Loading...
350 NE 102 St (2)Date • ' Time Type Insp'n Permit No Name Address C ' \ ( 0 Company sJ ', Phone # Y For Inspector:) / 4 / 0 Approved Correction MIAMI SHORES VILLA BUILDING DEPARTME 305- 795 -2204 Building Inspection Request Re- Insp'n Fee ❑ Date Type Insp'n Permit No. Approved Correction Re- Insp'n Fee MIAMI SHORES VILLAGE BUILDING DEPARTM 305- 795 -2204 u Building Inspection Reque I Time p 2_ Z003 _ a o3 Jam/ Name .R� Address 0 0 "� Company Phone # For Inspector:(0/C7 MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Request Date 7 30 Time Type Insp' n , r _ r) flf (d Permit No.? 1 .2W .263 Name I G Y Ur . Address ✓ 5 0 14E C2- S Company 600 SeC Phone # 7O For Inspector: P) I3 Approved Correction LYE 1 Re- Insp'n Fee ❑�/ e7/29/2003 10:54 .3055133472 W 7,15 s'ei:r: rar'1. , A f �Swry h{ far y AY�' t 4:7 ✓dk £S p° L� 1 9 ui. a b f L �E a6. ' rr yT :m w�� A '.ate br .'�. 9.r1.N�4K r`kAt i g � lp :tr ^ yyyC � { w �� t � t yyppy 'l ,.tGk3,•�" •};`�t�.;�.5r ', l � WT) °.'11�Y� .�'�LA"f 7;':R� _���F /`2Q�1 l�A �'S ����'M .R L� �t� �7'r. �'f�•'1�,� "�� ��4 �� �)Tt; r,Y J�7 Sa :rS( , "!' ¢)W K i4'.. ��i.�F�,4. )�•pR�v'U' >y, R b n .RICt'0i �+ i '�'7'Wni 3 .1 ivt', 4 1 * ::J''. a;,. r1 •:'�i't'" ^ ; PAGE 01 CONTRACTOR - II °� / q - -� Name do 85 5 / / G `'t' J/aii )V ,4 License No. 520 q 0 Wt.. l t.. Address .'10 O &) 1..80 S°_ N . /iis. 'fit. 3316 i Telephone 5-Ss, / p Fax O Q ? 7 _ 0a7o ® 'L m 50 2 , Qualifier Name 6 PROPERTY OWNER WNER :; New Construction Name 174VL LA2J<'tJ (� 5 /V i✓ Iar9 Sr Alteration Exterior Home Telephone Repair Business Telephone Alteration Interior Fax Demolish TYPE OF MANAGEMENT (✓ ) New Construction Enclosure Alteration Exterior Repair Alteration Interior Demolish Relocation of Structure Shell Only Foundation Only Add'l Attachment Other Add'1 Detachment Other RECEOVE JUL 2 9 2003 INSTRUCTIONS - The following steps must be taken to obtain a permit from the Miami Shores Village: Step 1. Complete the attached permit application which must be signed by the property owner and qualifier. Both signatures must be notarized. Please print or type to allgw for a more accurate processing of your application. If roofing work will be done, a roofing application must be submit- ted along with thi 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. APPLICATION Job Address: ✓ 50 iu s , (O sr: : Address .045r City State Zip Folio Nu ber l (-3;4, - 0 - 51 Description of Work ✓ %� 00 e -D )u " N + e (c . - 05FAi i Lot 5 Block 3? 1 Subdivis on S C,C 1 PB PG Zoning R -gyp , 0 - ` Linear Feet Current Use of Property Square Feet /� Units Floors Proposed Use of Property Value of Work r/''' �i ' Bldg Value Tenant Information PERMIT TYPE (✓ ) Building Electrical Mechanical Plumbing LPGX Roofing Fence Other v PERMIT CHANGE (✓ ) Chg. Contractor Renewal Revision Extension Supplement Reinspection ARCHITECT Name License No. Address Telephone Fax Valf/t 01 5 9 St. PERMIT APPLICATION W Master Permit No. 'PI 2 J O3 Subsidiary Permit No. al∎A. Shes. (, 33t - 3k Tax Assessed/Appraised: Value Flood Zone Base Floor Elev. ENGINEER Name License No. Address Telephone Fax Page 2 IMPORTANT NOTICES 1. 2. 3. STREETS AND NEIGHBORING PROPERTIES SHALL BE KEPT FREE FROM DIRT AND DEBRIS. 4. SWALES MUST BE PROTECTED FROM BEING DAMAGED BY EQUIPMENT OR VEHICLES, AND MAY NOT BE USED FOR STORAGE. A bond is required for work in or near the street/sidewalk. 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. )C STA Signat Thu QeLQ.'P 1GYIG'n 1r Print Name 1 Sw.m to and subscribed before me this W day o0019 , 0.� U Si : ature of Notary Public - vP Mabel Vargas = _'' Commission #DD2'1984 ;a •, `�? :Q= Expires: Jul 13, 2007 'o' a o°�' Bonded Thru OR, Prod u c edic e RA.,-i• Type of Identification Produced: �Y `WC. S L\ C. SE L: DO NOT BEGIN ANY WORK WITHOUT HAVING RECEIVED YOUR 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. All construction of demolition areas MUST BE MAINTAINED IN A CLEAN, NEAT AND SANITARY CONDITION free from construction debris. Personally known f Florida MIAM i ADE STATE OF FLORID : , BOUNTY OF MIAMI -DADE Print Name S� and subscribed before me this gnature of ry Public - tate o(Flori Ar�e\a eeor� Y PERMIT APPLICATION zg Yor Angela M Becker My Commission DD150048 o o' Expires November 15, 2006 Personally known Y OR, Produced Identification Type of Identification Produced: ELECTRICAL TYPE Minimum Fee QTY. TYPE Dryer QTt TYPE Outlet, Appliance QTY. '11 PI: Service Repair QTY. A/C Central 1 -3 Ton Fan Outlet, Wall Service, Temporary A/C Central 4 -7 Ton Fire Pump Outlet, Switch 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 jaundry Low -volt, Television Service, Number of Amps Water Heater New MECHANICAL TYPE Minimum Fee QTY. 't,YPE Condensate Drain QTY. TYPE Generator QTY. TYPE Refrigeration, Tons Q'I'V, 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 Supply, AC Well Bath Fan - Vented, # Fireplaces, Number of Pressure Vessel Temporary Toilet PLUMBING TYPE A/C Condensate QTY TYPE Drains, Roof QTY TYPE Miscellaneous Fixture Q . i . V . TYP1.: Soakage Pit Q . i . V . 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 Tray Septic Connection Water Heater Drainfield, 4" Tile/Res. jaundry 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 performed and quantity(ies) in the space provided below. RECEIVED AND REVIEWED BY: DATE: SEGTION: ' BY . DATE . Zoning Electrical - Mechanical i Plumbing - -- ; '' Fire Public Works ,, ,. .. . Structural _ _ . , Building Official - ; - . OFFICE USE ONLY': O OWNER - BUILDER FORM (Attach) O FIRE DEPARTMENT APPROVAL (Commercial / multi-family) • . ' (Specify & Attach) CHECKLIST O PROOF OF OWNERSHIP (Attach) • HRS / DERM APPROVAL (Septic / Sewer) . _ . . LI CONCURRENCY . 0 IMPACT FEE 0 CONTRACTOR REGISTRATION _ (New Construction) , - New Construction) - (On File) - i f • OTHER - 0 OTHER -- (Specify & Attach) PERMIT FEES . :-- $3.00 per page (Scanning Fee) ,,,- ' '$ Miami Shores Vdlage . -$ . • , Bond ' $ 500.00 Metropolitan DadeCounty (C.C.F.) $ 1, i ,sq.ft. = x/1000 .x 41.60) Inspector State Educational Fund $ (0 : ft) ... State DCA (Radon) - - ••• $ (g.ousci.ft.) Code Enforcement Fine • Zoning Review 1: Notary •• REVIEWED AND PREPARED BY: • 1=1 BPR APPROVAL (Restaurants) LI CONDO ASSOCIATION APPROVAL PERMIT APPLICATION • • - •(Attach) • 'I.,: • • DATE: 3 TOTAL $ • c( • ISSUING OFFICIAL 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 77 D APPLICANT: AGENT: PROPERTY ADDRESS: LOT: - 3 - [ 1 1 FINAL SY FILL [ [23] [24] [45] [16] / GIA 1 1";ii k 5eig T k 35 a A16 /(1. ss :::s :s :saa CHECKED [X] ITEM$ ARE NOT IN COMPLIANCE ==r - - --- -= ====s=ass— =======s TANK INSTALLATION [01] TANK SIZE ( 1 1 q au [3]_ [02] TANK MATERIAL [03] OUTLET DEVICE ( �f✓ [04] MULTI- CHAMBERED [ Y ,tt / ij ) [05] OUTLET FILTER 1"(J'z 1 e [06] LEGEND 4 14 [07] WATERTIGHT 0 (08) LEVEL [09] DEPTH TO LID DRAINFIELD INSTALLATION 36J [ ] 1 [ ] [11) [ ] [ [ ] [ 1 ] [ 1 1 [ [' �•] (16) [ 't : [i AREA [ 1] l 2 [ 3] 56 0 SQPT DISTRIBUTION 80X HEADER NUMBER OF DRAINLINEB DRAINLINE REPARATION 3 � !( DRAINLINE SLOPE DEPTH OF COVER ELEVATION [ABOVE /BELOW] BM SYSTEM LOCATION DOSING PUMPS / AGGREGATE SIZE f4 5 AGGREGATE EXCESSIVE FINES AGGREGATE DEPTH WITH / EXCAVATION MATERIAL FILL AMOUNT FILE. TEXTURE EXCAVATION DEPTH AREA REPLACED • [ REPLACEMENT MATERIAL X 57 i a- [ EXPLANATION OF VIOLATIONS / REMARIS: 1 1 CONSTRUCTION � {AP� O /DISAPPROVED]: J 0 1;� $ [APPROVED/�iI : ' ,9 '40,45 DH 4016, 10/97 (Previous Editions May Be Used) [� ) [36) [ ?) 1371 [ ( [ [40] [41] [42] [43] (44] [45] [46] [47] )481 Installer / Contractor STATE OF FLORIDA DEPARTMENT OF HEALTH ONSITE SEWAGE TREATMENT AND DIPOSAL SYSTEM CONSTRUCTION INSPECTION AND FINAL APPROVAL PERMIT NO. DATE PAID: FEE PAID: RECEIPT #: BLOCK: 3S SUBDIVISION: Otteerv. Skfre � C AI PROPERTY ID #: /( ' 3 x0/5 -0 /3 - 5/9 STATUTE OR RULE AND MUST BE CORRECTED. ss sssssssssssss�•s•••�- ••- - - -c SETBACKS [27] SURFACE WATER [28] DITCHES (29] PRIVATE WELLS [30] PUBLIC WELLS ( 31 ] IRRIGATION WELLS [32] POTABLE WATER LINES [33] BUILDING FOUNDATION /0 FT [34] PROPERTY LINES FT [35] OTHER FT FILLED / MOUND SYSTEM DRAINFIELD COVER SHOULDERS SLOPES STABILIZATION ADDITIONAL INFORMATION k Q C ====== ==== == 43- ?5 - 4?iL _7- - ©3 Sao d3o Si 7500/ / 0 FT FT FT FT FT FT UNOBSTRUCTED AREA STORMWATER RUNOFF ALARMS .MAINTENANCE AGREEMENT BUILDING AREA LOCATION CONFORMS WITH SITE 'PLAN FINAL SITE I CONTRACTOR 1 S u r )� a �G• OTHER d 7 ABANDONMENT [49] TANK PUMPED _ /_ / _. [SO] TANK CRUSHED & FILLED ___/ CHD DATE: 7 - 3 CHD DATE:? - 5 /— U Page 2 of 3 PERMIT NUMBER: LPermit tracking number assigned by CHD. APPLICANT: Property owner's full name. AGENT: Property owners legally authorized representative. MAILING ADDRESS: P.O. box or street mailing address for applicant or agent. LOT, BLOCK, SUBDIVISION Lot, Block and Subdivision for lot or • PROPERTY ID#: 27 character number for property. (property appraiser ID # or GIS location) COUNTY HEALTH DEPARTMENT CHECKS [X] ITEMS NOT IN COMPLIANCE WITH CONSTRUCTION PERMIT AND STATUTE OR RULE. INFORMATION IS COMPLETED BY CHD ON FOLLOWING ITEMS: TANK SIZE (gallons) TANK MATERIAL (concrete, fiberglass, etc) OUTLET FILTER (manufacturer, make, model) LEGEND (manufacturer code) DRAINFIELD AREA (square feet) DISTRIBUTION BOX / HEADER (check box) NUMBER OF DRAINLINES (number installed) SYSTEM ELEVATION (in relation to BM) DOSING PUMPS (number installed) SETBACKS (record actual setbacks in ft) SETBACKS OTHER (as required) STABILIZATION (date stabilized) CONTRACTOR (contractor installing system) ADDITIONAL INFORMATION (as required) ABANDONMENT TANK PUMPED (date) TANK CRUSHED AND FILLED (date) EXPLANATION OF VIOLATIONS: Record item number, explanation of violation, and required CONSTRUCTION APPROVAL: Circe approved or disapproved, CHD signature and date. AS BUILT INSTALLATION SKETCH FINAL APPROVAL: Circle approved or disapproved. CHD signature and date of approval. Final approval shall not be granted unit the CHD has confirmed that'building construction and lot grading are in substantial compliance with plans and specifications submitted with the permit application. ELEVATION WORKSHEET ELEVATION OF BENCHMARK 'OR REFERENCE POINT: EXISTING GROUND TOP OF AGGREGATE [+] SHOT H.I. H.I. H.I. H.I. [ -] SHOT [ -] SHOT [ -] SHOT ELEVATION BUILDING ELECTRICAL PLUMBING ROOFING Owner of Building =a MIAMI SHORES VILLAGE, FLORIDA DATE I- V3 19 ►t► PERMIT Architect Contractor or Builder • . , �.._ s. � ..• $ Legal Lot Description B1 N 9 7988 Contractor s • License No. Work to be performed under this Permit sa✓ t 43 tog. ; C 1 . � 'Ili ;pa te' , j 4 4 . 5671 Subdi- vision B d il d ding of 3 i 'GI c r Value o 1 Amount of 3 Project $ � Permit $ This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the 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. l ,/ d,, Signed BY INSPECTOR In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with 11 ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authoritie-' . Miami Shores Village. In as cepting this permit I assume responsibility for all work done by either, myself, m' agent, servant or employee. .� CONTRACTOR OR BUILDER AUTHORITY ABBOT Permit No _ Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. f .� 0 Owner's Name and Address --- ------- ------------- - - -__._ glik/IWO • No. 3 SO Street' v !-• - O `'' Registered Architect and /or Engineer____._ ' Plumbers Name- .__ _l/_�Y.kl 1 _ Employing • Location and Legal Description Lot_--- _--------- - -_ - -- - Street and Number where work is to be performed—No. State work to be performed and purpose of building (By Floors) New . Building _ Size Septic Tank.----_ - Feet of Drain Tile Nature of Water Supply: City— Well.__--__ ....... of Soakage Pit Amount of Permit $_ Remodeling My Commission Expires MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT _Type of Tank •C A"'_CL.__ No._ £ Street___ __. F .5 ,7: Block 3ED Addition --- ---------- -- - - -- -- (Signed)__ - Date Subdi on Street Repairs No. of Stories Capacity Gals __Dist. Feet of Tank or Drain Field from Well Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his o • gations 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 b . 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 pub notice ' or notices as are required by the Act. The undersigned agrees to employ only such sub- contractors, on work e perform under • erinit, as are licensed by Miami Shores Village. 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. Notary Public, State of Florida NOTE: A re- inspection fee of $1.00 will be made when such re inspection is made' necessary by improper notice for inspection, or faulty materials and /ar workmanship. CLOSETS BATH TUBS SHOWERS LAVA- TORIES S INKS SLOP SINKS LAUNDRY TUBE U URINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT' N5 TOTAL FI %TORES CONTR. LIST CHECK SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SW IM'G POOL CONTR. LIST CHECK - - - - - Permit No _ 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. f .� 0 Owner's Name and Address --- ------- ------------- - - -__._ glik/IWO • No. 3 SO Street' v !-• - O `'' Registered Architect and /or Engineer____._ ' Plumbers Name- .__ _l/_�Y.kl 1 _ Employing • Location and Legal Description Lot_--- _--------- - -_ - -- - Street and Number where work is to be performed—No. State work to be performed and purpose of building (By Floors) New . Building _ Size Septic Tank.----_ - Feet of Drain Tile Nature of Water Supply: City— Well.__--__ ....... of Soakage Pit Amount of Permit $_ Remodeling My Commission Expires MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT _Type of Tank •C A"'_CL.__ No._ £ Street___ __. F .5 ,7: Block 3ED Addition --- ---------- -- - - -- -- (Signed)__ - Date Subdi on Street Repairs No. of Stories Capacity Gals __Dist. Feet of Tank or Drain Field from Well Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his o • gations 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 b . 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 pub notice ' or notices as are required by the Act. The undersigned agrees to employ only such sub- contractors, on work e perform under • erinit, as are licensed by Miami Shores Village. 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. Notary Public, State of Florida NOTE: A re- inspection fee of $1.00 will be made when such re inspection is made' necessary by improper notice for inspection, or faulty materials and /ar workmanship. Permit No. _./_ Date/ Applicatiorf 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. Size Septic Tank Feet of Drain Tile Amount of Permit $ - -__. Owner's Name and Address __w_ c 42? No._ Registered Architect and /or Engineer �� Employing Plumber's Name_.r n )),(7 Location and Legal Description Lot...________ _ ._._.. ____ _ _ _ Block. Street and Number where work is to be performed —No State work to be performed and purpose of building (By Floors)________ --- __ -- _ �L '1 1V4/Pis New Building ____ Remodeling_____ _._ Addition._______. Repairs No. of Stories. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT (Signed ) Street_ Subdivision_ _ t_ Type of Tank Capacity Gals d_ --Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: City — Well._____ -...... - ..... __•---- ..... _- - - - - -_ -- -.Size of Soakage Pit 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 - contractor e mployed by him in the work to be performed under this permit; and will post or cause to be posted' for inspection on the,--,sit of the work such' public notice or notices as are required by the Act. The undersigned agrees to employ only such sub - contractor, on vork to performedVunder_ -t}ris permit, as are licensed by Miami Shores Village. ( Signed er Plumber. Street- ' __..J My Conunission Expires Notary Public, State of Florida STATE OF FLORIDA, I COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to admini er 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 worlcmanship. / CLOSETS Tints Tints 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 HEATER DEEP WELL SPRKLR. SYSTEM SWIM •G POOL CONTR• LIST CHECK Permit No. _./_ Date/ Applicatiorf 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. Size Septic Tank Feet of Drain Tile Amount of Permit $ - -__. Owner's Name and Address __w_ c 42? No._ Registered Architect and /or Engineer �� Employing Plumber's Name_.r n )),(7 Location and Legal Description Lot...________ _ ._._.. ____ _ _ _ Block. Street and Number where work is to be performed —No State work to be performed and purpose of building (By Floors)________ --- __ -- _ �L '1 1V4/Pis New Building ____ Remodeling_____ _._ Addition._______. Repairs No. of Stories. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT (Signed ) Street_ Subdivision_ _ t_ Type of Tank Capacity Gals d_ --Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: City — Well._____ -...... - ..... __•---- ..... _- - - - - -_ -- -.Size of Soakage Pit 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 - contractor e mployed by him in the work to be performed under this permit; and will post or cause to be posted' for inspection on the,--,sit of the work such' public notice or notices as are required by the Act. The undersigned agrees to employ only such sub - contractor, on vork to performedVunder_ -t}ris permit, as are licensed by Miami Shores Village. ( Signed er Plumber. Street- ' __..J My Conunission Expires Notary Public, State of Florida STATE OF FLORIDA, I COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to admini er 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 worlcmanship. / _ ., BUILDING ELECTRICAL PLUMBING Owner/o, Building Architect , or Builder Legal Description Address of .� t Building 4. MIAMI SHORES VILLAGE, FLORIDA ERMIT N? 6232 Work to be pfrjormed f inder this Permi Lot CONTRACTOR OR BUILDER DATE Subdi- vision BY Value of Project Contractor's License No 194g This permit is granted to the contractor or builder named above to construct the building or to install the equipment or . vice described in the appli- cation herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility %for a thorough knowledge of the ordinances and .regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the sea #ements oryspecifications and th the assumes respon- sibility for work done by his agents, servants or employees. Signed y �e� By "' INSPiOT ', In consideration of the issuance to me of this permit I agree to perform the work covered hereund r in compliance with all ordinances and wgulati9Qns pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shorbs•Vill'ave. In asvpting this permit I assume responsibility for all work done by either myself, my agent, servant or employee. AUTHORITY