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53 NE 101 St (13)MIAMI SHORES VILLAGE BUILDING DEPARTMENT / 305- 795 -2204 Building Inspection Request Date 51 Type Insp'n F6nO 1 P) Permit No. P i U -3oq . Name Address s a \' L `o t s• Company Phone # Inspection Date Approved Correction Re- Insp'n Fee Date Type Insp'n Permit No. Name Address Company Phone # For Inspector Approve Correction Re- Insp'n Fee MIAMI SHORES VILLAGE BUILDING DEPARTM 305- 795 -2204 Building Inspection Reques o o 0 Is Time r —wvwv wrc� -r J 53 /b/ - 1 1 e & Date Miami Shores Village, f quilding Department BUILDING PERMIT APPLICATION FBC 2001 Job Address (where the work is being done) City Miami Shores Village is Building Historically Designated YES Architect/Engineer's Name (if applicable) $ Value of Work For this Permit Code Enforcement $ Total Fee Now Due $ (Continued on opposite side) 10050 N.E.2 Skwe orida 33138 Tel: (�0 1;` 7,> i 6.8972 OCT 20 Permit No. PL' OV 30? -- :Master Permit No. , Ol — /3/3 Permit Type (circle): Building Electrical Mechanical Roofing Owner's Name (Fee Simple Titleholder) i��E O�lv Phone # 3O 449 9e9OO Owner's Address 9 AI E 1,01 576'7 City /PAM r kiltiekS State ' 0,2/ Zip ' 3 / . 58 Tenant/Lessee Name // //{- Phone # 53 WE /o / County Miami -Dade Zip " / 3 Contractor's Company Name .S/ ,t1J7A/1 Contractor's Address / SV ,U, (A). City Ni 174 / State 7 Zip ,_3 31 8 Qualifier. — G.> U / P State Certificate or Registration No. Certificate of Competency No. Phone # 70 W 2* / 96 C0 7EcTa -Eek/ !1 - Phone # 50646,85 Square Footage Of Work: Type of Work: ❑Ad ❑Alteration ❑New ❑ Repair/Replace ❑ Demolition Describe Work: ()<"-C%fl`P���6 of 5 Y5-rl7m 7Vf ' �!�- A- s / edE /A/ 7 Aloier Nf i * * * * * * * * * * * * * * * * * * * * * * * * * * ** F ees * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Submiffa� Fee $ � i Permit Fee $ / � CAG CCF $ 0 t CO /CC Notary $ Training/Education Fee $ 0, Technology Fee $ 3 • b Scanning $ Radon $ r-- Zoning Bond $ Structural Plan Review. $ �—.) Bonding Company's Name (if applicable B • • onding Company's Address City State Zip Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State Zip Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a nspection fee will be charged. AA i /Owne or Agent The foregoing ins ent was acknowledged before me this 3 i d of l ' , r ' , 20 , by �b 1 ` 1 Cat? � .l \AS who . Rersona known a or who has produced Signature My Commission Expires: * * * * * * * * * * * * * * * * * * * * * * * ** I * i,R. * * * * * * * * * * * * * ** * * * * * * * * ** APPLICATION APPROVED BY: Chc 05/13/03 Signature Contractor The foregoin instrument was acknowledged before me thus day of , 20 O4, b erld9 who is personally known to me or who has produced -� As identification and who did take an oath. as g tification and who did take an oath. NOT Y ' UB C: NOTARY PUBLIC: Sign: Sign: Print: Kr M r Y l (rA INS d tc Print: OF F.O, My Commission Expirbr'' 1 * * ** *,KAKI. 1(O* * * * *A *** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** MY COMMISSION # DD 189245 EXPIRES: May 26, 2007 Bonded Thru Nota blic Underwriters goat, /i1.1 Engineer Zoning 02 Plan s J a miner ITEM BATH TLB UNIT FEE ITEM SWITCH OUTLETS UNIT FEE ITEM SPACE HEATERS UNIT FEE BIDET LIGHT OUTLETS CENTRAL HEATING DISHWASHER RECEPTACLES A/C (WIND) DISPOSAL SERVICE TEMPORARY A/C (CENTRAL) DRINKING FOUNTAIN SERVICE SIZE IN AMPS DUCT WORK FLOOR MAIN SERVICE REPAIR/METER CHANGE REFRIGERATION GREASE TRAP APPLIANCE OUTLETS PROCESS AND PRESS PIPING INTERCEPTOR RANGE TOP UNDERGROUND TANKS LAVATORY OVEN ABOVE GROUND TANKS LAUNDRY TRAY WATER HEATER U.F. PRESSURE VESSELS CLOTHES WASHER MOTORS 0- 1 If STEAM BOILERS SHOWER ` MOTORS QVER 1- 3 If HOT WATER BOILERS SINK, POT /3 COMP. MOTCRS OVER 3- 5 if MECHANICAL VENTILATION SINK, RESIDENCE MOTORS OVER 5- 8 HP TRANSPORTING ASSEMBLIES SINK, SLOP MOTORS OVER 8- 10 HP ELEVATORS/ESCALATORS TEMPORARY WATER CLOSET MOTORS OVER 10- 25 HP FIRE SPRINKLER SYSTEMS URINAL MOTORS OVER 25-100 FP COOLING TOWERS WATER CLOSET MOTORS OVER 100 If VIOLATION INDIRECT WASTES - A/C WINDOW REINSPECTION WATER SUPPLY TO: AIR CONDITIONERS A/C UNIT STRIP HEATER FIRE SPRINKLER GENERATORS TRANSFORMERS 'HEATER -NEW INST. GENERATORS TRANSFORMERS HEATER - REPLACE GENERATORS TRANSFORMERS LAWN SPRINKLER -WELL SPECIAL PURPOSE SWIMMING POOL OUTLETS COMMERCIAL WATER SERVICE SIGN TUBES SEWER CONNECTIONS .SIGN TRANSFORMERS UTILITY -SEWER SIGN TIME CLOCK UTILITY -WATER FIXTURES SEPTIC TANK ANTENNA RELAY TELEVISION OUTLETS DRAINFIELO, 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 ADDENDUM TO BUILDING PERMIT APPLICATION (AN APPLICATION.FOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. IF A MASTER PERMIT HAS B. OBTAI '_ 6 . 1 'WNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.) PLUMBING ELECTRICAL MECHANICAL Miami Shores Village 10050 NE 2nd Avenue Phone: 305- 795 -2204 Printed: 11 /5/2004 Applicant: JORGE Owner: RIVAS JOB ADDRESS: 53 Contractor SHEAR SERVICES INC Local Phone: Parcel # 1132060131530 NE 101 Signed: (INSPECTOR) Plumbing Permit Permit Number: PL2004 -309 RIVAS JORGE ST Contractor's Address: 11767 SOUTH DIXIE #187 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 -10951 FEE2004 -10952 FEE2004 -10953 FEE2004 -10954 FEE2004 -10955 Description Building Fee CCF Notary Fee Training and Education Fee Technology Fee Total Fees: Amount $130.00 $0.60 $5.00 $0.20 $3.25 $139.05 Total Fees: $139.05 Total Receipts: $0.00 55. Permit Status: APPROVED Permit Expiration: 4/27/2005 Construction Value: $800.00 Work: EXCHANGE OF EXISTING TUBS FOR A SHOWER IN 2ND BATHROOM 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 1 assume responisibility for all work done by either myself, my agent, servants or employes. Signed: (Contractor or Builder) BY: Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Printed: 11/5/2004 Applicant: JORGE Owner: RIVAS JOB ADDRESS: 53 Contractor SHEAR SERVICES INC Local Phone: Parcel # 1132060131530 NE 101 Signed: (INSPECTOR) Plumbing Permit Permit Number: PL2004 -309 RIVAS JORGE ST Contractor's Address: 11767 SOUTH DIXIE #187 Permit Status: APPROVED Permit Expiration: 4/27/2005 Construction Value: $800.00 Work: EXCHANGE OF EXISTING TUBS FOR A SHOWER IN 2ND BATHROOM 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 -10951 FEE2004 -10952 FEE2004 -10953 FEE2004 -10954 FEE2004 -10955 Description Building Fee CCF Notary Fee Training and Education Fee Technology Fee Total Fees: Amount $130.00 $0.60 $5.00 $0.20 $3.25 $139.05 Total Fees: $139.05 Total Receipts: $ In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responisibility for all work done by either myself, my agent, servants or employes. Signed: (Contractor or Builder) BY: Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Printed: 11/5/2004 Applicant: JORGE Owner: RIVAS JOB ADDRESS: 53 NE 101 Contractor SHEAR SERVICES INC Local Phone: Parcel # 1132060131530 Signed: (INSPECTOR) Plumbing Permit Permit Number: PL2004 -309 RIVAS JORGE ST Fees: FEE2004 -10951 FEE2004 -10952 FEE2004 -10953 FEE2004 -10954 FEE2004 -10955 Description Building Fee CCF Notary Fee Training and Education Fee Technology Fee Total Fees: Amount $130.00 $0.60 $5.00 $0.20 $3.25 $139.05 Total Fees: $139.05 Total Receipts: $0.00 c� D 5� Permit Status: APPROVED Permit Expiration: 4/27/2005 Construction Value: $800.00 Work: EXCHANGE OF EXISTING TUBS FOR A SHOWER IN 2ND BATHROOM 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) Contractor's Address: 11767 SOUTH DIXIE #187 Legal Description: MIAMI SHORES SEC 1 AMD PB 10 -70 LOT 18 & E1/2 LOT 17 BLK 11 LOT SIZE BY: Page 1 of 1 Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Permit Number: PL2004 -309 Printed: 11 /5/2004 Applicant: JORGE Owner: RIVAS JOB ADDRESS: 53 Contractor SHEAR SERVICES INC Local Phone: Parcel # 1132060131530 NE 101 Signed: (INSPECTOR) Plumbing Permit RIVAS JORGE ST Contractor's Address: 11767 SOUTH DIXIE #187 Legal Description: MIAMI SHORES SEC 1 AMD PB 10 -70 LOT 18 & E1/2 LOT 17 BLK 11 LOT SIZE Fees: Description Amount FEE2004 -10951 Building Fee $130.00 FEE2004 -10952 CCF $0.60 FEE2004 -10953 Notary Fee $5.00 FEE2004 -10954 Training and Education Fee $0.20 FEE2004 -10955 Technology Fee $3.25 Total Fees: $139.05 Total Fees: $139.05 Total Receipts: $0.00 os `1• Permit Status: APPROVED Permit Expiration: 4/27/2005 Construction Value: $800.00 Work: EXCHANGE OF EXISTING TUBS FOR A SHOWER IN 2ND BATHROOM Page 1 of 1 In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responisibility for all work done by either myself, my agent, servants or employes. Signed: (Contractor or Builder) BY: Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Printed: 11/5/2004 Applicant: JORGE Owner: RIVAS JOB ADDRESS: 53 Contractor SHEAR SERVICES INC Local Phone: Parcel # 1132060131530 • NE 101 Signed: (INSPECTOR) Signed: (Contractor or Builder) Plumbing Permit Permit Number: PL2004 -309 RIVAS JORGE ST Contractor's Address: 11767 SOUTH DIXIE #187 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 -10951 FEE2004 -10952 FEE2004 -10953 FEE2004 -10954 FEE2004 -10955 Description Building Fee CCF Notary Fee Training and Education Fee Technology Fee Total Fees: Amount $130.00 $0.60 $5.00 $0.20 $3.25 $139.05 Total Fees: $139.05 Total Receipts: $0.00 Permit Status: APPROVED Permit Expiration: 4/27/2005 Construction Value: $800.00 Work: EXCHANGE OF EXISTING TUBS FOR A SHOWER IN 2ND BATHROOM 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. BY: Name Phone # For Inspector:C Approved Correction Re- Insp'n Fee MIAMI SHORES VILLAGE UILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Dat - O Time Type Insp'n •.! . ' ' .:tom u ! Permit No. c Address 53 ^t\ • C • C D 1 ,1_ Company MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date 1 /a� Type Insp'n "7 ) 309 Permit No. Name Address Company Phone # Inspection Date Approved Correction Re- Insp'n Fee 6-3 6 /old PERMIT APPLICATION FOR MIAMI SHORES VILLAGE 1005 .E. 2nd Avenue • Miami Shores, Florida 33138 • Phone: 305 - 795 -2 04-• - Fad: 1,8912 Date Job dd 5 i'VE /Di Tax Folio 1 Qz Z A 'IA Legal Description Historically Designated: Yes Owner /Lessee/Tenet 21, -t"} ArL..1O S C/1 Cr,H-.• ' Z - Q Master Permit # � a O Owner's Address 3'402— A e --- 1 1 5t" Phone 7't ZS S 7 5 ontracting Co. 4 A kAA 9 _P - Address Qualifier SS# State # Municipal # Phone Competency # Ins. Co. IF THERE IS NO PERMIT PACKAGE ACCESSIBLE ON THE JOB SITE FOR INSPECTORS TO VERIFY, THERE WILL BE NO INSPECTION. RE- INSPECTION FEE IS $50.00 AND MUST BE PAID IN ADVANCE BEFORE CALLING FOR ANOTHER INSPECTION. Permit Type (circle one): BUILDING ELECTRICAL CZLUMBING MECHANICAL ROOFING RK DESCRIPTION: S o ii e Square Ft. Estima Cost (value 3 a 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 ANY 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). 1 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 all disciplines. OWNERS AFFIDAVIT: I certify that all the foregoing information is accurate and that all work w/1 be done in compliance with all applicable laws regulating construction and zoning. Furthermore, I authorize the above named contractor to do the w k stated Signature of owner and/or Condo President Notary as to Owner and/or Condo President My Commission Expires FEES: PERMIT APPROVED: Zoning Building Mechanical Date Date Notary as to Contractor or Owner Builder My Commission Expires RADON C.C.F • 1 -- - ` NOTARY BOND TOTAL DUE g v) Electrical Signature of •ntractor or Owner Builder Date Date Plumbing / � Structural Engineer ITEM BATH 1 l.B UNIT • FEE ITEM SWITCH OUTLETS UNIT FEE ITEM SPACE HEATERS UNIT FEE 310ET LI GHT OUTLETS CENTRAL HEATING DISHWASHER RECEPTACLES A/C (WIND) 3ISPOSAL SERVICE TEMPORARY A/C (CENTRAL) DRINKING FOUNTAIN SERVICE SIZE IN AMPS DUCT WORK FLOOR GRAIN SERVICE REPAIR/METER CHANGE REFRIGERATION REASE TRAP APPLIANCE OUTLETS PROCESS AND PRESS PIPING INTERCEPTOR RANGE TOP UNDERGROUND TANKS _AVATORY OVEN ABOVE GROUND TANKS _AUNDRY TRAY WATER HEATER U.F. PRESSURE VESSELS :LOTHES WASHER MOTORS 0- 1 IP STEAMI BOILERS ;LOWER MOTORS OVER 1- 3 If HOT WATER BOILERS ;INK, POT /3 COMP. MOTCRS OVER 3- 5 If MECHANICAL VENTILATION ; 1 NK , RESIDENCE MOTORS OVER 5- 8 HP TRANSPORTING ASSEM3LIES ;INK, SLOP •E1RORARY MOTCRS OVER 8- 10 If ELEVATORS/ESCALATORS WATER CLOSET MOTORS OVER 10- 25 If FIRE SPRINKLER SYSTEMS JRINAL MOTCRS OVER 25-100 If COOLING TOWERS LATER CLOSET. - • •• - MOTORS OVER 100 If VIOLATION NDIRECT WASTES - A/c WINDOW RE INSPECT ION TER SUPPLY T0:. . AIR FOND IT I ONERS A/C UNIT - • -. STRIP HEATER F IRE SPRINKLER GENERATORS TRANSFORMERS HEATER -NEW INST: GENERATORS TRANSFORMERS _ - HEATER - REPLACE :_ GENERATORS TRANSFORMERS LAWN SPRINKLER -WELL • SPECIAL PURPOSE SWIMMING POOL WATER OUTLETS COMMERCIAL SERV ICE - EWER `' SIGN TUBES CONNECTIONS . SI GN TRANSFORMERS . ILITY -SEWER •ILITY SIGN TIMIE CLOCK -WATER • FIXT1. ES :PT IC TANK . . ANTENNA LAY TELEVISION OUTLETS VIOLATION AINFIELO, 4" TILE/RES. ' , P & ABANDON SEPTIC TANK • : - •. RE I? ?ECTION • AKAGE PIT CU. FT. _ TCH BASIN SO•ARGE WELL • MESTIC WELL - EA DRAIN ,-- 3F INLET _AR WATER HEATER - zE STAMJPIPE lL PIPING IN SPRINKLER SYSTEM RANGE "ER SET (GAS) PIPING _ ADDENDUM TO BUILDING PERMIT APPLICATION (AN APPLICATION FOR BUT PERMIT MUST ACCOMPANY THIS ADDENDUM. IF A RASTER PERMIT HAS B. OBTAINED, THE OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.) PLUMBING ELECTRICAL MECHANICAL Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Printed: 5/29/2003 Applicant: RICHARD Owner: CACCAMISE JOB ADDRESS: 53 Contractor Local Phone: Parcel # 1132060131530 Permit Status: APPROVED Permit Expiration: 11/25/2003 Construction Value: Work: SHOWER PAN RICHARD J CACCAMISE Pay to the order of S ( r�-3 NE 101 Legal Description: MIAMI SHORES SEC 1 AMD PB 10 -70 LOT 18 & E1/2 LOT 17 BLK 11 LOT SIZE , ?rb :DD Total Fees: -$0, Total Receipts: $0.00 ._r 1082 f^itt7■ MU WACHOVIA ACH RT 067006432 For l �- • ':06 70064 3 21: 1O.L0074834 18 LII' 108 2 Plumbing Permit Permit Number: PL2003 -145 CACCAMISE RICHARD ST Contractor's Address: 63-643/670 BRANCH 0906e Date $ cellars $50.00 :ompliance with all ordinances and regulations pertaining thereto and in strict tmi Shores Village. In accepting this permit I assume responisibility for all work BY: Permit No Nature of Water Supply: City —Well STATE OF FLORIDA, COUNTY OF DADE. ss. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT 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 conforniity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. � Owner's Name and Address _ I __ Cm � 4 JUL f Z ' ' � ' No 7 ' Street l 0 {_ Registered Ar and /or Engineer a , i . 1>� Employing Plumber's Name - - L No Street Location and Legal Description Lot — ` Block Subdivision Amount of Permit $ - ss_�Z -� - -- -- - - - - -- (Signed) ti 7fr Street and Number where work is to be performed —No. Street State work to be performed and purpose of building (By Floors) New Building Remodeling Addition Repairs Size Septic Tank Type of Tank Capacity Gals Feet of Drain 'file Dist. Feet of Tank or Drain Field from Well ''- i Size of Soakage Pit 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) ..a/' daW Master Plumber. i My Commission Expires Notary Public, State of Florida Plumbing Inspector. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personall/ 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 11, 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, o materials and /or workmanship. CLOSETS BATH Tues SHOWERS LAVA- TORIES SINKS SLOP SINKS LAUNDRY Tues 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 SWIM'G POOL • CONTR. LIST CHECK Permit No Nature of Water Supply: City —Well STATE OF FLORIDA, COUNTY OF DADE. ss. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT 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 conforniity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. � Owner's Name and Address _ I __ Cm � 4 JUL f Z ' ' � ' No 7 ' Street l 0 {_ Registered Ar and /or Engineer a , i . 1>� Employing Plumber's Name - - L No Street Location and Legal Description Lot — ` Block Subdivision Amount of Permit $ - ss_�Z -� - -- -- - - - - -- (Signed) ti 7fr Street and Number where work is to be performed —No. Street State work to be performed and purpose of building (By Floors) New Building Remodeling Addition Repairs Size Septic Tank Type of Tank Capacity Gals Feet of Drain 'file Dist. Feet of Tank or Drain Field from Well ''- i Size of Soakage Pit 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) ..a/' daW Master Plumber. i My Commission Expires Notary Public, State of Florida Plumbing Inspector. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personall/ 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 11, 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, o materials and /or workmanship. •UILDING LECTRICAL 'LUMBING rchitect r MIAMI SHORES VILLAGE, FLORIDA PERMIT N° 5695 Work to be performed under this Permit ' t (.-'' )weer of uilding t �. �,; t'f✓' .r' DATE 194_ Contractor's / 3 7 tj License No : ontractor r Builder .ega1 Lot Bl. )escription ddress of uilding 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- 3tion herefor in strict compliance with all ordinances pertaining thereto and w th the understanding that the work will be performed in compliance with any lans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked any time if the work is not done in compliance with such ordinances or if the plan are changed without authorization. A further condition upon which this ermit is granted is the understanding that the contractor or builder named abov s es the r ,gulations pertaining to the work covered hereby whether shown on the plans'o? vingyor } , . e er or specification nd thttt he sumes respon- bility for work done by his agents, servants or employees. Signed • By INSI5ECTOR In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations :;rtaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. 1 a e g th' permit I ass e respons' s ility for a work done by e' self y nt, orvant or em yee. ti CONTRACT OR BUILDER Subdi- vision Value of Project BY Amt. of 51,, ° Permit elt "" sibility for a thorough knowledge of the ordinances and AUTHORITY OWNER :� LOT BLOCK SUBDIVIS "se • Issued to, Fixtures Fixtures Sewer •tic Tank 1iami Jhorerillage F L O A I D A PLUMBING PERMIT N9 _ 1303 . , f to install the following described plumbing, in accordance with the laws, statutes and regu- lations of Miami Shores Village, Florida and the State of Florida, governing plumbing a d drainage work done in iami Shores Village, Florida. For a 1/ story building at �+ Total $ 7 Village Plumbing Inspector Received Payment by « • FRONT DEPTH HEIGHT STORIES TYPE OF CONSTRUCTION BUILDING TO BE USED FOR ROOP COST OF BUILDING PERMIT FEE Frame, Tile Concrete, Stucco Residence, Apts., Stores, Hotel BUILDING PERMIT MIAMI SHORES VILLH,_ OFFICE OF BUILDING INSPECTOR 4 Il. / Miami Shores Village, Florida, , 19 NO. Owner of Building Architect Contractor or Builder PROPOSED LOCATION PART OP LOT STREET LOT BLOCK DESCRIPTION OF BUILDING SUBDIVISION N° 615 This permit is issued to To the building above described, as per application, Plans and Specifications heretofore filed in this office. This permit 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 change in the plans and specifications unauthorized by the building inspector. BUILDING INSPECTOR In consideration of the issuance to me of this building permit I hereby agree to do the proposed construction in strict conformity with the application and plans and specifications thereof heretofore by me submitted, and in compliance with all provisions of all building laws of the State of Florida, all the building ordinances and zoning laws of Miami Shores Village and all rules and regulations of the building department of Miami Shores Village. Dated , 19 t• t (SEAL) BLDING . PLUMBING Owner of Building Architect MIAMI SHORES VILLAGE, FLORIDA DATE PERMIT N? 5695 Work to be performed under this Permit LP's Contractor qe,teep or Builder Legal Lot �/ BL Description CONTRAC OR BUILDER Contractor's License No. Subdi- vision /44 1 4,4 1-11 /317 Address of Value of Amt. o tI Building 3 3 t/ /01 " `f'' Project Permi �,. 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 a t 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 umes the r ponsibility for a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the pl eatem is or specifications a that he a mes respon- sibility for work done by his agents, servants or employees. Signed. By • /�' INS ECTOR In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance wit.J nal ordinances a rpgu3gtion5 plans, drawings, statements or specifications submitted to the proper auth s of Miami Shore Village. pertaining thereto and in strict conformity with the - In acce ting this permit I ass me responsibility for all work done by either myself, my agent servant or em loyee. ir 0 AUTHORITY 194_ BultIDMI:G= ELEC—ToRtGrAt PERMIT A N° _ _61 PLUMBING ' • Owner of Building 4 NAME Architect and/or Engineer NAME Contractor or Builder NAME Proposed Location F '12, // Dated , 19 - 1 ADDRESS ADDRESS ADDRESS MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT , 191. .41 LICENSE NO. LICENSE NO. LOT BLOCK SUB—DIVISION NO. STREET , i s t„ t . 1 : ) r I . '., This permit is issued to ., To the building above described, as per application, Plans and Specifications heretofore filed in this office. This permit 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 ch5e—in the plans and specifications unauthorized by the building inspector. - -,, i /- , tj'' $ ' .0 AMOUNT RECD. PAYMENT ACCT. DEPT. INSPECTOR In consideration of the issuance to me of this permit I hereby agree to the proposed construction in strict conformity with the application and plans and specifications thereof heretofore by me submitted, and in compliance with all provisions of all building laws of the State of Florida, all the building ordinances and zoning laws of Miami Shores Village and all rules and regulations of the building department of Miami Shores Village. (SEAL) 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 inspec4on or faulty materials and/or workmanship. No. STREET PART OF LOT LOT BLOCK SUBDIVISION / `, �' tk r s ,✓� d J 7 // ,J�f A i • J '/ ' /q/ \— FRONT DEPTH HEIGHT STORIES TYPE OF CONSTRUCTION 1 BUILDING TO SSf'UFED FOR.,�,.f; -. ROOF COST OF BUILDING PERMIT FEE /n Frame, Tile Concrete, Stucco } ,' Residence, Apts., .Stores, Hotel • BUILDING PERMIT Owner of Building Architect • Contractor or Builder Miami Shores Village, Florida, PROPOSED LOCATION MIAMI SHORES VILLAGE OFFICE OF BUILDING INSPECTOR DESCRIPTION OF BUILDING This permit is issued to r� t � C r , �J ¢ 4 '' ,o f i . 4 .., - . To `, ti y , the building above described, as per application, Plans and Specifications heretofore filed in this office. This permit 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 egulations of the building department of Miami Shores Village. This permit may be revoked at any time upon Ithe violation of any provisions of said si ws, ordinances or rules and regulations, or upon any change in the plans and specifications unauthorized by the building inspector. A' (' building ordinances and zoning laws of Miami Shores Village and all rules and Dated 4 , 19 1 ,19 615 BUILDING INSPECTOR In consideration of the issuance to me of this building permit I hereby agree to do the proposed construction in strict conformity with the application and plans and specifications thereof heretofore by me submitted, and in compliance with all provisions of all building laws of the State of Florida, all the regulations of the building department. of Miami Shores V lage. CAA i` .d u►� -.vim. (SEAL) CITY OF MIAMI, FLORIDA I SUBMIT HEREWITH, APPLICATION AND MECHANICAL PLAN FOR A PLUMBING PERMIT. EMPLOYING PLUMBER STORY NEW OLD ADDITION REMODEL OWNER OR AGENT LOT BLOCK BATH TUB BIDET DENTAL CUSPIDOR DISHWASHER DRINKING FOUNTAIN FLOOR DRAIN GREASE TRAP INDIRECT WASTE LAVATORY LAUNDRY TRAY LAUNDRY WASHER SHOWER SINK BAR SINK, GLASS SINK, POT SINK, RESIDENCE SINK, SLOP SINK, 3 - COMPARTMENT TEMPORARY WATER CLOSET URINAL FIXTURES SET ON OLD ROUGH INTERCEPTORS WATER CLOSET BLDG. PERMIT NO. BUILDING DEPARTMENT DIVISION OF PLUMBING INSPECTION &Oa P 0 BOX 708 COCONUT GROVE STATION— MIAMI 33, FLORIDA Z S / .6z,16 tvi,t4/ f(1 DWELLING ✓ DUPLEX ROOMING HOUSE APARTMENT SUBDIVISION SEWER CONNECTIONS: AT CENTER OF STREET AT CURB EXISTING BUILDING SEWER TO SEPTIC TANK RAIN WATER TO: STREET GUTTER PERVIOUS AREA 0 SIGNATURE: DATE HOTEL OFFICE BUILDING GARAGE STORE WATER PIPING TO: AIR - CONDITIONING UNIT BOILER BOOSTER FOR SOLAR BOTTLED GAS WATER HEATER ELECTRIC WATER HEATER FIRE - SPRINKLER SYSTEM FIRE- STANDPIPES HOT & COLD FOR WASHING MACHINE IRRIGATION SYSTEMS SIAMESE CONNECTION SOLAR WATER HEATER STANDPIPES STORAGE TANK SWIMMING POOL WATER SERVICE WATER SOFTENER ADDRESS OF JOB 573 i C - DRAW MECHANICAL PLAN ON BACK /2- 2 7 -S - LUNCH AND JUICE STORE RESTAURANT BEER AND LIQUOR BAR AT PROPERTY LINE IN ALLEY EXISTING BUILDING DRAIN TO SOAKAGE PIT STORM SEWER SOAKAGE PIT DRAINAGE WELL WATER DRAINAGE: AREA DRAIN ROOF INLET REPAIRS: EXTENDING, REMODELING, ADDING TO OR REPAIRING THE FOLLOWING: BUILDING DRAIN SEWER PIPE . SOIL PIPE SIPHON - BREAKER VENT PIPE WASTE PIPE WATER PIPE MISCELLANEOUS :ZS' >Lctk ��� Registered Architect antl,Ler.fongivree'i Employing Plumber's Name Size Septic Tank Feet of Drain Tile My Commission Expires MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT r'ermit No.. I 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 '1,0 No. 1 1 4 /2 , _,/,' E` :fi r [[,, b P' n_4 Location and Legal Description Lot ' '` C I 'I Block i Street and Number where work is to be performed —No ✓ ••••• l 2 No - 7 7 1 r 1. / e- .°•"' Amount of Permit $ (Signed) Street � � � 1 ____ Date 1- 10 - -ll 1P 1 r Street Pi/ ' Subdivision o r " j Capacity Gals f,�' fit: is Street-- 7, `1/ ° / State work to be performed and purpose of building (By Floors) New Building / Remodeling Addition Repairs No. of Stories Type of Tank ( "tok e Feet of Tank or Drain Field from Well Nature of Water Supply: Size • of Soakage Pit 1 t p -------- - - - - -- 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 under signed agrees to employ only such sub - contractors, on work tob` performed under this permit, as are licensed by Miami Shores Village. f j (Signed) _ � - • = '1.2 `-•- '-'– -------- ----- - --v - - l------ – – STATE OF FLORIDA, 4 – "c a / C C yz 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. Notary Public. State of Florida 4 e .5 - 3 "" S 1 I y d14,6.4"- CLOSETS BATH TUBS SHOWERS LAVA - TORIES SINKS SLOP SINKS LAUNDRY TUBS URINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT'NS TOTAL FIXTURES CONTR. LI ST CHECK SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR H EATER DEEP WELL SPRKLR. SYSTEM SWIM 'G POOL CONTR. LIST / CHECK 6 A 6' 5 IV/ r 6 e7,� Registered Architect antl,Ler.fongivree'i Employing Plumber's Name Size Septic Tank Feet of Drain Tile My Commission Expires MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT r'ermit No.. I 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 '1,0 No. 1 1 4 /2 , _,/,' E` :fi r [[,, b P' n_4 Location and Legal Description Lot ' '` C I 'I Block i Street and Number where work is to be performed —No ✓ ••••• l 2 No - 7 7 1 r 1. / e- .°•"' Amount of Permit $ (Signed) Street � � � 1 ____ Date 1- 10 - -ll 1P 1 r Street Pi/ ' Subdivision o r " j Capacity Gals f,�' fit: is Street-- 7, `1/ ° / State work to be performed and purpose of building (By Floors) New Building / Remodeling Addition Repairs No. of Stories Type of Tank ( "tok e Feet of Tank or Drain Field from Well Nature of Water Supply: Size • of Soakage Pit 1 t p -------- - - - - -- 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 under signed agrees to employ only such sub - contractors, on work tob` performed under this permit, as are licensed by Miami Shores Village. f j (Signed) _ � - • = '1.2 `-•- '-'– -------- ----- - --v - - l------ – – STATE OF FLORIDA, 4 – "c a / C C yz 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. Notary Public. State of Florida 4 e .5 - 3 "" S 1 I y d14,6.4"- .7; Size Septic Tank _5790 Feet of Drain Tile Nature of Water Supply: City — Welt° STATE OF FLORIDA, } COUNTY OF DADE. ss. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Permit No. v 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 Registered Architect aficWerrgongirreer ,_ 4='-Ylelc Employing Plumber's Name Location and Legal Description Lot 2 Street and Number where work is to be performed —No. State work to be performed and purpose of building (By Floors) New Building Y/ 90 My Commission Expires 4 '!?,i..1 No '7 7 r Block Id Remodeling Addition Repairs No. of Stories Type of Tank 4, t ft.I Capacity Gals 31.41 S•?_____. Dist. Feet of Tank or Drain Field from Well (Signed) No 7 ¥7 Street Street Size of Soakage Pit. Subdivision_ � s1__ Street oaths and take Amount of Permit $__ (Signed) ttO Notary Public, State of Florida ie 031 aw 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 under signed agrees to employ only such sub - contractors, on work to performed under this permit, as are licensed by Miami Shores Village. Before me, the undersigned authority, a notary public, duly authorized to administer 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. acknowledgments, personally 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 Size Septic Tank _5790 Feet of Drain Tile Nature of Water Supply: City — Welt° STATE OF FLORIDA, } COUNTY OF DADE. ss. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Permit No. v 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 Registered Architect aficWerrgongirreer ,_ 4='-Ylelc Employing Plumber's Name Location and Legal Description Lot 2 Street and Number where work is to be performed —No. State work to be performed and purpose of building (By Floors) New Building Y/ 90 My Commission Expires 4 '!?,i..1 No '7 7 r Block Id Remodeling Addition Repairs No. of Stories Type of Tank 4, t ft.I Capacity Gals 31.41 S•?_____. Dist. Feet of Tank or Drain Field from Well (Signed) No 7 ¥7 Street Street Size of Soakage Pit. Subdivision_ � s1__ Street oaths and take Amount of Permit $__ (Signed) ttO Notary Public, State of Florida ie 031 aw 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 under signed agrees to employ only such sub - contractors, on work to performed under this permit, as are licensed by Miami Shores Village. Before me, the undersigned authority, a notary public, duly authorized to administer 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. acknowledgments, personally 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. G.s S H cik IL 0,5 7718 N. E. 2NOAVENUE JOHN F. GAFFNY PLUMBING CONTRACTOR MIAMI, FLA. PHONE 7 -5284 AS