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1154 NE 91 Terr (3)Date J ao - 9 'l Job Address _ I 4 5 1 / 2 4 - ' 9/ s r 7 -22 Tax Folio N-3 d- 0,5 L/ A/0 Legal Description Owner / Lessee / Tenant )1R- r A O nri S Master Permit # .106 Owner's Address Phone h 9/ yv Contracting Co. Q/,¢l P/ C=0 � � ,A .w /�3 i ,vd £'O Address ° Jt S3 G 3243 S �/13JMA / F Qualifier FbolO ,t• �16�e 32 Phone 61/ - z 400 State #9F0037$3 7Municipal #00-f?. ja./OrSCompetency # Ins.Co. Architect /Engineer Address Bonding Company Address Mortgagor Address Permit Type(circle one): BUILDING ELECTRICAL MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION mot/ ' Try it get S F w- /`�'•• FVa gbjLam`' 70 OTh Pit Square Ft. Estimated Cost(value) k7d 0 'Oa WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT). Application is hereby made to obtain a permit to do work and installation as indicated above, and on the attached addendum (if applicable). I certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits are required for ELECTRICAL, PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK. OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Furthermore, I //:// authorize th above -named contractor to do the work stated. Sign Date: -4- Notar as to Owner and /or Condo President My Commissiq^ B-rri,00: ` p B PU OFFICIAL NOTARY SEAL <i RUTH V MACK _ -le' * COMMISSION NUMBER ** * * ��, •t - * CC31+6182* �i QO MY COMMISSION EXP. ltDM F Of Ft. OC ,1997 PEES: PERMI APPROVED: PERMIT APPLICATION FOR MIAMI SHORES VILLAGE or Condo P esident Rt 1/ /// 4T1s2 / n-c nature of Contractor r Owner - Builder Notary as to Contract or Owner- Builder My Commission Expire NOTARY PUBLIC STATE OF FLORIDA MY COMMISSION EXP JULY 30,I$ 4 * BONDER TMW ORAL IR;. Rap* * . * ** * * t C.C.P. l• NOTARY TOTAL DUE 51t Fire Other Zoning Buildin: Electrical Mechanical Plumbin: 0 Engineering Date Legal Description n Historically Designated: Yes No l C Owner/Lessee / Tenant p„•,� LA anAv\C�,Q i2? v\/ '*� / I Master Permit # �-! 5 1 t (-{� � ■ � Owners Address T \ , � _ i. Phone 3 O'S 1 ^ s 2 � Contracting Co. �x t til re...... Address d $g (- sG7 > -P2--) Qualifier SS# Phone State # Municipal # Competency # Ins. Co. Architect/Engineer Address Bonding Company Address Mortgagor Address Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION 2, p OJ , . q}1 4 Q4 v\ c\ I Fz 6 t g. Zoo' 00 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. Signature of owner and/or Condo President Notary as to Owner and/or Condo President Date My Commission Expires: FEES: PERMIT PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Job Address \S (�- D� , C (( Tax Folio RADON APPROVED: Zoning Building Mechanical Plumbing C.C.F. NOTARY BOND Gt_-.—.■e„ ,f)') Notary as to Contract or Owner - Builder Date My CO OFFigAL NOTAY SEAL O . PRY v9 S MARG ARITA MONTIE L 2 1 y n COMM390N NUMBER *v, �ij • ; Oa CC797277 Q l',,, , '�' • MY COMMISSION EXPIRES DEC. 17,2002 Electrical TOTAL DUE Structural Engineer BUILDING ❑ ELECTRICAL ❑ PLUMBING ROOFING ❑ El Owner of Building �T r `/"� r5. -'t,' Architect Contractor or Builder Legal Description Address of Building / i Lot MIAMI SHORES VILLAGE. FLORIDA CONTRACTOR OR BUILDER PERMIT N9 9148 DATE 1951_ Contractor's License No "` / nn � y Work to be performed under this Permit 1 f ti r , t 1, (-4 6 ,.e rt • ' Bi. --' 7/ /I Subdi- vision Sq. Ft Value of Project $ 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 �ji specifications and that he assumes responsibility for work done by his agents, servants or employees. *-- j Signed• ' 'L.. - i BY 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 ermit I assume 4esponsibility for all work done by either, myself, my ent, servant or employee. ',T ' 2' , 4- 4-17 ,.../ ',...:,' ' , ,"..a BY Amt. of Permit $ AUTHORITY 17 BUILDING ELECTRICAL PLUMBING ROOFING •...er of Building Architect Contractor or Builder Legal Description Address of Building Lot J11 !: CONTRACTOR OR LER MIAMI SHORES VILLAGE. Er PERMIT N9 9150 • r Work to be performed under this Permit - ' =.. ft • I` ? •t Bl. Subdi- vision 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 a ecific ns and that he assumes responsibility for work done by his agents, servants or employees. Signed • /74 >. CTOR FLORIDA DATE 195 Contractor's License No. SQ. Ft Value of Project $ Amt. of Permit $ BY AUTHORITY -. 4 f BY 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. BUILDING ❑ MIAMI SHORES VILLAGE, FLORIDA ELECTRICAL ❑ Date — 1 19 PLUMBING PERMIT Np 9161 Contractor's ROOFING ❑ License No. jr C.• Owner of Building Architect Contractor or Builder Legal Description Address of Building v. 4- Lox f ❑ Work to be performed under this Permit CONTRACTOR or BUILDER sibility for work done by his agents, servant or et ployees. 11 B1 Subdi- vision Sq Ft Value of 1 Amount of 7 E 1 - 4 4 $ 11 1 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 applica- tion 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 s own on the Mans or dt'awings or in the statements or specifications and that he assumes respon- I 1 1/4 Signed • . r 'f1QS t PECTOR) BY In consideration of the issuance to me of this permit I agree to form the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, s ents or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by ither, myself, my age servant or employee. �� BY AUTHORITY MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Date... - -- -- - -I - Application is hereby male 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 Ordinaflce 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 Divi. n of Miami Shores Village shall be complied ' , whether herein specified or not. A copy of approved plan nd specifications must be t at building during progress of w Owner's Name and Address__ Registered architect and /or En Em g f P P lumber's Name Location and Legal Description Lot. Sttraet and Number where work is to be performed —No State work to be performed and purpose of building (By Floors )_--------- . -__ -- - ------------__ - -- New Building_ -_.. ---- _-- .-- .--- .- _ -._ -. Remodeling ___ _ _ _ Addition.. Repairs Amount of Permit $ 6 STATE OF FLORIDA, ( as. COUNTY OF DADE. J My Commission Expires No/ (Signed). Street. /104) No. of St Capacity Gals Size Septic Tank--_ _—_------ .... - -- --_______Type of Tank Feet of Drain Tile_ -_ _ _ .... ...... . .. -----------...- --Dist. Feet of Tank or Drain Field from Well.- ........... __ -___._ Nature of Water Supply: City— Well.__._____ _ _ - _ __ ______Size of Soakage Pit (Signed)_ . .2__7 . .._ 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 5966, Compiled General Laws of Florida Permanent 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. 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. Notary Public, State of Florida Master Plumber. 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. CLO {[9a BATH TUBS SHOWER{ LAVA5 TDRI[{ SINKS SLOP SINKS LAUNDRY TU{e URINAL{ CATCH eA {IN FLOOR DRAIN DRINK! NO FOUNT' NS I /� , TOTAL FIXTURES corrrn. Ll aY CHECK , SEPTIC TANK SEWER CONN. DRAIN FIELD • �( � %� Fr • n H TER DEEP WELL SPRKLR. SYSTEM SWIM '13 POOL CONTN. LIST �� CHECK MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT Date... - -- -- - -I - Application is hereby male 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 Ordinaflce 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 Divi. n of Miami Shores Village shall be complied ' , whether herein specified or not. A copy of approved plan nd specifications must be t at building during progress of w Owner's Name and Address__ Registered architect and /or En Em g f P P lumber's Name Location and Legal Description Lot. Sttraet and Number where work is to be performed —No State work to be performed and purpose of building (By Floors )_--------- . -__ -- - ------------__ - -- New Building_ -_.. ---- _-- .-- .--- .- _ -._ -. Remodeling ___ _ _ _ Addition.. Repairs Amount of Permit $ 6 STATE OF FLORIDA, ( as. COUNTY OF DADE. J My Commission Expires No/ (Signed). Street. /104) No. of St Capacity Gals Size Septic Tank--_ _—_------ .... - -- --_______Type of Tank Feet of Drain Tile_ -_ _ _ .... ...... . .. -----------...- --Dist. Feet of Tank or Drain Field from Well.- ........... __ -___._ Nature of Water Supply: City— Well.__._____ _ _ - _ __ ______Size of Soakage Pit (Signed)_ . .2__7 . .._ 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 5966, Compiled General Laws of Florida Permanent 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. 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. Notary Public, State of Florida Master Plumber. 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. Permit No -7 - Application is hereby made for the approval of the detailed statement of the plans and specifications herewith sub('nitted 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. / Owners Name and Address_________-- - - -__ d___ No. ___ // '�_�` s Street_ �! i'r2 New Building Size Septic Tank Feet of Drain Tile Nature of Water Supply: City —Well Amount of Permit $ MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMEN APPLICATION FOR PLUMBING R" (Signed). Date t Y '�' = f — /fv--/ Registered Architect and /or Engines No/Y- 7 Employing Plumber's Namore-0.-/ -7- Location and Legal Description Lot_____________________ _ ___ Block_ Street and Number where work is to be performed—No../ / � State work to be performed and purpose of building (By Floors)_ Subdivision___ Street 9/2?- ✓ a ex- _ _ -- Remodeling__ Addition.- .-- --- •-- •- ---- _ -•.-- Repairs No. of Stories Type of Tank_____ Capacity Gals Dist. Feet of Tank or Drain Field from Well __Size of Soakage Pit ( Si _ ;* i > My Commission Expires Notary Public, State of Florida . k.--..._ Plu bang 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 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. Master Plumber. STATE OF FLORIDA, l 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. CLOSETS BATH TUBS SHOWERS LAVA- TORIES SINKS SLOP SINKS LAUNDRY Tuff URINALS CATCH BA. IN FLOOR DRAIN DRINKING DRINK FOUNT' NS TOTAL FIXTURES CONTR. LIST CHECK SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SW IM•O POOL CONTR. LIST / CHECK CHECK Permit No -7 - Application is hereby made for the approval of the detailed statement of the plans and specifications herewith sub('nitted 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. / Owners Name and Address_________-- - - -__ d___ No. ___ // '�_�` s Street_ �! i'r2 New Building Size Septic Tank Feet of Drain Tile Nature of Water Supply: City —Well Amount of Permit $ MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMEN APPLICATION FOR PLUMBING R" (Signed). Date t Y '�' = f — /fv--/ Registered Architect and /or Engines No/Y- 7 Employing Plumber's Namore-0.-/ -7- Location and Legal Description Lot_____________________ _ ___ Block_ Street and Number where work is to be performed—No../ / � State work to be performed and purpose of building (By Floors)_ Subdivision___ Street 9/2?- ✓ a ex- _ _ -- Remodeling__ Addition.- .-- --- •-- •- ---- _ -•.-- Repairs No. of Stories Type of Tank_____ Capacity Gals Dist. Feet of Tank or Drain Field from Well __Size of Soakage Pit ( Si _ ;* i > My Commission Expires Notary Public, State of Florida . k.--..._ Plu bang 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 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. Master Plumber. STATE OF FLORIDA, l 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 $1.00 will be made when such re- inspection is made necessary by improper notice for inspection, or faulty materials and /or workmanship. • MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING "'';144M T Permit No.__ - Date-- ----- -- % -- -- Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. , Owner's Name and Address' ._ _ No.__- _____ ..... _.__ Street Registered Architect and /or En ineer___ -�- _.. ` !_______ ; _ __ Employing Plumber's Name r- _ / lQt>' Street. __------- --- __ - -- Location and Legal Description Lot L B / look_ ry � - � � � b division _ division .......... Street and Number where work is to be performed —No ___111 ..E. jf 2$ State work to be performed and purpose of building (By Floors)_.___._________..____. New Building __ Remodeling ____._ Addition________. Repairs No. of Stories. _ Amount of Permit $ STATE OF FLORIDA, } COUNTY OF DADE. Nature of Water Supply: City —Well. i- Size Septic Tank - - - - �% �pype of Tank_ Feet of Drain Tile_ - --S. EG J�vist-Feet of Tank or Drain Field from Well __Size of Soakage Pit ( Sign Capacity Gals ) "7-x/ (Signed). _ &" My Commission Expires Notary Public, State of Florida ls9 Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that a 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 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. 6; Master Pl umber. 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 $1.00 will be made when such re- inspection is made•necessary by improper notice for inspection, or faulty materials and /or workmanship. CLOSETS TU66 TUBS SHOW ER• LAVA- TORIES SINKS SLOP SINKS LAUNDRY TUNS URINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT' NS TOTAL FIXTURES GOWN• LIST CHECK SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SW IM'G POOL CONTR. LIST CHECK _- • MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING "'';144M T Permit No.__ - Date-- ----- -- % -- -- Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of work. , Owner's Name and Address' ._ _ No.__- _____ ..... _.__ Street Registered Architect and /or En ineer___ -�- _.. ` !_______ ; _ __ Employing Plumber's Name r- _ / lQt>' Street. __------- --- __ - -- Location and Legal Description Lot L B / look_ ry � - � � � b division _ division .......... Street and Number where work is to be performed —No ___111 ..E. jf 2$ State work to be performed and purpose of building (By Floors)_.___._________..____. New Building __ Remodeling ____._ Addition________. Repairs No. of Stories. _ Amount of Permit $ STATE OF FLORIDA, } COUNTY OF DADE. Nature of Water Supply: City —Well. i- Size Septic Tank - - - - �% �pype of Tank_ Feet of Drain Tile_ - --S. EG J�vist-Feet of Tank or Drain Field from Well __Size of Soakage Pit ( Sign Capacity Gals ) "7-x/ (Signed). _ &" My Commission Expires Notary Public, State of Florida ls9 Plumbing Inspector. The undersigned applicant for this building permit does hereby certify that a 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 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. 6; Master Pl umber. 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.