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PLUMBINGPERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date 7 - 16` 9, Job Address l6vD 0.-E. Tax Folio Legal Description / Lessee / Tenant CL (S bIZU6) Owner's Address OM ,1 104,_ Contracting Co. "thGjM/Af Qualifier ,E /C 4 /? SS4 # Phone — 3 7 - 7V73 Master Permit MECHANICAL ROOFING PAVING PENCE SIGN Square Ft. Estimated Cost(value) WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER 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, and 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 MECHANICAL WORK. OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning, Furthermore, I authorize the above -named contractor to do the work stated. . _ j No ary as to"CaYiactor or - - :uilder actor or Owner- Builder ** FEES: PERMIT -' 0- DO RADON C.C.F. ' X° NOTARY TOTAL DUE 50, 5 APPROVED: Fire Other Zoning Building / Electrical Mechanical :, /► 7 ( -I! -0 e,43 /Q/ gfgineering arinit Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other stricture 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 hS _ Ls?T�- tai£it- _� No. - __lam' O° Registered Architect and /or Employing Plumber's Name V k °-1C• - 1Lc 62' T.L. No_ _IP :. __ Street--_ 1`.3 _: ' 1.7 Location and Legal Description _Block Subdivision._ Street and Number where work is to be performed —No l .{ I • ` - c i c _ . Street State work to be performed and purpose of building (By Floors)._ k t� �� _ft Q , l 4 t New Builjing _ -__ _ -_ Remodeling_._ _________ Addition_._____ Repairs No. of Stories. Size Septic Tank__ -__ -__ Feet of Drain Tile._-_ _-Dist. Feet of Tank or Drain Field from Well A ature of Water Supply: City— Well._____ —_ ..... _....... _..___....... .____.___.._Size of Soakage Pit ViC Amount of Permit s_. _.. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Type of Tank__ Capacity Gals. (Signed) - -_CS 1- Date 2 — (. — c 7•••"'"- Street " ‘ I. ( • Lit,IS My Commission Expires Notary Public, State of Florida Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accep is obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Flori ennanent Supplement, and has corn - 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 pennit; 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. ( Signed ) --- �._lp & . )t( a�.�a'� 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 well 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 therein by him stated are true. NOTE: A re- inspection fee of $1.00 will be made when such re- inspection is made•necessary by improper notice for inspection, or faulty materials and /or workmanship. rrLCiBE`�$ BATH TUBS SHOWERS LAVA. TORIES SINKS SLOP SINKS LAUNDRY Tuns URINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT' NS TOTAL FIXTURES GONTR LtS? - _ _ CMtCK t SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SW IM•G POOL Corm. LIST CHECK arinit Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other stricture 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 hS _ Ls?T�- tai£it- _� No. - __lam' O° Registered Architect and /or Employing Plumber's Name V k °-1C• - 1Lc 62' T.L. No_ _IP :. __ Street--_ 1`.3 _: ' 1.7 Location and Legal Description _Block Subdivision._ Street and Number where work is to be performed —No l .{ I • ` - c i c _ . Street State work to be performed and purpose of building (By Floors)._ k t� �� _ft Q , l 4 t New Builjing _ -__ _ -_ Remodeling_._ _________ Addition_._____ Repairs No. of Stories. Size Septic Tank__ -__ -__ Feet of Drain Tile._-_ _-Dist. Feet of Tank or Drain Field from Well A ature of Water Supply: City— Well._____ —_ ..... _....... _..___....... .____.___.._Size of Soakage Pit ViC Amount of Permit s_. _.. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Type of Tank__ Capacity Gals. (Signed) - -_CS 1- Date 2 — (. — c 7•••"'"- Street " ‘ I. ( • Lit,IS My Commission Expires Notary Public, State of Florida Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accep is obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Flori ennanent Supplement, and has corn - 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 pennit; 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. ( Signed ) --- �._lp & . )t( a�.�a'� 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 well 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 therein by him stated are true. 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. Size Septic Tank______ Feet of Drain Tile. • P r out :.u' - ...... - -_ STATE OF FLORIDA, COUNTY OF DADE. j MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT (Signed) /2,4 . Date ) - 1��� Application is hereby ,nsdF 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 buiidicg during progress of work. / T • Owners Name and Address ' © o___ _ -r _ -�J e 4✓ 1 No. ___ / po _ ._- Street. - 111_ /� Registered Architect and /or Engineer_ _____._— ____._______________-____ Employing Plumber's Name Location and Legal Description Lot__- Block Su vision_ - - - _ Street and Number where work is to be performed -No / GO 0 C Street Al E I.1 Te State work to be performed and purpose of building (By Floors)_._---- _--- _ -_ - - yS 7`e -/yJ New Building _ __..._.___. _..._.. Remodeling_._ __ ._- Addition._._ Repairs No. of Stories . . ...................... No. -- - - - -- — - Street.. Type of Tank_ Capacity Gals Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: City— Well .____________________________ — ____Size of Soakage Pit G 8 412_____ __SP r-_. dA__ S7 $ 7E••r _P- '= _ - -�'� °�¢ �! _ r g ar — o a - Amount of Permit $___A-?�s?____ .... ______ — (Signed)_ -- -•- _ - -_ - ==' _ _ Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts hisgations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and bus 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. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments , personally 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 construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. My Commission 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 and /or workmanship. CLOSETS BATH TUBS SHOWERS LAVA- TORIES SINKS SLOP SINKS LAUNDRY Tuns URINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT'N6 TOTAL FIXTURES CoNTR. LIST CHECK SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT G TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SWIM'G POOL Comm. LIST CHECK X _ —_— Size Septic Tank______ Feet of Drain Tile. • P r out :.u' - ...... - -_ STATE OF FLORIDA, COUNTY OF DADE. j MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT (Signed) /2,4 . Date ) - 1��� Application is hereby ,nsdF 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 buiidicg during progress of work. / T • Owners Name and Address ' © o___ _ -r _ -�J e 4✓ 1 No. ___ / po _ ._- Street. - 111_ /� Registered Architect and /or Engineer_ _____._— ____._______________-____ Employing Plumber's Name Location and Legal Description Lot__- Block Su vision_ - - - _ Street and Number where work is to be performed -No / GO 0 C Street Al E I.1 Te State work to be performed and purpose of building (By Floors)_._---- _--- _ -_ - - yS 7`e -/yJ New Building _ __..._.___. _..._.. Remodeling_._ __ ._- Addition._._ Repairs No. of Stories . . ...................... No. -- - - - -- — - Street.. Type of Tank_ Capacity Gals Dist. Feet of Tank or Drain Field from Well Nature of Water Supply: City— Well .____________________________ — ____Size of Soakage Pit G 8 412_____ __SP r-_. dA__ S7 $ 7E••r _P- '= _ - -�'� °�¢ �! _ r g ar — o a - Amount of Permit $___A-?�s?____ .... ______ — (Signed)_ -- -•- _ - -_ - ==' _ _ Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts hisgations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida Permanent Supplement, and bus 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. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments , personally 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 construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. My Commission 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 and /or workmanship. iTe it• 4 /v. ?) /14 AM ' Hoi<fr'S 5 \it I in • 4 4 - - — 1.1 4 4. es a ts_ LIST CHECK AA/> Permit No Registered Architect and /or Engineer Amount of Permit $ STATE OF FLORIDA, COUNTY OF DADE. j MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING r= ;k.MIT My Conunission Expires 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. E Owner's Name and Address : ` '' A I � K _ . No. — Street A, P -_ Employing Plumber's Name Le` ;? _`T 4 S ____ ' No. Location and Legal Descriptiot________ '______ __ Block_ 2 Street and Number where work is to be performed —No State work to be performed and purpose of building (By Floors) New Building tom Remodeling__._— ..... ___________ Addition________.___.__ ____.. Repairs No. of Stories Size Septic Tank--- _------- ------ --- --- --- -- - - - --- Type of Tank Feet of Drain Tile_______ _ ___________Dist. Feet of Tank or Drain Field from Well Nature of Water Supply iyWell.____ _ __ ____Size of Soakage Pit Capacity Gals. /4? (Signed) - - -( -- `` (Signed)- Date 7 / r ? 6 ______— _ Street__ — __ The undersigned applicant for this building permit does hereby certify that he understands and accepts under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida plied with the provisions thereof, and will require similar compliance from all contractors or sub -contra performed under this permit; and will post or cause to be posted' for inspection on the site of the wor required by the Act. The undersigned agrees to employ only such sub- contractors, on work to be licensed by Miami Shores Village. Subdivision . - Aieq L 4 r Street Plumbing Inspector. obligations as an employer of labor rmanent Supplement, and has coin- s employed by him in the work to be such public notice or notices as are performed under this permit, as are Notary Public, State of Florida e Master Plumber. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally 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 construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. 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. CLOSETS S BATH S SHOWERS L LAVA- S SINKS B SLOP L LAUNDRY U URINALS C CATCH F FLOOR D DRINKING T TOTAL COT TR. 7 7- / / / / X X- - / / i i gc'i I' CHECK a - r S SEPTIC S SEWER D DRAIN S SOAKAGE G GREASE D HEATER W DEEP S SPRKLR. S SW IM' G t t1",rE'; ,. CONTR. - - --- __ AA/> Permit No Registered Architect and /or Engineer Amount of Permit $ STATE OF FLORIDA, COUNTY OF DADE. j MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING r= ;k.MIT My Conunission Expires 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. E Owner's Name and Address : ` '' A I � K _ . No. — Street A, P -_ Employing Plumber's Name Le` ;? _`T 4 S ____ ' No. Location and Legal Descriptiot________ '______ __ Block_ 2 Street and Number where work is to be performed —No State work to be performed and purpose of building (By Floors) New Building tom Remodeling__._— ..... ___________ Addition________.___.__ ____.. Repairs No. of Stories Size Septic Tank--- _------- ------ --- --- --- -- - - - --- Type of Tank Feet of Drain Tile_______ _ ___________Dist. Feet of Tank or Drain Field from Well Nature of Water Supply iyWell.____ _ __ ____Size of Soakage Pit Capacity Gals. /4? (Signed) - - -( -- `` (Signed)- Date 7 / r ? 6 ______— _ Street__ — __ The undersigned applicant for this building permit does hereby certify that he understands and accepts under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida plied with the provisions thereof, and will require similar compliance from all contractors or sub -contra performed under this permit; and will post or cause to be posted' for inspection on the site of the wor required by the Act. The undersigned agrees to employ only such sub- contractors, on work to be licensed by Miami Shores Village. Subdivision . - Aieq L 4 r Street Plumbing Inspector. obligations as an employer of labor rmanent Supplement, and has coin- s employed by him in the work to be such public notice or notices as are performed under this permit, as are Notary Public, State of Florida e Master Plumber. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally 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 construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. 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. 1,7 (e et"' . , Permit No Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the ilding or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores illage, 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. Sire Septic Tank____ —___ Feet of Drain Tile____ - Nature of Water Supply: y —Well. Amount of Permit s_ STATE OF FLORIDA, 1 COUNTY OF DADE. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING r IIT r • Owner's Name and Address... / � � X , " ._r s , l i --- ' -' - --- �_��r'i`� -__�!. / �_�.._— No. ' • �—=----- •------ - - - - -- Street_' ?_�r�•%• • Registered Architect and /or Eng -- Employing Plumber's Name.. X1 v -_ /72 �! 1 4 - 4/ ' 1 ( _ ( No._-- __._.— __ —___ Street_ Location and Legal Description Lot_- Block _------- _- _--- __-_ -. Subdivision --__ --.r Street and Number where work is to be performed —No J P ee fit'.; Street � 7 4.4- State work to be performed and purpose of building (By Floors) _ ___.___. New Building __ -- _ -- Remodeling__ -- -- __ —_ -- Addition Repairs No. of Stories Type of Tank ____d< -i Cap Gals._ _ ‘'' � _Dist. Feet of Tank or Drain Fiel d from We ll _ Size of Soakage Pit Date.. - 1d .._ - • / (s..) - -= = - -� - - Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts h' obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida ennanent Supplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub -contra ors 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 die Act. The undersigned agrees to employ only such sub- contractors, on work to be performed under this permit, as are iloensed by Miami Shores Village. ( Signed). Master Plumber. My Commission Expires Notary Public, State of Florida . : .N L Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally 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 construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. 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 worlcmanship. CLOSETS BATH TUBS SHOWERS LAVA- TORICS SINKS SLOP SINKS LAUNDRY Tues U URINALS CATCH BASIN FLOOR DRAIN DRINKI NO FOUNT' NS TOTAL FIXTURE[ CONTR. LIST CHECK SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SW IM'G POOL CONTR. LIST CHECK - .-F''' -• Permit No Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the ilding or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores illage, 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. Sire Septic Tank____ —___ Feet of Drain Tile____ - Nature of Water Supply: y —Well. Amount of Permit s_ STATE OF FLORIDA, 1 COUNTY OF DADE. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING r IIT r • Owner's Name and Address... / � � X , " ._r s , l i --- ' -' - --- �_��r'i`� -__�!. / �_�.._— No. ' • �—=----- •------ - - - - -- Street_' ?_�r�•%• • Registered Architect and /or Eng -- Employing Plumber's Name.. X1 v -_ /72 �! 1 4 - 4/ ' 1 ( _ ( No._-- __._.— __ —___ Street_ Location and Legal Description Lot_- Block _------- _- _--- __-_ -. Subdivision --__ --.r Street and Number where work is to be performed —No J P ee fit'.; Street � 7 4.4- State work to be performed and purpose of building (By Floors) _ ___.___. New Building __ -- _ -- Remodeling__ -- -- __ —_ -- Addition Repairs No. of Stories Type of Tank ____d< -i Cap Gals._ _ ‘'' � _Dist. Feet of Tank or Drain Fiel d from We ll _ Size of Soakage Pit Date.. - 1d .._ - • / (s..) - -= = - -� - - Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that he understands and accepts h' obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida ennanent Supplement, and has com- plied with the provisions thereof, and will require similar compliance from all contractors or sub -contra ors 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 die Act. The undersigned agrees to employ only such sub- contractors, on work to be performed under this permit, as are iloensed by Miami Shores Village. ( Signed). Master Plumber. My Commission Expires Notary Public, State of Florida . : .N L Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally 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 construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. 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 worlcmanship. APPLICATION FOR BUILDING PERMIT Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build- ing 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 the work. 7" Date Q U / ) , 19..,5 . c( Owner's Name and Address.... r_ A-- ES No. /00 Street 7 . Registered Architect and /or Engineer Name and address of licensed contractor_ ) XT 4 10 /f a /5 Location and legal description of lot to be built on: Lot Block Subdivision c-c AY-E.-7? S E /) G / Street and Number where work is to be done !V C 7/ l ` tff f. State work to be done and purpose of building (by floors) 1 7- 77 , ,Z New T 4 �€ tdifoi no other purpose. New Building. - �'� To be constructed of Kind of foundation CI Estimated Total cost of improvements $ r _ Amount of Permit $ Zone cubage required _Plan Cubage Distance to next nearest building Size of Building Lot Maximum live load to be borne by each floor I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may be sent to 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 5966, Compiled General Laws of Florida, Permanent Supplement, and has complied 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 subcontractors, on work to be performed under this permit, as are licensed by Miami Shores Village. /� (Signed) C Remarks STATE OF FLORIDA, COUNTY OF DADE. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap- peared and who, being by me first duly sworn, upon oa . .oses and says that he is the of the above described construction, that he h . carefu read the foregoing application, and that he did sign the same, and that all facts therein by him stated are true. Permit No Disapproved (Signed) ..>? Chainnan Member Member �fZ l } ss. uilding MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT Remodeling Addition Date pector Repairs No. of Stories fi Roof Covering_... 7 /: C'' /Y(') / t r ` p to me well known, Read, Sworn to and Subscribed before me. PLANNING BOARD DATE Notary Public, State of Florida My Commission Expires Member Member Member Council Approved Date Disapproved Date NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has been obtained from the Planning Board. A re- inspection fee of $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and /or workmanship. BUILDING ❑ " ELECTRICAL ❑ DATE ! 195 PLUMBING ® PERMIT N? 9033 Contractor's z 7 License No ROOFING ❑ Owner of Building Architect Contractor or Builder Legal Description Address of Building Lot ❑ Work to be performed under this Permit CONTRACTOR OR BUILDER MIAMI SHORES VILLAGE, FLORIDA Bl. r / r 6 ,c Subdi- vision BY f Sq. Ft Value of Project $ Amt. of 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 herefor in strict compliance with all ordinances pertaining thereto and with the understanding 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 upon which 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 statements or specifications and tIiiat he assumes responsibility for work done by his agents, servants or employees. Signed • - - - 8Y 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 pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee. AUTHORITY BUILDING ELECTRICAL PLUMBING ROOFING El Owner of Building Architect O ontractor or Builder Legal Description Lot ✓i f PERMIT N9 9006 Address of Building / r 1' CONTRACTOR OR BUILDER MIAMI SHORES VILLAGE. FLORIDA B►. Work to be performed under this Permit Subdi- vision SQ. Ft Value of Project $ DATE 7 l ' Contractor's License No c Amt. of Permit $ BY AUTHORITY 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 understanding 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 upon which 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 statements or specifications and that he assumes responsibility for work done by his agents, servants or employees. I' Signed: 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 pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee.