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15447MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT f /f 73 Application is hereby made for the approval of the detailed statement of the plans and specifications herewith su:mitted for the building or other structure herein described. Thls 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 of building during progress of work. �� Owners Name and Address J4! //( No 0 ® Street ! r '� ✓ Ve - Registered Architect and /or Engineer Employing Plumbers Name L##Ile'� s�� 1�A d . , NO +, _._.,._....,..... Sti �. Location and Legal Description Lot_ BlocIr Subdivision Street and Number where work is to be performed —No . //a 00 Streetdi..6 _,z :- V/ State work to be performed and purpose of building (By Floors)_ed2ALDEliI Ti Pe - Ate New Building Remodeling o Addition. Repairs__ No. of Stories... Z. ...... Permit No.. .LC` I Size Septic Tank_ Feet of Drain Tile Nature of Water Supply: City —Well. Type of Tank nat. Feet of Tank or Drain Field from Well Size of Soakage Pit_ The undersigned applicant for this building permit does hereby certify that he understands and accepts his o •rations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5988, Compiled General Laws of Florida Pennanent 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. to me well known, and who, being by me first duly :. + i upon oath deposes and says that of the above described construction, that be has carefully read the foregoing applies therein by him stated are true. Notary Public, State of Florida at large My Cnrnoui F My Commission p�efl (Signed) and that .Capacity Public, State Florida STATE OF FLORIDA, COUNTY OF DADE. b Before e undersi_.• -• u +ority, a notary publi uly authorized to administer oaths and take acknowledgments, personally appeared e that all facts NOTE: A re- inspection fee of $1.00 will be made when c _, rs inspeedun is mode.neoomory by improper notice for haspection, or faulty materials and /ce workmanship. CLOSETS BATH TUBE SHOWERS LAVA• Toms N SINKS SLOP SINKS LAUNDRY TUSK URINALS CATCH BAsiN FLOOR DRAIN DRINKING FOUNT•NS 1� • I ,/' -, '(d° -,4 TOTAL FIXTURES CONTR. LIST " N l Z La 4/, 7Z CHECK SEPTIC TANK SEWER CONN. DRAIN F IELD SOAKAGE PIT GREASE TRAP SOLAR H EATER DEEP WELL SPRKLR. SYSTEM SWIM'G POOL CONTR. Liar CHECK MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT f /f 73 Application is hereby made for the approval of the detailed statement of the plans and specifications herewith su:mitted for the building or other structure herein described. Thls 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 of building during progress of work. �� Owners Name and Address J4! //( No 0 ® Street ! r '� ✓ Ve - Registered Architect and /or Engineer Employing Plumbers Name L##Ile'� s�� 1�A d . , NO +, _._.,._....,..... Sti �. Location and Legal Description Lot_ BlocIr Subdivision Street and Number where work is to be performed —No . //a 00 Streetdi..6 _,z :- V/ State work to be performed and purpose of building (By Floors)_ed2ALDEliI Ti Pe - Ate New Building Remodeling o Addition. Repairs__ No. of Stories... Z. ...... Permit No.. .LC` I Size Septic Tank_ Feet of Drain Tile Nature of Water Supply: City —Well. Type of Tank nat. Feet of Tank or Drain Field from Well Size of Soakage Pit_ The undersigned applicant for this building permit does hereby certify that he understands and accepts his o •rations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5988, Compiled General Laws of Florida Pennanent 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. to me well known, and who, being by me first duly :. + i upon oath deposes and says that of the above described construction, that be has carefully read the foregoing applies therein by him stated are true. Notary Public, State of Florida at large My Cnrnoui F My Commission p�efl (Signed) and that .Capacity Public, State Florida STATE OF FLORIDA, COUNTY OF DADE. b Before e undersi_.• -• u +ority, a notary publi uly authorized to administer oaths and take acknowledgments, personally appeared e that all facts NOTE: A re- inspection fee of $1.00 will be made when c _, rs inspeedun is mode.neoomory by improper notice for haspection, or faulty materials and /ce workmanship.