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PLUMBINGAddress Company Phone # Inspection Date Approved Correction Re-Insp'n Fee MIAMI SHORES VILLAGE Ai BUILDING DEPARTMENT 305- 795 -2204 Building, Inspection Request Date Type Insp'n Permit No. 7E_ o4 - Name 3fls��73— �o og/ /0-/e-g BUILDING PERMIT APPLICATION FBC 2001 Permit Type (circle): Building Electrical Owner's Name (Fee Simple Titleholder) Miami Shores Village 10050 .E. . ' icP l I T 1: (3 795. V ! 224 UJFax: 4 (30 20 Owner's Address LI n (. \O City `('N'\ .ir;:■ riz.5 State Tenant /Lessee Name �— Job Address (where the work is being done) •4 t"l F. 1 City Miami Shores Village County Miami -Dade Zip 33 Is Building Historically Designated YES NO Contractor's Company Name , , Q Phone # _ Contractor's Address S t? !1 o S e City `ran r - ' • Qualifier State Certificate or Registration No. Certificate of Competency No. Architect/Engineer's Name (if applicable) Phone # - - -�"� $ Value of Work For this Permit is 300 Type of Work: ['Addition Describe Work: Total Fee Now Due $ (Continued on opposite side) «0 r Ll `) ❑Alteration 1 e • artment ❑New es, Florida 33138 ) 756.8972 Phone # Permit No. Master Permit No. State =l Zip 3 1 3� ��- .P00 - Se zip `33 i 3e deb —/( Mechanical Roofing Phone # ` cp - Square Footage Of Work: Repair/Replace ❑ Demolition • allI * * * * * * * * * * * * * * * * * * * * * * * * * ** *F * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Submittal Fee $ Permit Fee $ 160 0 �� CCF $ v(10 CO /CC Notary $ Training/Education Fee $ Technology Fee $ 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 Hurst 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 the absence of such posted notice, the inspection will not he approved and a reinspection fee will be charged. SignaturL Owner or Agent Contractor The foregoing instrument was ckno .:ed before me this The foregoing instrument was acknowledged before me this day o 20-0/-?by ,l ���I[ of , 20 _ — . , by nVlto i personal) known to me r who has produced who is personally known to me or who has produced entification and who did take an oath. as identification and who did take an oath. NOTARY P Sig P My Commission Exp es: Chc 05 /13/03 IC Signature AMA _ flint e %jrah'AIE , mmission# Bonded .,,, Atlantic Bonding Co., inc My Commission Expires: ***************************************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** NOTARY PUBLIC: H. Gone' 8 6 Sign: 2008 Print: ******* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** *********************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** -, // APPLICATION APPROVED BY:I / /ti`e/l l 4' -/r -6) y Plans Examiner Engineer Zoning 1 ITEM BATH TlB UNIT FEE ITEM SWITCH OUTLETS UNIT FEE ITEM SPACE HEATERS UNIT FEE BIDET LIGHT OUTLETS CENTRAL HEATING DISHWASHER RECEPTACLES A/C (WIND) DISPOSAL SERVICE TEMPORARY A/C (CENTRAL) DRINKING FOUNTAIN SERVICE SIZE IN AhPS DUCT WORK FLOOR DRAIN SERVICE REPAIR/METER CHANGE REFRIGERATION GREASE TRAP APPLIANCE CURETS PROCESS AND PRESS PIPING INTERCEPTOR RANGE TOP UNDERGROUND TANKS LAVATORY ✓ OVEN ABOVE GROUND TANKS LAUNDRY TRAY WATER HEATER U.F. PRESSURE VESSELS CLOTHES WASHER MOTORS 0- 1 HP STEAM BOILERS SHOWER MOTORS OVER 1- 3 HP HOT WATER BOILERS SINK, POT /3 COMP. MOTORS OVER 3- 5 HP MECHANICAL VENTILATION SINK, RESIDENCE tr MOTORS OVER 5- 8 HP TRANSPORTING ASSEMBLIES SINK, SLOP MOTORS OVER 8- 10 HP ELEVATORS/ESCALATORS TEMPORARY WATER CLOSET MOTORS OVER 10- 25 HP FIRE SPRINKLER SYSTEMS URINAL MOTORS OVER 25-100 HP COOLING TOWERS WATER CLOSET MOTORS OVER 100 HP VIOLATION INDIRECT WASTES- ' A/C WINDOW REINSPECTION WATER SUPPLY TO: AIR CONDITIONERS A/C UNIT STRIP HEATER FIRE SPRINKLER GENERATORS TRANSFORMERS HEATER -NEW INST. GENERATORS TRANSFORMERS HEATER - REPLACE GENERATORS TRANSFORMERS LAWN SPRINKLER -WELL SPECIAL PURPOSE SWIMMING POOL OUTLETS COMiERCIAL WATER SERVICE SIGN TUBES SEWER CONNECTIONS SIGN TRANSFORMERS UTILITY -SEWER SIGN TIME CLOCK UTILITY -WATER FIXTLRES SEPTIC TANK ANTENNA RELAY TELEVISION OUTLETS DRAINFIELD, 4 TILE/RES. VIOLATION PUMP & ABANDON SEPTIC TANK REINSPECTION SOAKAGE PIT CU. FT. CATCH BASIN DISCHARGE WELL DOMESTIC WELL AREA DRAIN ROOF INLET SOLAR WATER HEATER FIRE STANDPIPE POOL PIPING LAWN SPRINKLER SYSTEM GAS RANGE METER SET (GAS) GAS PIPING ADDENDUM TO BUILDING PERMIT APPLICATION (AN APPLICATVdN FOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. IF A MASTER PERMIT HAS B. OBTAINED,, THE OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.) PLUMBING ELECTRICAL MECHANICAL Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Printed: 1/4/2005 Applicant: JAVIER Owner: GUARDERAS JOB ADDRESS: 54 Contractor Local Phone: Parcel # 1132060131470 Legal Description: MIAMI SHORES SEC 1 AMD PB 10 -70 LOT 5 & LOT 6 BLK 11 LOT SIZE Signed: NE 102 Fees: Description Amount FEE2005 -35 Building Fee $160.00 FEE2005 -36 CCF $0.60 FEE2005 -37 Notary Fee $5.00 FEE2005 -38 Training and Education Fee $0.20 FEE2005 -39 Technology Fee $4.00 FEE2005 -40 Submittal Fee ($50.00) Total Fees: $119.80 Total Fees: $119.80 Total Receipts: $0.00 Permit Status: CLOSED Permit Expiration: 6/26/2005 Construction Value: $300.00 . Work: REPLACE SHOWER FAUCETS, SINK AND TOILET (INSPECTOR) Plumbing Permit Permit Number: PL2004 -325 GUARDERAS JAVIER ST Contractor's Address: Page 1 of 1 4• 0 1 , i0 g 'O 9 /O 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 I assume responisibility for all work done by either myself, my agent, servants or employes. Signed: (Contractor or Builder) BY: • PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date / /5 c /Job Address A/ �� /L� / O Z 5TTax Folio Legal Description , ` Historically Designated: Yes No Owner/Lessee / Tenant re> YF/ Master Permit # y p� (0 Owner's Address Phone Contracting Co. ` A Dc/411/C A CJ5 /Qv Address /1/ c ST Qualifier �,�� S e0�/ / SS# - Phone C ` �` %- e State # C, Municipal # Competency # Ins. Co. Architect/Engineer Address Bonding Company Address Mortgagor ddress Permit Type (circle one): BUILDING ELECTRICAL UMBING ECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION // -S7 /,7/1 N ✓✓ ✓ Z/7C /J J" 5l/l/fC - / /) " Dig Square Ft. Estimated Cost (value) c-- Signature of owner and/or Condo President Date Notary as to Owner and/or Condo President My Commission Expires: FEES: PERMIT/ (Y RADON APPROVED: Zoning Building Mechanical Plumbing Date Notary as to Contr My Commission E Electrical 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. ontractolclor Owner- ui I .LAT {i Y'U 1 ,IC ST MN OF .0 UDA COMMISSION NO CL'7 C MMISStON l:3(P• i✓9A'i 1 C.C.F..+V NOTARY , BOND c )7 Date Date ©/ Structural Engineer ITEM BATH 11•B UNIT FEE ITEM SWITCH CUTLETS UNIT FEE ITEM SPACE HEATERS UNIT FEE BIDET LIGHT OUTLETS CENTRAL HEATING DISHWASHER RECEPTACLES ' A/C (WIND) DISPOSAL SERVICE TERPCRARY A/C (CENTRAL) DRINKING FOUNTAIN SERVICE SIZE IN APS DUCT WORK FLOOR DRAIN SERVICE REPAIR/1€TER CHANGE REFRIGERATION GREASE TRAP APPLIANCE CUTLETS % ! PROCESS AND PRESS PIPING INTERCEPTOR RANGE TCP _UNDERGROUND TANKS LAVATORY OVEN 1 ABOVE GROUND TANKS LAUNDRY TRAY WATER HEATER U.F. PRESSURE VESSELS CLOTHES WASHER MOTORS 0- 1 HP STEAM BOILERS SHOWER MOTORS OVER 1- 3 FP HOT WATER BOILERS SINK, POT /3 COMP. MOTCRS OVER 3- 5 FP MECHANICAL VENTILATION SINK, RESIDENCE MOTORS OVER 5- 8 FP TRANSPORTING ASSEMBLIES SINK, SLOP MOTORS OVER 8- 10 FP ELEVATORS/ESCALATORS TEMPORARY WATER CLOSET ROTORS OVER 10- 25 FP FIRE SPRINKLER SYSTEMS URINAL MOTORS OVER 25-100 hP COOLING TOWERS WATER CLOSET MOTORS OVER 100 NP VIOLATION INDIRECT WASTES A/C WINDOW REINSPECTION WATER SUPPLY TO: AIR CONDITIONERS A/C UNIT STRIP HEATER FIRE SPRINKLER GENERATORS TRANSFORMERS HEATER -NEW INST. GENERATORS TRANSFORMERS HEATER- REPLACE GENERATORS TRANSFORMERS LAWN SPRINKLER -WELL SPECIAL PURPOSE SWIRMING POOL CUTLETS CORMERCIAL WATER SERVICE SIGN TUBES SEWER CONNECTIONS SIGN TRANSFORMERS ITILITY -SEWER SIGN TIME CLOCK ITILITY -WATER FIXTURES ;EPTIC TANK ANTENNA 1ELAY TELEVISION OUTLETS ;RAINFIELO, 4' TILE/RES. VIOLATION 'ARP & ABANDON SEPTIC TANK REINSPECTION :OAKAGE PIT CU. FT. :ATCH BASIN )ISCHARGE WELL 'OMESTIC WELL REA DRAIN OOF INLET OLAR WATER HEATER IRE STANDPIPE 001 PIPING AWN SPRINKLER SYSTEM AS RANGE ETER SET (GAS) AS PIPING • (AN APPLICATION FOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. IF A MASTER PERMIT HAS B. OBTAINED, THE OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.) PLUMBING ADDENDUM TO BUILDING PERMIT APPLICATION ELECTRICAL MECHANICAL Legal Description Owner / Lessee / Tenant WORK DESCRIPTION Signat *e of o T an Date: APPROVED: PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date 7/15/93 Job Address 54 N.E. 102 St. Mechanical � -g 6 f.3L // Whitaker Owner's Address 54 N.E. 102 St. Phone 751 -1991 Contracting Co. Douglas Orr Plumbing, Inc. Address 301 Flagler Dr, Miami Springs Qualifier Douglas Orr SS# Phone 305 -887 -1687 State # 021452 Municipal # Competency # 0012463 Ins.Co. 8/2/93 Architect /Engineer Address Bonding Company Address Mortgagor Address Permit Type(circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN REplace hot water heater Square Ft. Estimated Cost(value) $1nn_nn 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 c' tractor to do the work stated. or Condo Presi:ent esident Notary nn 1 ' p/• OFFI W. NOTARY SEAL My Comm tfion EXp 8 E VIDAL CY S: Dr,I �,I�.SI' N NUPAEER pp r k>.; OO 486 ** * 1 :'* U G. 1Y , :: : *'?'. "c ;... :;ON OXP. FEES: PERMIT .38.80 RADON Zoning Tax Folio 11-3206-013-1470-2. Sec / /9i(,1 Apo Signatu e of Date: Master Permit # a9,/ tractor or Owner- Builder Notary as to Contractor or Owner- Builder My Comm AL NOTARY SEAL JUDITH E VIDAL ,i * COMMISSION NUMBER * * * ? t Y $ CSC 1 904e6 e Oc F O`` kIY cOmmissiom EXP. I ** Fire Other Buildin lumbin Electrical Engineering • 'ermit No My Commission Expires MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT C9$3- Type of Tank_ — .--- _ -_ - -• _Dist Feet of Tank or Drain Field from Well 1pplication is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other tructure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida. ud all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division If Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept et iullding during progress of work. `, J�/ )wnei s Name and Address 2' ./ e "" �J 1 4 C le iegistered Architect and /or En eer L'inploytni Plumber's Name 41�L= '....S ._ . _ No, a....Y` :..... Itrest., _. ' Location and Legal Description Lot. sc.-' 4 e 1 ww Slo l Subdivision Street and Number where work L to be performed —No Sy ! ° // 0 • y /d - Street.. — ..._..._. State work to be performed and purpose of building (By Floors)__ —..�! � - � !6 1Vadic4't-- L 74 01-1✓9'!.e 1r/ 0)(64,) is0 New Building..__._--- .- •-- ......._.. Remodeling_—._.. — Addition...___._.__ Repairs No. of Stories... ..... ..... ... Date... No.$ 4/ . Street_L 577. .. Capacity Cals... _-- Amount of Permit ( �� S )- ` a ! —- 0 _4L �sl Size Septic Tank__. Feet of Drain Tile I Nature of Water Supply: City—WeIL Size of Soakage Pit. _._ .. .. S' E ,x/10 o�� __ �7 es _1?f}! _. fY . 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 hrr com- plied with the provisions thereof, and will require similar compliance from all oontractors 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. (Signed) 'a' G.... _._... _. ....._ Muter Plumber. STATE OF FLORIDA, COUNTY OF DADE. r 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 swarm, upon oath deposes and says that he is the -_ -.._ .. _. - ..- •--- ... -.. _ _...._. of the above described construction, that he her carefully read the foregoing application, and that he dM 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 bo made whys ace t dup.odos i, ss.d.•saosm.ry by lmprvper notios for Inspection, or fauky materials and /or workman:lip. CLOaRg BATH Tung .N OVA• TONICS GIN" SLOP SINKS LAUNDRY Tug[ URINALS CATCH BASIN FLOOR DRAIN ORINKI NO FOUNT' NS TOTAL F17TUR ES CONTI. LIST CHECK - SEPTIC TANK SEWER CONN. DRAIN PI[LD SOAKAGE PIT G TRAP SOLAR NEATER DRIP WELL SPRKLR. SYSTEM SWIM•O POOL CONTa. LIST CN[CK • 'ermit No My Commission Expires MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT C9$3- Type of Tank_ — .--- _ -_ - -• _Dist Feet of Tank or Drain Field from Well 1pplication is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other tructure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida. ud all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division If Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept et iullding during progress of work. `, J�/ )wnei s Name and Address 2' ./ e "" �J 1 4 C le iegistered Architect and /or En eer L'inploytni Plumber's Name 41�L= '....S ._ . _ No, a....Y` :..... Itrest., _. ' Location and Legal Description Lot. sc.-' 4 e 1 ww Slo l Subdivision Street and Number where work L to be performed —No Sy ! ° // 0 • y /d - Street.. — ..._..._. State work to be performed and purpose of building (By Floors)__ —..�! � - � !6 1Vadic4't-- L 74 01-1✓9'!.e 1r/ 0)(64,) is0 New Building..__._--- .- •-- ......._.. Remodeling_—._.. — Addition...___._.__ Repairs No. of Stories... ..... ..... ... Date... No.$ 4/ . Street_L 577. .. Capacity Cals... _-- Amount of Permit ( �� S )- ` a ! —- 0 _4L �sl Size Septic Tank__. Feet of Drain Tile I Nature of Water Supply: City—WeIL Size of Soakage Pit. _._ .. .. S' E ,x/10 o�� __ �7 es _1?f}! _. fY . 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 hrr com- plied with the provisions thereof, and will require similar compliance from all oontractors 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. (Signed) 'a' G.... _._... _. ....._ Muter Plumber. STATE OF FLORIDA, COUNTY OF DADE. r 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 swarm, upon oath deposes and says that he is the -_ -.._ .. _. - ..- •--- ... -.. _ _...._. of the above described construction, that he her carefully read the foregoing application, and that he dM 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 bo made whys ace t dup.odos i, ss.d.•saosm.ry by lmprvper notios for Inspection, or fauky materials and /or workman:lip. • • STR T . 0R ;VENUE • szciItw • .---- - o sao,d s f' X j s / i A:) *6 . 6/ 6 - o` i.vE . Pi � iL /w „Tr' 9 9 Z / Rot 79--A1/= r9 a, c ,7 co / p C>pl.G . S 8'° S "T nC Sit 14.. 1.. 1 Is ST1t(T ••orrw ..,ur, no+so+ . -��'. �:.. _. 22/31 L DA:i • 03 si INDICAT NOR. - 4 D 1 R 11.c Cr. • BUILDING ELECTRICAL PLUMBING" Owner of 1 Building f q tf Architect Contractor t� --.,, or Builder -° ' ' / / ‘ * In consideration of the issuance to me of this permit I agr @e to pertaining nd i strict formity with the plans, drawings In accep is p rm ass esponsibility for all work done b ACTOR OR BUILDER MIAMI SHORES VILLAGE, FLORIDA de DATE ' 19 6536 IT N° Subdi- vision Value of Project BY Contractor',, /' t' License Not. t.vtl'1 ` it G..- (�� 3 Work to be performed under this Permit ) / l 4 ` 4 Legal Lot Bl• Description Address of /.� �.t 1) .,__ Building .� 1-- /■" ' .". This permit is granted to the contractor or builder named above to construct the building or to install the equipment or deGice 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 o e or antes and regulations pertaining to the work covered hereby whether shown on the plans or wr s or in the staten s or specifica • ns and the es respon- sibility for work done by his agents, servants or employees. / �•. Amt. of Permit .— B 0 INSP CTOR e work covered hereunder in compliance with., ordinances andi regpli4ions is or specifications submitted to the proper authorities of Miami Sh es Village. yself, my agent, servant or employee. • AUTHORITY BUILDING ELECTRICAL PLUMBING Owner of Building Architect Contractor 2) or Builder Legal Description Lot MIAMI SHORES VILLAGE, FLORIDA P - ' MIT N° 6356 Work to be performed under this Permit -4 tt 1/4 Bl. Subdi- vision Address of �� AL,. Building This permit is granted to the contractor or b der named above to construct the building or to install the equipment or device escribed in the appli- cation herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performe n 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 th ordinances and regulations pertaining to the work covered hereby whether shown on the plans or gs or in the s ,at ents or specifications and t e assumes respon- sibility for work done by his agents, servants or employees. s f Value of Project 440/4 JR 4 By � • y . INSPECTOR In consideration of the issuance pertaining thereto and in strict conf ity with the plans, drawings, si(ments or specifications submitted to the proper authorities of Miami Short In a6CePyng this pert I assume s Asibility der all wor done by either,m self, my agent, servant or employee. ',/) F BUILD CONTRACTOR OR BUI / BY � ��� d Signe I } e Ji DATE Contractor's Li ense No 4 Amt. of Permit AUTHORITY 194 S N r A - pu ff 'gNOt_1L l L e-r 5 t 4 I3k o c 1'/ i / S /— TO' _ SIto cd/ 1-0v Ire, w 0, Tow, 7-&-7e 5'4°1461c 7t o Permit No.__ 5 6 MIAIJ SHORES - VILLAGE PLUMBING INSPECTION DEPARTMENT , r APPLICATION FOR PLUMBING PERMIT Date Application is hereby made for the approval of the detailed statement of the plans and specifications herewith s>fbmitted 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 1= n No 7 Street / ' ' !' .-, Owners Name and Address_ x_ J .. __ .1--....--.....!L .. ' ', ,,.,� Registered Architect and /or Engiifeer No Street Employing Plumber's Name Location and Legal Description Lot Block Subdivision 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 Nature of Water Supply: City —Well Amount of Permit $ STATE OF FLORIDA, 1 COUNTY OF DADE. 1 ss. My Commission Expires _________ (Signed) (Signed ) Y v&.L Repairs No. of Stories _ Size Septic Tank Type of Tank Capacity Gals Feet of Drain Tile Dist. Feet of Tank or Drain Field 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 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. 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. LIST ") CHECK SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SWIM'G POOL %i , / i CONTR. UST 7 CHECK Permit No.__ 5 6 MIAIJ SHORES - VILLAGE PLUMBING INSPECTION DEPARTMENT , r APPLICATION FOR PLUMBING PERMIT Date Application is hereby made for the approval of the detailed statement of the plans and specifications herewith s>fbmitted 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 1= n No 7 Street / ' ' !' .-, Owners Name and Address_ x_ J .. __ .1--....--.....!L .. ' ', ,,.,� Registered Architect and /or Engiifeer No Street Employing Plumber's Name Location and Legal Description Lot Block Subdivision 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 Nature of Water Supply: City —Well Amount of Permit $ STATE OF FLORIDA, 1 COUNTY OF DADE. 1 ss. My Commission Expires _________ (Signed) (Signed ) Y v&.L Repairs No. of Stories _ Size Septic Tank Type of Tank Capacity Gals Feet of Drain Tile Dist. Feet of Tank or Drain Field 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 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. 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. Permit No. Size Septic Tank Lt' STATE OF FLORIDA, l ss. COUNTY OF DADE. J MIAMI SHORES VILLAGE PLUMBING INSLICTION 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 w rk Owner's Name and Address / • l / Nn / .:'`� r _x' Street Registered Architect and/or Engineer ' - --.s. __-, Employing Plumber's Name No Street . Location and Legal Description Lot 0 .. 1, � Block /1 Subdivision_._,:_, t� 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 ( . Type of Tank_ <___ Capacity Gals. Feet of Drain Tile Z & ,Dist. Nature of Water Supply: City —Well.. Li - "J ;1 Size of Soakage Pit — Date._ eet of Tank or Drain Field from Well Amount of Permit $ ( Signed) �! r No. of Stories 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 "cerrr 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 • • : k to be performed under this permit, as are licensed by Miami Shores Village. Master Plwn er. 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. 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. Size Septic Tank Lt' STATE OF FLORIDA, l ss. COUNTY OF DADE. J MIAMI SHORES VILLAGE PLUMBING INSLICTION 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 w rk Owner's Name and Address / • l / Nn / .:'`� r _x' Street Registered Architect and/or Engineer ' - --.s. __-, Employing Plumber's Name No Street . Location and Legal Description Lot 0 .. 1, � Block /1 Subdivision_._,:_, t� 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 ( . Type of Tank_ <___ Capacity Gals. Feet of Drain Tile Z & ,Dist. Nature of Water Supply: City —Well.. Li - "J ;1 Size of Soakage Pit — Date._ eet of Tank or Drain Field from Well Amount of Permit $ ( Signed) �! r No. of Stories 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 "cerrr 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 • • : k to be performed under this permit, as are licensed by Miami Shores Village. Master Plwn er. 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. BUILDING ELECTRICAL PLUMBING ROOFING Contractor r or Builder `-' Address of Building 0 Legal Lot Description MIAMI SHORES VILLAGE. PERMIT N? 5434 Owner of r Building Architect dr• Bl. J Subdi- vision Value of Project $ FLORIDA DATF Contractor's t 195 License No. t (e'z' Work to be performed under this Permit Amount of `1_ ' 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 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 responsibility for work done by his agents, servants or employees. In consideration of the issuance to me pertaining thereto and in strict conformity with cepting thi4 permit I assume responsibility for CCDNTRACTOR OR BUILd1 R Signed. ,, gy. INSPECTOR of this permit I agree to perform the work coverefhereunder in compliance with all ordin• es and regulations the plans, drawings, statements or spec to s submitted to the proper authorities .o Miami Shor= Village. In as all work do ' er, i self, my • = e t, se ant or employee. 6 . h 12041 SHORES VILLAGE, FLA. JOB ADDRESS N° 6071 (-; , •2 -2 INSPECTION /--); TIME READY REMARKS: INSPECTOR DATE Permit No Date , cc- Application is hereby made for the approval of the detailed statement of the plans and specifications herewith subrtted for the b ding or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores illage, Florida, and all provisions of the Laws of State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall • `•mplied with, whether herein specified or nut. A copy of approved plans and specifications must be kept at building during progress of wo Owner's Name and Address Registered Architect an. .r Engineer..__ Employing Plumber' Location and Legal Des ption Lot-.- Bl Street and Number w ere work is to be performed —No S� State work to be performed and purpose of building (By Floors) ________ New Building ....... -- ______....... __ _____ -- Remodeling ___.__ Addition Size Septic Tank Feet of Drain Tile______ Nature of Water Supply: City —Well f Amount of Permit $ MIAMI SHORES VIL AG PLUMBING INSPECTION DEPARTMEN APPLICATION FOR PLUMBING ? ( Signed) _ (Signed). Street __,Xr. O Z. / Repairs No. of Stories . . ... .. .......... Type of Tank__ Capacity Gals _Dist. Feet of Tank or Drain Field from Well --Size of Soakage Pit Plumbing Inspector. The undersigned applicant for s 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 : work such public notice or notices as are required by the Act. The undersigned agrees to employ only such sub- contractors, to be performed under this permit, as are licensed by Miami Shores Village. STATE OF FLORIDA, COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared Master Plumber. 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 SHOWER! LAVA. TOR1E8 SINKS SLOP 81NK8 LAUNDRY TUBE URINAL! CATCH BASIN FLOOR DRAIN DRINKING FOUNT'NB TOTAL FIXTURE! 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 , cc- Application is hereby made for the approval of the detailed statement of the plans and specifications herewith subrtted for the b ding or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores illage, Florida, and all provisions of the Laws of State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall • `•mplied with, whether herein specified or nut. A copy of approved plans and specifications must be kept at building during progress of wo Owner's Name and Address Registered Architect an. .r Engineer..__ Employing Plumber' Location and Legal Des ption Lot-.- Bl Street and Number w ere work is to be performed —No S� State work to be performed and purpose of building (By Floors) ________ New Building ....... -- ______....... __ _____ -- Remodeling ___.__ Addition Size Septic Tank Feet of Drain Tile______ Nature of Water Supply: City —Well f Amount of Permit $ MIAMI SHORES VIL AG PLUMBING INSPECTION DEPARTMEN APPLICATION FOR PLUMBING ? ( Signed) _ (Signed). Street __,Xr. O Z. / Repairs No. of Stories . . ... .. .......... Type of Tank__ Capacity Gals _Dist. Feet of Tank or Drain Field from Well --Size of Soakage Pit Plumbing Inspector. The undersigned applicant for s 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 : work such public notice or notices as are required by the Act. The undersigned agrees to employ only such sub- contractors, to be performed under this permit, as are licensed by Miami Shores Village. STATE OF FLORIDA, COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared Master Plumber. 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. BUILDING ELECTRICAL PLUMBING ROOFING Owner of Building Architect Contractor or Builder Legal Description Address of Building Lot MIAMI SHORES VILLAGE. FLORIDA ❑ DATE ' % 195 PERMIT N° 3546 Contractor's License No. ❑ ❑ Work to be performed under this Permit Bl Subdi- vision Value of Amount of Project $ II Permit $ This permit is granted to the contractor or builder named above to construc the building or to install the equipment or device described in the application 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 responsibility for work done 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 pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In ac- cepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. CONTRACTOR OR BUILDER BY AUTHORITY off. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Permit No Date ' — / 6 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 ll ("1-4. f r No. `r Street 4 /l/ 2 Registered Architect and /or Engineer _----_______---- _- 6 -- _��___-------------- ___. -- ,dl3 s - te Cf .� y,- I7 J /Y 11/ , P 7 Employing Plumber's Name .� �Y _�___ —�S � —____ No._______ _ Street_._ Sk Location and Legal Description Block Subdivision ....... -_- _ street fr 4 /a - Sy Street and Number where work is to be performed —No State work to be performed and purpose of building (By Floors) _. -------------------_-_-_-__-.-- New Building —_____ Remodeling___ —___ Addition_______._ Repairs No. of Stories. Size Septic Tank. .......... ____------------- - - - ... ---_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 Amount of Permit $ -. (Signed) _ Capacity Gals 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 bus 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 tlie 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. 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. 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 7' Ge .e f/ MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Permit No Date ' — / 6 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 ll ("1-4. f r No. `r Street 4 /l/ 2 Registered Architect and /or Engineer _----_______---- _- 6 -- _��___-------------- ___. -- ,dl3 s - te Cf .� y,- I7 J /Y 11/ , P 7 Employing Plumber's Name .� �Y _�___ —�S � —____ No._______ _ Street_._ Sk Location and Legal Description Block Subdivision ....... -_- _ street fr 4 /a - Sy Street and Number where work is to be performed —No State work to be performed and purpose of building (By Floors) _. -------------------_-_-_-__-.-- New Building —_____ Remodeling___ —___ Addition_______._ Repairs No. of Stories. Size Septic Tank. .......... ____------------- - - - ... ---_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 Amount of Permit $ -. (Signed) _ Capacity Gals 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 bus 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 tlie 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. 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.