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53 NE 101 St (11)Type Insp'n Inspection Date Approved Correction Re-Insp'n Fee MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date Fi x'10 15.P P i Permit No. 21 £D _ 6 Name COO-0 r Address 5 3 N ^ IC I 54 Company L f n v uo I Phone # MIAMI SHORES VILLA BUILDING DEPARTME 305- 795 -2204 Buil¢ingInspection Request Date l 0 `4 Type Insp'n Permit No. Name ei1.(/,t..4,2— Address 3 /) ) Di „QA Company (.(f Ij G)UCC -U 1.9(°v n (01 Phone # 7 S — MA! 11!, Inspection Date Approved Correction Re- Insp'n Fee a MIAMI SHOR VILLAGE BUILDING DEPART ENT 305- 795 -2204 Building Inspection Reques Date a O(-) f Top no)-- oct Type Insp'n Permit No. 2 1 Name 5y) lynC ' Address 4 1 q t 01 Company Phone #V U UO /� �V IQ Inspection Date Approved Correction Re- Insp'n Fee .(mil j A A BUILDING PERMIT APPLICATIO FBC 2001 Permit Type (circle): Building Owner's Name (Fee Simple Titleholder) Owner's Address .J o AI E col City c ` State Tenant/Lessee Name Job Address (where the work is being done) City Miami Shores Village Is Building Historically Designated YES Contractor's Company Name f UQ (7 t ft Phone # •Yi0 trt —1 7/ft� Contractor's Address 7 q g 9 /VU/ 6 � City Qualifier, Type of Work: Describe Work: Total Fee Now Due $ (Continued on opposite side) Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Electri cal / NO State �L /Veraa 05) 756.8972 Plumbin Master Permit No. Phone # /UE /0/ j County Miami -Dade Architect/Engineer's Name (if applicable) Phone # $ Value of Work For this Permit /,000. ❑Addition ❑Alteration 00 .Vc.to-re // Mechanical Roofing c./ There . eaeta)7//56 Phone # dm; V.Pred) / • Zip 3 6 6 .24/ %rliiro New e fi Submittal Fee $ Permit Fee $ J 7 Notary $ Training/Education Fee $ D Code Enforcement $ Structural Plan Review. $ [r Repair bra /le) Y 6� Permit No. ?L2oo1 -- /SS Square Footage Of Work: OD * * * * * * * * * * * * * * * * * * * * * * * * * * ** F ees * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** is rni Zip Scanning $ Radon $ Zoning Bond Zip 80-/ CCF$ , b V Technology Fee $ ep1a7 ❑ Demolition CO /CC 3 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 tha a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject o attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection ' is occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be app ov.. and a reinspection fee will be charged. Signa�[ure/,./ /;_ ( . �/ Owner or Agent J V /Contractor. The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this2) day off "LILA , 20 d',kby / , who is personally known to me or who has produced As identification and who did take an oath. as identification and who did take an oath. day of by who is personally known to me or who has produced NO UBLIC: Si Print: My Commission Expire OFFICIAL NOTARY SEAL AMARIL' S VALDEZ NOTARY PUBLIC STATE OF FLORIDA COMMISSION NO. D13140143 MY COMMISSION EXP. AUG. 742006 ***************************************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** State Certificate or Registration No. Certificate of Competency No. * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** APPLICATION APPROVED BY Chc 12/15/03 NOTARY P LIC: (Certificate of Competency Holder) NOTARY PUBLIC STATE OF FLORIDA OFFICIAL NOTARY SEAL Si Print: My Commi sibtiION EXP. AUG. 72006 ********************************* * * * * * * * * * * * * * * ** * * * * * * * * * * * * * ** Plans Examiner Engineer Zoning I • c /4Yc cl • Qadh, (, e PROPERTY STREET ADDRESS: 3 � C. Io APPLICANT: STATE OF FLORIDA DEPARTMENT OF HEALTH ONSITE SEWAGE DISPOSAL SYSTEM CONSTRUCTION PERMIT Authority: Chapter 381, FS & Chapter LOT: 1 7 BLOCK: ( SUBDIVISION: i g /\--f 4 ( fYc^ p c PROPERTY ID #: � [SECTION /TOWNSHIP /RANGE /PARCEL NUMBER] ( 2 - 040- o I 3- '� 7 n (OR TAX ID NUMBER] SYSTEM DESIGN AND SPECIFICATIONS T [C . 0 ] [GALLONS" /GPD] SEPTIC TANK /AEROBIC UNIT A ( ] [GALLONS / GPD] N [ .) GALLONS GREASE. INTERCEPTOR CAPACITY K [ 1 GALLONS PER DOSE DOSING TANK CAPACITY r SPECIFICATIONS BY: / v( ;-7/ 1 %PPROVED BY: )ATE ISSUED: 0 y )H 4016, 10/96 (Replaces HRS -H Form 4016 (page 1) which may be used) Stock Number: 5744- 001 - 4016-0) • SYSTEM [ A FILLED Iv) BED Applicant AGENT: TITLE: PERMIT f DATE PAID FEE PAID. RECEIPT 0 10D-6, FAC 13-5 ( UNDER BOTTOM OF DRAT FU.LD • ... It — 16 u z $ 7 ngn? • CONSTRUCTION PERMIT OR: [)..5) New System [h] Existing System (' ] Holding Tank ( ] Temporary /Experimentai ( \A] Repair (P) Abandonment [ (J] Other(Specify) SYSTEM MUST BE CONSTRUCTED IN ACCORDANCE WITH SPECIFICATIONS AND STANDARDS OF CHAPTER 10D -6, FAC. REPAIR PERMITS AND HOLDING TANK PERMITS .EXPIRE 90 DAYS FROM THE DATE OF ISSUE. ALL OTHER PERMITS EXPIRE ONE YEAR FROM THE DATE OF ISSUE. DEPARTMENT OF HEALTH APPROVAL OF SYSTEM DOES NOT GUARANTEE•SATISFACTORY PERFORMANCE FOR ANY SPECIFIC PERIOD OF TIME. ANY CHANGE IN MATERIAL FACTS WHICH SERVED AS'A BASIS FOR ISSUANCE OF THIS PERMIT REQUIRE THE APPLICANT TO MODIFY THE PERMIT APPLICATION. SUCH MODIFICATIONS MAY RESULT IN THIS PERMIT BEING MADE NULL AND VOID. CAPACITY . MULTI- CHAMBERED /IN SERIES:[ ) CAPACITY MULTI- CHAMBERED /IN SERIES:[ ] [MAXIMUM CAPACITY SINGLE TANK: 1250 GALLONS) DOSE HATE [ ] PER 24 HRS NO. OF PUMPS: [ (2;(:)0 ] SQUARE FEET PRIMARY DRAINFIELD SYSTEM R [ ] SQUARE FEET A .TYPE SYSTEM: [ STANDARD I CONFIGURATION: ( J TRENCH � F LOCATION ' OF BENCHMARK: ,/ Z � 7 `'t 6;: ✓l 0 T • T. I ELEVATION OF PROPOSED SYSTEM SITE [2() % 01] (INCHES /FT] [ABOVE /BELOW] BENCHMARK /REFERENCE POINT E BOTTOM OF DRAINFIELD TO BE [ ' o 0 ] [INCHES /FT] [ABOVE/ ELOWJ BENCHMARK /REFERENCE POINT L D FILL REQUIRED: [0 01) INCHES EXCAVATION REQUIRED: [42_ ] INCHES INSTALL [ Vt . OF SLIGHTHLY LIM! 1 ED SOIL ] MOUND ] E I Q1 1,.aTC Crj)?,n'F !C '3 Y1' 7i BOTTOM OF (1}:. "a ....._.,_. 3_.i : _. t.i1`v .._.... ( t 0 Pi:;ZIr'IL 1 ER OF EXCi.WA1'ION A F ��'......i.:J �. .(\71 (I�t:T' WFDA A .O THAN AN THE LT070 ED BSQRP 110 .f F T 6 TRENCH l`1 l •• t (J 6 (�+ CHD EXPIRATION DATE: ' ( , o / L( Y Page 1 of 2 (AN APPLICATION FOR BUILDING PERMIT MUST ACCOMPANY THIS•ADDENDUM. IF A RASTER PERMIT HAS B. OBTAINED, THE OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.) B PLUMBING ADDENDUM TO BUILDING PERMIT APPLICATION ELECTRICAL MECHANICAL TEM TUB UNIT 'FEE ITEM UNIT SWITCH OUTLETS FEE ITEM SPACE HEATERS UNIT FEE ATH IDET LIGHT CURETS CENTRAL HEATING ISHWASHER. RECEPTACLES A/C (WIND) SERVICE TEMPORARY A/C (CENTRAL) DISPOSAL FOUNTAIN SERVICE SIZE IN AMPS DUCT WORK iRINKSNG LOOK DRAIN SERVICE REPAIR/METER CHANGE REFRIGERATION TRAP' APPLIANCE OUTLETS PROCESS AND PRESS PIPING CREASE RANGE TOP UNDERGROUND TANKS NTERCEPTOR OVEN ABOVE GROUND TANKS .AVATORY TRAY WATER HEATER U.F. PRESSURE VESSELS .AUNDRY WASHER MOTORS 0— 1 HP STEAM BOILERS ;LOTHES RiOWER MOTORS OVER 1— 3 HP HOT WATER BOILERS SINK, POT /3 COMP. MOTORS OVER 3— 5 HP MECHANICAL VENTILATION ;INK, RESIDENCE MOTORS OVER 5— 8 HP TRANSPORTING ASSEMBLIES ;INK, SLOP MOTORS OVER 8— 10 HP ELEVATORS/ESCALATORS TEMPORARY WATER CLOSET MOTORS OVER 10— 25 HP FIRE SPRINKLER SYSTEMS URINAL MOTORS OVER 25-100 HP COOLING TOWERS MATER CLOSET MOTORS OVER 100 HP VIOLATION INDIRECT WASTES- A/C WINDOW REINSPECTION WATER SUPPLY TO: AIR CONDITIONERS • A/C UNIT STRIP HEATER FIRE SPRINKLER GENERATORS TRANSFORMERS • GENERATORS TRANSFORMERS 'HEATER INST. —NEW GENERATORS TRANSFORMERS HEATER REPLACE — SPECIAL PURPOSE _ LAWN SPRINKLER —WELL SWIMdING POOL OUTLETS COMIMERCIAL WATER SERVICE SIGN TUBES . SEWER CONNECTIONS SIGN TRANSFORMERS UTILITY —SEWER SIGN TIME CLOCK • UTILITY —WATER FIXTURES SEPTIC TANK ANTENNA RELAY TELEVISION OUTLETS DRAINFIELD, 4' TILE/RES. VIOLATION PUMP & ABANDON SEPTIC TANK REINSPECTION _ SOAKAGE PIT CU. FT. CATCH BASIN DISCHARGE WELL DOMESTIC WELL AREA DRAIN ROOF INLET SOLAR WATER HEATER FIRE STANDPIPE POOL PIPING LAWN SPRINKLER SYSTEM GAS RANGE METER SET (GAS) GAS PIPING (AN APPLICATION FOR BUILDING PERMIT MUST ACCOMPANY THIS•ADDENDUM. IF A RASTER PERMIT HAS B. OBTAINED, THE OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.) B PLUMBING ADDENDUM TO BUILDING PERMIT APPLICATION ELECTRICAL MECHANICAL Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Printed: 6/9/2004 Applicant: RICHARD Owner: CACCAMISE JOB ADDRESS: 53 Parcel # 1132060131530 NE 101 Contractor LUIS QUALITY PLUMBING Local Phone: 305 -553 -7155 Signed: (INSPECTOR) Plumbing Permit Permit Number: PL2004 -158 CACCAMISE RICHARD ST Contractor's Address: 7939 N. W. 64 ST. Permit Status: APPROVED Permit Expiration: 11/24/2004 Construction Value: $1,000.00 Work: INSTALL DRAINFIELD Page 1 of 1 Legal Description: MIAMI SHORES SEC 1 AMD PB 10 -70 LOT 18 & E1/2 LOT 17 BLK 11 LOT SIZE Fees: FEE2004 -5854 FEE2004 -5855 FEE2004 -5856 FEE2004 -5857 FEE2004 -5858 Description Building Fee CCF Training and Education Fee Technology Fee Builders Bond Total Fees: Amount $175.00 $0.60 $0.20 $4.37 $300.00 $480.17 Total Fees: $480.17 Total Receipts: $480.17 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 CONSTRUCTION INSPECTION APPLICANT: �C�M.` C. 1 C--' 9-. 'c k-- AGENT: \'1C- `7 O -. 1nckyvA �. PROPERTY ADDRESS: 5 `� 1 �� ` '� `-. C. A �• LOT: k BLOCK: SUBDIVISION: 1- 3 \ \- * • � `� � PROPERTY ID it 1 1 ` a Cis - 15 CHECKED CHECKED [X) ITEMS ARE NOT IN COMPLIANCE WITH ] l l [10] [11] [ [13] [14) [15] [16] [17] [18) [19] [20) [ CONSTRUCT FINAL SY DR 4016, 10 TANK INSTALLATION [01] TANK SIZE [1 [02] TANK MATERIAL [03] OUTLET DEVICE - [04] MULTI-CHAMBERED J, Y 4 [05] OUTLET FI ER l [06] LEGEND [07] WATERTIGHT [08] LEVEL / v 1 /-7/. ' 'g [09) DEPTH TO LID C 1 DRAINFIELD INS Ii4(44°N 3/ AREA [1] [2] SQFT DISTRIBUTION BOX _ HEAD NUMBER OF DRAINLINES DRAINLINE SEPARATION 34 DRAINLINE SLOPE ., DEPTH OF COVER / / ELEVATION [ABOVE /BELOW] BM _ SYSTEM LOCATION ` '� `— DOSING PUMPS /� l �� AGGREGATE SIZE ` AGGREGATE EICESSIyE FINES AGGREGATE DEPTH / FILL / EXCAVATION MATERIAL [22] FILL AMOUNT f e. [23] FILL TEXTURE [24] EXCAVATION DEPTH [25].. AREA REPLACED [26) REPLACEMENT MATERIAL EXPLANATION OF VIOLATIONS / REMARKS: [ [ [ •/ t SAPPROVED]: SAPPROVED]: (Previous Editions Nay Be Used) AND DIPOSAL SYSTEM AND FINAL APPROVAL STATUTE OR RULE AND MUST BE SETBACKS SURFACE WATER DITCHES PRIVATE WELLS PUBLIC WELLS [ [ [29] [30] [31] [32] [33] [ [35] PERMIT 116.C) — DATE PAID: - S d -c_A4- FEE PAID: 1 \ CORRECTED. / FT i./ )A FT C— { FT IRRIGATION WELLS / Q.7Z FT POTABLE WATER LINES / y FT BUILDING FOUNDATION 7 FT PROPERTY LINES FT OTHER FT FILLED / MOUND SYSTEM [36] DRAINFIELD COVER [37] SHOULDERS [38] SLOPES [39] STABILIZATION ADDITIONAL INFORMATION [40] UNOBSTRUCTED AREA [41] STORMWATER RUNOFF [42] -- ALARMS [43] MAINTENANCE AGREEMENT [44] BUILDING AREA [45] LOCATION CONFORMS WITH SITE P [46] FINAL SITEAORA „ • [47] CONTRACTOR [48] OTHER ABANDONNENT [49] TANK PUMPED _/ [50] TANK CRUSHED & F � :. 1 �c _ � /.0, > CHD PT 1: Applicant PT 2: Installer /Contractor PT 3: Building Department PT 4: Health Department DATE: DATE: Page 2 of 3 Permit No. e- 9 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 specif}c qhs must be kept at building during progress of work. ,, // Owners Name and Address_.. 11 Icr No. _ 5 4') ±,t Street. ,k14 Registered Architect and /or / _ � __ / _ 'r Employing Plumber's Name__ .!_ ! /�.Jk o 1L.L� I��LCJ�11_-- - Location and Legal Description Lot_ -� � Bloock _ Street and Number where work is to be performed —No 6 �� -' Street 1-_ ` , State work to be performed and purpose of building ( By Floors) ..... --- ... ----------...... — New Building _.. Remodeling —__ Addition____ Repairs Size Septic Tank-. Feet of Drain Tile_ _ Nature of Water Supply: City —Well. Amount of Permit $_ STATE OF FLORIDA, COUNTY OF DADE. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Capacity Gals. ______Type of Tank__ Feet of Tank or Drain Field from Well __Size of Soakage Pit (Signed) - My Commission Expires Notary Public, State of Florida ✓�v P1 ; . ing Ins No. of Stories.... ........ _._. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent S ,.. ement, 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 erformed under this pennit, as are licensed by Miami Shores Village. ( Signed Master Plumber. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared •to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the ..____....._.... of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspt ': zn, or faulty materials and /or workmanship. CLOSETS BATH TUBS SHOWERS LAVA- TORIES SINKS SLOP SINKS LAUNDRY TUBS U RINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT'NS TOTAL FIXTURES CONTR. LIST CHECK SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SWIM'G POOL CONTR. LIST CHECK Permit No. e- 9 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 specif}c qhs must be kept at building during progress of work. ,, // Owners Name and Address_.. 11 Icr No. _ 5 4') ±,t Street. ,k14 Registered Architect and /or / _ � __ / _ 'r Employing Plumber's Name__ .!_ ! /�.Jk o 1L.L� I��LCJ�11_-- - Location and Legal Description Lot_ -� � Bloock _ Street and Number where work is to be performed —No 6 �� -' Street 1-_ ` , State work to be performed and purpose of building ( By Floors) ..... --- ... ----------...... — New Building _.. Remodeling —__ Addition____ Repairs Size Septic Tank-. Feet of Drain Tile_ _ Nature of Water Supply: City —Well. Amount of Permit $_ STATE OF FLORIDA, COUNTY OF DADE. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Capacity Gals. ______Type of Tank__ Feet of Tank or Drain Field from Well __Size of Soakage Pit (Signed) - My Commission Expires Notary Public, State of Florida ✓�v P1 ; . ing Ins No. of Stories.... ........ _._. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent S ,.. ement, 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 erformed under this pennit, as are licensed by Miami Shores Village. ( Signed Master Plumber. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared •to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the ..____....._.... of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspt ': zn, or faulty materials and /or workmanship. Permit No Date ° - 9 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. 1 � � , 4,P &Q 5 _____— '-- __ -.__ No.— -- --- - - - - - 6 - - -- Street__ _1 _ .._° 1 - _ Owner's Name and Address - �_ — ________ —__ —_ � � � / _ Registered Architect and /or E gineer__ -- _ -- Employing Plumber's Name fi r 3 !!!k_ 1/176/.c R /c c i A/ C Location and Legal Description Lot Street and Number where work is to be performed -No State work to be performed and purpose of building (By Floors 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 $ Deg STATE OF FLORIDA, 1 COUNTY OF DADE. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT _Type of Tank Block Addition. (Signed)- No. __i 99 3c /W Street —�? 7 Q tre _ _ _.. `(_ 114 (Signed) "d Repairs No. of Stories. Capacity Gals._ The undersigned applicant for this building permit does hereby certify that he understands and accepts his oblige .ns : an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Pernnane S •element, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employe. 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 un. 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 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 insp. . -In, or faulty materials and /or worlmnanship. CLOSETS BATH TUBS S LAVA- TORIES SINKS SLOP SINKS LAUNDRY TUBS U CATCH BASIN FLOOR DRAIN DRINKING DRINK 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 Date ° - 9 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. 1 � � , 4,P &Q 5 _____— '-- __ -.__ No.— -- --- - - - - - 6 - - -- Street__ _1 _ .._° 1 - _ Owner's Name and Address - �_ — ________ —__ —_ � � � / _ Registered Architect and /or E gineer__ -- _ -- Employing Plumber's Name fi r 3 !!!k_ 1/176/.c R /c c i A/ C Location and Legal Description Lot Street and Number where work is to be performed -No State work to be performed and purpose of building (By Floors 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 $ Deg STATE OF FLORIDA, 1 COUNTY OF DADE. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT _Type of Tank Block Addition. (Signed)- No. __i 99 3c /W Street —�? 7 Q tre _ _ _.. `(_ 114 (Signed) "d Repairs No. of Stories. Capacity Gals._ The undersigned applicant for this building permit does hereby certify that he understands and accepts his oblige .ns : an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Pernnane S •element, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employe. 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 un. 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 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 insp. . -In, or faulty materials and /or worlmnanship. oc2-( Permit No ro f MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work Owner's Name and Address Registered Architect and /or E Employing Plumber's Name_ ___/f -- •--- •_ - -- No._ _ ------------- ____ -- Street Date__ No._ Street_ _ 3//irt Location and Legal Description Lot. - �A6 Blorti Street and Number where work is to be performed —No ` v! . L Q L Street State work to be performe8 and purpose of building (By Floors) _._________.___________._______ New Building ........ ________........ '- __ -_._ Remodeling__-_ .... ____ -___ -- Addition---- ____ -- Repairs Size Septic Tank_ ..... _-- - Feet of Drain Tile. -/ - -� ee •f Tank or Drain Field from Well Nature of Water Supply: ity— Well.__-- ____._ ...... of Soakage Pit Amount of Permit $____ STATE OF FLORIDA, COUNTY OF DADE. My Commission Expires Subdivision. No. of Stories . . ...................... Capacity Gals. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obliga o . s as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permane, upplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by film 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 required by the Act. The undersigned agrees to•employ only such sub=contractors, on work to be pert this permit, as licensed by Miami Shores Village. are are /l Master Pldm 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. 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. CLOSITB BATH TUBS SHOWERS LAVA- TORIES SINKS SLOP SINKS LAUNDRY TUBS URINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT' NS TOTAL FIXTURES CONTR. LIST CHICK SEPTIC TANK SEWER CONK. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SW IM'G POOL. CONTR. LIST CHECK oc2-( Permit No ro f MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work Owner's Name and Address Registered Architect and /or E Employing Plumber's Name_ ___/f -- •--- •_ - -- No._ _ ------------- ____ -- Street Date__ No._ Street_ _ 3//irt Location and Legal Description Lot. - �A6 Blorti Street and Number where work is to be performed —No ` v! . L Q L Street State work to be performe8 and purpose of building (By Floors) _._________.___________._______ New Building ........ ________........ '- __ -_._ Remodeling__-_ .... ____ -___ -- Addition---- ____ -- Repairs Size Septic Tank_ ..... _-- - Feet of Drain Tile. -/ - -� ee •f Tank or Drain Field from Well Nature of Water Supply: ity— Well.__-- ____._ ...... of Soakage Pit Amount of Permit $____ STATE OF FLORIDA, COUNTY OF DADE. My Commission Expires Subdivision. No. of Stories . . ...................... Capacity Gals. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obliga o . s as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permane, upplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by film 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 required by the Act. The undersigned agrees to•employ only such sub=contractors, on work to be pert this permit, as licensed by Miami Shores Village. are are /l Master Pldm 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. 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. S ~ BUI tN ' ELE-GTRICAt PERMIT A N° PLUMBING Illibner of Building ME ,,( -7 NAME ♦ 7 Architect and /or Engineer NAME Contractor or Builder NAME Proposed Location 7'" 1'1 1 / ._- _/ I BLOCK '' SUB- DAUSION NO. ( ,, f STREET This permit is issued to C t el t �" , ` " 1 L V 11( (0 • I la, + """"° To the building above described, as per application, Plans and S ecifications heretofore filed in this office. This per is granted upon the express condition that all facts stated in the application are true and that the construction complies strictly with the plans and' specifications submitted, and in accordance and compliance with the building laws of the State of Florida and with the building ordinances and zoning laws of Miami Shores Village, and rules and regulations of the building department of Miami Shores Village. This permit may be revoked at any time upon the violation of any provisions of said laws, ordinances or rules and regulations, or upon any chap in the plans and specifications unauthorized by the building inspector. ' Ci + /( ' Dated AMOUNT L lr LOT In consideration of the issuance to p ans and specifications thereof heretofore building . ordinances and zoning laws of RECD. PAYMENT ACCT. DEPT. 61 �l -r-v- 1 0 19 .1 at ADDRESS ADDRESS ADDRESS me of this permit I hereby agree to the proposed construction in strict conformity with the application and by me submitted, and in compliance with all provisions of all building laws of the State of Florida, all the Miami Shores Village and all rules and regulations of the building department of Miami Shores Village. f a� NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has been obtained from the Planning Board. 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. 19 A C 6 MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT LICENSE NO. LICENSE NO. INSPECTOR (SEAL) BUILDING ELECTRICAL PLUMBING ROOFING Architect Contractor or Builder Legal Lot Description Address of Building MIAMI SHORES VILLAGE. FLORIDA ❑ DATE - 195 PERMIT N9 2891 Contractor's License No. Et ❑ Work to be performed under this Permit Owner of Building 81 j` Subdi- vision Value of Project $ Amount of Permit $ This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the application herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes responsibility for work done by his agents, servants or employees. Signed' �: > ° BY -,... INSPECTOR In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted 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. CONTRACTOR OR BUILDER BY AUTHORITY o