517 NE 102 St (9)PERMIT APPLI FOR MIAMI SHORES VILLAGE
Date S -06 Job Address G /b 02 gT r 1 Tax Folio I ) J O � j 0 l'] 0 �S
ly- LS
H Ili) p/ o{ m s 9, P$+s
Owner/Lessee / Tenant / /�� ►mac• —
S /1NC /Da_ slitxt
Owner's Address
Contracting Co.
Qualifier
State #
Architect/Engineer
Bonding Company
Mortgagor
Ins. Co.
Square Ft.
Condo President
c 3 f p d L ic �Address l""1C S Z /41A 1-1 Q- ,bh„, SS#
Municipal 11 Competency #
APPROVED:
Zoning Building
Mechanical Plumbing
/GPO)
Da
,A
Date'
Historically Designated: Yes No
Address
Address
Address
Master Permit #
Phone
- ? Phone Io'tf /- 7 r9
4/77 a
Permit Type (circle one): BUILDING LECTRICAL PLUMBIN MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION / �-- ce_ (f,
Estimated Cost (value) 16' sa ' ~
WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY RESULT IN YOU
PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LEND]
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.
OWNER'S AFFIDAVIT: I certify that all the fore g information is accurate and that all work will be done in compliance with all applicable laws regulating
construction ning. Furthern e, I autho ' e the above -named contractor to do the work stated.
Notary as to Owner and/or Condo President
My Commission Expires:
v..; vvvv•ev•rtsv•Pufwvvv-tre-,
STEPHEN E COCKING
State of Fi008104101
Comm #:
My Comm. 0 8 691 60
,� O O,y.�
FEES: PERMIT bV. U 0 RADON C.C.F. o () NOTARY 0 5
No
to C. 'tra
My Commission E
or • er- Builder
C- S- - ri gs-- 4 /- /o3- -0
Electrical
NOTARY SEAL
ANGELA M BECKER
saoN NUMB
•
'111' 4 CC766697
cn
OF F� O0:9 M' COMMON 2 E O XP ES
Date
BOND�c(p O•• O 0
TOTAL DUES
Date
Structural Engineer
CO STRUCTION PERMIT F
WI New System [ flee
[ Repair
APPLICANT:
0
T
H
E
R
SPECIFICATIONS BY:
APPROVED BY:
DATE ISSUED:
,
STATE OF FLORIDA
DEPARTMENT OF HEALTH
ONSITE SEWAGE DISPOSAL SYSTEM
CONSTRUCTION PERMIT
Authority: Chapter 381, FS
PROPERTY STREET ADDRESS:
LOT: Q� t BLOCK: SUBDIVISION: f A ��_
PROPERTY ID #:
D ( (00] SQUARE FEET PRIMARY DRAINFIELD SYSTEM
R [ ] SQUARE FEET SYSTEM
A TYPE SYSTEM: [V] STANDARD [IJ FILLED
I CONFIGURATION: ( J] TRENCH [ r) BED
N
F LOCATION OF BENCHMARK: 1. C ( 3
I ELEVATION OF PROPOSED SYSTEM SITE [p ]
E BOTTOM OF DRAINFIELD TO BE [ 414.-0 ]
L g
D FILL REQUIRED: [.+ ] INCHES
R:
Existing System
Abandonment
PERMIT # ®oA .. S Ra
DATE PAID / (fa _ S_'r - 7 FEE PAID $ 746, n 0
RECEIPT # 3 7 604
FAC - C, - ea c .S
Holding Tank (14 Temporary /Experimental
Other(Specify)
�4"' 4
A GENT: � �
( 7i l�4 1 /l l , e c A r Y l l� Y0A,
(INCHES/ET )[ABOVE/
(fI HES' FT] (ABOV ' BELO
TITLE:
•
( J] MOUND
Ali
t
TITLE: e C I
[SECTION /TOWNSHIP /RANGE /PARCEL NUMBER]
(OR TAX 'ID NUMBER]
SYSTEM MUST BE CONSTRUCTED IN ACCORDANCE WITH SPECIFICATIONS AND STANDARDS OF CHAPTER 10D -6,
FAC. REPAIR PERMITS AND HOLDING TANK PERMITS EXPIRE 90 DAYS FROM THE DATE OF ISSUE. ALL OTHER
PERMITS EXPIRE ONE YEAR FROM THE DATE OF ISSUE. DEPARTMENT OF HEALTH APPROVAL OF SYSTEM DOES
NOT GUARANTEE SATISFACTORY PERFORMANCE FOR ANY SPECIFIC PERIOD OF TIME. 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 BEING MADE NULL AND VOID.
SYSTEM DESIGN AND SPECIFICATIONS
6ge vAo
T 1769 J [GALLONS / GPD] SEPTIC TAN /AEROBIC UNIT CAPACITY • MULTI- CHAMBERED /IN SERIES : ]
A [ ] [GALLONS / GPD] ---"— CAPACITY MULTI- CHAMBERED /IN SERIES:( J
N [ ] GALLONS GREASE INTERCEPTOR CAPACITY (MAXIMUM CAPACITY SINGLE TANK: 1250 GALLONS]
K ( ' ] GALLONS PER DOSE DOSING TANK CAPACITY DOSE-RATE ( ] PER 24 HRS NO. OF PUMPS: ( 1
EXCAVATION REQUIRED: (INZ ] INCHES
-
1 ni
BENCHMARK /REFERENCE POINT
BENCHMARK /REFERENCE POINT
INSTALL 12° Or' LOAMY COARSE SAND
UNDER BOTTOM OF DRAINFIELD
SUBMIT EEN:dhiViArir■ ki r �►
BOTTOM OF DRAINFIELD ELEVATION Y"
• •EXPIRATION DATE:
THE SEpriic TAMN SHALL BE PUMPED MD A SCUD
DH 4016, 10/96 (Replaces HRS -H Form 4016 [page 1] which maybe UB � C U M OF / !CE INSTALLED ON THE 0! ' TEE-
(Stock Number: 5744- 001- 4016 -0) Applicant
CHD
Page 1 of 2
STATE OF FLORIDA
DEPARTMENT OF HEALTH AND REHABILITATIVE SERVICES
APPLICATION FOR ONSITE SEWAGE DISPOSAL SYSTEM CONSTRUCTION PARMII
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PART II SITE PLAN,
Permit Application Number
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Site Plan Submitted by:
Plan Approved' \-)
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Notes 1 SI) - 64,4 /114310
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(
SIGNATURE
HRS-H Form 4015, Feb 85 (Obsoletes previous editions which may ndt be used)
Stock Number: 5744-002-4015-6)
Not Approved
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ALL CHANGE3E APPO'tIED BY THE COUNTY PUBLIC HEALTH UNIT
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County Public Unit
Page 2 of 3
Permit No
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 be eon specified or not. A copy of approved plans and specification must be kept at
building during progress of work.
Owners Name and Address
(;)11?1' AT J
9
Registered Architect and /or Engineer ` _
Employing Plumber's Name � i Mitt • 1. � J ., Na....,.. -? . I �b +h.�l: � � . .. .
Location and Legal Description Lot.
Bloc
Street and Number where work is to be performed —No ( Street'_. ..7
State work to be performed and purpose of building (By Floors) . 7• � �• •• • `G! '
New Building_._ .__ _.._ _.. Remodeling_ —_ -_._ _— Addition.____ —. _ ...... Repairs ✓
Size Septic Tank_
Feet of Drain Tile
Nature of Water Supply: City—Well.
Amount of Permit $
0 0
(Signed)
No. S ^) 2.—. street.. _`l ?c L AZ
Type of Tank
nfst. Feet of Tank or Drain Field from Well
Size of Soakage Pit.
(sue)1" -- ) IJ0 . 53Y
Subd1vlslon_____
No. of Stories. .....
r-
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 5988, Compiled General Laws of Florida Permanent Supplement, and hrs 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 '', under this permit, as are
licensed by Miami Shores Village.
Plumber.
STATE OF FLORIDA, 1 µ
COUNTY OF DADE.
Before me, the undersigned authority, • 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 bas 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 Pub&o, State of Florida
NOTE: A re- inspection fee of $1.00 will be made when awl te.11aspaod= is saada•nsosasaey by improper notice for inspecdon. ar feu*
material and/or wad®ansblp
CLOUTS
BATH
Tung
SHOWERS
LAVA.
RI
TOES
SINKS
SLOP
SINKS
LAUNDRY
Tug[
UR
CATCH
BASIN
FLOOR
DRAIN
DRINK NO
F OUNT'NS
TOTAL
FIXTURES
CONTII.
LIST
CHECK
._ ��1
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
D[Er
WELL
S ►RKLR.
SYSTEM
SWIM'O
POOL
r
COMM
LIST
CHECK
Permit No
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 be eon specified or not. A copy of approved plans and specification must be kept at
building during progress of work.
Owners Name and Address
(;)11?1' AT J
9
Registered Architect and /or Engineer ` _
Employing Plumber's Name � i Mitt • 1. � J ., Na....,.. -? . I �b +h.�l: � � . .. .
Location and Legal Description Lot.
Bloc
Street and Number where work is to be performed —No ( Street'_. ..7
State work to be performed and purpose of building (By Floors) . 7• � �• •• • `G! '
New Building_._ .__ _.._ _.. Remodeling_ —_ -_._ _— Addition.____ —. _ ...... Repairs ✓
Size Septic Tank_
Feet of Drain Tile
Nature of Water Supply: City—Well.
Amount of Permit $
0 0
(Signed)
No. S ^) 2.—. street.. _`l ?c L AZ
Type of Tank
nfst. Feet of Tank or Drain Field from Well
Size of Soakage Pit.
(sue)1" -- ) IJ0 . 53Y
Subd1vlslon_____
No. of Stories. .....
r-
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 5988, Compiled General Laws of Florida Permanent Supplement, and hrs 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 '', under this permit, as are
licensed by Miami Shores Village.
Plumber.
STATE OF FLORIDA, 1 µ
COUNTY OF DADE.
Before me, the undersigned authority, • 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 bas 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 Pub&o, State of Florida
NOTE: A re- inspection fee of $1.00 will be made when awl te.11aspaod= is saada•nsosasaey by improper notice for inspecdon. ar feu*
material and/or wad®ansblp
Registered Architect and /or En ineer
Employing Plumber's Name -- •
Size Septic Tank
Feet of Drain Tile..
Nature of Water Supply: City —Well.
STATE OF FLORIDA,
COUNTY OF DADE. j
MIAMI SHORES VIL lGE
PLUMBING INSPECTION DEPARTMEN?'
APPLICATION FOR PLUMBING ;o.M8T
Permit No Date / ,�
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida,
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division
of Miami Shores Village shall be complied with, whether herein s. : 'fled or not. A copy of approved plans and specifications must be kept at
building during progress of work.
Owner's Name and Address__
Type ank
moist. F
o._ ____.._.._ - -_ - - -- _ Street.
_.. __.._._.. _ Subdivision--
Street and Number where work is to be performed —No / P treet
State work to be performed and purpose of building (By Floors) - __.__
New Building Remodeling____ _�_._ Addition_______._ Repairs No. of Stories
Location and Legal Description Lot Block
a
Amount of Permit $ -------- _------ _.__._.
My Commission Expires Notary Public, State of Florida
No.________ Street
Capacity Gals.
ield from 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 - 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 .erformed under is en 't, as are
licensed by Miami Shores Village.
(Signed)
sitter Plumber.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the
of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made•necessary by improper notice for inspection, or faulty
materials and /or workmanship.
CLOSETS
BATH
TUBS
SHOWERS
LAVA-
TORIES
INK
SINKS
SLOP
SINKS
LAUNDRY
Tues
U RINALS
CATCH
BASIN
FLOOR
DRAIN
DRINK NG
FOUNT'NS
TOTAL
FI %TURES
CONTR.
LIST
CHECK
SEPTIC
TANK
SEWER
CONK.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SW IM'G
POOL
CONTR. LIST
LIST
CHECK
Registered Architect and /or En ineer
Employing Plumber's Name -- •
Size Septic Tank
Feet of Drain Tile..
Nature of Water Supply: City —Well.
STATE OF FLORIDA,
COUNTY OF DADE. j
MIAMI SHORES VIL lGE
PLUMBING INSPECTION DEPARTMEN?'
APPLICATION FOR PLUMBING ;o.M8T
Permit No Date / ,�
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other
structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida,
and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division
of Miami Shores Village shall be complied with, whether herein s. : 'fled or not. A copy of approved plans and specifications must be kept at
building during progress of work.
Owner's Name and Address__
Type ank
moist. F
o._ ____.._.._ - -_ - - -- _ Street.
_.. __.._._.. _ Subdivision--
Street and Number where work is to be performed —No / P treet
State work to be performed and purpose of building (By Floors) - __.__
New Building Remodeling____ _�_._ Addition_______._ Repairs No. of Stories
Location and Legal Description Lot Block
a
Amount of Permit $ -------- _------ _.__._.
My Commission Expires Notary Public, State of Florida
No.________ Street
Capacity Gals.
ield from 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 - 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 .erformed under is en 't, as are
licensed by Miami Shores Village.
(Signed)
sitter Plumber.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the
of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made•necessary by improper notice for inspection, or faulty
materials and /or workmanship.
REMARKS
of Miami Shores N° _ 3616
ilk/e
r
LESS
A.SPECTION 11
TIME READY
riz
/ ./e
Du iN F/EU) o14 r, 4,4)04.
INSPECTOR DATE 4 0
;UILDING
LECTRICAL
'LUMBING
.00FING
?wner of
luilding
architect
contractor
1' Builder
.egal Lot
)escription
address of
. uilding
CONTRACTOR OR BUILDER
MIAMI SHORES VILLAGE. FLORIDA
PERMIT N° 3116
Work to be performed under this Permit
B1
BY
Subdi-
vision
Value of
Project $
DATF —J 4 / 195
Contractor's
License No.
Amount of
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 application
erefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans,
rawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any
me 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
ranted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations
ertaining 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
one by his agents, servants or employees.
Signed. BY
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
ertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In ac-
4pting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee.
4 Al
AUTHORITY
JOB:
BUILDING
•
•
ELECTRICAL
PLUMBING •
Inspector's Report:
•
•
•
"52 )/67
WORK
DONE BY:
•
•
▪ : REQUESTED
/#1 -z-f/
The following is ready for Inspection:
: WILL BE READY
40
F _,
Permit No.. -� - _---- ___ . ---- _ --
Application is hereby ade for the approval of the detailed statement of the plans and specifications herewith su itted for the building or other
structure herein desc ed. 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 compliedeivith, whether herein specified or not. A copy of approved plans and specifications must be kept at
building during progress of work. . t
y ,. r ,
Owner's Name and Address ________________, — — — / No.,� `_ -� "'_ ' .(. Street_./_4_ • ° e,�__ fr L
Registered Architect and /or En „ Ont e r _ -- ” - "^ • r / '
-
Employing Plumber's Name-;4 : - , ' loo � Street_-
Location and Legal Description Lot___ , •',, �__ _, ` - _ = _Black_ "` ' _ _ Subdivisiefn_C_x�_ . •
t' •
Street and Number where work is to be performed—No w
• _— _�'"•' ` __ e_ Street- „r_:�. _ase - - -_ _ - -
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.
- — - - - -- — -- -
'
Amount of Permit $9''
— ,J
MIAMI S H TES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Remodeling
(Signed)
Date___
I� r
,- L -
—__ Addition___— Repairs ,__ —___ No. of Stories_____
Type of Tank __ ✓ _! ' •:. ___ S_e ____ Capacity Gals._ _:_
Dist. Feet of Tank or Drain Field from Well____ __-- _______________________ —______
Size of Soakage Pit ._________ —_____
- 7 4
.(Signed) . f �t y� —�- - — -- — + > f , ______- --
Pluat6ing Inspector.
The undersigned applicant for this building permit does hereby certify ylj , a
he understands and accepts his obligations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Con$led 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.
Master Plumber.
STATE OF FLORIDA,
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.
My Commission Expires 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 /or workmanship.
CLOSETS
BATH
TUBS
SHOWERS
LAVA-
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TUBS
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT'NS
TOTAL
FIXTURES
CONTR.
LI ST
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SWIM•G
POOL
CONTR.
LIST
CHECK
F _,
Permit No.. -� - _---- ___ . ---- _ --
Application is hereby ade for the approval of the detailed statement of the plans and specifications herewith su itted for the building or other
structure herein desc ed. 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 compliedeivith, whether herein specified or not. A copy of approved plans and specifications must be kept at
building during progress of work. . t
y ,. r ,
Owner's Name and Address ________________, — — — / No.,� `_ -� "'_ ' .(. Street_./_4_ • ° e,�__ fr L
Registered Architect and /or En „ Ont e r _ -- ” - "^ • r / '
-
Employing Plumber's Name-;4 : - , ' loo � Street_-
Location and Legal Description Lot___ , •',, �__ _, ` - _ = _Black_ "` ' _ _ Subdivisiefn_C_x�_ . •
t' •
Street and Number where work is to be performed—No w
• _— _�'"•' ` __ e_ Street- „r_:�. _ase - - -_ _ - -
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.
- — - - - -- — -- -
'
Amount of Permit $9''
— ,J
MIAMI S H TES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Remodeling
(Signed)
Date___
I� r
,- L -
—__ Addition___— Repairs ,__ —___ No. of Stories_____
Type of Tank __ ✓ _! ' •:. ___ S_e ____ Capacity Gals._ _:_
Dist. Feet of Tank or Drain Field from Well____ __-- _______________________ —______
Size of Soakage Pit ._________ —_____
- 7 4
.(Signed) . f �t y� —�- - — -- — + > f , ______- --
Pluat6ing Inspector.
The undersigned applicant for this building permit does hereby certify ylj , a
he understands and accepts his obligations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Con$led 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.
Master Plumber.
STATE OF FLORIDA,
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.
My Commission Expires 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 /or workmanship.
Employing Plumber's Nam
appeared
MIAMI SHORES VILLAGE
),APPLICATION FOR PLUMBING PERMIT
Permit _________ Date
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith subtfiitted 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. a
j N
Owner's Name and Address 1 _ cr No ______ Street '
Registered Architect and /or Enc`
Fa-
PLUMBING INSPECTION DEPARTMENT
-------------------
Amount of Permit $_ ___— __________—____ __— ________ (Signed)
7777 ,
r ...0 '
Location and Legal Description Lot_______ -L,._ _ ,P Block. :— _____ Subdiviston
- - - - -- — :, .L -- _-------------- - --
Street and Number where work is to be performed —No ,,.4I Z y ' __4 — cam _ _ Street_,,__ *__�__s_`�j__.__ —__ —__
State work to be performed and purpose of building (By Floors)
New Building __ Remodeling Addition Repairs ____ No. of Stories____
Nature of Water Supply: City —Well Size of Soakage Pit
(Signed)
My Commission Expires Notary Public. State of Florida
Capacity Gals. ~- -_
Size Septic Tank - _ _ __— _ Type of Tank
6'
Feet of Drain Tile__________,;,_.__ _ —___ Dist. Feet of Tank or Drain Field from Well____--_ _—_______— ___-_______-_-- _.____
Pluming Inspector.
undersigned applicant for this building permit does hereby certify r ,,* he understands and accepts his obligations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Co .sled 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.
Master Plumber.
STATE OF FLORIDA,
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.
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty
materials and /or workmanship.
CLOSETS
BATH
TUBS
SHOWERS
LAVA
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TUBS
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT'NS
TOTAL
FIXTURES
CONTR.
LIST
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SWIM'G
POOL
CONTR.
LIST
CHECK
Employing Plumber's Nam
appeared
MIAMI SHORES VILLAGE
),APPLICATION FOR PLUMBING PERMIT
Permit _________ Date
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith subtfiitted 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. a
j N
Owner's Name and Address 1 _ cr No ______ Street '
Registered Architect and /or Enc`
Fa-
PLUMBING INSPECTION DEPARTMENT
-------------------
Amount of Permit $_ ___— __________—____ __— ________ (Signed)
7777 ,
r ...0 '
Location and Legal Description Lot_______ -L,._ _ ,P Block. :— _____ Subdiviston
- - - - -- — :, .L -- _-------------- - --
Street and Number where work is to be performed —No ,,.4I Z y ' __4 — cam _ _ Street_,,__ *__�__s_`�j__.__ —__ —__
State work to be performed and purpose of building (By Floors)
New Building __ Remodeling Addition Repairs ____ No. of Stories____
Nature of Water Supply: City —Well Size of Soakage Pit
(Signed)
My Commission Expires Notary Public. State of Florida
Capacity Gals. ~- -_
Size Septic Tank - _ _ __— _ Type of Tank
6'
Feet of Drain Tile__________,;,_.__ _ —___ Dist. Feet of Tank or Drain Field from Well____--_ _—_______— ___-_______-_-- _.____
Pluming Inspector.
undersigned applicant for this building permit does hereby certify r ,,* he understands and accepts his obligations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Co .sled 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.
Master Plumber.
STATE OF FLORIDA,
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.
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.