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27261/7A/k Permit No New Building Size Septic TVA Feet of Drain Tile Nature of Water Supply (7Gsgs i- li/v.) MIAMI SHORES VILLAG PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT 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. /� / //° Owner's Name and Address JJk/ / ! 6 6 No -t / J ' ' Registered Architect and /or Engineer _ Employing Plumber's ® � '� 42/' , .L^ 1 U✓2al e 2h1 ,1�— No. .4/AS � a� ®/4 .. 1 /L4t{j� d Desdit�tion 5- 41 /t/ t SS 8104_ Subdt g/ A `A T Street and Number whore work is to be performed —No. i AV 0 ° 1 /,S State work to be performea and purpose of building (By Fkeors) .55. i e2� X. Remodeling Addition Repairs - - -- ._ ................ No. of Stories........ Type of Tank T)lat. Feet of Tank or Drain Field from Well We1L Amount of Permit $ ,� 50 E/201y2rii2 D4I Size of Soakage Pit (Sim i Date._1. 7 Capacity cooc-iLLSLY___ 10 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 5968, Compiled General Laws of Florida Permanent Supplement, and hay com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the worm to to 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 arr 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. (Signed) c, e. .1. e Master Plumber. STATE OF FLORIDA, COUNTY OF DADE. S Before me, the ands ... a thority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared /728 Nu a /a/9 ,r) ___ -- P e �.c.1. to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the..G /2. . . ... .. -- of the above described construction, that be has carefully read the foregoing a oa, a that he did sign th S, anti all facts therein by him stated are true. NOTARY PUBLIC STATE Of FLORIDA C C`�.jin...�.r,, • 1 . ; ^ . " Notary Public, Sta of Florida URDU TNNU E i' • NOTE: A're- inspection fee of $LOO will be made whom mak rrirpsodos it mod.. amomory by Lmprupm notice for Inspection, or lanky materials and /or workmanship. CLOSETS BATH Twill SHOWER! LAVA. QN S SIN SLOP SINKS LAUNDRY Tun! URINAL! CATCH BASIN FLOOR DRAIN DRINKING POUNT•Ns TOTAL FixTURES CONTR. LIST - 5 / �y 40a ®!d tfJ'! ®® d ® I / ' 3 / [r nI, f�. vv / � ie CHECK IP SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PiT G TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM S*IM'O POOL CoNTR. Lt ET CHECK er6.0/9 7. - /7A/k Permit No New Building Size Septic TVA Feet of Drain Tile Nature of Water Supply (7Gsgs i- li/v.) MIAMI SHORES VILLAG PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT 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. /� / //° Owner's Name and Address JJk/ / ! 6 6 No -t / J ' ' Registered Architect and /or Engineer _ Employing Plumber's ® � '� 42/' , .L^ 1 U✓2al e 2h1 ,1�— No. .4/AS � a� ®/4 .. 1 /L4t{j� d Desdit�tion 5- 41 /t/ t SS 8104_ Subdt g/ A `A T Street and Number whore work is to be performed —No. i AV 0 ° 1 /,S State work to be performea and purpose of building (By Fkeors) .55. i e2� X. Remodeling Addition Repairs - - -- ._ ................ No. of Stories........ Type of Tank T)lat. Feet of Tank or Drain Field from Well We1L Amount of Permit $ ,� 50 E/201y2rii2 D4I Size of Soakage Pit (Sim i Date._1. 7 Capacity cooc-iLLSLY___ 10 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 5968, Compiled General Laws of Florida Permanent Supplement, and hay com- plied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the worm to to 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 arr 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. (Signed) c, e. .1. e Master Plumber. STATE OF FLORIDA, COUNTY OF DADE. S Before me, the ands ... a thority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared /728 Nu a /a/9 ,r) ___ -- P e �.c.1. to me well known, and who, being by me first duly sworn, upon oath deposes and says that he is the..G /2. . . ... .. -- of the above described construction, that be has carefully read the foregoing a oa, a that he did sign th S, anti all facts therein by him stated are true. NOTARY PUBLIC STATE Of FLORIDA C C`�.jin...�.r,, • 1 . ; ^ . " Notary Public, Sta of Florida URDU TNNU E i' • NOTE: A're- inspection fee of $LOO will be made whom mak rrirpsodos it mod.. amomory by Lmprupm notice for Inspection, or lanky materials and /or workmanship.