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284 NE 102 St (16)3516 k MIAMI SHORES VILLAGE "'yhb BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Dates / 1 Type Insp'n F Permit No. — Z Name JC1 1')C.+ VU C, Address 284 NE. IpZ S 1- Company J C P k'rribi n 9 E.r v I Ces (305) 936- 41 99 Phone # Inspection Date Approved Correction Re- Insp'n Fee Date Type Insp'n Permit No Name MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Time • a. Address U "' /00c;,5- Compan ' k T . 3 ` Phone # 'q5L JJ 3(0 f For Inspector: 0 Name & Date Approved 0 Correction El Re- Insp'n Fee ❑ Inspection Number: INSP -3755 Inspection Date: 12/20/2005 Inspector: Levrack, James Owner: VUKOVIC, VLADIMIR Job Address: 284 102 Street NE Miami Shores Village, FL Project: <NONE> CL Contractor: J C PLUMBING SERVICES, INC Building Department Comments Tuesday, December 20, 2005 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Block: Permit Number: PL2005 -201 Permit Type: Imported Permit Inspection Type: Final Work Classification: Plumbing Phone Number Parcel Number 1132060134710 Lot: Phone: 305- 796 -4663 Page 1 of 2 q ii , (5 TEO te, Ki Passed Comments I '4' 7`P Failed Correction Needed Re- Inspection Fee ($75) No Additional Inspections can be scheduled re- inspection fee is paid. until Inspection Number: INSP -3755 Inspection Date: 12/20/2005 Inspector: Levrack, James Owner: VUKOVIC, VLADIMIR Job Address: 284 102 Street NE Miami Shores Village, FL Project: <NONE> CL Contractor: J C PLUMBING SERVICES, INC Building Department Comments Tuesday, December 20, 2005 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Block: Permit Number: PL2005 -201 Permit Type: Imported Permit Inspection Type: Final Work Classification: Plumbing Phone Number Parcel Number 1132060134710 Lot: Phone: 305- 796 -4663 Page 1 of 2 FINAL GAS >� I Passed r Ins e or mments Failed Correction Needed Re- Inspection Fee ($75) No Additional Inspections can be scheduled re- inspection fee is paid. until Inspection Number: I NSP -3 Inspection Date: 12/22/2005 Inspector: Levrack, James Owner: VUKOVIC, VLADIMIR Job Address: 284 102 Street NE Miami Shores Village, FL 33138- Project: <NONE> Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Contractor: AMERIGAS PROPANE AND SUBSIDIARIES Building Department Comments Block: Permit Type: Imported Permit Inspection Type: Final Work Classification: <NONE> Phone Number P1.2005 -289 Parcel Number 1132060134710 Lot: Phone: 305 - 883 -8600 Wednesday, December 21, 2005 Page 2 of 2 6 +. MIAMI S ORES VILLAGE BUILDING DEPART W 0 2005 305- 795 -2204 Building Inspection Request Dateel CS Type Insp'n R & . - H "* Permit No. — – 289 Address Phone # Name Inspection Date Approved Correction Re- Insp'n Fee J/4.4-4-- UV K o J C 2841 Ica Companyia 1Q 5 Pp C'7F2), q BUILDING PERMIT APPLICATION FBC 2001 Permit Type (circle): Building Electrical ' lumbing Mechanical Roofing Owner's Name (Fee Simple Titleholder) ,)(Wet 4- i V I-AD \MKo YZ C Phone # ,03 757- 4. gR c! /OE / 0 a sf1 re__ City � 1 S Tenant/Lessee Name Job Address (where the work is being done) City Miami Shores Village Is Building Historically Designated YES Zip NO 14 r Contractor's Company Name Q=Q 1 P �J / ��• one # � � ' ��3 c6' 6 Contractor's Address ���� /14_1 9 City State Zip 3q /74 Qualifier State Certificate or Registration No. tA ©c9CG 9 Certificate of Competency No. Architect/Engineer's Name (if applicable) / $ Value of Work • /DO. T his Permit tQ : Type of Work: /� - C/ / U �, �.. ,.e c U Demolition Describe Work: / 2'7� c9Q es -c-/ / '�O J c2 j .L 'citrate, _ xcizer & 4 4 Total Fee Now Due $ (Continued on opposite side) State IbebO Miami Shores Village J / 4 / / J // ) Building Department - 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) °5. .04_F ;_(.305) 756.8972 ' O 2 3 7 .. , r Permit No. r '_ Master Permit No. /5,6 9 8 County Miami -Dade Zip 33/ 3S/ Phone # Square Footage Of Work: Phone # ** * * * ** * * * ** **** *,t*** * * *** * ` 5 ***** * *** * *** * * * * * * * * * * * * * * * *,k �- Submittal Fee $ Permit Fee $ 16o �" CCF $ • l0 CO /CC Notary $ Training/Education Fee $ 0 • 40 , Technology Fee $ , C Scanning $ 3• W Radon $ Zoning Bond $ Code Enforcement $ Structural Plan Review. $ Bonding Company's Name (if applicable) Bondgn,; CcAhaany'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 wil of be appro e.. d a rein . ection fee will be charged. sonally known to m s identific Signatu The f% •:oing instrument was acknowledged before me thi?\ day n 20v) , b)C \C , who is p NOTAR Si Print: chc 05/13/03 Owner or Agent or who has produced "off Sumuog 3 u miv 600Z `60 KIN is snuiuo D My Commission Expir �szstaa # D * * * * * * * * * * * * * * * * * **UNim** Wig* ion and wh t did take an oath. papuog NOTARY Y U �'>4 AIIV1ON * * * * * * * * * * * ** 3 r *F.'kl�;ff5 * * * * * * ** Commission # DD432320 APPLICATIO , • „ fires• JULY 09, 2009 YSonding Co., Inc Signature`�r, The forego' : instru day of who is rent: ************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *, * ** *, * *** *" * * * ** My Commission Expires: *. ** *: * * * * * * * * * * * * * * * * * * * * * * * ** * * * * * * / * * * * * * * * * * * * * * * ** A ly a rT Plans Examiner Engineer Zoning Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Permit Number: PL2005 -289 Printed: 9/26/2005 Applicant: JANET VUKOVIC Owner: VUKOVIC JANET JOB ADDRESS: 284 NE 102 ST Contractor Local Phone: 305 - 883 -8600 Parcel # 1132060134710 Plumbing Permit AMERIGAS PROPANE AND SUBSIDIARIES Contractor's Address: 10052 NW 89 AVENUE Legal Description: MIAMI SHORES SEC 1 AMD PB 10 -70 LOT 1 & LOT 2 BLK 35 LOT SIZE Fees: Description Amount FEE2005 -12811 Building Fee $160.00 FEE2005 -12812 CCF $1.20 FEE2005 -12813 Training and Education Fee $0.40 FEE2005 -12814 Technology Fee $4.00 FEE2005 -12815 Scanning Fee $3.00 Total Fees: $168.60 Total Fees: $168.60 Total Receipts: $168.60 Permit Status: APPROVED Permit Expiration: 3/22/2006 Construction Value: $1,800.00 Work: GAS LINE Signed: (INSPECTOR) Page 1 of 1 SEP 2 6 PAID )�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: kat 4 / (r: jDO . r Gols Eauzir 114444 6 cue. s A4 /-/, 6 00 Zit) 0444-zaa s eouLa414 0144... fi7 Sag) 420e•e• 644-cv Qateift. AmeriGas, LPG 00899 10052 NW 89 Ave., Medley, Fl 33178 'Tel. 3O-3c,&-60O F 1 JO: 40 vt Arp 242 W 0-44,6eilid atta DATE: REVISED: SCALE APPROVED 8'f: DRAWN BY: AFFIDAVIT: , • This iistaltalion shall comply with NF-PA 54, NFPA 58, as well as al state & local codes and regulations. Page / of GENERAL SITE PLAN Signature of Chaffer PRINT RAW. otszinert- LC oc.) j8=1 Sworn to and subscribed before me this day of .20 by SEA!) . . , Perstrafty klador or Pr-du Typ. ci i:rrafication Pmduce ‘‘, • • • 55142 N.W. 7th STREET, SUITE 202 MIAMI, F,(_ORIDA■33126 TELEPHONE; (305) 264-2660 FAX: (305) 264 -0229 / Nona pururt Att LAND SURVEYORS BOUNDARY SURVEY 20 Scale 1" _ z 89'6 ?'jg T= z. Si ` 3 5`32 SURVEY NO.." 785/ SHEET NO. OF G o BUILDING PERMIT APPLICATION FBC 2001 Owner's Address 7i r4y AfC /6 L 5 City PI 41t'l ( S If0(Lds State Tenant/Lessee Name Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (3 Permit Type (circle): Building Electrical Plumbing Mechanical Roofing Owner's Name (Fee Simple Titleholder) V U CQ of C H Phone # 305 7 CI 7 7 Job Address (where the work is being done) 2 g ��{ /0 2 Sr - Qualifier 'rd V ' 04- tit T 8972 1 7 Permit No. 7 C2' 43 „JJ ster Permit No. Zip 33/ (o / Phone # City Miami Shores Village County 'ami -Dzde Zip 3 3/ / Is Building Historically Designated YES NO Contractor's Company Name P 4415 DLct -t f / Phone # fD 5" 2-3 Z" 7669 Contractor's Address / /t9.2-4 5 Ze /77 S% Cit S I ( 0 4 / State G Zip 9 / 9'6 S 44(0 State Certificate or Registration No. 0 5-7 Z 5 ' etc' Certificate of Competency No. Architect/Engineer's Name (if applicable) Phone # $ Value of Work For this Permit Type of Work: ['Addition ['Alteration ❑New Describe Work: R p 1 f &-- ��" C Loc: T J i 9A90 ro Code Enforcement $ Structural Plan Review. $ Total Fee Now Due $ (Continued on opposite side) Square Footage Of Work: * * * * * * * * * * * * * * * * * * * * * * * * ** ** F ees * * * * * * * * * * * * * * * * * * * * * * * * * * * *** Submittal Fee $ - 0 Permit Fee $ Notary $ Training/Education Fee $ Scanning $ Radon $ ❑ Repair/Replace ❑ Demolition S #1 c•cir (Z) ,° 4_4- I/ 'ti 2 9 , CCF Technology Fee $ Zoning Bond $ CO /CC /i/-azd 0-q/rm t— Bonding Company's Name (if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State Zip Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will t b approved and a reinspection fee will be charged. Signature Signature The oing instrument was ac owledged before me us I g? The •: - egoing instrument was acknowled ` � day of = V ����,a'Y'(L"40 • �! . � .. , ,� , 20057 1 '_ _ �r � ( who .ersonally nown to me or who has produced ' ?�U whs � sonally kn Awn to me j.P3— o aa- 8 (00 - .0.5- A ° ;dentificati and 1 did take Woo 79a (i 7 r n who did an oath. - s rdenitrfica .: NOTARY �o did take an oath. / ' NOT Y PUBLIC sign: ,./101 4�. � _ Y H. ' . -11 Si r .�.,r,Y,.:..a:.�: �' W��� fires: Ma 26, 2008 Pri j�eird l � .•r, i 1:• F. Atlantic Bonding Co., Inc. My Commission Expires: 51 _ , O L OP My Commission Expires: ******* * * * * * * * * * * * * * * * * * * *k * * * * * * ** * * * * * * * * * * * * * * * * ** alit********** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** APPLICATION APPROVED BY: " 04 # '∎Cfi✓L- / / 0 Plans Examiner Engineer Zoning Chc 05/13/03 Owner or Agent 20 QJ, 3-y Contractor r who has produc 1 E :lell mmisslon #D0323870 2 6.2008 ) Bonded ' •,�i an tic Bondin Co., Inc. * * * * * * ** ed before me this PLUMBING (AN APPLICATION FOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. IF A MASTER PERMIT HAS B. OB .MEII, Tag_ O tIiE S SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.) ADDENDUM TO BUILDING PERMIT APPLICATION ELECTRICAL MECHANICAL ITEM BATH TUB 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 DRAIN SERVICE REPAIR/IETER CHANGE REFRIGERATION GREASE TRAP APPLIANCE OUTLETS PROCESS AND PRESS PIPING INTERCEPTOR RANGE TOP UNDERGROUND TANKS LAVATORY 1 OVEN ABOVE GROUND TANKS LAUNDRY TRAY • WATER HEATER U.F. PRESSURE VESSELS CLOTHES WASHER MOTORS 0- 1 HP STEAM BOILERS SHOWER 1 MOTORS AVER 1- 3 HP HOT WATER BOILERS SINK, POT /3 COMP. MOTORS OVER 3- 5 HP MECHANICAL VENTILATION SINK, RESIDENCE MOTORS OVER 5- 8 HP TRANSPORTING ASSEM3LIES 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 HP COOLING TOWERS WATER CLOSET 1 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 COM+IERCIAL 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 PUAP & ABANDON SEPTIC TANK RE INSPECTION 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 PLUMBING (AN APPLICATION FOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. IF A MASTER PERMIT HAS B. OB .MEII, Tag_ O tIiE S SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.) ADDENDUM TO BUILDING PERMIT APPLICATION ELECTRICAL MECHANICAL re-- itofe Zgu ivy /) z s r EC1EPVED JAN 1 12 5 �Q� S c, re..--+t/i: 4, ! . z s r • 9. (1. P 4 - A/ ECIFj ® JAN '' 1 nn �m t fr T (�L Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Permit Number: PL2005 -13 Printed: 1 /18/2005 Applicant: JANET VUKOVIC Owner: VUKOVIC JANET JOB ADDRESS: 284 NE 102 ST Contractor DAVIS PLUMBING Local Phone: 305 - 232 -7669 Parcel # 1132060134710 Signed: (INSPECTOR) Plumbing Permit Contractor's Address: 16026 S. W. 147 ST. Page 1 of 1 Legal Description: MIAMI SHORES SEC 1 AMD PB 10 -70 LOT 1 & LOT 2 BLK 35 LOT SIZE Fees: Description Amount FEE2005 -677 Building Fee $165.00 FEE2005 -678 Training and Education Fee $0.80 FEE2005 -679 Notary Fee $5.00 FEE2005 -680 Scanning Fee $3.00 FEE2005 -681 Training and Education Fee $0.80 FEE2005 -682 Technology Fee $4.12 Total Fees: $178.72 Total Fees: $178 2 Total Receipts: $ ia_ - : Permit Status: APPROVED Permit Expiration: 7/10/2005 Construction Value: $4,100.00 Work: REPLACE EXISTING SHOWER, LAVATORY AND WATER CLOSET WITH NEW ONES INCLUDING WATER PIPING. In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responisibility for all work done by either myself, my agent, servants or employes. Signed: (Contractor or Builder) BY: BUILDING PERMIT APPLICATION FBC 2001 Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Permit Type (circle): Building Electrical Plumbing Mechanical Roofing Owner's Name (Fee Simple Ti leholder �/ Phone # Owner's Address C / 2 g /VG L� City J Statte // Zip ��l e Tenant/Lessee Name / V / Phone # Master Permit No. Permit No. P — Job Address (where the work is being done) sh7 /"6 C" City Miami Shores Village County Miami -Dade Is Building Historically Designated YES NO Contractor's Company Name . C vlitg1 Q,v1C�S Phone # ( 22q - 1 n9 Contractor's Address 3 50 0 l•-•\'`c - nC. Pot aW b2 City 16 1V N`TUla State FL Zip 331 Qualifier -VAN CAQ•L.OS ( and Zip State Certificate or Registration No. CFCVy2( 2):71 Certificate of Competency No. Architect /Engineer's Name (if applicable) Phone # $ Value of Work For this Permit 4 , ODD• Ob Square Footage Of Work: Type of Work: Addition ❑Alteration ❑New Repair /Replace ❑ Demolition Describe Work: / , in R � MO 1)EL1 N6 AK }> N. k/J 6A * * * * * * * * * * * * * * * * * * * * * * * * * * ** F ees * *, * * * * * * * * * * * * * * * * * * * * * * * * ** C Submittal Fee $ Permit Fee $ / V r'�� CCF $ 1 - CO /CC Notary $ J- Training /Education Fee $ 0 • COO Technology Fee $ 3 .70 Scanning $ .3 .OD. Radon $ Zoning Bond $ Code Enforcement $ Structural Plan Review. $ Total Fee Now Due $ (Continued on opposite side) Bonding Company's Name (if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State Zip Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. the asen • of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature Signature Owner or Agent The foregoing instrument was acknowledged before me this day of ,20,by who is personally known to me or who has produced As identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC Sign: Sign: Print: Print: ** * * * * * * * ** * * * * * * * * * * * * * * * * * * * * ** APPLICATION APPROVED BY chc 05/13/03 The foregoing instrument: was day o who Contr. tor 2 , by rsonally known to me or owledged before me thiI i uon GIPS o has produced entification and whJii take an oath. ,91.18L! My Commission Expires:... , My Co mission Eic :ir s: ************************************************ * * * * * * * * * * * * * * * * * * * * * * * ** * * * * ** 1 ** * * * * * * * * * * * * * * * * * * * * ** Plans Examiner Engineer Zoning ITEM BATH TUB UNIT 3 FEE ITEM SWITCH OUTLETS UNIT 'FEE ITEM SPACE HEATERS UNIT FEE BIDET LIGHT OUTLETS CENTRAL HEATING DISHWASHER f RECEPTACLES A/C (WIND) DISPOSAL l SERVICE TEMPORARY A/C (CENTRAL) DRINKING FOUNTAIN SERVICE SIZE IN AMPS DUCT WORK FLOOR DRAIN SERVICE REPAIR/METER CHANGE REFRIGERATION GREASE TRAP APPLIANCE OUTLETS PROCESS AND PRESS PIPING INTERCEPTOR RANGE TOP UNDERGROUND TANKS LAVATORY li OVEN ABOVE MOUND TANKS LAUNDRY TRAY WATER HEATER U.F. PRESSURE VESSELS CLOTHES WASHER J MOTORS 0- 1 HP STEAM BOILERS SHOWER MOTORS OVER 1- 3 HP HOT WATER BOILERS SINK, POT /3 COMP. MOTORS OVER 3- 5 HP MECHANICAL VENTILATION SINK, RESIDENCE J 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 41 MOTORS OVER 100 If VIOLATION INDIRECT WASTES - ' A/C WINDOW REINSPECT ION 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 SWI)AIING POOL OUTLETS COMMERCIAL WATER SERVICE J SIGN TUBES . SEWER CONNECTIONS .SIGN TRANSFORMERS UTILITY -SEWER SIGN TIME CLOCK UTILITY -WATER FIXTLRES SEPTIC TANK ANTENNA RELAY TELEVISION OUTLETS GRAINFIELD, 4" TILE/RES. VIOLATION PUMP & ABANDON SEPTIC TANK REINSPECT ION 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 MASTER PERMIT HAS B. OBTAINED; THE OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.) PLUMBING ADDENDUM TO BUILDING PERMIT APPLICATION ELECTRICAL MECHANICAL Miami Shores Village 10050 NE 2nd Avenue Phone: 305- 795 -2204 Permit Number: PL2005 -201 Printed: 8/12/2005 Applicant: JANET VUKOVIC Owner: VUKOVIC JANET JOB ADDRESS: 284 NE 102 ST Contractor J C PLUMBING SERVICES, INC Contractor's Address: 3500 MYSTIC POINT DR Local Phone: 305 - 796 -4663 Parcel # 1132060134710 Plumbing Permit Page 1 of 1 Legal Description: MIAMI SHORES SEC 1 AMD PB 10 -70 LOT 1 & LOT 2 BLK 35 LOT SIZE Fees: Description Amount FEE2005 -11149 Building Fee $145.00 FEE2005 -11150 CCF $1.80 FEE2005 -11151 Notary Fee $5.00 FEE2005 -11152 Training and Education Fee $0.60 FEE2005 -11153 Technology Fee $3.70 FEE2005 -11154 Scanning Fee $3.00 Total Fees: $159.10 Total Fees: $159.10 Total Receipts: $0.00 Permit Status: APPROVED Permit Expiration: 12/18/2005 Construction Value: $3,000.00 Work: INTERIOR REMODELING AND NEW BATH Signed: (INSPECTOR) AUG 12 PAID LK 4 z Z 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: i PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date Job Address A t Z 0 Y N6 / O ° L s-r Tax Folio Legal Description Historically Designated: Yes No Owner/Lessee / Tenant)( V l - D 1 Y1( \/d k D V i C Owner's Address 2 3 9 / L' f O 2 S r, 4 U Contracting Co. 1 k ?�- `� � t )I Cr Qualifier S 7G ws" i-4 iS State # C ,-C 05' 72Sy y Municipal # Architect/Engineer Bonding Company Mortgagor a . - of owner and/or Condo President Date 2 1 93 95 MY4‘-/6a0 41' .11d — N. era's t• Owner aid/or Co/1%g 71.10 LAR Date Commission ExpiARY PyBLIC STATE OP FLORIDA CQM■LSSION NO. 0Y714103 ..ALCOMMISSION EXP. MAL FEES: PERMIT APPROVED: Zoning Mechanical Plumbing 611 ss# 3 Vs S 7cPO Address Competency # Address Address Address Phone Permit Type (circle one): BUILDING ELECTRICAL LUMBIN MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTIO e P T (A-ce W e - e tTMe '9' 'lc) ( tee p 1. - newt - P . 11 t. W P_ Square Ft. Estimated Cost (value) (/ qyZ tc °. 0 t 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 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. OWNERS AP'I''IDAVIT: I certify that all the foregoing information is accurate and that all work l j done in compliance with all applicable I re: lating construction and zoning. Furthermore, I authorize the above -named contractor to do the wort Contractor lure J A /rte/ / .. No k I.as o Contra or My Commission Expire RADON C.C.F. /. p p 0 NOTARY c Building Electrical Master Permit # ql (0 1 D 3as' 258 o7 Ins. Co. ,4e )eS • GLADYS) VILLA NOTARY PUBLIC SPATE CP FLORIDA COMMISSION NO. CC714103 Y COMMISSION EXP. MAR. 1 002 . l Date DO er- Builder ' late 0 7�z 6� 0 3 0 Structural Engineer ITEM BATH RE UNIT 0 FEE ITEM SWITCH CUTLETS UNIT FEE ITEM SPACE HEATERS UNIT FEE BIDET LIGHT OUTLETS CENTRAL. HEATING DISHWASHER RECEPTACLES A/C (WING) 0I SPOSAL SERVICE TEMPCRARY A/C (CENTRAL) OR INKING FOUNTAIN - SERVICE SIZE IN AAPS DUCT WORK =LOCK GRAIN SERVICE REPAIR/METER CHANGE REFRIGERATION :R EASE TRAP APPLIANCE CUTLETS PROCESS AND PRESS PIPING INTERCEPTOR RANGE TOP UNDERGROUND TANKS LAVATORY OVEN ABOVE (MOUND TANKS LAUNDRY TRAY WATER HEATER U.F. PRESSURE VESSELS :LOTHES WASHER MOTORS 0- 1 If STEAM BOILERS SHOWER MOTORS OVER 1- 3 HP HOT WATER BOILERS 3INK, POT /3 CORP. MOTORS OVER 3- 5 HP MECHANICAL VENTILATION 3INK, RESIDENCE MOTORS OVER 5- 8 HP TRANSPORTING ASSEMBLIES 3INK, SLOP MOTORS OVER 8- 10 If ELEVATORS/ESCALATORS TEMPORARY WATER CLOSET MD TORS OVER 10- 25 If FIRE SPRINKLER SYSTEMS URINAL MOTORS OVER 25-100 HP COOLING TOWERS iATER CLOSET . MOTORS OVER 100 If VIOLATION INDIRECT WASTES A/C WIICON RE INSPECT ION iATER SUPPLY TO: AIR CONDITIONERS A/C UNIT STRIP HEATER F IRE SPRINKLER GENERATORS TRANSFORMERS • HEATER -NEW INST. GENERATORS TRANSFORMERS I HEATER - REPLACE GENERATORS TRANSFORMERS LAWN SPRINKLER -WELL SPECIAL PURPOSE SWIM}aING POOL CUTLETS COM4ERCIAL WATER SERVICE SIGN T I3ES EWER CONNECTIONS SIGN TRANSFORMERS TILITY -SEWER SIGN TIMIE CLOCK TILITY -WATER FIXTLRES _PTIC TANK ANTENNA =LAY TELEVISION CUTLETS 1AINFIELO, 4' TILE/RES. _ VIOLATION JMP & ABANDON SEPTIC TANK RE INSPECT ION JAKAGE PIT CU. FT. . TCH BASIN ISCHARGE WELL :MESTIC WELL LEA GRAIN AF INLET ;L WATER HEATER RE STANDPIPE AL PIPING . ,WN SPRINKLER SYSTEM S RANGE TER SET (GAS) S PIPING W4'4 A 1 I f R kkCe 2 �Fec j erz 4'J Pg rTta 1 IseV 1tCetr&e,., -1- o ., A-crt_ r Fl Pes. PLUMBING ADDENDUM TO BUILDING PERMIT APPLICATION (AN APPLICATION FOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. IF A MASTER PERMIT HAS B. OBTAINED, THE OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.) ELECTRICAL MECHANICAL JOB: • BUILDING ELECTRICAL PLUMBING The following Inspector''s Report! • • • • • • • • • • • AD : WORK DONE BY: • REQUESTED • is ready for Inspection: 2 seY/ WILL BE READY : - At; - ‘0 • 11 if Z.- 4• Permit No. .___ 5 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 Engineer - - ---- - - - --- -------- - -- - -- --- Employing Plumber's Name _____ -_ — No.74 _. 4" Street Location and Legal Description Lot____— ________ ______ — _______— ________Block_ Subdivision_ _ —_ _____ ______— ______ __________ Street and Number where work is to be performed —No State work to be performed and purpose of building (By Floors) New Building Remodeling Addition Repairs No. of Stories Size Septic Tank_____— ________________________—______ Type of Tank Feet of Drain Tile_ Amount of Permit $_ appeared 7 My Commission Expires NOTE: A re- inspection fee of materials and /or workmanship. —_ —__ Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: City —Well. Size of Soakage Pit No. ___,�f'-Q Capacity Gals Date Plumbing Inspector. The undersigned applicant for this building permit does hereby certify thyf'he understands and acce. ` 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 be performed under this permit, as are licensed by Miami Shores Village. (Signed) ________ er Plumber. STATE OF FLORIDA, 1 ss. COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally 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 $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty 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 SOAKAGE FIELD PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SWIM'G POOL CONTR. LIST CHECK ' / ZJ Permit No. .___ 5 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 Engineer - - ---- - - - --- -------- - -- - -- --- Employing Plumber's Name _____ -_ — No.74 _. 4" Street Location and Legal Description Lot____— ________ ______ — _______— ________Block_ Subdivision_ _ —_ _____ ______— ______ __________ Street and Number where work is to be performed —No State work to be performed and purpose of building (By Floors) New Building Remodeling Addition Repairs No. of Stories Size Septic Tank_____— ________________________—______ Type of Tank Feet of Drain Tile_ Amount of Permit $_ appeared 7 My Commission Expires NOTE: A re- inspection fee of materials and /or workmanship. —_ —__ Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: City —Well. Size of Soakage Pit No. ___,�f'-Q Capacity Gals Date Plumbing Inspector. The undersigned applicant for this building permit does hereby certify thyf'he understands and acce. ` 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 be performed under this permit, as are licensed by Miami Shores Village. (Signed) ________ er Plumber. STATE OF FLORIDA, 1 ss. COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally 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 $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty BUILDING ELECTRICAL PLUMBING ROOFING Owner of Building Architect Contractor or Builder Legal Description Address of Building Lot ❑ PERMIT N? 1675 MIAMI SHORES VILLAGE. FLORIDA Work to be performed under this Permit Bl. Subdi- vision 4 . q f. , Value of Project $ DATE Contractor's License No 195 Amount of -, Permit $ This permit is granted to the contractor or builder named above to construc 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' _ � �. 1 4 BY INSPECTOR In consideration of the issuance to me of this permit I agree 4o perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto ins . conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In ac- cepting this perm nsibility for ,all work done by either, myself, my agent, servant or employee. • ER BY AUTHORITY 6Agi*° N9 1879 Street Address Approved use by occupancy Remarks. CERTIFICATE 'OF OCCUPANCY Owner, Agent or Tenant of Building Lot _ Block C MIAMI SHORES VILLAGE, FLORIDA BUILDING DIVISION Miami Shores Village, Fla , I 1-S3 bdivision ( (s This Certificate of Occupancy issued to the above named for building at above named location only upon the express provision that the applicant will abide by and comply with all conditions of Ordinances Nos. 92, 93, 94 and 97, known ss the Zoning, Electrical, Plumbing and Building Ordinances of Miami Shores Village pertaining to the erection, construction, alteration or remodeling .f buildings or structures. T Vt. . 1 s DING Dl SION B4ILDIN LEC 'RICIt PLUMBING ROOFING Owner of Building Architect Contractor or Builder Legal Description, Address of Building 0 o PER Work to be peo ;MIAMI SHORES V1LLACE FLORIDA DATE Contra or's License No 5001 ed ti =ler this Permit Value of Project $ This permit is granted to the contractor or budder gamed above `to construct the building or to install the equipment or device described in the application herefor in strict compliance with all ordi �'ances{p-arta ng thereto and with the understanding that the work will be performed in compliance with any plans, drawings, statements or specifications that may been;eubmitted to an approved by the proper municipal authorkies. This Permit may be revoked at any time if the work is not done in compliance with ch ordinances or if the plans are changed without authorization. A'. +further condition upon which this permit is granted is the understanding that the con rector or builder named above assumes the responsibility for a thorough linevAledge of the ordinances and regulations pertaining to the work covered hereby wh shown on the plans or dra, or iu the statetents or specifications and that he assumes responsibility for work done by his agents, servants or employees. Arnt. of Permit IFS CTOI In consideration of the issuance to me of this permit I agree to p •. i•: m the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity; with e-plans, drawings,4tatem - is or specifications submitted to the proper authorities of lvliami Shores Village. In .. pting this tzarmit I assume responsibility, for all work done either, mys -.,, my .- � � , servant or employee. Amount of Permit $ New Building ___ emode _ Addition. Nature of Water Supply; City -Well My Commission Expires MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT - _ (Signed)- _.-- -_ -_ -. Repairs. Size of Soakage I'it Date ..7 Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or othe) 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 Divisior of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. Owner's Name and Address. __ . ._.._ __ -` No Street Registered Architect and /or Engineer _ �___ -___ _ Employing Plumber's °' s Name - ° 4 . 7 0 ._- No.._..._ ._._.__..._. Street. and Legal Description Lot ..._....___ - ______ , Block__ .- __-- __ .--- -_ - - -_ - Subdivision - - - - -- _ Street and Number where work is to be performed -No , 71.£ /02---`� Sweet. State work to be performed and purpose of - building (By Floors)-- Size Septic Tank - -�"-� - Type of Tank__ � N _C... 7 Feet of Drain Tile !L G -Dist. Feet of Tank or Drain Field from Well Capacity Gals. /-. - -7 Notary Public, State of Florida No. of Stories ..... ........... .. . Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as au employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and hLs 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 an 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 ac personally .,ppeare 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 tar 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 Earl materials and /o . woi�anship. CLOSETS BATH TUss SHOWERS LAVA. TORIES SINKS SLOP SINKS LAUNDRY Tuee URINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT'NS TOTAL FIXTUREI 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 Amount of Permit $ New Building ___ emode _ Addition. Nature of Water Supply; City -Well My Commission Expires MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT - _ (Signed)- _.-- -_ -_ -. Repairs. Size of Soakage I'it Date ..7 Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or othe) 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 Divisior of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. Owner's Name and Address. __ . ._.._ __ -` No Street Registered Architect and /or Engineer _ �___ -___ _ Employing Plumber's °' s Name - ° 4 . 7 0 ._- No.._..._ ._._.__..._. Street. and Legal Description Lot ..._....___ - ______ , Block__ .- __-- __ .--- -_ - - -_ - Subdivision - - - - -- _ Street and Number where work is to be performed -No , 71.£ /02---`� Sweet. State work to be performed and purpose of - building (By Floors)-- Size Septic Tank - -�"-� - Type of Tank__ � N _C... 7 Feet of Drain Tile !L G -Dist. Feet of Tank or Drain Field from Well Capacity Gals. /-. - -7 Notary Public, State of Florida No. of Stories ..... ........... .. . Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as au employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and hLs 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 an 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 ac personally .,ppeare 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 tar 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 Earl materials and /o . woi�anship. —!- CLOSETS BATH TUBS SHOWERS LAVA. TORIES SINKS SLOP SINKS LAUNDRY TUBS URINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT•NS W 0.1+, TOTAL FIXTUREI Comm. LIST I I � - -- CHECK � �� / j 7- ' 2 - / d d SEPTIC TANK SEWER CONN. / DRAIN FIELD SOAKAGE PIT GREASE TRAP .leeRR HEATER DEEP WELL SPRKLR. SYSTEM SWIM'S POOL CONTR. LIST CHECK _ � / E/ i9 � e4s Permit No. Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or Dolly, 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 Divisior of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept al building during progress of work. Owner's Name and Address. _ � __-_- No.__ Street Registered Architect and /or Engine -- _ -'_ -- .___.. __.____.. - - -___ _ Employing Plumber's Name. .4_ ".4. > • —____ _- _---- _ -_.._ No.__ Street Location and Legal Description Lot - - -_ - •--------- -_ -___ _- __-_ ._._ Block_.____-- __-- _ -_ _ _ __ __ ______ __ Subdivision _- _--- __.._.__ Street and Number where work is to be performed —No flfl�� t- -_.. Stree State work to be performed and purpose of building (By Floors) ' New Building Feet of Drain Tile Nature of Water Supply: City —Well . Amount of Permit $_ ...... / 56-0 7 Remodeling ..... __. ......... __.______ Addition___ Repairs . .. ...... ...... No. of Stories Size Septic Tank Type of Tank_._ MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Dist. Feet of Tank or Drain Field from Well Size of Soakage Pit (Signed) _. (Signed)_ Date Capacity Gals. Plumbing Inspector. The undersigned applicant or this building permit does hereby certify that he understands and accepts his obligations as all employer of labor under the Florida Workmen's Compensation Act, being Section 5960, Compiled General Laws of Florida Permanent Supplement, and m- 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. 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 ,Ippeare to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all tat. therein by him stated are true. My Commission Expires Notary Public, State of Florida N • • A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or hail mat • ' •1 s and /or workmanship. ,kl4