897 NE 91 Terr-C So
MIAMI SHORES VIL':AG
PLUMBING INSPECTION DEPARTMLN - :
APPLICATION FOR PLUMBING .k. I "
Permit No
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 confor n :ty 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 not. A copy of approved plans and specifications must be kept at
building during progress of work.
Owner's Name and Address f �� �� No.
Registered Architect and /or En ineer_
Employing Plumber's Name._ _ a. A4f Sep_pc A n t.z. (o
Location and Legal Description Lot_
Block__
Street and Number where work is to be performed —No Street
State work to be performed and purpose of building (By Floors r
New Building Remodeling Addition__ _____� -- Repairs
Size Septic Tank Type of Tank
e �'_ =( Capacity Gals SS 6 ( '14
.. Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City —Well Size of Soakage Pit
Feet of Drain Tile
Amount of Permit $
2 �
STATE OF FLORIDA, 1
COUNTY OF DADE.
Before me, the undersigned authority, a notary public,
My Con''mission Expires
Date
4, ( ,j
and acceptyhis o
s of Florida Permanent
sub - contractors employe
f e work such p
r k to be—perf rm ed°
The undersigned applicant for this building permit does hereby certify that he understan
under the Florida Workmen's Compensation Act, being Section 5966, Compiled Ge " eral La
plied with the provisions thereof, and will require similar compliance from all con actors o
performed under this permit; and will post or cause to be posted' for inspection o. the site
required by the Act. The undersigned agrees to employ only such sub - contra +.rs, on
licensed by Miami Shores Village.
No. of Stories. _ .
Notary Public, State of Florida
P
C717 Street_i
Street
Subdivision ...... -- ........... ___________ .......
Plumbing Inspector.
tions as an employer of labor
upplement, and has com-
by him in the work to be
c notice or notices as are
nder, this permit, as ar
Masterr"Plurnber:
ster oaths and take ackno iedgments, 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
TUBE
[ S
LAVA•
TORIES
S INKS
SLOP
SINKS
LAUNDRY
TUBS
U
URINALS
CATCH
BASIN
FLOOR
DRAIN
DRINKING
FOUNT •NS
TOTAL
FIXTURES
CONTR.
LIST
CHECK
SEPTIC
TANK
SEWER
CONN.
DRAIN
FIELD
SOAKAGE
PIT
GREASE
TRAP
SOLAR
HEATER
-_
DEEP
WELL
SPRKLR.
SYSTEM
SWIM•G
POOL
CONTR.
LIST
CHECK
/
_
,
-C So
MIAMI SHORES VIL':AG
PLUMBING INSPECTION DEPARTMLN - :
APPLICATION FOR PLUMBING .k. I "
Permit No
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 confor n :ty 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 not. A copy of approved plans and specifications must be kept at
building during progress of work.
Owner's Name and Address f �� �� No.
Registered Architect and /or En ineer_
Employing Plumber's Name._ _ a. A4f Sep_pc A n t.z. (o
Location and Legal Description Lot_
Block__
Street and Number where work is to be performed —No Street
State work to be performed and purpose of building (By Floors r
New Building Remodeling Addition__ _____� -- Repairs
Size Septic Tank Type of Tank
e �'_ =( Capacity Gals SS 6 ( '14
.. Dist. Feet of Tank or Drain Field from Well
Nature of Water Supply: City —Well Size of Soakage Pit
Feet of Drain Tile
Amount of Permit $
2 �
STATE OF FLORIDA, 1
COUNTY OF DADE.
Before me, the undersigned authority, a notary public,
My Con''mission Expires
Date
4, ( ,j
and acceptyhis o
s of Florida Permanent
sub - contractors employe
f e work such p
r k to be—perf rm ed°
The undersigned applicant for this building permit does hereby certify that he understan
under the Florida Workmen's Compensation Act, being Section 5966, Compiled Ge " eral La
plied with the provisions thereof, and will require similar compliance from all con actors o
performed under this permit; and will post or cause to be posted' for inspection o. the site
required by the Act. The undersigned agrees to employ only such sub - contra +.rs, on
licensed by Miami Shores Village.
No. of Stories. _ .
Notary Public, State of Florida
P
C717 Street_i
Street
Subdivision ...... -- ........... ___________ .......
Plumbing Inspector.
tions as an employer of labor
upplement, and has com-
by him in the work to be
c notice or notices as are
nder, this permit, as ar
Masterr"Plurnber:
ster oaths and take ackno iedgments, 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.
M! MI SHORES VILLAGE, FLA.
JOB
ADDRESS d it
INSPECTIONQ
TIME READY — - s"--1 -4 -7
REMARKS:
INSPECTOR
MIAMI , ;: VILLAGE, FLA.
JOB
ADDRESS 1
INSPECTION 2
TIME READY
REMARKS: —
N? 6040
DATE
N° 6051