Loading...
541 NE 102 St (6)MIAMI SHORES VILLAG BUILDING DEPARTMEN 305- 795 -2204 Building Inspection Request Date Type lnsp'n �I.4 i ∎ ' 4 A dr' Permit No. Name Address Compaq Phone # Inspection Date Approved Correction Re- Insp'n Fee T'y C . ).6_%.201 � MIAMI SHORES VILLAG BUILDING DEPARTMEN 305- 795 -2204 Building Inspection Request Type Insp'n Permit No Name Address Inspection Date ) Approved Correction Re- Insp'n Fee -1 /Jo qui-a—c. MIAMI SHORES ' LAGE BUILDING DEPARTM1NT 305- 795 -2204 Building Inspection Request DateS)) ! I U -i Type lnsp'n , / „•r._ J �. i . l t . -� Permit No. ` )) a i 1 :), 4- Name C� .lam `� � }n 0-1 Address S C �t Y ! r. � �� D Company 7,, / U\ ( n r Phone # Inspection Date ' Approved Correction Re-Insp'n Fee 7 BUILDING PERMIT APPLICATION FBC 2001 Permit Type (circle): Building Electrical 0 c1 Relit)) 5y/ /"/t. zs� City ke4 C44 State / 0 Zip /3 Q Tenant/Lessee Name �Gi,/ /S 21/ Owner's Name (Fee Simple Titleholder) Owner's Address Job Address (where the work is being done) City Miami Shores Village Is Building Historically Designated YES NO Contractor's Company Name Contractor's Address ( C*0 State pi, City / p4 / / n Qualifier 'k &/ 8. a d , Architect/Engineer's Name (if applicable) Phone # $ Value of Work For this Permit �ta Type of Work: ❑Addition Describe Work: � 6 th,,_. r Submittal Fee $ Notary $ .$ b • f Scanning s.3 0 U Code Enforcement $ Total Fee Now Due $ 4Z (Continued on opposite side) Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 ❑Alteration ['New Permit Fee $ 1 7 S , °° Training/Education Fee $ -1 Radon $ Zoning Structural Plan Review. $ Permit No. Master Permit No. Phone# 7 -427 -L i2 County Miami -Dade //�� t I � e, (: S j' o! I CD-403 It e -Phone # Zip Zip ` 37l t1 Square Footage Of Work: L2 Repair eplace i fl: W-i�.� (ae-c --iv ie �( ' ••••••••••••••••••••••••••••F •••••••••••••••••••••••••••••• Ptcl ex- 1 APR 22 Mit P1200(1 rIce) /14/ K' Mechanical Roofing Phone # 7 e • W 'S (A) - 7&51 . ) ❑ Demolition CCF $ t \ Q CO /CC Technology Fee $ Bond $ �� Q Bonding Company's Name (if applicable) Bonding Company's Address I ,Y City State Zip Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State Zip Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Owner or Agent The foregoing instrument was acknowledged before me this day of e.: ,20 f, by / & 7 e who is personally known to me or whdhas produced Contractor The foregoing in ent was acknowledged before me thi , da , 2(FU by �.�I��n..�_� , _ 1 w to is p sonally known to me or who has produced As identification and who did take an oath. - ° = - entification and who did take an oath. NOTARY PUBLI NOTARY UBLIC� Sign: Sign. My Commission Expires: (Certific te of Competency Holder) State Certificate or Registration No. Certificate of Competency No. * * * * * * * * * * * * * * * * * * * * * * * ** APPLICATION APPROVE Mc 12/15/03 Signature My Commission Expires: < , *,**** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** * * * '( * * * * * * * * * * * * * * * * * * * ** Plans Examiner Engineer Zoning 04/22/2004 09:12 D A I N F i L D 3056515610 3056515510 STATE OF FLORIDA DE ?ARTMFNT OF HEALTH ONSITE. SEwAGEi TREATMENT AND D;.'SPOSAL SYSTEM CONSTRUCTION PERMIT CONSTRUCTION PERMIT FOR; J New Sytem [ ;I Rxiati'ng System [ ]Holding Tank [ ] Innovative Other [ X JRepair t ;Abandonment [ ;Temporary [ NA ] APPLICANT; >RGsily,_ Mary E11an_ _ AGENT: SA0021074 Tereee PROPERTY STREET ADDRESS: 541 NS 102 St Miami Sores FL 33139 LOT; 16 BLOCK: '93 SUDDI.VISION: Miami Shore* Sec 4 [Sect /Township /A 77 1 17.4 - - - - -_ [OR TAX ID NUMBER] PROPERTY ID 4: 11 -3206- 017 -0960 SYSTEM MUST EIE CONSTRuC?ED IN ACCORDANCE WITH SP FCaFl " "CA':'I+3KS bND 9TANDARbs dF CH R 64E DEPARTMENT APPROVAL or SYSTEM DOES NOT CUARANT,E SATISFACTORY PERFORMANCE FOR ANY SPECIFIC TIME ?ER ;OD, ANY Crl,[5.NOE IN MATERIAL FACTS WHICH SERVED AS H BASIS FOR ISSuANCE OF REQUIRE THE APPLICANT TO MODIFY ThE PERMIT APPLICATION. £UCR MODIFICATION MAY TH:,'s PERMIT BEING MAO NOLL ANC VOID. ISSUANCZ OF ' mrs PERMIT DOES NOT EXEMPT 7HE AP;>I,ICANT FROM COMPLIANCE OTHER FEDERAL, STATE OR LOCAL PERMITTING REQUIRED FOR PROPERTY DEVELOPMENT. SYSTEM DESIGN AND SPECIFICATIOA'S T A N [ K t 900 )Gallons SEPTIC TANK 4 ) t.ialiens 4 ]GALLONS GREASE /NTERCEP`"OR CAPACITY 0 1 0 XLLONJ U0OINCi 'TANK CAPACITY ( C ]GALLONS t 9o0 ]SQUARE [ 0 ' SCDAR2 TYPE EYST M: COZ GURAT) ON: FEET elET [ [ ?RIMARY tRAINFIEE N ;STANDARD N ) TRENCH D SYSTEM SYSTEM C N ] FIL..LED [ N ]BED MR C SEPTIC DRAIN CO PAGE 01 CENTRAX #: 13 -S3- 20541 DATE PAID: FEE PAID : -- RECEI PT : OSTDSNHR : 04 MULT. :- CHAMEERZD /IN SERIES: [If ] M; :LTa - CRr'MBEREb /TPJ Sji:AIESc (y 1 [ C J DOSES PER 24 HRS 4 RUMPS[ 0 1 [ N IMQUND [ N ] I' N ] LOCATION TO ]1ENCHMARNt , ELEVATION OF PROPOSED SYSTEM SITE : 1.9 j i 1PERT ) ( BELOW) 1 ENCHMARR /AEFEFt1 NON POT)7T SOTTCM OF [RATNF /ELb TO BE ; 4.4 ] [ FEST ] '1 BEl04) BENCHMARK /REFERENCE POI17T FILL REQUIRED :( 0.0 ]IN:HES EXCAVATION REQUIRED: [ 30.0 1 INCHES OTHER REMARKS: 1- Install 0000 gals. category -0 septic tank equipped with an approvAd inter. 2 -The licensed contractor installing the system is responsible for installing the minimum category of tank in aeaordanoe with sec. 642-6.013(3)(f), FAC. 3 - Install 300 pet, ft. of drairtield in bed configuration. 4- Invert elevation of drainfield to be no lees than 8,10' MOM). 5- )Qcttoe of dreinfield elevation to be no loss than 7.60' NOW. 6- Existing Septic tank to be properly abandoned. THIS PERMIT I3 NOT P'OR ADDITION. SPECIFICATION'S BY: ,!Andre Pool APPROVED BY: Andre, Paul DATE ISSUED: 40.6/04 _ DH 4016, 01/97 (um:clotoa pcuv.Q23 TO anw4 edltilAs'Whitti- tray not be 'xsed) TILE: TITLE: Professional Eagan Daces CHD EXL'iRFtTC1A! Dr1TE: , 7`11/04 11 vnw. 1 .4 'f ZLVEF.'tSSOE t0 :1PT t00Z/9T/20 04/22/2004 09:12 3056515610 Scale: Each block represents 5 feet end 1 inch = 50 feet. t. , 1 , . L. • • • • ' • • , ' . .7. 1 ...... i 1 I • • STATE OF FLORIDA DEPARTMENT OF HEALTH 4PPLICATION FOR (MITE SEWAGE DISPOSAL SYSTEM CONSTRUCTION P it /Li g / Permit Appicatton Numb �.. • �. I .. . 1 .. ; , j ' , . 7 j .... 1. ! .! i I. J. I +. ..�: I Site Plan submIttec by: Plan Approved By • PART I1- SITE PLAN - MR C SEPTIC DRAIN CO PAGE 02 • • ; ..;, .• • . • : • ;., 1 I . _ ,....,. •- . • r r.• h ••-- 1 .. -, ,.......,- , -• --.I • Nates:t — 541 1�3�.t,•= 1� a � n�pl d _ { 1 c� c. f -, c c. 4-0 Date County Health Department APPLICANT: STATE OF FLORIDA DEPARTMENT OF HEALTH ONSITE SEWAGE TREATMENT AND CONSTRUCTION INSPECTION AND --- AGENT :.S', ®a'�` /0 7 PROPERTY ADDRESS: 6 ,' It /. E. , f i' 2 LOT: BLOCK: %.3 SUBDIVISION: .7. .�,� %." � : ID 1: 17-324°'a/, 07 s==ss.ss=s=ssss =s. = = =.s:mwsss= CHECKED [X] ITEMS ARE NOT IN COMPLIANCE WITH STATUTE sssssssssssssssssssssssssssss TANK INSTALLATION [01] TANK SIZE (1)70 G, (2) [02) TANK MATERIAL ,K,e , e ( 03] OUTLET DEVICE ,� [04] MULTI- CHAMBERED [ J / N ) [ 05) OUTLET FI TER e r� _ 2--- [ 06 ] LEGEND , . (; ` l - / 1 - d� [07 ] WATERTIGHT,. ti .._ <: [08] LEVEL b_ [09) DEPTH TO LID I 1 I I I l l l l l l DRAINFIELD INSTALLATION AREA [1V sT.xi [Z]� SQFT DISTRIBUTION BOX HEADER NUMBER OF DRAINLINES DRAINLINE SEPARATION 'A DRAINLINE SLOPE DEPTH OF COVER �=n ELEVATION (ABOVE /HEL0Wi BM SYSTEM LOCATION DOSING PUMPS AGGREGATE SIZE - . e/ z0.0.1, AGGREGATE EXCESSIVE FINES AGGREGATE DEPTH ✓ ' / EXCAVATION MATERIAL FILL AMOUNT 0 ' ' FILL TEXTURE EXCAVATION DEPTH AREA REPLACED • REPLACEMENT MATERIAL EXPLANATION OF VIOLATIONS / REMARKS: 1 1 [ DIPOSAL SYSTEM FINAL APPROVAL PERMIT NO. r/ % ©% /i ( DATE PAID: 4 1-1G- n V/ PEE PAID: C' c RECEIPT #s /J oe: / sssssss:sssssssssssssssssssssss OR RULE AND MUST BE CORRECTED. ssssssssssssssas CONSTRUCTION APPROVE /DISAPM'ROVED] sgr/y << ) C f /JCL. FINAL SYSTENQ [,t1PLTOD'_/,DISAPPROVED] : d&zew.9 °1/,. _ Pi j DH 4016, 10/97 (Previous Editions May Be Ussd) Installer / Contractor FILLED / MOUND SYSTEM C:36) DRAINFIELD COVER (37] SHOULDERS [38] SLOPES [39] STABILIZATION SETBACKS [ ] [17] SURFACE WATER Al ' 4 FT I ) [28) DITCHES FT ( ] [19] PRIVATE WELLS FT ( ] (30] PUBLIC WELLS FT 1 l (3 IRRIGATION WELLS N /a FT [ ] [32] POTABLE WATER LINES 10 FT I1 ) [33] BUILDING FOUNDATION S_' FT [ ] (34] PROPERTY LINES j" FT ( l [35] OTHER FT ADDITIONNAL INFORMATION [40] UNOBSTRUCTED AREA (41] STORMWATER RUNOFF (42] ALARMS [43] MAINTENANCE AGREEMENT [44) BUILDING AREA [45) LOCATION CONFORMS WITH SITE PLAN L, (46] FINAL SITE GRADING (47) CONTRACTOR 2 [48] OTHER ABANDONMENT (49] TANK PUMPED Y/-21/ [50] TANK CRUSHED & FILLED ZL/A I /G l l l l CHD DATE: V- ,Z /- CI t/ CHD DATE: V -< 1. 0 Page 2 of 3' • PERMIT NUMBER: Permit tracking number assigned by CHD. APPLICANT: Property owners full name. AGENT: . Property owners legally authorized=representative. MAILING ADDRESS: P.O. box or street mailing address for applicant or agent. LOT, BLOCK, SUBDIVISION Lot, Block and Subdivision for lot or PROPERTY ID#: 27 character number for property. (property appraiser ID # or GIS location) COUNTY HEALTH DEPARTMENT CHECKS [X] ITEMS NOT IN COMPLIANCE WITH CONSTRUCTION PERMIT AND STATUTE OR RULE. INFORMATION IS COMPLETED BY CHD ON FOLLOWING ITEMS: TANK SIZE (gallons) TANK MATERIAL (concrete, fiberglass, etc) OUTLET FILTER (manufacturer, make, model) LEGEND (manufacturer code) DRAINFIELD AREA (square feet) DISTRIBUTION BOX / HEADER (check box) NUMBER OF DRAINLINES (number installed) SYSTEM ELEVATION (in relation to BM) DOSING PUMPS (number installed) SETBACKS (record actual setbacks in ft) SETBACKS OTHER (as required) STABILIZATION (date stabilized) CONTRACTOR (contractor installing system) ADDITIONAL INFORMATION (as required) ABANDONMENT TANK PUMPED (date) TANK CRUSHED AND FILLED (date) EXPLANATION OF VIOLATIONS: CONSTRUCTION APPROVAL: AS BUILT INSTALLATION SKETCH Record item number, explanation of violation, and required Cirde approved or disapproved, CHD signature and date. FINAL APPROVAL: Circle approved or disapproved. CHD signature and date of approval. Final approval shall not be granted unit the CHD has confirmed that'building construction and lot grading are in substantial compliance with plans and specifications submitted with the permit application. ELEVATION WORKSHEET ELEVATION OF BENCHMARK OR REFERENCE POINT: EXISTING GROUND TOP OF AGGREGATE [4] SHOT - HI ' H.I. ' ' ` H.I. H.I. [ -J SHOT [ -] SHOT [ -] SHOT ELEVATION *(c) 2004 -- Southeast Florida MLS -- INFORMATION IS BELIEVED ACCURATE BUT IS NOT WARRANTED* This Listing is Courtesy Of: RE/MAX PARTNERS Contact: MAURICIO REYES with KELLER WILLIAMS EAGLE REALTY(305- 757 -1700) Page 2 of 2 04/15/04 04:26 PM http:// sef. mlxchange .com/MiddleTier /GetViewEx.asp 4/15/2004 Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Printed: 4/30/2004 Applicant: DAVID /MARYELLEN KELLY Owner: KELLY DAVID /MARYELLEN JOB ADDRESS: 541 NE 102 ST Contractor MR C'S SEPTIC TANK Local Phone: 305 - 651 -7859 Parcel # 1132060170960 Signed: (INSPECTOR) Plumbing Permit Permit Number: PL2004 -126 Contractor's Address: P 0 BOX 693239 Legal Description: MIAMI SHORES SEC 4 AMD PLAT Page 1 of 1 Permit Status: APPROVED Permit Expiration: 10/25/2004 Construction Value: Work: NEW DRAINFIELD AND SEPTIC PB 15 -14 LOT 16 & W1/2 LOT 17 Fees: Description Amount FEE2004 -4397 Building Fee $175.00 FEE2004 -4398 CCF $1.20 FEE2004 -4399 Notary Fee $5.00 FEE2004 -4400 Training and Education Fee $0.40 FEE2004 -4401 Technology Fee $4.37 FEE2004 -4402 Scanning Fee $3.00 FEE2004 -4403 Builders Bond $300.00 Total Fees: $488.97 Total Fees: $488.97 Total Receipts: $488.97 In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responisibility for all work done by either myself, my agent, servants or employes. Signed: (Contractor or Builder) BY: 4 f;� Building Department N 2 1 a 110050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 or BUILDING PERMIT APPLICATION FBC 2001 Permit Type (circle): Building Electrical ke-a 7 Owner's Address / 5 /» Z City /!, w f ly State •' Tenant/Lessee Name /47 Owner's Name (Fee Simple Titleholder) Job Address (where the work is being done) City Miami Shores Village Is Building Historically Designated YES Qualifier $ Value of Work For this Permit / / e Type of Work: ['Addition ❑Alteration Describe Work: /4%. Q as Submittal Fee $ Permit Fee $ - 75... 1 2L. Notary $ S, 0 0 Training/Education Fee $ • a 0 Scanning $ Radon $ Code Enforcement $ Total Fee Now Due $ ((9 (7 (Continued on opposite side) Miami Shores Village NO Structural Plan Review. $ County Miami -Dade Master Permit No. v y - /.l9/ X. Mechanical Roofing Phone # 28‘ ° v2-1 L9.472 Zip ',;11 Architect/Engineer's Name (if applicable) l Phone # Permit No.PJ200 1 7 Phone# 7P 3- 19 9'2-• Zip Contractor's Company Name A • ( S PV I re Phone # C ,r /- ?157 Contractor's Address /q/ 7 L ^/ G✓- L.-al- City N' o2Gt 4 At State p/ Zip y /o,c Cl (1- Square Footage Of Work: New ❑ Repair/Replace ❑ Demolition * * * * * * * * * * * * * * * * * * * * * * * * * * ** F ees * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** CCF $ b ( CO /CC Technology Fee $ I , Zoning Bond $ Bonding Company's Name (if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State Zip Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is•issued. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature Signature Owner or Agent Contractor The foregoing instrument was acknowledged before me this The going in 'II ent was acknowledged before me tlu : day of , 20 , by , da ,,._ima / y , 2� , b who is personally known tone %%M roduced who is personally known to me or who has produced A iden if ion and who did take an oath. -a1 end tification and who did take an oath. NOTARY PUB C: ) ..)/ NOTARY Sign: Print: My Commission Expires: My Commission Expires: -:. (Certificate of Competency Holder) State Certificate or Registration No. Certificate of Competency No. **** * * * * * * * * * * * * * * * * * * * * * * * * * * * ******************************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Plans Examiner Engineer Zoning APPLICATION APPROVED BY: Chc 12/15/03 Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Permit Number: PL2004 -127 Printed: 4/30/2004 Plumbing Permit Applicant: DAVID /MARYELLEN KELLY Owner: KELLY DAVID /MARYELLEN JOB ADDRESS: 541 NE 102 ST Contractor MR C'S SEPTIC TANK Local Phone: 305 - 651 -7859 Parcel # 1132060170960 (INSPECTOR) Signed: Contractor's Address: P 0 BOX 693239 Legal Description: MIAMI SHORES SEC 4 AMD PLAT Permit Status: APPROVED Permit Expiration: 10/25/2004 Construction Value: $1,000.00 Work: ABANDON SEPTIC TANK Page 1 of 1 PB 15-14 LOT 16 & W1/2 LOT 17 Fees: Description Amount FEE2004 -4392 Building Fee $175.00 FEE2004 -4393 CCF $0.60 FEE2004 -4394 Notary Fee $5.00 FEE2004 -4395 Training and Education Fee $0.20 FEE2004 -4396 Technology Fee $4.37 Total Fees: $185.17 Total Fees: $185.17 Total Receipts: $185.17 In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit 1 assume responisibility for all work done by either myself, my agent, servants or employes. Signed: (Contractor or Builder) BY: 3 Permit No Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. Owner's Name and Address . � f_ ���g LLI - - -� No._ 7�- _--- - - - - -_ Street )2,_67,./ . Registered Architect and /or Engin r ___ /l^ ��__ �_.__ — _. Employing Plumber's Name Ll Location and Legal Description Lot_______ _ ._._ .____ _ _ _ Block Street and Number where work is to be performed —No Street • C: _ / O. 2- State work to be performed and purpose of building (By Floors) -- •___ -_ _-------- _-- New Building __ - ____.. Remodeling ______._________._______ Addition Amount of Permit $ 2_ - STATE OF FLORIDA, COUNTY OF DADE. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT _Type of Tank. Size Septic Tank Feet of Drain Tile__n25 _ __.__ _ _Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: City —W —__ ________Size of Soakage Pit_____ ( Signed) (Signed). Date - may -- q,1 / ._1t_ X2 0 street_ 44L Repairs -- -- _- _ - -• -- - -• -_ -. -. -- No of Stories_ ......... .... Capacity Gals. My Commission Expires Notary Public, State of Florida aster Plumber. 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 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, personall;- 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 worinnanship. CLOSETS 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 SWIM•G POOL CONTR. LIK CHECK ---.� _ 3 Permit No Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. Owner's Name and Address . � f_ ���g LLI - - -� No._ 7�- _--- - - - - -_ Street )2,_67,./ . Registered Architect and /or Engin r ___ /l^ ��__ �_.__ — _. Employing Plumber's Name Ll Location and Legal Description Lot_______ _ ._._ .____ _ _ _ Block Street and Number where work is to be performed —No Street • C: _ / O. 2- State work to be performed and purpose of building (By Floors) -- •___ -_ _-------- _-- New Building __ - ____.. Remodeling ______._________._______ Addition Amount of Permit $ 2_ - STATE OF FLORIDA, COUNTY OF DADE. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT _Type of Tank. Size Septic Tank Feet of Drain Tile__n25 _ __.__ _ _Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: City —W —__ ________Size of Soakage Pit_____ ( Signed) (Signed). Date - may -- q,1 / ._1t_ X2 0 street_ 44L Repairs -- -- _- _ - -• -- - -• -_ -. -. -- No of Stories_ ......... .... Capacity Gals. My Commission Expires Notary Public, State of Florida aster Plumber. 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 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, personall;- 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 worinnanship. BUILDING ELECTRICAL PLUMBING ROOFING Owner of Building Architect Contractor or Builder Legal Description Address of Building MIAMI SHORES VILLAGE, FLORIDA ❑ DATE °' PERMIT N9 6213 0 Lot '`' B1 Work to be performed under this Permit _/,;, 'k -'- Value of Project $ Amount of Permit $ Contractor's ' - ° r License No. 19 , Subdi- vision This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the applica- tion herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes respon- sibility for work done by his agents, servants or employees. Signed. .t- INSPECTOR In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance th all ordind regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In as cepting this permit,I assume responsibility for all work done by either, myself, my agent, servant or employee. ' CONTRA OR BUJ AUTHORITY ABBOT0 O NER . LOT BLOCK SUBDIVISI'. I , liami cShores9llage F L 0 fl 1 D A PLUMBING PERMIT r ffo install the following described plumbing, in accordance with the laws, statutes and regu- lations of Miami Shores Village, Florida and the State of Florida, governing plumbing a drainage work done icy Miami Shores Village, Florida. For a_f story Fixtures Fixtures � buildin t r/ Sewer $ •tic Tank $ Total ■9 1160 f/A: 7 Y/ 4- 7-7 Village Plumbing Inspector Received Payment by a Permit Permission is hereby granted to install the following described plumbing, in accordance with th'3 • laws, statutes and .regui at;.ons of Miami Shores Village, Florida anc. the State of Florida, governing plumbing and drainage work done in Miami Shores Village, Florida. For a At No. "g / 69 1/d1/,‘ Lot gift/ Block / Subdivision I/' ,% ,A,.- Fixtures 531 As Shown on attached approved plans. FIXTURES ROUGHED IN FIXTURES SET _$. • SEWER Payment Received SEPTIC TANK6 ) By TOTAL 12 Village Plumbing Inspector MIAMI SHORES VILLAGE Plnmb:Lng Permit Miami Shores Villag Fla. ,hf■• aa This permit issued subject to approval of County Plumbing Inspector, - "