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867 NE 91 Terr (10)Permit No. / l4 '_ Application is hereby made for the approval of the detailed statement of the plans and specifications herewith subinitt for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miai i 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 C t •4 (.---t / tLJ No Street Registered Architect and /or 5 ng PLUMBING & SEPTIC TANK CO. 1 i"' Employing Plumber's Name No. Street �� ,/w►C.E' Location and Legal Description Lot ,- .-- Block Subdivision $ d , / Street and Number where work is to be performed —No t- I ! ��(A, Street' Amount of Permit $ STATE OF FLORIDA, 1 COUNTY OF DADE. I ss. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT State work to be perforned id purpose of building (By Floors) ( Signed) Date�._ - �J New Building Remodeling Addition Repairs No. of Stories Size Septic Tank Type of Tank e _� Capacity Gals ' Feet of Drain Tile ___________ Dist. Feet of Tank or Drain Field from Well Nature of Water Suppl City Well Size of Soakage Pit ( Signed) 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 finder this permit, as are licensed by Miami Shores Village. My Commission Expires 'Notary Public, State of Florida aster 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 BATH TUBS SHOWERS LAVA- TORIES SINKS / SLOP SINKS LAUNDRY TUBS / URINALS CATCH BASIN FLOOR DRAIN DRINKING FOUNT'NS / I TOTAL FIXTURES CONTR. LIST / 1 / CHECK fer7) Fj � 'r SEPTIC TANK SEWER CONN. DRAIN FIELD SOAKAGE PIT GREASE TRAP SOLAR HEATER DEEP WELL SPRKLR. SYSTEM SW IM'G POOL CONTR. LIST / 0.29 4 /L CHECK K Permit No. / l4 '_ Application is hereby made for the approval of the detailed statement of the plans and specifications herewith subinitt for the building or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miai i 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 C t •4 (.---t / tLJ No Street Registered Architect and /or 5 ng PLUMBING & SEPTIC TANK CO. 1 i"' Employing Plumber's Name No. Street �� ,/w►C.E' Location and Legal Description Lot ,- .-- Block Subdivision $ d , / Street and Number where work is to be performed —No t- I ! ��(A, Street' Amount of Permit $ STATE OF FLORIDA, 1 COUNTY OF DADE. I ss. MIAMI SHORES VILLAGE PLUMBING INSPECTION DEPARTMENT APPLICATION FOR PLUMBING PERMIT State work to be perforned id purpose of building (By Floors) ( Signed) Date�._ - �J New Building Remodeling Addition Repairs No. of Stories Size Septic Tank Type of Tank e _� Capacity Gals ' Feet of Drain Tile ___________ Dist. Feet of Tank or Drain Field from Well Nature of Water Suppl City Well Size of Soakage Pit ( Signed) 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 finder this permit, as are licensed by Miami Shores Village. My Commission Expires 'Notary Public, State of Florida aster 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.