941 NE 91 Terr (7)PERMIT APPLIC FOR MIAMI SHORES VILLAGE
Dat 4 r ( Job Addres� 1 4 t NE , Ve C', Tax Folio 1 l — CD— 00. 00E-)CD
I �Q i(1I
V\O
Legal Description
Owner/Lessee / Tenant
Owner's Address qL41 tye O U` „ Phone
rSias �' �
Address � �. ��
Contracting Co. 1 ti' . �.(� L , v
c e / Qualifier U �� L 1 ri trt
State # Municipal # Competency #
Architect/Engineer
Bonding Company
Mortgagor
Permit Type (circle one): BUILDING ELECTRICAL
WORK DESCRIPTION r, 40 RA
Square Ft.
WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY RESULT IN YOUR
PAYING TWICE FOR IlVIPROVEMENTS 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 s
RADON
C.C.F.
Historically Designated: Yes
Address
Address
Address
i t i g
Master Permit #
ss# 067 7 ?0?3
Ins. Co.
ECHANICAL ROOFING PAVING FENCE SIGN
Estimated Cost (value) 9 � �-t ,
No
No . as to Contractor or Owntr- Builder G1.J1D' Y i ; , R ' 1 ate
My ' ommission Expires: RICi/ tY PU)T 1C ; ;� C F'..t
CtON:MI`SION NO. CC7i4 ;C.1
M C OMMN ON EXP. 1.i A,2 1 2
NOTARY BOND 3 on. 0 0
TOTAL DUE
APPROVED:
Zoning Building Electrical
Mechanical Plumbing
Structural Engineer
PERMIT NO. •
ADDRESS:
MIAMI SHORES VILLAGE
BUILDING / ZONING DEPARTMENT'
SECTION
BY
DATE
ZONING
ELECTRICAL •
MECHANICAL
PLUMBING
FIRE
' PUBLIC WORKS
h STRUCTURAL
BUILDING OFFICIAL
1. Subject to compliance with aft Federal. State.
Co'mty.Wtage rt1(es and regulations. ViVage assume
no responsibility for accuracy ()floc results from
these plans.
2. This copy of plans mat be available on
building site or no Inspection wtif b. conducted.
•
JOB ADDRESS q
APPLICANT
CRITIQUE SHEET
C 71 71:
PHONE ##
APPUCATION #
SHEET OF
MISCELLANEOUS
6//oi
DATE COMMENTS INITIALS
Scale: Each block represents 10 feet and 1 inch = 40 feet.
r
_ --� — �—
I
1 ' is
x
L
Notes: .
STATE OF FLORIDA
DEPARTMENT OF HEALTH
APPLICATION FOR ONSITE SEWAGE DISPOSAL SYSTEM CONSTRUCTION PERMIT
Permit Application Number
;
DH 4015, 10/96 (Replaces HRS -H Form 4015 which may be used)
(Stock Number: 5744 -002 -4015 -6)
PART II - SITEPLAN
J _I
- , —�,. _ — f j-- , —� — ; —
r � i , •'7; I
•
';
-
Site Plan submitted by:
Plan Approved ,Not Approved
By
ALL CHANGES MUST BE APPROVED BY THE COUNTY HEALTH DEPARTMENT
Date
County Health Department
Page 2 of 4
CONRUCTION PERMIT FO :
0,4 New System Existing System
[ ' Repair [44' Abandonment
A�
• 411.0o1
A [ ] ]]
N [
K [ ]
R
A
I
N
F
I
E
L
D
O
T
H
E
R
APPROVED BY:
BLOCK:
D 4 j /a ] SQUARE
[ ] SQUARE
TYPE SYSTEM:
CONFIGURATION:
SPECIFICATIONS BY:
DATE ISSUED:
STATE OF FLORIDA
DEPARTMENT OF HEALTH
ONSITE SEWAGE DISPOSAL SYSTEM
CONSTRUCTION PERMIT
Authority: Chapter 381, FS &
F''
PROPERTY STREET ADDRESS:
i
SYSTEM DESIGN AND SPECIFICATIONS
0 -. -
SUBDIVISION:
PROPERTY ID a „ [SECTION /TOWNS IP /RANGE /PARCEL NUMBER]
- V .•I Y 1 ) '� ►- I (OR TAX ID NU
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. DEPARTMENT OF HEALTH APPROVAL OF SYSTEM DOES
NOT GUARANTEE SATISFACTORY PERFORMANCE FOR ANY SPECIFIC PERIOD OF TIME. ANY CHANGE IN MATERIAL
FACTS WHICH SERVED AS A BASIS FOR ISSUANCE OF THIS PERMIT REQUIRE THE APPLICANT TO MODIFY THE
PERMIT APPLICATION. SUCH MODIFICATIONS MAY RESULT IN THIS PERMIT BEING MADE NULL AND VOID.
] S
[GALLONS / GPDEPTIC T AEROBIC UNIT CAPACITY
[GALLONS / GPD] �!
GALLONS GREASE INTERCEPTOR CAPACITY
GALLONS PER DOSE DOSING TANK CAPACITY
FEET PRIMARY DRAINFIELD
FEET
[`11) STANDARD
4 TRENCH
LOCATION OF BENCHMARK: /J + A
ELEVATION OF PROPOSED SYSTEM SITE [4}• • ]
BOTTOM OF DRAINFIELD TO BE [ .'a
FILL REQUIRED: [J.- j( ] INCHES
DH 4016, 10/96 (Replaces HRS -H Form 4016 (page 11 which may be used)
(Stock Number: 5744 -001 - 4016 -0)
[ A
Chapter 10D -6, FAC
A
/ding Tank
] ther(Specify)
SYSTEM
SYSTEM
FILLED
1 BED
- (b 0
Applicant
AGENT: _,,
N!1
TITLE:
t r t •
TITLE:
[ 4 MOUND
[,A
PERMIT #
DATE PAID
FEE PAID
RECEIPT
/.S
a
y
OP lit _- II
l,- ? )�
$
c_! j.p / no
y? / I - . 7
emporary /Experimental
MULTI- CHAMBERED /IN SERIES:[
CAPACITY MULTI- CHAMBERED /IN SERIES:[
[MAXIMUM CAPACITY SINGLE TANK: 1250 GALLON ]
DOSE RATE [ ] PER 24 HRS NO. OF PUMPS: [ ]
[I14 �S / v [ABOVE ,ENFHMABK /FERENCE POINT
[ / FT)`T't RA E'ACHMARK/ REFERENCE POINT
EXCAVATION REQUIRED: 1.,1 INCHES
/ I
' 'Lt ti r.r 7 , ��•
EXPIRATION DATE
CHD
Page 1 of 2
INSTRUCTIONS:
PERMIT NUMBER: Permit tracking number by County Health Department.
APPLICATION FOR: Check type of permit; if "Other" specify type in blank.
APPLICANT: Property owner's full name.
TELEPHONE: Telephone number for applicant or agent.
AGENT: Property owner's legally authorized representative.
MAILING ADDRESS: P.O. box or street mailing address for applicant or agent.
LOT, BLOCK, SUBDIVISION or
PROPERTY ID #: 27 character ID number for property. (Health Department may require property appraiser ID# or
section /township /range /parcel number.)
SYSTEM DESIGN AND
SPECIFICATIONS:
TANK: Minimum specifications from Chapter 10D -6, FAC.
DRAINFIELD: Minimum specifications from Chapter 10D-6, FAC.
OTHER: Other specifications, such as operating permit requirements, low- volume flush toilets, variance provisos.
SPECIFICATIONS BY: Name of individual providing specifications. If designed by a registered engineer must be sealed.
APPROVED BY: County Health Department personnel reviewing and approving permit.
DATE ISSUED: Date permit is issued by County Health Department.
•
EXPIRATION DATE: One year from date issued if the system has not been installed. Permits for system repairs become void 90 days from the
date issued.
BUILDING
ELECTRICAL
PLUMBING
Work Rio be performed under this Permit
•
1
Building
Owner of
Architect
Contractor
or Builder
Legal
Description
Address of
Building
Lot j-
,CONTRACTOR QR BUILDER
t
MIAMI SHORES VILLAGE, FLORIDA_
DATE
PERMIT N° 2385
Contractor's '
License No.
Subdi
vision
.a
r
Value of Amt. of .' i`: . --
Project Permit • • -- f.
194
This peril% t is ranted to the contractor or builder named above to construct the building or to install the equipment or device described in the
application herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance
with any plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may
be revoked at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition
upon which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of
the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and
that he assumes responsibility for work done by his agents, servants or employees.
Signed- By t
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 regula.
tions pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores
Village. In accepting thisyermit I assume responsibility for all work done by either myself, my agent, servant or employee.
BY
AUTHORITY
BUILDING
ELECTRICAL
PLUMBING
j/
Owner of
Building
Architect
Contractor
or Builder
Legal Lot
Description
Address of �,
Building
PERMIT N° 2407
Work to be performed under this Perini
MIAMI SHORES VILLAGE, FLORIDA
1f
BL
Subdi-
vision
Value of
Project
DATE
Contractor's
License No.
[Amt. of
Permit
i f
r
c
t, .
194_
This permit is granted to the contractor or builder named above to construct the building or to install the • equipment or device described in the
application herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance
with any plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may
be revoked at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition
upon which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of
the ordinances and regulations pertaining to the work covered hereby whether shown on th i dr ings,or in the statements or specifi9ations and
that he assumes responsibility for work done by his agents, servants or employees. f
Signed- ll ../0i
i_ 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 regula-
tions pertaining thereto and in strict conformity with the plans, drawings, stateifients or specifications submitted to the proper authorities of Miami Shores
Vill E" ,In accepting this permit I assume responsibility for all work done bVeith r myself, my agent, servant or employee.
e.1 f
CONTRACTOR OR BUILDER t BY AUTHORITY
Lot
- .,
Owners Name 14c.NO - - Add or
GertAAL E fr la.
E — Contra - c - ter IT.c.No. Ad
Cub.Cont. 20 " -3 7
Zone' ;Cu.Ft.d/4,
Plat Restriction Chkd. By
To Planning Board 4;
Re-Submitted to P.B,
Plans & Spec. checkedby
To Council
MiSe1.51' "
New Const.
Sub 'vision
Approved
Ap p r ovc d
Approved
luna
ree
Rejected
Rejected
Rejected
Bldg.Permit No. 23 3 4 i Date 4 - 2. ‘-g/ - Fee // 0 f ) Cost &, YOO "
T y p e C__7. a . /f Stories Roof
New Construction Al teratioris
Plumbing Permit No.,2 3 kJ" Date 7-/ 4/ Fee
.......4--------
Septic Tank /1 It It
Sewer it
It
7 - -
2.,4
Fee c5V-P
Electrical Pormit NO.
' Fixturos
Heater - ,...
MO tarS
Hi sc 1 . -
New Construction
lui I di ng Insp. ...- ...-,-- 56.-t *-' 7 - BT 0.1fisp. ),.
y,,J4qi,iri6 t
4 I /1111r
- .
- .
I '
BeaitiW` L & 'Lintels
Clean-Up
'lumbing Ins.
Fiiss
s _
Septic
HZ t r,
Final 6 ertirl.:d':,
ectrical Insp..
Roughing
FixtUres
Final
Date By
ea
.0
12VAISP7fiert
•
r14.tfo n
...■•■■•■■■
By -Insp.
%a -
, ,,aarikze
Ra-Insp
- •
- If
orvica 0. K. to.g Co..-» .0f 0.ccup . Issued
R
. .
13y; - Re- Insp. By
•
By RO-qtrSt'i,. By„ •
- • -
N° • 231
CERTIFICATE OF OCCUPANCY
MIAMI SHORES VILLAGE, FLORIDA
BUILDING DIVISION
Nam' Shors Villag - Fla.,
E /0
Owner, Agept gr1'ant of Building
,��� .r
Lot ---- Block
Street Address
Approved use by occupancy
Remarks:
This Certificate of Occupancy is issued to the above named
for building at above named location only upon the express provision that the applicant will
abide by and comply with all conditions of Ordinances Nos. 92, 93, 94 and 97, known as the
Zoning, Electrical, Plumbing and Building Ordinances of Miami Shores Village pertaining to e
erection, construction, alteration or remodeling of buil s gr structu
�,;,' BUILDING DIV ION
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
se
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 regula-
tions 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 the work.
'
Date_____,._____ = - _ — — , 19"_ r-
w No. -! r -` _ Street' .41 `
/
I a' ` , , '
Name and address of licensed contractor • + / ' ` Y
Location and legal description of lot to be bu on:
Lott - _/....." ` ` Block__—___— _____. Subdivision
Street and Nurhber where work is to be done (i. -- , .L f `-
/
Owner's Name and Address
Registered Architect and /or Engineer
State work to be done and purpose of building (by floors)
1 *I
' k
and for no other purpose.
New Building_____ ____— _— _______ Remodeling_ __ Addition_ Repairs No. of Stories__
• .
To be constructed of_____ Kind of foundation . R Roof Covering___
/ .—
Estimated Total cost of improvements $ _ - __Amount of Permit $
Zone cubage required ✓ —Plan Cubage - .___, ---
Distance to next nearest building Size of Building Lot
Maximum live load to be borne by each floor
I hereby submit all the plans and specifications for said building. All notices w reference to the building and its construction may
be sent to (' - - t
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 complied with the provisions thereof, and will require similar compliance from pit contractors or sub - contractors employed by him
in the work to be performed under this permit; and will post or ciuse to be posted forAnspectign the site of the work such public notice
or notices as are required by the Act. The undersigned agrees to employ only such au} contra ors, on work to be performed under this
permit, as are licensed by Miami Shores Village.
Remarks (Signed)
STATE OF FLORIDA,
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally
appeared
• Y
and who, being by me first duly sworn, upon oath deposes and says that be is the
of the above described construction, that he has carefully read the foregoing application, and that be did sign the same, and that all facts
therein by him stated are true. [�
Permit No._ _ —rte Date T� Read, Sworn to and Subscribed before me.
Disapproved
(Signed)
Building Inspector
Date
ANNING BOARD
r
Notary Public, State of Florida
Commission Expires_
DATE
Chairma �� ' Member
Membe `� ='�� F/� Member
Member Member
Council Approved_
Date
to me well known,
Disapproved _D
NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has been obtained from
the Planning Board.
A re- inspection fee of $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty
materials and/or workmanship.
•
Owner's Name and Address
Amount of Permit
STATE OF FLORIDA, k
COUNTY OF DADE.
My Commission Expires
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
4
Permit No.. = _A_
No Street__
_(Signed)
(Signed) i i 11 ___:_1___ — _
Notary Public. State of Florida
Date , V • T
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith bmitted for the building or other
structure herein described. This application is made in compliance and conformity with the Building Ordin e 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.
Registered Architect and/or Engineer
Employing Plumber's Name ____ _ r' � _ No ___/ Street _____4__= �________ -- ___ice.
F.)) 7 6./7 � „ J . Aa -- - 7- C '
Location and Legal Descripti Lot_ ,
�__ __
__Y:_�_____.__ _ ______Bloc ___,.Z — Subdivision _Ys-- _�_x;jr ,L ___ !.
r
Street and Number where work is to be performed— No.__ _X4 - 4 . - . 7 __, . /e Street ____________ __-____ _____- __ ____ _------ _- __________
State work to be performed and purpose of building (By Floors)
New Building —____ __ Remodeling Addition Repairs No. of Stories
`
Size Septic Tank____ Type of Tank .___ r ' Y _ te'l , __ 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 _____ __ __________
__ ________________________�_ —___.
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 under signed agrees to employ only such sub - contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village.
M er Plumber.
Before me, •the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally
appeared
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the .
of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty
materials and /or workmanship.
CLOSETS
BATH
TUBS
SHOWERS
LAVA.
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TUBS
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT•NS
TOTAL
FIXTURES
CONTR.
LIST
3
J
/
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
DEEP
WELL
SPRKLR.
SYSTEM
SWIM'G
POOL
CONTR.
LIST
/
f
CHECK
•
Owner's Name and Address
Amount of Permit
STATE OF FLORIDA, k
COUNTY OF DADE.
My Commission Expires
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
4
Permit No.. = _A_
No Street__
_(Signed)
(Signed) i i 11 ___:_1___ — _
Notary Public. State of Florida
Date , V • T
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith bmitted for the building or other
structure herein described. This application is made in compliance and conformity with the Building Ordin e 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.
Registered Architect and/or Engineer
Employing Plumber's Name ____ _ r' � _ No ___/ Street _____4__= �________ -- ___ice.
F.)) 7 6./7 � „ J . Aa -- - 7- C '
Location and Legal Descripti Lot_ ,
�__ __
__Y:_�_____.__ _ ______Bloc ___,.Z — Subdivision _Ys-- _�_x;jr ,L ___ !.
r
Street and Number where work is to be performed— No.__ _X4 - 4 . - . 7 __, . /e Street ____________ __-____ _____- __ ____ _------ _- __________
State work to be performed and purpose of building (By Floors)
New Building —____ __ Remodeling Addition Repairs No. of Stories
`
Size Septic Tank____ Type of Tank .___ r ' Y _ te'l , __ 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 _____ __ __________
__ ________________________�_ —___.
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 under signed agrees to employ only such sub - contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village.
M er Plumber.
Before me, •the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally
appeared
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the .
of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty
materials and /or workmanship.
Permit" No..____
New Building_____ —_ _ ____ Remodeling
Size Septic Tank —__ _______ Type of Tank .
Feet of Drain Tile_
Amount of Permit $__
My Commission Expires
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Addition Repairs
f
Date
Application is hereby made for the approval of the detailed statement of the plans and specifications her ewi ubmitted or the
building or other
structure herein described. This application is made in compliance and conformity with the Building Ordinaoe 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 __ No Street
Registered Architect and /or Engin er __ 1___________
Employing Plumber's Name _–___'
Location and Legal Descriptill Lot_ __le_
State work to be performed and purpose of building (By Floors)
s�
Capacity Gals
Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City —Well. Size of Soakage Pit
No. of Stories
(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 under signed agrees to employ only such sub - contractors, on work to be performed under this .'rmit, as are
licensed by Miami Shores Village.
, ..��
(Signed) 4 474V__
f` .. llf er Plumber.
STATE OF FLORIDA, ( f
COUNTY OF DADE. ss. �f
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 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
- TUBSS
SHOWERS
LAVA-
TORIES
SINKS
SLOP
SINKS
LAUNDRY
TUBS
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT'NS
TOTAL
FIXTURES
CONTR. IST
L IST
/
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..____
New Building_____ —_ _ ____ Remodeling
Size Septic Tank —__ _______ Type of Tank .
Feet of Drain Tile_
Amount of Permit $__
My Commission Expires
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Addition Repairs
f
Date
Application is hereby made for the approval of the detailed statement of the plans and specifications her ewi ubmitted or the
building or other
structure herein described. This application is made in compliance and conformity with the Building Ordinaoe 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 __ No Street
Registered Architect and /or Engin er __ 1___________
Employing Plumber's Name _–___'
Location and Legal Descriptill Lot_ __le_
State work to be performed and purpose of building (By Floors)
s�
Capacity Gals
Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City —Well. Size of Soakage Pit
No. of Stories
(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 under signed agrees to employ only such sub - contractors, on work to be performed under this .'rmit, as are
licensed by Miami Shores Village.
, ..��
(Signed) 4 474V__
f` .. llf er Plumber.
STATE OF FLORIDA, ( f
COUNTY OF DADE. ss. �f
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 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.
(
/,
•
/
7718 N. E. 2ND AVENUE PHONE 7-5284
MIAMI, FLA.
„
—
/ 6
• ** co .?
JOHN F. GAFFNY
PLUMBING CONTRACTOR
f .
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-
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.11■1•011
permit No. - - -`"� `_', /i Date
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the /buildin¢�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, w ether 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 2 No 7 1'
Registered Architect and /or Engineer
Employing Electrician's Name _
Location and Legal Description Lot
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
1
State work to be performed and purpose of building (By Floors)
New Building____ Remodeling
•
No. ____ tre t_
Block Subdivision_ � - - -r�
Street and Number where work is to be performed —No _
Addition Repairs No. of Stories.
Service Overhead Size Feeders Conduit
Un rground
Type of Installation— Conduit Tubing
Amount of Permit $
My Commission Expires
" L.
Main Sw Amps. Main Fuses / ,Amps.
B.X.L. Metal Moulding
Street __ ' ______f1 / 2p; --
ectrical 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 under signed agrees to employ only such sub - contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village.
(Signed)
aster El ctnc n.
STATE OF FLORIDA,
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally
appeared
to me well known, and who, being by me first duly sworn, upon oath deposes and says that be 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 b}Yhim 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.
SWITCH
OUTLETS
- -
/ // /
LIGHT
OUTLETS
/ • // /
PLUG
R
�
FIXTURES
NO.LAMPS
REFRIG.
OUTLET
/
IRON
OUTLET
/
RANGE
OUTLET
j / l
RANGE
CONN.
WATER
HEATER
W. HEAT.
CONN.
!/
SPACE
HEATER
STRIP
HEATER
TOTAL
CONTR.
LIST
CHECK
ENT.
SW.
DIST.
CAB.
SERVICE
TEMP.
SERVICE
PERM.
MOTORS
0-1 HP
MOTORS
1 -5 HP
NEON
TRANS.
RADIO
TOTAL
CONTR.
L151'
CHECK
permit No. - - -`"� `_', /i Date
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the /buildin¢�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, w ether 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 2 No 7 1'
Registered Architect and /or Engineer
Employing Electrician's Name _
Location and Legal Description Lot
MIAMI SHORES VILLAGE
ELECTRICAL INSPECTION DEPARTMENT
APPLICATION FOR ELECTRICAL PERMIT
1
State work to be performed and purpose of building (By Floors)
New Building____ Remodeling
•
No. ____ tre t_
Block Subdivision_ � - - -r�
Street and Number where work is to be performed —No _
Addition Repairs No. of Stories.
Service Overhead Size Feeders Conduit
Un rground
Type of Installation— Conduit Tubing
Amount of Permit $
My Commission Expires
" L.
Main Sw Amps. Main Fuses / ,Amps.
B.X.L. Metal Moulding
Street __ ' ______f1 / 2p; --
ectrical 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 under signed agrees to employ only such sub - contractors, on work to be performed under this permit, as are
licensed by Miami Shores Village.
(Signed)
aster El ctnc n.
STATE OF FLORIDA,
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally
appeared
to me well known, and who, being by me first duly sworn, upon oath deposes and says that be 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 b}Yhim stated are true.
Notary Public. State of Florida
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty
materials and /or workmanship.
Permit No.
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 cpspplied with, whether herein specified or not. A copy of approved plans and specifications must be kept at
building during progress of work
'__ ___ No.___9__ / _E •
Registered Architect and /or Engineer _____ _____— _____________ ___ ___ _LC-�, <ch_ —_ _:_- te...- --
Employing Plumber's Name — No._____ F J_ /_____LIL Street___.
Location and Legal Description Lot_— _Z C ___________Block____ Subdivisio
Street and Number where work is to be performed —No._ 4 l___l -C___L ____-_________— _ —__—_ treet 7 0 ,Z__ -
State work to be performed and purpose of building (By Floors) ______
Owner's Name and Address
Amount of Permit S_
under
plied with the provisions thereof,
performed under this permit; and
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
(Signed)
New Building___— Remodeling __ Addition____ Repairs No. of Stories
Size Septic Type of Tank _
Date
Feet of Drain Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City —Well Size of Soakage Pit
V/
Street___ _ •
Capacity
required by the Act. The under signed agrees to employ only sub - contractors, on weik^ to ,be perfo d this
licensed by Miami Shores Village. l < !,�
My Commission Expires Notary Public. State of Florida
Plumbing Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor
the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has com-
and will require similar compliance from all contractors or sub - contractors employed by him in the work to be
will post or cause to be posted for inspection on the site of the work such public notice o
Ig tires as are
rmtt, ;
(Signed) _______ ':
.� /
STATE OF FLORIDA, •
COUNTY OF DADE. ss.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally
appeared
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the
of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty
materials and /or workmanship.
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.
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 cpspplied with, whether herein specified or not. A copy of approved plans and specifications must be kept at
building during progress of work
'__ ___ No.___9__ / _E •
Registered Architect and /or Engineer _____ _____— _____________ ___ ___ _LC-�, <ch_ —_ _:_- te...- --
Employing Plumber's Name — No._____ F J_ /_____LIL Street___.
Location and Legal Description Lot_— _Z C ___________Block____ Subdivisio
Street and Number where work is to be performed —No._ 4 l___l -C___L ____-_________— _ —__—_ treet 7 0 ,Z__ -
State work to be performed and purpose of building (By Floors) ______
Owner's Name and Address
Amount of Permit S_
under
plied with the provisions thereof,
performed under this permit; and
MIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
(Signed)
New Building___— Remodeling __ Addition____ Repairs No. of Stories
Size Septic Type of Tank _
Date
Feet of Drain Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City —Well Size of Soakage Pit
V/
Street___ _ •
Capacity
required by the Act. The under signed agrees to employ only sub - contractors, on weik^ to ,be perfo d this
licensed by Miami Shores Village. l < !,�
My Commission Expires Notary Public. State of Florida
Plumbing Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor
the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and has com-
and will require similar compliance from all contractors or sub - contractors employed by him in the work to be
will post or cause to be posted for inspection on the site of the work such public notice o
Ig tires as are
rmtt, ;
(Signed) _______ ':
.� /
STATE OF FLORIDA, •
COUNTY OF DADE. ss.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally
appeared
to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the
of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty
materials and /or workmanship.
Too
JOB:
BUILDING
ELECTRICAL
PLUMBING
• •
• •
• •
• •
• ••
• •
4• •
• •
• •
• •
• •
•
• •
. .
• •
AD:
WORK
DONE BY:
REQUEST]
The following is ready for Inspection:
Inspector's Report:
: WILL BE READY
t ,'
JOB: t
BUILDING
PLUMBING
•
ELECTRICAL
Inspector's Report: -
. 41 G4.... r PC.4
* .f
•
•
•
▪ WORK
• • DONE BY:
• :
• :
•
•
•
•
The following is ready for Inspection:
AD: � /
REQUESTED
: WILL BE READY
•
•
•
•
d
f
•
•
JOB:
BUILDING
PLUMBING
le
ELECTRICAL
•
•
•
•
WORK
AD:
•
•
The following is ready for Ins.p3ction:
Inspector's Report:
DONE BY:
REQUESTED : WILL BE READY
• • •
•
• • •
•
•
• •
•
• 4-
-
JOB:
BUILDING
ELECTRICAL
PLUMBING
Inspector's Roport:
••
AD:
WORK
DONE BY:
REQUESTED
•
• • • •
•• •
• •
▪ •
•
• : •
•
• •
The following is ready for Inspection:
•
: WILL BE READY
•
•
•
=
• /
JOB:
BUILDING
ELECTRICAL
PLUMBING
• -'
Inspector's Report:
The following is ready for Inspiction:
AD:
WORK
DONE BY: Lt s t..
• • • REQUESTED : WILL BE READY
• •
•
•
•
• •
ION
r
1
•
JOB:, (U., 1, \ er. AD ,P L/ Ld7j f
BUILDING
ELECTRICAL
PLUMBING
Inspector's Report:
•
WORK
• DONE BY:
The following is ready for Inspection:
REQUESTED
: WILL BE READY
7// , ‘AL/
. 2 /‘ #)v7.
JOB:
BUILDING
PLUMBING
•
•
•
•
ELECTRICAL
:
•
•
Inspector's Report:
y—
WORK
• DONE BY:
•
•
The following is ready for Inspection:
AD: �� )1r El ,'
REQUESTED
• •
• •
W LL BE READY
t...4
M
•
JOB:
BUILDING
•
•
ELECTRICAL
PLUMBING
/// • �'. '.
•
•
•
•
f -
" The following is ready for Inspection:
Inspector's Report:
•
•
•
•
:
AD:
WORK
• DONE BY:
. : REQUESTED
: WILL BE READY
•
•
•
•
•
1
./ .
I
f /
41
'
2 ..;►.. ;
r
.f'
r.
P
Permit No
1
y1
Owner's Name and Address ___
Registered Architect and /or Engineer r �`'�'►�
Employing Plumber's Name
Location and Legal Description
Street and Number where work is to be performed —No l ' �?I _C -
State work to be performed and purpose of building (By Floors)
Amount of Permit $_ !'__
MIAMI SHORES VILLAGE
My Commission Expires
PLUMBING INSPECTION DEPARTMENT
No
_ (Signed)
APPLICATION FOR PLUMBING PERMIT
0
•
Date
Application is hereby ma 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 c plied with, whether herein specified or not. A copy of approved plans and specifications must be kept at
building during progress of work /
f
- 1 •
No Ac - - - -- — f
J � /�i Street--- - -9
Notary Public. State of Florida
Street_ _ ° �e'"'
Subdivisions!
Street-- -- 1�=------ - - - - --
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
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 .ublic notice o ices as are
required by the Act. The under signed agrees to employ only„...such sub - contractors, on w 7 tobe rf•vl d . his rmil, js
licensed by Miami Shores Village. CC..a�a �, 1.. •"'
STATE OF FLORIDA,
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer- oaths and take acknowledgments, personally
appeared w_______
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
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
1
y1
Owner's Name and Address ___
Registered Architect and /or Engineer r �`'�'►�
Employing Plumber's Name
Location and Legal Description
Street and Number where work is to be performed —No l ' �?I _C -
State work to be performed and purpose of building (By Floors)
Amount of Permit $_ !'__
MIAMI SHORES VILLAGE
My Commission Expires
PLUMBING INSPECTION DEPARTMENT
No
_ (Signed)
APPLICATION FOR PLUMBING PERMIT
0
•
Date
Application is hereby ma 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 c plied with, whether herein specified or not. A copy of approved plans and specifications must be kept at
building during progress of work /
f
- 1 •
No Ac - - - -- — f
J � /�i Street--- - -9
Notary Public. State of Florida
Street_ _ ° �e'"'
Subdivisions!
Street-- -- 1�=------ - - - - --
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
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 .ublic notice o ices as are
required by the Act. The under signed agrees to employ only„...such sub - contractors, on w 7 tobe rf•vl d . his rmil, js
licensed by Miami Shores Village. CC..a�a �, 1.. •"'
STATE OF FLORIDA,
COUNTY OF DADE.
Before me, the undersigned authority, a notary public, duly authorized to administer- oaths and take acknowledgments, personally
appeared w_______
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.