317 NE 102 StMIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
ilding Inspection Request
Time
Type Insp'
Permit No
Name
Address 3
Company
Phone # ?
For Inspector.✓
Approved
Correction
Re- Insp'n Fee
CH<
MIAMI SHORES VILLAGE
BUILDING DEPARTMEN
305- 795 -2204
Building Inspection Request
Dat ' 4 )
•
Approved
Correction
Re- Insp'n Fee
o
o
Time
Address
Company
Phone # � ) For Inspector: C I ) ) ) 03 PN
r/
Miami Shores Village
r--- 10050 NE 2nd Avenue
Phone: 305-795-2204
Printed: 3/11/2003
M Applicant: DIANE LOFFREDO
0 Owner: LOFFREDO DIANE
P JOB ADDRESS: 317 NE 102 ST
Contractor BOBS SEPTIC & DRAIN INC
PAY
TO THE
ORDER OF
Local Phone: 305 - 558 -5818
Parcel # 1132060135060
Permit Status:
BOB'S SEPTIC & DRAIN, INC.
1020 NE 130TH ST. PH. 305 - 558 -5818
NORTH MIAMI, FL 33161 -4211
c tibank®
CITIBANK, F.S.B. BR. *37 •
2750 AVENTURA BOULEVARD
AVENTURA, FL 33180
APPROVED Permit Expiration: 9/7/2003
FOR
11'00557411' 1:266086 5 54 2 2? 60 69u■
Plumbing Permit
Permit Number: PL2003 -66
Contractor's Address: 1020 NE 130 ST
Legal Description: MIAMI SHORES SEC 1 AMD PB 10 -70 LOT 15 & W1/2 LOT 16 BLK 37 LOT SIZE
Fees: Description
FEE2003 -1441 Builder's Bond
FEE2003 -1442 Building Fee
FEE2003 -1443 CCF
FEE2003 -1444 Notary Fee
Total Fees:
Amount
$300.00
$80.00
$1.80
$5.00
$386.80
Total Fees: $386.80
Total Receipts: $0.00
Construction Value: $2,500.00
Work: 300 sq drainfield installation
If there is no permit package accessible on the job -site for inspectors to verify, there will be no inspections. Re- inspection
�?I
Ade ,0
*of
l
DATE
//
5574
63- 86557
2660
5,CV
o re/ fb
kre
Page 1 of 1
lication herefor in strict compliance with all
:ifications that may have been submitted to
Is or if the plans are changed without
:ponsibility for a thorough knowledge of the
that he assumes responsibility for work done
ons pertaining thereto and in strict conformity
responisibility for all work done by either
A
• 1
s%c .
111 1hi.
F.L.0
The
STEPHEN K LOFFREDO
317 NE • TREET
q 11-03;0,2
M 6-00
n 1' L163-791-52-403-0
i
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''' '. SAFE. IVE Ilac
601486 1 •
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03/04/2003 12:50 3055133472
LOT: 16 BLOCK: 37
STATE OF FLORIDA
DEPARTMENT OF HEALTH
.ONSITE SEWAGE TREATMENT
CONSTRUCTION PERMIT
CONSTRUCTION PERMIT FOR:
[ ]New System [ ;Existing System
( X ]Repair ( ]Abandonment
APPLICANT: Loffredo, Stephen
PROPERTY STREET ADDRESS: 317 NE 102 St Miami Shores FL 33138 • • ••• ••
PROPERTY ID #: 11- 3206 -013 -6060
SYSTEM MUST BE CONSTRUCTED IN ACCORDANCE WITH SPECIFICATIONS AND STANDARDS OF CHAPTER 64E -6,FAC
DEPARTMENT APPROVAL OF SYSTEM DOES NOT GUARANTEE SATISFACTORY PERFORMAiNCE FOR ANY SPECIFIC TIME
PERIOD. ANY CHANGE IN MATERIAL FACTS WHICH SERVED AS A BASIS FOR ISSUANCE OF THIS PERMIT,
REQUIRE THE APPLICANT TO MODIFY THE PERMIT APPLICATION. SUCH MODIFICATIONS MAY RESULT IN THIS
PERMIT EEING MADE NULL AND VOID. ISSUANCE OF THIS PERMIT DOES NOT EXEMPT THE APPLICANT FROM
COMPLIANCE WITH OTHER FEDERAL, STATE OR LOCAL PERMITTING REQUIRED FOR PROPERTY DEVELOPMENT.
SYSTEM DESIGN AND SPECIFICATIONS
750 ]Gallons SEPTIC TANK
0 ]Gallons
0 JGALLONS GREASE INTERCEPTOR CAPACITY
0 JGALLONS DOSING TANK CAPACITY [ 0 ]GALLONS
( 200 )SQUARE FEET PRIMARY DRAINFIELD SYSTEM
[ 0 )SQUARE FEET
TYPE SYSTEM: (' 'STANDARD
CONFIGURATION! '� N ]TRENCH
OTHER REMARKS:
This permit is not for addition(o).
*Existing 750 g1. septic tank to remain.
*Install 200 aq.ft. of drainfield.
*Invert elevation to be no leas than 7.60' NGVD.
*Bottom elevation to be no lees than 7.10' NGVD.
SUBDIVISION: Miami Shores
[Section /Township Range /Parcel No.'
[On TAX ID -NUMBER]
LOCATION TO BENCHMARK: Top of Bottom F1 12.4 0' NQVD.
ELEVATION OF PROPOSED SYSTEM SITE [ 2.8 ] [ FEET ]
BOTTOM OF DRAINFIELD TO BE [ 5.3 ] ( FEET
FILL REQUIRED: [ 0.0 ]INCHES EXCAVATION REQUIRED: [
d6p DEVICE
F1ff O rLEd TEE
SPECIFICATIONS BY: Icaza, Carlos
DATE ISSUED: 3/4/03
• • ••• •
•• • • • •
• • • • • •
• • • •••
AND DISPOSAL 9h'STf • •
F r)
4
•
•
OSTDS
[ ]Holding Tank [ ] Innovative Other
[ ]Temporary ( NA ]
• • • • • •• ••• �••
AGENT: SR09421b»1t, :PERT &DAiROSERT
• • • • • • • •
SYSTEM
( N ]PILLED
rEED
o
TITLE!
• •
• • •
• • • •• • • •
. • • • • • • •
• • • •
APPROVED BY: Icaza, Carlos TITLE: Engineer I
DH 4015, 03/S/ (ObeoletcS previous editions which may not be used)
(Stook Number: 3744 - 001 - 401.6 (an(.dh coon A91@ -ii
;• •teq. ##: 13 -SG -15753
• D D:
ATt PALM
s
i `EF+i P AID
RECEIPT .
OSTDSNSR
• •••
• • •
•
MULTI - CHAMBERED /IN SERIES: [Y J
MULTI - CHAMBERED /IN SERIES: [Y
0 [ 0 ]DOSES PER 24 FIRS ## PUMPS( 0 ]
[ N ]MOUND ( N ]
[ N I
( BELOW BENCHMARK /REFERENCE POINT
( BELOW ] BENCHMARK/REFERENCE POINT
30.0 1 INCHES
PAGE 01
03 -0669- -R
THIS PERMIT T NOT t `. ' f "i' S)
INVERT r t'.E vAT iC+,7 _2, .(i.L` _L-) E
BOTTOM OF DRAINFIELD 7. / O '�c.ie
Dade CHD
EXPIRATION DATE: 6/2/03
Page 1 of 2
CONTRACTOR
Name ; o /AV 1��/I' tZIT I 1
License No.5 2 n q � 0l 1 /
�� —( ! b
Address
t o 2o 4J, 6 l3o 577 AA/17
Telephone ✓ 58 Fax Q(� oa 70
Qualifier Name - A dB TA- -t-,q-
PROPERTY OWNER
Nme Lc Name LFei o
pg G C 4 )
Address
3/7 AJ E, /off 57:
Home Telephone c 1 /
5/i
Business Telephone
Fax
TYPE OF MANAGEMENT (✓ )
New Construction
Enclosure
Alteration Exterior
Repair
Alteration Interior
Demolish
Relocation of Structure
Shell Only
Foundation Only
Add'1 Attachment
Other
Add'l Detachment
Other
Step 1.
Job Address:
PERMIT TYPE (✓ )
Building
Electrical
Mechanical
Plumbing
LPGX
Roofing
Fence
Other
416 ST
Address Apt.
Chg. Contractor
Renewal
Revision
Extension
Supplement
Reinspection
ARCHITECT
Name
Address
A/4
License No.
Telephone
Fax
• • • •
• • • • ••• •
• • • • • • • • • •
• • • • • • • • • •
w
• • • •
• • • • PERMIT APPLICATION
Master ?writ No. • • • 1 3
Subsidiaiy7Ma iif I3o: • •
•
• •
INSTRUCTIONS - The following steps must be taken to obtain a permit from the l\'liami Shores Village:
•• • • • •• ••• ••
Complete the attached permit application which must be signed by the prsaety »s efar I c�alifidt. signatures must be notarized. Please
print or type to allow for a more accurate processing of your application • ro, fi * work /i11 be dope, a roofing application must be submit-
• ted along with this permit application.
• • • • • • • ••
Step 2. Submit the completed application with all necessary documents to the Building, Planning and Zoning Department for processing. During the
processing of your application, you may be asked to submit additional information.
A PPLICATION
/ 54/&s. °F% 3313k
City State Zip
Folio Number // 367061 0/3'5060 '506 Description of Work ^` - 7 2 7 11J
Lot /6, Block 3 7 - 7 - 21rR - AP- /� /U
Subdivision Sc:AA PB PG Zoning 1N, ci- 1
Linear Feet
Current Use of Property Square Feet Units Floors
Proposed Use of Property Value of Work
Tenant Information
Bldg Value
Tax Assessed/Appraised Value
Flood Zone Base Floor Elev.
PERMIT CHANGE (✓ )
ENGINEER
Name
Address
W)19
License No.
Telephone
Fax
Page 2
...
•
• •
• •
••• •
• • •
• ••• • •
• • • • •
•••••••
•
•
•
•
PERMIT APPLICATION
IMPORTANT NOTICES
••• • • •
1. DO NOT BEGIN ANY WORK Wfretni 1 flAVIt'G RECEIVED `fOWR VALIDATED PERMIT AND PERMIT CARD. Applying for a permit does not grant
the right to begin construction. HOURS OF CONSTRUCTION are limited to: Monday through Friday from 7:30 a.m. to 6:00 p.m., and Saturday from 8:00 a.m.
to 5:00 p.m. No inspections will be conducted on weekends or holidays.
2. All construction of demolition areas MUST AB MAI)WWZ'A1N, D J 4 9 Cj,. §AN, NEAT AND SANITARY CONDITION free from construction debris.
3. STREETS AND NEIGHBORING PROP RTIa SDAtL:3F FR .E•FROM DIRT AND DEBRIS.
4. SWALES MUST BE PROTECTED F&OM BENQ t AQE13 Fle EQUIPMENT OR VEHICLES, AND MAY NOT BE USED FOR STORAGE. A bond is
required for work in or near the street/si$dwdlle. • • • • • • • •
5. CONSTRUCTION TRAILERS ARE PROHIBITED ON SINGLE FAMILY RESIDENTIAL CONSTRUCTION SITES. Other construction may have a trailer
which requires a separate permit.
6. PORTABLE TOILETS for a construction site require a separate permit.
7. DO NOT DISCHARGE WATER INTO THE RIGHT OF WAY OR STORM DRAINS without approval from the Building, Planning and Zoning Department.
8. EQUIPMENT AND MATERIALS SHALL BE STORED at least 10 feet from the edge of pavement.
9. Department of Health and Rehabilitative Services (HRS) approval is required for applications involving septic tanks. Department of Environmental Resources
Management (DERM) and/or Miami -Dade Water and Sewer Department (MDWASD) approval is required for applications involving sewers.
AFFIDAVIT - Please read carefully.
Application is hereby made to obtain a permit to do work and installation as indicated. I, the OWNER of the property, 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, POOL, EXTERIOR DOOR, MECHANICAL, WINDOW, FENCE; DRIVEWAY,
ROOFING and SIGNS and there may be additional permits required from other governmental agencies.
I, the OWNER of the property, have disclosed all information related to any work at the property performed in the prior twelve
months to the Building Official. Further, I am fully aware that if the cumulative cost of work to my home or business under this and
any other permit equals or exceeds fifty percent (50 %) of the fair market value of the structure, the entire structure must meet the
present federal flood criteria for finished floor elevation. I am also fully aware that if the total cost of work to my home or business
under this and any other permit exceeds fifty percent (50 %) of the replacement cost of the structure, then the entire structure must
conform to the current code requirements of the Building Code.
WARNING TO OWNER: Your failure to record a NOTICE OF COMMENCEMENT may result in you paying twice for
improvements to your property. If you are spending more than $2,500 or intend to obtain financing, you may wish to consult with
your attorney or lender before recording your Notice of Commencement. The Notice of Commencement must be recorded at:
22 N.W. 1st Street, 1' Floor, (305) 679 -1078. Once recorded, the Notice of Commencement must be POSTED AT THE JOB SITE in
accordance with Section 713 -35 of Florida Statutes. Review the brochure at Village Hall on Construction Lien Law and
Choosing a Contractor.
Print Name
Sworn to and subs
bed before me this day of
Signature of Notary Public - State of Florida
SEAL:
STA
Signa
Print Name
worn to and subscribed before me this
gnature i Notary ' i lic - . . orida
ngela M Becker
:F My Commission D0150048
V "di Expires November 15, 2006
SEAL:
Personally known OR, Produced Identification Personally known 'OR, Produced Identification
Type of Identification Produced: Type of Identification Produced:
ELECTRICAL
'fVI'E
Minimum Fee
QTY.
TYPE
Dryer
Q'I'Y.
TY PE
Outlet, Appliance : : :.. •
QTY.
, •
'rm.:
Service Repair
Q'I'Y.
A/C Central 1 -3 Ton
Dryer Vents, Number of
Fan
Ventilation, Cost
Outlet, Wall
Ductwork, Cost of
Service, Temporary
Periodic Inspections
A/C Central 4 -7 Ton
Fire Sprinkler System
Fire Pump
Outlet, Switch
Fireplaces, Number of
Signs
A/C Central 8 -15 Ton
Fixture - Fluorescent
Oven
Space Heater (kw)
A/C Central 16-20 Ton
Fixture Light
Parking Lot Lights
Spas/Hot Tubs
A/C Central 20+ Ton
Flood Lights
Plugmold/Strip
Subfeeds, No. of Amps
A/C Window
FPL - Load Central
Posts
Swim Pool, Commercial
Air Conditioners
Garbage Disposal
Range/Range Top
Swim Pool, Residential
Chiller
Generators, etc.
Receptacles
Switchboards
Clear Violations
Heat Recovery
Refrigerator, Comm. (p/PH)
Temp Serv., Construction
Compactor
Low -volt, Burglar
Refrigerator, Domestic
Temp for Test - 30 days
Deep Freezer
Low -volt, Fire
Renew - Temp Service
Water Closet
Demolition
Low -volt, Intercom/Teleph.
Repair Circuits
Water Heater
Dishwasher
/
V
Low -volt, Television
Service, Number of Amps
Water Heater New
MECHANICAL
TYPE
Minimum Fee
QTY. ■ l yPE
Condensate Drain
QTY. TYPE
Generator
QTY. TYPE Q'fy.
Refrigeration, Tons
A/C Central, Tons
Cooling Tower
Heating Strips, each
Vent Hood, Cost
A/C Wall/Win. Tons
Dryer Vents, Number of
Paint Booth
Ventilation, Cost
Air Handler, Tons
Ductwork, Cost of
Piping, Flammable Liquid
Periodic Inspections
Barbecue
Fire Sprinkler System
Process/Pressure Piping
Bath Fan - Vented, #
Fireplaces, Number of
Pressure Vessel
PLUMBING
TYPE
A/C Condensate
QTY.
TYPE.
Drains, Roof
QTY.
TYPE.
Miscellaneous Fixture
QTY.
7'1'1'E
Soakage Pit
QTY.
Bath Tub
Drinking Fountain
Miscellaneous Repairs
Solar Water Heater
Bidet
Filter Replace
Pool Piping
Sprinkler Repair
Cap - Fixture
Fountain
Pump and Abandon
Sprinkler System
Cap - Water
Gas - Appliance
Pump, Domestic
Supply, AC Well
Cap - Sewer
Gas - Natural
Pump, Fire Stand
Temporary Toilet
Catch Basin
Gas - Propane
Pump, Re- circulate
Temporary Water Closet
Clothes Washer
Gas Piping
Pump, Replace - Pool
Urinal
Dental Chair
Grease Trap
Pump, Sprinkler
Utility - Sewer
Discharge Well
Ice Maker
Pump, Sump
Utility - Water
Dishwasher
Indirect Wastes
Relay Repair
Vacuum Pump
Disposal
Interceptor
Roof Inlet
Water Closet
Domestic Well
Laundry Tray
Septic Connection
Water Heater
Drainfield, 4" Tile/Res.
/
V
Lavatory
Septic Tank
Water Heater New
Drains, Area
Meter Set (Gas)
Sewer Connection
Water Re -pipe
Drains, Floor
Minimum Fee
Shower
Water Service
Drains, French
Miscellaneous Equipment
Sink
Well, Supply
Page 3
. .• •
• • •.• •
• . • .. •
• ••..•••
• •
••.
• .••
•
• • • • • PERMIT APPLICATION
•
••.
• . •
INSTRUCTIONS: Please indicate the type of work being perfgrrped atcl:gt tity(fe9� in ale space provided below. •
RECEIVED AND REVIEWED BY: DATE:
SECTION
BY
DATE
Zoning
Electrical
Mechanical
Plumbin:
011MkilVar
-0'
Fire
Public Works
Structural
Building Official
Page 4
OFFICE USE ONLY
❑ CONCURRENCY
(New Construction)
❑ OTHER
(Specify & Attach)
• ..
• •
• •
••• •
••• •
• • •
❑ OWNER - BUILDER FORM
(Attach) • • • • •
• •
• ••
❑ FIRE DEPARTMENT •
•
APPROVAL (Commercial / " •••
multi - family)
•
• • • • • • •
• ••• • • •
• • • • • •
••••••• •
• •
• .•
•••
•
CHECKLIST
❑ PROOF OF OWNERSHIP
• (Attach)
. • • • • • •
VMS/ S/ IZE APPROVAL
(S>sptiC / Se .t)
Cl IMPACT FEE
(New Construction)
0 OTHER
(Specify & Attach)
PERMIT APPLICATION
❑ CONDO ASSOCIATION APPROVAL
(Attach)
❑ BPR APPROVAL (Restaurants)
❑ CONTRACTOR REGISTRATION
(On File)
PERMIT FEES
$3.00 per page (Scanning Fee) $
Miami Shores Village
Bond
Metropolitan Dade County (C.C.F.)
Inspector State Educational Fund $
State DCA (Radon) $
Code Enforcement Fine $
Zoning Review
Notary
o a
( s .ft.. ) x/1000
(¢.005 /sq.ft.)
(¢.01 /sq.ft.)
TOTAL s3 F6 e O
ISSUING OFFICIAL
REVIEWED AND PREPARED BY: DATE:
CONDITION OF APPROVAL
Revised July 2001
10050 N.E. 2 AVE., MIAMI SHORES, FL • (305) 795 -2207 • FAX (305) 756 -8972 • http : / /www.miamishoresvillage.com
•
Date:
Please deliver these documents immedlately to:
To /"/ Ai ti 1 e
01: ),, S AFLS
Fax #
Front:
FACSIMILE TRANSMISSION
1
i
• • Soptic rllntcs • or.aa. rrnpa
• & Drain Fields • Sewer
dot Cleaning
CC#000652 • State Certified • Septic Tank Contractor
P,O, Box 812333 • North Miami, Florida 33261.2333
Phone: (305) 558.5818
Dade (305) 558.5818 Brow (954) 820 -5099 Fax (305) 893-0270
# Of Pages Including Cover Sheet 3
MESSAGE:
MIX 6
1 SEPTIC & DRAIN INC
Lo f F'2.o40 J-6.1
o h 1 G,. L 1441) c,o i yo Rh
"24 Hour Service • Licensed & Insured"
APPLICANT:
AGENT:
PROPERTY ADDRESS:
CHECKED (X]
=== = masses
1
1
1
I
1
1
1
l
1
1
1
1
1
1
1
l
TANK
(01]
[02]
(03]
(041
[0S]
[06]
[
[08]
(09]
STATE OF FLORIDA
DEPARTMENT OF HEALTH
ONSITE SEWAGE TREATMENT AND DIPOBAL SYSTEM
CONSTRUCTION INSPECTION AND FINAL APPROVAL
S!PL.., 10 17,-E c' ,�
v -i; (
t
5l
LOT: / !." BLOCK: 3 7 SURD IVISIOE r).; / • St td)
ITEMS ARE NOT IN COIWLIums WIT4
amalsssssssicrommm==ss
INSTALLATION
TANK BIZ. (1] 7 - ) J [ 2 ) _
TANK NATERIAL i
OUTLET DEVICE Q.44e.r/
MULTI - CHAMBERED [ X / )
OUTLET FILTER t1 l-&
LEGEND `P,
WATERTIGHT
LEVEL
DEPTH TO LID
DRAINFIELD INSTALLATION
(10 ] AREA [ i (3 >< 1 C: ( 2] 33 5; 5Q1.7
[11) DISTRIBUTION SOX BEADS&
(12) MUSSER OF DRAI)LIN88
[13,] DRAINLINE SEPARATION ,.
[14] DRAINLINZ SLOPE
- 115) DEPTH OF COVER
(161 ELEVATION [ABOVE /BEIAw] BM
(171 SYSTEM LOCATION
(18] DOSING PUMPS
(19 ] AGGREGATE SIZE l'
(20] AGGREGATE EXCESSIVE FINES
(21] AGGREGATE DEPTH
FILL / EXCAVATION MATERIAL
(22] FILL AMOUNT )
(23) FITS. TEXTURE
(24] EXCAVATION DEPTH
(25] AREA REPLACED
(26] REPLACEMENT MATERIALL,,,
•
PILMAL SYS711 ' ( APPIIAVED /D
DH 4016, 10/97 (Pca 'vious Editions May De Used)
STATUTE ON RULE AND
1
1
1
l
l
1
1
1
l
1
CONSTRUCTIQW (APPROVED/DISAPPROVED): . I w . I
(
[30]
(
(32]
[33]
(34)
(35)
PERMIT NO.
DATE PAID:
FEZ PAID:
RECEIPT #:
PROPERTY ID #: 1 /- 120Q-015-5o 6a
(27) SURFACE WATER
[22] =CEEB
PRIVATE WELLS
PUBLIC HELLS
IRRIGATION WELLS
POTABLE WATER LINES
BUILDING FOUNDATION
PROPERTY LINES
OTHER
FILLED / MOUND SYSTEM
[36] DRAINFIELD COVER
(37) SHOULDERS
(38] SLOPES
[39] STABILIZATION
MUST BE CORRECTED.
. 63. 06 618
FT
rT
FT
FT
, FT
FT
FT
FT
TT
ADDITIONAL INFORMATION
(40] UNOBSTRUCTED AREA 0k
[41] STORMWATER RUMOFF oJv
(42] ALARMS
[43) MAINTENANCE AGREEMENT
(44] BUILDING AREA
(45 ] LOCATION CONFORMS WITH SITE PLAN
[46] FINAL SITE GRADING .
(47) CONTRACTOR i:01/ . $ 7/C
[48] OTHER
ABANDONMENT
(49] TANK PUMPED _ /___/
(50 ] TANK CRUSHED & FILLED
EXPLANATION OF VIOLATIONS /REMARKS:
[ 1
[ 1
[
(
c
CEO DATE: 3 - '0 3
t J. .
PT 1: ADp■cont
FT 2: hlblaller/Gentre610r
PT 3: 6uilinq Deparmlent
PT 4: neaPIn Depanment
CED Dams t 3 - G L'5
Page 2 of 3
s d* W4 /
37
M Q AI)
Permit No ' ' 747 ' 2
Amount of 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. -
Owners Name and Address Lawson N 317 NE 102 street.. M. Shores
Registered Architect and /or Engineer
Employing Plumber's Name 0 , G L L l,.oyd Septic Tatxt � '�, Na . streetalislai ......�._ ......� -.. _
Location and* Description Lot. Bkx4
Street and N ) where work L to be performed —No. 317 NE 10 7
State work to be performed and purpose of building (By Floors)
New Building..__._ — _- •- .-- ...... - -_ -- Remodeling____.._..._.____ Addition
Size Septic Tank_
Feet of Drain Tile
Nature of Water Supply: City —Well
$750. oo value
CC #12842
MIAMI SHORES VILLAGE Insurance to 12/10/84
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Type of Tank__.— — .------ ___ -..
—Dist. Feet of Tank or Drain Field from Well..
Size of Soakage Pit.
( Signed) _
( Signed) '
Subdivision.
streetk iami._Shores
Repairs No. of Stories. .. ....
_Capacity Cals. .__. —. __.._ .. - -..-
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 IIaY com-
piied with the provisions thereof, and will require similar compliance from all contractors or sub- contractors employed by him in the wort- 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 arr
required by the Act. The undersigned agrees to employ only such sub - contractors, work to be performed under this permit, Ks are
licensed by Miami Shores Villages 0
Master Plumber.
STATE OF FLORIDA, I µ
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 slips the same, and that all facts
therein by him stated are true.
My Commission Expires Notary Public, State of Florida
NOTE: A re- inspection fee of $1.00 will be made when anei mlnspeotfen !s mow aeoasery by fmpoper nodes for mspec iost, or faulty
materials and/or workmanship.
CLOSETS
BATH
TUSa
SHOWERS
LAVA•
TORIES
S INKS
SLOP
•1NKS
LAUNDRY
Tuna
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINK NO
FOUNT' NS
TOTAL
PIETuREe
Comm.
LIST
•
_
CHECK
•
J
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
G
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SW IM'O
POOL
0
I .�
Comm.
LIST
CHECK
s d* W4 /
37
M Q AI)
Permit No ' ' 747 ' 2
Amount of 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. -
Owners Name and Address Lawson N 317 NE 102 street.. M. Shores
Registered Architect and /or Engineer
Employing Plumber's Name 0 , G L L l,.oyd Septic Tatxt � '�, Na . streetalislai ......�._ ......� -.. _
Location and* Description Lot. Bkx4
Street and N ) where work L to be performed —No. 317 NE 10 7
State work to be performed and purpose of building (By Floors)
New Building..__._ — _- •- .-- ...... - -_ -- Remodeling____.._..._.____ Addition
Size Septic Tank_
Feet of Drain Tile
Nature of Water Supply: City —Well
$750. oo value
CC #12842
MIAMI SHORES VILLAGE Insurance to 12/10/84
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Type of Tank__.— — .------ ___ -..
—Dist. Feet of Tank or Drain Field from Well..
Size of Soakage Pit.
( Signed) _
( Signed) '
Subdivision.
streetk iami._Shores
Repairs No. of Stories. .. ....
_Capacity Cals. .__. —. __.._ .. - -..-
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 IIaY com-
piied with the provisions thereof, and will require similar compliance from all contractors or sub- contractors employed by him in the wort- 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 arr
required by the Act. The undersigned agrees to employ only such sub - contractors, work to be performed under this permit, Ks are
licensed by Miami Shores Villages 0
Master Plumber.
STATE OF FLORIDA, I µ
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 slips the same, and that all facts
therein by him stated are true.
My Commission Expires Notary Public, State of Florida
NOTE: A re- inspection fee of $1.00 will be made when anei mlnspeotfen !s mow aeoasery by fmpoper nodes for mspec iost, or faulty
materials and/or workmanship.
BUILDING
ELECTRICAL
PLUMBING
ROOFING
MIAMI SHORES VILLAGE, FLORIDA
PERMIT
Owner of
Building it �i a •° ,. ; ,. � c ,• s _ A
Architect
Contractor
or Builder
Legal Lot
Description II Bl
N° 7113
Address of Value of I Amount of ' <�--�-
Building `' ; Project $ I Permit $ w
This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the applica-
tion herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any
plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked
at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further 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 respon-
sibility for work done by his agents, servants or employees.
Signed. 1 _ / � - 0 , -r ' • t , . "' INSPECTOR
In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance. with all ordinances and regulations
pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In ac-
cepting this permit I assume responsibility for ell work done by either, myself, my agent, servant or employee.
CONTRACTOR OR BUILDER
DATE /
Contractor's
License No.
19 ;‘..,
Work to be performed under this Permit
Subdi-
vision
BY AUTHORITY •aeon e'
Permit No 71 3 ____
Owner's Name and Address
Registered Architect and /or Engineer.______— _______ � - -_�
Employing Plumber's Name
Location and Legal Description Lot__
Street and Number where work is to be performed —No •
Amount of Permit $
STATE OF FLORIDA,
COUNTY OF DADE.
op
My Commission Expires
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
New Building Remodeling_____ _________ Addition
Block
(Signed)....(e_V
(Signed).
Date._
Application is hereby made for the approval of the detailed statement of the plans and specifications herewitlubmitted 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.
No. 3 1 _ ! Street_
_. /_J��
No Street_1V_-W_ . -- ..
Subdivision
Street_ .4/.
State work to be performed and purpose of building (By Floors)_--- _____ _____ _. ____ ___ ._____._____
Repairs No. of Stories... ..... .... . ....
Type of Tank..___ Capacity Gals.
Size Septic Tank
j
Feet of Drain Tile 3 �C� r� _ - - -Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City — Well.____. ._.._._ .... of Soakage Pit
The undersigned applicant for this building permit does hereby certify that he understands and accepts his .. : ations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Pen ... ent 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.
Plumbing Inspector.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the .
of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
Notary Public, State of Florida
a / 5 /fa
Master Plumber.
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty
materials and /or workmanship.
CLO86TB
BATH
TUBS
SHOWERS
LAVA-
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TUBS
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT'NB
TOTAL
FIXTURES
CONTR.
LIST
_
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SWIM'G
POOL
CONTR.
LIST
CHECK
'
Permit No 71 3 ____
Owner's Name and Address
Registered Architect and /or Engineer.______— _______ � - -_�
Employing Plumber's Name
Location and Legal Description Lot__
Street and Number where work is to be performed —No •
Amount of Permit $
STATE OF FLORIDA,
COUNTY OF DADE.
op
My Commission Expires
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
New Building Remodeling_____ _________ Addition
Block
(Signed)....(e_V
(Signed).
Date._
Application is hereby made for the approval of the detailed statement of the plans and specifications herewitlubmitted 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.
No. 3 1 _ ! Street_
_. /_J��
No Street_1V_-W_ . -- ..
Subdivision
Street_ .4/.
State work to be performed and purpose of building (By Floors)_--- _____ _____ _. ____ ___ ._____._____
Repairs No. of Stories... ..... .... . ....
Type of Tank..___ Capacity Gals.
Size Septic Tank
j
Feet of Drain Tile 3 �C� r� _ - - -Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City — Well.____. ._.._._ .... of Soakage Pit
The undersigned applicant for this building permit does hereby certify that he understands and accepts his .. : ations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Pen ... ent 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.
Plumbing Inspector.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the .
of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
Notary Public, State of Florida
a / 5 /fa
Master Plumber.
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty
materials and /or workmanship.
Permit No. 2 ---��
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build or o her
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 _ ___ _ f_? L_F___i__ No 17
Registered Architect and /or Engineer
Employing Plumber's Name No 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 e : Type of Tank Capacity Gals
Feet of Drain Tile
Nature of Water Supply: City —Well
Amount of Permit $__
ss.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Dist. Feet of Tank or Drain Field from Well
(Signed
t
Street
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspe
materials and /or workmanship.
Date __ C 2 0 - 1
My Commission Expires Notary Public, State of Florida
Size of Soakage Pit
Plumbing Inspector.
that 1 e understands The undersigned applicant for this building permit does hereby certify d ers t. a
nds and accepts his obli jns 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 unde this permit, as are
licensed by Miami Shores Village. _
(Signed
6 ',( ^` '
.fe,lerPlu+gber.
STATE OF FLORIDA, 1
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.
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
SW IM'G
POOL
CONTR.
LIST
V
CHECK
Permit No. 2 ---��
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build or o her
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 _ ___ _ f_? L_F___i__ No 17
Registered Architect and /or Engineer
Employing Plumber's Name No 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 e : Type of Tank Capacity Gals
Feet of Drain Tile
Nature of Water Supply: City —Well
Amount of Permit $__
ss.
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Dist. Feet of Tank or Drain Field from Well
(Signed
t
Street
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspe
materials and /or workmanship.
Date __ C 2 0 - 1
My Commission Expires Notary Public, State of Florida
Size of Soakage Pit
Plumbing Inspector.
that 1 e understands The undersigned applicant for this building permit does hereby certify d ers t. a
nds and accepts his obli jns 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 unde this permit, as are
licensed by Miami Shores Village. _
(Signed
6 ',( ^` '
.fe,lerPlu+gber.
STATE OF FLORIDA, 1
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.