1005 NE 91 Terr (8)</-
Registered Arc�itect d /or Engineer
Employing Plum 's Name_-_
MIAMI SHORES VIL1AGE
PLUMBING INSPECTION DEPAR.TMEW
APPLICATION FOR PLUMBING !' /ViIT
Permit No ............ _ -- Date
Application is hereby lade for the approval of the detailed statement of the plans and specifications herewith sub ted 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. nn nn
Owners Name and Address ____------- _- ____._________.• -___ `__ ...... �,
Location and Legal Description Lot.- Block Subdivision
Street q / �
State work to be performed and purpose of building (By Floors)__
Street and Number where work is to be performed —No / ° ° f
New Building . .____._ Remodeling Addition__
No.
No._ yK/ W , Aa - treet..b )7 1
Repairs No. of Stories_
Size Septic Tank _____ °_ °__ _ Type of Tank__ 4. _Capacity Gals.
Feet of Drain Tile_._ Feet of Tank or Drain Field from Well
Nature of Water Supply: I City— Well.__ — ______________ __._Size of Soalcage Pit
-------
6a
Amount of Permit $_
GTATE OF FLORIDA,
:MINTY OF DADE.
(Signed) -
Street
t
My Commission Expires Notary Public, State of Florida
Plumbing Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obl' ations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General. Laws of Florida Penn ent 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. / i
(Signed)___ c----
Signed) c-- Master Plumber.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take aclmowledgments, personally appeared
to me well knc.vn, 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
therrin 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
BATH
TUBS
SHOWERS
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LAVA-
TORIES
SINKS
SLOP
SINKS
LAUNDRY
Tues
U RINAL{
CATCH
BASIN
FLOOR
DRAIN
DRINK] NG
FOUNT' NS
TOTAL
FIXTURE6
CONTR.
LIST
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
1111
SPRKLR.
SYSTEM
SW IM'G
POOL
CONTR.
Uri'
CHECK
</-
Registered Arc�itect d /or Engineer
Employing Plum 's Name_-_
MIAMI SHORES VIL1AGE
PLUMBING INSPECTION DEPAR.TMEW
APPLICATION FOR PLUMBING !' /ViIT
Permit No ............ _ -- Date
Application is hereby lade for the approval of the detailed statement of the plans and specifications herewith sub ted 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. nn nn
Owners Name and Address ____------- _- ____._________.• -___ `__ ...... �,
Location and Legal Description Lot.- Block Subdivision
Street q / �
State work to be performed and purpose of building (By Floors)__
Street and Number where work is to be performed —No / ° ° f
New Building . .____._ Remodeling Addition__
No.
No._ yK/ W , Aa - treet..b )7 1
Repairs No. of Stories_
Size Septic Tank _____ °_ °__ _ Type of Tank__ 4. _Capacity Gals.
Feet of Drain Tile_._ Feet of Tank or Drain Field from Well
Nature of Water Supply: I City— Well.__ — ______________ __._Size of Soalcage Pit
-------
6a
Amount of Permit $_
GTATE OF FLORIDA,
:MINTY OF DADE.
(Signed) -
Street
t
My Commission Expires Notary Public, State of Florida
Plumbing Inspector.
The undersigned applicant for this building permit does hereby certify that he understands and accepts his obl' ations as an employer of labor
under the Florida Workmen's Compensation Act, being Section 5966, Compiled General. Laws of Florida Penn ent 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. / i
(Signed)___ c----
Signed) c-- Master Plumber.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take aclmowledgments, personally appeared
to me well knc.vn, 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
therrin 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.
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEF'ARTMENT
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.
Date 19 ,:
Owner's Name and Address _. ._ .. r� I7 �l* C
, iYy 0 r a � Q �� 140.__ .1 4 0 . Street-- (/..
Registered Architect and /or Engineer
AI.
Name and address of licensed contractor__. 6__ _ 4
Location and legal description of lot to be built on:
Street and Number where work is to be done._
State work to be don rid purpose of building (by floors)
Lot J ° Block / Subdivision Z41 / -
of .
NING BOARD DATE
sa c
and for no other purpose.
New Building_ L Remodeling Addition Repairs No. of Stories
To be constructed of Kind of foun ja ion � Amount of Permit $ Roof c7 of Covering , ( `- OP. (l (% /1 '
$ - -
Estimated Total cost of improvements e c co •
P - -- -
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. . ) �
Remarks
(Signed�l__�_��
STATE OF FLORIDA,
COUNTY OF DADE. ss.
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 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 s d are true.
S2
Permit No ? j Date - Read, Sworn to and Subscribed before me.
Disapproved 4
Date
Notary Public, State of Florida
(Signed) W / .. - ^ 4lO
Building Inspect. ' My Commission Expires
to me well known,
Chairman Mem : er
Member Membe
Member .- ._ . Member
Council Approved Date Disapproved Date
NOTE: A charge of $1.00 will be made for making corrections or changes to thi ,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.