w nJ���la�7 �' � r Z• r` � �P� 11��
n,9 � ` n��U 41V,� pt, 3: ns Applicant
aller /Contractor
pt 4: Building Departme
PERMIT NO. O A. 5
DATE PAID:
FEE PAID:
RECEIPT #:
Innovative
Al 1 ) 6 1 C) / tgrAtTer
w
LOT: 2 BLOCK: / SUBDIVISION :'
[SECTION, TOWNSHIP, RANGE, PARCEL NUMBER]
PROPERTY ID #: _ 9 - 3 04 -017- £ c ,N [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.
SYSTEM DESIGN AND SPEC J�FICA II
i t 'y
T [ ] GALLOSPD 'i'' /AEROBIC UNIT CAPACITY MULTI- CHAMBERED /IN- SERIES [ ]
A [� ] GALLONS / GPD CAPACITY MULTI- CHAMBERED /IN- SERIES [ ]
N [ 1 GALLONS GREASE INTERCEPTOR CAPACITY [MAXIMUM CAPACITY SINGLE TANK: 1250 GALLONS]
K [ ]
] DOSES PER 24 HRS # PUMPS [ ]
SYSTEM ` �
[ "'FILLED [ I1U MOUND [4,4)
J i0 7 w CCI
BENCFIItARR /REFERENCE POINT ,
BENCHMARK /REFERENCE POINT
l•
BY:
AVIL/ jialaW)
C O D U M
TITLE:
Page 1 of 3
INSTRUCTIONS:
PERMIT NUMBER: Permit tracking number assigned by CPHU.
CONSTRUCTION
PERMIT FOR: Check type of permit, if "Other" specify type in blank.
APPLICANT: Property owner's full name.
SYSTEM DESIGN AND
SPECIFICATIONS:
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 64E -6, 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.
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Site Plan Submitted by:
By
STATE OF FLORIDA
DEPARTMENT OF HEALTH AND REHABILITATIVE SERVICES 6' c,
APPLICATION FOR ONSITE SEWAGE DISPOSAL SYSTEM CONSTRUCTION PERMIT'
1 1 I Permit Application Number
it
4
I
ats-14/1
Plan Approved y Not Approved
HRS -H Form 4015, Feb 85 (Obsoletes previous editions which may not be used)
(Stock Number: 5744-002-4015-6)
PART II - SITE PLAN
4 je- . i tirv.
SIGNATURE
erp, Af
ALL CHANGES MUST E4APPROVED BY THE COUNTY PUBLIC HEALTH UNIT
e3
TITfA �'
G ' ,
Date 3[
County Public Unit
Page 2 of 3
PERMIT APPLICATION FOR MUNICIPALITIES OF DADE COUNTY
(OWNER TO RETAIN COPY)
Job Address
Legal
7 / mr /d/ s'S�
Description hf 4'F ? a ` e nt ij 9/ MJbv L(
tic PAVE
Owner / Lessee / Tenant
Owner's Address
pri
Al / 4 Qe1 -°O7ic
.0 Yet
Contracting Co. :
Qualifier ,j64114) . M1EKS
State #
Oil 7 TS
Architect /Engineer
Bonding Company
Mortgagor
/v i gs
AAOIL-
IAN
Competency #
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL PAVING FENCE SIGN
WORK DESCRIPTION eLA �/ �1 /ti 1N�1T['� t-� ��/ ' AS Ren"ily f K `o 4 ;
A- 2 gocL Rost c4ence.
0 /3 )3, zc
Square Ft. Estimated Costifrimol. $ Mel
WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO
DO SO MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU
INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE
RECORDING YOUR NOTICE OF COMMENCEMENT).
Application is hereby made to obtain a permit to do work and installation as indicated. I certify
that all work will be performed to meet the standards of all laws regulating construction in this
jurisdiction. I understand that separate permits are required for ELECTRICAL, PLUMBING, SIGNS,
POOLS, ROOFING, and MECHANICAL work.
OWNER'S AFFIDAVIT: I 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.
Furthermore, I authorize the above -named contractor to do the rk stated.
i° %19/
�Ih
o
No ry s to Owner and /or
My Commission Expires: d/ /6
*
PERMIT FEE: APPROVED:
Zoning
Mechanical
Fire
Building
Plumbing
SRS
Address
2A
Address
Address
Address
Tax Folio // 8g /I eleese0
Master Permit # o ��
phone
phone
Electrical
2 A=4 14%
7.S -iv "d
Ins . Co * 7y /''tV 7frA L •
Signature of Owner and `glr Cara Win= g ture of Contrac • -r Owner- Builder
Date: Dat :
Notary as /to Contractor or Owner - Builder.
My Commission ExpireNi ARY PJJBLIC STATE _OF FLORIbA
* * * NY *ONNISSIONkEXP. MAR *1,1992 *
BONDED THRU GENERAL INS. UND.
Other
g' J ngineering
Permit No ............ 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 ... __ _�A/ ____ No.__— _____— _____.__ Street_
Registered Architect and /or Engii6b3_S�-:. .__ , HIV CO.... IN
ew
- — -- I - - - - - --
Employing Plumber's Name A1.23 E 23rd ST., HIALEM No._._...____ __._ Street_.
Location and Legal Description Lot Block __________.___.. Subdivision ------ :_---__-_ __ _.
Street and Number where work is to be performed —No y 7L 1 �G / Street_
State work to be performed and purpose of building (By Floors)- ____ ......... _ _______ ...... _ ...... _
New Building ___ Remodeling____.__ —__ Addition__._ -_.__ Repairs No. of Stories.
Amount of Permit $
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING
Type of Tank__ Capacity Gals
Size Septic Tank .......
____ -_•-
Feet of Drain Tile__ia 84 -1 -Dist. Feet of Tank or Drain Field from Well_
Nature of Water Supply: City —Well Size of Soakage Pit
(Signed) _ _.
(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 t}ie 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, t as.
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.
—� �- 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.
CLOUTS
BATH
TUBS
S
LAVA-
TORIES
SINSIN
SLOP
SINK!
LAUNDRY
Tues
I N AL !
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT' NS
TOTAL
FIXTURES
CONTR.
LIST
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SW 114'0
POOL
CONTR.
LIST
CHECK
Permit No ............ 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 ... __ _�A/ ____ No.__— _____— _____.__ Street_
Registered Architect and /or Engii6b3_S�-:. .__ , HIV CO.... IN
ew
- — -- I - - - - - --
Employing Plumber's Name A1.23 E 23rd ST., HIALEM No._._...____ __._ Street_.
Location and Legal Description Lot Block __________.___.. Subdivision ------ :_---__-_ __ _.
Street and Number where work is to be performed —No y 7L 1 �G / Street_
State work to be performed and purpose of building (By Floors)- ____ ......... _ _______ ...... _ ...... _
New Building ___ Remodeling____.__ —__ Addition__._ -_.__ Repairs No. of Stories.
Amount of Permit $
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING
Type of Tank__ Capacity Gals
Size Septic Tank .......
____ -_•-
Feet of Drain Tile__ia 84 -1 -Dist. Feet of Tank or Drain Field from Well_
Nature of Water Supply: City —Well Size of Soakage Pit
(Signed) _ _.
(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 t}ie 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, t as.
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.
—� �- 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
ELECTRICAL
PLUMBING
ROOFING
Owner of
R
Building `.
Address of
Building
4 "/ I r.r
CONTRACTOR OR BUILDER
MIAMI SHORES VILLAGE. FLORIDA
DATR ' 195 C
Contractor's
License No
❑
PERMIT N? 6799
0
i
Architect
Contractor
or Builder
Legal Lot
Description
Work to be performed under this Permit
Bl.
Subdi-
vision
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 cr in th statements or specifications and th61 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 r - reunder in compliance with all ordinances and regulations
pertaining thereto and in strict conformity with the plans, drawings, statements or specifications su itted to the proper authorities of Miami Shores Village. In ac•
cepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee.
BY
/
/r 2
Value of
Project $
t
Amount of ! "
Permit $
AUTHORITY
6 ` '
Permit No
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. r� �
•
Owner's Name and AddressJ__ - / 3 - ' • No. ! 1 ' e ' Street / /
Registered Architect and /or Engineer
No /cf.? f2t// Street__ - D2
C
Amount of Permit $ Tom
•
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
■
Employing Plumber's Name 49,
Location and Legal Description Lot____ _ Block Subdivision
Street and Number where work is to be performed —No. 7/ /!' • Street / /-11
State work 'to be performed and purpose of building (By Floors)
New Building Remodeling Addition Repairs No. of Stories
Dist. Feet of Tank or Drain Field from Well
_ (Sig edr
(Signed)
un
Date___ / O /
My Commission Expires Notary Public, State of Florida
Size Septic Tank Type of Tank Capacity Gals
Feet of Drain Tile.__
Nature of Water Supply: City—Well . /r 7 Size of Soakage Pit
11�
- w -
P . robing Insp tor.
The undersigned applicant for this building permit does hereby certify that he un.erstands 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 perf med under this permit, as are
licensed by Miami Shores Village.
Master Plumber.
STATE OF FLORIDA, }
ss.
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the
of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty
materials and /or workmanship.
CLOSETS
BATH
TUBS
SHOWERS
LAVA-
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TUBS
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUN7 NS
'I
TOTAL
FIXTURES
CONTR.
LIST
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
H EATER
DEEP
WELL
SPRKLR.
SYSTEM
SW IM'G
POOL
CONTR.
LIST
CHECK
Permit No
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. r� �
•
Owner's Name and AddressJ__ - / 3 - ' • No. ! 1 ' e ' Street / /
Registered Architect and /or Engineer
No /cf.? f2t// Street__ - D2
C
Amount of Permit $ Tom
•
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
■
Employing Plumber's Name 49,
Location and Legal Description Lot____ _ Block Subdivision
Street and Number where work is to be performed —No. 7/ /!' • Street / /-11
State work 'to be performed and purpose of building (By Floors)
New Building Remodeling Addition Repairs No. of Stories
Dist. Feet of Tank or Drain Field from Well
_ (Sig edr
(Signed)
un
Date___ / O /
My Commission Expires Notary Public, State of Florida
Size Septic Tank Type of Tank Capacity Gals
Feet of Drain Tile.__
Nature of Water Supply: City—Well . /r 7 Size of Soakage Pit
11�
- w -
P . robing Insp tor.
The undersigned applicant for this building permit does hereby certify that he un.erstands 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 perf med under this permit, as are
licensed by Miami Shores Village.
Master Plumber.
STATE OF FLORIDA, }
ss.
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.
monsir
BUILDING
• ELECTRICAL
PLUMBING
ROOFING
Owner of
Building
MIAMI SHORES: VILLAGE, FLORIDA
DATE
PERMIT Ill 11053
ork o be performed under this Permi
Il
Architect
Contractor
br Builder
Legal
Description.
Address of
$ixlding
i
:' T permit i ranted the cont or or .udder namedTabo to c struct the buildi tarter
herefor in strict compliance a3ith all ordinances pertaining thereto an . a understa .. g that
drawings, statements or specifications that may have been submitted to and • .pro ed'b
time if the, work is not done in compliance with such ordinances or if the plan: are cha
granted is.therunderstanding that the contractor or builder named above assu es the
pertaining the work covered hereby whether shown on the plans or drawin:..r in
done by lais agents, servants or employees. _ _
Signed:
i In consideration of the issuance to me othislrermit I agree to perfo
pertaining thereto and in strict conform ty�dvith the plans, d wings, statement
In accepting this permit I assume responsibility for all done by either,
LDER . BY
C ontractor s
c = nse No
41 M - "itief ar
Value o Amt. o
Project "°$' Permit
11 the equipment or device des .+ 'bed in plication
ork will be performed in compliance with a plans,
e prc er unicipal authorities. This Permit may be revoked any
. rithrmt authorization. A further condition upon which this permit.is
esponsibility for a thorough knowledge o the ordinances and regulations
he statements or specifications and tha J assumes responsibility for work
IN:+
the wdrk' covered hereunder in compliance with all ordinances regul
or specifications submitted to the proper authorities of Mia
yself, my agent, servant or employee.
AUTHORITY -
hores Vil ge.
Permit No 9 J
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 9 ' (3. 9/ r'�'4 No 7/ C , Street__
Registered Architect and /or Engineer / / h � /
Employing Plumber's Name__GY_2 / ��II4 4.t� '�' A No / 3 3 dP w Street 4 .9.- 44- '
Location and Legal Description Lot Block Subdivision
Street and Number where work is to be performed —No. '/ 7 / 77 ` Street 1 /
State work to be performed and purpose of building (By Floors)
New Building Remodeling Addition Repairs No. of Stories
��. f wSiize Septic Tank Type of Tank Capacity Gals
beet of Drain Tile__ _1 / t Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City —Well. Size of Soakage Pit
Amount of Permit $_
/ o� lumbing Inspector.
The undersigned applicant for this building permit does hereby certify that h und: stands and accepts his obligifis as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled l ene :1 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.
STATE OF FLORIDA,
ss.
COUNTY OF DADE.
Before me, the undersigned authority, a notary pull
to me well known, and who, being by me first duly swot
of the above described construction, that he has carel
therein by Him stated are true.
My Commission Expires
NOTE: A re- inspection fee of $1.00 will be made
materials and /or workmanship.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
9JJA
Company
Job
Address
Inspection
Time Ready
Date Z / /l — !'r
REQUEST FOR INSPECTIO
PHONE
-" 7/ 1,1
CLOSETS
BATH
TUBS
SHOWERS
LAVA-
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TUBS
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOU NT' 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
Permit No 9 J
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 9 ' (3. 9/ r'�'4 No 7/ C , Street__
Registered Architect and /or Engineer / / h � /
Employing Plumber's Name__GY_2 / ��II4 4.t� '�' A No / 3 3 dP w Street 4 .9.- 44- '
Location and Legal Description Lot Block Subdivision
Street and Number where work is to be performed —No. '/ 7 / 77 ` Street 1 /
State work to be performed and purpose of building (By Floors)
New Building Remodeling Addition Repairs No. of Stories
��. f wSiize Septic Tank Type of Tank Capacity Gals
beet of Drain Tile__ _1 / t Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City —Well. Size of Soakage Pit
Amount of Permit $_
/ o� lumbing Inspector.
The undersigned applicant for this building permit does hereby certify that h und: stands and accepts his obligifis as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled l ene :1 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.
STATE OF FLORIDA,
ss.
COUNTY OF DADE.
Before me, the undersigned authority, a notary pull
to me well known, and who, being by me first duly swot
of the above described construction, that he has carel
therein by Him stated are true.
My Commission Expires
NOTE: A re- inspection fee of $1.00 will be made
materials and /or workmanship.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
9JJA
Company
Job
Address
Inspection
Time Ready
Date Z / /l — !'r
REQUEST FOR INSPECTIO
PHONE
-" 7/ 1,1
ijj °
MA J
c • 16 msta 1 e:siktipment or ctmaitekitscrthed in the w
a
e w* w opp:ca,t,tlanio:
o#lt la 0 erformett b. , t krate ith . ps,
040t 0- 0 et
Thi be t any
a a .,•‘„
;`,:'• z,
'1 • • + T ..7•1
af a 1
Mt, tate he 4Siti resp
f0- 0 0
hoteonder in compliame ty
at OteitiCagt* slit sitted to the ptiver math
' ',.' ' a-Volt nal" afgetoti servasat or employee.
, .
••■
p
1
AUTHOR-IT
BUILDING
ELECTRICAL
PLUMBING
Owner of
Building
1► Work to be performed under this Permi
MIAMI SHORES VILLAGE, FLORIDA
DATE • '� 194
ERMIT N° 4572 r C Liontractcense No or's / f�
er+:e
S
Architect
Contractor
or Builder
Legal: Lot
Description
Address of - ,rr /PI r Value of • Amt. of
Building / ' " !! Project I Permit
This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the 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 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 st ements or specifications and that he assumes respon-
( By 4 .
INSPECTOR •
In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with Sllpedinances and *gitiallibns1
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 respq tiii y for a work done by either myself, my agent, servant or employee.
am' rS
r44
Bl.
sibility for work done by his agents, servants or employees.
Signed.
CONTRACTOR OR BUILDER
Subdi-
vision
BY AUTHORITY,
Architect
Contractor
or Builder
BUILDING,
ELECTRICAL
PLUMBING
Owner of
Building
Legal Lot I
Description
Address of Value of Amt. of
Building \4 4 1'j`'' '" Project '+ Permit /
This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device de in th ° a .pli-
cation herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance Any
plans, drawings, statements or specifications that may have been submitted to and approved by' the proper municipal authorities. This Per pit 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 sta�ments or specifications and that `he assumes respon-
sibility for work dole by his agents, servants or employees.
I Signed. L0 - , By !
INSPECTOR
CONTRACTOR
s
MIAMI SHORES VILLAGE, FLORIDA
DATE f I
ERMIT NO % ' 4572
Work to be performed under this Permi
B1.
R BUILDER
In consideration o the issuance to me of this permit 1. 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 Shore Village.
In acceptin_ this permit I assume respo? for all work done by either myself, my agent, servant or employee.
Subdi-
vision'
BY
Contractor's
License No
AUTHORITY
1941
e •
Permit No. g/!
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 to 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.
O■ner's Name and Address C=y No
Registered Architect and /or En ' eer
y C6 sal J tvc ... S _ .
>tn�p l'1
!� �ti�a1
�!✓ / '/ � 6
r-
L.ocatfbrand gal Descri don Lot ` - d' `
Subdivision 14 f.,21,241.6'
Street and Number where work L to be performed —No Y 7l � � Street. /0 �
State work to be ormed and of buildin (By Floor /a� /� 041 (-L9-7-6-1(- 11-TG'yC
I� purpose 6 Y )- - �IQ.Cdr_ - �-- - --- - --
New Building. .__. _ ___._._.........__. Remodeling__. _ __ Addition..._--___.-- __..... Repairs No. of Stories
Size Septic Tank__
Feet of Drain Tile
Nature of Water Supply: City —Wells __________
Amount of Permit $
STATE OF FLORIDA,
COUNTY OF DADE. B&
to me well known, and who, being by me first duly sworn, upon oath deposes and says
of the above described construction, that he has carefully read the foregoing appli
therein by him stated are true.
MY C NOTARY PygL RIDA
01iNIs9 Firi�uK
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Type Tank—__ ----.--.. ....._._.__._._....._....__ - -.0
_Dist. Feet of Tank or Drain Field from Well. .._.___ Size of Soakage Pit
(Signed
(Signed)
e
3
that Le
Date..._.. 4
9q
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 5988, Compiled General Laws of Florida Permanent Supplement, and bay cam.
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 far inspection on the site of the work such public notice or notices es cur
required by the Act.. The undersigned agrees to employ only such sub -con . noon. work to be performed under this permit, as are
licensed by Miami Shores Village.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
tiTDS Lr% Zr////t
Notary Pu . of Florida
Master Plumber. -
and that all facts
BONDED THRU GENERAL INS.
NOTE: A re- inspection fee of $1.00 will made when snob re-laspeotfas Y enade'e,oaewry by improper notice for inspection, or fault,
materials and /or workmanship.
CLOSETS
BATH
TUBS
aNOW[Ra
LAVA•
TORIES
/INK•
SLOP
SINK[
LAUNORT
TuvS
UR INAL/
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT'N/
TOTAL
FIATURt•
CONTR.
LIST
CHICK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
60AKAOt
PIT
G
TRAP
SOLAR
MEATIER
D[[1+
WILL
SPRKLR.
S M
SWIM'o
POOL
CoHTR.
LIST
CN[CK
1
Permit No. g/!
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 to 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.
O■ner's Name and Address C=y No
Registered Architect and /or En ' eer
y C6 sal J tvc ... S _ .
>tn�p l'1
!� �ti�a1
�!✓ / '/ � 6
r-
L.ocatfbrand gal Descri don Lot ` - d' `
Subdivision 14 f.,21,241.6'
Street and Number where work L to be performed —No Y 7l � � Street. /0 �
State work to be ormed and of buildin (By Floor /a� /� 041 (-L9-7-6-1(- 11-TG'yC
I� purpose 6 Y )- - �IQ.Cdr_ - �-- - --- - --
New Building. .__. _ ___._._.........__. Remodeling__. _ __ Addition..._--___.-- __..... Repairs No. of Stories
Size Septic Tank__
Feet of Drain Tile
Nature of Water Supply: City —Wells __________
Amount of Permit $
STATE OF FLORIDA,
COUNTY OF DADE. B&
to me well known, and who, being by me first duly sworn, upon oath deposes and says
of the above described construction, that he has carefully read the foregoing appli
therein by him stated are true.
MY C NOTARY PygL RIDA
01iNIs9 Firi�uK
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Type Tank—__ ----.--.. ....._._.__._._....._....__ - -.0
_Dist. Feet of Tank or Drain Field from Well. .._.___ Size of Soakage Pit
(Signed
(Signed)
e
3
that Le
Date..._.. 4
9q
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 5988, Compiled General Laws of Florida Permanent Supplement, and bay cam.
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 far inspection on the site of the work such public notice or notices es cur
required by the Act.. The undersigned agrees to employ only such sub -con . noon. work to be performed under this permit, as are
licensed by Miami Shores Village.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
tiTDS Lr% Zr////t
Notary Pu . of Florida
Master Plumber. -
and that all facts
BONDED THRU GENERAL INS.
NOTE: A re- inspection fee of $1.00 will made when snob re-laspeotfas Y enade'e,oaewry by improper notice for inspection, or fault,
materials and /or workmanship.