1480 NE 102 ST PLUMBINGMIAMI SHORES VILLAGE,
PLUMBING INSPECTION DEPARTMENT
APPLICATION FOR PLUMBING PERMIT:1
Permit -s
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 Shares 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 k.
Owner's Name and Address_ y 46 ,V-,S n Street—.
Registered Architect and/or
Employing Plumber's Name -
a, C, No to
Lon and Legal Description Lot Street and Numb-or where vork is to be Iked-No- ��Str
Static work to be performed and purpose of building (By Flom)
Now Building— er
—AddIt:ion------ No. of Stories... -.-.-1
Sim Septic -- - ----- - -Type, of Tank— —_-Capacity Gals.
Feet of Drain
Nature of Water
Amount of Permit
Feet of Tank or Drain Field from Well_ ..... . .
Sizo, of Soakage Pit_
(Signed)
Plumbing hispector.
The undersigned applic�nt 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 " being Section 5985. Compiled General Laws of Florida Permanent Supplement, and has com-
plied with the provisions thqrsof, and will require similar compliance from all contractors or sub-contractors employed by him in the work to be
performed under this permiti, and will post or cause to be posted for inspection on the site of the work such public notice or notices as are
reqWred by the A& The undersigned agrees to employ only such subcontractors, on work to be performed under this permit, as are
licensed by Mimi Shores Village.
(signed)_._..._. (J Motor Plumber.
STATE OF FLORMA,
COUNTY OF DADE. "7,
Before me, the imdersij Aed authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
to me well known, and who, being by me first "y sworn, upon'cath deposes and. says that he is .... . ..
tithe above described that he has carefully read the foregoing application, and �� he did sign the same, and that A facts
therein by him stated we trae.
My Expires Notary Public, State of Florida
N,(,,T7EE: A w," fee of $1.00 witbe made when such io4aspection is made•necessary by improper notice for Inspection, or faulty
_j and/or worlinanship.
LA
CLOSETS
OATH
TUBS
1(SHOWERS
LAVA-
TORIES
SINKS
SLOP LAUNDRY
SINKS Tuns URINALS
CATCH
BASIN
FLOOR
MAIN
DRINKING
FouNT'NS
TOTAL
FIXTURES
CONTH.
CHEM
SEPTIC
SEWER
DRAIN
SOAKAGE
GREASE'
40"VI1 DEEP SPRKLR.
SWIM*G
TANK
CONN.—
FIELD
PIT
TRAP
HEATER WELL SYSTEM
POOL
I!
CONTR.
LIST
P
CHECK
Sim Septic -- - ----- - -Type, of Tank— —_-Capacity Gals.
Feet of Drain
Nature of Water
Amount of Permit
Feet of Tank or Drain Field from Well_ ..... . .
Sizo, of Soakage Pit_
(Signed)
Plumbing hispector.
The undersigned applic�nt 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 " being Section 5985. Compiled General Laws of Florida Permanent Supplement, and has com-
plied with the provisions thqrsof, and will require similar compliance from all contractors or sub-contractors employed by him in the work to be
performed under this permiti, and will post or cause to be posted for inspection on the site of the work such public notice or notices as are
reqWred by the A& The undersigned agrees to employ only such subcontractors, on work to be performed under this permit, as are
licensed by Mimi Shores Village.
(signed)_._..._. (J Motor Plumber.
STATE OF FLORMA,
COUNTY OF DADE. "7,
Before me, the imdersij Aed authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
to me well known, and who, being by me first "y sworn, upon'cath deposes and. says that he is .... . ..
tithe above described that he has carefully read the foregoing application, and �� he did sign the same, and that A facts
therein by him stated we trae.
My Expires Notary Public, State of Florida
N,(,,T7EE: A w," fee of $1.00 witbe made when such io4aspection is made•necessary by improper notice for Inspection, or faulty
_j and/or worlinanship.
LA
Permit No.__ -*'-- CJ ?' -E-
Application is hereby made
structure herein described. I
and all provisions of the La,
of Miami Shores Village sh
building during progress of
Owner's Name and
Registered Architect and /or
MIAMI SHORES VIL1 AGE.
PLUMBING INSPECTION DEPARTMEW
APPLICATION FOR PLUMBING `N.k *1T
Date — Z-2
r the approval of the detailed statement of the plans and specifications herewith submitted for the building or other
s application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida,
of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Dh ision
be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at
No. ._-__-___-__-___ Street-_____ __— _.___—_----- ..____..........
Employing Plumber's Name___ No-
Location and Legal Demos' Lot— .., Rim& Su
Street and Number is to be poked-No
State work to be performer land purpose of building (By Floors) _ --
New Buil g Remodeling- Addition_ -- Repairs — _______.._. No. of Stories_ -_ ......
Size Septic T , Type of T - _— __Capacity Gals•----- -
Feet of Drain Tile A. Feet of Tank or Drain Field from Well.________T _ _- ____— _-- ----------- —
Nature of Water Supply:
of Soakage Pit— _ __ _ _ _ __ ..........
Amount of Permit $ ( signed) _ _ ___............ _ ..........
Plumbing Inspector.
The undersigned app t for this building permit does bereby certify that he understands and aeoepts his obligations as an employer of labor
under the Florida Worlanen s Compensation Act, being Section 5988, Compiled General Laws of Florida Permanent Supplement, and has eon-
plied with the provisions th eof, and will require similar compliance from all contractors or sub- contractors employed by him in the work to be
performed under this perms •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-contrjWm on to o t, as are
licensed by Missal shores
Master Plumber.
STATE OF FLORIDA, 1 a&
COUNTY OF DADE. j
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
to miheewell imown, and ho' being by me first duly sworn, upon oath deposes and-says that he is the - .__._.______ _�__. --
that he has carefully read the foregoing appli cation, and that he did sign the same, and that all facts
therein by him stated are true.
My � �wn fission Expires Notary Public, State of Florida
NOTE: A re- ' fee of $1.00 will be made when such re- inspection is made-necessary by Improper notice for inspection, or faulty
materials and /err p.
CLOSETS
BATH
j SHOWERS
LAVA-
SINKS
SLOP
LAUNDRY
URINALS
CATCH
FLOOR
DRINKING
TOTAL
TUBS
TORIES
SINKS
Tune
BASIN
DRAIN
FOUNT•NS
FIXTURES
CONTR.
LIST
CHECK
SEPTIC
SEWER
DRAIN
.SOAKAGE
GREASE'
SOLAR
DEEP SPRKLR.
SWIM•G
TANK
CONN.
F, IELD
PIT
TRAP
HEATER
WELL SYSTEM
POOL
ONTR
LT
CHECK
Size Septic T , Type of T - _— __Capacity Gals•----- -
Feet of Drain Tile A. Feet of Tank or Drain Field from Well.________T _ _- ____— _-- ----------- —
Nature of Water Supply:
of Soakage Pit— _ __ _ _ _ __ ..........
Amount of Permit $ ( signed) _ _ ___............ _ ..........
Plumbing Inspector.
The undersigned app t for this building permit does bereby certify that he understands and aeoepts his obligations as an employer of labor
under the Florida Worlanen s Compensation Act, being Section 5988, Compiled General Laws of Florida Permanent Supplement, and has eon-
plied with the provisions th eof, and will require similar compliance from all contractors or sub- contractors employed by him in the work to be
performed under this perms •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-contrjWm on to o t, as are
licensed by Missal shores
Master Plumber.
STATE OF FLORIDA, 1 a&
COUNTY OF DADE. j
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
to miheewell imown, and ho' being by me first duly sworn, upon oath deposes and-says that he is the - .__._.______ _�__. --
that he has carefully read the foregoing appli cation, and that he did sign the same, and that all facts
therein by him stated are true.
My � �wn fission Expires Notary Public, State of Florida
NOTE: A re- ' fee of $1.00 will be made when such re- inspection is made-necessary by Improper notice for inspection, or faulty
materials and /err p.
Date ° a. I �'> Job
Legal Description
OwnerAAssee / Tenant �R i
Owner's Address I''kI .
Contracting Co: h6 ( 1n
Qualifier . nni� h
State* 0,-FCC) I�`i, =_
Arclritect/Engineer�
Bonding Company
Mortgagor
Permit Type (circle one):
WORK DESCRIPTION.
Square Ft
APPLICATION FOR MIAMI
),441nC- N-E 102' 2,-.', Tax Folio,
IIrstorically Designated: I
Master
Phone
;Vnre,�� Plumb i Address qQC
Lrx a ih 1 n
Municipal # n l j;-,' Competency # Ck—(�(
Address
Address
Address
MMDING ELECTRICAL LUMBING_ MECHANICAL
'ice P i 2-e i-on-i — r ►�V i G�
Estimated Cost (value) —
VILLAGE
No
t#
v' I y �`i �4- r-n i , FL
Phone (3M-)' -q5 I
Ins. Co.
PAVING FENCE SIGN
iV'—�
WARNING TO OWNER: 1 YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY
RESULT IN YOUR PAYING TWICE FOR EMPROVEMENVTS TO YOUR PROPERTY (IF YOU INTEND TO OBTAIN FINANCING,
CONSULT WITH YOUR.)d.ENDER 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, anti 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 MEC CAL WORK
OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work M11 be done in compliance with all applicable
laws / ��tstructi Wing. Furthermor , I authorize the'above -named contractor to d the work stated.
of owner and/or
--`
�,, () r
as to
President Date Signs a of Contractor o, Owner- der Date
as r es Date der Date
-- r
FEES: PERMIT W-) RADON C.C.F. i'� (p NOTARY
APPROVED:
Zoning Building Elec
Mechanical Plumbing E
r
cla E SuviDage
Commission CC661145
rtes AugM 16.2001
BOND
20
TOTAL DUE._ —�
ADDENDUM TO BUILDING PERMIT APPLICATION
'(AN APPLICATION FOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. IF A MASTER PERMIT HAS BEEN
OBTAINED, THE OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.)
PLUMBING ELECTRICAL MECHANICAL
ITEM
BATH TUB
UNIT
FEE
ITEM
SNITCH OUTLETS
UNIT
FEE
ITEM
SPACE HEATERS
LIMIT
FEE
BIDET
LIGHT OUTLETS
CENTRAL HEATING
DISHWASHER
RECEPTACLES
A/C (WINO)
OISP(m
SERVICE TEMPORARY
A/C (CENTRAL.)
DRINKING FOUNTAIN
SERVICE SIZE IN AMPS
OLICT WORK
FLOOR GRAIN
SERVICE REPAIRAETTER CHANGE
REFRIGERATION
GREASE TRAP
APPLIANCE CUMETS
PROCESS AND PRESS PIPING
INTERCEPTOR
RANGE TOP
UNOERGROIAO TANKS
LAVATORY
OVEN
ABOVE GlIOUND TANKS
LAMY TRAY
WATER HEATER
U.F. PRESSURE VESSELS
CLOTHES WASHER
MOTORS O- 1 NP
STEAM BOILERS
son
MOTORS OVER 1- 3 FP
HOT WATER BOILERS
SINK, POT/3 COMP.
MOTORS OVER 3- 5 HP
MECHANICAL VENTILATION
SINK, RESIDED
MOTORS OVER 5- 8 HP
TRANSPORTING ASSEMBLIES
SINK, SLOP
MOTORS OVER 8- 10 HP
ELEVATORS/ESCALATORS
TEMPORARY WATER C.OSET
MOTORS OVER 10- 25 HP
FIRE SPRINKLER SYSTEMS
URINAL
MOTORS OVER 25-100 FP
COOLING TOWERS
WATER CLOSET
MOTORS OVER 100 FP
VIOLATION
INDIRECT WASTES
A/C WINDOW
REINSPECTION
WATER SUPPLY TO:
AIR CONDITIONERS
A/C UNIT
STRIP HEATER
FIRE SPRINKLER
GENERATORS TRANSFORMERS
HEATER -NEW INST.
GENERATORS TRANSFORMERS
HEATER - REPLACE
GENERATORS TRANSFORMERS
LAWN WRIKERWELL
SPECIAL PURPOSE
SWIMMING Pam
OUTLETS COMMERCIAL
WATER SERVICE
SIGN TUBES
SEWER CONNECTIONS
SIGN TRANSFORMERS
UTILITY -SEWER
SIGN TIME ROCK
UTILITY -WATER
F IXTR>FRES
SEPTIC TANK
ANTENNA
RELAY
TELEVISION OUTLETS
ORAINFIELD, 4' TILE/RES.
VIOLATION
PUMP 5 ABANDON SEPTIC TANK
REINSPECTION
SOAKAGE PIT CU. FT.
CATCH BASIN
DISCHARGE WELL
DOMESTIC WELL
AREA C RAIN
ROOF INLI T
SOLAR WATER HEATER
FIRE STANDPIPE
POOL PIPING
LAWN SPRINKLER SYSTEM
GAS RANGE
METER SET (GAS)
GAS PIPING