1263 NE 92 StMIAMI SHORES VILLAGE
PLUMBING INSPECTION DEPARTMENT .
APPLICATION FOR PLUMBING PERMIT
- - — ----
Date ---
---- ---------- - - - ------------------- ----
---------
Permit No ........ . x1--/-ZX. h submitted for the building or other
Application is hereby made for the approval of the detailed statement of the plans and specificatjo* her ewit
structure herein described. This application is made in compliance and conformity with the BuildQ Ordinance of Miami Share.-; Village, Florida,
and all provisions of the Laws of the State of Florida, all ordinances of khami Shores Village and all rules and regulations of the Building Division
of Mianii Shores Village shall Ile 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 ------ ------------------- No
------------- ---------- ----------------------- --
13 istered Architect and/or — --- — -----
Employing Plumbers Name ------- -------- No..4; Street
...... ... Subdivision - - -.- — ------
Location and Legal Description Lot...______. 6{
-----------
----------------------------------
Street and Number where work is to be performed—No. Street --
y Flows) ------------
State work to be performed -and purpose of building (B
New Building----��— Remodeling.-.-.. - - -------- Addifion- Repairs -------------------------- No. of Stories— -,-1-
-------------
�
1
LAVA'
_
SLOP LAUNDRY I I L-.N DR
y URINALS CA : FLOOR
DRINKING
FEES
I � I N K- �SI N KS TU BS BASIN 1 D R FoUNT'NS
CLOSETS1 TUBS � SOWERS �TOR 'E.
CONTR.
LIST
CHECK SOAKAGE GREASE SOLAR DEEP PRKLR. SW I WG
SEPTIC SEWER DRAIN HEATER WELL SYSTEM POOL
TANK CONN. FIELD PIT TRAP
CONTR. jI
CHECK
01
of Tank,----7 ---------------
Sin Septic Tank ----------
:V Dist, Feet of Tank or Drain Field from Well.
Feet of Drain Ti1c.. *�.,011 �11
Of Soakage
Nature of Water supply: City—well,-�---"
(Signed)
Amount of Permit Plumbing Inspector.
t does hereby certify that lie understands and accepts his ohligllt ons its an employer of labor
applicant for this building permit anent Supplement, and has The undersigned en's Compensation Act, being Section 59.66, Compiled Geii6ral Laws of Florida Perm
under the Florida Workno and will require similar compliance from all contractors or sub-conLractors employed by hini in the work to be
plied wit], the provisions thereof, sp.ection on the site of the work nich Public notice or notices as ire
permit; and will post or cause to be posted for in be perforined under this vennit, as are
performed under this ploy only such sub-contractors, on work' to
required by the Act. The undersigned agrees to cul
licensed by Miami Sh ores Village.
-�h- -ber.
(Signed)---------
-kas 11
STATE OF FLORIDA, I ss.
COUNTY OF DADE. rized to administer oaths and take acknowledgments, personally appeared
Before me, the undersigned authority, a notary public, duly autho
---------- -- ----- ---------- ------------ --
--- ----- • -..... ------ -------
d who, being by me first duly sworn, upon oath deposes and says that lie is the ------ I did ----------- d ----------------------------------------------
to me well known, an n, that he has carefully read the foregoing application, and that e sign e same, and that all facts
of the above described construction,
therein by him stated are true.
------------------- --- T—ubfic, --
r_ tate of Florida
------ I ----- Rotai�
My Commission Expires
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.
MIAMI SHORES VILLAGE, FLORIDA
lUrLDING
El
',LECTRICAL
L-] PERMIT No
1UMBING
17
Work to be performed under this I
)wner of
l
,wilding
-
Iachitect
:ontrcactor
r Builder_
9911
DA'
.1
Contractor's
License No-
195
Subdi.
egcd Lot Bl, vision
teSCi`lptiOr1 -
Lddress Of Value of I Amt. of
uilding Project $ III Permit $
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
erefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans,
swings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any
;me if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition uron which this permit is
ranted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations
ertaining 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
one by his agents; servants or employees.
1
Signed: BY
INSPVcxon
In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations
ertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village.
n accepting this permit I assume responsibility for all work done .by either, myself, my agent, servant or employee.
CONTRACTOR OR BUILDER
I
BY
AUTHORITY
BUILDING
ELECTRICAL
PLUMBING
Owner of
Architect
Contractor
or Builder
Legal Lot
ileac r•ri ni i nn
MIAMI SHORES VILLAGE, FLORIDA
71
PERMIT N° 10125
Work to be performed under this Permit
11 Bl.
Subdi-
vision
DATE 195
Contractor's
License No.
A
.
Value of
Address bf Amt of
y
Project $ Permit $
Building r'
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 under =landing 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 t1j;Dn LVh1Ch 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 statemg+ts or specifications and that he asswnes responsibility for work
done by his agents, servants or employees.
Signed : I BY
INSPECTOR
In consideration of the issuance to me of this permit I agree to pefform the work covered hereunder in compliance with all ordinances and regulations
pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of,,Miami Shores Village.
In acceptsag this.permit I assume responsibility for all work done by either, myself, my agent, servant or employee.
CONTRACTOR OR BUILDER
BY
AUTHORITY
MIAMI SHORES VILLAGE. FLORIDA
BUILDING
;LECMICAL
'LUMBING
❑ PERMIT
tOOFING
❑
)wner of
uilding
rchitect
' ontractor
r Builder
PVT° 44'79
Work to he performed under this
DATE 195
Contractor's
License No.
Permit
A i' s
egal Lot Subdi-
escription — Bl. vision
.ddress of Value of Amount of 'w..
iilding — i' Project i �. �+ Permit $ `
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
-refor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans,
swings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any
ne 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
anted is the understanding that the contractor or builder named above assumes the responsibility for a thoroygh knowledge of the ordinances and regulations
!rtaining to the work covered hereby whether shown on the plans or drawings or in the statements or clf�cations and that he assumes responsibility for work
me by his agents, servants or employees. r rf
INSPECTOR
In consideration of the issuance to me of this permit I agree, to perform the work covered hefeunder in compliance with all ordinances and regulations
?rtaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In ac-
pting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee.
CONTRACTOR OR BUILDER
BY
AUTHORITY o
MIAMI SHORES VILLAGE, FLORIDA
IUMDING F 1 DATE
ELECTRICAL 1! PERMIT N° 9828 Contractor's
II,UMBING License No.—
Work to be performed under this Permit
)caner of
archite_ct
, ontractor
egal Lot
Bl.
Subdi-
vision
Ikddress of Value of Amt. of
uilding 11 Project $ Permit $
95
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
.erefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans,
swings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any
ime 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
ranted is the understanding that the contractor or builder named above assumes the responsibility For a thorough knowledge of the ordinances and regulations
ertaininP� 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
:one by his agents, servants or employees.
Signed: BY
INSPECTOR
In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations
- ertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village.
n accepting this permit I assume responsibility for all work done�by either, myself, my agent, servant or employee.
CONTRACTOR OR BUILDER BY AUTHORITY