The URL can be used to link to this page

534 NE 102 St (13)Contracting Co. (...0 /Fq e Qualifier ‹PfrrW,--- WORK DESCRIPTION Square Ft. fr 3OZ, PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Dater y \ 2-6 k S Job Address X S 31 0 E. 101 Sr Tax Folio Legal Description Historically Designated: Yes Owner/Lessee / Tenant ' 0 r4 Soy./ I..) 6N 13 LA CAL �-r Owner's Address State # Municipal # Competency # Ins. Co. Architect/Engineer Bonding Company Mortgagor Permit Type (circle one): BUILDING ELECTRICA / • J PLUMBING Estimated Cost (value) er / ' ae5 WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.) Application is hereby made to obtain a permit to do work and installation as indicated above, and on the attached addendum (if applicable). I certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits are required for ELECTRICAL, PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK. 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. Furthermore, I authorize the above -named contractor to do the work stated. .t S gnature of owner and/or Condo President Date N otary My Co • NOTARY SEAL O SANDRA IS PS MONTIEL * A � * COMMISSION NUMBER a 'r.•:r Q CC401261 MY COMMISSION EXP. F OF F\ AUG. 17 199$ FEES: PERMIT 10 RADON -Z6 -etc Date APPROVED: Zoning Building Mechanical Plumbing Master Permit # 37737 Phone cri 6 Li- No Address -J 7 L. r SS# - - -� Phone ado v�— --� ?377 Address Address Address ECHANICAL ROOFING PAVING FENCE SIGN Contractor or Owner- Builder Signa Notary My Co i`" i NOTARY SEAL SANDRA M MONTIEL 2 ; C". * COMMISSION NUMBER CC401261 7, ��'• -� ' QQ MY COMMISSION .EXP. OF Fti AUG. 17 1998 sion Date C.C.F. NOTARY / TOTAL DUE #fr ® Electrical Date Engineering C TRUCTION PERMIT FOR: (1 1 New System [ril Existing System p; Tank [4 [1 ] Repair [Abandonment [ ] Other(Specify) . c ; /1"/dv 7. 4/1c /: AGENT: al / c. ' PO `i �� PROPERTY STREET ADDRESS: 5e / 67 /oz. i ,ps/ -- LOT: APPLICANT: PROPERTY ID #: 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. HRS 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 DESIGL AND SP D [ a aes S DARE FEET R [ ] SQUARE FEET 0 T H " E R STATE OF FLORIDA DEPARTMENT OF HEALTH AND REHABILITATIVE SERVICES ONSITE SEWAGE DISPOSAL SYSTEM CONSTRUCTION PERMIT Authority: Chapter 381, FS & Chapter 10D -6, FAC BLOCK: SUBDIVISION: CIFICATIONS T ] G ALLO / GPD] SEPTIC ;;17L4AEROBIC UNIT A [ ] [GALLONS / GPD] N [ ] GALLONS GREASE INTERCEPTOR CAPACITY K [ ] GALLONS PER DOSE DOSING TANK CAPACITY RIMARY DRAINFIELD SYSTEM SYSTEM [ ] FILLED [ ] MOUND [ [ ] BED [ A TYPE SYSTEM: [ ] STANDARD I CONFIGURATION: [ ] TRENCH N F LOCATION OF BENCHMARK: I ELEVATION OF PROPOSED SYSTEM SITE [ E BOTTOM OF DRAINFIELD TO BE [ L D FILL REQUIRED: [ ] INCHES EXCAVATION REQUIRED: [ TWSTALL )'12 OF LOAMY COARSE SAND UNDER OT 2 ; R� ; � SU p,/��T' ??^L. T:T ,�^, 7.T''a .' A 7' r;-�r, . �^ n rti + ..l ll... :Y__.o i. c..i v`�a..t .a:�� .�. L: �: -. L.�J171� C.iTAn P W SPECIFICATIONS BY: APPROVED BY: DATE ISSUED: ! v {i i ' F 7.1',I . IC TC .,T nru _ ♦vat ♦ IC .; Z .l :- „y t,.:l��v •:' y �� a1 V 2 7 - 1 [INCHES /FT] [ABOVE /BELOW) BENCHMARK /REFERENCE POINT ] [INCHES /FT] [ABOVE /BELOW] BENCHMARK /REFERENCE POINT [SECTION /TOWNSHIP /RANGE /PARCEL NUMBER] [OR TAX ID NUMBER] TITLE: TITLE: 57 nl q m EXPIRATION DATE: 7 2 ' HRS -H Form 4016, Mar 92 (Obsoletes previous editions which may not be used) (Stock Number: 5744-001- 4016 - 0) PERMIT # DATE PAID FEE PAID $ RECEIPT # ] INCHES CAPACITY MULTI- CHAMBERED /IN SERIES:[ ] CAPACITY MULTI- CHAMBERED /IN SERIES:[ ] [MAXIMUM CAPACITY SINGLE TANK: 1250 GALLONS] DOSE RATE [ ] PER 24 HRS NO. OF PUMPS: [ ] I CPHU Page 1 of 2 LOT: PROPERTY ID #: STATE OF FLORIDA DEPARTMENT OF HEALTH AND REHABILITATIVE SERVICES ONSITE SEWAGE DISPOSAL SYSTEM SITE EVALUATION AND SYSTEM SPECIFICATIONS j&/ � �� ifP/14e AGENT: 14140e AG BLOCK: / <;1 SUBDIVISION: ��i TO BE COMPLETED BY ENGINEER; HEALTH UNIT'EMPLOYEE, OR OTHER QUALIFIED PERSON. ENGINEER'S MUST PROVIDE REGISTRATION NUMBER AND SIGN AND SEAL EACH PAGE OF SUBMITTAL. COMPLETE ALL ITEMS. PROPERTY SIZE CONFORMS TO SITE P TOTAL ESTIMATED SEWAGE FLOW: AUTHORIZED SEWAGE FLOW: UNOBSTRUCTED AREA AVAILABLE: BENCHMARK /REFERENCE POINT LOCATION,, :._ ELEVATION OF PROPOSED SYSTEM SITEIS THE MINIMUM SETBAC SURFACE WATER: WELLS: PUBLIC: BUILDING FOUNDATIONS: ICH CAN BE .MAINTAINED FROM THE PROP FT DITCHES /SW,.ES: FTIMITED USE: FT FT PROPER LINES: SITE SUBJECT TO FREQUENT FLOODING: [ ] YES [ AN0 10 YEAR FLOOD ELEVATION FOR SITE: SOIL PROFILE NFORMATION SITE 1 Munsell # /Color USDA SOIL SERIES: Text Depth /) to , 1t r� tQ to to to to to to to OBSERVED WATER TABLE: INCHES [ABOVE / BELQ EXISTING GRADE. TYPE: [PERCHED / APPARENT] ESTIMATED WET SEASON WAT TABLE ELEVATION: ete/ INCHES [ ABOVE / BELOW ] EXIST N GRADE. HIGH WATER TABLE VEGETATION: [ ] YES [ ] NO SOIL TEXTURE /LOADING RATE FOR SYSTEM SIZING: DRAINFIELD CONFIGURATION: [ ] TRENCH [ REMARKS /ADDLE CRITERIA: SITE EVALUATED BY: HRS -H Form 4015, Mar 92 (Obsoletes previous editio (Stock Number: 5744- 003 - 4015 -1) [Section /Township /Range /Parcel No. or Tax [ ] YES ( NO NET USABLE AREA AVAILABLE: GALLONS PER DAY [RESIDENCES -TABLE 1 / OT GALLONS PER DAY [1500 GPD /ACRE OR 2500 SQFT UNOBSTRUCTED AREA REQUIRED: [INCHES /FT] FT MSL /NGVD ] BED P / PERMIT 1` [ABOVE /BELOW] BENCHMARK /REFERENCE POINT SED SYSTEM TO THE FOLLOWING FEATURE FT NORMALLY WET? [ ] YES [= NO E: _ FT NON-POTABLE: FT POTABLE WATER LINES: . ;. I FT 10 YEAR FLOODIN ?[ ] YES [NO SITE ELEVATION: FT MSL /NGVD SOIL PROFILE INFORMATION SITE 2 /e/,?27 DNumber] Aik ACRES R -TABLE 2] /ACRE] SQFT. MOTTLING:..[ ] YES [ ] NO DEPTH: INCHES DEPTH OF EXCAVATION: 44* INCHES OTHER (SPECIFY) DATE: /76...4 ATE: 2' -ft Page 3 of 3 APCATION FOR: [ New System (V] Repair 1 2 3 4 STATE OF FLORIDA DEPARTMENT OF HEALTH AND REHABILITATIVE SERVICES ONSITE SEWAGE DISPOSAL SYSTEM APPLICATION FOR CONSTRUCTION PERMIT Authority: Chapter 381, FS & Chapter 1OD -6, FAC APPLICANT: 0; / 44Jg 16 i AGENT: MAILING ADDRESS: ( 7 4 /r 6 �� TO BE COMPLETED BY APPLICANT OR APPLICANT'S AUTHORIZED AGENT. ATTACH BUILDING PLAN AND TO -SCALE SITE PLAN SHOWING PERTINENT FEATURES REQUIRED BY CHAPTER 1OD -6, FLORIDA ADMINISTRATIVE CODE. PROPERTY INFORMATION [IF LOT IS NOT IN A RECORDED SUBDIVISION, ATTACH LEGAL DESCRIPTION OR DEED] LOT: ev BLOCK: SUBDIVISION: DATE OF � � A *t SUBDIVISION: PROPER Y ID #: A* [Section /Township /Range /Parcel No.] ZONING: .. PROPERTY SIZE: :� ACRES [Sqft /43560] PROPERTY WATER SUPPLY: [ ] PRIVATE ['PUBLIC PROPERTY STREET ADDRESS: nr , W (441 DIRECTIONS TO PROPERTY: BUILDING INFORMATION [ PRESIDENTIAL Unit Type of No. of No Establishment Bedrooms ge) APPLICANT'S SIGNATURE: /4/ Existing System [4 Tank [ Temporary /Experimental Abandonment ( Other(Specify) 4k orcroi HRS -H Form 4015, Mar 92 (Obsoletes previous editions which may not be used) (Stock Number: 5744 - 001 - 4015-1) TELEPHONE: ] COMMERCIAL Building # Persons Area Sgft Served PERMIT # r3� /22 DATE PAID FEE PAID $ RECEIPT # Business Activity For Commercial Only [ ] Garbage Grinders /Disposals [ ] Spas /Hot Tubs [ ] Floor /Equipment Drains [ ] Ultra -low Volume Flush Toilets [ ] Other (Specify) DATE: Page 1 of Scale: Each block represents 5 feet and 1 inch = 50 feet. ::::::ERM t M 'M IMMEM MM " t t t ■tt t t t t ' : t:tM :ti .......... m..rv,�;.- L..,.. WNW., tN .1. ■.. ..... ■.� / ■ ■ / ■ / ■ / ■ ■ ■ � ■1 °1 i�I ■ D o m I �� ' � ��tt %��O/tttttMtN ®� t ■■ ■ a■ ■■■Iiil ■ ■allm ■ ■ ■. imi ,.m mo�t —■■■ ■ ■■ ■ammo. ■■a oa. ■.■ ■■.■11 . ■r.�' - �.... ■ ■ aCCt�C�m�S� �t '■�'u::::::::'n'i::iiGi::� m.■■■...■ ■t ■.i■■� ��V, ■■ ■ ■■.■ ■ ■■■ IN ■■■■■■■■ ■gi■■Piiiii ■■n■■■■ ■ �n■n ■■n■■a■ ■ mmr1 ■/■ ■ t ■ ■ ■ ■ am . ..U U I.t' ■. ..xm •ii N! limp= .■ .■.. mi ii = ''ti'a'C '■ ' ■ .r"" i�� ,, v i'■ ■■i■■ii�ii� ■.m i ii■■■ ■ „um= . �■ ■m■mm■n um... mom att■ =ME ■ l ■ ■ ■■ ■■■■■■■■ ! .UU.■UI. ■m ■ ■ ■n ■ ..■■■ ■ ■ ■ ■. ■■■u. ■■ ■t■ ■ ■■.■ ■■ ■ ■■■■ ■ ■ ■ r. C - fiiri' •• ■■ NI .� ■ ■■ ■t■ .a■. ■a ■■11■m■■ .aa ■ ..... ■t.■�i�' - W ,lL` ■I! a1 ■■ / ■,v ma t � p l o ■■■■11■..■.■■. ■ ■o ■ rl 1 I■■■ ■ ■m ■m■ ! AMINE .■ .. ..:..r. 11 ■.amm... �at..m■ - , mm ■■am ■.a �. - yltrit . ..■ t ; - mM.■•N ■t.. t ■■■■■■ t ■ t ■■■■■■■■. R IMI ,�, t ■ ■ ■ ■Ul.■■■ ■■ own, i....■■■■■■ ■ ■••1101■ ■� ■■■ ■11 ■■ iiii..■ � ■ ■�■��■�� lll .t�0 m 1 ■•11. ■ ■.uu..'■'t•■t■■ mu C m. mmam :•i ■ ' ► im • Im C: . :�..i rip. • ■ ■ o■ ■o ■■ ■■ ■■ ■ o P lir . ■�If1 M ■■ ■■ . II■ ■ . ■■■■MU■■■■■ ■■O . ■CC ■ ■.. s.r. ■ FIVIIMOIROMIRI ... ■ t _ C �jC .■ . a .■ ■■■ tC ■ ■ ■ -11 U ■uuu� ii■■M ■■...m i Itt ■i■ ■■ ■ ■ �t :. - D , . . ■t ■riAl. tw ta.a■m a ME ■ [�vial ■■C■■=■■■.0■ ■�i■ l� .. .�.p 'ii u■■■.■■■■■.■■■■■■ ■m■ ■ ■■ O "' J J,' ..UI IUUittt� : M ' .4UII a j �.i.i A % " .:vv::u t■ ■/ t - --r- ■ 't■ ■•W ' ■� : / •U■■a�' .■ 7 fliiiimali mama I II Utt' ■ ■ r ■■■.■ r `i� � % of im _ m in i m i MOM MI ■ , ■i■i '!■■'O ■ C ::: ■ /■ t■ Mtt"0 T & .:wi '4 ■C ■ ■■■■■l■ l l■i�.I ■ l■ ■y ■ ■■ ■ ■ a■ s 4 n A ■ ■a ■■ma. ■Q■a■ ■ ■ ■ ■■.■ 1111 ■■■ mum. ■ . • ! 3 � � ■ a 011 E r: : U . p ■ ■ : ::I t M Um mO N MEE ■�..�a .. ■ttt■. ■ rg ■■ ■a ■■ o ■■ ■ •u mmi■ ■ ui■ ■ t o MOM ■■ ■■ ■ ME ' - ■ • ■ l ■to■ ■ ■alo� I■■oo �C' • . ■■ I_ ? - �� ■. a... 111.311 ■ ■ ■■ ■ � ,� um t i . mI �uIU' I � .. ... �► iu. ■o.. �_ �_■ .a...I ■a■ ■m. . ■ ■ ■ . � '•5 . ■ ■ Y " ■■■■ ■ ■ ■ 1 I i ... 9.l, u. ._ ■ -- - o. IUII I ` .■ ■ U.I l ■■ I■■nI /■ MU ■■■ ■ m i .�.■ - 41201111,11,74164011 _ -z._ . -.�■ ■■■■■•i ■ � a■ ..0■ ' .. ` ■ n. r iiii ma ■■■.'111■ ■■•Btt�E. .oat.�p . .. : ■ .... ..�'....■:�■.. .. . � ■■anon■ ■11 ■ ■. ■t ■ ■ ■� ■■ ■ i �.i ■.. ■ �� ■ ■ �: mo MO MI ■■■■■a■.m■■■■■.■ ■ii■■■■ m■ ■■t■ iiii" mum mamma ■ ■ ■■/ ■ ON ■ � t :� OR ... �� ■ Ctt� ■■ tt .m .■ ' ■ta�. ttitt■... ■■.■ ■. ■ ■. ■ m tti mamma . i ■■■■ m.. ■a .■■ m■ ■■■■■■■ .. ■. .■■ ■■■■■.■■ ■a■tm■. ■EN ME ■m■ MUM ■■■ ■■:.... t I. ' " tt t .I� .. UU.....I .t ..U... t.a ■m■ Y 11.m■. ■ ■ ■ ■ ■a. ..m ■■■m■■ ■ . ot.■ ■amt ■o ■■m mums • ■o■ mmo ■■ ■omam ma ■0■ =■11 ■Cat■mt■o ■ MOM . . ■tmo ..■.a■■omt.mm■■toomamo.■. ■ m■ t ' . I ' m mmo l m ••• ■•SU■ mmmomommom ..Irma ■.. •Ul•UU Mt " 01..■ ■ti■.IUUU. I RUM 0111■■...■■ • ■ _ Notes: Site Plan submitted by: Plan Approved By STATE OF FLORIDA DEPARTMENT OF HEALTH AND REHABILITATIVE SERVICES APPLICATION FOR ONSITE SEWAGE DISPOSAL SYSTEM CONSTRUC R I Permit Application Number / I ' / �1 / � PART II - SITE PLAN HRS-H Form 4015, Feb 85 (Obsoletes previous editions which may not be used) (Stock Number. 5744-002-4015-6) SIGNATURE Not Approved o TITLE Date County Public Unit ALL CHANGES MUST BE APPROVED BY THE COUNTY PUBLIC HEALTH 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 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 Nature of Water Supply: City —Well. Amount of Permit $ _Type of Tank —. Dist- Feet of Tank or Drain Field from Wen ..._.___.- Size of Soakage Pit. (Si No 63 4 s free t .NE - 10 7 < 57 Owner's Name and Address Registered Architect and /or s Enginq - ec y ev _ -� in✓� i /r 2 P °� 9 Employing Plumber e 0 0/0 A d_ Si✓Plie ... Na „_. . 5 • itn.t d.: : ... � et•.. en Location and Legal Description Lot. Block Subdi . _____..._.._— Street and Number where work is to be performed —No. 4 a — Street .._.... _.. _ . 2 ST . State work to be performed and purpose of building (By Floors) — i°1..1 .4 QQ £Q _.... .T' New Building- - - - - -_ _ _..---- ........_.. Remodeling ___.. -.._.______ Addition...- _ - -..__ Repairs No. of Stories. .. .. ..... ..... (sigaed )_sic ; aittkk � 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 Pennanent 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 such public notice or notices as am required by die Act. The undersigned agrees to employ only such sub - contractors, work • be performed un,Ier this permit, as are licensed by Miami Shores Village. Master Plumber. - STATE OF FLORIDA, l 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 appli cation, 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 mob Swispsotlaa is load. a.osesery by improper Dodo, for inspection, or bulb materials and/or workmanship. CLOarTS BATH "runs T SMOW[Ra LAVA. TOR1ta SIN" SINKS • LAUNDRY Tuna U RINAL/ CATCH SAa1N FLOOR DRAIN DRINKING FOUNT' NS TOTAL FIXTUR[a CoNTR. LIST CHICK + OW WELL SPRKLR. 6 M SWIM'O POOL I ! SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT 0 TRAP SOLAR H EAT[R CONTR. Liar ' ,"_ CN[CII 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 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 Nature of Water Supply: City —Well. Amount of Permit $ _Type of Tank —. Dist- Feet of Tank or Drain Field from Wen ..._.___.- Size of Soakage Pit. (Si No 63 4 s free t .NE - 10 7 < 57 Owner's Name and Address Registered Architect and /or s Enginq - ec y ev _ -� in✓� i /r 2 P °� 9 Employing Plumber e 0 0/0 A d_ Si✓Plie ... Na „_. . 5 • itn.t d.: : ... � et•.. en Location and Legal Description Lot. Block Subdi . _____..._.._— Street and Number where work is to be performed —No. 4 a — Street .._.... _.. _ . 2 ST . State work to be performed and purpose of building (By Floors) — i°1..1 .4 QQ £Q _.... .T' New Building- - - - - -_ _ _..---- ........_.. Remodeling ___.. -.._.______ Addition...- _ - -..__ Repairs No. of Stories. .. .. ..... ..... (sigaed )_sic ; aittkk � 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 Pennanent 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 such public notice or notices as am required by die Act. The undersigned agrees to employ only such sub - contractors, work • be performed un,Ier this permit, as are licensed by Miami Shores Village. Master Plumber. - STATE OF FLORIDA, l 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 appli cation, 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 mob Swispsotlaa is load. a.osesery by improper Dodo, for inspection, or bulb materials and/or workmanship. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT 6 Permit No d 667 _ Date... e4 : / 9 7 . Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. Owner's Name and Address e-406101.501,, No Registered Architect and /or Engineer - � - g p - Employing Plumber's Name C.'..1 /�� 5-etY.Y No. ,.,..• Iltr O�Z :.../. 4 .2. . 0/ /. 5 Location and Legal Description Lot. Street and Number where work is to be performed —No Street.. State work to be performed and purpose of building (By Floors) New Building._ -._ ___ _ _ Remodeling_____ _ ._. _ __ Addition-- - - - - -. _ __... Repairs No. of Stories...... _ ..... ........ Mock Size Septic Tank__ Type of Feet of Drain Tile 19" g 1 5i ---Dist- Feet of Tank or Drain Field from Well Nature of Water Supply: City—Well. Size of Soakage Pit. Amount of Permit $ STATE OF FLORIDA, 1 COUNTY OF DADE. S The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligati under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Pennanent 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 caned under this permit, as are licensed by Miami Shores Village. (Signed) (Signed) ( i street.. .S 3Y N. 'i. ai 517 Capacity Gals.. 7 as an employer of labor upplement, and has com- Master Plumber. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take aclmwwledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath depose. and says that be is the_ ..._..._.._..._.._... of the above described construction, that he has carefully lead the foregoing application, and that be did sign the same, and that all facts therein by him stated are true. My Commission gspine Notary Public. State of Florida NOTE: A re- inspection fee of $1.00 will be mads whoa sssc1 raiospaodasi is mode•m.ossmry by improper notice for Inspection, or faulty materials and /ar workmanship. a[ CLoT[ BATH • Tulsa SHOW[Ra LAVA. TORIES .INKS SLOP a1NKS LAUNDRY Ts US URINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT' NS TOTAL FIXTURES CONTR. LIST CHECK • SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HATER DEEP WELL SPRKLR. SYSTEM SWIM'G POOL CONTR. LIST CHECK MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT 6 Permit No d 667 _ Date... e4 : / 9 7 . Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. Owner's Name and Address e-406101.501,, No Registered Architect and /or Engineer - � - g p - Employing Plumber's Name C.'..1 /�� 5-etY.Y No. ,.,..• Iltr O�Z :.../. 4 .2. . 0/ /. 5 Location and Legal Description Lot. Street and Number where work is to be performed —No Street.. State work to be performed and purpose of building (By Floors) New Building._ -._ ___ _ _ Remodeling_____ _ ._. _ __ Addition-- - - - - -. _ __... Repairs No. of Stories...... _ ..... ........ Mock Size Septic Tank__ Type of Feet of Drain Tile 19" g 1 5i ---Dist- Feet of Tank or Drain Field from Well Nature of Water Supply: City—Well. Size of Soakage Pit. Amount of Permit $ STATE OF FLORIDA, 1 COUNTY OF DADE. S The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligati under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Pennanent 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 caned under this permit, as are licensed by Miami Shores Village. (Signed) (Signed) ( i street.. .S 3Y N. 'i. ai 517 Capacity Gals.. 7 as an employer of labor upplement, and has com- Master Plumber. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take aclmwwledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath depose. and says that be is the_ ..._..._.._..._.._... of the above described construction, that he has carefully lead the foregoing application, and that be did sign the same, and that all facts therein by him stated are true. My Commission gspine Notary Public. State of Florida NOTE: A re- inspection fee of $1.00 will be mads whoa sssc1 raiospaodasi is mode•m.ossmry by improper notice for Inspection, or faulty materials and /ar workmanship. se—D Permit No Size Septic Tank Feet of Drain Tile Nature of Water Supply: City —Well Amount of Permit $_ STATE OF FLORIDA, as. COUNTY OF DADE. j MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. ^ 1 ' a � Owners Name and Address _ � I� �?--- _ ..._..- No. -__ -_— `�'___ Street- M, /0 R S7 Registered Architect and /or Engineer____ Employing Plumber's Name MI <ten_(__ ! ee-f5' C NO.________ 7 _ 5 Street__ ` Location and Legal Description _- Street and Number where work is to be performed —No L1y �Street. /J t State work to be performed and purpose of building (By Floors)_.---------------_, 1�L' J.. 0�3- L�--- (- Ql..��-- '--- ' - - - -�� 4�L,Q�� New. Building __ Remodeling Addition__ Block (Signed) Date__.!' /MC N Subdivision Repairs ° v' No. of Stories. ___ _Type of Tank_ Capacity Gals __Dist. Feet of Tank or Drain Field from Well _Size of Soakage Pit 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 Flo • : =anent Supplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub -co . • actors - mployed by him in the work to be performed under this permit; and will post or cause to be posted' for inspection on the of th work s ch public notice or notices as are required by the Act. The undersigned agrees to employ only such sub - contractors, • ork to b % rfo d under this permit, as are licensed by Miami Shores Village. / 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 66 Plumbing Inspector. 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. CLOSETS BATH TUBS SHOWER! LAVA- TORIES SINKS SLOP SINKS LAUNDRY 'rues T R INALS 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 SWIM'G POOL CONTR. LIST CHECK -- se—D Permit No Size Septic Tank Feet of Drain Tile Nature of Water Supply: City —Well Amount of Permit $_ STATE OF FLORIDA, as. COUNTY OF DADE. j MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. ^ 1 ' a � Owners Name and Address _ � I� �?--- _ ..._..- No. -__ -_— `�'___ Street- M, /0 R S7 Registered Architect and /or Engineer____ Employing Plumber's Name MI <ten_(__ ! ee-f5' C NO.________ 7 _ 5 Street__ ` Location and Legal Description _- Street and Number where work is to be performed —No L1y �Street. /J t State work to be performed and purpose of building (By Floors)_.---------------_, 1�L' J.. 0�3- L�--- (- Ql..��-- '--- ' - - - -�� 4�L,Q�� New. Building __ Remodeling Addition__ Block (Signed) Date__.!' /MC N Subdivision Repairs ° v' No. of Stories. ___ _Type of Tank_ Capacity Gals __Dist. Feet of Tank or Drain Field from Well _Size of Soakage Pit 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 Flo • : =anent Supplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub -co . • actors - mployed by him in the work to be performed under this permit; and will post or cause to be posted' for inspection on the of th work s ch public notice or notices as are required by the Act. The undersigned agrees to employ only such sub - contractors, • ork to b % rfo d under this permit, as are licensed by Miami Shores Village. / 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 66 Plumbing Inspector. 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 ! 0 Size Septic Tank Feet of Drain Tile Nature of Water Supply: City —Well Amount of Permit $ STATE OF FLORIDA, } COUNTY OF DADE. 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 submitt ed for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. Owner's Name and Address 1 [._____27,11l1_I_7:a A1_.______ __ -- __._.__.- No.— i2__ _ Street../Y/ 4E. / 0 �. Registered Architect and /or Engineer _____W - ___— �_____ Employing Plumber's Name CW.19S.L____ fl Street_/I .E_ -- 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)__ New Building ____ Remodeling_____ Addition._._______.__ Repairs No. of Stories (Signed)_ Date Street ,/1� �� / Type of Tank Dist. Feet of Tank or Drain Field from Well - Size of Soakage Pit Capacity Gals (Signed) _____ Subdivision My Commission Expires Notary Public, State of Florida 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 5986, 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 under this perinit, as are licensed by Miami Shores Village. O - ' &, Master 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. CLOS[r6 BATH TUBS SHOWERS LAVA. TORIES SINKS SLOP SINKS LAUNDRY TUBS U 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 SW IM'G POOL CONTR. LIST CHECK Permit No ! 0 Size Septic Tank Feet of Drain Tile Nature of Water Supply: City —Well Amount of Permit $ STATE OF FLORIDA, } COUNTY OF DADE. 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 submitt ed for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. Owner's Name and Address 1 [._____27,11l1_I_7:a A1_.______ __ -- __._.__.- No.— i2__ _ Street../Y/ 4E. / 0 �. Registered Architect and /or Engineer _____W - ___— �_____ Employing Plumber's Name CW.19S.L____ fl Street_/I .E_ -- 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)__ New Building ____ Remodeling_____ Addition._._______.__ Repairs No. of Stories (Signed)_ Date Street ,/1� �� / Type of Tank Dist. Feet of Tank or Drain Field from Well - Size of Soakage Pit Capacity Gals (Signed) _____ Subdivision My Commission Expires Notary Public, State of Florida 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 5986, 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 under this perinit, as are licensed by Miami Shores Village. O - ' &, Master 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. Permit No. /43 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 specified or not. A copy of approved plans and specifications must be kept at building during progress of work. Owner's Name and Address 711 .t;_ . -t' /' 4!f '_________-_ No._ ,�` L� -- +�-- �- --F- -- - - -- -- Street Registered Architect and /or Engineer_____________________-- =-" -� � � - -_ - -- _------------ _ _ - -. - -- __ -- Employing Plumber's Name _:: � .;,,t - -- NO P / _ �° __ Street__2 F Location and Legal Description Lot____-- _—___— ___ __ - - -__ _ r �� 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 - -- — - - -- - - - -- --- - - - - - - - - - - Amount of Permit $ _ -- - - - - -. STATE OF FLORIDA, I COUNTY OF DADE. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Addition Type of Tank (Signed)._ (Signed)._ „4,0‘1,14-0 1; --- Street Repairs No. of Stories._ Capacity Gals Size Septic Tank Feet of Drain Tile_-.___ Nature of Water Supply: City — Well.___ __ ------- __ ---- ____.____---- _______— ____.Size of Soakage Pit 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 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 performed under this permit, as are licensed by Miami Shores Village. 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 beaaster 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. CLOSETS BATH TUBS SHOWERS LAVA. TORIES SINKS . SLOP SINKS LAUNDRY TUBS URINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT'NS TOTAL FI %TURES CONTR. LIST CHECK SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL - SPRKLR. SYSTEM SWIM'G POOL CONTR. LIST _ y J f y i CHECK Permit No. /43 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 specified or not. A copy of approved plans and specifications must be kept at building during progress of work. Owner's Name and Address 711 .t;_ . -t' /' 4!f '_________-_ No._ ,�` L� -- +�-- �- --F- -- - - -- -- Street Registered Architect and /or Engineer_____________________-- =-" -� � � - -_ - -- _------------ _ _ - -. - -- __ -- Employing Plumber's Name _:: � .;,,t - -- NO P / _ �° __ Street__2 F Location and Legal Description Lot____-- _—___— ___ __ - - -__ _ r �� 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 - -- — - - -- - - - -- --- - - - - - - - - - - Amount of Permit $ _ -- - - - - -. STATE OF FLORIDA, I COUNTY OF DADE. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Addition Type of Tank (Signed)._ (Signed)._ „4,0‘1,14-0 1; --- Street Repairs No. of Stories._ Capacity Gals Size Septic Tank Feet of Drain Tile_-.___ Nature of Water Supply: City — Well.___ __ ------- __ ---- ____.____---- _______— ____.Size of Soakage Pit 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 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 performed under this permit, as are licensed by Miami Shores Village. 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 beaaster 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 �— 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. Size Septic Tank j Tjype of Tank Amount of Permit $--- ________ _ STATE OF FLORIDA, COUNTY OF DADE. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT No. 13 _L_____ Block (Signed) _ (Sign Date Subdivision-- - - -_ -: Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. ,, / Owner's Name and Address. _ l!, ____VOr/N.5Gl i/_ Registered Architect and /or nginee Employing Plumber's N Location and Legal Des tion Lot. Street_.* " /d 2 -.5--1-°/_.44".1 �P_'.•A- —_. No. -__j 7_��_ Street-_Z Street Repairs No. of Stories.. Capacity Gals. C Feet of Drain Tile__& � - ..__ __• _ _�!: ___mo A ist. Feet of Tank or Drain Field from Well Nature of Water Supply: City—Well._ ,., Size So ge 't 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 Pennanent Supplement, and Itas 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. Master-Flumher.. 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 81.00 will be made when such re- inspection is made•necessary by improper notice for inspection, or faulty materials and /or workmanship. CLOSETS BATH TUBS S 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 SW IM'G POOL CONTR. LIST - --- CHECK Permit No �— 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. Size Septic Tank j Tjype of Tank Amount of Permit $--- ________ _ STATE OF FLORIDA, COUNTY OF DADE. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT No. 13 _L_____ Block (Signed) _ (Sign Date Subdivision-- - - -_ -: Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. ,, / Owner's Name and Address. _ l!, ____VOr/N.5Gl i/_ Registered Architect and /or nginee Employing Plumber's N Location and Legal Des tion Lot. Street_.* " /d 2 -.5--1-°/_.44".1 �P_'.•A- —_. No. -__j 7_��_ Street-_Z Street Repairs No. of Stories.. Capacity Gals. C Feet of Drain Tile__& � - ..__ __• _ _�!: ___mo A ist. Feet of Tank or Drain Field from Well Nature of Water Supply: City—Well._ ,., Size So ge 't 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 Pennanent Supplement, and Itas 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. Master-Flumher.. 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 81.00 will be made when such re- inspection is made•necessary by improper notice for inspection, or faulty materials and /or workmanship. -UILDING LECTRICAL 'LUMBING Jwner of wilding - '7 MIAMI SHORES VILLAGE, FLORIDA PERMIT N. ` 4159 Work to be performed under this Permi ">rchitect Subdi- vision Value of Project DATE i 19444 Contractor's License No. % ontractor )r Builder .egal Lot Bl. Description address of luilding 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 appli- .ation herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be perfornied in compliance with any flans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked It 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 ,ermit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and egulations 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. . fir 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 iertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores„Village. In accepting this permit I assume responsibility for all work done bXei ter myself, my agent, servant or employee. "r + . CONTRACTOR OR BUILDER BY AUTHORITY Amt. of Permit