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PLUMBINGBUILDING PERMIT APPLICATION FBC 2001 Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Permit No. PLa003 Master Permit No. Permit Type (circle): Building Electrical ( Phjalstrf, Mechanical Roofing Owner's Name (Fee Simple Titleholder) _ � fil, 1 k /$r {/ Phone # J - ‘/ ' WS00 Owner's Address 7 6 A/ ( /0 Z 51' City h, an1; M,OY'..S State Tenant/Lessee Name Phone # Job Address (where the work is being done) (� /U 6 42 'S ' 3 3/ a City P Miami Shores Village County Miami-Dade Zip Is Building Historically Designated YES NO / 1 Contractor's Company Name 14/ C �(:� l D Phone # �'- 620 — 83 2 0 Contractor's Address /72gS /1/6 /z C 3 3/ 6 9 City State / l Zip 3 '?/ Qualifier 014/A C ✓ Architect/Engineer's Name (if applicable) h e # Architect/Engineer's Address City State Zip S Value of Work For this Permit Zip 33 / 3 8 „15)-0 Square Footage Of Work: Number of: Bays Stories Families Bedrooms Z Baths •Type of Work: DAdditio ['Alteration ['New Repair/Replace 0 Demolition Describe Work: i *Z 1/ 5q fiL 197 fiat/ ` ��. L 7 n .5 5* * * * * * * * * * * * * * * * * * * * * * * * * * * ** F ees * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** County Escrow Fee $ ( Permit Fee $ C .0(7; (7 Notary $ Education/ Training Fee $ Tech $ Scanning $ Radon $ Code Enforcement $ Bond $ a(( C f _ Struct. $ Minus Plans Check Fee $ Total Fee Now Due $ > <, 1 -1`' Pad Csa�`, 3gi (Continued on opposite side) 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 " 6 ' 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 $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not bejapproved and a reinspection fee will be charged. • 7./f Signature �( m(/' Owner or Agent (i!7 The fore oing instrument was acknowledged before me this / day of d. 2 20 CA by who is personally kn t • M' .. has produced_.. /) l NOTAR Slg #: { y • Print \ : f ar-: T 7 chc7/7/03 State Certificate or Registration No. **** * * * * * * * * ** * * * * * * * * ** * * * * *** ** / APPLICATION APPROVED BY: I d who did take an oath. Contractor The fore oing instrument was acknowledged before me this day of t jt / `� 20C3, by who is perso known to tt3v �` produced as fit: �i • , , ,. �d take an oath. NOTARY PU$LI r .: Sign �: 1, Print: My Commission Expfrf ` � / ��. My Commission E l�s (Certificate of Competency Holder) Certificate of Competency No. ***************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Plans Examiner Engineer Zoning CONSTRUCTION PERMIT FOR: [ ]New System [ ]Existing System [ [ X ]Repair [ ]Abandonment [ APPLICANT: Bordeaux, Walter PROPERTY STREET ADDRESS: 76 NE 102 St Miami FL 33138 LOT: 2 STATE OF FLORIDA DEPARTMENT OF HEALTH ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM CONSTRUCTION PERMIT BLOCK: 11 SUBDIVISION: Miami Shores [Section /Township /Range /Parcel No.] PROPERTY ID #: 11- 3206 - 013 -1460 [OR TAX ID NUMBER] SYSTEM MUST BE CONSTRUCTED IN ACCORDANCE WITH SPECIFICATIONS AND STANDARDS OF CHAPTER 64E -6,FAC DEPARTMENT APPROVAL OF SYSTEM DOES NOT GUARANTEE SATISFACTORY PERFORMANCE FOR ANY SPECIFIC TIME PERIOD. 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. ISSUANCE OF THIS PERMIT DOES NOT EXEMPT THE APPLICANT FROM COMPLIANCE WITH OTHER FEDERAL, STATE OR LOCAL PERMITTING REQUIRED FOR PROPERTY DEVELOPMENT. SYSTEM DESIGN AND SPECIFICATIONS T [ 1050 ]Gallons SEPTIC TANK A [ 0 ]Gallons N [ 0 ]GALLONS GREASE INTERCEPTOR CAPACITY K [ 0 ]GALLONS DOSING TANK CAPACITY [ 0 ]GALLONS @ D [ 300 ]SQUARE FEET PRIMARY DRAINFIELD SYSTEM R [ 0 ]SQUARE FEET SYSTEM A TYPE SYSTEM: [ N ]STANDARD [ N ]FILLED [ N ]MOUND [ N ] I CONFIGURATION: [ N ]TRENCH [ ]BED [ N ] N F LOCATION TO BENCHMARK: Top of Bottom F1 or, 12.70' NGVD. I ELEVATION OF PROPOSED SYSTEM SITE [ 1.5 ] [ FEET ] [ BELOW BENCHMARK /REFERENCE POINT E BOTTOM OF DRAINFIELD TO BE [ 3.5 ] [ FEET ] [ BELOW BENCHMARK /REFERENCE POINT L D FILL REQUIRED: [ 0.0 ]INCHES EXCAVATION REQUIRED: [ 24.0 ] INCHES OTHER REMARKS: THIS PEMIT IS NOT FOR ADDITIONS. *Existing 1050 gl. septic tank to remain. *Install 300 sq.ft. of drainfield. *Invert elevation to be no less than 9.70' NGVD. *Bottom elevation to be no less than 9.20' NGVD. DME61(O ®i3 DIEtlGIN OMVIAM ©E1 `ME °MEV ME DATE ISSUED: 8/18/03 SPECIFICATIONS BY: Icaza, Carlos APPROVED BY: Icaza, Carlos AGENT: WALLACE P, Ponder Wallace TITLE: DH 4016, 03/97 (Obsoletes previous editions which may not be used) (Stock Number: 5744- 001 - 4016 -0) (ostds_cons_4016 -1) TITLE: Engineer I CENTRAX #: 13 -SG -17627 DATE PAID: FEE PAID : $ RECEIPT . OSTDSNBR : 03 - 2541 - - ]Holding Tank [ ] Innovative Other ] Temporary [ NA ] MULTI - CHAMBERED /IN SERIES: [Y ] MULTI - CHAMBERED /IN SERIES: [Y ] [0 ]DOSES PER 24 HRS # PUMPS[ 0 ] Dade CHD EXPIRATION DATE: 11/16/03 Page 1 of 2 :ale: Each block re • 4 -,-,--,-1 1 14 lan submitted by: ,pproved STATE OF FLORIDA DEPARTMENT OF HEALTH -LICATION FOR ONSITE SEWAGE DISPOSAL SYSTEM CONSTRUCTION PERM63 asci Permit Application Number resents 5 feet and 1 inch = 50 feet. Signature PART II - SITE PLAN- — • 11111111•1 MUM 1111111111a .1..... 6 i .:...1 , __f_i___,_.,....• 1 .....4_, • a a : • . lb i 4- -1-: -*--1-1-4"..- . . . • 4.- . - 111 6 . 46. m mom nn MINEMINNINNE • nn ifininnn Ma; MU irligr m NM imoninierumeriainnorwAlilionsimmos ug mmumnrcmsmIl minnallnzannn MAMO f WIN • m 122E111:001 orn SIM NM EIP S NI MIME • 1 • IN ISNIONNIII IN MI 1 I •. r I 16111111111 A 111111111. In 111111.1111111111 MO IN " 1 1 0 guns ionsnon T Ms 11mir nonmennnininn nn MOM i Bs 111 unt essoin missiiii P 411111=111111111111111 11 11 KIM IN '!!'inn INMAN n n EjI aliarijaidameiewah WILEMEMILMI 41. 1 maimimmv R„ f i l •g_A. 1 1 P n li rriO si • +4 111 • 0 it I . ardlingffilIMINIMJ.MIEWAIN A., /1 Si .".■•• a IllIfififfillImml _Intiminsi, mow A 1 0 ; 1_ • 1- - -f I - -f- -t.- I I- - • 1 -f. -4- • - j - 1 -4- 4 . 1 - r• - r - r , • "1 ' • t ; • --; • 1- • — ,- 1 - • • : • . 4 H t t .. - t tt • • -4- f- • f ; t• - • ..t ! - t•-; !. ; 7- 7 ;. . , • . .,. • -t • i• ; • 71 i7 Date County Health Department L CHANGES MUST BE APPROVED BY THE COUNTY HEALTH DEPARTMENT 98 (Replaces HRS-H Form 4015 which may be used) w: 5 744-002-401S-6) Not Approved ,.-ANT: a SITE EVALUATED BY: ,e FLORIDA ,.RTMENT OF HEALTH .iNSITE SEWAGE DISPOSAL SYSTEM SITE EVALUATION AND SYSTEM SPECIFICATIONS AT: st . 3 BLOCK: THE MINIMUM SETBACK,% SURFACE WATER: WELLS: PUBLIC: BUILDING FOUNDATIONS: ICH FT 11 'ROPERTY ID ` : 6 1 6 0 NO BE COMPLETED BY ENGINEER, HEALTH UNIT ?ROVIDE REGISTRATION NUMBER AND SIGN AND ?ROPERTY SIZE CONFORMS TO SITE PLAN: TOTAL ESTIMATED SEWAGE FLOW: kUTHORIZED SEWAGE FLOW: JNOBSTRUCTED AREA AVAILABLE: BENCHMARK /REFERENCE POINT LOCATION: SOIL PROFILE INFORMATION SITE 1 SUBDIVISION: 6> ELEVATION OF PROPOSED SYSTEM SITE IS / (INCHES CAN BE MAINTAINED FROM THE DITCHES /SW ES: LIMITED USE: N/ FT S FT PROPERTY LINES: SITE SUBJECT TO FREQUENT FLOODING: [ ] YES 10 YEAR FLOOD ELEVATION FOR SITE: IAA Munsel 10 USDA SOIL SERIES: Textu a ) rpe pth 5�; to to vI( to to • to to to to t. A r ;lam OBSERVED WATER TABLE: INCHES [ABOVE ESTIMATED WET SEASON WATER T LE ELEVATIO HIGH WATER TABLE VEGETATION: [ ] YES [ SOIL TEXTURE /LOADING RATE FOR SYSTEM SIZING: DRAINFIELD CONFIGURATION: [ ] TRENCH [ BED REMARKS /ADDITIONAL CRITERIA: DH 4015, 10/96 (Replaces HRS -H Form 4015 (Page 31 which may be used) (Stock Number: 5744 -003- 4015 -1) AGENT: 8 r e [Section /Township /Range /Parcel No. or EMPLOYEE, OR OTHER QUALIFIED PERSON. ENGINEER'S MUST SE ACH PAGE OF SUBMITTAL. COMPLETE ALL ITEMS. ES [ ] NO NET US = VAILABLE: GALLONS PER DAY SI' . ABLE 1 GALLONS PER DAY [1500 GPD /ACRE 0 SQFT UNOBSTRUCTED AREA REQUIRED: NO FT MSL /NGVD [ABOVE ty" BENCHMARK PROPOSED SYSTEM TO THE FOLLOWING FEATURES: FT NO Y WET? [ ] YES �� //��[ NO PRIVATE: / FT NON- POTABLE: it FT / FT POTAB jr1ATE S • R LI 1-6 FT g SOIL PROFILE INFORMATION SITE 2 PERMIT 1. O.3 ax ID Number] ,017 ACRES ER -TABLE 2] /ACRE] SQFT 10 YEAR FLOODING? ,e ] YES [ NO ,C SITE ELEVATION: �, FT MSL /NGVD r Alfr • 7L T Munsell USDA OIL SERIES: Texture Depth to to � — — to to to to to to EXISTING GRADE. TYPE* INCHES [ ABOVE / NG: [ ] YES [ RCHED / ] EXISTI EPTH: J DEPTH OF EXCAVATION: G GRADE. INCHES INCHES 0 •ER (SPECIFY) Page 3 of 3 • TEM ATH TUB UNIT FEE ITEM SWITCH CUTLETS UNIT FEE ITEM SPACE HEATERS UNIT FEE IDET LIGHT OUTLETS CENTRAL. HEATING 1SHWASHER RECEPTACLES A/C (WIND) ISPOSAL SERVICE TEMPORARY A/C (CENTRAL) RINKING FOUNTAIN SERVICE SIZE IN MPS DUCT WORK LOOK DRAIN SERVICE REPAIR/METER CHANGE REFRIGERATION :REASE TRAP APPLIANCE OUTLETS PROCESS AND PRESS PIPING NTERCEPTOR RANGE TOP UNDERGROUND TANKS .AVATORY OVEN ABOVE GROUND TANKS .AUNDRY TRAY WATER HEATER U.F. PRESSURE VESSELS :LOTHES WASHER MOTORS 0- 1 HP STEAM BOILERS MOWER MOTORS OVER 1- 3 HP HOT WATER BOILERS ;INK, POT /3 COMP. MOTORS OVER 3- 5 HP MECHANICAL VENTILATION ;INK, RESIDENCE MOTORS OVER 5- 8 HP TRANSPORTING ASSEMBLIES ;INK, SLOP MOTORS OVER 8- 10 HP ELEVATORS/ESCALATORS TEMPORARY WATER CLOSET MOTORS OVER 10- 25 HP FIRE SPRINKLER SYSTEMS JRINAL MOTORS OVER 25-100 HP COOLING TOWERS PATER CLOSET MOTORS OVER 100 If VIOLATION INDIRECT-WASTES A/C WINDOW REINSPECTION YATER SIPPLY TO: AIR CONDITIONERS A/C UNIT STRIP HEATER FIRE SPRINKLER GENERATORS TRANSFORMERS HEATER -NEW INST. GENERATORS TRANSFORMERS I HEATER - REPLACE GENERATORS TRANSFORMERS LAWN SPRINKLER -WELL SPECIAL PURPOSE SWIMMING POOL OUTLETS COMMERCIAL WATER SERVICE SIGN TUBES EWER CONNECTIONS SIGN TRANSFORMERS JTILITY -SEWER SIGN TIME CLOCK JTILITY -WATER FIXTURES ;EPTIC TANK ANTENNA 1 TELEVISION OUTLETS ",,-� tAI IELD 4 TILE/RES./v ^r VIOLATION 'LW & ABANDON SEPTIC TANK REINSPECTION OAKAGE PIT CU. FT. ;ATCH BASIN DISCHARGE WELL DOMESTIC WELL AREA ;DRAIN ROOF `INLET t SOLAR` WATER HEATER =IRE STANDPIPE '00L PIPING • _AWN SPRINKLER SYSTEM LAS RANGE €TER SET (GAS) 3AS PIPING ADDENDUM TO BUILDING PERMIT APPLICATION 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 ELECTRICAL MECHANICAL MIAtil SHORES VILLAGE, FLA. N9 5286 JOB �� ADDRESS ��/ 'C, /0.e. INSPECTION A >, r, (7 ,A) e TIME READY REMARKS / ' I ) INSPECTOR Ea DATE Architect Contractor or Builder Legal Lot Description Address of Building MIAMI SHORES VILLAGE, PERMIT N° 10783 Work to be performed under this Permit J6. Bi. Signed In consideration of the issuance to me of this permit I agr p • .n thereto and in strict conformity with the plans, drawin In a•• g this permit I assume responsibility for all work do e • g # 10/ er'1 CaAJ 10 /'• A CONTRACT"( OR BUILDER Subdi- vision Value of Project $ iq 1. FLORIDA DATE ! Contractor's License No I j / � , ` • �., +,. BY INSPECTOR t A-444 4-4-11 ■ AUTHORITY r. 2 1 19 II Amt. of , !.. Permit $ f ,....�... This permit granted to the contractor or builder named above to construct the building or to install the equipment or device described in application f in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance ith any plans, p, moments or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be evoked at any the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon whi thi3 permit is is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances d regulations g to the work covered hereby whether shown on the plans or drawings or in the statements of specifications and that he assumes responsib ' for work his agents, servants or employees. perform the work covered hereunder in compliance with all ordinances and regulations tements or specifications submitted to the proper authorities of Miami Shores Village. er, myself, my agent, servant or employee. MIAMI SHORES VILLAGE. FLORIDA BUILDING ❑ ELECTRICAL ❑ DATE /1 ` PERMIT N° 46 0 3 Contractor License No PLUMBING ❑ ROOFING ❑ l Owner of Building Architect Contractor or Builder Legal Lot Description Address of Building /€ONTRACTOR OR BUILDER l -t Work to be performed under this Permit Bl r INSPECTOR BY 4 Subdi- vision Value of Project $ u Amount of Permit $ / c 195 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 specificatkirtesq0 that he assumes responsibility for work done by his agents, servants or employees. Signed ` BY .. In consideration of the issuance to me of this permit I agree to perform the work covered hereu . . er in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitte• o 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, •' ployee. , C'. AUTHORITY MIAMI SNORES VILLAGE BUILDING DEPARTME 305- 795 -2204 Building Inspection Request Date Type Insp'n Permit No. Name Address Com Phone # For Inspector: 147 q I [ Approved Correction Re- Insp'n Fee o o Permit No MIAMI SHORES VIL9 AGZ PLUMBING INSPECTION DEPARTME N':' APPLICATION FOR PLUMBING" ,1',MlT 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. , Owners Name and Address ED 1 // i L R E N A ne _94 /�' _ e. Street___ 't Registered Architect and /or Engineer_______ __--- -___ _ _ --- _------- -- -_.__ � - - ------ -•-- - -. q Employing Plumber's Name 1� t 1 __ 4 '?,e/E6 N o._ ��� _.. 1!!' Street - -1 ef Location and Legal Description Lot____ ......... ..... ___________ Block __- .-- --_-_ -. Subdivision Street and Number where work is to be performed- No._24 21/ L • 4 " .2 ' State work to be performed and purpose of building (By Floors)- New Building Remodeling _.__ Addition .•__•___ Repairs No. of Stories Amount of Permit $- -'- -- - - - - -- - - - -- - - ( Signed) - -- J My Commission Expires Street Capacity Gals. Size Septic Tank pit t#3. of Tank_ Feet of Drain Tile__ ____ LDe�,e _/@ . Fret of Tank or Drain Field from Well_ __ .......... ____..... _ Nature of Water Supply: City - Well._____ _ _ — ____Size of Soakage Pit Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his oblig ons as an employer of labor under the Florida Workmen's Compensation Act, being Section 5988, 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 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. f :TATS OF FLORIDA, I COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. Notary Public, State of Florida 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 SHOWERS LAVA- TORIES SINKS SLOP SINKS LAUNDRY TUee U RINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT'NS TOTAL FIXTURES CONTR. LIST CHECK SEPTIC TANK SEWER Comm DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SWIM•G POOL CONTR. LIST - CHECK Permit No MIAMI SHORES VIL9 AGZ PLUMBING INSPECTION DEPARTME N':' APPLICATION FOR PLUMBING" ,1',MlT 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. , Owners Name and Address ED 1 // i L R E N A ne _94 /�' _ e. Street___ 't Registered Architect and /or Engineer_______ __--- -___ _ _ --- _------- -- -_.__ � - - ------ -•-- - -. q Employing Plumber's Name 1� t 1 __ 4 '?,e/E6 N o._ ��� _.. 1!!' Street - -1 ef Location and Legal Description Lot____ ......... ..... ___________ Block __- .-- --_-_ -. Subdivision Street and Number where work is to be performed- No._24 21/ L • 4 " .2 ' State work to be performed and purpose of building (By Floors)- New Building Remodeling _.__ Addition .•__•___ Repairs No. of Stories Amount of Permit $- -'- -- - - - - -- - - - -- - - ( Signed) - -- J My Commission Expires Street Capacity Gals. Size Septic Tank pit t#3. of Tank_ Feet of Drain Tile__ ____ LDe�,e _/@ . Fret of Tank or Drain Field from Well_ __ .......... ____..... _ Nature of Water Supply: City - Well._____ _ _ — ____Size of Soakage Pit Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his oblig ons as an employer of labor under the Florida Workmen's Compensation Act, being Section 5988, 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 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. f :TATS OF FLORIDA, I COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. Notary Public, State of Florida 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./, 7 MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT 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 1 )! Registered Architect and /or Engineer Name 4 A: CI ss. !'t oa ,,' 1 r No / Street No ) �/ Legal Description Lot / Block Subdivision rt 1 Street and Number where work is to be performed —No ' 1 __ ' ( / " • Street State work to be performed and purpose of building (By Floors) lit'"? W AJ s/ =r , N 't -f . s- ri ., New Building Remodeling Addition 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 Nature of Water Supply: City —Well. G 1 Size of Soakage Pit t f an Amount of Permit A¢___ D "' ( Signed) 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 corn- 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. t f 7* ( Signed) '' Y - Street STATE OF FLORIDA,I COUNTY OF DADE. 1 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 mad 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' NE 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./, 7 MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT 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 1 )! Registered Architect and /or Engineer Name 4 A: CI ss. !'t oa ,,' 1 r No / Street No ) �/ Legal Description Lot / Block Subdivision rt 1 Street and Number where work is to be performed —No ' 1 __ ' ( / " • Street State work to be performed and purpose of building (By Floors) lit'"? W AJ s/ =r , N 't -f . s- ri ., New Building Remodeling Addition 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 Nature of Water Supply: City —Well. G 1 Size of Soakage Pit t f an Amount of Permit A¢___ D "' ( Signed) 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 corn- 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. t f 7* ( Signed) '' Y - Street STATE OF FLORIDA,I COUNTY OF DADE. 1 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 mad necessary by improper notice for inspection, or faulty materials and /or workmanship. BUILDING ELECTRICAL PLUMBING Owner of Building Architect Contractor or Builder PERMIT N2 8876 Work to be performed under this Permit MIAMI SHORES VILLAGE, FLORIDA DATE _ I 4 /, Subdi- vision 19 4 i d Contractor's License No. Legal Lot Bl. Description Address of �, ` 3 -. ti . .e Value of Amt. of Building ` ( � , N , Project Permit i I/ ; 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- cation herefor in strict compliance with all ordinances pertaining thereto and w th 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 .: �[. / ; + - • . i:. C (... B 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 accepji this permit I // ss a respor3Sbility for all work done by either myself, my agent, servant or employee. CONTRACTOR OR BUILDER U BY AUTHORITY REQUEST FOR INSPECTION Company Job aon Address Yi1 �. 1 " Inspection PHONE Permit No. 712 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. p c ([ �/ Owner's Name and Address____ MR5 B. Coo P . R No.__ 76 1 ^, , . ' /OyStreet Registered Architect and /or Engineer Employing Plumber's Name - RO $ g_R T Se- H M/ e- I T Z 4,T) No S `J t! 5 1,4 Street 7 i` t' Location and Legal Description Lot Block Subdivision_ Street and Number where work is to be performed —No -26 / Street State work to be performed and purpose of building (By Floors) h " ' ' ' - r New Building Remodeling Addition 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 Nature of Water Supply: City —Well. _________________Size of Soakage Pit Amount of Permit $ ° ss. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT (Signed) (Signed) Date L - G - umbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligatio s an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent plement, 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. aster Plumber. • STATE OF FLORIDA, 1 COUNTY OF DADE. I 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 SWIM'S POOL CONTR. LIST CHECK Permit No. 712 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. p c ([ �/ Owner's Name and Address____ MR5 B. Coo P . R No.__ 76 1 ^, , . ' /OyStreet Registered Architect and /or Engineer Employing Plumber's Name - RO $ g_R T Se- H M/ e- I T Z 4,T) No S `J t! 5 1,4 Street 7 i` t' Location and Legal Description Lot Block Subdivision_ Street and Number where work is to be performed —No -26 / Street State work to be performed and purpose of building (By Floors) h " ' ' ' - r New Building Remodeling Addition 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 Nature of Water Supply: City —Well. _________________Size of Soakage Pit Amount of Permit $ ° ss. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT (Signed) (Signed) Date L - G - umbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligatio s an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent plement, 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. aster Plumber. • STATE OF FLORIDA, 1 COUNTY OF DADE. I 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. 7-- a 1'8z alt.. I�+o Permit No. Date / Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. Pe ,/� Kai Owner's Name and Address �!3.Q!t ' - L �'Y/ No - f 4 Street_ - E ' / 0 2 - -S' T e Registered Architect and /or Engineer — „ t j Str eet '' L' _C Employing ' Plumber's _,� _ kt } . P Ymg Plumbers N fl 1 r_: 1 % t L) ___C` �_ No. Location and Legal Description Lot // • Block / Subdivision t . _i_ _L___ 4,�- G/ L. Street and Number where work is to be performed— No 1P ___ / u __. A 0 r Y 1■ Street State work to be performed and purpose of building (By Floors) New Building .__ _ Remodeling Addition Repairs No. of Stories p - D Amount of Permit $_ s s. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Size Septic Tank Type of Tank Capacity Gals Feet of Drain Tile Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: City —Well — Size of Soakage Pit (Signed • _ (Signed) ,eft r 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 pennit, as are licensed by Miami Shores Village. STATE OF FLORIDA, t 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 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 SHOWERS LAVA- TORIES SINKS SLOP SINKS LAUNDRY TUBS URINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT NS TOTAL FIXTURES -_ CONTR. LIST � /1_ "•�C / �y j ( � - • CHECK SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SWIM'G POOL CONTR. LIST CHECK 7-- a 1'8z alt.. I�+o Permit No. Date / Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. Pe ,/� Kai Owner's Name and Address �!3.Q!t ' - L �'Y/ No - f 4 Street_ - E ' / 0 2 - -S' T e Registered Architect and /or Engineer — „ t j Str eet '' L' _C Employing ' Plumber's _,� _ kt } . P Ymg Plumbers N fl 1 r_: 1 % t L) ___C` �_ No. Location and Legal Description Lot // • Block / Subdivision t . _i_ _L___ 4,�- G/ L. Street and Number where work is to be performed— No 1P ___ / u __. A 0 r Y 1■ Street State work to be performed and purpose of building (By Floors) New Building .__ _ Remodeling Addition Repairs No. of Stories p - D Amount of Permit $_ s s. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Size Septic Tank Type of Tank Capacity Gals Feet of Drain Tile Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: City —Well — Size of Soakage Pit (Signed • _ (Signed) ,eft r 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 pennit, as are licensed by Miami Shores Village. STATE OF FLORIDA, t 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 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.