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5 NE 102 St (14)Dat Type Insp'n Permit No. Name Address Compan Phone # Inspection Date Approved Correction Re- Insp'n Fee MIAMI SI[ORES VILLAGE • BUILDING DEPARTMENT 305- 795 -2204 Building Inspection Reques oy Type Insp'n Permit No. Name Address C• pany ( —CI Inspection Date k 1 0 Phone # Dat Mo Approved Correction Re- Insp'n Fee MIAMI SHORES VILLAGE BUILDING DEPARTMEN 305- 795 -2204 Building Inspection Request LPL A. • i __• 1 . c)7 MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305- 795 -2204 Building Inspection R Dat2_4( Type Insp'n Permit No.�) D ll Name Address _ 0 Company / C 1 P I — Phone # 'LC 1, Inspection Date 2 J C / 0 '1 Approved Correction Re-Insp'n Fee Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 BUILDING Permit No. PERMIT APPLICATION FBC 2001 Permit Type (circle): Building Electrical Owner's Name (Fee Simple Titleholder) / $ / f ' Phone # Owner's Address S /v . 1V 2 5, 'Li City i G'4 r;40vo State Tenant/Lessee Name A Sit// r Contractor's Company Name State Certificate or Registration No. $ Value of Work For this Permit ' .S a 'a Total Fee Now Due $ (Continued on opposite side) a Master Permit No. Job Address (where the work is being done) 5 Alt ' /p 2—S City Miami Shores Village County Miami -Dade Zip Is Building Historically Designated YES NO "Ift , n je 1 Phone # Contractor's Address I7 7 3 /�!.✓. i� � Cit /i✓ Alegi' State Zip 334j Qualifier c L - A Zip 3 3r 3 g Phone # Certificate of Competency No. Architect/Engineer's Name (if applicable) Phone # Square Footage Of Work: Mechanical Roofing Type of Work: ❑Addition ❑AI e ration � ❑New epa /Replace ❑ Demolition Describe Work: ; //11.f# 9 e—z> /<,. * * * * * * * * * * * * * * * * * * * * * * * * * * ** F ees * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Submittal Fee $ Permit Fee $ f 7S • CCF $ /, o 0 CO /CC Notary $ .S, 0 0 Training/Education Fee $ T 0 Technology Fee.$ l i� 7 Scanning $ Radon $ Zoning Bond $ Code Enforcement $ Structural Plan Review. $ 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 y absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. My Commission Expires: * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** APPLICATION APPROVED BY: Chc 05/13/03 NOTARY PUBLIC: NOTARY P Sign: Sign: ,A.A.` . Print: Print: t , ► ro My Commission Expires: Signature Signature Owner or Agent Contractor The foregoing instrument was acknowledged before me this The f regoing instrument was acknowledged before me this day of , 20 _, by day of , 2®.., b who is personally known to me or who has produced who is personally known to me or who has produced As identification and who did take an oath. as identification and who did take an oath. l3LIC: Ettgires Nc iember 16. )006 ***************************************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** PExaminer Engineer Zoning Miami Shores Village 10050 NE 2nd Avenue Plumbing Permit Phone: 305 - 795 -2204 Permit Number: PL2004 -185 Printed: 6/29/2004 Applicant: Owner: SAKZ JOB ADDRESS: 5 Contractor MR C'S SEPTIC TANK Local Phone: 305 - 651 - 7859 Parcel # 1132060131640 Signed: NE 102 (INSPECTOR) ROBERT ST Contractor's Address: P 0 BOX 693239 Permit Status: APPROVED Permit Expiration: 12/26/2004 Construction Value: $1,500.00 Work: INSTALL 900 GAL. SEPTIC TANK Page 1 of 1 Legal Description: MIAMI SHORES SEC 1 AMD PB 10 -70 LOTS 13 & 14 LOT SIZE IRREGULAR OR Fees: Description Amount FEE2004 -6490 Building Fee $175.00 FEE2004 -6491 CCF $1.20 FEE2004 -6492 Notary Fee $5.00 FEE2004 -6493 Training and Education Fee $0.40 FEE2004 -6494 Technology Fee $4.37 Total Fees: $185.97 Total Fees: $185.97 Total Receipts: $185.97 In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit 1 assume responisibility for all work done by either myself, my agent, servants or employes. Signed: (Contractor or Builder) BY: - - -- CLOSE TS BATH Tue. SHOWER• LAVA• TORIES SINKS SLOP SINK[ LAUNDRY Tuns URINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT'N• TOTAL FI*TUR[[ CONTR. LIST CHECK _ SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP - SOLAR HEATER DEEP WILL SPRKLR. 6 SWIM'O POOL CONTR. LIST CHECK Permit No Q 3 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 subn(itted 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 f k g uring progress o work. Owner's Name and Address 7 ZW1 No. Registered Architect and /or Engineer Employing Plumber's MUSIC ./.14 O ibrigL .- 8treeLIV .. s Block Subdivision______ . Location and Legal Desctiption Lot. ['� Street and Number where work is to be performed —No `�' Street N _ / Q 2- - State work to be performed and purpose of building (By Floors)_-______ .. .c...L.A4_._ 7 - " - -5 .1.4?: 4:-. ...._ ... - ... I.N. New Building __ Remodeling —_ - - -_ -- Addition...- ...__. Repairs No. of Stories.. Size Septic Tank_-.- -_------ -_• - -- — - - -- _.:.Type of- Tank — Feet of Drain Tile___ _ ____ _____Dist. Feet of Tank or Drain Field from Well. Nature of Water Supply: City—Well. — ___._ —._ -Size of Soakage Pit - -•Q C/ Amount of Permit $ L (Signed ) - (Signed) Capacity gala.._ _ 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 5968, Compiled General Laws of Florida Permanent Supplement, and Isar com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employ - • him in the work to be performed under this permit; and will post or cause to be posted' for inspection on the site o ork such otice or notices as are required by the Act The undersigned agrees to employ only such sub - contractors, on • k to . Per nd this permit, as are licensed by Miami Shores Village. aster Plumber. STATE OF FLORIDA, i 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 be did sign 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 mob ore inspection L made•neceasary by improper notice for inspection, or faulty materials and /ce workmanship.