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PLUMBING10 � (55'y 3 MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Permit No ao-3.? Date Application i hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build ng 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 th Building Di • slon 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. - -.- I � _ _ __ _. No..± � - � Street _ L_. 2 Registered Architect and!or Engineer Employing Plumber's Nam94 IAWLip� P� _ No._ ....__- . Street Location and Legal Description Lot----__-_-- -_ ____------.___-- — - - - Block__ _---- _---_----____-- Subdivision - Street and Number where work is to be performed -No +� _ -- �._;6E3 _ street..12 -:7` 7 _ State work to he performed and purpose of building (By Floors) _ ! 1Ci A -. C)rZA1 IJ F Lki- 0 _ _ f- T New Building-------- ------ --- - - ---------- Remodeling--------- --- -- -- _ _ Addition---- Repairs_ _-- No. of Stories CLOSETS BATH TUBS SHOWERS LAVA- TOR IES SINKS SLOP SINKS LAUNDRY TUBS URINALS CATCH BASIN FLOOR DRAIN DRINKING TOTAL FOU"T'NS F XTURES CONTR. LIST CHECK SEPTIC SEWER DRAIN SOAKAGE GREASE SOLAR DEEP SPRKLR SWIM'G TANK CONN. FIELD PIT TRAP HEATER WELL SYSTEM POOL CoNTR. Llir CHECK 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. ____ __ _ _ _ __ Si 5 of Soakage Pit Amount of Permit $ -- - ----- - - - ( Signed) _- _ - Pl..mb,*,g In:pecto. The undersigned applicant for this building permit does hereby certify that he understands and accepts hil obligations as an enployer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, awl 1 a,, om- plied with the provisions thereof, and will require similar compliance from all contractors or sub-cs mploy, d by hin in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of theontr ark h public notice or no Ices as are regyired by the Act. The undersigned agrees to employ only such sub contractor work A6 be o. ed under this per nit, as are licensed by Miami Shores Village. Master Plumber STATE OF FLORIDA, COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgn ents, personall 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 constriction, that he has carefully read the foregoing application, and that he did sign the same, and that all acts therein by hum stated are true. My Commission Expires -- — Notary Public, State of Florida W 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 SNORES VILLAGE, FLORIDA _ -- -19 UUILDING ❑ Date— _• J LECTRI CAL ❑ PERMIT N 0 10033 Contractor's 'LUMBING EllLicense No. --�� tOOFING ❑ ❑ Work to be performed under this Permit )wner of - — — iuilding j krchitect _ r �-. �;ontractor Z#;p er 7r Builder ' Legal Lot I Bl. Description s� Subdi- V 3 3q. Ft. Ft. `� Amount of {' value of 11 Permit (t Address of , � e - =; {, Project $. Buildingon%truct the lica- This permit is granted to the contractor 0 esupertaining theilder named reto andwiththeunderstand that tmuo c pal eqwork uipmebe nt es. This ]Permerformed in ittpmay cbe1 revoked tion herefor in strict compliance with all roved by the proper on which this plans, drawings, statements or specifications that may have been submitted to anle d approved changed without far a thorough kzation. A nowledge a co of the ordinances and at any time if the work is not done inn compliance mPat h�n aces or if tl ntiatstor or builder such nnamed above assnmesethresponsibility rnentshar'spec specifications and that `he assumes re%pon- permit is granted is the understanding or in regulations pertaining to the work covered hereby whether shown an the plans or drawings sibility for work done by his agents, servants or employees. (INSPECTOR) BY ions Signed e plans, ings, statements yr specifications submitted to the proper authoritiesof Miami Shores Village.In consideration of the issuance to m o is peYagree to perform the work covered hereunder is compliance with all ordinances and rVil ate. pertaining thereto and in strict conformity w P + In accepting this permit I assume responsibility for all work done by either, mysel� my agent, servant or employee, •wr•' r. =� ��• A[�'I'HORITY BY CONTRACTOR or BUILDER MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMEN" APPLICATION FOR PLUMBING 7':'4,.MIT Permit No... ------ 3 Date..._... .I! .71-,5 7------- 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. S C - Owner's Name and Address------------------- _.. No --- ------- ------ - --- - ---- _-------- _ Registered Architect and/or Engin-_....--.................._.._----..-----.-_._ -�... Employing Plumber's Name ....... J /_.!_b!� _. _ �_ _..-.-.--_.....-- Street__-----------_ _ - __-...- Location and Legal Description Lot --- ---- -Block7----�.- Subdivision ------ .--------------- ---------------------- Street and Number where work is to be perfcrrmcd-No._ State work to be performed and purpose of building (By Floors)-------------------------------------------------------------------------------------------- ------------------•-------------- New Building----------------------- -------- Remodeling--------------------------- Addition...__-.--_____... Repairs -------------------------- No. of Stories- - -------•-•--------- - BATH CLOSETS TUBS SHOWER■ 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 Size Septic Tank_...__..__-___-. Type of Tank ....... _--.._Capacity Gals.___.._ -.---•--..__..... Feet of Drain Tile.__ _ _ eat of Tank or Drain Field from Well ------------------------------------------- ---------------- ------------------------------- Nature of Water Supply- City -Well ---- ----- -------- -------- -------- ------------ ---- ---- Size of Soakage Pit ........ ._--_-__-.__---------------- ..... .-........ . --------- .....------•j---•-----------._.._..----- Amount of Permit - ..:.......... - �umbin.,...- g ..I.•-nsp-.. _e.ctor....._ . .._ PI The undersigned applicant for this building.permit does hereby certify that he ►understands and a' is 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 lids 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 requiv,u by the ACL The undersigned agrees to employ only such sub -contractors, on work to be performed under this permit, as are licensed by Miami Shares Village. (signed)— � �--�-----.--� ..--- �� Master Plumber. 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 yell 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 there:a by "- stated are true. laly Co 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 audlor workmanship.