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PLUMBINGPermit No._. 0 __ MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. Q 4/I - G Owner's Name and Address_ _ s - /riln t _ __�_____ No.2 %__1 __Q___7' Street Registered Architect and /or En ' eer_________ —_____ Employing Plumber's O / 'vKl-rR ��{{,,� --- _- --- �--- �-__ -- - _d -_ --- No.���./.� r+ Street_____ Location and Legal Description Block __ Subdivision Street and Number where work is to be performed —No Street State work to be performed and purpose of building (By Floors)._ N Building _ -__._ Remodeling____ ____ Addition.___ Repairs No. of Stories. Size Septic Tank_ ______ _-___- -- ___________ _--_____ ----- - -- - -- -Type of Tanlr Capacity Gals Feet of Drain Tile_________ ____ -Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: alp — Well.____.___________.____ _ _____Size of Soakage Pit 1 Amount of Per= -_ .�- - - -- - -- — - - -- — -_� ( Signed)- - tote 61 b) ._ .. Plumbing Inspector. Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5968, Compiled General Laws of Florida 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 t be rformed under t}yi5) permit, as are licensed by Miami Shores Village. (Signed)._ _ es' STATE OF FLORIDA, } COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared Date 17-- 28- 7 / My Commission Expires Notary Public, State of Florida er 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. NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made•necessary by improper notice for inspection, or faulty materials and /or workmanship. CLOSETS BATH TUBS SHOWER! LAVA- TORIES SINKS N SLOP SINKS LAUNDRY TUBS URINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT'NS TOTAL FIXTURES CONTR. LIST CHECK SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SWIM•G POOL CONTR. LIST ✓ - -- - CHECK Permit No._. 0 __ MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. Q 4/I - G Owner's Name and Address_ _ s - /riln t _ __�_____ No.2 %__1 __Q___7' Street Registered Architect and /or En ' eer_________ —_____ Employing Plumber's O / 'vKl-rR ��{{,,� --- _- --- �--- �-__ -- - _d -_ --- No.���./.� r+ Street_____ Location and Legal Description Block __ Subdivision Street and Number where work is to be performed —No Street State work to be performed and purpose of building (By Floors)._ N Building _ -__._ Remodeling____ ____ Addition.___ Repairs No. of Stories. Size Septic Tank_ ______ _-___- -- ___________ _--_____ ----- - -- - -- -Type of Tanlr Capacity Gals Feet of Drain Tile_________ ____ -Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: alp — Well.____.___________.____ _ _____Size of Soakage Pit 1 Amount of Per= -_ .�- - - -- - -- — - - -- — -_� ( Signed)- - tote 61 b) ._ .. Plumbing Inspector. Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5968, Compiled General Laws of Florida 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 t be rformed under t}yi5) permit, as are licensed by Miami Shores Village. (Signed)._ _ es' STATE OF FLORIDA, } COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared Date 17-- 28- 7 / My Commission Expires Notary Public, State of Florida er 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. 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 Contractor / (,„ or Builder Legal Lot Description 40044 CONTRACTOR OR BUILDER MIAMI SHORES VILLAGE, FLORIDA DATE /, 194_ E R M I T N° 6679 Contractor's License No Work ybe performed under this Permit k • Owner of Building Architect Bl. Subdi- vision Value of Project Address of Building This permit is gran d 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 is . 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 conditi po rich this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge - ' the o : a ces and regulations pertaining to the work covered hereby whether shown on the plans or drawings or a statements orecifications an . d uu respon- sibility for work done by his agents, servants or employees. Amt. of Permit i Signed: ; ri '' INSPECTOR In consideration of the issuance to me of this permit I agree to perforip"the work covered hereunder in compliance with tH 'Ordinances and agu ?awns pertaining thereto a in strict confo t wi the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this mit I assume re or all fork done by either myself, my agent, servant or employee. BY 4 ) 9i AUTHORITY BUILDING ELECTRICAL PLUMBING Owner of Buil. Architect : Contractor t or Builder f t f f'{ ,, / 1.--d 77 Legal Lot Bl: Description MIAMI SHORES VILLAGE, FLORIDA DATE ,- 194- PERMIT N° 6807 Work to be performed under this Permit Subdi- vision Value of Project Contractor's License No. Building J ' 2 4 , l Permit This permit is ranted to the contractor or builder named above to construct the building or to install the equipment or devic( 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 res o sibility for a thorough knowledge of the 6idinaaefs and regulations pertaining to the work covered hereby whether shown on the plans or drawings orl}testatements or specifications and that he assumes.gespon- sibility for work done by his agents, servants or employees. „x X 00'' y,.:.wM Signed: -' +; 4 By ,: INSPECTOR In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with a and rggij tins pertaining thereto and in strict conformity with the lans, drawings, statements or specifications submitted to the proper authorities of Miami Shorts • accepting this permit . sume responsibility fo work done by either myself, my agent, servant or employee. AUTHORITY Date Cr. () [ Application is hereby mad for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein describe This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the aws 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. Permit No Owner's Name and Address 4 8. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT No. ' Street__ et- -- Registered Architect and /or En ' eer Employing Plumber's Name - ■fi No Location and Legal Description Lot 1 _— __ 2 ___3 Block / 2 Street and Number where work is to be performed —No State work to be performed and purpose of building (By New Building Remodeling Addition Repairs No. of Stories Septic Tank Feet of Drain Tile /D O Nature of Water Supply: City —Well . ---- - - - -_( - 4 `�r Type of Tank Dist. Feet of Tank or Drain Field from Well Size of Soakage Pit Capacity Gals. (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 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 befterformed under this permit, as are licensed by Miami Shores Village. Amount of Permit $ ss. My Commission Expires (Signed) Street Subdivision A- Master Plumber. 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. 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 ' -J TOTAL FIXTURES TR. CON ST LI / / 1 r f ' CHICK r SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SWIM'G POOL / =! - CONTR. LIST / l3./ CHECK I Date Cr. () [ Application is hereby mad for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein describe This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the aws 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. Permit No Owner's Name and Address 4 8. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT No. ' Street__ et- -- Registered Architect and /or En ' eer Employing Plumber's Name - ■fi No Location and Legal Description Lot 1 _— __ 2 ___3 Block / 2 Street and Number where work is to be performed —No State work to be performed and purpose of building (By New Building Remodeling Addition Repairs No. of Stories Septic Tank Feet of Drain Tile /D O Nature of Water Supply: City —Well . ---- - - - -_( - 4 `�r Type of Tank Dist. Feet of Tank or Drain Field from Well Size of Soakage Pit Capacity Gals. (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 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 befterformed under this permit, as are licensed by Miami Shores Village. Amount of Permit $ ss. My Commission Expires (Signed) Street Subdivision A- Master Plumber. 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. 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. TEI 40 -2580 ri S. E. VAS N N PLUMBING AND HEATING CONTRACTOR SEPTIC TANKS I • • 337 SOUTH STATE HIGHWAY SOUTH MIAMI, FLA. NN Permit No. 'MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Application is hereby made r the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein described. his 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 con fed with, whether herein spe 4fied or not. A copy of approved plans and specifications must be kept at building during progress of wor / Owner's Name and Addrese { Registered Architect and /or Engi r__ eir Employing Plumber's Name _4_4-1 No. Street Location and Legal Description Lot_ Street and Number where work is to be performed —No ss. Blo k_ Subdivision Amount of Permit $ — ____________ (Signed) ( Signed) Street Street State work to be performed and purpose of building (By Floors) New Building Remodeling Addition____ Repairs 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 Date '° No. of Stories__ __ My Commission Expires Notary Public, State of Florida 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. Master Plumber. STATE OF FLORIDA, 1 COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared tome well known, and who, being by me first duly sworn, upon oath deposes and says that he is the of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty materials and /or workmanship. CLOSETS BATH TUBS SHOWERS LAVA- TORIES SINKS SLOP SINKS LAUNDRY TUBS URINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT'NS TOTAL FIXTURES CONTR. LIST CHECK SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SWIM'G POOL CONTR. LIST CHECK Permit No. 'MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Application is hereby made r the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein described. his 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 con fed with, whether herein spe 4fied or not. A copy of approved plans and specifications must be kept at building during progress of wor / Owner's Name and Addrese { Registered Architect and /or Engi r__ eir Employing Plumber's Name _4_4-1 No. Street Location and Legal Description Lot_ Street and Number where work is to be performed —No ss. Blo k_ Subdivision Amount of Permit $ — ____________ (Signed) ( Signed) Street Street State work to be performed and purpose of building (By Floors) New Building Remodeling Addition____ Repairs 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 Date '° No. of Stories__ __ My Commission Expires Notary Public, State of Florida 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. Master Plumber. STATE OF FLORIDA, 1 COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared tome well known, and who, being by me first duly sworn, upon oath deposes and says that he is the of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty materials and /or workmanship. PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date 9 - a - 9 ? Job Address r9 9 /✓ -('. /V Tax Folio Legal Description Historically Designated: Yes No 6;;;Pessee / Tenant /t / // / q /vi S Master Permit # ( 9 7 , a g 6 Owner's Address ("/ Al. f . / 0 a w oP e • Phone 75 5 ? °Z Contracting Co. 797;9 ,C ext ✓e . Address /3 b 9 A/- 4'' 3' y .- Qualifier .ter ; �, i.�✓ State # O SSf Municipal # OSs Competency # Osrt Ins. Co. Address Address Architect/Engineer Bonding Company VA Mortgagor w// -. Permit Type (circle one): BUILDING ELECTRICAL UMBING ECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION et/9i; A /e/o Square Ft. a O 0,1;r 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. ure of owner and/or Condo President Notary as to Owner and/or Condo Presidgrit Date My Commission Expires: 77 3 /Y7 FEES: PERMIT RADON C.C.F. SS# / Phone 30x - /yo l Y(.7 Address Estimated Cost (value) /02. o a, o 0 Signature of Contractor or Owner- Builder Notary as to Contractor or Owner- Builder My Co ANNA QUINONES MY COMMISSION 0 CC 502181 E%PINE8: October 18, 1999 g '," ^" &Med 7hru Nefvy public lknden', tern NOTARY BOND ate 0,2 CONS RUCTION PERMIT r (/ New System [ ( )/] Repair 1 STATE OF FLORIDA DEPARTMENT OF HEALTH AND REHABILITATIVE SERVICES g ONSITE SEWAGE DISPOSAL SYSTEM CONSTRUCTION PERMIT Authority: Chapter 381, FS & Chapter 10D -6, Abandonment APPLICANT: A� A1//` LU /Ll / 4144 r PROPERTY STREET ADDRESS: A� /d? ,21e LOT : 2 2 a t 2 BLOCK : PROPERTY ID #: 1/ 3 z a Q / 5 / 6y () SYSTEM MUST BE CONSTRUCTED IN ACCORDANCE WITH SPECIFICATIONS AND STANDARDS OF CHAPTER 10D -6,. FAC REPAIR PERMITS AND HOLDING TANK PERMITS EXPIRE 90 DAYS FROM THE DATE OF ISSUE. ALL OTHER PERMITS EXPIRE ONE YEAR FROM THE DATE OF ISSUE.. HRS APPROVAL'OF:SYSTEM DOES NOT GUARANTEE SATISFACTORY PERFORMANCE FOR ANY SPECIFIC PERIOD OF TIME. ANY CHANGE IN MATERIAL FACTS WHICH SERVED AS A BASIS FOR ISSUANCE OF THIS PERMIT, REQUIRE'THE APPLICANT'TOMODIFY THE PERMIT APPLICATION. SUCH MODIFICATIONS MAY RESULT IN THIS PERMIT BEING MADE NULL.AND VOID. SYSTEM DESIGN AND SPECIFICATIONS T A N K D R A I N F I E L D 0 T H E R Existing System (� Ha/ding Tank ( / 2 SUBDIVISION: /,-;-, S ,e-e-Q r ��Drf .1 7Sv J GALLONS GPD] SEPTIC TANK UNIT CAPACITY MULTI- CHAMBERED /IN SERIES:[ ] [ ] [GALLONS / GPD] CAPACITY MULTI- CHAMBERED /IN SERIES:[ ] [ ] GALLONS GREASE INTERCEPTOR CAPACITY [MAXIMUM CAPACITY SINGLE TANK: 1250 GALLONS] [ ] GALLONS PER DOSE `DOSING TANK CAPACITY DOSE RATE ( ] PER 24 HRS NO. OF PUMPS: [ ] d2., i . (/a �, 64 (1.1�4 SQUARE FEET PRIMARY DRAINFIELD SYSTEM [ 1 SQUARE FEET SYSTEM TYPE SYSTEM: [ ] STANDARD ( J FILLED ( ] MOUND CONFIGURATION: ( ] TRENCH [ t J D [ LOCATION OF BENCHMARK: ELEVATION OF PROPOSED SYSTEM SITE 7.3 8] [INCHES T ABOVE AELOYILBENCHMARK /REFEREN NT BOTTOM OF DRAINFIELD TO BE [ �Q INCH J FT ] [ABOVE / BENCHMARK1FERENCE POIN FIB REQUIRED.: ( � ] INCHES EXCAVATION REQUIRED: Ario .1 %R 3C , ^. \. rF F 1.J,• :-. _ :4 L ... NC_ ;•T �� ±• • r.- Di ELENA 7 SPECIFICATIONS BY: APPROVED BY: DATE ISSUED: 6 4, ocl- /t TITLE: TITLE: FAC AGENT: Al [SECTION /TOWNSHIP /RANGE /PARCEL NUMBER] (OR TAX ID NUMBER] ] PERMIT # PR 2 2 - d DATE PAID - FEE PAID $ RECEIPT # / 7 Temporary /Experimental' EXPIRATION DATE: 2 d;;;.! _.' IN E, HRS -H Form 4016, Mar 92 (Obsoletes previous editions which may not be used) (Stock Number: 5744-001- 4016-0) Page 1 of 2 STATE OF FLORIDA DEPARTMENT OF HEALTH AND REHABILITATIVE SERVICES ONSITE SEWAGE DISPOSAL SYSTEM SITE EVALUATION AND SYSTEM SPECIFICATIONS � J; LL)AH LOT: aa-d BLOCK: I )- SUBDIVISION: PROPERTY ID #: 3 a o b o; 3 / ), 9 0 PROPERTY SIZE CONFORMS TO SITE P TOTAL ESTIMATED SEWAGE FLOW: AUTHORIZED SEWAGE FLOW: UNOBSTRUCTED AREA AVAILABLE: SITE SUBJECT TO FREQUENT FLOODING: 10 YEAR FLOOD ELEVATION FOR SITE: SOIL PROFILE INFORMATION SITE 1 Munsell # /Color Texture Depth DR2 Orylz� -(� c) to / to e'• to to USDA SOIL SERIES: - 2 - Al i-. Ut bA- - to to to to ?2" REMARKS /ADDITIONAL CRITE 40o [ ] YES s s. SITE EVALUATED BY! j/ (,( O �t /�. 1t:1 M HRS-H Form 4015, Mar 92 (Obsoletes previous editions which may not be used) (Stock Number: 5744- 003 - 4015 -1) AGENT: (-e J n ✓P / 0, '° 5 . PERMIT # , 1, 5 /2 o.. -flp [Section /Township /Range /Parcel No. or Tax ID Number] TO BE COMPLETED BY ENGINEER, HEALTH UNIT EMPLOYEE, OR OTHER QUALIFIED PERSON. ENGINEER'S MUST PROVIDE REGISTRATION NUMBER AND SIGN AND SEAL EACH PAGE OF SUBMITTAL. COMPLETE ALL ITEMS. [y] YES [ ] NO NET USABLE AREA AVAILABLE' 6 7J ACRES 8 J, 1 0 GALLONS PER DAY [RESIDENCES -TABLE 1 / OTHER -TABLE 2] GALLONS PER DAY [1500 GPD /ACRE OR 2500 GPD /ACRE] SQFT UNOBSTRUCTED AREA REQUIRED: o 00 O SQFT BENCHMARK /REFERENCE POINT LOCATION: ELEVATION OF PROPOSED SYSTEM SITE IS 7,3.E [INCHES/ [ABO ELOW BENCHMARK /REFERENCE POINT THE MINIMUM SETBACK WHICH CAN BE MAINTAINED FROM THE PROPOSED SYSTEM TO THE FOLLOWING FEATURES: SURFACE WATER: N/ ' FT DITCHES /SWALES: /JO FT NORMALLY WET? [ ] YES [}j' NO WELLS: PUBLIC: N/ r FT LIMITED USE: N Ip FT PRIVATE: /») FT NON- POTABLE: rq. FT BUILDING FOUNDATIONS: .,� FT PROPERTY LINES: .S FT POTABLE WATER LINES: 17 'FT 04 NO 10 YEAR FLOODING? [ ] YES [17 NO FT MSL /NGVD SITE ELEVATION: ,,r) FT MSL /NGVD SOIL PROFILE INFORMATION SITE 2 Munsell j /Color n p nA. �qv Texture Depth Or 0 to .SA -o� f! to to to to to to to 7J USDA SOIL SERIES : �M v / 6 ter. , OBSERVED WATER TABLE: )y�/. INCHES [ABOVE /C,isi' EXISTING GRADE. ESTIMATED WET SEASON WATER TABLE ELEVATION: ‘ INCHES [ ABOVE / HIGH WATER TABLE VEGETATION: [ ] YES [ ] NO MOTTLING: [ ] YES [ ] NO TYPE: PERCHED /_2 llrf 1 EXISTING GRADE. DEPTH: INCHES SOIL TEXTURE /LOADING RATE FOR SYSTEM SIZING: DEPTH OF EXCAVATION: 3 6 INCHES DRAINFIELD CONFIGURATION: [ ] TRENCH (Y] BED [ ] OTHER (SPECIFY) DATE: Page 3 of 3 APPLICATION FOR: / g/ ] New System [AA Existing System [,(/] Holding Tank [t/JTemporary /Experimental [(j ] Repair [4,/ Abandonment [i✓] Other(Specify) APPLICANT: AGENT: MAILING ADDRESS: n A TO BE COMPLETED BY APPLICANT OR APPLICANT'S AUTHORIZED AGENT. ATTACH BUILDING PLAN AND TO -SCALE SITE PLAN SHOWING PERTINENT FEATURES REQUIRED BY CHAPTER 10D -6, FLORIDA ADMINISTRATIVE CODE. PROPERTY INFORMATION [IF LOT IS NOT IN A RECORDED SUBDIVISION, ATTACH LEGAL DESCRIPTION OR DEED] LOT: 3 BLOCK: PROPERTY ID #: //-3 b fj 13- PROPERTY SIZE: ACRES [Sqft /43560] Or c > PROPERTY STREET ADDRESS: DIRECTIONS TO PROPERTY: BUILDING INFORMATION [] RESIDENTIAL Unit Type of / /// No. of No Establishment Bedrooms 2 3 4 Garbage Grinders /Disposals ] Ultra -low Volume Flush Toilets APPLICANT'S SIGNATURE: STATE OF FLORIDA DEPARTMENT OF HEALTH AND REHABILITATIVE SERVICES ONSITE SEWAGE DISPOSAL SYSTEM APPLICATION FOR CONSTRUCTION PERMIT Authority: Chapter 381, FS & Chapter 10D -6, FAC 1-(-)# /1 4.15- 7 /C e s O L.J o ,4 o -/e - �7i,. c . SUBDIVISION: A I to .4ve a ice) . •j —. ^r' DATE: HRS-H Form 4015, Mar 92 (Obsoletes previous editions which may not be used) Page 1 of (Stock Number: 5744 - 001 - 4015-1) ( PERMIT 1 • DATE PAID FEE PAID $ RECEIPT 1 TELEPHONE: -, f10 — 6 , 32 f'v 33/v2 // DATE OF Q 14 i�t i -) NOC Q S SUBDIVISION. 1 7 Y,- [Section /Township /Range /Parcel No.] ZONING: PROPERTY WATER SUPPLY: [ ] PRIVATE ] COMMERCIAL /c/ )3)31- �/� . ] Building 1 Persons Business Activity Area Saft Served For Commercial Only PUBLIC (/i6 pas /Hot Tubs [44 ioor /Equipment Drains Vi Other (Specify) Scale: Site Plan submitted by Plan Approved By STATE OF FLORIDA DEPARTMENT OF HEALTH AND REHABILITATIVE SERVICES APPLICATION FOR ONSITE SEWAGE DISPOSAL SYSTEM CONSTRUCTION PERMIT Permit Application Number 9 ALL CHANGES MUST BE APPROVED BY THE COUNTY PUBLIC HEALTH UNIT i PART 1I - SITE PLAN Each block represents 5 feet and 1 inch = 50 feet. n 1 9 23 f I- f L Notes: v)4 el I.- 2/ -92 does o ?lam 7-‘ O T E f r SIGNATURE rst Not Approved �-- Sfrt cC1iti i�. /00 TITLE Date O' - c-C- County Public Unit MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT qq Permit No Date Z. _ Application is hereby made approval for t he a val of the detailed statement of the plans and specifications her red b � mitted 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 Addr Registered Architect and /or Engin Employing Plumber's Name Location and Legal Description Lot. Block SubdlvWoq Street and Number where work is to be performed —No 9 Street. — - r ,l State work to be performed and purpose of building (By Floors) ___.._._..... New Building Remodeling____ — ___.__ Addition Size Septic Feet of Drain Tilet.a � 9 l2�� No.11 9 Z StTeet-.LQ . ..'...., __._...Type of Tank__ __Dist. Feet of Tank or Drain Field from Well..._.. ...... Nature of Water Supply: City — Well. ------- .----- •-- - -____ — ...Size of Soakage Pit Amount of Permit $ 2.O (Signed) (Signed) Repair Capacity Gals No. of Stories Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obbjatlons as an employer of labor under the Florida Workmen's Compensation Act, being Section 5988, Compiled General Laws of Florida Permanent Supplement, and Ilan com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such sub - contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. Master Plumber. STATE OF FLORIDA, ss. 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 be has carefully read the foregoing application, and that be did sign the same, and that all facts therein by hire stated are true. My Commission Expires Notary Public, State of Florida NOTE: A re- inspection fee of $1.00 will be made wbm such rslaspeetion is made.neoessary by improper notice for inspection, or faulty materials and /or workmanship. CLOSETS BATH T Se SHOWERS LAVA• TORIES SINKS SLOP SINK[ LAUNDRY TUee URINAL[ CATCH BASIN FLOOR DRAIN DRINKING FOUNT'N• TOTAL FIXTURES CoNTII. 1.1 ST CHECK SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT G TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SWIM'G P001. CONTR. LIST CHECK MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT qq Permit No Date Z. _ Application is hereby made approval for t he a val of the detailed statement of the plans and specifications her red b � mitted 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 Addr Registered Architect and /or Engin Employing Plumber's Name Location and Legal Description Lot. Block SubdlvWoq Street and Number where work is to be performed —No 9 Street. — - r ,l State work to be performed and purpose of building (By Floors) ___.._._..... New Building Remodeling____ — ___.__ Addition Size Septic Feet of Drain Tilet.a � 9 l2�� No.11 9 Z StTeet-.LQ . ..'...., __._...Type of Tank__ __Dist. Feet of Tank or Drain Field from Well..._.. ...... Nature of Water Supply: City — Well. ------- .----- •-- - -____ — ...Size of Soakage Pit Amount of Permit $ 2.O (Signed) (Signed) Repair Capacity Gals No. of Stories Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts his obbjatlons as an employer of labor under the Florida Workmen's Compensation Act, being Section 5988, Compiled General Laws of Florida Permanent Supplement, and Ilan com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such sub - contractors, on work to be performed under this permit, as are licensed by Miami Shores Village. Master Plumber. STATE OF FLORIDA, ss. 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 be has carefully read the foregoing application, and that be did sign the same, and that all facts therein by hire stated are true. My Commission Expires Notary Public, State of Florida NOTE: A re- inspection fee of $1.00 will be made wbm such rslaspeetion is made.neoessary 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 ❑ PERMIT N? 8545 CONTRACTOR OR BUILDER MIAMI SHORES VILLAGE. t % . Bl. 1 r Subdi- vision Sq. Ft Value of Project $ • FLORIDA DATE ,,.f, Contractor's License No Work to be performed under this Permit Amt. of Permit $ BY AUTHORITY 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. Th$ 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 coritlition 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 j 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 considerate f the iss e to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto d irrg� strict c formity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this rmit II rgsponsibility for all work done by either, myself, my agent, servant or employee. 4VEN‘17 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. u / C UC ._.. � Owner's Name and AddressL� ,�`�'- WL�!.F____1> 0_ ___ No._ - -A/1, ____ Street./ O 2 " Registered Architect and /or Engineer __._ _ _�._.___..___.__._._____ Employing Plumber's Name Gaf!RN_5t/ __/C laa,K No.Iq L L. - Street -1.�.__ ..._.__.._._...._...... Location and Legal Description Lot_ Block Subdivision Street and Number where work is to be performed—No._ ,A1C /4' g $ 71 Street State work to be performed and purpose of building (By Floors)_ New Building Remodeling ______ .......... ______ Addition.--_.-_ Repairs No. of Stories. Amount of Permit $ MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING Size Septic Tank / Type of Tank Feet of Drain Tile_.. J'1 k 2 ----- -Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: City— Well .- ___. -__ __ -- __Size of Soakage Pit (Signed) _ Plu ing'Inspeetor The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Su lenient, and bus corn- y him in the work to be n.:.e or notices as are plied with the provisions thereof, and will require similar compliance from all contractors or performed under this permit; and will post or cause to be posted' for inspection on the sit required by the Act. The undersigned agrees to employ only such sub- contractors, licensed by Miami Shores Village. Capacity Gals. ( Signed )..- contractors employed e work � public to be s permit, as are Master Plumber. STATE OF FLORIDA, COUNTY OF DADE. j 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 cf 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. CLOSET/ BATH Toots SHOWERS LAVA- TORIES SINKS SLOP SINKS LAUNORY Tuff URINAL/ CATCH BASIN FLOOR DRAIN DRINK NO FOUNT' NS TOTAL FIXTURES COhTR. LIST CHECK SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SW I POOL CONTR. LIST CHECK 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. u / C UC ._.. � Owner's Name and AddressL� ,�`�'- WL�!.F____1> 0_ ___ No._ - -A/1, ____ Street./ O 2 " Registered Architect and /or Engineer __._ _ _�._.___..___.__._._____ Employing Plumber's Name Gaf!RN_5t/ __/C laa,K No.Iq L L. - Street -1.�.__ ..._.__.._._...._...... Location and Legal Description Lot_ Block Subdivision Street and Number where work is to be performed—No._ ,A1C /4' g $ 71 Street State work to be performed and purpose of building (By Floors)_ New Building Remodeling ______ .......... ______ Addition.--_.-_ Repairs No. of Stories. Amount of Permit $ MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING Size Septic Tank / Type of Tank Feet of Drain Tile_.. J'1 k 2 ----- -Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: City— Well .- ___. -__ __ -- __Size of Soakage Pit (Signed) _ Plu ing'Inspeetor The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Su lenient, and bus corn- y him in the work to be n.:.e or notices as are plied with the provisions thereof, and will require similar compliance from all contractors or performed under this permit; and will post or cause to be posted' for inspection on the sit required by the Act. The undersigned agrees to employ only such sub- contractors, licensed by Miami Shores Village. Capacity Gals. ( Signed )..- contractors employed e work � public to be s permit, as are Master Plumber. STATE OF FLORIDA, COUNTY OF DADE. j 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 cf 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.